November 2019 PULSE

NOVEMBER 2019

ROCKTOBER! Unmatched Experiences, Clinical Excellence, and Lifelong Relationships WOW! This truly has been Rocktober. There are so many ways we’re following through on our mission of providing unmatched experiences, clinical excellence, and lifelong relationships.

THE GREAT PUMPKIN It is real…….a highly competitive group of creative pumpkin creators are hard at work. We have rocket ships, fog, and even babies involved this year!

ORTHOPAEDIC RESIDENCY! In last issue of the PULSE I wrote about the journey to the application for an orthopedic residency program.

Two days after the issue went to “print” we received official notice of a 5-year accreditation!

TWP #9!

Yes! We are one of only a small handful of Connecticut companies to achieve this honor! We finished at our best ever ranking number 3! PTSMC also received a special award for “Outstanding Values”.

PTSMC #24!

On Monday October 21st, Kasey Adinolfi became the proud partner in Wethersfield. In a whirl wind of activities we went from lease signature to an open door in about three weeks.

GIVING THANKS Last week, the Admin Team delivered apples and pears in celebration of the people that make PTSMC a great company! Thanks for bringing our mission to PT for LIfe. “I love you to the core”!

TDN 1,2,3!

Early this year we made a huge financial and clinical commitment to TDN 1,2 and 3. On Columbus Day Weekend, 12 PTSMC clinicians successfully earned the credentials CMTDN! Clinical Excellence!

Bryan Baker Stephen Strong Melissa Boutagy (Lembo) Erik Schmitt Danielle Dunn Rick Purdy Ted Fifield Rebecca Petrosino Channing Harwood Josh McAdams Fred Havlicek Tom Kassan

IN THIS ISSUE Clinician’s Corner by Amber Manville Understanding Scelroderma Introducing Our New CDCs! Breathing for Relaxation by Greg Schlossinger HR Buzz End of Year Reminders Thanksgiving Holiday Schedule Dependent Care Savings Account 401(k) Reminders PTSMC Retirement Webcast Need a Refresher on Your Retirement Options?

Wellness Program #GetMoving Holiday Edition Lifebeat - Fuel Your Fall Fall Activities

Looking for the Strivehub Fab 5?

It’s moved to page 3!

Thanks, Alan

IT’S OFFICIAL! The PTSMC Orthopaedic Physical Therapy Residency Program is fully accredited! Our accreditation was granted on September 30th by ABPTRFE and is good for the next 5 years.

Welcome to PTSMC Wethersfield!

PTSMC Wethersfield opened its doors on October 21st with Kasey Adinolfi as Partner & Director. The new clinic has a state-of-the-art design and updated equipment. Congratulations to Kasey and welcome to the family! Kasey’s pictured here in the new clinic with her brother.

“I am extremely proud of the group of clinicians who contributed to the development of this program and would like to thank all those in the Admin office for their support throughout the process.

Last but not least, thank you to our first residency graduates, Channing Harwood, Erik Schmitt, and John Galer. It is an honor to teach and mentor such dedicated professionals,” said Mike Gans, Orthopaedic Residency Program Director

CLINICIAN’S CORNER UNDERSTANDING SCLERODERMA

By Amber Manville, PT, DPT PT for Life Southbury One day, a patient came into the office for an evaluation of her left foot. She reported she has also been diagnosed with CREST syndrome. She then paused and said, “Have you ever heard of CREST?” I responded that I had and in fact, had one other patient who was diagnosed. She sighed in relief and stated, “Oh good, no one ever knows what it is, they think of the toothpaste.” This statement made me reflect on how refreshing our knowledge of different diagnoses can be to a lot of patients. Considering this interaction, I felt that highlighting a rare disease would be crucial for expanding our knowledge as clinicians.

Scleroderma is broken into localized and systemic scleroderma.

