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Old 11-26-2010, 09:09 AM   #43
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Now my left knee eventually needs scoping, though the pain isn't as bad, and a steroid shot has kept the knife away for a while.

Gene
Left knee scheduled for scoping in mid-December. I'm tired of the intermittent pain, though I have no problem walking on flat, even surfaces. Stairs, not so good. Hiking over irregular surfaces, problematical at times. Might as well get it done, it's not getting any better.

Gene
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Old 12-01-2010, 10:05 PM   #44
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1 month - I'm back

To my forum friends, it has been 1 month since I had my surgery. I have to say - as others have said- I am glad that I have done this surgery. So far the knee pain that I had prior to surgery is totally gone. I do experience some discomfort in the knee area. Thankfully I was able to get into the Providence Rehab Center, so I went from the hospital area to the rehab. It was a great relief for us as I would have had to go to some other rehab center w/o the extensive on physical therapy. I have been walking without a walker for a few weeks already. I must keep working on "walking" correctly. For so long I was limping, schuffling along that I must work on not getting back into a habit. To date I continue to go to PT and beginning tomorrow I will start working with my "PT (- personal trainer) at our local gym. She will be working with me on my core and stability. It looks as if I will have a few more sessions with the outpatient physical therapist.
Overall to date I am extremely happy with how I am doing. And I am so very grateful to my devoted husband (RustyRivet) who had done so many things out of this element, ie, grocery shopping, laundry, meals and dishes. He has been a true blessing for me.
I will continue to work hard on getting back on all the mobility so that I will be able to take many A/S trips this spring, and meeting many of you along the way.
In the mean time my goal is to continue to lose a few more pounds (a added benifit to surgery and not being able to raid the fridge easily) and enjoy our trip in January to Cabo. thanks to all for the support and I will continue to keep you posted and will also appreciate your comments/support. Susan
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Old 12-02-2010, 06:41 AM   #45
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Good to hear, Susan. Helpful hubbies are worth their weight in gold. And then, there are Physical Therapists! Did you know they have to have Doctorate degrees these days?!

I have begun taking Glucosamine MSN, per my wonderful chiropractor, and am happy to report my very worst knee is noticeably more comfortable.

Good luck with your continued rehab.


Maggie
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Old 12-02-2010, 08:53 AM   #46
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I don't think physical therapists have to have doctorate, unless that's true in Illinois. If that were so, there would be very few P.T.'s.

Sometimes I wondered when I was seeing one many years ago whether they had a degree in torture and what kind of evil person would be attracted to that profession. But I knew it was doing me good and I kept at it because I wanted to be as normal as possible (no, it didn't help my mental problems very much).

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Old 12-02-2010, 09:11 AM   #47
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My sister is a PT in Oregon, went to PT school (2 years I think) after getting her BA. She is not an MD by any stretch of the imagination, though she is married to one.
I go see my dentist this AM, as a prerequisite for also having knee replacement. These days they are being very careful to have you infection-free before doing any surgery, as that infection can travel to the surgical area or, worse yet, to the heart.
Susan- glad your rehab is going well, and that you're happy with your decision. Best wishes- tim
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Old 12-02-2010, 01:00 PM   #48
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I don't think physical therapists have to have doctorate, unless that's true in Illinois. If that were so, there would be very few P.T.'s.

Sometimes I wondered when I was seeing one many years ago whether they had a degree in torture and what kind of evil person would be attracted to that profession. But I knew it was doing me good and I kept at it because I wanted to be as normal as possible (no, it didn't help my mental problems very much).

Gene
They do in fact now have to have Doctorate degrees to be licensed, registered, certified or whatever. This may just be in Illinois but I suspect not. PT's used to be Bachelor's, then Master's Degrees---now it is Doctorates, with the prior degreed PT's grandfathered in. I don't know when the changes occurred.

I have a PTA degree from 1970 (a little known fact). Registered PT's in 1970 had Bachelor's degrees.

