Vivian Chow

[Vivian Chow @vchows_triad]

Interventional pain management physician gave in-service today on use of nerve stimulators, sympathetic nerve blocks, & ketamine infusion therapy in CRPS & chronic pain. Also emphasized multidisciplinary approach & was excited to learn from PT&OT. Love interdisciplinary teamwork!

[Vivian Chow @vchows_triad]

51 y/o male w/ LBP & co-morbid dx of fetal alcohol syndrome. Mother in law says pt sometimes exaggerates symp for attention due to complicated social hx. Shifted tx from STM ➡️ exercise w/➕ encouragement relieved ALL of pt's pain! Remember to address psychosocial factors too!

[Vivian Chow @vchows_triad]

63 y/o female with dec c/s rotation & pain relieved by unloading shoulder girdle. However, STM UT last session did not improve pain or range. Tried up glides & SNAGs today & pt had over 15 deg inc in ROM. Impt reminder to consider PRIMARY limiting factor in a pt’s function! 🤓

[Vivian Chow @vchows_triad]

56 y/o presented for eval of neck & back pain, along with acute stabbing pain in anterior LLQ. Reported nausea & dark reddish urine for the last 2 days, but thought it was from SuperBeet supplements. Red flags & pain with visceral palpation led me to immediately refer out! 🚨

[Vivian Chow @vchows_triad]

Pt is a 13 y/o male s/p Salter Harris fx in Oct 2018. No pain but dec glute strength & significant movement coordination deficits with lunges & squats. Pt would like to return to football & running. Suggestions on how to approach his strengthening & exercise program? @JasonCozby

[Vivian Chow @vchows_triad]

44 y/o female hair & makeup stylist w/ chronic neck pain: (+)CRLF, hypomobile 1st rib, tight anterior scalenes & upper trap, numbness/tingling in both arms and hands with OH motions that is resolved with “shaking it out”. Double crush syndrome or something else? 🤔@JasonCozby

[Vivian Chow @vchows_triad]

55 y/o male evaled last week for LBP & LLE numbness. Notable findings: swayback posture, painful L/S ext, & dec core activation. HEP: focus on engaging core muscles when walking. Pt returned for 1st follow-up today & self-discharged due to complete pain relief! 👏🏼 @JasonCozby

[Vivian Chow @vchows_triad]

36 y/o pregnant female with localized R heel pain. Exam: ⬇️ sensation in S1 dermatome, R PF MMT 2/25, and no sx’s when sacroiliac belt used for gait. Turns out pregnancy ➡️ lumbopelvic instability ➡️ S1 nerve root impingement! Reminder to always consider the big picture!

[Vivian Chow @vchows_triad]

22 y/o male w/ fibromylagia and new onset of HAs, C/S radiculopathy, & TMJ pain. Discovered that forward head posture was the culprit behind his impairments: inc capital ext leading to tight subocciptals, compression of upper C/S nerve roots, & overused jaw muscles. @JasonCozby

[Vivian Chow @vchows_triad]

Memory & cognition might be impaired in patients with Alzheimer’s Disease but movement is not! Exercise can be preventative and potentially disease-modifying for these patients 🚶🏻‍♂️🏃🏻‍♀️ 🏊🏻‍♂️ 🚴🏻‍♀️👍🏼 #PT546week13 @juliehershberg @manjiridahdul

[Vivian Chow @vchows_triad]

Key points for managing CNS neuroplasms:
🚩 Recognize red flags
👀👃🏼👂🏼Neuro screen
🧠 Monitor post-surgery
♿️ Understand prognosis for recovery vs compensation
🚴🏼‍♀️ Exercise + rehab
👨‍👩‍👧‍👦 Emotional support for family
#PT546Week12 @juliehershberg @manjiridahdul

[Vivian Chow @vchows_triad]

Signs we should refer a patient to imaging after a concussion 🏈⚽️🥊🏂
📈 Progressing neuro symptoms
🤯 Severe headache
😴 Lethargy/unresponsiveness
👀 Cranial nerve involvement
🤮 Vomiting
🧠 Weakness & posturing reflexes
#PT546week11 @manjiridahdul

[SPINALpedia @SPINALpedia]

Finally a wheelchair emoji! https://t.co/DeEl5JT9c8

[Vivian Chow @vchows_triad]

First use SNOOPPPP signs to rule out secondary headache, then frequency, duration, and intensity of symptoms to determine specific headache disorder. Associated symptoms can include:
🤢 Nausea & vomiting
💡 Light sensitivity
🙉 Fear of loud sounds #PT546week10 @juliehershberg

[SPINALpedia @SPINALpedia]

RT @thetimes: A disabled Australian man is aiming to become the first paraplegic to reach base camp on Everest https://t.co/CQ14BJmnth #mondaymotivation

[Vivian Chow @vchows_triad]

Every 40 seconds, someone in the US has a stroke. That’s why it’s important to act FAST!
F: Facial drooping
A: Arm weakness or numbness
S: Speech difficulty
T: Time, call 9-1-1 ASAP! ⏱📞🚑🚨 #PT546week9 @juliehershberg

[Vivian Chow @vchows_triad]

Movement analysis can provide clues for identifying the type of cerebral palsy your patient has:
Spastic—inc tone & spasticity, impaired selective control
Dyskinetic—involuntary movement patterns
Ataxia—wide BOS & general instability
#PT546week9 @juliehershberg @bsargent_usc

[Vivian Chow @vchows_triad]

Keys to MS diagnosis 🔑
🧐 Clinical exam
⏱ DIT: symptoms at different times
🌌 DIS: damage in different spaces of the CNS
✂️ Lesions in MRI
➕ Positive oligoclonal bands in the CSF
🙅🏻‍♀️ And rule out other possible diagnoses
#PT546Week7 @juliehershberg

[Vivian Chow @vchows_triad]

@NoraDarakDPT @juliehershberg #CupidShuffle #ParkinsonShuffle 💃🏻🕺🏻

[Vivian Chow @vchows_triad]

Parkinson Shuffle:
Shake left, shake left, shake left, shake left
Shake right, shake right, shake right, shake right
Lean back, lean back, lean back, lean back
Now walk it by yourself, now walk it by yourself
Down down do your dance, do your dance #PT546Week6 @NoraDarakDPT