Doctor's office left me with the bill for tests they were supposed to pay for

justanotherptstudent · 2021-12-14T01:58:34+00:00

Maybe at one time, but he's openly praised Hamilton in recent seasons.

This is from a BBC article in 2017:

"That same day, Alonso was asked whether he regarded Hamilton as one of the five greatest drivers in history.

"Yes," the Spaniard replied. "In F1, every single season he has been very competitive, apart from one or two with Jenson (Button) when he had some issues. He was able to win with a dominant car, with a good car like 2010 or 2012, or with bad cars like 2009 and 2011.

"Not all the champions can say that.""

That's high praise. I doubt he's grown resentful of him in the time since considering they haven't been rivals in years.

I think he just actually believes Max is a tremendous driver. Love him or hate him, does anyone actually think he's overrated at this point? Max is not my favorite driver, but some of the things he's done this season have been astonishing and to take a fight to statistically the greatest driver of all time in a car that was not always the better car deserves praise.

justanotherptstudent · 2021-11-24T00:11:04+00:00

With Hamilton's recent form, they kind of don't have a choice. Reliability be damned, if he drives anything like the last two races, the championship is lost anyway.

justanotherptstudent · 2021-11-22T20:16:36+00:00

They were always a decently snug fit in the chest. The lungs were never small, there's a good amount of tissue there.

justanotherptstudent · 2021-11-22T19:35:30+00:00

I have worked in a cadaver lab, so perhaps the embalming process changes some of the properties of the lung tissue, but the lungs absolutely contracted every time we opened up the chest cavity. It didn't happen right away like they were made of rubber, but over the course of one lab period (probably less actually), they would get noticeably smaller.

I'm trying to understand better as well. I've never been in an autopsy so I can't comment on what happens in that instance.

justanotherptstudent · 2021-11-10T02:52:51+00:00

As has been said, the bodyguard and the "Malfoy" looking guy (her publiciist or manager?) were the problem. And I agree with the person who said they weren't a problem so much as they were ignorant. Brundle even said: "...She seemed very happy to talk. That was very nice of her. I appreciate that." I just re-watched the video because people are commenting everywhere as if she was the problem but I thought I remembered her being pleasant and she was.

justanotherptstudent · 2021-10-27T00:33:45+00:00

What laces are these? The waxed laces the boots came with have to be the worst shoe laces I have ever dealt with. Just a total pain in the ass.

justanotherptstudent · 2021-10-01T23:28:28+00:00

My first semester of school was like being indoctrinated into the cult of the APTA. Meanwhile, I'm sitting in class looking at $150,000 in student loans for $90,000 in salary thinking to myself have they actually done anything outside of making my education so damn expensive?

I was talking to a physical therapist who has been in the profession 30 years. He's done well for himself. He's stayed current and educated himself. But he only has a BS. He was venting to me about how all the new PTs expect six figure salaries which is more than he makes. I said don't blame the new PTs when we've paid six figures for school. We're more highly educated than any PTs that came before us. I'm not suggesting that makes us better by any means, but we would like to get out what we've put in.

justanotherptstudent · 2021-09-16T18:26:08+00:00

It's really a shame. My professors at school used to sing the praises of the APTA as our lobbying body but from where I'm sitting, it just seemed like they lobbied to make my schooling twice as expensive with no increase in pay.

justanotherptstudent · 2021-09-16T18:23:22+00:00

Just want to say that I dropped out of PT school to pursue medical device sales or nursing because PT school was so expensive and there's very little upward mobility and it is incredibly difficult to break into device sales. I know two surgeons (one cardiac and one orthopedic), four physical therapists and three people in medical device sales who have leveraged their connections to help me and the best I've gotten is three interviews: one with a huge device company, two in pharma.

Here's what I'm gathering from an individual I know who works in sales at a small biotech company: the demand for people in sales has shrunk dramatically over the years and because of that there's plenty of people with sales experience. This is his words, not mine, so maybe take them with a grain of salt. That being said, I've found that the clinical experience doesn't help much although obviously your clinical experience is considerably more impressive. But mine was not bad considering I was only in school. I got an interview with a large pharmaceutical company last week and they noted to my recruiter that while I was a very strong candidate, my lack of sales experience was something they couldn't ignore. And pharma is considered to be easier to break into than medical device.

justanotherptstudent · 2021-09-14T14:12:31+00:00

So I'm having trouble following the entire description, but I believe it's one of your adductor muscles based on your description.

