Two Braces & A Conversation

The following patient story by @DrDunawayDPT recounts an extraordinary experience from @STANDHaiti. It’s a quick read that reminded me of how lucky I am, and how valuable our service is to those in need.

Familiarize yourself with Justin by reading my 2-part Interview with him here & here. You can find a recap of the Fall 2015 STANDHaiti trip here.

Are you a Physical Therapist wanting to participate in this unique opportunity? Then check out their website for more info: http://www.standhaitiproject.org/.

Here’s Justin.


This is not a story of superior physical therapy prowess, amazing diagnostic problem solving, or out of this world rockstar manual therapy skills. This is a story of a case so incredibly simple and fairly terribly tragic, with a mildly uplifting finish. In a system with adequate care and resources, this patient would have received emergency care, surgery, and physical therapy, getting him back on his feet with minimal to no enduring consequences. Even in the most poverty stricken areas in the United States, he would have received the care he needed to return to function. Instead, this case takes place in the incredibly impoverished streets of Port-de-Paix, Haiti, where aside from our teams periodic two week trips, there is no care or resources for the injured and poor.

While in Haiti, Morgan and I have very little time to actually treat patients. Our days are consumed with the daunting and stressful task of “keeping the wheels turning”. However, we love patient care and need to take breaks to recharge and zero out, AKA treat patients. It was the third day of our trip before I could break away from logistics detail and get my hands on a patient… and I was “jonesing” to do so. I grabbed a table, a translator, and the next chart in the stack and was ready to get to work. As I read the chart that said “knee trouble” and then saw a man carry a 17 year old boy to my table, I realized immediately that, in this case, that means “I can’t walk any more”. My first reaction was: my first patient all week and there will be nothing I can do for him. I started shifting from excitement to sadness.

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After a very sad subjective and some graphic photos printed on computer paper, this is what I learned. The boy was brutally attacked in early July, beaten and drug through the streets. The assailant then took out a knife and very deliberately severed both the boy’s patellar tendons and left him in the street. His goal was to take away the boy’s ability to walk… and he succeeded. In the US, someone would have found the boy within a few hours of the attack. They would have called an ambulance and he would have been admitted to the emergency room. Despite living in poverty, he would most likely have Medicaid and would have received emergency surgery, reattaching his patellar tendons, and mostly have been sent to physical therapy. Over the next few months, he would have regained strength, relearned to control his knees, and returned to function. He would have returned to being a teenage boy: running, playing sports, regaining his life… but that’s here in the US.

Back to Haiti. The patient was carried to my table, just as he was carried everywhere. He hadn’t stood up since his injury in July. Once a normal teenager, he has now become a burden on his friends and family, a member who cannot contribute in any way. An objective exam revealed two patellas that, in sitting with knees flexed to 90 degrees, sat somewhere in the distal 3rd of the femur. He demonstrated strong hamstrings/glutes and had maintained some ability to activate his quads, but lacked the ability to extend either knee more than a few degrees. The patient also exhibited fear of standing, depression, and other psychological symptoms from the traumatic experience. The patient expressed interest in surgery, but in this area, those services are non-existent.

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Seeing that he had hip/hamstring strength and some ability to activate his quads, I attempted to have him stand. He and I both quickly realized that with some assistance for knee control (locking into extension), he could stand and balance. If I manually controlled his knees from buckling during flexion, and helped him hold his knee in extension when striding, he could walk. After a quick consult with Morgan, we decided that a pair of hinged knee braces with adjustable flexion/extension locks might just do the trick. We were able to find and fit him with these successfully. We allowed the knees to move from 0-60 degrees, added a little training and fear avoidance education, and really just told the boy “you can walk, trust your legs, practice… you will fall and then you will get up… you will be just fine”…

He took a few steps… and then a few more. He walked through the clinic, slowly and clumsily at first, and then faster and with more confidence. We walked up and down the stairs, then out on to the back patio… where he cried. These were his first steps since June, his first steps since he had given in to the thought that he would never walk again. He has a long way to go and will never be 100%, probably never get his surgery, and will always have some major dysfunction, but now he can walk. There is no brilliant PT work in this case, no medical miracle or amazing surgery, just two braces and a conversation.


