Question

[Guest guest]

Ejection Fraction refers to the percentage of blood being pumped out of the

left ventricle of the heart to the rest of the body. Normal ejection

fraction is between 55-75%. No one pumps out 100% of the blood from the left

ventricle. The lower the number, the less blood is being pumped through the

body. This affects a lot of things, one of which is decreased oxygen to the

cells of the body.

Mike

on 8/27/02 1:47 AM, granpam01 at ccandme@... wrote:

> Hi all,

>

> Would someone explain " ejection fraction " to me please? I feel kinda stupid

> that I can't

> seem to understand just what it means & what

> it's importance is...

>

> Thanks,

> Pam in AK

>

>

>

> Please visit the Zapper homepage at

> http://www.ZapLife.org

>

>

[Guest guest]

,

A synovial cyst or ganglion in this area is a valid DDX. This can be irritated by the lower edge of the pant and knee pad in knee length gear and exertional force through the tissue. This can be imaged with MR. As a matter of fact my associate just had his imaged last Friday. However, the transient nature tends to indicate a none encapsulated inflammation, more like a fascial herniation or descending inflammation with in the semitend/membranosis compartment. What position does he play and is the inflammation soft or firm.

Ted

Ted Forcum, DC, DACBSP, FICC, CSCSBack In Motion Sports Injuries Clinic, LLC11385 SW Scholls Ferry RoadBeaverton, Oregon 97008ph 503.524.9040

On Tue, 8 Oct 2002 06:30:45 -0700 "carpentier" <carpentier@...> writes:

I have an interesting patient that maybe someone could shed some light on. 16 y.o. male, athlete. Currently in football. Periodically he gets a "knot" behind his knee that swells up rapidly and usually goes away within 1/2 hour. The area is stiff and painful when it is present. It is often after a hard football game or practice. He indicates the medial hamstring tendon when localizing it.

All of his knee ortho tests are normal, there is no laxity, no pain on palpation, no indication of any other problems.

The only thing I can hypothesize is that he has a cystic area within the tendon sheath that fills with traumatic use, but has a leak and dissipates rapidly.

I can't see that it will be possible to image it, for it dissipates too rapidly and is sporadic enough to make it impossible to get to a facility and actually have it still be there by the time X imaging source is fired up and used.

Any other ideas?

K. Carpentier, D.C., D.A.B.C.O.Burns, OROregonDCs rules:1. Keep correspondence professional; the purpose of the listserve is to foster communication and collegiality. No personal attacks on listserve members will be tolerated.2. Always sign your e-mails with your first and last name.3. The listserve is not secure; your e-mail could end up anywhere. However, it is against the rules of the listserve to copy, print, forward, or otherwise distribute correspondence written by another member without his or her consent, unless all personal identifiers have been removed.

[Guest guest]

,

Like Ted, I look at these things like a ganglion or cyst so treat it with

ultrasound and of course adjusting the Atlas.

Salter's Ortho textbook discusses the Popliteal Cyst or Baker's cyst:

" A cyst is somewhat similar to a ganglion and may develop in the popliteal

region, usually in relation to the semimembranous bursa. Such popliteal

cysts are common in childhood but seldom cause symptoms. ..regresses

spontaneously during childhood.

In adults, popliteal cysts usually communicate with he knee joint through a

hollow stalk and in a sense represent a " synovial hernia " . Thus, in the

presence of a synovial effusion of the knee, due either to rheumatoid

arthritis or DJD, the popliteal cyst becomes distended but the effusion and

may extend distally even as far as mid-calf [YUCK!!].

If a popliteal cyst becomes sufficiently enlarged, that it interferes with

knee function, operative excision of the cyst and exploration of the joint

are indicated. "

Hope this helps narrow things down.

--

E. Abrahamson, D.C.

Chiropractic physician

Lake Oswego Chiropractic Clinic

601 First Street

Lake Oswego, OR 97034

503-635-6246

> From: " carpentier " <carpentier@...>

> Date: Tue, 8 Oct 2002 06:30:45 -0700

> " Chiro-Sci " <chirosci-list@...>

> Cc: " Oregon DCs " < >

> Subject: question

>

> I have an interesting patient that maybe someone could shed some light on. 16

> y.o. male, athlete. Currently in football. Periodically he gets a " knot "

> behind his knee that swells up rapidly and usually goes away within 1/2 hour.