Systemic scleroderma includes CREST syndrome and diffuse scleroderma. CREST syndrome is a localized variant of limited cutaneous systemic sclerosis (lcSSc) which is characterized by calcinosis causing tightness mostly in the hands and face, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyl, and Telangiectasias.1,2,3 Patients can have 2-5 of these symptoms and have lower incidence of internal involvement.1,3 Diffuse scleroderma (dSSc) can occur more rapidly and can affect the organs, such as the heart, leading to heart, kidney, and lung involvement. Conditions including pulmonary fibrosis and hypertension can result in weakness, joint pain and myopathy. Diffuse scleroderma can worsen rapidly in the first five years. There is also another form of systemic sclerodermas which is an overlap of limited and diffuse. 1,2,4 Localized scleroderma can include morphea, which includes oval shaped patches on the trunk. Linear scleroderma includes band-like lesions on the skin. This form primarily affects the skin but not the organs and may impact the joints and muscles. The use of blood tests, skin biopsy, x-rays of joints and lungs, specific organ tests such as lung function, GI series, and distinctive serum antibodies which are found in 90% of cases can aid in confirmation of scleroderma.2,5 Physical therapy can assist in the improvement of ROM and improve joint mobility in these patients. Patients can experience contractures, arthralgias and tendon friction rubs. In patients with dSSc management of ROM and stretching to decrease contracture risks is very important. Regular exercise as well as active and passive stretching are important in maintaining flexibility and have been shown effective. Skin can be sclerotic and may be sensitive to pressures placed on it. Aquatics can also be effective for exercise to aid in the sensitvity.4,5 Self-administered stretching programs have shown to

improve ROM of the fingers. Manual stretching and ROM exercises which consist of exaggerated facial movement have also been effective in mouth opening which can affect oral health. Massage and joint mobilizations were shown to improve fist closure. Paraffin wax with exercise has been shown to be effective in treatment of the hands with improving extensibility of collagen. This has been shown to be more effective than exercise alone.5 Protection of swollen and painful joints can also be important and lightweight splints may be used for joint protection however dynamic splints have not been shown effective.4,5 Cardiopulmonary involvement must be considered and may present with limitations with aerobic and endurance capacity, however resistance and stretching programs as well as breathing and aerobic exercises showed positive results.5 Patient education on taking blood pressure three times a week to assess for acute hypertension is also very important for patients.4 It is important to take into consideration the effect these other diagnoses may have on our patients that can affect their POC and tolerance of treatment.

1. Adigun R, Hariz A. Systemic Sclerosis (CREST syndrome). StatPearls [Internet].

January 2019. https://www.ncbi.nlm.nih.gov/books/NBK430875/. Accessed October 23, 2019.

2. Hachulla E, Launay D. Diagnosis and Classification of Systemic Sclerosis. Clinical Reviews in Allergy & Immunology. 2010;40(2):78-83. doi:10.1007/s12016-010-8198-y.

3. CREST syndrome. Genetic and Rare Diseases Information Center. https://rarediseases.info.nih.gov/diseases/12430/crest-syndrome. Accessed October 25, 2019.

4. Goodman CC, Fuller KS. Pathology: Implications for the Physical Therapist. St. Louis, MO: Elsevier Saunders; 2015.

5. Poole JL. Musculoskeletal rehabilitation in the person with scleroderma. Current Opinion in Rheumatology. 2010;22(2):205-212. doi:10.1097/bor.0b013e328335a7d2.

Congratulations to our new Community Development Coordinators!

Congratulations to Ally Condo and Danica Sadowski! Both have been hired to be part time Community Development Coordinators at PTSMC. Ally and Danica will be splitting their time between their new roles and the Avon and New Milford clinics, respectively.

Ally joined PTSMC Newington in 2016 while completing her Exercise Science degree at Central Connecticut State University. She started with an internship before becoming a PT Aide and assisting with the front desk operations for a period of time. Ally transferred to the Avon clinic to support Transitional Rehab coverage during a leave of absence. During that time, she maintained the client base and offered stretching classes. Ally is excited to educate the community about health and wellness and to continue to spread the PT for Life mission. In addition, she looks forward to networking and meeting new people who can make a positive impact on the lives of PTSMC patients and the communities we serve. In her free time, Ally loves to hike, spend time outdoors, travel and see new places, and spend time with friends and family at the beach in Madison where she grew up.

Danica comes from New Milford and joined PTSMC New Milford in May 2017 as a PT Aide after completing her Exercise Science degree at the University of Connecticut. She will maintain a split role at PTSMC, continuing to support New Milford as an Aide while bringing her knowledge and interpersonal skills to the Community Development Coordinator position. Danica is excited to grow within PTSMC and to meet and work with new people throughout Connecticut. When not working, Danica enjoys an occasional doughnut (or two) and loves taking her pit bull for walks.