Connect with Dr. Justin Dunaway & STANDHaiti via twitter: @DrDunawayDPT & @STANDHaiti

Find me: @Cinema_Air

STANDHaiti Report: Fall 2015 recap & Upcoming Opportunities

Here’s an update on STAND Haiti’s Fall 2015 trip by Dr. Justin Dunaway. Find out more about Justin and STAND Haiti by clicking on the blue links you just read.

FYI – the next trip is scheduled for Jan 22 to Feb 7, 2016.

Enjoy!


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There’s nothing like a hurricane to give you perspective. You would think that torrential rains, mud-sloshed roads, and wind gusts up to 60 mph would keep people at home. As it turns out, the care we provide in Port-de-Paix, Haiti is so valuable that the elements themselves did not prevent people from seeking care from STAND clinicians!

Over the two weeks that STAND had its clinic doors open, we treated over 1,350 patients. People came to have back pain addressed, post stroke drop foot assisted, and spinal cord injury therapy plans created! New prosthetics were built for amputees, patients’ infections and maladies were addressed by our medical staff, both kids and adults received appropriate orthoses and assistive devices, and people left with less pain and more hope!

Additionally, during STAND’s time in Port-de-Paix, we created jobs for 41 locals, gave medical screenings and care for school children, and provided clinical education hours for a local nursing school. Our teams of physical therapists, prosthetists, orthotists, and nurses worked selflessly to make a difference in each patient’s life. Hailing from fifteen states across the US (plus one amazing prosthetist from Leogane, Haiti), STAND’s fall team made the magic happen on levels we could never have imagined!

Wk 2 team

In the end, it was our ground crew in Haiti that made this all possible. Without the hardwork and dedication of Lifaite, Gomez, and all of our support staff in Port-de-Paix, this extent of success would have been difficult even to imagine.

With every cog turning and each team member working to decrease our patients’ pain and disability, STAND’s fall trip of 2015 will be one for the books! We cannot thank each member of our STAND family enough for making this trip more than just a success, for making it a memorable beginning to our growing work in Haiti.

Stay tuned! Excerpts, patient stories, and therapists’ reflections are on their way!

If you’re interested in joining the STAND family our next trip is Jan 22- Feb 7th and you can volunteer for 1 or 2 weeks, then please contact us at JDunaway@Stand4Haiti.org or MDenny@Stand4Haiti.org.

Morgan and Justin

 STAND sig

A Financier & his Backache

Back pain as an expression of internal/external incongruency that can generate a fortune? Possibly. The following two passages are from George Soros‘ book, The Alchemy of Finance.

My biographer quotes my son Robert as saying:

My father will sit down and give you theories to explain why he does this or that. But I remember seeing it as a kid and thinking, Jesus Christ, at least half of this is bullshit. I mean, you know the reason he changes his position on the market or whatever is because his back starts killing him. It has nothing to do with reason. He literally goes into a spasm, and it’s this early warning sign.

Mr. Soros goes on to explain,

My son is right about the backache. I used to treat it as a warning sign that something was wrong in the portfolio. It used to occur before I knew what was wrong, often even before the fund began to decline in value. That is what made it so valuable as a signal. It would be wrong, however, to dismiss the theory on that account because it was the theory that me take the signal so seriously. I knew that I did not act on the basis on knowledge; I was acutely aware of uncertainty and was always on the lookout for mistakes. As I mentioned earlier, it is when I did not know the flaws in my positions that I had to worry. When I finally discovered what was wrong my backache usually went away.

The Irish Times celebrated the 84th birthday of “the most successful hedge fund manager in history” with an article on some lessons you can glean from Mr. Soros’ storied career. Included in the article was the following:

Soros has admitted to relying greatly on “animal instincts”, saying the onset of acute pain was often “a signal that there was something wrong in my portfolio”.

His decisions, then, “are really made using a combination of theory and instinct.

Sometimes our bodies express themselves from a base of unexplainable manifestation and intelligence. The question is: What do you do when your body speaks to you?

