7/30/11

Today on the scale: 229


I stepped on the scale on Memorial Day at 261.  I was in Hastings Nebraska on a clinical rotation which left my afternoons (from 2PM and later) completely open.  I dropped from 261 to 229 by eating a little less, and a  little healthier, and being active a lot more.  It started with walking (a mile) to the gym to swim.  Then I dusted off the road bike.  Biking 2 - 3 days/wk, swimming 2x weekly (sometimes the same day as biking), and walking back and forth to groceries, the gym, and the hospital.  None of it was dramatic - except maybe the biking.  But I love riding my bicycle.  It was an easy change to make.

My goal, from here on out, is to continue exercising into my final semester going into my last two clinical rotations.   The first 35 pounds came off very quickly once I got interested, but I know that my happy routine will be challenged with school, moving, and new clinical experiences.  My goal, by May 2012, is to be under 210 lbs.  GET 'ER DONE!

-d

7/25/11

Freaktrain,thebug
Freaktrain at thebug! Good shows tonight!

7/18/11

Chondrocyte Implantation Procedure Presentation

Additional Resources and Research (*.rar format) and My PPT Presentation

I just presented a case study presentation on a patient I saw in my last clinical rotation.  The purpose of the presentation was to explore 3rd Generation Autologous Chondrocyte Implantation (ACI) indications and contraindications for therapy.

To briefly summarize, rehab protocols and movement restriction post-op depends GREATLY on the site and size of the site grafted with chondrocytes.   The patient in the case presented had chondrocytes grafted to the articular surface of his patella.  Compression of the grafting site can decrease chondrocyte proliferation by more than half of un-compressed controls.  This compression is not immediately reversible, either, as chondrocyte proliferation begins to plateau at 7 days post op (in animal studies).

Different portions of the patella articulate with the femur depending on the angle of knee bend. The portion of the patella which was grafted with juvenile chondrocytes would have articulated with the femur between 30 and 60-70 degrees.  Tension through the quadricep inside that range would compress the patella and grafting site directly into the femur and hurt chondrocyte proliferation.

In order to effectively decide on a protocol, we, as autonomous practitioners of PT, have a foundation in sciences (such as biomechanics, kindesiology, cell biology, research) to keep up to date with novel surgical procedures.  We have the skills, abilities, and informational background to make clinical decisions for patients as technology continues to advance in the medical field.  Don't get left behind.



1.Buckwalter JA.  Articular Cartilage: injuries and potential for healing.  J of Ortho Spo
2.Hettrich C, Crawford D, Rodeo, Scott.  Cartilage Repair: Third-Generation Cell-based Technologies – Basic Science, Surgical Techniques, and Clinical Outcomes.  Sports Med Arthrosc Rev. 16:4; 2008.
3.Kon E, Gobb A, Filardo G, et al. Arthroscopic Second Generation Autologous Chondrocyte Implantion Compared with Microfracture for Chondral Lesions of the Knee. Am J Sports Med. 37:33; 2009.
4.Li K, Falcovitz YH, Nagrampa JP, Chen AC, et al. Mechanical Compression Modulates Proliferation of Transplanted Chondrocytes. J Orthop Res. 18:3; 2000
5.Levangie PK, Norkin CC.  Joint Structure And Function: A Comprehensive Analysis Fourth (4th) Edition. 4th Edition; 2005.

7/14/11

A fish does not know it is in water.

From lifehacker: 
           "The point: it's easy to forget that what surrounds you is only normal because it's what you know. To others, those surroundings might seem pretty strange."


This is a little off topic specifically...  When I am really stressed out, I have a tendency to forget about everything going on around me, and just focus on me, and my stress.  It's like being in murky water with junk floating around in it.  I focus so much on myself, and the things happening to me in the immediate present - more of a mechanical response to stimuli, like some kind of a survival instinct.  I completely lose sight of the future, and can't see anything else happening around me.  Just me, stuck in the murky water alone. 




Also, when I get stressed out, I apparently misplace things.  I found my wallet in the freezer a few days ago, and this morning put my glasses in the dishwasher.  Wallet is fine.  My glasses got all bendy and look like they belong on a wax figure from Ripley's Believe it or Not.

7/2/11

2nd of july fireworks over coors field sunset for your viewing pleasure.
2nd of july fireworks over coors field sunset for your viewing pleasure.