Ms. Alison M. Garcia

A spine herniabetter known as a herniated discis a common condition. In terms of fixed, it is a matter of severity that comes into play. Some small herniations will recede on their own and dont require intervention. Others may remain stable and not cause any symptoms whatsoever. However, they become problematic when they irritate the. Serves around them causing symptoms of radiculopathy (pain down the extremity, numbness, paresthesias/prickling feelings) or myelopathy (weakness of a portion of the limb). These two problems are indications for surgery or further intervention to relieve symptoms. Even after a procedure, the fixed disc may be temporary as subsequent herniation can occur, collapse of a disc space, or shifting of the vertebrae due to a weakened disc space (spondylolisthesis) can occur and continue symptoms to the same or higher degree. Consult with a spine surgeon regarding your MRI imaging and consult with detailed information of your symptoms, duration and if you have attempted any physical therapy or epidural injection trials, and they will provide you more guidance. Dr Garcia

Usually PT will start about 2-4 weeks after a rotator cuff surgery. You want enough time to heal wounds which is around 10-14 days prior to movement that could jeopardize it. Some other surgeries, like formal fractures or breaks, may require longer non-weight bearing times. Speak to your surgeon about your surgery and what time frame he recommends for the specific procedure you are having Dr Garcia

Physical therapy should occur after any injury and especially after surgeries as tissues are weakened from being manipulated during a procedure. No question, hard yes. The more mobile you remain in life, the longer life you will live. Immobility leads to infections, sores and shorter lifespans. Dr Garcia

Absolutely. And believe it or not, strength training can also improve back pain with the proper technique. Dr Garcia

I think the answer to this question would vary by specialist. I personally think swimming is one of the best exercises for joints and bursitis issues. And it doesnt have to be full on laps. Just movement in the water against resistance. Extension, elevation, abduction and adduction movements. If this is not accessible. I would consider using therabands and using resistance to strengthen without putting significant tension or pressure on the joint. Garcia

If you are looking for maximal recovery it is highly recommended to do a course of physical therapy after an acute fracture. If you incorrectly bear weight on a limb and break the bone further it can cause more long term complications. Some hairline fractures are an exception, but consultation with your orthopedist will establish PT needs Dr Garcia

Knee strength is not about lifting, its about resistance and toning. A lot of success has come from theraband or resistance band workouts, which can be the easiest for every day use, also can utilize swimming if you have a pool water resistance is awesome for the joints, but knee stabilization exercises are also a huge help. Ask your physical therapist post surgery about the many different exercises you can use to strengthen your knee in this way without overdoing it. Dr Garcia

Yes absolutely, but the real work is what you bring home from your sessions. Therabands work amazing for joint injuries and building the muscles around long bones. You can get them for cheap off Amazon and there are many videos that will demonstrate additional activities you can slowly add to your regimen for guidance. This will build muscular tone AND help with range of motion and all exercises are easily performed at home if you are restricted from going to a gym. Dr Garcia

Physical therapy regimens are usually in blocks of 4-8 weeks depending on what you are prescribed. Back pain however is very common, usually a result of improper sitting position, improper lifting and/or extensive abdominal weight gain. You are not garuntee to do only one round each time you suffer from back pain or throughout your life, very often this can be ongoing . Additional focus on weight loss, placing your bottom to the back of the chair when sitting to assist with posture, avoid slouching to one side or the other and use your legs primarily (similar to a squat) when bending to provide protection for your back long term . Dr Garcia

I can only speak from the perspective of a surgical PA or intensive care PA. But our daily routine usually is as follows: IF you are at a hospital where PAs are primary and working in a specialty with few residents, the morning starts with a hand off on all patients on service and proceeds with the PA team deligating roles for the day. Some will go to the OR and be the first assist to the surgeon in the operating room , some will go to interventional radiology and assist with performance of angiograms, and others will remain on the floor taking care of the daily needs of patients. Some days, operations are short and sweet, and others will require near 8hours of standing in an operating room performing procedures back to back. You grow close with your team and you learn how to adjust your life around this kind of schedule. In intensive care, you arrive early, receive handoff on critical patients and their needs. You have about 30mins - 1h to familiarize yourself with patient concerns and address any emergencies before rounds with the attendings begin where you go from top down in regard to systems overview of whatever ailments they may have. You spend the day taking care of the critical needs of these patients while answering consultations, responding to level 1 traumas, and organizing bed shifts through the hospital to accommodate the sickest patients. If a patient goes into cardiac arrest, you are responsible for running the resucitation code and placing any lines in the patients for access. You don't se the OR in this position, but you do all bedside procedures to facilitate care. Both positions involve 12-14h shifts at least 3-4 x / week . You are not garunteed a break, very often you will eat while continuing work or have to excuse yourself temporarily to use the bathroom. Shifts may vary. You may be required to work days/nights/weekends/holidays. There are no longer, at least in NYC, any "cozy shifts" where you can avoid flex unless you are in outpatient offices, which provide usually less money. However, if you love what you do, you'll be fine. The passion for the work will outweigh the stresses that it brings. And YOU WILL BE, the primary person to engage with all families, even over the attending clinicians. The reality of the situation. Great question. Dr. Garcia

Recovery of motor movements after a brain surgery are dependent on what your diagnosis is.
For example, a stroke in the MCA region of the brain, a center that controls motor functions of the opposite side effected, can have some form of recovery if an acute thrombus is the cause and is removed as soon as possible, however, embolus strokes/ pressure related strokes/ and chronic strokes in this region will not demonstrate the same results.
An acute subdural hematoma that is evacuated before full loss of function can also result in some motor recovery, but if not evacuated quickly (within 24h after onset of pressure) can result in permanent loss of function.
Brain tumors also produce marginal results. A brain mass on the motor cortex does not garuntee recovery of function after removal and peri operative concerns such as stroke/seizures/ and bleeding in the tumor bed can all pose as further problems for recovery.
Your surgeon should be going through these possible outcomes with you prior to surgery.

Overall, no matter your diagnosis, medicine only attempts to fix the structural problem in these cases and should be followed by extensive physical and occupational therapy regimens for which each patient post op is responsible for. The depth of recovery, should the diagnosis be one that can result in improvement (given no complications arise) truly lies in the follow up care that each patient engages in.

Thank you for your question