Huddle up, fitness enthusiasts. You’re going to want to hear this one.
St. Tammany Health System Director of Rehab Services Bert Lindsey recently visited The Lake 94.7-FM to discuss the health system’s new musculoskeletal ultrasound program, a game-changing technique that allows care providers to more quickly and easily diagnose soft-tissue injuries.
With it, injured athletes can receive the targeted care they need to get back on their feet as quickly as possible. But just as importantly, it in many cases reduces the need for overprescription of opioids and other habit-forming painkillers.
Listen in to Bert’s conversation with The Lake host Charles Dowdy through the embedded audio player below or at The Lake website. You can also scroll down to read a transcript of their chat, which has been lightly edited for clarity and length.
Charles Dowdy: Got our friends from St. Tammany Health System here. Tim, how has your morning been other than traffic?
Tim San Fillippo: It has been good, Charles. …
Charles: We got another guy here as well, Bert Lindsey. We haven’t seen him in a while. How have you been?
Bert Lindsey: I have been working.
Charles: Yeah, well you and Tim both, apparently. A little bit of background on you, if you don’t mind. Kind of who, what, when, where as far as who you are.
Bert: I am a physical therapist. I am the director of Rehab Services and Patient Mobility for the Acute Care Hospital of St. Tammany, part of St. Tammany Health System.
Charles: Alright, you have been here before. You and I have talked before. What is on your mind as far as today is concerned?
Bert: So, as part of our efforts to bring innovation to this community, we are about to roll out a very large musculoskeletal ultrasound program.
Charles: All right, so what does that mean?
Bert: So, everybody is pretty familiar with ultrasound. Women get them every time they get ready to have a baby. They and their husband will see the little child inside of her. They use it for all kinds of organ assessments. It is now going to be used for the assessment of musculoskeletal injuries. So, if you have ever seen a game, a pro ball game, and those people get hurt and they go to the tent. They may get an X-ray, but if they go back to the locker room, there is a clinician or physician back there using musculoskeletal ultrasound to scan them on the spot for injury, which is why they get to go back in the game so quick.
Charles: So now you guys are going to be able to employ that.
Bert: It has been a three-year journey. We have a couple of people who passed the national boards (and) two of us are taking it in May.
Tim: That is a very thorough exam. It is tough.
Bert: It is extremely tough. It is a physician exam that they let physical therapist, nurse practitioners and physicians assistants sit in on.
Charles: Why is it this important that you guys have this ability now?
Bert: So, let’s just use the shoulder as an example. We’ve got a lot of student athletes of all different ages in this community that play all year round. They will have a trainer. They may have a physician or a therapist that is on their team that follows them. We all do special orthopedic tests if they have an injury. But to get an MRI to definitively diagnose an injury, it is very difficult because insurances just don’t want to give you that. They make you go through a lot of conservative treatments. Part of what we did for opioid advancement to reduce the exposure to opioids, we brought this modality in because if your child gets injured, and I can assess them on the field and I see something that is significant, I can get that patient to the physician and we can get the MRI immediately instead of making them go through rounds of opioids, rounds of therapy which are just going to cause them pain, because no one can see underneath the skin unless you have an MRI.
This technology is special because you can actually do videos. So you can see dynamic movement, see if ligaments are strained or torn. It is just phenomenal. All over the world except for here (in the United States), it has been used for 25 years.
Charles: Why is that?
Bert: Because they don’t have MRI’s and CT’s. Most of your developing countries don’t have that. So most of the physicians there use (musculoskeletal ultrasound). It is a primary go-to for them.
Charles: So, to speak, it is not a new technology. It is a new ability here locally. Fair enough?
Bert: The first published paper on using ultrasound on musculoskeletal issues was 1972. It didn’t really become in vogue until the early ’90s. Technology has just improved so much now. You can get a fantastic picture now. Image quality is fantastic.
Charles: Let’s talk about I guess one of the big benefits. Not only is it instant but the fact that you are not going under, you are not -- there is no after affects.
Bert: There are no side effects. You just get a warm gel put on you and we show you the images in real time. We can actually move your joints and stress your joints so you can actually see exactly what that stress is doing on your ligaments and joints. We can find tendonitis, real bursitis -- anything that shows up from that perspective. We can see it immediately.