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Old 12-02-2010, 01:37 PM   #49
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the degree is a PhD, not MD. Most states have already adopted this requirement.
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Old 12-02-2010, 07:53 PM   #50
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Go Susan

Hey great to hear how you're doing, steady and slow...each day brings improvments! And yeah, I forgot to thank the tireless help with "everything", Nurse Nanc...Home support team leader.
Hey, rode my bike today! And best of all, we're going camping in the morning! Out of the house, cabin fever is REAL!
Heal Safe!
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Old 12-02-2010, 09:20 PM   #51
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elfirebob, Good for you. I am only riding a stationary bike so far. Don't know when we will get our next trip out, but am sure looking forward to it. Susan
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Old 12-03-2010, 07:57 AM   #52
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Susan - it's so good to hear that your surgery was a success - congratulations!
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Old 12-03-2010, 09:00 AM   #53
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They do in fact now have to have Doctorate degrees to be licensed, registered, certified or whatever. This may just be in Illinois but I suspect not. PT's used to be Bachelor's, then Master's Degrees---now it is Doctorates, with the prior degreed PT's grandfathered in. I don't know when the changes occurred.
That's news to me. Given the difficulty in getting a Ph.D., I guess they'll be a shortage in the future, or they will have someone with lesser credentials like nurse practitioners and physician's assistants working under "supervision". Either way, I'm sure fees will go up a lot. Insurance often does not pay for sufficient physical therapy now.

I'm glad I won't need PT for a knee scoping.

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Old 12-03-2010, 09:29 AM   #54
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That's news to me. Given the difficulty in getting a Ph.D., I guess they'll be a shortage in the future, or they will have someone with lesser credentials like nurse practitioners and physician's assistants working under "supervision". Either way, I'm sure fees will go up a lot. Insurance often does not pay for sufficient physical therapy now.

I'm glad I won't need PT for a knee scoping.

Gene
There have been PTA's (Physical Therapy Assistant) with Associate Degrees working under Registered Physical Therapists for 40 years (I was in the first graduating class). Kind of like LPN's and RN's, who can do much but not everything.


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Old 12-03-2010, 12:28 PM   #55
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physical therapy education and licensing has been interesting to follow over the last 40 years.

this is perhaps the most 'tightly' and successfully controlled discipline,

by their lobby/professional organization the apta.

the apta has long emphasized some of its 'labor union' function and quite successfully, when other health professionals were clueless.

they have always managed to keep the supply side TIGHT and thereby keep the demand high and help with the salary structure.

during periods of genuine shortages when other health fields were ENLARGING class size or boosting enrollment...

the apta and pt schools held fast to small classes.

that worked as planned and demand remains strong for graduates.

there MAY still be a shortage, but what really exists is a maldistribution.

with jobs in rural areas or in senior based facilities going un filled.

urban areas are pretty well stocked these days (except for some hospital/IN patient jobs which are no fun)

and we won't see 'foreign school graduates' or much in the way of 'alternative path' trainees filling the jobs.

again very tight control and lobbying has worked very well from within the organization.

the future looks very good for pt and it appears demand will continue to grow with the aging population....

IF the money and reimbursement (primarily medicare) can survive.
________

the current 'entry level' degree program is not a Ph. D. it is a DPT.

as in doctor of physical therapy...

Doctor of Physical Therapy - Wikipedia, the free encyclopedia

the terminology for the entry level degree has evolved from bachelors to masters to doctors...

but the Dpt is still the 'entry level' degree, one doesn't first get a B' or M' and then advance to a D' level sheep skin.

again this works to advance public perception of the qualifications and training required.

the actual curriculum has changed some but not to the extent one might think given the name applied to the degree.

it is still basically a 3 year training program with 7-8 month of clinical experience (so about 2 + years of academics.

this used to happen after about 2+ years of 'undergraduate' education but now a 4 year (bach' degree) is the starting point.
__________

traditionally pt was part of the 'allied health' fields which included...

occupational therapy, speech therapy, respiratory therapy, recreational therapy, social workers and so on...

for at least 20 years pt has worked HARD to not be included in that general classification...

the apta also has resisted getting lumped in with physicians assistants, or nurse practitioners, or pharmacy

or ANY field that must work under some other provider.