Kudos to Heather Feiner, who has done an incredible job setting the foundation for relationships in our communities and connecting our people to influential residents and business owners in the towns we serve. Having regional CDCs will offer PTSMC the opportunity to leverage current relationships, create new ones and, most importantly, focus on depth in our community activities.

The regional CDC breakdown is as follows: Heather Feiner - Central/Shoreline Branford East Hampton Essex Groton Guilford Middletown New Haven New London Orange Wallingford Westbrook

Ally Condo - Greater Hartford Avon Newington Plainville Southington West Hartford Wethersfield Windsor

Danica Sadowski - Western/Southwestern CT Fairfield Naugatuck New Milford Southbury Watertown Waterbury

2019 Courses

Email coned@ptsmc.com to register

Email coned@ptsmc.com to attend November 14, 4pm - 8pm PTSMC Newington Vestibular/Concussion Internal Course by Rick Purdy

StriveHub Fab 5 “The staff is warm and friendly, and they make you feel very comfortable. Ted (Raczka) is a great physical therapist who listened to my symptoms and knew right away what the problem was and how to go about making it better. Their hours fit right into my schedule and always accommodate me. Glad my doctor referred me to them. I highly recommend them.” - Branford “My therapist, Amber Manville, has been wonderful! She is very attentive and supportive to my needs and explains things very well. I feel like I am in good hands and feel blessed to have been helped by the PTs from this group.” - Southbury “Compared to other physical therapy services I’ve received in the past these services are top notch. I was feeling better, stronger, less pain, in one appointment.” - Guilford “My therapist was professional, knowledgeable, respectful and encouraging. This was my first time in PT. I am 75, and did not know what to expect. I was immediately put at ease. I have made good progress and am almost at my goals.” - Newington “Your facility is run very well. The staff is friendly and courteous. And most of all, they’re extremely knowledgeable of my problems and how to create a great care plan to help me on my way to recovery.” - East Hampton

STUDENT PROGRAM UPDATE Renee Lascarides (QU) will facilitate a discussion on Blood Flow Restriction on November 4th at 1:00 pm in Wallingford.

Miranda Zygmunt (QU) will present “Moving Past the Rest is Best - Treating Concussions” on November 11th at 1:00 pm in Waterbury.

Alyssa Lubin (QU) will present “Fall Risk Research - Decrease and Prevention in the Geriatric Population” on November 12th at 12:00 pm in Orange.

HUMAN RESOURCES

HR End of the Year Reminders

Have you used your Personal Holiday Day for 2019? Use it or lose it.

Reset date is January 1, 2020.

2019 Holiday Policy PTSMC recognizes six (6) national holidays and one (1) employee personal holiday in which eligible employees are provided with paid time off.

Dependent Care Savings Account/DCSA

Eligible employees must request their Personal Day using the holiday selection:

Are you paying for dependent care for your children or elderly parent? Did you know that PTSMC offers a program where you can get reimbursed for those expenses with PRE-TAX dollars through payroll?

• Click on Time Off icon

Employees meeting the following eligibility requirements can have PRE-TAX deductions from their paychecks so that they can be reimbursed for dependent care expenses tax free.

Eligibility Requirements • Employee has a child “who needs daily care while you are at work” • Or, employee has a disabled parent or spouse “who needs daily care while you are at work” • Incurring the expense allows you to work • Employee must be scheduled to work 20 or more hours per week • Eligible expenses may include the costs for dependent care at home or in a day care center or after school care for children under age 13 • Employee may contribute up to $5000 in a calendar year to the dependent care savings account if you are married and file a joint return or if you are single and file as head of household.

There are a few government rules and regulations regarding this benefit. If interested, contact Sandra Boccialetti at sandra.boccialetti@ptsmc.com for specific details. All employees currently in the plan will receive the required paperwork from Sandra by November 15, 2019. Enrollment for January 2020 must be completed by December 13, 2019.

