IN THIS ISSUE
AUGUST 2019
Clinician’s Corner by Stephen Strong Understanding Persistent Postural-Perceptual Dizziness
WOW! THAT’S A LOT OF MEETINGS... The 2019 mid-year meetings have officially concluded. On Thursday July 30th at 5 PM we wrapped up our 233rd meeting with PTSMC’s partners and directors! This year we averaged 77 meetings a day over three very full days. I know it sounds crazy, however, I The final mid-years group on July 30th. think it was great. This year we hosted two groups of seven and one group of nine PTSMC leaders. to our efforts? Did we do a good job for the communiWe enjoyed breakfast together at 7 AM and then off ties we serve? What can we improve upon? Are we to the races. The format resembled a slow version of improving the quality of people’s lives? speed dating. Each partner and director are scheduled for ten twenty-five minute meetings with The conclusion of the 2019 mid-year meetings left me members of the Admin team. One-on-one time was energized and confident. I am extremely impressed spent with every department including: Accounting, with what we have been able to accomplish through the Business Development, Community Development, half way point. We have been busy and our people are Facilities, Human Resources, Marketing, Operations, stepping up to meet the challenge. and a Partner meeting with me. I am also confident. Confident that every partner and A horn sounded at the conclusion of each twenty-five PTSMC employee is focused to deliver on our PT for Life minute segment and the Admin building took on the culture. Improving the quality of our patients’ lives and air of high school as everyone hit the hallways our people’s lives by providing unmatched experiences, looking for their next stop. We concluded each day clinical excellence, and lifelong relationships is who we with a “full-group” meeting and team building. are and what we do. I really enjoy the mid-year meetings. They offer a great opportunity to reflect on the challenges and successes of the first six months. How are PTSMC’s people? How does our leadership feel about the first half of the year? How are our customers responding
Our work, your work, is changing lives for the better. Thanks for all you do. Alan
PTSMC Family Picnic on August 18th The PTSMC Family Picnic August 18, 2019 11 am - 5 pm Holiday Hill 43 Candee Road Prospect, CT 06712 Invitations should have been received in the via inter office or snail mail. RSVP to your clinic point person by August 7th. Get ready for a fun day that includes a cornhole tournament, breakfast and lunch buffets, refreshments, pool, kickball, volleyball, basketball, badminton, tennis, mini golf, kids activities and much more! If you have any questions, please reach out to Mallory or Emily!
HR Buzz November and December Vacation Requests 2019 Vacation Schedule The Extra Mile Optimize Your PTSMC Welcome Center PTSMC Health Insurance Wellness Resources
StriveHub Fab 5
“Fred Havlicek is a knowledgeable and skilled therapist. All the support staff - from the receptionists to the assistant therapists are personable, helpful, and skilled at what they do. Overall, a great experience. I will (and have) highly recommend them to my friends, family and associates.” - New Haven “Excellent care & friendly environment! Joe treated my knee, back & elbow with great success! Both Joe (Caligiuri) and Ariel (Toth) prepared me to continue my strengthening and stretching that has helped me greatly. Liz (Walton) was always friendly and helpful when coming in for my appointments. Thank you all so much!” - Naugatuck “Friendly front desk staff. Friendly and committed PT staff. Activities are always well coordinated, professional, and individualized. Highly recommend!” - Westbrook “Excellent facility - clean ,well run, organized, cutting edge. Excellent staff - the time they take to fix the problem is worth it. It works! Nick (Almonte) is the best.” - Orange “The whole environment at PTSMC was a dream come true. I was originally referred by my friend because she experienced great results with her physical therapy. But, on top of that, they added a big touch of care and personality. My injury immediately begin to recover with their help. Tom (Kassan) is awesome!” - West Hartford
CLINICIAN’S CORNER
UNDERSTANDING PERSISTENT POSTURAL-PERCEPTUAL DIZZINESS By Stephen Strong, PT, DPT from Groton & Newington