> The area is stiff and painful when it is present. It is often after a hard

> football game or practice. He indicates the medial hamstring tendon when

> localizing it.

>

> All of his knee ortho tests are normal, there is no laxity, no pain on

> palpation, no indication of any other problems.

>

> The only thing I can hypothesize is that he has a cystic area within the

> tendon sheath that fills with traumatic use, but has a leak and dissipates

> rapidly.

>

> I can't see that it will be possible to image it, for it dissipates too

> rapidly and is sporadic enough to make it impossible to get to a facility and

> actually have it still be there by the time X imaging source is fired up and

> used.

>

> Any other ideas?

>

> K. Carpentier, D.C., D.A.B.C.O.

> Burns, OR

>

[Guest guest]

I agree with y'all (or y'all agree with me) on the Baker's cyst or synovial cyst. I still don't think that we can image the cyst if it isn't fluid filled (collapsed sides of cyst appearing as congruent tissue) and the fluid filling never lasts more than 1/2 hour which isn't enough time anywhere (let alone Eastern Oregon) to get through a door into an imaging modality.

Or am I wrong about not being able to visualize a collapsed cyst? I know I'm not wrong about not getting into imaging in less than 1/2 hour. ;-)

K. Carpentier, D.C., D.A.B.C.O.Burns, OR

[Guest guest]

Ask a radiologist.

Abrahamson, D.C.

> From: " carpentier " <carpentier@...>

> Date: Wed, 9 Oct 2002 05:55:50 -0700

> " Chiro-Sci " <chirosci-list@...>

> Cc: " Oregon DCs " < >

> Subject: Re: question

>

> I agree with y'all (or y'all agree with me) on the Baker's cyst or synovial

> cyst. I still don't think that we can image the cyst if it isn't fluid filled

> (collapsed sides of cyst appearing as congruent tissue) and the fluid filling

> never lasts more than 1/2 hour which isn't enough time anywhere (let alone

> Eastern Oregon) to get through a door into an imaging modality.

>

> Or am I wrong about not being able to visualize a collapsed cyst? I know I'm

> not wrong about not getting into imaging in less than 1/2 hour. ;-)

>

> K. Carpentier, D.C., D.A.B.C.O.

> Burns, OR

>

[Guest guest]

Synovial cysts (popliteal cyst & Baker's cyst are the

same thing - just location specific) are well imaged

with MRI but if it is collapsed it may be trickier to

see. Tell the radiologist what you are looking for so

he can scrutinize the scan for a collapsed cyst. Also

consider ordering a MR arthrogram which would likely

fill the collapsed cyst with contrast and make it

visible. The MR will also rule out tumor, vascular

problem or other condition. Remember that 80-90% of

popliteal cysts have meniscal tears associated with them

(usually posterior horn of medial meniscus) which the MR

will also be able to evaluate.

--

D. Stecher, DC,DACBR,CCSP

Open Advanced MRI & CT

9370 SW Greenburg Rd., Ste J

Portland, OR 97223

Office: (503) 246-6666

Mobile: (503) 380-5333

> Ask a radiologist.

> Abrahamson, D.C.

>

> > From: " carpentier " <carpentier@...>

> > Date: Wed, 9 Oct 2002 05:55:50 -0700

> > " Chiro-Sci " <chirosci-list@...>

> > Cc: " Oregon DCs " < >

> > Subject: Re: question

> >

> > I agree with y'all (or y'all agree with me) on the Baker's cyst or synovial

> > cyst. I still don't think that we can image the cyst if it isn't fluid

filled

> > (collapsed sides of cyst appearing as congruent tissue) and the fluid

filling

> > never lasts more than 1/2 hour which isn't enough time anywhere (let alone

> > Eastern Oregon) to get through a door into an imaging modality.

