Recruiting Forum Football Talk II

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#165,777
#165,777
volatil said:
Doc I have an interview with Orthopedic Group. I’ll be doing joint injections and go to surgery once a week with surgeon doing mainly joint replacement. I want this job.
Click to expand...

It’s an excellent type job. I would definitely find out what your oncall status will be. How often do you have to round on weekends, etc. Call is the unfun part...

Ask if they do PRP and Stem cell injections.
Ask for Ultrasound training (invaluable for musculoskeletal practices). It’s absolutely great for Baker’s cysts. Also for Suprapatellar recess injections (great for Synvisc One injections...otherwise they hurt). Many insurers require Synvisc for gel injections or I wouldn’t use it. >30% of people have a painful synovitis flare after Synvisc, whether it is the 3 series or One. Once I learned that, I just inject with 40 mg Kenalog whenever I have to use Synvisc. (Treatment for the reactive synovitis is a steroid shot). Have had zero synovitis flares since I started doing that. Ultrasound is also excellent for hip injections...office procedure and easier than fluoroscopy guidance. You can make plenty of diagnoses with Iltrasound as well. Invaluable for Piriformis injections (common problem after THA)

Use the smallest needle that you can for shots. I typically use a 25 gauge. Don’t ever use an 18 gauge, except to draw up the meds or to aspirate a potential Infected joint. (Or Baker’s Cyst). If you don’t draw up your injection meds, make sure that they don’t use the same needle to draw meds that you then use for the injection...dulls the needle and it hurts more. If you need to use bigger than a 25 gauge, then use the cold spray or put a lidocaine skin wheal. Always pull the skin taut before sticking the needle in, allows the sharp needle to slide through the skin rather than tearing a hole through loose skin...
I use a 22 or 20 gauge to inject the viscosupplementation gel. Easier to inject.

Once through the skin, advance the needle slowly. That way you don’t hit anything that you shouldn’t. Over time, you will be able to feel when you pass through the joint capsule... If the patient feels more than pressure, stop and redirect the needle slightly. Inject slowly and it shouldn’t hurt. If it hurts (not pressure) you are in something that you shouldn’t be (ligament, cartilage, etc). If it’s difficult to inject, you definitely are. That’s why I don’t use 18 gauge, you can inject into cartilage, ligament, and even bone with an 18 gauge...

That’s how I teach injections.
I hope that helps. Best advice that I ever got was to use the smallest possible needle...
 
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#165,778
#165,778
ChattaTNVol said:
Pruitt in his Friday presser was questioned in perhaps not so many words about how the team taking time off would affect his getting in a full fall camp before the season started. He replied that we were given ample time to start and it wasn’t like we were at the point where we were running out of time.

On August 17th when fall camp kicked off we had 40 days until the day before kickoff on September 26th. We were permitted to have 25 total preseason camp practices up to game day with a mandatory requirement for 2 off days per week. That was essentially a 6 week camp including game week. As a minimum we would be required to have 11 off days over the course of camp. We’ve completed 13 days of the 40 day period with 7 practices and 6 off days.

We have 18 permitted practices remaining and a minimum of 7 required off days remaining. We’ve taken at least 2 additional off days so far above and beyond those mandated for the first 13 days of camp but the mandated off days remaining remain. So at the start we had 25 practice days and 11 mandated off days which totaled to 36 days out of the 40 allocated for the preseason. We started with 4 days of total float and having thus far already used 2 of those float days we have 2 remaining, if we are to get in the full 18 days of allowable practices remaining.

In project controls we call schedule activities/tasks that have zero float “critical path”. Critical path activities attract a white hot spotlight. It often seems everybody everywhere is following critical path because if it slips it costs time and money, lots of money especially. Anyway, it is just as Pruitt says, we are not on critical path so no need for anyone to worry if there was anyone worrying. We still have 50% of our original float remaining. jmo.
Click to expand...

That's all true and you bring some good points, but I'm not certain that Pruitt even feels it's necessary to get to 25 preseason practices total.I would hope that no matter how many available practices there are we get at least 4 days off during game week which would mean we are already on the critical path.
 
#165,780
#165,780
VolsDoc81TX said:
It’s an excellent type job. I would definitely find out what your oncall status will be. How often do you have to round on weekends, etc. Call is the unfun part...

Ask if they do PRP and Stem cell injections.
Ask for Ultrasound training (invaluable for musculoskeletal practices). It’s absolutely great for Baker’s cysts. Also for Suprapatellar recess injections (great for Synvisc One injections...otherwise they hurt). Many insurers require Synvisc for gel injections or I wouldn’t use it. >30% of people have a painful synovitis flare after Synvisc, whether it is the 3 series or One. Once I learned that, I just inject with 40 mg Kenalog whenever I have to use Synvisc. (Treatment for the reactive synovitis is a steroid shot). Have had zero synovitis flares since I started doing that. Ultrasound is also excellent for hip injections...office procedure and easier than fluoroscopy guidance. You can make plenty of diagnoses with Iltrasound as well. Invaluable for Piriformis injections (common problem after THA)

Use the smallest needle that you can for shots. I typically use a 25 gauge. Don’t ever use an 18 gauge, except to draw up the meds or to aspirate a potential Infected joint. (Or Baker’s Cyst). If you don’t draw up your injection meds, make sure that they don’t use the same needle to draw meds that you then use for the injection...dulls the needle and it hurts more. If you need to use bigger than a 25 gauge, then use the cold spray or put a lidocaine skin wheal. Always pull the skin taut before sticking the needle in, allows the sharp needle to slide through the skin rather than tearing a hole through loose skin...
I use a 22 or 20 gauge to inject the viscosupplementation gel. Easier to inject.