Since beginning my time as a therapist for PTSMC, I have had the chance to study and practice my vestibular rehabilitation skills. Although we primarily see lower-moderate complexity vestibular cases, it is painfully true that not everyone is your “run-of-the-mill” BPPV case, and usually the more complex cases take a lot more research and creativity to ensure the best outcome. I recently experienced one of those unique cases. “Henry” presented to the clinic with a script that read “Vertigo.” Due to the lack of answers Henry received from other medical professionals, he did his own research to validate how he was feeling. All of his own research was done prior to attending physical therapy. Although we often frown on the idea of “Web-MDing” ourselves, what Henry found as a possible diagnosis seemed very plausible. Henry believes he has Persistent Postural-Perceptual Dizziness, or PPPD for short. PPPD is often characterized by “dizziness that is made worse while in an upright posture and with complex visual stimuli accompanied with the feeling of falling but without noticeable unsteadiness or any other neurological findings.” 1 Symptoms often “follow an episode of acute dizziness with different etiologies like vestibular neuritis or other vestibular disorders and usually get worse or have difficulty getting better secondary to poor compensatory activities and movements.”1 The pathophysiological processes pertaining to PPPD are not fully understood at this time, but could be related to increased attention to postural and visual control after the acute symptoms have decreased. The idea is that the patient continues to focus their eyes on fixed points while moving or to lean on objects for balance, preventing the balance system from “recalibrating” itself and leaving itself open to further fear avoidance behaviors and increased anxiety.1 Individuals with PPPD often complain of increased fatigue and exhaustion because they spend so much energy on these fear-avoidant behaviors that they never give their bodies the chance to regain function. According to an explorative study done on perspectives of working-age individuals who experience PPPD, three themes were found describing how patients often feel. The first theme is because of the limited medical and social validation with PPPD, people feel like they sound like they’re crazy. The second theme is that they feel like they are a shadow of themselves because of how strong of a negative impact the condition has had on them. And the third theme is that these individuals often ask themselves “How will I survive?” This can be referring to the often negative coping processes these individuals adopt.2 So now that we have an idea of what PPPD is, can it even be treated? A clinical review on PPPD found that Vestibular Rehabilitation Therapy (VRT) paired with cognitive behavioral therapy is often helpful in symptom reduction.1 An article on Vestibular Rehabilitation Therapy outcomes on individuals with
PPPD also concluded that customized VRT adequately reduced symptoms and improved QOL in individuals with PPPD.3 It is important for us as medical professionals to provide respect to the patient and acknowledge that what they are going through is genuine. We should help patients like Henry reflect on their symptoms and how those symptoms affect their everyday life. In addition, we have to be cognizant of their thoughts on the cause of their symptoms. Finally, explain to the patient that PPPD is well-known, possibly treatable, and discuss the positive effects of rehabilitation.1 It should be made clear that PPPD is different from social anxiety but may still be exacerbated by psychological factors.1 Through VRT the goal is to “reduce the experience of dizziness and imbalance by re-establishing effective and automatic eye-head coordination, reducing anxiety and self-monitoring, increasing fitness, boosting confidence and learning to live with dizziness.” 1 Exercises can be prescribed conservatively to individuals and can consist of: • head movements with eyes open or closed, while in a static position or while walking • balancing exercises while in static positions or while walking • balance exercises on a compliant or non-compliant surface or with changes to base of support • gait training, and gaze stabilization exercises through habituation.1,3 Thus far, despite the higher complexity of Henry’s case, he has made excellent progress in reducing his symptoms, learning to live with his dizziness/lightheadedness, increasing his confidence in his daily life, reducing his anxiety related to his condition, and overall improving his QOL. This goes to show that through a holistic approach to treatment even the most complex of cases can result in a positive outcome. Reference list: 1. Eldoen G, Ljostad, U, et. Al. Persistent postural-perceptual dizziess. Tidsskriftet. https://tidsskriftet.no/en/2019/05/klinisk-oversikt/persistent-postural-perceptual-dizziness. Publication date May 2019. Updated May 2019. Accessed July 23, 2019. 2. Nada, Ebtessam & Ibraheem, Ola & Hassaan, Mohammad. (2019). Vestibular rehabilitation therapy outcomes in patients with persistent postural-perceptual dizziness. https://www.researchgate.net/publication/330143287_Vestibular_Rehabilitation_Therapy_Outcomes_in_Patients_With_Persistent_Postural-Perceptual_Di zziness/. Annals of Otology, Rhinology & Laryngology. 3. Sezier, A, Saywell, N, et. Al. Working-age adults’ perspectives on living with persistent postural-perceptual dizziness: a qualitative exploratory study. https://bmjopen.bmj.com/content/9/4/e024326.long. MJ Journals. 2018;9(1).
