Announcement

Collapse
No announcement yet.

The Edge of the Spoon

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Barrett Dorko
    replied
    Hello,

    This active board quickly buried this thread ad I wanted it revived in light of my recent questions.

    Any takers?

    Leave a comment:


  • Barrett Dorko
    replied
    I just re-read this thread and find it a wonderful example of what might be accomplished by a group of therapists devoted to learning and sharing. I think I got more than I bargained for and have had to revisit some of the links provided as well.

    One question: When considering the origin of ectopic discharge and its management, is it fair to say that this will be manifest quite commonly as a tender spot, painful to palpation, likely to elicit spreading pain and often thought to be a local muscular "lesion" or dysfunction of the spindle? Do we know that it's more likely to be an abnormal impulse generating site (AIG)? Can we say that an accurate deep model includes a nervous membrane that has developed adreno-sensitive ion channels?

    Also: What exactly is the difference between transduction and transmission?

    I actually know some of these "edges" but also know that I can speak of them with more confidence and evidence at my fingertips if we consider all of this here. It will also provide another even more useful link for my poor future students.

    Leave a comment:


  • Jason Silvernail
    replied
    Chance, those are good links eric posted.
    Four origins - central sensitization, ectopic discharge, mechanical deformation, chemical irritation (thermal included here)
    Two mechanisms- central and peripheral

    Obviously overlap of these is the rule, not the exception here.

    Leave a comment:


  • EricM
    replied
    Hi Chance,
    I think you'll find some answers to these questions in these two threads:
    5 questions
    Consensus on Pain

    Leave a comment:


  • Chancellor Mobley
    replied
    I can now say, "When the patient is complaining of pain there are four origins and two mechanisms to consider. If you know nothing of these or what they represent it isn't because neuroscience hasn't taught us - it may be because you have yet to read it. Let's begin..." Barrett Dorko
    Barrett, would you mind expounding here. I've been reading a bit, yet it seems there is always more. Obviously, I could have missed something. Here is my simplistic version of what I have garnered with regards to the pain experience. I was thinking that there was one origin of pain and that that was the Nervous System. Within the origin of the N.S. I see that there are two states of reference, the central and peripheral one. Through the concert and mechanisms of these two the pain experience arises.


    With regards to the mechanisms, I am less clear. Barrett, when you speak of the two mechanisms to consider are you referring to the central and peripheral nervous systems and when you speak of the four origins are you speaking of the types of nociception within the P.N.S.(mechanical, chemical,and thermal)? If yes is the answer to the later half of my question, then I am still wondering what you may be referring to as one of the four origins? Regardless, I may be confused with my understanding of 'mechanism' and how it is being used in relationship to CNS and PNS or just off the mark. For me, it seems that nociception may be better defined as a mechanism within the PNS. Any help clearing my muddy waters would be appreciated.


    Chance

    Leave a comment:


  • Mary C
    replied
    What does a rank and file PT get?

    Leave a comment:


  • nari
    replied
    What kind of complaints are they making at the NS school? Is that due to lowered entry scores?
    Our top salary (for head of a hospital department of about 35 PTs) is around 110K, and the AU$ pretty well matches the CA$...most of the time. For someone who is a supervisor of an area, say Outpatients, the salary is around $76K. No overtime is paid in excess of 37.5 hrs/wk, but days off in lieu can be accrued, as well as a set 1 day a month off on full pay.

    Nari

    Leave a comment:


  • Mary C
    replied
    I used to be hard to get into physio here, too. Now the local school in Nova Scotia is complaining about the quality of recruits. Might have something to do with the lack of competitive salaries. The top in New Brunswick is 63K for 37.5 hrs/wk

    Leave a comment:


  • nari
    replied
    One doesn't have to know anything about the origin of a river to appreciate (or hate) its beauty and its dangers. However, to know about its origin adds to the appreciation of its effects on the land and people, and how its existence is very dependent on its origin.
    The origin/s of pain are crucial to know with respect to understanding something about its management. It's different from a something like a river, but there are similarities.

    There are so many people hanging out to do physiotherapy in Aust. that it is one of the few most difficult courses to get into. (One has to be in the top 2% when leaving secondary school). I'm not sure that's a good thing altogether.

    Nari

    Leave a comment:


  • John W
    replied
    Hey, Jon,

    What do you mean that I "may" be right?

    I don't think we'll be able to change the character of the users and exploiters. They are what they are. But I think it's possible to convince those who think it's too hard to embrace the change that comes with the neurobiological revolution that it could actually make their professional lives not only more interesting and rewarding, but in many ways less difficult.

    At least, that's been my experience. Once I got past being pissed off for getting gypped by my PT school, and buckled down for about a year and half and started reading about pain, I experienced a sense of freedom form the connective tissue morass that I'd become trapped in. My hands and my own nervous system felt a tremendous sense of relief from that inscrutable pile of nonsense.

    The other big issue is one of demoralization on the part of many earnest, yet frustrated, health care providers. This is a health care system-wide problem that affects all providers and is running off a good many physicians, nurses and PTs.

    I know some of those good, earnest PTs who wouldn't dare recommend that their kids go into this field- not the way things are now. What a shame and a waste.

    Leave a comment:


  • bobmfrptx
    replied
    Why would you believe I misinterpreted your statements?
    Having the courage and vision to undergo a journey without predetermined beliefs AND the knowledge to differentiate, process and grasp new evidence along the way is a must for anyones profession to grow. Appreciating the new scenery and magnitude of events along the way from several perspectives leads to more gratified senses and sensibilities. Watch out for Ijun Joe.

    Leave a comment:


  • Jon Newman
    replied
    Hi John,

    They don't want to embark on a journey that requires subservience of self and self-seeking motives. It's just too hard or too threatening to their egos and beliefs.
    You may be right. What can we do to make it easier or less threatening? If the answer is nothing then where else can we focus our energy?

    Leave a comment:


  • John W
    replied
    Floating down the river, I was struck by the timeless quality of the day. Without my watch the “current” events (pun intended) were intensified because they all involved “body time.”
    -Barrett Dorko from "On the River"

    And afterwards we would watch the lonesomeness of the river, and kind of lazy along, and by-and-by lazy off to sleep...So we would put in the day, lazying around, listening to the stillness.
    -Huck Finn from The Adventures of Huckleberry Finn

    I emphatically rest my case that Barrett Dorko is the modern day Huck Finn of PT!
    (Thanks, Eric.)

    Leave a comment:


  • EricM
    replied
    It probably won't surprise anyone that the river metaphor has been considered before now.
    On the River.
    Tributary part 1, part 2
    As two rivers meet.
    Last edited by EricM; 08-09-2008, 09:02 PM.

    Leave a comment:


  • John W
    replied
    Nick,
    I can assure you that no insult was intended in the comparison. Quite the contrary. And I think Barrett, whose literary breadth is wide and deep as far as I can tell, gets it. It is no small feat to appreciate the power and beauty of a river.

    Twain knew that heroism comes in all shapes, sizes, dialects and levels of formal education. But it doesn't come often.

    In Barrett's case, in addition to Huck Finn, I'd throw in a little Rodney Dangerfield with a smattering of Hemingway.

    Whether this is a tragic play is yet to be determined, and likely depends on those of us watching and perhaps choosing to participate in it.

    P.S.
    I just read the forgotten shoe thread that you referenced, and I rest my case: Barrett Dorko is Huck Finn. He just didn't know it at the time.
    Last edited by John W; 08-09-2008, 08:26 PM. Reason: added P.S.

    Leave a comment:

Working...
X