they've also worked hard to have all licensing, oversight and review done ONLY by other pts,

rather than the old daze when md types did the oversight.
________

the long term and primary goal has been parity with other direct providers...

think dentistry, podiatry, chiropractic, naturopathy and so on, where the provider is called 'doctor' instead of therapist.

terminology is so important and branding/degrees reflect this.

the goal is a public perception of PARITY with all those other doctors...

the fact is a 'doctorate in nursing' takes many more years to achieve and is much closer academically to the Ph.D. path.

this is basically REbranding within the PT field and adding SOME additional K/S/A to the curriculum.

dietitians have tried to follow a similar professional metamorphosis with the 'nutritionist' or food scientist rebranding.

it's all about public perceptions AND autonomy and ultimately direct access to patients and reimbursement (the ultimate goal)
_____________

within the PT umbrella, licensed physical therapists have long used a variety of assistants, aides, techs and so on...

because reimbursement has been so TIGHTLY linked to DIRECT patient care, boosting income historically meant 'treating more people'...

volume=hours=revenue.

so like anesthesiology, pt uses assistants (under their direct supervision) to TREAT more patients without direct 1-1 time limitations.

they leverage themselves and have been doing this successfully in the out patient and in patient setting for a long time.
__________

there was a time when basically CLUELESS doctors wrote "prescriptions" for physical therapy.

these docs with ZERO formal training in pt, who may have never been IN a pt clinic were expected to prescribe...

modality, frequency and duration of time spent with a therapist.

these same clueless md types were deciding WHEN to stop/start therapy,

which also impacted REVENUE for therapist and the success/failure of outcome FOR the patients.

within orthopedics many pts worked "under" a surgeon or in clinics that were part of doctor groups...

neither of these arrangements were professionally or financially satisfying for professionals trained in PT.

there were also concerns that the docs might be gaining financially by 'prescribing' the therapy.

PT financial growth and professional growth had ceilings and lead to high rates of BURN OUT...

many therapists simply left the field instead opting for equipment sales, long term facility management or other jobs.

so another goal of rebranding the profession and working toward parity is to keep folks TRAINED in pt, doing PT.

++++++

none of this has much/anything to do with the op,

it's good to read you (susan) survived the carpentry and remodel and the pain is better!

now best of luck with the most important part,

getting to a level of function that will allow enjoyment of streamin' and all things physical.

work hard, pain NOW is generally related to efforts at improvement, so keep pedaling and lifting and stretching!

((and where are the pictures of your new scars?))

cheers
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Old 12-03-2010, 12:42 PM   #56
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I wouldn't go to a paralegal for legal services unless there was close supervision by a lawyer. And I know how much anyone with a doctoral degree doesn't know. I also know some paralegals are not closely supervised. And having dealt with many lawyers, I know some of them are amazingly unprepared.

This makes me nervous about various assistants. I am sure some PTA's know more than a freshly minted Ph.D. when it comes to actually practicing. I know when I first got my law license, I felt ignorant of everything but arcane research. Then I found myself prosecuting slumlords in court and trying cases with no experience. That was scary. I am, from my own experience, skeptical about those with lack of experience. For the record, I won all those cases and managed not to wet my pants.

When I have a choice between a PA and an MD, I always pick the latter. Then I question the MD carefully about everything. Some docs like that, some hate it.

On the other hand, nonlicensed psychotherapists have as good or better outcomes as licensed ones according to research I was shown some years ago.

And I know that people can figure stuff out themselves if they apply themselves. When I had PT about 20 years ago for my back, the therapists had master's degrees—some were jerks, some were very good. There were some with bachelor's degrees, but they never worked on me. Selecting anyone for professional help has to do with experience, training, personality, sensitivity, and whether they are keeping up on things. If I know more than a doctor about a specific thing after I do a few hours research on the internet, then it's time to go elsewhere (I fired an internist early this year because of that plus his personality problems).

Which reminds me, I should go work out and torture myself (true self abuse). And, Maggie, how long did you work as a PTA?

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