> >

> > Or am I wrong about not being able to visualize a collapsed cyst? I know

I'm

> > not wrong about not getting into imaging in less than 1/2 hour. ;-)

> >

> > K. Carpentier, D.C., D.A.B.C.O.

> > Burns, OR

> >

>

>

>

> OregonDCs rules:

> 1. Keep correspondence professional; the purpose of the listserve is to foster

> communication and collegiality. No personal attacks on listserve members will

be

> tolerated.

> 2. Always sign your e-mails with your first and last name.

> 3. The listserve is not secure; your e-mail could end up anywhere. However, it

> is against the rules of the listserve to copy, print, forward, or otherwise

> distribute correspondence written by another member without his or her

consent,

> unless all personal identifiers have been removed.

>

>

[Guest guest]

Dr. Tim,

Can you give me an idea how much faith you have in the Apley's

compression/distraction test for posterior horn meniscus damage? Had a

football clipping injury recently with partial tear of the medical meniscus

evidenced by some loss saggital stability of the knee, and pain over the

medial joint line. I also suspect menicus when the joint line is

painful(possibly due to coronary ligs involved that often are associated

with a meniscus injury). So did the Apley's tests and found them to be

positive. My clinical opinion was that there was a medical collateral tear

along with posterior horn involvement of the medical meniscus. No MR--went

back to football after a quick recovery and is wearing a serious brace and

tape. What do you think?

Steve Lumsden

Re: question

> > >

> > > I agree with y'all (or y'all agree with me) on the Baker's cyst or

synovial

> > > cyst. I still don't think that we can image the cyst if it isn't

fluid filled

> > > (collapsed sides of cyst appearing as congruent tissue) and the fluid

filling

> > > never lasts more than 1/2 hour which isn't enough time anywhere (let

alone

> > > Eastern Oregon) to get through a door into an imaging modality.

> > >

> > > Or am I wrong about not being able to visualize a collapsed cyst? I

know I'm

> > > not wrong about not getting into imaging in less than 1/2 hour. ;-)

> > >

> > > K. Carpentier, D.C., D.A.B.C.O.

> > > Burns, OR

> > >

> >

> >

> >

> > OregonDCs rules:

> > 1. Keep correspondence professional; the purpose of the listserve is to

foster

> > communication and collegiality. No personal attacks on listserve members

will be

> > tolerated.

> > 2. Always sign your e-mails with your first and last name.

> > 3. The listserve is not secure; your e-mail could end up anywhere.

However, it

> > is against the rules of the listserve to copy, print, forward, or

otherwise

> > distribute correspondence written by another member without his or her

consent,

> > unless all personal identifiers have been removed.

> >

> >

[Guest guest]

Yes, it's okay to stay active--important actually. Go for a

leisurely walk or hike, dance, clean house, do yoga!! I think

staying active is the key to fat burning. BUT--I don't do anything

nearly as intense as HIIT 3 days a week. Leisurely activity

increases your metabolism but unlike a block of aerobic activity it

doesn't burn your muscle up. Have fun! Don't sit around on non-

cardio days--get out there and MOVE!!! Just try to stay below that

zone where you are out of breath and sweating up a storm. Activity is

NOT the same thing as cardio--but it does burn fat. Speaking of

activity--I'm done with my computer for the day--getting off my butt

and out the door.

Petra

> Does anyone exercise later on in the day after they already

exercise?

> You see, I have been getting bouts of energy in the day, and I feel

> like I am gonna go nuts if I dont start running a marathon at that

> moment. I feel its just waisted energy if I dont do nothing, but I

> don't want to compromise B4L.

> Help!! Jen

[Guest guest]

Very well put, Petra! I agree completely.

Lynda

[Guest guest]

I have recovered form a right adrenalectomy, and I would say that any significant stress is very physically draining. I had never put those two events together until your mail, but that is the way it has been for me.

I hope that I too have a future without high blood pressure, and can live without complications. Fatigue at the onset of stress is nothing compared to the fatigue of the tumor.

I am sure you father was trying to help, but just as certain she already new much of what was being hidden. Women are pretty intuitive. I find my husband trying to buffer for me too, and while I appreciate it, not is as draining as being ill with Conn's.