STUDENT PROGRAM UPDATE Devon Dusseault (AIC) will finish up his time in Plainville with Channing Harwood presenting on “Blood Flow Restriction Training” at 12:00 pm on Friday, August 2nd. CJ Luth (Franklin Pierce) will finish up his time in Waterbury with Joanna Fisher presenting on "Tissue Specific Rehabilitation" at 12:00 pm on Wednesday, August 7th. Lindsey Yanaros (URI) will begin her clinical in Plainville with Kevin Connellan on Monday, August 19th.
2019 Courses
The
Extra MILE
Email coned@ptsmc.com to attend August 21, 4pm - 8pm PTSMC Wallingford Upper Extremity - Internal Course by Danielle Dunn
October 12-14 Sacred Heart University Myopain TDN 3 Clinicians $1,095
Email coned@ptsmc.com to register
September 28-29 PTSMC Guilford Therapist Physical Therapeutic Neuroscience Avon Education:(part-time) Teaching People Newington About Pain Southington Clinicians $475 Learn more!
* Cost is subject to number of participants, meals and any additional instructor expenses.
Therapeutic Neuroscience Education: Teaching People About Pain PTSMC Guilford, Sept. 28-29, 2019 Learn cutting-edge techniques from ISPI to get your patients better, faster. This course is designed to update attendees on the latest evidence and clinical application of therapeutic neuroscience education (TNE) for patients in pain. Current best evidence has shown that pain neuroscience educational strategies utilizing neurobiology and neurophysiology are able to reduce pain, increase function, reduce fear and catastrophization, improve movement and change cognitions and brain activation during pain experiences. TNE changes patient beliefs regarding their pain, thus reducing the threat of pain. This class will discuss the clinical application and implementation of TNE for patients with acute, sub-acute and chronic pain. Special features include various metaphors, images, examples, and case studies. Course Details Credits: 15 contact hours Price: $475 Faculty: Terry Cox, PT, DPT, OCS, FAAPMPT, CAMT, TPS Faculty, Southwest Baptist University, EIM and ISPI
more Audit team changes! The Audit Team would like to thank Kasey Adinolfi for her great work as a clinical auditor. She has been an amazing member of our team for the last few years and is hanging up her auditing hat. As Kasey steps down, we are extremely excited to welcome physical therapist Katy Sullivan, PT from the Orange office, to the audit team. Katy is the 5th auditor on our team and will assist in supporting our ever growing PTSMC clinical staff in their documentation compliance!
This course is open to all PTs, PTAs, OTs, and ATCs.
Waiting…Waiting…Waiting… Let’s face it… Waiting rooms are notorious patient-experience killers. No one likes to sit in a waiting room staring at the wall or their phone waiting for an appointment. They would rather be outside enjoying the beautiful weather or spending time with friends and family. What if we could turn that “waiting room” stereotype around and make it a more positive experience? What if we could optimize the wait experience? PTSMC Welcome Centers (formerly known as waiting rooms!) are the first impression for our customers. How can we make sure our Welcome Centers are really welcoming? It’s different for every office, so take a few minutes and sit in your own Welcome Center. How does it feel? Are you comfortable? Can you see the TV? Are there up-to-date reading materials available? Is it clean? Are there any amenities that would make it more comfortable? After sitting in the literal seat of the patient, it’s time to take action. What can you do to make your PTSMC Welcome Center look inviting for customers? Go that extra mile and sift through the magazines and tidy up the Welcome Center. Consider adding children’s toys or books, a Keurig, snacks, or a new coat rack. Maybe the welcome center could use some seasonal décor or PTSMC-branded posters? The options are endless. Patients may not choose your office based on the Welcome Center alone, however, it is one of the first physical impressions they have and will affect their memory of the visit. A beautiful and comfortable Welcome Center is part of the experience that turns patients into loyal customers.
