Concerned about Large Events? Here is how the Medical Team Helps! w/ Andy Cox, PA-C

Physician Assistant Andy Cox is our guest of this latest podcast episode of Head to Total! Colleen Young, our host, and Andy talk about his journey on his path Physician Assistant, his work as on the SWAT team, and pull back the curtain on preparing for large scale events from the medical standpoint.

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Transcript

Colleen Young: Hey guys, welcome, yet again another episode of Head to Total. As we all know, it's our podcast that pulls back the curtain on all things medical. Wicked cool guest today, Andy Cox, who is a physician assistant extraordinaire, at Synergy Health Partners Orthopedic Urgent Care in Southeast Michigan. Welcome Andy, how are you?

Andy Cox: I'm excellent. How are you?

Colleen Young: I can hear a little bit of something going on in the background, you're in the Greg Grant Sports Complex right now?

Andy Cox: Yeah, I'm in the Greg Grant Sports Complex, they have a youth basketball camp going on right now on the other side of the wall, and the kids are having a lot of fun.

Colleen Young: You're gonna go out and play a game of horse after this, aren't you? 

Andy Cox: Absolutely, yeah. 

Colleen Young: Show those kids what it's all about. What's the age range of the kids out there, Andy? 

Andy Cox: So I didn't look at them yet today. But yesterday, they were from, I don't know, six, seven to some adult kids playing out there. So it's quite a huge range.

Colleen Young: I want the audience to learn a little bit about you because you've got some great experience and that's why I wanted to have you on the show today. So can you tell us who you are, what you do, and why you do it better?

Andy Cox: Yeah. So right now I'm a physician assistant with Synergy Health Partners, I do our Orthopedic Urgent Care that just opened up here within the Greg Grant sports complex. Before that, I was an EMT for a year and a paramedic for 10 years at a company called Medstar Ambulance, serving mostly Macomb County and a little bit of Detroit at the time. I loved the job but wanted to do more, so I told my family to hold on to their hats. I'm quitting my job and going back to school. We all moved to Kalamazoo and I went to school for five years and put all our lives on hold.

Colleen Young: Okay, so you've got to have some great stories about being an EMT in the city of Detroit. What is one positive story that you can tell us about a situation that you were in in Detroit?

Andy Cox: Obviously see lots of trauma, lots of bad things happen, but you get to be a part of making it better for somebody. I always tell people, when you work in EMS, you literally meet people during the 15 worst minutes of their life. And you get to have an impact on that. I've had lots of ugly calls in my career, but you get to make a difference for a lot of those people.

Colleen Young: So when you decided to make the switch from EMT, and I had talked to you once before, and when you were an EMT, you were on a task force or you were in the thick of it all with respect to a major event. I don't want to say terrorism, but it was a large-scale emergency event. Can you talk a little about that?

Andy Cox: Yeah, after 911 a lot of things changed in emergency services and a lot of task forces were developed. I headed up our company's special operations team. So I became our leader in disaster response, whether it was a terrorist attack or natural disaster even. I was involved in our Hurricane Katrina relief when we went down there. And then later, I became the team leader for our tactical medic program, and that was the Macomb County SWAT team doing medical support for them.

Colleen Young: Is it just cool to say I was on the SWAT team?

Andy Cox: It is, I have a little plaque on my wall at home. 

Colleen Young: So you make the transition, you become a physician assistant and then you started working immediately for Synergy Health Partners or did you have some other experience before that?

Andy Cox: No, I came straight out of PA school and my preceptor actually helped me out with getting a job here with Synergy Health Partners. And I came right out of school and started in orthopedics immediately.

Colleen Young: Awesome. Why orthopedics? 

Andy Cox: So that's an interesting question. Everyone, including myself, assumed that with my emergency background, I would get involved in emergency medicine, but I've always had kind of a love for orthopedics even as a paramedic. And I feel like when I did my rotation in emergency medicine, I wasn't doing the same kinds of cool things that I was doing as a paramedic, but I get to do a lot of cool things in orthopedics. So it's just super interesting to my geeky self, I guess.