Young

Independent Consultant

Southern Living at HOME

[Guest guest]

I have recovered form a right adrenalectomy, and I would say that any significant stress is very physically draining. I had never put those two events together until your mail, but that is the way it has been for me.

I hope that I too have a future without high blood pressure, and can live without complications. Fatigue at the onset of stress is nothing compared to the fatigue of the tumor.

I am sure you father was trying to help, but just as certain she already new much of what was being hidden. Women are pretty intuitive. I find my husband trying to buffer for me too, and while I appreciate it, not is as draining as being ill with Conn's.

Young

Independent Consultant

Southern Living at HOME

[Guest guest]

> But, I don't recall my mother having any major

> problems after the surgery. She seemed to be fine.

> Is this normal?

>

> _

My endocrinologist says this is very normal and pretty much what I have

experienced apart from a concern about my remaining adrenal gland not quite

coping with the additional load which accounts for the tiredness.

Helen

_________________________________________________

[Guest guest]

> But, I don't recall my mother having any major

> problems after the surgery. She seemed to be fine.

> Is this normal?

>

> _

My endocrinologist says this is very normal and pretty much what I have

experienced apart from a concern about my remaining adrenal gland not quite

coping with the additional load which accounts for the tiredness.

Helen

_________________________________________________

[Guest guest]

In a message dated 11/25/2002 5:53:21 PM US Mountain Standard Time,

sue22053@... writes:

> Is it just the spec ed teachers who can set

> goals?

The TEAM should set the goals. You can all come to the table with an idea of

what goals you want, and then based on evaluations decided AS A TEAM what the

goals will be. The goals will need to be worked on throughout the day, NOT

just in the sp ed room so the reg ed teacher should be a part of what they

are going to be or what she wants them to be.

One of the main problems is that most regular ed teachers are unfamiliar with

IEPs and goalsetting and tend to follow the lead of the sp ed teacher.

[Guest guest]

In a message dated 11/25/02 6:53:12 PM Central Standard Time,

sue22053@... writes:

HI Sue

.........I'll give you my answers in this kind of format lol now some of this

is in MHO

> My daughter is 5, included in kindergarten, with speech, ot and resource

room

>

> teacher. Here's my question. Is it just the spec ed teachers who can set

> goals? I thought the kindergarten teacher would set goals for her in the

> classroom. But I'm being told differently.

Reg Ed teachers contribute to the meeting by talking about their curriculum

and what age appropriate goals/objectives would suit your daughter, they also

come up with behavior ideas. Like if her classroom is learning letters and

letter sounds she would offer goal ideas and modifications for your daughter.

> My daughter has speech goals,

> some OT goals for the classroom, (i.e. writing, cutting with scissors,

> sensory stuff) and then the resource room teacher also has writing down as

a

> goal. I also want to put modification in the IEP, for example, the kids

are

> supposed to be able to count to 130 by the end of the year. This seems

> extreme for my daughter. So I want to change it to say....50. That way,

isn't

> she graded on how she's doing towards the 50 rather than the 130? I hope

> you understand what I'm trying to say here. Seems like on her last report

card,

> she was graded according to what she could do compared to rest of the

class,

> and that doesn't seem fair to me. Any help would be appreciated! Sue-MI

Yes, your daughter should be graded according to her IEP, not compared to

typical children in the class. Also a child needs no prior skills to be

included in Reg Ed. Here when Sara was in Kindy, they had letter books, one

letter per book with activities in it. While the Reg Ed children were

learning their skills like the letters and sounds and prephonics Sara was

identifying colors, shapes and sizes of the letter objects. We looked at

those letter books and found all kind of things Sara could learn from them

besides letter sounds lolol she was also graded and still is according to her

modifications and goals on the IEP.

