Angie Hinton: Back to Running for Better Health

Angie Hinton, PT ClientPhysical therapy has meant a great deal to me. I have been a member of the (Lebanon, NH, Recreation & Parks) Couch to 5k running group for three years now, and I had been feeling pretty confident about trying my first 10k this summer. That was put on hold in February when I fell on the ice while working. I ignored the pain for a little while, but it did not go away so I began PT. Come to find out, it was not my leg that was the issue but my back. The impact from my fall hurt my lower back causing several problems with my leg and foot. I wanted PT to help clear up the monster amounts of pain I was having and I wanted to get strong enough to run again. Working with Kate has been challenging and very rewarding, I did not think I could get to the point of sitting comfortably, let alone run, but she helped me believe that I could do it. Injuries can sideline you but you can come back. I am practicing with the run club and will run in the 5k race on the 4th of July!

Angie Hinton Runs the Couch to 5KI started to run because I wanted better health and better control of my diabetes. A month ago, after being on medications since 1994, I was taken off insulin and am beginning the process of getting off medication all together! The team at Cioffredi has given me so much more than they will ever know (so much more than PT). I thank them from the bottom of my heart and running shoes!!

–Angie Hinton, Lebanon


Dawn Famiglietti: A Story of ResilienceDawn Famiglietti: A Picture of Resilience

When Dawn Famiglietti of Sunapee reached out suddenly to break someone’s fall one day in late 2011, she was acting on instinct. She had no idea that this quick action would change her life forever, sending her on a journey of pain and healing that would test her to the core. Today, with rods and cages fusing together seven vertebrae in her lower back, Dawn shares inspiration and encouragement with everyone she meets.  Her message: “Don’t stop moving!”

UNBEARABLE PAIN

The scope of Dawn’s back injury did not become fully apparent for several months after the incident. During that time her life became a waking nightmare of unbearable pain. “We tried everything at first: steroid injections, chiropractic adjustments, massage, the pool,” but relief just wouldn’t come without increasing doses of narcotic pain medication—and then with greater frequency.  She suffered headaches, couldn’t sleep, and the pain that shot down her leg like an electric current was unrelenting. She found herself constantly lying on the floor, and away from her loved ones. “Standing was difficult, driving was almost impossible, and I couldn’t sit long enough to even have dinner with my family.”

EMOTIONAL TOLL

To hear her explain it, Dawn fought hard against the idea of being disabled, but the pain and the growing distance between living and merely existing took their toll. “I tried to stay positive in front of my family, but when they were gone I had panic attacks and anxiety. I was depressed.” Like so many people, Dawn found it hard to share her pain or ask for help, but it became too much. “I reached a point where I stopped caring, and I felt very desperate.” When the Christmas decorations didn’t even come out of storage in 2012, she knew she had hit bottom.

SURGERY AND REHABSeven-Vertebrae Lumbar Fusion X-Ray

A surgeon in Boston was finally able to repair Dawn’s severely damaged spine with a multilevel lumbar fusion, a procedure that took two days to complete. Then more than a year since her injury, he challenged her to take charge of her own care. “You can do anything you want,” he told her, “the question is only whether you want to do it.” Right away she knew that her top priority was to get back to normal living, and to move as pain free as possible with minimal use of medications.

Dawn arrived at Cioffredi  & Associates with a limp and still hurting from her initial recovery rehab, but determined to get back her life and her sense of herself.

“When you have back pain, people can’t see it. It’s not like there’s something obviously wrong with you. I had a hard time when I went back to work, because I think I felt like people wouldn’t believe that I was really injured—that they would think I was soaking the system.”

HELP FROM CIOFFREDI & ASSOCIATESDawn Famiglietti PT Client

Physical Therapists Marsha Wykes and Anna Hinman worked with Dawn during her rehabilitation. “They were wonderful,” Dawn reported. “They made me feel important, and that I wasn’t there for no reason. They gave me good information to follow; they educated me, and when I didn’t do my exercises the way I was supposed to,” she explained sheepishly, “I was gently prodded. I almost didn’t want to leave.”