@Cinema_Air

Interview with Dr. Karen Litzy, PT, DPT

Interested in Cash PT? Podcasts? Learning more about the evolving business of PT? Interviewing? Then today is your lucky day…and mine!

I had the incredible opportunity to interview Dr. Karen Litzy, PT, DPT. In the off-chance that you don’t know Karen, then…welcome to a new you. First, connect with her via twitter @KarenLitzyNYC, then head straight to her fantastic podcast series, “Health, Wealthy, & Smart”, and finally, check out Karen’s “Strictly Business Virtual Conference” – a TED-talk styled conference for PT. In case you find yourself in need of some quality PT in NYC, then get in touch with Karen via her cash practice website. Connect with Karen. It’ll be worth your while.

It’s a truly power-packed interview full of valuable insights & experiences. I’d re-reading this a few times to absorb & digest it all. Enjoy!


Let’s start at the beginning. Tell us your story about what led you into the wonderful world of Physical Therapy.

I have always been athletic..I played softball since I was 4 and was a gymnast for almost 9 years.  When I was in high school the local physical therapist (I grew up in a really small town in PA) wanted to do some strength and flexibility testing on me (given my gymnastics background).  I hung out at the office and really liked what they were doing.  That is the main reason I decided to go right into PT school after I graduated high school.  I also knew I wanted to work in the medical field but was not quite sure I wanted to be a doctor.  Physical therapy seemed to be a good fit for me at the time and if I wanted to go to medical school I could always make that decision later.  Needless to say I decided to stick with the PT thing as I really enjoyed spending quality time with the patients.

Also, my older sister is PT so I had some exposure to the education and profession through her.  And of course being the annoying little sister I had to do the same thing as her 🙂

You took your time developing your cash PT practice. Given the benefits of hindsight, how can I replicate what you have in less time?

I think if you have the guts you can jump right into a cash based practice.  The reason I didn’t is because I live in NYC and it is really expensive to live here.  I am talking really expensive…my rent alone is more than some PT clinics’ (also not in NYC) monthly costs.  So, I knew that I needed to have a consistent and high flow of income.  That is the main reason I took my time developing my business.  I needed to feel 100% comfortable that I could pay the bills I needed to pay as well as save a decent amount of money for retirement.  And I had to create my business all by myself…I didn’t have the luxury of a partner or a husband to help me out or to be a back up.

How can you replicate what I have in less time???  Know what kind of business you want:

  1. Know who your ideal clients are.  Create a very clear narrative around the clients you really love to treat and be around.  Then you can go out, seek those specific clients and spend your day surrounded by the kinds of clients you want to treat.  This will make your day something to look forward to!
  2. Know what you are good at and what you are not good at.  If something is not in your wheelhouse and/or you do not enjoy some part of the your business then outsource it!  I did not do this enough in the beginning and I regret that.  Even if it means spending more money (which it most certainly will) it frees you up to concentrate on the things you are good at and this will only strengthen your business.  
  3. In the beginning say yes to almost everything!  Put yourself out there as much as you can. This is where the hard work of being an entrepreneur comes in.  I can be a bit of an introvert sometimes and I didn’t say yes in the beginning to things as much as I could have and that may have hurt my business a bit.  That being said remember to not overcommit if you can’t follow through!
  4. I suffered (and to a certain extent still suffer) from imposter syndrome.  It is defined as: a term coined in the 1970’s by psychologists and researchers to informally describe people who are unable to internalize their accomplishments. (from Wikipedia)  After listening to hundreds of podcasts with celebrities and other accomplished folks I am realizing that so many people feel this way.  Now I use this feeling as a way to push myself forward, whereas in the past I think it absolutely held me back.  So if anyone is feeling this (which I think is pretty normal) use it as a means to push yourself forward and break through those uncomfortable times in your business…not hold you back out of fear!  Then when you do accomplish something in your business be sure to celebrate it…even if you are celebrating it by yourself!!