As far as writing goals and objects this is an area I am very involved in. I

am finding (here) the sped teachers goals and objectives to be wrote poorly,

not measurable, not based on her PLOP, and not clear. Watch out for words

like " to recognize " recognize " how " is what I ask. Terminology is very

important and there is somewhere a list of words NOT to be used in goal

writing ...... Im looking for it now for a parent Im helping. Objectives

should be a behavior/action word ex. recognize NO, point to, orally state

etc....... YES

OK Im off the point now lololol Im just a stickler (and Ive made many

mistakes lol) for the way a goal or objective is wrote lol thought Id share

Kathy mom to Sara 10

[Guest guest]

In a message dated 11/26/2002 12:10:30 AM Eastern Standard Time,

b4alltoday@... writes:

> . I

> am finding (here) the sped teachers goals and objectives to be wrote

> poorly,

> not measurable, not based on her PLOP, and not clear. Watch out for words

> like " to recognize " recognize " how " is what I ask.

Oh, let's have a poll on vague goals. I have seen words like " will

improve " or " improve " written in goals. " ny will improve his reading

skills. " Also " make progress " such as " ny will make progress on his

reading skills " and " make gains in " ALWAYS ask your team, your teachers,

" how will you measure the progress in this goal? " ;-)

Cheryl in VA

[Guest guest]

In a message dated 11/28/02 6:52:30 AM Central Standard Time,

web4mom@... writes:

> I have been very fortunate in that the school personnel usually show

> me a lot of respect, so the IEP really is a collaborative effort.

HI Bev

Our staff seems to change yearly, why I leave no assumptions in the IEP

............ it should always be wrote as if a stranger was reading it and had

to implement it

Kathy mom to Sara 10

[Guest guest]

A lot of our goals are stated in this form, which really doesn't bother

me. I would also have a hard time writing an umbrella goal for the many

very specific objectives I write for Danny's IEP.

I usually do write the objectives--things like, " Danny will tell time

for the hours of one to twelve in five minute increments, through the

hour plus fifty-five. " I usually submit my proposed objectives ahead

of time and let the teacher figure out the measurement part. I have not

found an incident of the objectives not being measureable.

The goals and objectives part of our meetings usually goes very

quickly. However, we routinely spend a lot of time on things like

behavior plan, safety plan, etc.

I have been very fortunate in that the school personnel usually show

me a lot of respect, so the IEP really is a collaborative effort. The

only times I have been really ticked have been over administrative

comments and decisions about equity of services, like computer lab.

Bev

wildwards@... wrote:

> In a message dated 11/26/2002 12:10:30 AM Eastern Standard Time,

> b4alltoday@... writes:

>

>

> > . I

> > am finding (here) the sped teachers goals and objectives to be wrote

> > poorly,

> > not measurable, not based on her PLOP, and not clear. Watch out for

> words

> > like " to recognize " recognize " how " is what I ask.

>

> Oh, let's have a poll on vague goals. I have seen words like " will

> improve " or " improve " written in goals. " ny will improve his

> reading

> skills. " Also " make progress " such as " ny will make progress on his

> reading skills " and " make gains in " ALWAYS ask your team, your

> teachers,

> " how will you measure the progress in this goal? " ;-)

> Cheryl in VA

>

>

>

[Guest guest]

In a message dated 11/27/02 10:16:30 PM Central Standard Time,

wildwards@... writes:

>

> >. I

> >am finding (here) the sped teachers goals and objectives to be wrote

> >poorly,

> >not measurable, not based on her PLOP, and not clear. Watch out for words

> >like " to recognize " recognize " how " is what I ask.

>

> Oh, let's have a poll on vague goals. I have seen words like " will

> improve " or " improve " written in goals. " ny will improve his reading

> skills. " Also " make progress " such as " ny will make progress on his

> reading skills " and " make gains in " ALWAYS ask your team, your teachers,

>

> " how will you measure the progress in this goal? " ;-)

> Cheryl in VA

>

Actually I got a statement straight from the horses mouth (so to speak, hehe)

after an IEP meeting. The sped teacher told me that they are taught/told to

at meetings where they learn about this stuff to make goals/objectives vague.

After hearing that I made sure that my advocate came to all meetings this

was the only way I could get them to actually do things more my way and less

their way. hehe

Joy

[Guest guest]

The sped teacher designs and writes (with help from the entire team) all the

goals and objectives. Parents AND the regular ed. teacher are part of the team.

