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Moehass
Boulder climber
Laguna Beach
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Topic Author's Reply - Oct 8, 2015 - 02:19pm PT
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Jim, thank you for sharing. This goes to show there's always a better way, we just have to find it.
Bad wife, the simmering serves to get all the collagen/connective tissue out and in a bioavailable form, right? So something like collagen hydrolysate from Vital Proteins would be just as good, right? Feel free to pm me your thoughts if there is a thing on this forum about endorsing commercial brands...etc
Frozenwaterfalls, what do u mean by 'reduce' here? Relocate?
Also and forced them to give me a visit with him , He wrote a note for me so I could go out of plan those are formidable feats, I didn't think that was even possible, how did you do it? I mean how did you build your argument? What did you say?....etc.
Obviously I suck when it comes to dealing with insurance
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Moehass
Boulder climber
Laguna Beach
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Topic Author's Reply - Oct 8, 2015 - 05:07pm PT
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Also, Frozenwaterfalls, it would be great if you can go into the details of what techniques and methods were used by both pts.
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Frozenwaterfalls
Ice climber
California
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Reduce is to put the bones in the joint back where they belong. Not sure why it is called reducing a dislocation but that is what I was always taught (in WRF and such...) My foot was at about 90 degrees of where it should be. Was pretty obvious something was dislocated and adrenaline and pain made me want it back in place pretty quickly!
As for getting a different opinion, Kaiser is a big pain to be sure. Not only do they want you to only see Kaiser doctors but only ones for the location that your GP is at. And some are more open to you getting a second opinion than others. I looked through their directory of orthopedic surgeons and found one with excellent credentials at the Walnut Creek location (I normally go to the Oakland location). Caveat is I did research in the bone implant field so I know a lot of the academic societies and organizations folks belong to so I could judge that this doctor should be pretty good. I then had to talk with my GP and explain the situation and she was willing to file a whole bunch of paperwork for me in order for me to get an appointment with him. Was a pain for me and a pain for her, but the risk of not getting a good diagnosis was worth the effort. Plus I have an excellent GP who was willing to do this for me.
As for the outside of Kaiser referral, the PTs would not see me without a doctor's note, irrespective of who was going to do the paying. But the orthopedic doc was the first to say that I would get better care outside of Kaiser for sports medicine issues so after we went over my MRI and x-ray results, he was more than happy to write the letter. Mind you, I had to pay for all my PT out of pocket at $80 a visit (whereas it was only a $10 co-pay at Kaiser) but $10 for nothing versus about 5-6 weeks of intensive PT (2-3 times a week for 1.5 hrs) getting me back to almost normal was worth it to me. It was a big expense I hadn't planned on, but therapy for going insane because it was really painful to even walk would probably be more expensive :).
Unfortunately, if you have an HMO, a lot of the time you have to be a very strong advocate for yourself. I am not sure how hard it is to go to a doctor/PT who is not on the list for a PPO or other insurance. Just keep asking questions and if you don't understand a policy or want a second opinion, don't be afraid to ask for clarification. It's your health! Fight for it as much as your fight for that final sloper on the top out :).
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Frozenwaterfalls
Ice climber
California
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Ahhh...been a while, but for the Kaiser PT they just did a few rotational movements while I was there with the PT (once a week) and then gave me a rubber band sort of thing and had me do rotational movements with it for resistance when I got home. Rotational range of motion and strength really did not seem to be my issue, but I am not a PT so I followed the instructions religiously with little benefit.
At my good PT, she first had me do a series of duck walks and other movements so she could see how I was compensating for the lack of rotation of my ankle and heel. Since I couldn't really bend my foot well (required me to hike on my toes when going even relatively gentle uphills), I was compensating by turning my hips out and other weird things. When I went in to PT I had to do a lot of flexion forward and back as well as balancing on one foot and rotating my body forward and back and side to side to try to get my proprioception back. I also did these sliding exercises where I stood with my feet planted and then slid one foot forward as far as I could. I could really see the difference as I got more and more flexibility back in my foot in how far I could slide my foot along the floor. Also toe raises to strengthen my foot in general. These were the later stage exercises and I had some in the earlier stages that I am forgetting. heck, I am forgetting a lot of them I am sure, but basically my PT asked me point blank when I told her about the rotational exercises against the resistance of the elastic band I had been doing what movement exactly in my natural motion does that mimic and strengthen? I had no answer...
I am sure that these descriptions make no sense whatsoever. I had pictures drawn for me and demos at PT so I could figure them out :). But really the big difference was my good PT had me do also sorts of walking around and other movements so she could see what the issue with movement was and could come up with a plan to fix it. Rather than "ankle/heel issues - see page 32 of generic PT protocol" which I had at Kaiser. They are not known for sports medicine PT there...
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Moehass
Boulder climber
Laguna Beach
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Topic Author's Reply - Oct 9, 2015 - 04:18pm PT
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Frozenwaterfalls, I think I'm in good hands, but one never can be too sure. Thank you very much for sharing
Everybody, I broke my initial recovery strategy down to three convergent aspects:
A. Proper* reduction of disruptive scar tissue.
B. Proper* restructuring and mobilization of newly modeled tissue or reformed tissue.
C. Proper* restoration and re-activation of proprioceptive function.
What do y'all think?
*Proper: employs Rapid Feedback Loop; aggressive and ambitous, but not hasty or wreckless.
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Moehass
Boulder climber
Laguna Beach
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Topic Author's Reply - Oct 15, 2015 - 01:01pm PT
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Got out of the splint few days ago. The boot fits a little differently with slightly more dorsiflexion, so it caused a little discomfort at first.
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