NOVEMBER BIRTHDAYS Pauline White Emily Hansen Sharon Hallahan Nicole Skirkanich Ally Condo Liz Walton Stephen Strong Victoria Carcova Vanessa Silva Cara McEvoy Emily Fillion Heidi Klein-Robbenhaar Liz Saunders Sandy Wickman Mason Brian Vo Cindy Hales Ryan Balavender Todd Cacopardo Dave Domkowski Amber Manville Mike Antunes Jordan Jud Monica Duque Joe Mabry Tyshell Le'Sane Christine Rasile

2 3 3 3 7 7 8 8 9 10 11 13 13 13 16 16 16 16 17 18 18 19 24 26 27 28

East Hampton Avon Essex Orange Admin & Avon Naugatuck Groton Orange Middletown Branford Admin Wallingford New London Admin Windsor Admin Admin East Hampton Orange Southbury Middletown Wallingford West Hartford Waterbury New Haven Admin

ANNIVERSARIES Ken King

Physical Therapist Westbrook

Leslie Riviere PSA

New London

Joe Caligiuri Partner & Director Naugatuck

• Click on Request Time Off in the left corner • Under the Type dropdown select “Holiday “and complete the remainder of your request with date and hours being requested.

401(k)

Employees who would like to make a change to their 401(k) biweekly contributions for the 1st quarter of 2020 must complete the request by Friday, December 13, 2020 to be effective with the January 1, 2020 payroll.

Login to www.jhancockpensions.com and click on “Manage” and then “Contributions.”

Thanksgiving Holiday Schedule

All clinics will have the option of opening 7:00 am – 5:00 pm on either Wednesday, November 21st or Friday, November 23rd.

PTSMC RETIREMENT WEBCAST! The PTSMC retirement plan is a powerful savings tool and a value-added benefit. We work closely with John Hancock who have more than 150 years of leadership and experience helping millions of Americans prepare for their financial futures. John Hancock is committed to providing you with the right tools and resources to help you make informed retirement planning decisions.

For many eligible PTSMC participants, the enrollment webcast was your first exposure to retirement planning. Often the information is overwhelming and confusing.

PTSMC is offering a “REFRESHER” webcast for those who would like to hear more information about the program, investing and what tools are available on the John Hancock website to assist you in planning for your FUTURE! Attend a live education webcast session, When: Nov 19, 2019 | 12:00 pm - 1:00 pm To sign up, email: Sandy Wickman Mason; sandy.mason@ptsmc.com In the subject line: I’m planning for my RETIREMENT A WEBCAST invite will be emailed to those who sign up. We look forward to your participation!

EMPLOYEE NEWS

NEW EMPLOYEES Welcome to PTSMC. We’re so happy to have you!

Tyshell Le’Sane, PSC New Haven

From left to right: Holly Riccitelli, PT Aide Essex Anthony Faria, PT Aide Middletown Joy Tso, PT Aide Avon Charles Brooks, PT Aide Plainville Faith Burns, PT Aide East Hampton

Joan Porper, Director of Payer Relations

From Left to Right: Rachel Bellone, PSC Wethersfield Emily Norton, PSC Newington

Mario Paredes, Physical Therapist Orange

CURRENT JOB OPPORTUNITIES to the following employees who have achieved the attendance reward for the 2nd and 3rd quarters of 2019.

Ryan Balavender, Director of Facilities, married Meghan McFee on September 14th on Block Island.

Megan Burke Kelley Cahill Victoria Carcova Daniel Delgado Danielle Dunn John Galer Susan Ginsburg Brian Greer Emily Hansen Channing Harwood Caitlin Lehane

Kristina Lipeika Joseph Mabry Lauren Mariotti Liz Melvin Traci O’Brien Andrew Perazella Harrison Picard Rick Purdy Danica Sadowski Emily Searle Stephanie Weyrauch

Patient Services Coordinator Physical Therapist West Hartford (part time) Middletown New Milford Windsor Physical Therapy Aide Westbrook Wethersfield Windsor

Practice Liaison Admin - will cover the west and southwest region

Patient Benefits Coordinator Part Time Office Assistant Admin Admin Check PTSMC.com for our most up to date postings and feel free to share! Call or email Jenn at jenn.detlefsen@ptsmc.com if you are interested in a PT Aide position. Call Karen or email at karen.havlicek@ptsmc.com if you are interested in a position other than PT Aide.

