Texas On My Mind

More snow has decided to fall on Philadelphia, threatening to ruin my plans once again. While I absolutely love the snow, I love Dallas and my family even more and just want to go to Texas this weekend. I am supposed to fly out this afternoon around 4:00. Yesterday, even when there was no snow in sight, Southwest cancelled all flights into and out of Philadelphia. Crazy! We don't even do that in Texas. It did snow all day and they were expecting winds gusting around 50-60 mph. Guess that wouldn't be the safest conditions to fly in. Yesterday was just a tough day because I was worried about not getting to Dallas. I am supposed to run the Cowtown Half Marathon on Saturday and I am just antsy to see my friends and family. (And to get my hair done!) There is now about an inch or so (maybe less, it's hard to tell from 14 stories up) of snow on the ground. That's nothing! I just checked Southwest and they have cancelled all morning flights to Dallas. Let's just hope that the don't decide to do the same to the afternoon.

Wipe Out

We had a blast yesterday at Blue Mountain! I snowboarded and then Jennifer and her friend Matt skied. It only took us about an hour and forty five minutes to get to the mountain. So close! I knew that I needed to take a lesson, so after we rented all of our things, I headed to the Valley Lodge for my lesson and they went skiing.

When I got to the school area, it was so packed. There were so many people learning how to both ski and snowboard. And they were most all way younger than me. They put about 6 of us in a group. I was the only girl, and the guys were probably all pre-teens and high schoolers. My teacher was also younger than me. They were probably thinking "who is this stupid girl who sucks? why did she have to be in our group". Our first drill was to first learn how to get into our snowboard. Got that one down. I did learn that I snowboard "goofy". That means that I put my right foot forward and my left foot back. "Regular" is the opposite way and what most people do. That's just awkward for me. Our next step was to learn how to skate (i think that's what it was called). We had to keep our front foot in our board and propel yourself across the ice. Then he taught us to put our back front on the back and skate and glide. Yeah, I pretty much sucked at both of those. I knew it was going to be a long day if I couldn't even get those two down.

We also learned how to walk up the hill with our board on one foot and then we got to practice falling. I think we all mastered that one pretty quick. It was then time to learn how to go down the hill. It was hard to keep yourself upright and I always wanted to keep my weight on my back foot which apparently is wrong. Well, I think I did a lot of things wrong all day. We practiced coming down the hill several times. Then he let us lose. Scary. I decided to stay on the bunny slopes to get the hang of it before meeting Jennifer and Matt. I don't think I even got the hang of it. But, after lunch, I went down the slopes with Jennifer. It probably took me an hour to get down. I would go a little ways and then crash. I just never felt in control. I would fall forward, I would fall backward. I would fall trying to get up. I just fell a lot. I felt bad that it was taking me forever to get anyway and Jennifer was skiing and then stopping to wait for me. At one point, I crashed on a turn. Well, I think I made some dude mad. As I was sitting there, I could hear Jennifer trying to get one of his friends to help me. Well, it turns out the dude that I made mad came over and helped me. He was very encouraging and helpful. Somewhat. It's hard to tell someone how to snowboard. You just do it. Plus, he's been doing this for 15 years. I tried to go a couple of times and fell hard. Right on my butt! It hurt so bad. Not only were my knees hurting and bruised, but now my butt hurt. There were a couple of times that I got going real well. Even made a turn. Then crashed! At least I was laughing every time I crashed. Even though I had more snow on my butt and face than was on the mountain, I was having a blast! I finally made it to the bottom. And in one piece.

After snowboarding for awhile I decided to go tubing. It looked like so much fun. You basically sit in a tube (much like the ones we use to float down the river in Texas) and slide down the mountain. There are people on each of the chutes that will push you down or even spin you. To get up the mountain, they have a magic carpet that will take you and your tube up. Apparently it hadn't been working earlier in the day, so people were having to walk up the mountain. Even after it started working, people were still walking, so that's what I decided to do. Much faster too. You didn't have to wait in line. It was a workout though! They had 5 area, two for single tubes and 2 for family tubes. There were then about 5 chutes per area. What was great is that they were pretty icy, so you could pick up some great speed. I was able to go down about 3 times. First I went down straight. The other two times I had the person helping at the top spin me. What fun! It went to fast and there were even some bumps along the way. I had never down anything like this and it was great!

