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Hello to all our friends,


 “The lessons we learn in life are not always appreciated or understood at the time we learn them.”


Thirty-five years ago, at the age of 34, when my wife and I and our two oldest children moved to South Bend to live and develop a physical therapy practice, I believed that I was meant to be in a small community. I also believed it would be a great place to bring up our family, and it has been! Here it is 35 years later, and I just turned 70 years young. Over time, we added two more children and through them, eight grandchildren. What I thought might grow to be a small practice of 4- 6 team members in the original basement office downtown across from the post office, has become a team of 34 (between our main Hickory Rd. location and our 15-year-old satellite on University of Notre Dame’s campus.)


As I reminisce about life in my early years, I can’t help but think about my dad, mom and brothers and sisters. Growing up I was responsible for preparing lunches for my nine brothers and sisters. I made peanut butter and jelly sandwiches, stacking them one on top of the other and cutting them all at once. I was also responsible for other tasks (as were we all) and would be evaluated by my mom or dad. Waiting to hear my parents’ assessment of my work was always a trying time. Almost every job was “incomplete” or “not up to par.” I hated those evaluations. I hated being held accountable for my work. At the time, I wondered how their critiques would help me. Why were they so, in my mind, demanding?


As I think back now, I actually need to thank my dad and mom for the service they did for me and for the strength of character they imbued in me. Within my family, we may argue about how to bring up children, who to vote for, even who may have been responsible for some dire events in our family history. But there is one thing we all learned that has made us successful as individuals - we are all responsible for what we do. We learned early and often that we needed to work hard and care about what we did. We knew not to blame others for our mistakes.


When I first moved to South Bend with my wife and two children (Mara & Michael), I was very anxious. Would I succeed in South Bend? In Illinois, patients had been able to come to see me without a referral from a physician; in Indiana, this was not yet the case. (This law changed in Indiana in 2013 and now allows patients to come directly to a physical therapist for up to 42 days without a physician referral). Back then, I needed to somehow get to know the physicians and prove to them that my physical therapy would benefit them more than the physical therapy they had been using.


During those scary times, when I wondered if I would be able to pay the bills, the lessons my parents taught came back and helped me a great deal. As the practice slowly developed, friends asked if I wanted investors to help me get over the hump. They all had more confidence in me than I had in myself. They believed in my abilities and my work ethic, and they were willing to invest to help me and eventually, themselves.


I was tempted to use their help, but my parents’ lessons came to me once again. If I took the assistance, life would be easier, but I wouldn’t be taking full responsibility. I thought it would be the easy way out. I was always told, “You have to be willing to put yourself on the line,” to become a stronger and better person. With these words ringing in my head, I chose the more difficult way and did not accept financial assistance from my friends.

By not taking the assistance I felt more pressure (just as I had waiting for my parents to inspect my work at home.) Yet, because of this, I decided to challenge myself in ways I would not have done before. I would market McDonald Physical Therapy. I hated the thought of going out to meet with physicians. I hated marketing of any kind. Why couldn’t I just open and have patients come in and see me? Nevertheless, I did go meet with physicians. I asked them to refer patients who had been to physical therapy or surgery and had not gotten better.


Patients did come to me for physical therapy, and they talked to other prospective patients. They also put in a good word to the physicians who had been brave enough to give me a chance. Physicians started to tell other physicians. Little by little our practice grew in ways I never thought possible.


I owe much of the growth of our physical therapy clinic to the challenging lessons of responsibility my parents taught me as a young person. I may have not enjoyed learning these lessons (at the time), but I thank God for my parents’ efforts and unwavering resolve. I also owe much to the patients who were willing to tell others about the new kid on the block and the physicians who gave me a chance. Thanks to all of you for helping us become a part of the community for the last 35 years. It has been and will continue to be a blessing.


Enjoy the journey,

Fran McDonald President/CEO

Physical Therapy vs Opioids: When to Choose Physical Therapy for Pain Management


Sales of prescribed opioids have quadrupled in the United States. This has happened even though "there has not been an overall change in the amount of pain that Americans report." (Centers for Disease Control & Prevention)


In response an opioid epidemic, the CDC released opioid prescription guidelines in March 2016. The guidelines recognize that prescribed opioids are appropriate in certain cases, including:

  • Cancer treatment.
  • Palliative care.
  • End-of-life care.
  • Certain acute care situations (such as after surgery), if properly dosed.


But for other pain management, the CDC recommends nonopioid approaches including physical therapy. The following are some reasons why you should choose physical therapy instead of prescribed opioids for pain.


Choose physical therapy when:

  • The risks of taking opioids outweigh the rewards.
  • Potential side effects of opioids include:
  • Depression.
  • Overdose.
  • Addiction.
  • Withdrawal symptoms when stopping use.


Because of these risks, "experts agree that opioids should not be used as firstline or routine therapy for chronic pain," the CDC guidelines state. Even in cases with limited evidence on the long-term benefits of non-opioid therapies, "risks are much lower" with non-opioid treatment.

  • You want to do more than mask the pain.
  • Opioids reduce the feeling of pain by disrupting pain signals to the brain. Physical therapists treat pain through movement. They partner with patients to improve or maintain their mobility and quality of life.
  • Your pain or function problems are linked to low back painhip or knee osteoarthritis, or fibromyalgia.
  • High-quality evidence supports exercise as part of a physical therapy treatment plan for these conditions.
  • Even when your doctor prescribes you opioids for pain.
  • Even when opioids are prescribed, the CDC recommends that patients should receive "the lowest effective dosage." It also says that opioids "should be combined" with nonopioid therapies, such as physical therapy.
  • Your pain lasts 90 days or more.
  • After 90 days pain is considered "chronic." The risks from continued opioid use increase. An estimated 116 million Americans have chronic pain each year. The CDC guidelines note that nonopioid therapies are "preferred" for chronic pain. They also say that physicians should only consider opioid therapy if the expected benefits for pain and function outweigh risks.


Before taking opioids, consult with a physical therapist to discuss options for safer treatment.


"Patient education and discussion before starting opioid therapy are critical so that patient preferences and values can be understood and used to inform clinical decisions," the CDC states.


Physical therapists can play a valuable role in the patient education process. They help people set realistic expectations for recovery with or without opioids.


Physical therapists are movement experts. They improve quality of life through hands-on care, patient education, and prescribed movement. You can contact a physical therapist directly for an evaluation.


**choosept.com


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