Colleen Young:You know, one of the things I love about you is you had mentioned that one of the big differences between being an EMT and seeing somebody's worse 15 minutes is now you get to see somebody at their worst 15 minutes but you get to see all the follow up care and the stuff that you get to help them along with. Now you can see a kid with a broken leg is now walking. I mean, that's all you, that's a lot of responsibility. This is why I just do podcasts. 

Andy Cox: This is probably my favorite part of the job that I do now versus then. Like I said before you, yes, you get to see them at their worst 15 minutes and you have a huge impact on that emergency situation, but I never get to see them in their recovery and how they've come through. And now I get to follow up with them from start to finish and it's awesome.

Colleen Young: So I know, Andy, that you skate, you play hockey, you’re a goalie, correct? 

Andy Cox: Yep. 

Colleen Young: Where do you play? Is it a Beer League? What's it all about?

Andy Cox: So I  actually play a few different places. I play in some just drop in type style hockey games throughout Macomb County, actually I play at Suburban Macomb Mount Clemens Ice Arena mostly, but a little bit down at St. Clair Shores too.

Colleen Young: Do they pick you up for more than one game? 

Andy Cox: I play on a team who tries to replace me every chance they get. We are formally known as the Bad Apples, but we recently changed our team name to the Pheasants. That's a Letterkenny reference.

Colleen Young: Nice. And I heard too, not only do you skate, but you golf. I heard there may have been a charity golf outing that you participated in, that you run, correct? What's that charity about?

Andy Cox: So I belong to an organization called the Nottingham Sportsman's Club, we're a social organization that does raise money for charities as well. Our primary charities are women and children's charities. We are Big Too, Our Kids on the go, which is a great program, and Lighthouse outreach, another fantastic organization. If anyone's interested, they can look those two organizations up. But we also donate money to MS Society and some other smaller charities as well.

Colleen Young: So talk to us a little bit about Orthopedic Urgent Care. We've heard some rumblings, I still don't know if everybody understands the concept of orthopedic urgent care. And you've got a captive audience there at the Greg Grant Sportsplex. What's it like on a daily basis? What happens? What are the injuries that you're seeing? How are things being triaged? Walk us through a day at the Orthopedic Urgent Care at Greg Grant? 

Andy Cox: Yeah, Orthopedic Urgent Care, first, it's an awesome concept that is still relatively new, I think, but it helps people that have an orthopedic injury. Maybe they rolled their ankle or broke their arm or wrist or something, it helps them skip some unnecessary steps in the healthcare system. So typically, you'd fall down, hurt your ankle or your arm, you have to go to an emergency room or a traditional urgent care, they would refer you to somebody, you'd have to wait a few days, and then see the Orthopedic Specialists. Now you can come in and see the orthopedic specialist right away. So you're saving time and money by doing that. So what we have here is Orthopedic Urgent care within a sportsplex. Where do people hurt themselves?

Colleen Young: Yeah, just walking in there I would hurt myself, so yes, it's completely beneficial.

Andy Cox: And we're not only open to people that have injured themselves here, obviously, but anyone can walk in at any time. We see a lot of back pains, we see a lot of ankles and wrist injuries so far since we've been going here.

Colleen Young: So Andy, as we were discussing, the Orthopedic Urgent Cares are starting to pop up more and more. People are getting more familiar with when to use them. What's the difference in why would someone choose a Synergy Health Partners Orthopedic Urgent Care versus another Orthopedic Urgent Care? 

Andy Cox: I think there are many reasons for that question, but one thing that Synergy Health Partners offers is one, we're large. So we are on both sides of town, kind of in the metro Detroit area. So it doesn't matter which side you live on or if you're over here playing a sport and get hurt and you want to follow up back on the other side of town, we have that available to you. But one of the best things about Synergy Health Partners is we offer everything you're going to need from your first evaluation, maybe it's at our Orthopedic Urgent Care. Maybe you come into the office, you have surgery, you need an MRI or physical therapy, we offer all of that in one place so that you can have your complete injury or pain resolved within our practice. 

Colleen Young: I heard too that when I'm walking in my inappropriate shoes up and down stairs, and I fall, because we all know I will, I can see someone like yourself in what 20 minutes?