After were were finished, we headed back to Philadelphia. On the way we decided to stop in Allentown for dinner. We wanted Mexican so we pulled out our phones and tried to find something. We ended up on the main drag of town and found some Columbian place. It was pretty authentic too. They hardly spoke English and we had a hard time deciphering the menu. I recognized one entree because my friends in Texas talk about it all the time: arroz con pollo. When it came out it was a HUGE plate! It's chicken and rice mixed together. It was really good. It also came with fried plantains. So yummy! It was so much food though. All of our plates were huge. Once we were satisfied, we headed back to the city. It wasn't the most comfortable ride either. My butt was really starting to hurt. I couldn't get comfortable. Every time I would move, it hurt. All I could think about was my half marathon next Saturday. Hope this heals up so that I can run.

All in all, a great Saturday! Something else to check off my list of things to do while I'm here.

Ordinary World

So, the weekend wasn't a total bust. Sunday I got up and went to church and then I was finally able to get a Zip Car and went shopping. I hit up Ikea, Pier 1, Target, and Super Fresh. I was able to get everything I needed (and plenty more). It was good just to get out and do something different. It's so hard not having a car that I can hop in and just go anywhere I want.

The rest of the afternoon and night was spent at Barnes and Noble (along with the rest of the city of Philadelphia) studying away. There are not many places in this small radius for people to go, get a cup of coffee and sit, so everyone ties to cram into every Starbucks and B&N. Everything was jam packed with people. Luckily I was able to grab the last remaining table. Good thing too, because I was on a roll. There are just days when I can sit and be so un-distracted and get so much reading accomplished. We had a lecture on Monday and I got all of that reading done, and we also had another lecture Wednesday, and I was able to finish that reading as well. I wasn't so lucky last night. I started reading up for next week's lecture and didn't have the same concentration. I read for about an hour and called it quits. I still have a week to get all of that done.

I spent today in the OR with one of our surgeons. I was able to see about 6 different procedures, none of which I had seen before. It was good to get away and see some of the cases that I will be treating when they come for follow up. We were finished around 2:30, so I had the afternoon off to do whatever I wanted. So I did absolutely nothing. It was great too! Not to many chances for that lately. Tomorrow we start back at square one with teaching at Jefferson. We have a new group of students and start over with teaching the three splints. Hopefully this group will be as good as my last group. I loved them!

As you can see, not much has been going on here. This Saturday I am going to the Poconos with Jennifer and one of her friends from back home. They are going to ski and I am going to learn how to snowboard. I have been wanting to do this for a few years now, and here's my chance. My mom shipped my ski clothes to me, so I'm all set. Hopefully I will come back in one piece.

Nothing I Can Do About It Now

So far, nothing has gone right this weekend. And it's only Saturday morning.

Last night, Jason was supposed to fly into Philadelphia for a long weekend. His flight was supposed to leave San Antonio at 2:45 and arrive here at 8:45. Well, clearly that didn't happen. His flight kept getting delayed which would mean he wouldn't make his connecting flight in Nashville and his was the last one out of Nashville. Even if he did make it there, he would have to wait until this morning to fly into Philadelphia. So we decided that he would cancel his flight and then plan to come with my parents in March. I don't know how many times I have said this, but I HATE the San Antonio airport. This isn't the first time that it has been involved in ruined plans. It's the end of the line, so if planes can't get there, they can't fly out either. Boo on San Antonio!

Since Jason wasn't coming, I decided to get a ZipCar and go to Target and the grocery store. It's a lot easier to drive down to the river to the larger stores than try to walk to South St. and carry everything home. I reserved a car for 8:30 and went to where it was parked. I got in, started the car, put it in reverse and all I heard were the tires just spinning. It was stuck in ice! So I grabbed the ice scraper and decided to try and break up some of the ice. Well, instead of cutting up some of the ice, I cut my hand. My biggest fear while I'm here doing this hand therapy fellowship is that I will get a hand injury and have to go to the ER to have one of our docs fix my hand. Luckily the ice scraper only cut the palm a little bit but it sure was a bleeder. There were snow near by, clearly, so I just stuck my hand on that. I tried several times more to get the car out, but no luck. So I sat on hold with ZipCar for about 10 minutes. Finally some lady was able to help me and she said that I wouldn't be charged for the car. Thank goodness!

So, I walked back home to spend another night doing absolutely nothing. It's getting real old! I feel like I don't get to interact with anyone except for people I work with, my patients, and the doorman. I was so looking forward to Jason being here and being able to go out and do something. Tonight we were supposed to go on a ghost tour of Philadelphia. I did ask my co-worker, Jason, and he might go with me. If not, I guess I'll go do that on my own as well. Yes, I'm having a pity party!