JUST KEEP MOVING

Dawn’s PT experience helped her to be constantly thinking about her posture and the way she does things, and even today she misses no opportunity to stretch or move. Most of her coworkers have no idea of the ordeal she has gone through since 2011, but they might just notice how energetic and positive she is. She always takes the stairs, often two at a time, and sometimes takes an extra set just to push herself. In her office, which is equipped with both a standing desk and a yoga mat, she’ll take a break and do a few stretches. If her door is open and someone sees her bending over in a forward fold, “l just tell them I’m looking for my contact lens. I don’t want anyone to say ‘Poor Dawn,’ I just know that I’ve got to keep moving, just keep those muscles moving.”

POSITIVE OUTLOOKDawn Famiglietti Back on Her Horse

While Dawn’s outcomes are remarkable, she will likely always have good days and “not-so-good days,” when back pain intrudes. She’s determined to keep her positive outlook, but on the tough days she allows herself a break—and occasionally even some Tylenol—and acknowledges that there are things she will always need to approach differently. There won’t be any sit-ups or back bends in her daily fitness routine, for example, but her doctors have cleared her for “everything but skydiving.” Mostly she just wants to keep on gardening, caring for her horses, taking her dog for longs walks, and filling the wood box.

“I set goals for myself that aren’t huge. I look at my behavior and I try not to get down on myself; to go easier for the big things and just always keep moving.”

Her next big goal has to do with her daughter’s wedding in September 2017, she explains bashfully, pointing to her feet. “I want to be able to wear shoes with a little heel.”

LEARN MORE about the kind of excellent physical therapy care that Dawn received at Cioffredi & Associates.

This article appeared in the Cioffredi & Associates July 2017 newsletter. View the entire issue online.



George Merrill’s Total Approach to Movement

Cioffredi & Associates is grateful to serve so many outstanding members of the Upper Valley community, and for the trust they place in us to restore and enhance movement and to get them back to doing the things they love. George Merrill took full advantage of our continuum of care services, and he was kind enough to share his “Movement for Life” experience…

George Merrill's Total Approach to Movement
Continue reading


Introducing Two New Members of the Cioffredi & Associates Team

Cioffredi & Associates | The Institute for Health & Human Performance is growing to better serve your needs, with the addition of a physical therapy clinician and an integrative health coach to our team.

JULIE MESSENGER, PT, DPTJulie Messenger PT DPT

Julie earned her Doctorate in PT in 2007, as well as a BS in Psychology in 2004, from Sacred Heart University. She has been practicing orthopaedic and sports rehabilitation therapy since 2007, with a special interest in adolescent athletes.

Julie loves all things “active and outdoors.” As a college athlete she captained her field hockey team, achieving second team All-American recognition, and served as assistant coach as a graduate student. She has experienced many areas of the country including Alaska and Washington state as a travel therapist, and enjoys snowboarding, biking, hiking, kayaking, and “playing with her pups!”

Learn more about how Julie can help you live a happier and healthier life.

MICHELE BOUTIN, Integrative Health Coach and Client Care RepresentativeMichele Boutin, Integrative Health Coach

Michele has been practicing as an Integrative Health Coach in the Upper Valley for the past 10 years, specializing in immune system and GI wellness and has, recently, added Personal Cheffing to her services. As a Freelance Writer in the field of Integrative Health, Michele’s pieces have been published in: Upper Upper Valley Parents Paper, HEAL, Kids Stuff, Kearsarge, and Upper Valley Life Magazine.

As the Client Care Representative, Michele ensures that all clients of Cioffredi & Associates get what they need and want from their care and that their experience with us is of the highest quality.

