Sunday, August 24, 2014

Back home, survived my trip

I went to a three day course out of town- I had to go the day before because I took the train. It was kind of lonesome. I didn't stay at the couse hotel- I missed the deadline and it sold out- and I didn't go with anyone or know anyone there. I was surprised to find myself lonely. Usually I am a pretty solitary person.

It was a good course, it really was. But I am finding that I am starting to learn less in these courses as I know more. Still, it is good to repeat and reinforce what I know- or that is what I tell myself.

But I found myself thinking- again- that maybe I should be doing some kind of clinical research. The main instructor was talking about modalities, and pretty much debunking low level laser. Except that there are now higher power class 4 lasers on the market- and we have one of them. And the laser research meta-analyses generally do not control for the power of the laser or the dose received. And I think that our 10 Watt laser really work. I was very skeptical when I started- but I really see it work. And I said this. And so the instructor said that I should do the research to show that it works.

So I have to think about this and what it would involve. A case study wouldn't change anyone's mind. and you can't do a double blinded study, because you can feel the heat of the laser. The patient will know. So I have to look at some research designs. The thing is, we don't have a huge number of patients and I am the only full-time therapist- so I will be administering most of the treatments, which means that I won't be blinded either.

Actually what I have in mind is a randomization to either ultrasound or laser for some condition that we get enough of in a year that we could get a study out of it. But I don't know if it is worth doing if I, the evaluator, is the one doing the treatments and the evaluations and is not blinded. Would anyone publish it?

And then there are probably a lot of hospital regulations, research proposals and clearances, etc. It all gets very involved. The collecting of data and the data analysis would be easy (I was a statistics teaching assistant). Everything else would be hard.

When not thinking about research my mood was up and down. But- I was able to ask one of the docs teaching the course a clinical questions which put my mind at rest about a post-surgical patient I was very afraid I had pushed too hard the day before- it turns out she was in the safe zone (as I had thought but needed reassurance). Sometimes I really am too neurotic to be a hand therapist- I worry too much.

1 comment:

Unknown said...

I didn't even know lazers are being used as a modality. Far too specializaed for anything I've done. That's interesting and based on the latest I know about ultrasound it should be fairly easy to prove many things are better than that. (Although I had better results with certain conditions than the research would agree with so I don't know. I certainly won't turn down ultrasound if they want to do it in PT, at least not in the early weeks.)

I think it's amazing you managed to break into such a specialized field. I could never remember all that complicated anatomy, much less any of the rest of what you have to know.