Andy Cox: Yeah, you will see a provider within 20 minutes if you come to our urgent care. The nice part about that is those times are actually much less than that. The length of time it takes you to register and fill out a little bit of paperwork on our tablet is the amount of time that it takes. We're gonna get you in, we're gonna take an x-ray, most likely, and you're gonna see myself or one of the other providers right away.

Colleen Young: Andy, here's the thing, some people come out of school, they don't know where to turn. I understand that you had some really good help and support and they pointed you towards Synergy Health Partners Orthopedic Urgent Care, what's it like? And why would someone coming out of school or a seasoned veteran like yourself want to work with the team over at Synergy Health Partners Orthopedic Urgent Care?

Andy Cox: I think, honestly, for me, it's the people, we have the best people. And I know every employee is going to say that about their organization, or maybe they're not, but our doctors, our administrative staff, and our support staff are all top-notch. And as huge as we are, it's still a very close family and that's what I love about it here.

Colleen Young: There's a rumor going around that in addition to the Orthopedic Urgent Care, that Synergy Health Partners also is co-located with a physical therapy with you. Which is got to be something that you love because then you're really seeing the patient grow, correct?

Andy Cox: Oh, yeah, it's really nice because with our physical therapy being right here in the same location, if I see a patient and I think they would benefit from some early physical therapy, we can set them up with an evaluation on the spot, and they can meet with a physical therapist that same day.

Colleen Young: I can imagine that unlike your traditional ER, or some say Ed, or some say, emergency room, that center has got to have a lot more equipment that's completely tailored to orthopedic issues/physical therapy. How many square feet do you have there, Andy? And are there treadmills, are there casting there? What's going on?

Andy Cox: Yeah, we have everything you would need for an orthopedic related event. I think we are somewhere near 1200 square feet. Don't quote me on that, I wasn't part of the building process.

Colleen Young: I’m quoting you Andy, yeah, I don't know why you don't know the plans and the layouts.

Andy Cox: But our physical therapy has the treadmills, they have a weight machine, like a leg press machine. They have all the things that you probably wouldn't see at a typical physical therapy. They have artificial turf to work on things like that, they have a sled that you can push and things designed for and geared for rehabbing the athlete as well.

Colleen Young: Great transition with athletes there because I heard another rumor that you are leading a medical team at the Detroit skating center for their national qualifying competition coming up in July. Can you talk about what it’s like to start planning a medical situation and a medical team for an event? That's like over 350 kids, adults of all ages? What's that all about? What's that like?

Andy Cox: It's kind of fun because it takes me back to my roots of emergency preparedness planning. So you have an event like this, you try and think of every possible scenario that could happen and be ready for it. But it's even more challenging than that because you never really know what's going to happen. And you can’t budget for the building falling down either so you have to try and plan for what you think is the most likely thing to happen so that you're prepared to help people when they need it. But you got to have the manpower and the equipment. So a lot of there's a lot of planning and processing that goes in to make it look super smooth when we put it all together.

Colleen Young: Do you feel or are there certain injuries that are more typical when it comes to figure skating, ice dancing? Are you looking more at the ankle or are you looking more at hips when there's a fall? What is your take on that?

Andy Cox: It's gonna be primarily ankles, wrists and possibly head or neck injuries. You know, if they fall and hit their head or bend when they land, that could also cause some issues.

Colleen Young: Yeah, I had the privilege of going out to the Detroit skating club for an event, Kurt Browning was there. I don't know if you've ever met Kurt Browning, but he was there. I had a few minutes to talk to him and he said, “Yes Colleen, falling on ice hurts.” Because it's amazing how they just bounce back up. Yeah, I'm sure it's easier when you're younger, but is there something in your body that just reacts that you're able to get up so quick? And you skate, you play hockey, you’re a goalie? 

Andy Cox: Yes. 

Colleen Young: Yeah, I mean what happens to the body when you're falling on ice like that?

Andy Cox: So we all have that little adrenaline rush when we're out there performing with 1000 eyes looking at us. I think that has a lot to do with it. But these guys are fine tuned athletes too and being in good shape helps tremendously. So you find a way to dig down and put that pain away. But I'll tell you what, when you get off the ice, it starts hurting a whole lot more.

