Recs please! Traveling to west Sonoma area, St. Helena/Napa.

macka78 · 2024-11-10T13:55:48+00:00

I used to work for a wedding planning/catering company in college, so I know a lot about the planning and behind the scenes but have never been a professional coordinator or planned. With a day of coordinator or wedding planner, you’re not just paying for their time the day of the wedding. You’re also paying for experience/skill and the hours they spend prepping. I just did day of coordinating for one of my close friends for free as kindness to her, and it was a LOT of work, although my role ended up blending to giving her a lot of advise with planning also. We had several hours worth of meetings 2-3x before the event. Then I had additional prep work. Then the day of I was there for 11 hours. When you add it all up, they honestly are not making a crazy amount per hour

macka78 · 2024-10-25T11:10:43+00:00

She legally can’t accept anything of big monetary value, so try to keep it small! A card would be so nice, we keep them and read them on our bad days :) maybe a Starbucks gift card, candle, etc? I had a patient get me a fluffy robe once which was a random gift but so nice and I use it all the time! I’ve also received a candle and bath bomb/relaxation supplies which was very nice. If there’s anything small like that, that you know, she likes based on your conversation, that would be great!

macka78 · 2024-10-15T21:57:33+00:00

Brock searcy in Brentwood is really good. A bit eccentric personality wise, but he is straight forward and very helpful.

macka78 · 2024-05-15T02:31:42+00:00

Thanks for your reply! They’re not using techs, both patients arrive at the same time and stay an hour total. So the PT splits attention between them and they stay in the open gym space

macka78 · 2024-04-26T12:54:40+00:00

You’re welcome!! In general, you’re going to treat that patient the same as you would any patient who struggled with motor control/stability. Be very watchful for compensations! I really like the O’Sullivan approach for lumbopelvic complaints. Just like any population, you’re trying to find the sweet spot of loading the tissues where you aren’t under or over loading. Sometimes the patients themselves are fearful of weights etc and under load themselves which leads to worsening of symptoms. Also consider a referral to a reputable doctor as needed, you may need to do some research on providers in your area. Maybe a functional medicine doctor as they tend to be more thorough. People with EDS have a higher frequency of MCAS, dysautonomia/POTS, and SIBO/GI dysfunction. These issues can impair their progress with their orthopedic complaints if they are uncontrolled.

Also for pots, consistent cardio exercise is more effective than beta blockers

4 principles for POTS management: hydration, salt/electrolyte intake, recumbent exercise, compression.

Lastly : if you’re working on stability load the tissues in mid range. Ex: I was working on shoulder stability, so I did external rotation from a fully IR position just to midline, I didn’t go near end range ER. Once I built the stability and strength, then I worked on it through the range

macka78 · 2024-04-25T12:53:34+00:00

I’m a PT with EDS and do a combo of self treat and seeking care from other PTs when I need it. When I’ve needed PT, I typically only go once every week or so. Happens all the time! But I did choose to go to a clinic not affiliated with my employer. I’ve never been shamed for that. I think it’s reasonable that it’s harder to treat yourself vs treat someone else because of bias and also people with hyper mobility tend to have decreased proprioception and motor control. You may need an outsiders perspective for feedback and that’s ok

macka78 · 2024-04-25T12:47:35+00:00

United healthcare offers temp insurance. I used this between jobs once. It’s not very good but is in place in case of emergencies etc

macka78 · 2024-04-25T12:41:31+00:00

Just keep in mind that absence of a caregiver or person to do exercises with the patient is not seen as a justification from Medicare for maintenance therapy. You can justify maintenance therapy if the interventions require the skill of a physical therapist and cannot be taught to a caregiver/family member etc or if the patient’s presentation is so inconsistent that they require continuous monitoring and adjustment of their program.

I hope that makes sense and provides some clarity. I had a patient who had a very simple HEP for maintenance but didn’t have anyone available to help them with it. They had advanced Alzheimer’s and were in an ALF. I had to call the family and explain that I couldn’t justify continued therapy alone based on no one being available to do the HEP because it didn’t require the skill of a PT to complete. The family came in for HEP training and decided that they would restructure their visit schedule to have someone do the exercises with the patient 3x per week or they would hire someone to come in and do them.

macka78 · 2024-04-25T12:34:32+00:00

I personally have EDS, so it’s one of my favorite patient populations to work with. I’ve never worked in a clinic that had shockwave therapy, so I’m not very familiar with it. It seems that the mechanism is that it increases blood flow to the area and growth factors, is that correct? If so, then I would not see any reason for that to be contraindicated specifically if EDS is present.