Modifications are designed by the team as well and MUST be included as part of

the IEP if the child has ANY time in the regular ed. classroom.

Elaine

Question

My daughter is 5, included in kindergarten, with speech, ot and resource room

teacher. Here's my question. Is it just the spec ed teachers who can set

goals? I thought the kindergarten teacher would set goals for her in the

classroom. But I'm being told differently. My daughter has speech goals,

some OT goals for the classroom, (i.e. writing, cutting with scissors,

sensory stuff) and then the resource room teacher also has writing down as a

goal. I also want to put modification in the IEP, for example, the kids are

supposed to be able to count to 130 by the end of the year. This seems

extreme for my daughter. So I want to change it to say....50. That way, isn't

she graded on how she's doing towards the 50 rather than the 130? I hope you

understand what I'm trying to say here. Seems like on her last report card,

she was graded according to what she could do compared to rest of the class,

and that doesn't seem fair to me. Any help would be appreciated! Sue-MI

[Guest guest]

What drives me crazy is when they say they will measure this immeasurable goal

by " teacher data " which you never see since it doesn't exist.

Elaine

Re: Question

In a message dated 11/26/2002 12:10:30 AM Eastern Standard Time,

b4alltoday@... writes:

> . I

> am finding (here) the sped teachers goals and objectives to be wrote

> poorly,

> not measurable, not based on her PLOP, and not clear. Watch out for words

> like " to recognize " recognize " how " is what I ask.

Oh, let's have a poll on vague goals. I have seen words like " will

improve " or " improve " written in goals. " ny will improve his reading

skills. " Also " make progress " such as " ny will make progress on his

reading skills " and " make gains in " ALWAYS ask your team, your teachers,

" how will you measure the progress in this goal? " ;-)

Cheryl in VA

[Guest guest]

In a message dated 12/1/2002 12:03:39 PM Eastern Standard Time,

dbonorato4@... writes:

> by " teacher data " which you never see since it doesn't exist.

>

I know, I am advising parents to request in writing samples of the data and

charts of the recorded teacher observations ...... as a way to force them to

start keeping the data. Our school system has assured us that they have

preached and preached to the teachers that they must maintain the data the

progress is based on. Our sped director has told parents to ask the teacher

for the data.

We will see what happens!

Cheryl in VA

[Guest guest]

I can't wait to see what happens when someone asks for the data. I work with

two sped teachers who teacher children labeled SLD (specific learning

disability). I don't know if they keep data or not, but I see them constantly

involved in paperwork. Since my boss is also head of the dept., she has the

behavior class too and they are self-contained only after months of attempting

inclusion and documentation. I wish they did as much for kids with DS in the

target schools for them.

Elaine

Re: Question

In a message dated 12/1/2002 12:03:39 PM Eastern Standard Time,

dbonorato4@... writes:

> by " teacher data " which you never see since it doesn't exist.

>

I know, I am advising parents to request in writing samples of the data and

charts of the recorded teacher observations ...... as a way to force them to

start keeping the data. Our school system has assured us that they have

preached and preached to the teachers that they must maintain the data the

progress is based on. Our sped director has told parents to ask the teacher

for the data.

We will see what happens!

Cheryl in VA

[Guest guest]

I find WV rather appealing. Can you send me the info, too?

Bev

Question

I am possibly entertaining the thought of moving sometime in the future to

either Tennessee or West Virginia. For those on the list who are from

either of those states, can you give me some kind of an idea as to what is

there both educationally and medically? Also, what kind of therapies and

programs are offered where you are.

Thanks!

Judi - Proud mother to Jordan 7, ds and Savannah 10 weeks, nda

Where ever you go....

There you are

[Guest guest]

Not sure where I want to live just yet. I don't want the absolute boonies, but

I don't want a big city either. But if I get my way maybe four years or so, so

I've got some time. I want to be in the country and PA is just not doing it for

me. I don't feel " home " here and need a change. My mom just joined this list

and she's gonna kill me when she finds out hee hee!

Judi - Proud mother to Jordan 7, ds and Savannah 10 weeks, nda

Where ever you go....

There you are