This morning I was also supposed to go work out with Lance at 10. I was running late, so I texted him on my way to the gym. Right as I'm about to turn the corner to the gym, he calls to tell me that he overslept. So, no workout today. Boo! It's alright though. I actually didn't feel like working out today. So, everything I had planned for this weekend has gone down the drain. Next weekend we are planning on going to Blue Mountain to ski and snowboard. Let's see if that happens!

In other news...yesterday was the last class for Session 1 of splinting. My students were making a resting hand splint. They had to use a tough material, but many of their splints looked really good. Even better than some of the earlier ones. Here are a few pictures of my class.

Break Me Out

So yesterday was a snow day and today I didn't have to go into work until 10. I was able to get so much done yesterday, but it was so nice to be able to leave my apartment today. This morning the sun was shining but there was still lots of snow on the ground. It was so pretty! I enjoyed my short walk to work this morning. We weren't anticipating on seeing too many patients today. We had about 8 actually show up. So, to fill our time, Lauren had Jennifer and me make the Radial Never Palsy Splint. It was actually a fun splint to make. A little tedious at times, and I was thinking it was going to be really ugly, but it turned out well. It's a splint for a pretty devastating injury, but they say it helps so much.

Tomorrow is my last class for the first round of splinting lab. I have had these students for 4 weeks, so I decided to make brownies for them tomorrow. I of course did not have any of the ingredients so I had to trudge to the store in all of the snow. I actually enjoyed the walk as the snow just makes everything so gorgeous. These are pictures from my walk tonight.

This is how a patient would present with a radial nerve palsy. The would not be able to actively extend their fingers or wrist. So the splint works to hold them in extension but allow for active flexion against the elastic straps around the fingers.

Let it Snow! Let it Snow! Let it Snow!

Guess who had the day off today?! That's right, we had a snow day today!

All day Monday people at work were talking about the coming snow and getting all worried. Being from Texas, I have to say people go a little overboard when it snows there. I always though that people in the northeast kept it a little more together than those in the south. I was wrong. By 11:00 yesterday (Tuesday), the administrators of the hand center had already cancelled work for today (Wednesday). Even schools and businesses in Texas don't do that! They were acting like a blizzard was headed our way. But, I won't argue with them. I'll take a snow day any day, especially since Wednesday is my longest day to be at work.

Last night I was to meet with Lance. I needed to get in a good run, so I headed to the gym a little early. Well, every member of the gym must have had the same idea as me because every treadmill and elliptical was taken. Boo! So, I had to take it to the streets, well sidewalks. I was in shorts but at least had my jacket. I was about 1/4 mile into my run and it started snowing. I couldn't believe it. At first it was just a little snow. Then it just started coming down. I had about 40 minutes to run and I wasn't going to let a little snow get in my way. I sure did get a few crazy looks though. I can say that was a first though...running in shorts while it's snowing. After my run I had another tough but great workout with Lance and then I headed home. By now, it was really snowing and starting to accumulate on the ground. So pretty!

This morning when I woke up, there wasn't too much snow on the ground and it wasn't snowing. But as the day went on, it really started to snow and fewer and fewer cars were on the road. I wanted to venture to the Art Museum, but nobody wanted to go with me and I wasn't too keen on the 2 1/2 mile walk. So, I've stayed in and studied, cleaned, and gotten lots done. Sometimes you just need a day like that. Oh, and I just got a text that said we don't have to be at work until 10:00 tomorrow. Yay!!!

Ain't Nothin' Like

Yesterday I got to finally experience a big snow fall. Yes, it snows in Texas, just not like this. And it also doesn't last. It snowed a little over a foot or so and it was gorgeous! I figured I wouldn't see this much again, so I decided to go walk around. I was probably gone for about 3 and a half hours. I walked from my place to Old City to see Independence Hall. I then walked toward City Hall and JFK Plaza. I could see the Art Museum in the far distance and it looked like there were a lot of people standing on the steps. I couldn't figure out what they were doing. As I started walking that way, these guys walked by with their sleds and made some comment about there already being a lot of people on the steps. They were totally sledding down the museum steps! I would have never thought of that!!! I had to see this! There were so many people there and they were using all sorts of things to sled with. Some had plastic discs, some had actual sleds and some were even using plastic storage lids. The best though were the snowboarders. They were actually snowboarding dow the steps and had even built a ramp to jump over. I was amazed! We definitely don't do that in Texas! I'm sorry I missed out on it. But you better believe that if it snows again I will be out there sledding down the steps!

