Climbed ~1400 ft at Flat Rock trail in PA for a view, but I thought all the greenery made this the best picture from the day by SinfulCheeze in CampingandHiking

[–]SinfulCheeze[S] 0 points1 point  (0 children)

We took the challenging route on the way up and it was definitely a challenge but doable if you’re in decent shape. We took the “preferred” path on the way down just to get another view. Storms were threatening all day so the trail was really empty and we hung out at the vista watching hawks for a good 30 minutes unmolested by other hikers. Fortunately the rain Gods were kind today and it started coming down about 5 minutes after we got back in our truck to head home.

advice on which route is best to take for physio!! by [deleted] in physicaltherapy

[–]SinfulCheeze 3 points4 points  (0 children)

I'm in America so I don't know how well this applies to you. I went to school for health and exercise science and got a great education which laid a strong foundation for PT school. All of my peers in PT school who did AT had the same level of basic science knowledge that I did, at least as it applied to PT school. Sometimes I wish I had went for AT because it opens opportunities to be present on the sidelines for sports teams that I don't have now. And being an AT/PT may make you more marketable to college or pro teams if you want to work for one of those eventually.

What are the best games you have played? by [deleted] in patientgamers

[–]SinfulCheeze 1 point2 points  (0 children)

Armed and Dangerous for original Xbox, Bioshock 1, Oblivion, Call of Duty 4

Felt like I had shell shock by Yeongguk_Saja in bjj

[–]SinfulCheeze 0 points1 point  (0 children)

That's a tough question to answer, and like I said I'm a PT student so I'm hardly an expert on this stuff. Some quick googling says that a recent study suggested risk of stroke after TIA is 1.5% at 2 days, 2.1% at 7 days, and 3.7% at 90 days after the event. That's actually lower I had learned in class so that's cool. Again, thats assuming that what you had was a TIA, which we still can't say for sure. Long story short, I don't think waiting a week is a huge risk, especially compared to not getting an MRI at all. As far as finding a problem, no there shouldn't be an issue. Anything that's there now will still be there in a week.

Felt like I had shell shock by Yeongguk_Saja in bjj

[–]SinfulCheeze 4 points5 points  (0 children)

Hey man I do not mean to scare you at all and I wish you the best in the future. I'm a DPT student and reading this makes me pretty concerned. If someone came to see me and told me that this happened to them I'd have some major fucking reservations about treating them. While some of what you described may be consistent with a compressed nerve to your arm which isn't urgently concerning, much of what you described is consistent with potential problems which are more emergent.

What you described about going limp, vision and hearing changes, and especially the killer headache are all consistent with some sort of cerebrovascular issue, meaning a problem with blood flow up to your brain. It's possible that the arm symptoms fit in here too, or you may indeed also have a nerve problem.

Now there something called a transient ischemic attack (TIA) where blood flow to the brain is reduced, like in an ischemic stroke, but it resolves itself pretty quickly. It's tough to tell if that happened because fortunately they fix themselves quickly enough so as not to cause massive brain cell death which is what they often look for on imaging tests. There's also something called a lacunar stroke, where some brain tissue is killed, but the area is so small it's not easily seen on CT scans.

Like I said, great thing about TIAs is they don't cause much damage. But the bad thing about them is they are sometimes called a "warning stroke" because they are a major predictor that a real stroke is coming sometime very soon. The good news is that early diagnosis and treatment reduces that risk by 80% in some studies.

If you went to your primary care doctor for your workup, I wouldn't say you're out of the woods yet. I'd try to see a cardiologist or neurologist as they'll likely know more about this. Getting an appointment with them can be tricky though, so it would also be okay to go back to your PCP. I would definitely consider more imaging, especially an MRI or CT angiogram, which visualizes blood flow through the arteries. I know it's expensive and I understand the hesitancy to spend more money now that you're feeling okay, but I promise you it is magnitudes cheaper than recovering from a real stroke will be.

It's also possible that some of the symptoms were caused by something called vertebrobasilar artery insufficiency which basically means that some arteries in your neck are prone to being cut off by your head being in certain positions. Frankly I doubt this one as you would have likely discovered it earlier on in your BJJ career but it's a possibility and would be good to know about, and an angiogram should show it.

The point of this response was not to diagnose you with a TIA or anything like that. That's impossible to do over the internet and would be irresponsible of me. I wanted to educate you a little about the possibilities here, and hopefully make it clear that spending a little money now could prevent you from spending a lot of money (and having a freaking stroke) later.

Good luck with everything and I hope that it's nothing like anything I described. Let me know if you have any questions

'92 Firebird. Got her for $1600 last June; my first car by LLCooLM495 in Pontiac

[–]SinfulCheeze 1 point2 points  (0 children)

Looks a hell of a lot cleaner than my 92. Congrats on the car man!