Be the reason “someone smiles today”
HUMAN RESOURCES
2019 HOLIDAY SCHEDULE
NOVEMBER AND DECEMBER VACATION REQUESTS
Employees can submit time off requests for November and December, however, please know that requests will be approved starting September 25, 2019. Employees may only request time off during one holiday during the November and December request period. The following is the vacation approval process: Employees may submit a vacation time request at any time during the year, however, the submission and approval deadlines for November and December requests are listed below. Submission Deadline September 15, 2019
The November and December Holidays for 2019 and New Year’s Day Holiday for 2020 will be observed as follows: Thursday, November 28th Thanksgiving Wednesday, December 25th Christmas Wednesday, January 1st New Year’s Day Tuesday, December 24th Christmas Eve Schedule All clinics will be open from 7:00 am – 1:00 pm on Tuesday, December 24th. All full-time employees who are scheduled to work 8 hours a day and work form 7:00 am – 1:00 pm will be paid for 8 hours on this day. All employees who have requested time off on this day will use the total vacation hours requested. Tuesday, December 31st New Year’s Eve Schedule All clinics will be open from 7:00 am – 3:00 pm on Tuesday, December 31st. Employees working 8 hours on this day can take a ½ hour paid lunch. Employees do not enter your ½ hour lunch time on your time sheet, however in the notes section enter ½ hour lunch taken. Never underestimate the power of two words that only take a second to say and can make the difference to your coworkers’ every day. Take that second each day to SAY:
Director Approval Deadline September 25, 2019
You can still submit your request after the September 15th deadline, but these requests will be approved based on the following considerations: • Time available • Seniority • Length of time requested (preference given to extended time vs. one day)
AUGUST BIRTHDAYS Kevin Connellan Livia Shehu Madison Edmunds Caitlin Chaput Colleen Menard Sarah Engel Michelle Kijewski Sarah Alkire Sean Walsh Sarah LaPlante Craig Katko
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Plainville Watertown Naugatuck Guilford New Milford Groton Wallingford New Haven Waterbury Middletown Essex
Cierra Hungerford Erik Schmitt Tom Kassan Suhani Patel Olivia Tarca Leslie Riviere Tyler Naef Elton Purvis Jack Pearce Lauren Peladeau Zack Niziolek
“Good Morning!”
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Admin Westbrook West Hartford Branford Windsor New London East Hampton Westbrook Groton Groton Avon
Bella Olmstead Erik Olsen Caitlin Greco Nick Almonte Isabelle Stowik Walter Coombs Bryan Baker Matt Sampson Stevie Fell Tracy Caligiuri Sylwia Danowski
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New London Southbury Westbrook Orange Wallingford Branford Westbrook Guilford Waterbury Waterbury Newington
ANNIVERSARIES Allyson Hemstock Andrew Mead Brittany Kearney Cassidy Elm Chloe Pearce Meghan DiPisa Patrick Brodoff Rebecca Petrosino
PT Aide/PSC PT Aide PT Aide PT Aide PSC PT Aide PT Aide Physical Therapist
New Haven Guilford East Hampton Waterbury Groton New Milford Newington Waterbury
Jeff Daley Liz Melvin Mickie Picheco
Physical Therapist PSC PSA
New London Avon Southbury
EMPLOYEE NEWS
NEW EMPLOYEES Welcome to PTSMC. We’re so happy to have you!
From left to right: From left to right: k! c Mackenzie Cattaruzza, PT Aide New Haven Gabe May, PT Avon ba e Ashley Monahan, PT Aide Windsor Brook Uliano, PT New Haven Katherine Annecchino, PT Aide New Haven lcom Marileni Brisita, Float PT e Geena Catalano, PT Aide Westbrook Gabby Didiano, PT Middletown W Danielle Pilgrim, PT Aide New Milford
From left to right: Kelly Cozzolino, PSC Plainville Caitlin Rossi, Massage Therapist Plainville
CURRENT JOB OPPORTUNITIES AT PTSMC Patient Services Coordinator Branford Fairfield Guilford New Haven Athletic Trainer Certified Middletown
Physical Therapist Middletown Naugatuck New London New Milford Orange Plainville Southington
IT Systems Coordinator Admin Director of Payer Relations Admin
Check PTSMC.com for our most up to date postings and feel free to share! We’re always interested in connecting with referrals of colleagues and friends. Call Karen or email at karen.havlicek@ptsmc.com if you are interested in a position.