What surprised me while I was walking around was how few people were around and everything was closed. I always hear that people in the south just don't know how to handle snow and ice so everything is closed and no one wants to get out. Well, it's no different here. I was going to study at Starbucks, but every Starbucks in the city was closed. As were Barnes and Noble and Borders. I couldn't believe it. So I got absolutely nothing done yesterday, but I was able to enjoy the day of snow.

City Hall

The Parkway

The Philadelphia Art Museum

That dog looks ridiculous!

Winter Wonderland

It's snowing!!!! Like, a lot! It's gorgeous outside. All week my patients and coworkers have been talking about all the snow that is coming this weekend. Well, it's here! Tonight Jennifer, Teresa and myself headed down to Penn's Landing to go ice skating on the outdoor rink. It's right by the Delware River with the Ben Franklin bridge and New Jersey in the background. Best part was that it started snowing right as we were getting on the ice. We couldn't have asked for a better time to go ice skating. There's just something about skating while it's snowing. It makes it legit. In Texas we ice skate in malls. This is like hard core northern skating.

Teresa, Jennifer and me

Jennifer and Me

So that was my fun for the weekend. Now it's time to study. I'm meeting Lance in the morning at 8:30, then I'm hitting the books. I have quite a bit to read to try and catch up. Next weekend Jason, my brother, is coming for a visit. I can't wait to show him my new city. There is so much to see and do and I just hope we can get some of it in while he's here. He's crazy! He wants to come in the winter while it's really cold, and then also when it warms up. Living in San Antonio, he doesn't get much of a winter. Well, he's gonna experience it here. The weekend after that...I'm going to the Poconos!!!!!! I have only skied once in my life but now I want to snowboard. There's a resort about an hour and a half from Philly and they have a great school to learn how to snowboard. So, I think Jennifer and myself are going to venture up there. Jason (co-worker) and some of his friends might come along too. I'm sooooo excited! When else will I get to ski/snowboard in the Poconos?!

Put Up or Shut Up

Why do people have to be difficult? I was having a relatively nice day. I treated a couple of patients yesterday morning and then was on splints in the afternoon with Dave. They want us to try making a long arm splint so, when the next one came over, it was mine. This isn't a splint we commonly make. I actually make more of them at Scottish Rite with our arthrogryposis patients than I do here. They are also a lot easier on kids. With adults, there is so much material you have to work with, it becomes quite a mess. Well, yesterday afternoon we had a patient who needed a long arm splint, so Dave let me work on this splint. All by myself. In fact, he was halfway across the room when I made it. Scary! It also didn't help that the patient was rather difficult. Not the worst, but she could have been a little more helpful. Her first question to me was "do you need my hand for this?". Um, no ma'am I can just imagine how your arm will fit in this splint and make it. YES, I need you here for this! She then kept asking me when I would be finished. And while I know I am slower than the CHT's, it is a labor intensive splint and takes some time. Well, it was looking good on her arm, except it wasn't long enough on her humerus. But, Dave came in to save the day and we added a piece to the back. Not the prettiest splint, but it got that lady on her way. Hopefully I will get another chance to make one and it won't be a disaster.

I was a little drained after that one. The next splint I made was for a guy who amputated the tip of his finger. It was an easy cap splint made of Aquaplast. Easy peasy! But then the absolute worst. I had to make a thumb spica for a patient that was not going to be happy no matter what. And she wasn't. Luckily Dave was there and could intercede. I was so frustrated with this woman and I was doing exactly what the doctor ordered but she just wasn't having it. I probably spent over and hour trying to make this lady happy. Finally I let Dave finish it. I had had enough!

To top it all off, Wednesdays are our long days. We actually were finished by 8:00 and got to practice the splint we are teaching tomorrow. We had a kid come over who was born with a diagnosis that I commonly see at TSRH. It was fun to work with him. He just needed a thumb spica though. The only difference with here and TSRH is that if he were at TSRH, I would have put him in a neoprene (soft) splint. But it was good practice to make this splint on him.

The splint of the day was the Sugartong. It is quite an ugly spint but one that we will be making a lot of for one specific doctor. This is my rendition. It was made on Dave, but I had to use Jason to model it.







Dave then made this hand based radial gutter on a patient and they were nice enough to get a picture for me. This is a fun one to make, but can be challenging too.