 

 


Humanities and Health

Do you know someone who exercises regularly, but it’s almost a compulsive activity to “manage stress?” Controlling their weight is a constant “battle.” Going to their physician is a source of stress, as they wait to see what their numbers are going to be; worrying about their blood pressure, cholesterol, or other lab values they’re monitoring.William Cioffredi, PT

Then there’s the person for whom exercise and activity are enjoyments. They seem to eat sensibly, and you don’t hear them describing things that they should or shouldn’t be eating. They just generally seem to be happy, laugh easily, and seem confident without being cocky. They get sad in appropriate situations, but the sadness doesn’t persist. They don’t seem to be “battling” anything in their life. If they have a health problem, it doesn’t seem to dominate their life.

At a time when technology seems to be advancing at the speed of light, research is delving deeper and deeper into our own biology for the answers to better health. Yet our country is one of the largest consumers of pain and psychotropic medication, as well as alcohol and other drugs that help us to interface with life.

Could it be that one of the challenges with our health is that our understanding of the humanities and human behavior has not kept up with the pace of technology in the natural sciences? If it piques your interest, consider attending our Speaker Series event in May.

Learn More about our Spring 2017 Speaker Series

Featuring Dr. Cathleen Beaver and Dr. Dominic Candido, founders of Enhance Health.

WEDNESDAY, MAY 24, 2017

5:15-7:00 p.m.

Cioffredi & Associates | The Institute for Health & Human Performance

112 Etna Road, Lebanon, New Hampshire


Happy, Healthy New Year

The Pursuit of Happiness

“The pursuit of happiness…” Our forefathers thought it important enough to include it the Declaration of Independence, and yet I’m struck by how we, here in New England at least, seem to talk more about improving our health—and our healthcare—than we talk about our happiness (maybe happiness is more a West Coast thing?). Despite continuous advances in medicine, people are expressing more anxiety about their health to me than at any previous time in my career. As this New Year begins, my wish is that we can all achieve both.

Competence and Confidence

Like healthcare, the pursuit of happiness is big business in the United States. For me, it’s important to realize that they are not the same, although they can overlap. I’m talking about the condition of happiness, not that temporary emotion whose opposite is “sadness.” The condition of happiness can include appropriate periods of feeling sad, at the loss of a friend or a pet, for example, but the condition of happiness persists. There are two elements I’ve observed that seem to be fundamental to people enjoying the condition of happiness: competence and confidence. Whether it’s in a skill or within a relationship, feeling competent and confident seems vital to success. What if you felt this way about your health?

Health and Relationships

The subtitle of Ruth Whippman’s recent book, “America the Anxious,” explains “How Our Pursuit of Happiness Is Creating a Nation of Nervous Wrecks.” If that is so, we are a less healthy nation, since there is clear biological evidence that chronic stress negatively affects our basic physiology. Whippman found evidence that yoga, meditation, and mindfulness show positive physiological effects, but her research revealed that the strongest indicator of happiness was connected to relationships.

Helping People

In our practice, people come to us primarily because they have a painful condition. I believe our greatest success is demonstrated when we can help them achieve confidence and competence in taking care of that aspect of their health. Strong relationships are fundamental to delivering on this success.

And so…to those professionals with whom we have had the pleasure to work, and to those individuals whom we’ve had the privilege to treat, I wish you a healthy and happy New Year.

Sincerely,
Billy

William Cioffredi, PT
Founder

View  & Read the Entire Winter 2017 Newsletter Online!

Cioffredi Newsletter January 2017 Cover

 

 


Cioffredi & Associates Recognized Nationally with PRACTICE OF THE YEAR 2016 Honorable Mention

Cioffredi Recognized Nationally Top 4 PT Practice

 

December 2016

Cioffredi & Associates was named recipient of one of three national 2016 Honorable Mentions for ADVANCE magazine’s Practice of the Year award. Read on for an excerpt from the full article in the December 2016 edition of ADVANCE for Physical Therapy & Rehab Medicine.

 

Second Consecutive Year

For the second consecutive year, Cioffredi & Associates|The Institute for Health and Human Performance, located in Lebanon, NH, has earned a “top 4” designation in the Advance Healthcare Network’s ADVANCE Magazine’s Physical Therapy Practice of the Year award competition.