Physical Therapy Aide Branford East Hampton Essex Fairfield Groton Middletown Naugatuck New Haven New London Southbury Waterbury Westbrook Windsor
Congratulations to the following employees who have achieved the attendance reward for the 1st and 2nd quarters of 2019. Meagan Battige Juliann Chacko Nancy Chilson Zack Currie Kathryn Flodquist Nathan Gockel
Eric Horne Danielle Jaffer Miranda Jasienowski Molly Killeen Josh McAdams Michael McGowan
Allyson Melillo Chloe Pearce Kaitlyn Pearson Dominique Riley Jason Smutnick
Congratulations!
Melissa Lembo, PT Guilford married Nabil Boutagy on July 28th.
Life Beat THE HYDRATION STATION Don’t let the summer heat keep you from having fun in the sun! Do your best to always hydrate, and if you’re ever dehydrated use these tips to identify it and bounce back.
PTSMC Health Insurance Wellness resources Most health insurances have a wellness platform for their member to access. Employees under one of the United Health Care plans that PTSMC offers have access to a program called Rally. This is a resource that promotes personal health and wellness. It is designed to motivate and assist you to achieve any wellness goals through small changes over time. Whether your goal is to become more active, improve your mood, reduce stress, take control financially, or eat healthier, Rally has a personalized method to assist you. Through challenges and missions (anywhere from meditation, number of hours without screens, save $3 a day, meet with friends once a week, track your eating), Rally makes it fun to achieve your goals. Additionally, you earn Rally coins to cash in for various prizes. So check it out! If you or a family member have a United Health Care plan, go to rallyhealth.com to get started. See some more information below pulled from the UHC website.
Signs of dehydration...
PRE or RE Hydrate Use a tracking system for drinking at least half of your body weight in oz of water each day- set timers, use an app, draw markers on a large water bottle, put a rubber band on your water bottle each time you finish one Add electrolytes to your water. Check out these electrolyte powder options: Liquid IV Hydration Multiplier, Biosteel Sports Hydration Mixes, Pedialyte Power Packs Eat foods with high water content: watermelon, cantaloupe, strawberries, oranges, grapefruits, cucumbers, zucchinis, celery, tomatoes, bell peppers
The simplest way to get started is on the computer. Login to your United Health Care account online and look for the Health Resources tab.
Create a Rally login, then follow the prompts to your Rally age health survey. There you can set up your missions and challenges. Then go download the app! Your info will synchronize when you loin there.
Avoid drinking too much coffee, soda or alcohol. Yes we do it, so when indulging remember moderation, and for each cup/can/glass follow up with double the H2O! Jazz up your water by drinking seltzer and/or adding fruit (lemon, berries, lime, orange) and mint leaves.
The more missions you complete, the more Rally coins you earn, the more prizes you access!
PTSMC Happenings
- OUT IN THE COMMUNITY THIS MONTH -
Saturday, August 3rd at 8:00 am New London at Ocean Beach Half
Groton attended the Blessing of the Fleet 5k.
Middletown completed the Terrain Race in Hartford as a team.
Naugatuck took a staff outing to the Adventure Park in Bridgeport.
Sunday, August 11th at 9:00 am Westbrook at Bluefish Festival Wednesday, August 21st at 3:00 pm West Hartford at Blue Back Square Health Fair Friday - Sunday, August 23-25th All Day Event Plainville at Plainville Balloon Festival Saturday, August 31st at 9:00 am Naugatuck at Sao Paio 5k
Newington attended the Newington Extravaganza and Fireworks.
Groton went out for trivia at Margarita’s and came in 1st place!
Mikayla Raffone, New Haven PT Aide, donated 12 inches of hair to children in need. Wallingford celebrated Disney Day in the clinic.
Naugatuck, New Milford, Southbury, Waterbury, and Watertown attended the Hopkins Vineyard Triathlon at Lake Waramaug.
Guilford attended the Sea Leg Shuffle.
SoCIAl Media Sensation
New London celebrated Partner & Director Scott Olmstead’s 50th birthday.
Employee Spotlight
Brian Greer, PT, DPT, CERT. MDT Watertown Physical Therapist Jacky Severance, PSC in Middletown, always sends photos to share on social media. She also shares ideas on ways to market the clinic outside of social media.
Brian loves that the Watertown office feels like a family. Learn more about Brian in this month’s Employee Spotlight at ptsmc.com/videos