Friday, January 29, 2016

My Thoughts on ADD / ADHD

So, some of you know that I was diagnosed with ADD (when it was still called that) as a youngster. Over the years, I've figured out a way to channel all that energy. I don't think it's anything except a super power at this point. Once you can properly engage & channel minds on this far side of the attention-continuum-curve, it's basically like channeling the power of the sun.

I did a video blog on this via my Dad Blog called "Daddy In The Raw: The Real Life of a Work At Home Dad." It's linked below. I hope you enjoy it and that it helps!


Wednesday, January 27, 2016

Vertical Balance: A New Look At Work-Life-Balance

Following a Periscope by Dr. Jeff Moore on balance and entrepreneurialism, I went to thinking about how I'm achieving balance. I realized for years, I had it wrong. I was balancing life as one balances things on a plate. Hence, the sayings like, "My plate is full." However, I think that a new way of looking at balance is vertically. Originally, I sad like the leaning tower of Pisa. A better way of seeing it, is like the game Jenga.

Here's my video blab on achieving work-life-balance by doing it vertically.

Monday, January 11, 2016

CSM and Disneyland

So, I put out a poll on Facebook and Twitter. Here are the results:

There will be at least 30 of your colleagues & their families, romping around at the Happiest Place On Earth!

Can both be done?! Well... I'll let you decide ;) This post isn't about finding or making the time. This post is all about what you can do while you're at Disneyland and some tips from a seasoned Disneyland Annual Passholder in how you can maximize your Disney experience at the parks. After all, if you've decided to go... you already know that it is worth it. And, if you are wavering, maybe this post will show you what 30+ people already know... it is worth it ;)

LOL. Who are we kidding? Of course I'm trying to get you to go!

CSM and Disneyland

I probably don't even need to say it, you probably already know: I'm a Disney FIEND. I love all things Disney & Star Wars; therefore, Disneyland (and Disney California Adventure) is just plain awesome. The fact that CSM is but and only next door to the Disneyland Resort, I can only hope that more and more of you will be helping me do a #DisneyPT TAKEOVER!

Considering that most of the CSM activities will be ceasing around 5 or 6pm -- AND -- that Disneyland is open until midnight for both the Friday & Saturday... there should be plenty of opportunities to get into the parks.

Here's what's up!
The Disneyland Resort is undergoing all sorts of changes in preparation for Star Wars land. What this means is that the train will be down and much of that same area surrounding the transition between Frontierland and Fantasyland. The good news is that because there is a bit less to do there, you don't have to feel paralyzed by too many options and trying to fit everything in. You'll have your option of park hoppers and various ticket prices to reflect how many days you wish to get in.

If anything, I'm hoping to organize an unofficial PT takeover... but, more news on that later.

If you haven't been to Disneyland in the last couple years... or decade. This is what you stand to gain!
  1. Tommorrowland is entirely Star Wars'd out. The whole place is now undergoing something called the Season of the Force. The whole area has Star Wars music, decor, and Star Tours is now a 4-D experience along with a special scene which ties in the new Star Wars movie, The Force Awakens!
  2. The Paint The Night Parade is perhaps Disneyland's best parade ever! Not only did it debut for Disneyland's 60th anniversary; it gave the proper nods to the old Electrical Parade which is now available in Disney World, Orlando.
  3. Oh, right! It's Disneyland's Diamond Anniversary!
  4. Many of the "fun" rollercoasters have been upgraded. This includes the Matterhorn Bobsled as well as Frontierland's Big Thunder Mountain. I went on Big Thunder just last week and the upgrades are incredible!
  5. Disneyland allows for FastPasses for you to spend in the park while your pass, waits in line and allows for a return time for you to cut the majority of most lines. If you have children, you can also use what is called a Rider Switch Pass where one of you waits through the line and the other gets to do something else. Then, you switch the passes and take 3 guests with you to cut the majority of the line. A similar effect goes for wheelchair access.
  6. There are a LOT more new shows including Mickey and the Magical Map, a brand new World of Color show in Disney California Adventure.
  7. Oh! And, if you aren't familiar with Disney California Adventure... it's the "adult" park. There, you will find great food, great rides (actual rollercoasters and what not), and great booze. That's right ALCOHOL.
  8. Space Mountain is now Hyperspace Mountain, re-themed with projections of Star Wars effects to really accelerate the ride experience.
  9. Many of the dark rides in Fantasyland have been upgraded in one fashion or another. An example is Alice in Wonderland and the new dynamic projections they have as you go through the ride itself.
  10. Downtown Disney has become its own thing. Great shops. Excellent food. Speaking of which, maybe #10.5 is Trader Sam's Tavern at the Disneyland Hotel... the volcano explodes regularly... as does the rush in drink orders ;)
So, finally, I must ask... if you're not planning on going yet... are you now?!

Wednesday, January 6, 2016

Three-In-One BLAB Fest

Hi everyone,

Here is a much delayed release of my 3-in-1 blab session covering acute physical therapy, vitals, and professional ownership. I meant to release this quite a bit earlier, but! Well... life :)

So here they are!