Now in its 15th year, the ADVANCE Practice of the Year Contest tallies anonymous entries from across the country and scores them on a range of success metrics. The contest is free to enter and is never connected with advertising contracts or incentives.

Other recipients of the top 4 honors included Foothills Sports Medicine Physical Therapy, a practice with 22 clinic location headquartered in Phoenix, Arizona, and Synergy Physical Therapy & Sports Medicine based in Jacksonville, North Carolina.

We continue to be grateful for the opportunity to work with wonderful people here in the Upper Valley!

About Cioffredi & Associates, Lebanon, N.H. 

Cioffredi & Associates is located in Lebanon, N.H., near Dartmouth College, Dartmouth Hitchcock Medical Center, and Alice Peck Day Memorial Hospital. Founder Bill Cioffredi, PT, grew up in Rutland, Vt., graduated from the University of Pennsylvania in 1979, and began his professional career at Dartmouth-Hitchcock Medical Center right out of school. While at DHMC he met Ruth Curtis, an OT specializing in hand rehabilitation.

In 1985 Bill and Ruth married, and established the Cioffredi Orthopaedic & Sports Therapy Center. Originally, the practice was open part-time, with Bill as sole provider. As the caseload grew, he brought on additional staff to meet demand and to maintain his policy of immediate therapist access. The organization moved four times since its inception, each time to a larger and more efficient space. Today the practice has 23 staff members offering a full complement of therapy services.

“In 2014, we moved to new location and developed the Institute for Health and Human Performance,” said CEO Amy Hayward. “The vision of the institute was to provide adjunctive and complementary services, which include medically based personal training, nutrition counseling, massage therapy, and health coaching to our existing rehabilitation services. It also allowed us the ability to provide educational forums and programming on a variety of healthcare topics to the general public. The institute is now viewed as a resource of knowledge for in the community.”Cioffredi Award Winning Practice

Their patient-first customer service philosophy includes immediate therapist access, a warm and welcoming therapy environment, inspiring open floor plan complete with cathedral ceilings, natural light, and views of the surrounding woods, and a client care representative who meets with all new patients.

Pillars of maintaining a committed therapy team include a mentorship program, a continuing education allowance, regular 1:1 meetings with supervisors, opportunity to participate in a speaker series, and a fun working environment that often features free breakfast and lunch, staff contests, and regular outings for pizza and bowling. Cioffredi & Associates regularly hosts DPT students as a clinical affiliation site.

Newer offerings include a corporate wellness program and occupational health services. “We are currently working with two local banks that, combined, employ over 350 people, as well as a large accounting firm,” Hayward said. “In our occupational health services we are currently piloting a program working with 36 glass blowers for a nationally recognized company.”

balance workoutAdditional services include a balance and vestibular program that offers free fall prevention screens to people ages 65 and older, and a pediatric therapy program that fills a void in the community for outpatient pediatric services. A speaker series, single-topic seminars, presentations at schools and senior centers, physician meetings, and regular e-mail and social media communication top the list of community engagement.

“In addition to highly competent clinical care, we believe there are other aspects that make up the total patient experience,” Hayward said. “Not only quality of care and clinical outcomes, but a highly satisfied client that has formed a relationship with our office.”


HEALTH CARE COSTS DON’T NEED TO BE A MYSTERY

Making choices about healthcare can be difficult. You want to know—upfront—what you will be expected to pay for services before you incur any costs. You have personal values, you want quality care, and you prefer to make important decisions based on evidence.Informed Healthcare Choice

Healthcare providers and insurance companies have a duty to provide information about the cost of services, and you always have options about where and how you are treated. Ask questions and do some research before you are referred for physical therapy or other healthcare services.

WE ENDORSE PRICE TRANSPARENCY

We’re here to help the pain go away . . . not create more. If you’d like information about the cost of our services, up front, just ask. Call us at 603-643-7788. We’re treating from 6:30 a.m. to 7:00 p.m. in 2017.