PTSMC Happenings

- OUT IN THE COMMUNITY THIS MONTH Wednesday, November 6th at 6:30 pm Tom Kassan presenting on skiing injuries at REI Wednesday, November 20th at 11:00 am Nick Almonte presenting on vertigo and balance at the JCC of Greater New Haven Thanksgiving Thursday, November 28th at 10 am Southbury at Southbury Turkey Trot

Orange celebrated a “Choose PT” day to raise awareness about PT as an alternative to opioids.

Carol Corbo, PT Aide Waterbury, celebrated 35 years with PTSMC. She’s pictured with Rob Bass, Float PT.

Kasey Adinolfi, Partner & Director of PTSMC Wethersfield attended the UConn Student Athlete Career Fair.

Fairfield stretched runners out at the Sound Tigers 5k.

New Milford (bottom) and New Haven raised awareness for Breast Cancer Awareness Month in their clinics.

Guilford (left) and New London celebrated National Boss’s Day. Pictured from left to right is Steve Platt, Partner & Director of PTSMC Guilford, and Jeff Daley, Physical Therapist at PTSMC New London, and Scott Olmstead, Partner & Director of PTSMC New London.

SoCIAl Media Sensation EVERYONE!

Thanks to everyone who sent in pictures of your pumpkins!

Check out the full album on our Facebook page.

Westbrook stretched runners out at the Chamard Vineyard Half Marathon.

Patient Testimonial

Shradha Rana, PT Middletown, has been working with Beatrice.

Beatrice is extremely grateful for Shradha and said, “You inspire me.

You are my inspiration.” It’s people like Beatrice who inspire all of us and remind us why we do what we do!

Life Beat

Fuel Your Fall

#GETMOVING

Holiday Edition Are you ready to #GetMoving again?

Well put on your most festive active gear, because the PTSMC Wellness Program is hosting a #GetMoving Holiday Challenge for the first time!

Fall is one of the best seasons in New England because of the crisp air and beautiful scenery. On the flip side, fall also brings the cold and longer hours of darkness. So, here are some tips to fuel your mind, mood, body, and appetite and keep your personal fire going!

Mind & Mood: Our mind is powerful, and we CAN control how we feel by the actions that we take, big or small. Some simple things that can keep our spirits up when the weather changes include: Change your Netflix binge watching all alone to a “Movie Night” with friends or family Cook festive fall recipes Take a drive or even a weekend getaway to view fall foliage Sleep 7-9 hours a night- too little or too much can throw off your energy Take on a “fall fitness challenge”- Use Pinterest, Google or YouTube to find a gym or at home workout routine. The more you move your body the better you mentally feel!

Take advantage of the beautiful fall days and get outside Body: Vitamin D plays a large role in the regulation of our immune system and lacking this vitamin increases our chances of getting sick. A main source of Vit. D is from sunlight. So, as we continue to lose daylight it is vital to fuel your body with an alternative source, such as taking a Vit. D supplement.

Additionally, to avoid the fall-time flues, we all benefit from washing our hands, drinking plenty of water, and choosing to eat foods that are high in nutrients and vitamins.

Appetite: To best fuel your appetite and health, look for seasonal foods.

This means these foods are “in-season” and at their peak during fall. Here are a few examples: Fruits: Citrus fruits, apples, pomegranates, pears, cranberries Veggies: Spinach, celery, kale, carrots, artichokes, broccoli, sweet potato Squash: Acorn squash, spaghetti squash, pumpkin Whole Grains: Oats, millet, brown rice, quinoa Herbs: Cinnamon, rosemary, thyme, dill, basil, turmeric, ginger Legumes: Chickpeas, lentils, beans, soybeans Fish: Haddock, cod, sole, sea bass

Between the parties, food, spirits and sweets, your health might end up feeling less than bright and cheery by New Years’ Day. If you set goals and commit to them, you can sleigh the holidays and feel better than a kid on Christmas morning!

What is #GetMoving? #GetMoving is a company-wide, social-media based initiative to inspire physical activity and well-being through friendly competition. The challenge is simple: be active 3 days a week for 30 minutes, over 3 weeks.