Once through the skin, advance the needle slowly. That way you don’t hit anything that you shouldn’t. Over time, you will be able to feel when you pass through the joint capsule... If the patient feels more than pressure, stop and redirect the needle slightly. Inject slowly and it shouldn’t hurt. If it hurts (not pressure) you are in something that you shouldn’t be (ligament, cartilage, etc). If it’s difficult to inject, you definitely are. That’s why I don’t use 18 gauge, you can inject into cartilage, ligament, and even bone with an 18 gauge...

That’s how I teach injections.
I hope that helps. Best advice that I ever got was to use the smallest possible needle...
Click to expand...
Phone interview on Thursday, manager stated all injections are US guided. This is my dream job. I love procedures. Ortho and Cardiology have always been the goal. I have Hospitalist, Primary Care, Urgent, Acute Care experience. This would be icing on the cake for my career.

Thanks for the advice.
 
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#165,782
#165,782
volatil said:
Phone interview on Thursday, manager stated all injections are US guided. This is my dream job. I love procedures. Ortho and Cardiology have always been the goal. I have Hospitalist, Primary Care, Urgent, Acute Care experience. This would be icing on the cake for my career.

Thanks for the advice.
Click to expand...
Good luck man!
 
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#165,784
#165,784
volatil said:
Phone interview on Thursday, manager stated all injections are US guided. This is my dream job. I love procedures. Ortho and Cardiology have always been the goal. I have Hospitalist, Primary Care, Urgent, Acute Care experience. This would be icing on the cake for my career.

Thanks for the advice.
Click to expand...

AAPM&R puts on a great ultrasound course series.
Once pandemic settles down, look for a course put on by orthosono.com Usually in Vegas. I was supposed to teach at the next one, but it was canceled...

Stay away from MSKUS, put on and run by an arse...
 
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#165,788
#165,788
VolsDoc81TX said:
It’s an excellent type job. I would definitely find out what your oncall status will be. How often do you have to round on weekends, etc. Call is the unfun part...

Ask if they do PRP and Stem cell injections.
Ask for Ultrasound training (invaluable for musculoskeletal practices). It’s absolutely great for Baker’s cysts. Also for Suprapatellar recess injections (great for Synvisc One injections...otherwise they hurt). Many insurers require Synvisc for gel injections or I wouldn’t use it. >30% of people have a painful synovitis flare after Synvisc, whether it is the 3 series or One. Once I learned that, I just inject with 40 mg Kenalog whenever I have to use Synvisc. (Treatment for the reactive synovitis is a steroid shot). Have had zero synovitis flares since I started doing that. Ultrasound is also excellent for hip injections...office procedure and easier than fluoroscopy guidance. You can make plenty of diagnoses with Iltrasound as well. Invaluable for Piriformis injections (common problem after THA)

Use the smallest needle that you can for shots. I typically use a 25 gauge. Don’t ever use an 18 gauge, except to draw up the meds or to aspirate a potential Infected joint. (Or Baker’s Cyst). If you don’t draw up your injection meds, make sure that they don’t use the same needle to draw meds that you then use for the injection...dulls the needle and it hurts more. If you need to use bigger than a 25 gauge, then use the cold spray or put a lidocaine skin wheal. Always pull the skin taut before sticking the needle in, allows the sharp needle to slide through the skin rather than tearing a hole through loose skin...
I use a 22 or 20 gauge to inject the viscosupplementation gel. Easier to inject.

Once through the skin, advance the needle slowly. That way you don’t hit anything that you shouldn’t. Over time, you will be able to feel when you pass through the joint capsule... If the patient feels more than pressure, stop and redirect the needle slightly. Inject slowly and it shouldn’t hurt. If it hurts (not pressure) you are in something that you shouldn’t be (ligament, cartilage, etc). If it’s difficult to inject, you definitely are. That’s why I don’t use 18 gauge, you can inject into cartilage, ligament, and even bone with an 18 gauge...

That’s how I teach injections.
I hope that helps. Best advice that I ever got was to use the smallest possible needle...
Click to expand...
I stopped reading after about the second sentence, but it looks like great advice !!
 
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#165,794
#165,794
volatil said:
Doc I have an interview with Orthopedic Group. I’ll be doing joint injections and go to surgery once a week with surgeon doing mainly joint replacement. I want this job.
Click to expand...
Back in my day we used to just smoke the joints.

Now you young-uns are injecting it and getting replacements?

You hear this chit @TrippieRedd ?
 
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#165,795
#165,795
gordonr24 said:
Ja’Marr Chase opting out this season at LSU.
Click to expand...
I really wish we could have played them this year. They are going to have such a massive drop off after graduation, early entries, and opt outs. I think that’s the third or fourth starter opting out and they only returned 8 from last years team. Their offensive line has barely practiced because they have so many linemen in quarantine.
 
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