COST COMPARISON TOOLS

Here are some cost-comparison* resources that can help:

HEALTHCARE BLUEBOOK

NH Health Cost Website

VT BCBS Website 

*Be sure that you’re comparing “apples to apples.” Costs per visit will vary between providers, and so it’s best to get detailed information directly from your provider’s office.


REVIEW YOUR COVERAGE

It’s important to consult your health insurance plan, to be sure you understand your responsibility.

  • What services are covered or excluded?
  • Do you have a deductible? Co-pay responsibility? Co-insurance coverage?
  • Are you scheduling with an in-network provider? (Check the Cioffredi In-Network Provider List)

Got Questions? Please Ask!

Call 603-643-7788 or email scheduling@cioffredi.com

 

empower yourself

 


Don’t Let Winter Cause you Pain

Shoveling Snow and Avoiding Injury

Sadie shovels snow at Cioffredi & Associates Physical Therapy Clinic.PREPARE YOURSELF

Warm up your muscles before starting, by moving and stretching. If this is going to be the only exercise you’ve gotten for a while, consider hiring a teenager to help. Shoveling snow is a remarkably strenuous activity!

  • Dress appropriately. Wear boots with good tread (or add traction), and dress in light, water-repellant layers. Be mindful to stay warm without getting overheated.
  • Shovel many light loads, rather than fewer heavy ones.
  • Avoid twisting, and switch sides. Take a step when throwing the snow to minimize twisting, and try to avoid throwing every load in the same direction.
  • Take frequent breaks and drink plenty of water.
  • Be reasonable. Don’t feel that you need to clear every flake of snow from your property.

**WARNING** Head indoors right away if you feel pain or tightness in your chest, you feel lightheaded or short of breath, your heart starts racing, or some other physical change makes you nervous. (Snow shoveling is a known trigger for heart attacks!)

SHOW YOUR SHOVELING SMARTS

Show shovels stored in a garage, so they are cold.
Store your shovel where it’s cold.
Snow sticks to a warm shovel and adds strain to the job. Tip: If you have trouble with a sticky shovel, try a light coating of cooking spray on the blade.

Clean off cars first.
Get all the snow on the ground before you start shoveling.

Make a disposal plan and be systematic.
Don’t shovel the same snow twice. Be sure you’re moving it to its final destination. Tip: You can pile snow on a plastic tarp to drag it to a more distant disposal spot if you need to, but be sure not to overload it!

Shovel snow when it’s at its lightest.
Be aware of changing temperatures so that you can avoid moving a large accumulation of heavy wet snow, or after it has become packed and icy from foot traffic. Tip: If you do need to clear packed or icy snow, chose a shovel with a metal blade.

Illustration of different types of snow shovels.

CHOOSE THE RIGHT SNOW SHOVEL

Handle Length
Taller people should look for a longer handle to avoid excessive bending. Shorter people will not get good leverage with a long-handled shovel, and so should choose a shorter handle style.

Blade Size
The larger the shovel blade, the heavier it will be when you fill it. If you have concerns about your strength or balance, or fear aggravating an injury, choose a shovel with a smaller blade.

Weight
Handles and blades come in a variety of materials from wood to metal to plastic. Lighter materials may come with some disadvantages as far as sturdiness, but it may be worth the trade-off to save you the extra strain of lifting a heavy shovel.

Flat or Rounded Shovel?
Flat shovels are better at cutting through deep or dense drifts, like the ones created by a snow plow. Rounded shovels are good for scooping loose snow and allow for pushing snow along a path or sidewalk.

Best Shovel for Back Safety?

A shovel with an ergonomic handle (bent at a sharp angle) reduces the need to bend over. This design also prevents you from lifting heavy scoops which, while frustrating, is generally better for your back.

And if winter gets the better of you, we’re here to help!

Here’s a winter injury success story to encourage you . . . #CHOOSEPT


Call us today for help with your winter aches and pains: 603-643-7788

Cioffredi & Associates

112 Etna Road
P. O. Box 727
Lebanon, New Hampshire 03766
United States (US)
Phone: 603-643-7788
Fax: 603-643-0022
Email: scheduling@cioffredi.com