Colleen Young: How often do you get a chance to play hockey these days with everything that you've got going on?

Andy Cox: I'm not playing nearly as much as I want to. I tried to get out once every week or two, but there was a day when I was playing three, four days a week. That's what I would love to get back to.

Colleen Young: But you know, it always amazes me the difference between the hockey skate, the figure skate, and everything that goes into ankle stability and things of that nature. And as I watched Kurt skate, it's flawless, and the footwork that goes into it. Does that lead to as they age or as I age, which is happening too rapidly, are those ligaments deteriorating? Or are the muscles deteriorating? Is there some advice that you would give to athletes of that nature to help strengthen their condition? You yourself as a hockey player, although you're what, 25, 26, I'm sure that there are certain things that you do. Put the beer down before going on the ice, things of that nature. You know, how do you keep in shape? 

Andy Cox: It's important if you're gonna do any type of that, whether it's a Beer League, or you're a high-level athlete, you need to make sure that you are constantly exercising, especially your core, but also your joints that take on a lot of stress. The best way to do that is to have a physical therapy evaluation, we actually have that here at our physical therapy department, they'll do an evaluation that involves cameras and lots of cool stuff to look at your own body mechanics and then teach you ways to change those body mechanics if they're going to potentially lead to an injury or some problems down the road. But your own strength training and cardiovascular fitness and core strength is really key to keeping you as healthy as possible while you're performing. And really decreases your chance of having a major injury.

Colleen Young: I'm going to switch back and talk to you a little bit more about the competition that's in July. The way you're structuring your team, do you have a certain amount of physical therapists, a certain amount of EMTs, a certain amount of physician assistant, just medical doctors in general, is there a certain way you structure the team? Or is it pretty much all hands on deck, we just get the qualified people in the door.

Andy Cox: So it's a little bit of both of that. Obviously, you need bodies that can provide medical care. But we have an interesting group because we are very multidisciplinary. So we have some PTS, we have doctors and PAs, we have some people with EMS training as well. So we get to take all these branches of medicine and healthcare and put them together as a cohesive team. And we will have a hierarchy, so to speak of a lead medical person, but every person in the job or that's there has their role. And I don't think a lot of other events are going to be structured quite like this. It's going to be really neat.

Colleen Young: Andy, I always like to ask medical professionals like yourself, I'm not the most graceful, I'm not going to be figure skating, I'm not even going to walk on ice. I trip going up the stairs versus down the stairs. But on occasion, I play a mean game of putt-putt but also severe league softball. And in all seriousness, for those of us that played purely softball or other sports up to the professional athlete, what are the basics? What are the recommendations regarding stretching, hydration, how to prepare to get in the game?

Andy Cox: Yeah, so it all starts with obviously, a healthy diet. And especially if you're trying to avoid injury and staying in good shape, you need to have a good stretching program. And it's not good enough to just stretch your hamstrings a little bit before you go out onto the field, you need to work on stretching almost every day beforehand. You know, some research, and this is a little bit outside of my expertise, but a lot of research is pointing to static stretching just before an event is not even considered ideal right now. You want to work on your stretching and your flexibility every day within your life, but especially leading up to whatever events you're going to be performing. So it's not just about that Sunday night hockey game, it's about being prepared for it all week before you get there.

Colleen Young: And that week leading up to the event, there may or may not be some crown and diets, there might be a Yingling or two. What's the hydration like? Is it really the week leading up to the event to be safe? Or is it the day of just pounding a lot of water and electrolytes and Gatorade? What do you recommend there?

Andy Cox: Again, it's always about a healthy lifestyle every day. But especially leading up to the event, you definitely want to be hydrated before you go out because once you start sweating and everything else, dehydration happens pretty quickly. So you do want to be prepared for the day of but that healthy lifestyle of good eating and hydration habits are a daily thing we should be working on.

Colleen Young: Andy, we're running short on time. It is great to have you. I know you have a lot going on. Thank you for the time that you've spent with us. Enjoy your day at the Orthopedic Urgent Care out there at Greg Grant, play some basketball for us, and we'll talk to you soon.

Andy Cox: Sounds great, thank you so much.