Tomorrow is our thrid class to teach and we are making the hand based thumb spica. Hopefully it won't be too bad and they will do as well as they did last week. We are also going ice skating tomorrow. There is an outdoor skating rink down by the Delaware River. It's going to be so cold, but I can't wait!

With My Own Two Hands

Since I can't really take pictures of what I do on a daily basis (major HIPAA violation) I thought I would show you a few of the splints I made recently. I am putting together a book of all of the patterns and pictures of the splints I am learning. I will then have that to take back to Texas with me and reference as needed. These three splints were not made on actual patients. Although I did get to make my first forearm based ulnar gutter on a patient today. It turned out great, too!

This is a Clam Shell/Bivalve Wrist Splint. It combines the first splint we made (volar wrist splint) and then you add the dorsal component for added stability. The top piece locks in place on the bottom piece. I think this is a fun one to make because the top piece just snaps right into place.

This is a hand based fracture brace/clam shell. It is low profile and usually used for athletes that have a mid-metacarpal shaft fracture. It allows them to return to sports but be able to wear the splint under their glove or whatever. Pretty basic splint.

This is a finger belly splint. It is used to stretch a PIP flexion contracture. I don't think it's the prettiest of splints, but it's good at reducing the amount of PIP flexion.





We have a list of splints that we will be making and we are about 1/4 of the way through. That's pretty amazing considering we are only on our fifth week here. I will hopefully be taking more pictures of the splints we make.

Update on my abs...They are feeling much better, but still sore. I worked out again with Lance tonight and told him about my abs. He told me that I would be happy to know that we would not be doing abs tonight. Phew! He did try to kill my legs though. He asked me if I was sore anywhere else after our workouts and I told him mainly in my arms. I think he was a little sad that I wasn't sore in my legs. So, I think that is going to be his goal now. Tonight he had me do pull ups (assisted with the machine. there's no way I could pull my body weight up. never have been able to!). He also had me do dips, but that was killing my shoulder. My own fault though since I haven't exactly been doing my rehab since surgery. Surprise, surprise! After doing arms, I did a hamstring curl/hip extension exercise using a stability ball. It was tough! But, before we started Lance was positioning my legs. I could tell he was just staring at my legs and then I realized what he was looking at. He noticed all of my scars from softball/falling while running/falling off my bike. How embarrassing! He just kind of chuckled and said he figured I was an aggressive athlete with all of these scars. No Lance, I just haven't learned to not slide and how to stay on two feet. The last set of exercises he had me do was walking lunges, then go immediately into an incline leg press/squat. It was so tough and I was so scared of the machine. I was very hesitant to go into a deep squat. I did that each three times and by the end, my legs were worn out. He really is on a mission to give my legs a good workout. Although, he did say since I'm doing a lot of running, my legs are able to recover a lot faster. We will see how I feel tomorrow!

Alright, I'm off to bed. Wednesdays are long for us. Conference at 6:30 and clinic until at least 9:00 tomorrow night. But, it gives us more time to practice out splints!

Hard Core Troubadour

So far week 5 has been good. Mondays at the Hand Center can be a little stressful, but today was a good day. Not too busy, no drama, etc. We even got out of there a little early. Nice way to end a Monday. I decided that since Tuesday nights are reserved for my runs and workout with Lance, I figured I must do some studying tonight. So, I headed down the street to Starbucks. I was in a groove, getting quite a bit of studying done. That is until I was interrupted by the Barista telling me that they would be closing in 5 minutes. I looked at my watch and it was 8:55. Seriously, you close at 9:00. In Dallas, they wouldn't close for at least another two hours. I looked up all of the Starbucks in Philadelphia and they all close at 9:00. How sorry is that!

I figured since I wouldn't get in a workout tonight that I might as well get up before work and go for a swim. I woke up at 4:45 hoping to get to the gym around 5. I arrived around 5:15 to find that the gym didn't open until 5:30. That means I only would be able to swim for 30 minutes before having to get ready for work. That was quite all right after the way I was feeling. I seriously think I strained, if not tore, an abdominal muscle. I have never experienced this kind of pain before. I have been doing some different ab workouts with Lance and was feeling great until yesterday. It's even worse today. While swimming, I pulled myself out of the pool to get my kickboard and just about died. I had a really hard time swimming after that. Every time I cough, sneeze, laugh, lie down, or do any other movement that my abs have to work, my stomach kills me. I am working out with Lance again tomorrow so hopefully this will be better by then. There really is no treatment either, other than rest and I don't want to do that. Imagine that! Hopefully tomorrow's workout won't be so focused on core.