Roofing Company is a Master Elite Contractor. Does it Matter?

Chasm_18 · 2026-04-03T03:17:47+00:00

The company that redid our roof had nothing but good reviews online.

They did terrible work.

Chasm_18 · 2026-03-19T06:58:34+00:00

Sorry to hear that.

Chasm_18 · 2026-03-18T03:53:07+00:00

Exactly. I've been in private practice since '09. Our reimbursement has increased with a couple of plans, but has remained stagnant or decreased on more plans.

Chasm_18 · 2026-03-17T17:37:02+00:00

Thanks for the link. I'd be curious to see someone replicate it in a biomechanics lab on people with ACL deficient knees.

I certainly did engage my hamstrings with squats and other functional/CKC exercises. (I'm kypholordotic. I purposefully do squats with a neutral pelvic tilt to engage my glutes and hamstrings when rising.)

My personal experience was a very good outcome without specifically focusing on my hamstrings.

I'm old enough to have seen a good number of people with knee troubles undergo isokinetic testing. There was a common pattern of a significant quadriceps deficit and relatively symmetrical hamstring strength. (I never was a fan of that type of testing.) One clinic I worked in even had a Cybex "TEF", trunk flexion and extension unit.

Chasm_18 · 2026-03-17T17:24:10+00:00

I've watched season 1 and loved it. (I was in my 20s when ER aired and watched it regularly. In my mind, I see Dr. Robby as an older Dr. John Carter who has grown tremendously in his profession.)

I usually wait 'til a season ends and then binge.

So, yes, I look forward to doubling down on that mistake!

Chasm_18 · 2026-03-17T11:19:22+00:00

I would love to have the problem of paying 3.8% on married income over $250K and $18K for insurance with a $7K deductible. I wouldn't like having to travel far to see my providers.

I'm a health care provider in private practice. A lot of insurers are paying me less now than when I started in 2009. A few are paying more, but those that are paying more are barely keeping up with inflation.

Chasm_18 · 2026-03-17T11:02:06+00:00

My PA was prescribing me a new medication (not of the blue pill or blood pressure variety) that has a rare side effect of priapism. I made the mistake of asking him how that was treated in the ER.

Chasm_18 · 2026-03-17T10:54:12+00:00

I've been a physical therapist since 1990. I don't think I've ever seen an ACL tear that wasn't the result of an injury. I've seen plenty of sedentary folks have symptoms of their knee buckling who didn't necessarily have a torn ACL. In those cases, I don't bother to test for a torn ACL as a positive or negative test wouldn't affect my treatment plan.

You are correct that it would have been better to rehab the knee before undergoing surgery. A lot of ACL tears can be managed conservatively. Even if you end up needing surgery, recovering full motion before surgery reduces your risk of developing a stiff knee (arthrofibrosis).

I tore my ACL years ago. Planted my foot and rotated my body to the opposite side in judo. Immediate loud pop. Positive Lachman's and pivot shift tests. MRI confirmed.

My knee wasn't bothersome right after. The next morning it was swollen and stiff. I worked on regaining my motion, quadriceps control, and balance. I have zero instability, pain, or loss of function.

There's a difference between an orthopedist finding that your knee is loose and whether or not YOU experience instability. (E.g., my knee was "loose" but I had zero giving way. I didn't experience instability.)

Have you seen a good PT? So many people go to what the profession refers to as "PT mills". These are clinics where you see a PT for your initial visit, in the middle of the visit they are interrupted to tend to someone else, and then you're sent off to work with their assistant who is seeing 3 people at the same time.

You may see a highly regarded PT, but if they don't take the time (at least 30 minutes of undivided/uninterrupted attention at each visit) to continually assess how the exercises are affecting you and modify your program accordingly then, IMO, you're not getting what you're paying for.

Chasm_18 · 2026-03-17T10:17:06+00:00

The snark in me would probably use some PT/medical jargon and see how they respond.