Charles: That is crazy. Every time I have done it, though, my wife and I have been like, “Aaaahhhhh” – you know, in terms of there, “Is another kid in there? How did this happen?”
Tim: Speaking of kids: What does this mean for your young athlete? You know that is itching to get back on the field.
Bert: Well, you know we see a lot of people now in their 30s. They have been playing sports all year round since their twenties and their teens, throughout college. They are starting to suffer a number of adverse effects from that in their 30s. They should not be getting these issues until they are in their 50s and 60s. But what happens is the student athlete wants to play through pain. The coach doesn’t exactly know what the status of the person is, even if they have a trainer there, a therapist or a doctor. They are just testing injuries for ligaments and what not. X-rays will not show soft-tissue injury, so if you could come in after you get hurt or after practice and get your scan, we would be able to give you exact dimensions of your tendonitis or tear or whatever issues you have. You would have the peace of mind, and your mom and dad would, of knowing (you) don’t have an injury. And then, if you have to be held out for your own good, you can come back and get scanned again. It takes about five minutes. It is pretty quick.
Charles: Is it a machine you are getting in?
Bert: No, it is just a mobile unit. Just consider the one that they used on your wife for the ultrasound. It is just the machine that holds it. We can set it up anywhere. In fact, we have some small units that we can set up on the fly – I was going bring one here, but I wasn’t sure about the sound interference – that are handheld and they go right to your iPhone. So, you can just scan right there.
Charles: That is incredible.
Bert: It is incredible. Technology has come a long way.
Charles: Tim I will let you respond to this, but Bert is kind of like the guy in the beer commercial: the most interesting man in the world. You know what I mean?
Tim: He sure is.
Charles: He has got a lot going on.
Tim: Ex-military.
Charles: Yeah
Tim: He plays guitar or bass.
Bert: I play lead guitar in a church band
Charles: And now he has got some newfangled technology that he --
Tim: -- newfangled hand wand to make sure that your injuries are taken care of correctly.
Charles: You did say, how many people are actually certified in this?
Bert: Less than 900 people in the nation, well actually the world, who have the APCA, the ARDMS certification for diagnostic ultrasound.
Charles: That is incredible.
Bert: It is. You know, one of the core values of St. Tammany Health System is innovation, so they have done everything they can to get us prepped for these exams. It takes thousands of hours.
Charles: And it is not necessarily something the hospital had to have. It is just something that they wanted to have. In other words, it is a benefit to their patients.
Bert: It is. And again, it all stemmed from us trying to do whatever we could do to avoid opioid exposure. I am doing a 90-minute workshop with Jay Morange and Ashley Wilson in Chicago for the American Hospital Association on the sixth of next month. One third of it is going to be on this. Anything you can do to reduce exposure will eventually result in a reduction of dependence, so the sooner you can get someone with an injury most properly assessed and to the right physician, … the easier it is going to be for them to not have that initial exposure (to opioids).
Charles: And just to make sure I am closing the circle here. But, in years past – I don’t know how long ago – somebody comes in and they have got an injury. We just didn’t know what we were doing in a lot of respects. We were giving them medicine that in a lot of instances was not necessarily the best thing.
Bert: Right, but a lot of that was actually propagated by CMS. which is the entity that runs healthcare. They were pushing pain as the fifth vital sign and they wanted everybody to address pain. Then the Oxycontin issue came in. Needless to say, there are studies out there that say a 16-year-old pitcher that has exposure to two different scripts and 90 days to Oxycodone will have a much greater chance of some kind of lifelong addiction.
Charles: It makes sense.
Bert: It makes sense.
Charles: Yeah, what have I missed. Anything else?
Bert: No, I am studying for boards. I am taking my exam in May. So, when I am not doing this lecture in Chicago I am going to studying.
Charles: Alright, well thank you for the visit. It is good to see you again. Tim.
Tim: Definitely hats off to Bert and his crew. From what I understand, not only are we some of the few in the Gulf South to have it. Across the nation.
Bert: No one has ever done it on this scale.
Tim: It is amazing. Just a quick information piece for our community: Our friends over in our HR Department are putting on
an onsite job fair for maintenance-type employees. We are talking about support services, coordinator, maintenance scheduler, mechanic, maintenance mechanic, apprentice and ground technician. That event is going to be held on Wednesday, March 9, from 1 to 4 p.m. If you have any questions, give Aarion a call at (985)898-4415.