  1. Vitals are VITAL (A Follow Up)
  2. 5 Ways Acute Care Was My Ultimate Game Changer
  3. Physical Therapy Attitude Check: Do you own or do you work?
Thanks for all the inspiration and engagement regarding those Facebook posts. Hope you enjoy these. And, get ready to laugh because it is beyond apparent how exhausted I was recording these. LOL! =P

Physical Therapy Attitude Check: Do you own or do you work?

Physical Therapists tend to go to their daily jobs as workers. And, yet, there is all this complaint about being undervalued, under appreciated, being at the bottom of the totem pole, etc.  Ironically, this attitude is actually the root of the problem.

If you "work for," you will always care less.

If you "take ownership," then you will always care more. And, we need people to care more.

5 Ways Acute Care Was My Ultimate Game Changer

You either love it or hate. If you're like me, you probably went into PT school thinking about outpatient ortho and/or sports, waiting that magical 5 years until you're good enough, and then opening up your own business.

Well, as life would have it, I would rotate through various settings and some how found the acute care hospital to be my love and passion as it pertains to the raw potential to which PTs can learn -- and -- to which PTs can contribute.

Here Are 5 Ways Acute Care Was My Ultimate Game Changer

  1. Best application of knowledge base.
  2. Highest level of clinical diversity. Yep, I did plenty of manual, ortho, and even ED.
  3. Highest level of clinical complexity. Where else are you going to get someone who has 20 different medical conditions, blood that should be melting out of their body, vital signs that make no sense, but are agreed by all in the medical team to appropriate for home discharge?
  4. INTENSITY. With the most intense medical situations & most intense patient care scenarios.
  5. Largest political canvas in healthcare. Acute care requires savvy to navigate and typically 10-15 years to move into a significant space of leadership (system level, VP, c-level, etc.), 2-5 years for first promotion. 5-10 years for leadership opportunities.

Some quick commentary. People get scared of the ICU. Well, the ICU is the safest place. You have the quickest response team right there, more monitoring that you could ever ask for. Rarely, does anything "go wrong" in terms of PT in the ICU. In fact and in my experience, all the accidents, strokes, and crazy events occurred on ortho (DVTs), trauma (complexity, despite medical stability), and medical units (because, the guard is down).

Additionally in acute care, you get exposure and opportunities to serve in wound care; be it laser, wound VAC, or MIST... or traditional stuff, sharps, even maggot. You get imaging, coordination with the entire healthcare spectrum of professionals. 

The opportunity in acute care for PT is immense. The ability to leverage nearly the entire spectrum of our clinical training is wonderful. Sure, you're not going to do mobs on everyone. But, really, is doing mobs all that PT is about? Surely not.

Think about acute care. It was the ultimate game changer for me. It remains, to this day, one of the most influential and significant leveraged experiences which affects my clinical practice.

If you're a student, get IN a hospital rotation. If you're a new grad, get some per diem hours... you will never regret it.

Vitals Are VITAL!

So, I shared on the Doctor of Physical Therapy student's Facebook group this insane vitals situation, with a patient I saw this past week. You can find it linked HERE:

Essentially, I had a patient present with absolutely no signs, no distress, no discomfort, no nothing... with a normal'ish blood pressure. But! With a heart rate of 37bpm and O2 saturation of 77%.

Yeah... NOT. NORMAL.

My intent in posting that to the Facebook group was to convey how important it is to take vitals. I know it is still a point of disagreement and contention. Still, I've been told more than once that in any discipline or setting in healthcare, failure to take vitals (when someone goes wrong) is the first place lawyers check in terms of negligence.

Just something to think about. You've been warned.

In any case, I'll get on with this post only to say that it is a PASSIONATE topic for me. If you resonate with me, be on fire with me! If it offends you, I'm sorry it does... it doesn't change the facts. But, I think you'll find that the majority of clinical leaders out there agrees with the position I take.

Here's a quick recap:

Follow Up: Vitals Are VITAL!

To my knowledge, it's a happy ending. Our patient recovered and we can't entirely explain what happened. Personally, I still think referring to ED would've been more prudent -- but, per the policy given & the process followed, she was deemed medically stable enough to stay inpatient. However, the cardiologist involved did suggest "other" avenues of approach given a repeat situation.

My interpretation? I think there was a massively hidden cardiac issue given the "regular" irregular heart rate, history of complaint of chest pain, fatigue, etc. Doesn't that sound like a heart attack to you? Sure, the question: What could we have done? Comes up. Maybe nothing, maybe everything.

The fact is, without taking those vitals, most clinicians would've gone ahead with a full course of treatment for the day. That would've included a lot of exercise, both strength & cardio; exercise that very well may have cause the situation to go from odd into critical.

My follow up, simply stated, is this: Vitals are vital, not just because they are standard of care. Not just because it may implicate negligence when omitted. Not just because it's the right thing to do.

Vitals are vital because they serve as the prerequisite for just about EVERY physical therapy intervention we know. Exercise? It starts with vitals because we are causing a physiological stress response. And... I could go on. But, I just stopped typing this long list because it's exhaustive to even do so. Really, if you can't think of why and how important the cardiorespiratory system -- one QUARTER, mind you -- of physical therapy practice is, in how it interacts and is interdependent with the other three systems we treat... someone, needs to rethink how they practice.

Harsh? Sure. But, vitals are vital. Don't you dare put your patient at risk, ever.