One thing I want to make very clear…owning your own business is hard work.  It is very time consuming, especially in the beginning. There is no “leaving your work at work” anymore….you are your work….you are your brand….and you should be thinking that all the time.  That would be my biggest piece of advice to any budding entrepreneur.  Be consistent and true to your vision and your brand no matter where you are and who you are with.  You never know where that next referral will come from and who needs that special thing that only you have.

Why did you start podcasting?

I kind of fell into podcasting.  It all started after I was asked to be a guest on my friend’s podcast.  He was running his podcast out of an online radio station.  After our interview the manager of the that station asked if I wanted my own show, and I said yes.  Back then I was doing each episode live..no editing!  I had no idea what I was doing and at the time there weren’t many PT related podcasts to look for for guidance.  So I had to figure it out on my own, and I am still trying to move the podcast forward.  But I do know that I am so thankful for the guests I have had on the podcast and I continue to learn something new each week.  If nothing else I am pretty sure I could get onto Jeopardy at this point (which is one of my life’s goals).   

How do you find your guests? How do you prep for them?

So many ways!  When I first started I interviewed friends and colleagues I already knew.  This was a great decision because it helped me to be more comfortable with the interview process, and like I said above, at the time it was live…so no edits.  Once I was a little more comfortable I reached out to people I admired and they said yes.  Now I find a lot of guests through social media, mainly Twitter.  I also have a lot of guests reach out to me to come on the podcast.  That makes me really happy..that people value the podcast enough to ask to come on as a guest.

When I first started I think I over prepared for each interview.  This made the interviews stiff and robotic.  Now, I do my research on each guest.  I read their books, listen to lectures, watch Ted Talks, read blogs, etc.  I make sure that I am as prepared as I can possibly be and when I start the interview I give up about 70% of the control of the interview over to the guest.  I will redirect and summarize when necessary but the guest has to feel like they can speak freely, otherwise the interview will not feel authentic or organic.

How have you changed your interviewing style over the years?

I like to think I have gotten a little bit better!  I started taking improv lessons with Harris Doran a great writer and actor in NYC.  This was one of the best decisions I have made in a while.  Through my improv lessons I learned how to actively listen and think on my feet.  This has helped my interviewing style and process beyond words.

When it comes to interviewing, are there people you model or admire? How have they influenced you?

Of course! Once I started the podcast I tried to watch and listen to so many interviews.  The interviewers I connected with are:

Oprah…how could I now include her on this list.  She is thoughtful, empathetic, and a great listener.  Oprah shows that it is ok to be vulnerable as the interviewer which is something I need to get better at.  She has also been doing it for decades!

Marc Maron the host of the WTF podcast.  There is such an ease and curiosity with his interviews that makes them so engaging.  He also has a knack for getting his guests to really open up, which is not an easy thing to do.  This is what I am hoping I can do because it means that my guests feel comfortable and safe.

Claudia Dreifus, writer for the New York Times.  She has been in the interview business for decades and she gave me a great piece of advice about interviewing: As the interviewer you have to do your research and be as prepared as you can possibly be (so the guest is less likely to get one past you).  Once the interview starts, you ask the first question and then give about 70% of the interview over to the guest.  This advice changed the way I interviewed.  I went from a bit of an uptight interviewer to more relaxed.

Meredith Vieira.  I love her because she is so natural and at ease with every guest.  She shows that you can be smart, funny and witty no matter who you are interviewing.  She comes across as a real person and that is what connects with a guest and an audience.  Plus I was in an elevator with her a few months ago and she really is nice!

David Letterman.  He is so quick and smart as a result of years in the business and his stand up/improv background.  I only wish I was that quick.  But watching him did inspire me to take improv classes and I think it is helping with interviews on the podcast and with clients!

I love the virtual conference you’ve started! (http://healthywealthysmart.com/) Tell us about the process of getting this idea off the ground.

First of all thank you!  It was a lot of hard work and time and I am really proud of it.  I think it is full of great info from some of the smartest people I know.  