We’re changing the game for the Holiday Challenge, so if you want to win a great health-related prize, read carefully below: 1) The challenge runs for 3 weeks: Monday December 2nd through Sunday December 22nd Each DAY you work out/get active for at least 30 min, you will earn you 10 points. To earn those points, you must also submit a photo via email or post one on social media (and make sure to tag PTSMC). Multiple submissions or posts per day will not earn you addition points - this challenge is about the number of DAYS you are active.

2) You can earn BONUS POINTS by participating in the following activities: • Weekly Workout - The PWP will send out a weekly activity/workout each Monday. If you do the WW as 1 of your 3 activities that week, then you will receive 5 bonus points (No, you will not be awarded extra for doing it more than once).

• Wellness Meet Up - Join us at the Christopher Martin’s Christmas Run for Children 5k in New Haven on December 8th. If you run, walk, work the PTSMC tent, or simply come out to support, you will earn 50 bonus points!

3) Prizes will be awarded based on 3 tiers of points. The more points you earn, the better the prize you will receive. More details on the point tiers will be in a future email.

4) Social Media Users - you can post on Facebook, Instagram, or Twitter and tag @ptsmc. Use “#GetMoving” in your post. Instagram stories count make sure to tag us or we won’t see it!

If you don’t use social media, email your weekly workouts to wellness@ptsmc.com with at least one picture attached. Be sure to note if you completed the WW! 5) Finally, Clinic Challenges are back. The PWP will send out 2 challenges, and clinics will compete to see who can master each task. Remember to have fun with it - everyone LOVED the videos from Spring #GetMoving, so we can’t wait to see your Holiday Challenge videos!

More information will be going out in an email from wellness@ptsmc.com, so stay tuned and get excited to #GetMoving!

Breathing for Relaxation

PTSMC Ran for Healing Meals!

By Greg Schlossinger, Employer Services Coordinator

Mini-relaxations can help allay fear and reduce pain while you sit in the dentist's chair or lie on an examination table. They're equally helpful in stress reduction before an important meeting, while stuck in traffic, or when faced with tense situations. Here are a few quick relaxation techniques to try: Count down slowly from 10 to zero. With each number, take one complete breath, inhaling and exhaling. For example, breathe in deeply saying "ten" to yourself. Breathe out slowly. On your next breath, say "nine," and so on. If you feel lightheaded, count down more slowly to space your breaths further apart. When you reach zero, you should feel more relaxed. If not, go through the exercise again.

Thank you to anyone in the PTSMC Family who participated in the Hartford Marathon events to raise money for Healing Meals, whether you ran, volunteered, or donated.

Healing Meals raised over $72,000 to provide over 8,000 organic, healthy meals to individuals and families dealing with a health crisis.

While sitting down, take a break from whatever you're doing and check your body for tension. Relax your facial muscles and allow your jaw to fall open slightly. Let your shoulders drop. Let your arms fall to your sides. Allow your hands to loosen so that there are spaces between your fingers. Uncross your legs or ankles. Shake your legs out and let them sink into your chair.

Feel your shins and calves become heavier and your feet grow roots into the floor. Now breathe in slowly and breathe out slowly. Each time you breathe out, try to relax even more.

Next time you are in a stressful situation, try these out and feel the difference!

PTSMC Volunteers and Runners!

From left to right:

Tom Kirsch, PT Avon Emily Fillion, Marketing Coordinator Mallory Mason, Administrative Operations Coordinator Shelby Howe, PT Aide Avon Emily Hansen, Assistant Director Avon Cody Filingeri, PT Aide Avon

Connecticut Fall Activities Before getting cozy by the fireplace with a warm beverage, get out and take advantage of Connecticut’s activities that showcase New England Fall spirit!

Corn Maze: Lyman Orchards (Middlefield), Brown’s Harvest (Windsor), Wells Hollow Farms (Shelton), Garden’s Dream (Enfield), Castle Hill Farm (Newtown), Fair Weather Growers Fall Fest and Corn Maze (Cromwell) Hiking: Talcott Mountain State Park (Simsbury), Devil’s Hopyard State Park (East Haddam), Mt. Tom State Park (Washington Depot), Southford Falls (Southbury), Kent State Falls Park (Kent), Macedonia Brook State Park (Kent) Sports: Support your local teams! UConn, CCSU, and Yale all have home football games in November, which will be perfect for tailgating.