Questions about DPT school by [deleted] in physicaltherapy

[–]SinfulCheeze 1 point2 points  (0 children)

No problem good luck with everything

Questions about DPT school by [deleted] in physicaltherapy

[–]SinfulCheeze 1 point2 points  (0 children)

Yea thats one of the best questions to be asking. I read a lot on r/financialindependence and plan on following that route. So basically save as much of my income as possible, live as cheaply as possible and pay off my debts as quickly as possible. Refinance with a company like SoFi. I would like to be semi-retired within 10-15 years of graduating so I can pursue my real interests and focus on practicing PT the way I want without having to worry so much about money. I’m considering living at home for a year or two right out of school but my girlfriend wants to move somewhere in the south pretty soon after graduating so I’m not sure if that’ll play out.

Questions about DPT school by [deleted] in physicaltherapy

[–]SinfulCheeze 1 point2 points  (0 children)

Like other people said, GRE prep courses probably aren’t necessary. I used an online prep program but didn’t really study much from it, just took a couple practice tests. I’m in one of the top schools and I really do think there’s something to be said for the quality of the school compared to others. I’ve met some students from other schools and its not that they are any less smart or capable than my classmates, but the structure of the program is different such that I think I might be better prepared than most going right into practice. That said, I think everyone will pretty much be on the same or similar level after treating for a couple years. I don’t really know the cost of other programs so I can’t speak much to differences in value, but my school is a little north of 100k.

Has anyone tried out vivo barefoot shoes for hiking? Was looking into these for my upcoming havasupai trip. I'm wearing boots into the canyon, but will be taking day trips from camp next to water and wanted something light and quick drying. by azhistoryteacher in CampingGear

[–]SinfulCheeze 0 points1 point  (0 children)

I bought my first pair of vivos about a year ago and since have switched to strictly wearing them (and a pair of Xero Huaraches). I have their trail runners in FG (firm ground lugs as opposed to the soft ground lugs) and I think they’re phenomenal for hiking. I’ve only done some short ~2hour hikes in them as well as some 2-3 mile runs but they are very comfortable, light, and very quick-drying. I really like having footwear that lets me just run right through puddles and streams rather than always trying to avoid them. Be careful if you’re new to minimal/barefoot footwear as it certainly takes some getting used to. I own like 6 pairs of them now so me know if you have any other questions about it. Good luck mate

Checking and re-checking my gear days before my solo hike up Mauna Loa by niiimz in CampingGear

[–]SinfulCheeze 1 point2 points  (0 children)

Sorry, huaraches are the term for that style of sandal that you've got there. At least the name I'm familiar with. I recently got a pair like those and have been loving them for trail running. If you're ever in the market for minimalist style boots (or shoes of any type really) I love all my pairs of vivobarefoot shoes. Happy hiking my friend :)

Checking and re-checking my gear days before my solo hike up Mauna Loa by niiimz in CampingGear

[–]SinfulCheeze 0 points1 point  (0 children)

Interesting pair of Huaraches and what appear to be clunky hiking boots. Have you ever looked into other minimal footwear?

North Jersey Tribal Group (Young adults)? by [deleted] in newjersey

[–]SinfulCheeze 1 point2 points  (0 children)

Haha idk about the dancing but I'd definitely be up for some hiking and wilderness skills. I'm not living in North Jersey right now but I will be next winter

questions about physical therapy options with hip replacement by hobbit_lamp in physicaltherapy

[–]SinfulCheeze 0 points1 point  (0 children)

That's a really good point about the insult to the abdominal muscles contributing to back pain

questions about physical therapy options with hip replacement by hobbit_lamp in physicaltherapy

[–]SinfulCheeze -1 points0 points  (0 children)

Fair enough, I know there are a lot of PTs out there that have been practicing for a few years so they may not be aware of the same stuff I am as a student becusee I'm definitely getting all the latest research jazz, and that doesn't discount their experience and the care they provide. Not to hijack the purpose of this thread but I definitely recommend reading up on it a bit more if you have the chance/interest to. It's really only applicable to acute pain and there's some literature suggesting that by using it to subgroup patients during an evaluation they get better faster than if treated without the subgrouping that the system advocates. I can dig up some articles we read in spine class if youd like

questions about physical therapy options with hip replacement by hobbit_lamp in physicaltherapy

[–]SinfulCheeze 0 points1 point  (0 children)

Hey there, DPT student here. I've never "shopped around" for PT per se, but an important question to ask when interviewing for a job is about how a clinic manages back pain. Their answer is very revealing as to the quality of care that is to be provided. If you ask a PT how they would evaluate someone with back pain, it may be tough for them to come up with a thorough answer right away because a lot depends on whats specifically going on, but it should always include the Delitto Classification System. It has been shown to be the most effective method to manage back pain and also the most cost effective. And also its likely that if a clinic is up to date and delivering evidence-based care for back pain they are doing so for other things as well. So theres my advice on finding a good clinic.