It took me a while to figure out what topics I wanted to cover and how I wanted it to look. That part probably took about 2-3 months.  That included talking with a lot of my clients (who happen to be very successful people) and talking with other PTs and students trying to find out what aspects of the business side of PT they wanted to learn more about.  Once I hooked up with my project manager it took another 4-5 months to get it all together.  That included reaching out to the contributors to the conference.  I had written down an ideal list of speakers and I was able to get everyone!  So that was a big win and was very exciting.  I have to say I really didn’t have many surprises…the project manager takes care of all of the backend stuff so if there were surprises she was there to handle it.  Like I said above if it is not in your wheelhouse then outsource it!  

The marketing aspect was good…but it s could have been better.  It was a lesson learned for me and the next time I have a whole new marketing strategy in mind…can you say Leadpages!!!  I will also change my planning process by using a very comprehensive survey funnel.  Erica Meloe and I have something up our sleeves right now and will hopefully have something fun coming out in the next few months! I will use all that I have learned through running these programs to make this new project very fun and exciting!

How did you find the right people to hire for this project?

I had been watching several online business conferences through a women’s entrepreneurial group I am a part of and reached out to one of the women who hosted a conference.  She gave me the information of the project manager she used, I reached out to her and she took me on as a client.  From there the project manager helped to hire the rest of the team.  The team included a virtual assistant, web developer (who we found through Fiverr), and graphic designer.  I also had my lawyer help out with contracts and disclaimers and finally a sound engineer to tweak some of the interviews.

Favorite books and/or authors?

PT-related:

Explain Pain by Dr. Lorimer Moseley & Dr. David Butler.  

Aches and Pains by Louis Gifford.  

Therapeutic Neuroscience Education: Teaching Patients About Pain by Dr. Adriaan Louw & Dr. Louie Puentendura.

In my opinion all of these books should be standard in every PT program.  If they are not please seek them out and read them.  They will change the way you see and treat everyone who comes your way…patient or not.

Not PT-related:

Bossypants by Tina Fey.

Yes Please by Amy Poehler

Start With Why by Simon Sinek

The Power of Habit by Charles Duhigg

The Life Changing Magic of Tidying by Marie Kondo (it really is life changing!)

Dead Wake by Erik Larson (I love all of his books..the Devil in the White City is probably my fav book of all time).

The Girl on the Train by Paula Hawkins

Why Not Me? by Mindy Kaling

The next book on my list is The Brain: The Story of You by David Eagleman. I will let you know how it is!

(I listen to a lot of books on Audible when I am traveling around the city seeing patients).

If you could have dinner with any famous individual who is no longer with us, then whom would you choose? Why?

This was absolutely the hardest question of the bunch! I think the famous person I would want to sit down to a dinner with is the lovely and hilarious Joan Rivers!  If you have not yet seen the documentary about her, A Piece of Work, then stop reading this right now and watch it!  There are several reasons I would want to sit down with Joan:

  • She broke so many barriers not only for women in comedy but for women in general.  I would love to talk to her about this and if she had an idea of the icon she was becoming.  Was she aware that she was busting through barriers at the time? I suspect she did!
  • She had been knocked down so many times in her private life and in her career.  I would ask her where and how she found the strength and perseverance to not only keep going but to thrive and grow. This is such an admirable quality in a person.
  • She had an amazing work ethic and I would love to know how, even in her 80s, she kept that going.
  • How did she become a stand out performer in a traditionally male dominated occupation.  Not that PT is a traditionally male dominated occupation but being a private practice owner in PT seems to be.  I also find that truly being heard as a woman in PT is a challenge.  I think Dr. Sandy Hilton put it perfectly (I am going to paraphrase here) but she said something to the effect of “women in PT are taken less seriously about serious stuff”.  I think that is spot on…at least in my experience.  I am sure Joan experienced this most of her life……so how did she deal with it??
  • Of course I would love her advice for a fellow female entrepreneur.  Everything from goal setting, marketing, relationships, networking and of course her best fashion advice!
  • Finally, this is a sit down dinner so I would want to spend the majority of that dinner laughing.  And with Joan I don’t think that would be a problem!

Karen, this has been a phenomenally informative & entertaining interview! Thank you so much for your time & generosity!

Connect with Karen on twitter: @KarenLitzyNYC

Find me: @Cinema_Air