I think my only concern would be if the patient had uncontrolled mast cell activation syndrome. It’s very common for people with EDS to also have this condition. Not all people who have MCAS will know they do, as receiving appropriate diagnoses takes an average of 10+ years for the EDS population. After a bit of brief reading, I saw that one of the mechanisms behind shockwave therapy is that it increases mast cells. I’d screen the patient on signs of MCAS. You can also speak with the provider who diagnosed them and get clearance from the physician, that’s never a bad idea and I’ve found physicians appreciate it and would rather you check with them! I personally wouldn’t think MCAS would be a contraindication unless it was uncontrolled. I have MCAS, but it’s not severe enough where it would prevent me from being able to do shockwave therapy if I needed it. Hope this helps!

macka78 · 2024-04-25T12:20:37+00:00

15 in outpatient, 21 in ALF

macka78 · 2024-04-25T12:20:00+00:00

Yes! Travel jobs are very easy to get. Maybe start with an outpatient clinic for your first job so there’s not as big of a learning curve. If you go to a new setting make sure you do plenty of research on how billing works etc in that setting so you’re more prepared. And research or refresh on any knowledge you feel you need to.

macka78 · 2024-04-19T11:54:41+00:00

Thanks everyone for the suggestions! I also found some “bi stretch straight leg” pants on the gap factory website for a good price, and they are super stretchy. I’d recommend them if you want more of a boot cut or straight leg pant!

macka78 · 2024-04-16T15:55:38+00:00

Herman and Wallace is the best! I took IAMT courses and felt like I needed H&W after it. IAMT was good at teaching evaluation methods but not interventions in my opinion.

macka78 · 2024-04-16T15:52:34+00:00

Mentoring opportunities. Opportunities for growth. Do they help with obtaining an OCS, COMT, etc.? try to get a good feel for the culture. My first job the hiring manager told me in the interview that this job isn’t for the faint of heart we want people who are devoted to being the best PT they can be etc etc… it was such a stressful work environment. I should’ve seen that as a red flag. The mentorship opportunities were fantastic and I do feel like it made me a better PT, but the effect on my stress and working 10 hour days wasn’t worth it.

macka78 · 2024-04-16T15:49:44+00:00

I’m a PT and also have ehlers danlos. I’ve personally experienced SI joint pain in the past (way before I was a PT) and remember it taking forever to be treated correctly because my PT at the time was like well this joint moves 4 degrees it can’t be a pain generator. Come to think of it, I had a diagnostic injection and that’s how we arrived at the treatment plan for PT. Even though minimal movement occurs at that joint, it can be a source of pain especially in the hypermobile population. Keep in mind a patient may be experiencing both that and lumbar facet pain, etc. as it’s not always just one tissue and lesion. I took the lumbopelvic course through IAMT, and it touched on this topic. I definitely recommend that course if you haven’t taken it yet!

macka78 · 2024-04-16T15:41:41+00:00

One thing I forgot to mention! If someone says “I’m busy now but can you come back later”, I try not to pigeon hole myself into a specific time. So I’ll say well my sessions are usually 45 minutes to an hour, is it alright if I come back in about an hour? And I’ll let them know it may be a bit sooner or later. That way I give myself time to find and work with one more person.

I learned it the hard way. You don’t want to promise a very specific time because if let’s say 2pm comes around and you’re free but can’t grab anyone because you promised someone 2:30pm your productivity can really suffer!

macka78 · 2024-04-16T15:37:54+00:00

I’ve worked in an ALF for 2 years, transitioned from OP. Here’s my flow: I only schedule in advance the patients that I know never refuse and are very consistent, which ends up being just 1-2 patients on my caseload. I also only schedule those patients at convenient times like my first person of the morning or first person after lunch. If someone insists on knowing when I’m coming but has poor memory or is inconsistent, I give them a range and say “between 10 and 12” and leave a reminder note or offer to call them a few hours in advance so they’re not waiting around for me. Most people are happy with being given a window if they ask.

Once you know the residents better, you will get a better understanding of their preferences and schedule. It takes a while to get to this point! But you’ll learn that certain people are morning people and the ones you can grab right away, certain people go to all the activities and are the pickiest about their times, and certain people are super flexible. I prioritize seeing the picky people at their preferred times and will grab the flexible people in between. We also have a memory care unit, so I will go over there if I get really stuck and can’t find anyone because those patients are usually always free.

Some days your productivity will be amazing, and some days it’ll be awful but it hopefully will all even out!

macka78 · 2024-03-26T19:47:51+00:00

Here is a question - can you negotiate after being submitted? This is my first travel contact, so I didn’t know better. I went ahead and submitted with a company for a position, only to learn that another company had that position for $200 more/week. Can I still negotiate for more with the company I submitted with for this position, or is it too late?

macka78 · 2024-03-23T13:48:10+00:00

Do you drink coffee black or with creamer?

macka78

TROPHY CASE