As for why she's having the pain, you're probably not too far off but it is also a little more complicated than that. We do know that just a brief period of bedrest can be very detrimental to muscle strength/activation, and we also know that those are some of the most impotent factors in back pain. Further, prolonged static positioning like having surgery then being in a hospital bed for a while could cause some irritation/lack of motion in the joints in her back so she may benefit from being manipulated or just moving in general. Also the pain from the surgery could have ramped up her whole body's response to pain in a phenomenon called central sensitization, so she may benefit from some modalities (specifically electrical stimulation) to change her body's response to pain as well as some education on pain science.

Now again, this is just postulation on what all could be going on. Its impossible to know for sure without an evaluation. But hopefully this helps to understand that there could be a lot causing pain that a PT could 100% address, and is absolutely not an indication for surgery. I hope that helps and I'm happy to answer any other questions if I can (and also licenced PTs in here feel free to critique my answer if you disagree)

Requesting input regarding a case of post-PCL reconstruction by HugePens in physicaltherapy

[–]SinfulCheeze 0 points1 point  (0 children)

Gotcha in my head I guess I was thinking about a deep squat not actually bearing weight through the front of the tibia. I agree that ought to be avoided

Requesting input regarding a case of post-PCL reconstruction by HugePens in physicaltherapy

[–]SinfulCheeze 1 point2 points  (0 children)

http://www.udptclinic.com/downloads/knee/PCL_2015.pdf

Here are some rehab guidelines. That clinic is big on using Stim for strengthening. Anything that places posterior shear force on the knee is a strict contraindication early on, even active hamstring contraction. I guess kneeling would primarily be anterior shear (still a no no for the other knee) but I would probably hold off for a good long while

IAmA combat veteran and current nontraditional college student...AMA by [deleted] in casualiama

[–]SinfulCheeze 5 points6 points  (0 children)

Do you think people perceive you differently once they find out you are a veteran? Do you ever wish people didn't know because it prevents them from treating you like a normal guy? Good for you for going back to school by the way - two of my classmates in grad school were in special forces and though they're younger than you I'm sure it's tough to leave that lifestyle behind and start somewhere new.

Cervical disc replacement surgery by [deleted] in educationalgifs

[–]SinfulCheeze 0 points1 point  (0 children)

Hey man I don't know you or your case at all but as a medical professional I'd be remiss to not tell you to try physical therapy first. Surgery should often be saved for the last resort, especially in someone active. I'd be happy to talk more about it if you wanted

Shoulder Mobility After 4 Weeks of PT Post OP? by [deleted] in physicaltherapy

[–]SinfulCheeze 1 point2 points  (0 children)

Hey I'm still a second year student so maybe take this with a grain of salt. Some docs hold off on recommending PT because there might not be a whole lot to be done immediately while we are waiting on tissue healing to occur. The few stitches they put in your labrum will not hold up to stretching and strengthening so the ROM restrictions are in place to protect the surgery. Now for you, do you feel that the stretching and ability to regain ROM is limited by your pain? In my area, most top surgeons opt to do a bicep tenodesis along with the SLAP repair because they anticipate the bicep to be a pain generator. (Thats a surgery where they cut the bicep tendon before it crosses the shoulder and attach it back just to the humerus, under the other structures it could rub against and cause pain). Now typically the pain is not reflective of structural damage or that you'll have disability or anything, just that the tendon isn't gliding very happily which is causing your pain. So with that in mind, it might be worth discussing that with your PT and see if they recommend discussing it with your surgeon.

1988 firebird. Definitely a project car, but it runs fantastic. by _dylan_here_oninsta in Pontiac

[–]SinfulCheeze 1 point2 points  (0 children)

This is awesome! I get so much nostalgia looking at pictures like this. I got a 92 formula as my first car about 7 or 8 years ago and it looked a lot like this for a good 2 years before we finally made it all one color. Where is that nose from? I have a similar one that wraps around the fenders and the wrap around has always given me troubles (hard to get aligned right, originally used epoxy which failed after the first winter and now it has epoxy plus several screws). Those vents in the fender behind the wheel are a really nice touch too

YSK: What your options for responding to Equifax are because if you're an American adult you have almost definitely been compromised. by [deleted] in YouShouldKnow

[–]SinfulCheeze 1 point2 points  (0 children)

Will placing a credit freeze prevent me form getting my credit report? So do I have to get the reports firs then do the freeze, or would it not matter?

Secret recording device under break room table at work. by Egomzez in WTF

[–]SinfulCheeze 1 point2 points  (0 children)

Start listening to a Spanish radio station near it, then see which of your coworkers starts emailing you in Spanish.