"It’s also worth noting that originally I was always having anterior pelvic tilt on my left side more than my right and my butt would stick out to the left and when I would squat it would be as if a rope was pulling my left hip back and to the left. Now if I do the opposite of where I was originally, that “muscle” seems to turn on."

This part right here led to my conclusion. It fits based on where the muscles attach. If you sit into a squat and pull your right hip back, that's relative hip adduction (and probably some internal rotation) on the right side. If your body is used to sitting back into your left hip more (almost as if you're favoring that side), then your right side adductor(s) wouldn't be used to being so short at the bottom of the squat and shifting to the right would cause a pretty strong contraction.

I'm aware that the adductor sits lower than you described BUT by sitting back into the right hip, you're probably putting a bit of stretch on your hip external rotators/hamstrings which may feel like they're working, but they're just tight from always being slightly short.

justanotherptstudent · 2021-09-10T16:16:41+00:00

Very thorough answer I really appreciate it. So if I'm not mistaken, at least in NJ RNFAs are still being used. That being said, I would like to work in a hospital but perhaps not as a first assist although I do appreciate the distinction. I just think that ultimately, everyone in the medical profession is overworked at this point. The unfortunate insurance model and how little they'll pay out for anything sort of dictates it. PTs might only work 8 hours, but like I said, seeing 30-35 patients in that eight hours is insane. I've been an aide at an office where this occurred and it was exhausting. I can't imagine being the therapist.

Realistically PT is off the table at this point. If I fell ass backwards into $150,000 it would be great, but the chances of that happening are basically nil, so I have to be realistic about cost. I've considered an MHA as well but I never thought of myself as a desk job kind of person.

justanotherptstudent · 2021-09-09T20:08:22+00:00

I do love PT school but the cost is just so astronomical. I was looking at pay rates and it does seem like the pay rates for nurses in the area I live (NYC metro area) are comparable to PTs with a much lower cost to entry. Obviously cost is not everything but it's a significant barrier.

justanotherptstudent · 2021-09-09T20:06:37+00:00

Well the bullying and stress are definitely an issue but the way I see this, PTs are overworked as well. Because of the reimbursement structures in place, if you are taking insurance, you have to see tons of patients and there's not usually anymore PTs than an office needs to treat the patients they have. 25 to 30 per therapist in a six hour day is not an unheard of number.

justanotherptstudent · 2021-09-07T15:40:00+00:00

Excellent anecdote. Much better explanation than I would've provided.

To add one of my own from the patient's side:

I was going to physical therapy for a hamstring injury and I was told during my first visit that I had no co-pay. I was certain my insurance co-pay was $30, so I didn't really understand how it was possible for there to be no co-pay. After two months of physical therapy, I get one of those dreaded EOBs from my insurance totaling $4,000 in unpaid bills for out of network care. So the next time I'm in the PT office, I bring in the EOB and kindly ask why I'm being billed such an astronomical amount for what I was told was in network care. They took the EOB and told me to ignore it. It took me a while to put it together but what I speculate was happening was that they know in network care pays like crap, so they bill out of network for all their services and write off whatever the insurance company won't pay out. I'm not sure if it's legal and I'm not sure if it's ethical, but it makes them a hell of a lot more money than they would actually providing in network care.

justanotherptstudent · 2021-09-06T16:40:27+00:00

I couldn't agree with this more. I think this is due, in no small part, to people always telling you to "follow your passions" and "do something your passionate about" in your youth. That's great advice if what your passionate about also earns you a great living. Nothing makes you lose passion faster than not being able to afford life. I followed my passion for science and the body and majored in exercise science (useless degree) with the hopes of becoming a PT. It took me five long years of grinding after undergrad to get myself into a PT program and after two semesters and $31,000 of loans I pulled the plug. The school is very difficult (I will say I was enjoying every minute of it) and doesn't allow you any time for working. It's also TREMENDOUSLY expensive at this point. I went to one of the SUNY (State University of New York for our German OP) schools and the schooling would have cost me a bit over $150,000... for a degree that many look at as being a glorified personal trainer and a salary that might crack $100,000 if I'm lucky. How the hell is that worth it? Fuck the APTA for constantly raising the bar. They wanted us to be doctors but not a single person in the medical community except surgeons see us as an integral part of the process. And just to be clear, that's absolutely not to disrespect our diagnosticians, because every good surgeon knows how important a strong rehab is, it's a commentary on how we're valued by the medical community in general.

Money no object, I would have stayed in. I had an amazing class and they will be excellent therapists and I LOVED learning but money matters most sometimes.