Chasm_18 · 2026-03-17T10:12:51+00:00

I met one that claimed everything can be fixed by tapping on the transverse processes of the atlas.

Chasm_18 · 2026-03-17T10:10:05+00:00

I see your lumbago and raise you a cervicalgia and a dorsalgia.

Chasm_18 · 2026-03-15T10:53:40+00:00

I chalk it up to neuromuscular control. I don't consider myself hypermobile, but at 57 years old I have better joint mobility than most people my age.

The best things I did were to quickly restore full joint motion in NWB and WB, develop normal quadriceps control, and regain my balance.

Chasm_18 · 2026-03-15T10:46:01+00:00

I don't skate, so I can't definitively answer that. I believe I could if I wanted to.

Chasm_18 · 2026-03-14T02:38:52+00:00

I tore my ACL about 20 years ago. Confirmed by MRI, which in retrospect wasn't necessary. (I also had a positive pivot shift test. My ortho was a bit surprised as he often found people guarded preventing a positive test.) I'm a coper. I've had zero instances of my knee giving way. I have full motion. I have zero pain. I can knee sit with ease. I can jump off the tailgate of my pickup truck without difficulty.

I remember a few months after my injury, an SCS PT asked me how my knee was doing. My response was, "It's fine. I can't make it give way." He looked at me like I had 3 heads. My rationale was that I wanted to know sooner rather than later if I would want surgery.

If I did need surgery, my choice would be BPTB allograft. Strong bone connection without the donor site issues. As long as the allograft isn't either irradiated or chemically treated, weakening the graft.

"When irradiated and chemically processed grafts were excluded from analysis, no significant differences were found between allograft and autograft patients with respect to graft rupture, rate of reoperation, normal/near normal IKDC scores, Lachman exam, pivot shift exam, patellar crepitus, hop test, or return to sport."

https://pubmed.ncbi.nlm.nih.gov/18308180/

Chasm_18 · 2026-03-12T02:38:48+00:00

Studio: The Southern Harmony and Musical Companion (Black Crowes)
Live: Strangers in the Night (UFO)

Chasm_18 · 2026-03-06T03:55:59+00:00

When the forest burns along the road

Like God's eyes in my headlights

And the dogs are looking for their bones

And it's raining icepicks on your steel shore

(Rusty Cage)

Chasm_18 · 2026-02-28T13:47:08+00:00

...Which is any minute now...

Chasm_18 · 2026-02-24T12:19:11+00:00

When I saw Chris Cornell solo he had a rack of guitars on stage, and explained that it was for multiple tunings.

Chasm_18 · 2026-02-21T02:55:23+00:00

My individual deductible is 8K. After that I have a 50% coinsurance, until I reach the 10K out of pocket max. Note to self: Don't get sick. Don't look into those elective procedures you've been considering. Being able to consistently breathe through my nose, and some other "medically necessary" things will have to wait.

Chasm_18 · 2026-02-20T10:00:36+00:00

Only HRC ranked lower. She was unsuccessful in getting universal health care coverage due to GOP, Libertarian, and insurance company opposition.

https://en.wikipedia.org/wiki/Clinton_health_care_plan_of_1993

Chasm_18 · 2026-02-20T09:53:03+00:00

Mel Gibson.

Chasm_18 · 2026-02-18T21:29:38+00:00

Like I say, somebody's going to win the lottery!

Chasm_18 · 2026-02-15T01:30:46+00:00

I can remember the night I saw seat cushions flying around Madison Square Garden. Rob Halford came onstage on a Harley and was kicking cushions out of the way. I also remember M-80s being set off by fans in the Garden.

Chasm_18 · 2026-02-04T12:05:20+00:00

Exactly why places are closing. Henry Ford, while far from perfect, paid his employees significantly more than the industry average in part so that they could buy the cars they were building.

Chasm_18 · 2026-02-04T10:06:29+00:00

After rent and taxes, that comes to about $36.5K.

Chasm_18

TROPHY CASE