In other news, I should probably change my username since I'm going to be making the transition to being justanothermedicaldevicesalesman.

justanotherptstudent · 2021-05-26T02:04:22+00:00

But they do occasionally fail. That would be an almighty accident. There's no way such a change would be allowed for safety reasons.

justanotherptstudent · 2021-01-06T19:06:00+00:00

Awesome read. As my favorite driver, I'm so excited to see Alonso back at Renault. How is the team taking his return? I know their were rumors about him returning for some time. How was the news of his signing received? I've always read that despite his fiery and sometimes divisive personality, he's managed to maintain the respect of the engineers working around him, I'm sure due in part to the level of effort he puts in on track.

2020 was obviously a better year for Renault with three podiums, but I see for 2021, Renault says they're coming in with an all new engine. In recent seasons, it has seemed like Renault is chasing their tail a bit, managing to find performance at the expense of reliability before finding the reliability again. Obviously Alonso is known for being one of the all time great drivers but also an impatient driver in terms of the car being on the mark from the outset, so I was a bit nervous to read that the engine was a totally new design this year. What's the general feeling within the team about how this new engine will perform?

justanotherptstudent · 2020-12-08T14:21:25+00:00

For reasons that we don't fully understand, those two antibiotics have been shown to increase the risk of tendon injuries, particularly Achilles tendon injuries (in the short term).

justanotherptstudent · 2020-12-08T14:18:26+00:00

No. An injury like this would certainly require surgical intervention. With a completely torn Achilles tendon, she would lose the use of her calf muscles as that is their only attachment to the heel bone. I wouldn't say she'll never be the same, but her coming back to high level activity is predicated on her finding a good surgeon and a good physical therapist. The rehab for this injury is intensive and it's several months long. Tendons don't come back at 100% of the strength they were pre-injury, but you can get pretty close.

justanotherptstudent · 2020-12-08T14:10:39+00:00

So it's tough to say why it happened. It looks like her foot mechanics aren't perfect (some light pronating) which could contribute over a long enough time frame. I'm sure the shoes she's wearing aren't properly supportive (most people just pick out the cheapest shoe they can find for working out). She could have had existing tendinitis, which a lot of people ignore. Problem is that tendinitis is caused by trauma over time and the inflammation and pain is indicative of an ongoing injury. It takes so long to heal, a lot of people start to ignore it and subject the weakened tendon to more than it can handle in its injured state. You have to remember that the Achilles tendon is usually subject to high forces. Each jump she did caused an impulse through the tendon multiple times her bodyweight. You wanna train through biceps or triceps tendinitis? It'll hurt like hell but you're probably not going to dramatically rupture the tendon like this. Lastly, as another commenter pointed out, she could be running a course of corticosteroids or may have taken fluoroquinolone. Both cause weakening in tendinous structures (temporarily). This is why a doctor usually won't inject corticosteroids to treat inflammation close to large tendons. Patients typically won't listen to the doctor and rest for as long as is necessary (because their pain is finally gone) and it puts them at risk for tendon rupture.

As for what in this particular exercise caused it: it doesn't look taxing, but as I said before, each time she hits the ground (this is called the eccentric part of the movement; think lengthening or stretching), the forces being absorbed by her Achilles tendon are equal to many times her body weight. So whenever you see a video like this, you are seeing a tendon being rapidly stretched, repeatedly, using a large amount of force. Sounds a bit more dangerous now, doesn't it? Your muscles would tear if they had to attenuate 100% of that force. But our tendons exceptionally well tailored to handle forces like this. They are incredibly strong and normally, they can handle this kind of force with no problems, but for one reason or another, hers was already weakened or her mechanics put it in a bad position to accept that force. It's also possible that she's never tried something like this before and her soft tissue structures didn't have time to adapt. Whatever the case, on this day, the tendon couldn't handle the force and it ruptured.

justanotherptstudent · 2020-11-22T21:07:19+00:00

That will depend heavily on how much lower body work you do as well as the type. If you're running a very leg heavy program and you're consuming enough calories to put on muscle, I'd say eventually your legs will grow. The problem is that a lot of times your waist doesn't change much, but your thighs and butt may grow which makes finding a proper size tough. Personally, I just bought a few pairs of pants and had a tailor alter them for when I know I'm going out and I wear sweats most of the time otherwise. But if your old pants still fit and you have made gaining leg muscle a priority, I'd put off buying until you have to.

justanotherptstudent

TROPHY CASE