{"version":"1.0.0","segments":[{"speaker":"Charles Goldfarb","startTime":3.6,"endTime":5.97,"body":"Welcome to the"},{"speaker":"Charles Goldfarb","startTime":3.6,"endTime":5.97,"body":"upper hand podcast where Chuck"},{"speaker":"Charles Goldfarb","startTime":6.0,"endTime":7.53,"body":"and Chris talk Hand Surgery."},{"speaker":"Chris Dy","startTime":7.9,"endTime":9.7,"body":"We are two hand"},{"speaker":"Chris Dy","startTime":7.9,"endTime":9.7,"body":"surgeons at Washington"},{"speaker":"Chris Dy","startTime":9.7,"endTime":12.34,"body":"University in St. Louis here to"},{"speaker":"Chris Dy","startTime":9.7,"endTime":12.34,"body":"talk about all things hand"},{"speaker":"Chris Dy","startTime":12.34,"endTime":14.62,"body":"surgery related from technical"},{"speaker":"Chris Dy","startTime":12.34,"endTime":14.62,"body":"to personal."},{"speaker":"Charles Goldfarb","startTime":15.33,"endTime":17.43,"body":"Please"},{"speaker":"Charles Goldfarb","startTime":15.33,"endTime":17.43,"body":"subscribe, wherever you get your"},{"speaker":"Charles Goldfarb","startTime":17.43,"endTime":17.97,"body":"podcasts."},{"speaker":"Chris Dy","startTime":18.94,"endTime":21.31,"body":"And thank you in"},{"speaker":"Chris Dy","startTime":18.94,"endTime":21.31,"body":"advance for leaving a review and"},{"speaker":"Chris Dy","startTime":21.31,"endTime":23.56,"body":"leaving a rating wherever you"},{"speaker":"Chris Dy","startTime":21.31,"endTime":23.56,"body":"get your podcast."},{"speaker":"Charles Goldfarb","startTime":25.23,"endTime":26.19,"body":"Oh, hey,"},{"speaker":"Charles Goldfarb","startTime":25.23,"endTime":26.19,"body":"Chris."},{"speaker":"Chris Dy","startTime":27.149,"endTime":28.199,"body":"Hey, Chuck, how are"},{"speaker":"Chris Dy","startTime":27.149,"endTime":28.199,"body":"you?"},{"speaker":"Charles Goldfarb","startTime":28.739,"endTime":30.809,"body":"I am really"},{"speaker":"Charles Goldfarb","startTime":28.739,"endTime":30.809,"body":"good. How are you?"},{"speaker":"Chris Dy","startTime":31.109,"endTime":35.309,"body":"I'm great. You know,"},{"speaker":"Chris Dy","startTime":31.109,"endTime":35.309,"body":"it's, we're at the end of March"},{"speaker":"Chris Dy","startTime":35.309,"endTime":39.059,"body":"now. We've been we're gonna be"},{"speaker":"Chris Dy","startTime":35.309,"endTime":39.059,"body":"you know, heading into April."},{"speaker":"Chris Dy","startTime":39.059,"endTime":41.159,"body":"Pretty soon. Spring is coming."},{"speaker":"Chris Dy","startTime":39.059,"endTime":41.159,"body":"The weather in St. Louis"},{"speaker":"Chris Dy","startTime":41.159,"endTime":42.149,"body":"certainly reflects that. Oh,"},{"speaker":"Charles Goldfarb","startTime":42.839,"endTime":46.679,"body":"my God. It is"},{"speaker":"Charles Goldfarb","startTime":42.839,"endTime":46.679,"body":"I am. I do suffer from seasonal"},{"speaker":"Charles Goldfarb","startTime":46.679,"endTime":49.199,"body":"affective disorder. Although I"},{"speaker":"Charles Goldfarb","startTime":46.679,"endTime":49.199,"body":"should say that carefully. I"},{"speaker":"Charles Goldfarb","startTime":49.199,"endTime":52.169,"body":"don't really suffer. And I'm"},{"speaker":"Charles Goldfarb","startTime":49.199,"endTime":52.169,"body":"sure there are people who do but"},{"speaker":"Charles Goldfarb","startTime":52.439,"endTime":54.209,"body":"I need sunny weather soon."},{"speaker":"Chris Dy","startTime":54.78,"endTime":56.94,"body":"Yeah, absolutely."},{"speaker":"Chris Dy","startTime":54.78,"endTime":56.94,"body":"Well, you know, we've decided,"},{"speaker":"Chris Dy","startTime":57.27,"endTime":60.09,"body":"so I didn't realize this was a"},{"speaker":"Chris Dy","startTime":57.27,"endTime":60.09,"body":"thing until we moved to St."},{"speaker":"Chris Dy","startTime":60.09,"endTime":63.54,"body":"Louis. The pool opening and"},{"speaker":"Chris Dy","startTime":60.09,"endTime":63.54,"body":"closing thing didn't happen in"},{"speaker":"Chris Dy","startTime":63.54,"endTime":66.0,"body":"Florida. The pool was always"},{"speaker":"Chris Dy","startTime":63.54,"endTime":66.0,"body":"open in Florida, before it was"},{"speaker":"Chris Dy","startTime":66.0,"endTime":70.2,"body":"cold or hot. But we decided to"},{"speaker":"Chris Dy","startTime":66.0,"endTime":70.2,"body":"open the pool on May 1. And I'm"},{"speaker":"Chris Dy","startTime":70.2,"endTime":73.14,"body":"really super excited about that."},{"speaker":"Chris Dy","startTime":70.2,"endTime":73.14,"body":"So it's kind of like a countdown"},{"speaker":"Chris Dy","startTime":73.14,"endTime":75.21,"body":"to that that's at least what's"},{"speaker":"Chris Dy","startTime":73.14,"endTime":75.21,"body":"going on in our house."},{"speaker":"Charles Goldfarb","startTime":75.75,"endTime":77.52,"body":"Yeah, the"},{"speaker":"Charles Goldfarb","startTime":75.75,"endTime":77.52,"body":"other reason I'm excited is we"},{"speaker":"Charles Goldfarb","startTime":77.52,"endTime":81.15,"body":"you know, we heard I heard once"},{"speaker":"Charles Goldfarb","startTime":77.52,"endTime":81.15,"body":"that someone didn't think our"},{"speaker":"Charles Goldfarb","startTime":81.15,"endTime":85.26,"body":"audio on our podcast was top"},{"speaker":"Charles Goldfarb","startTime":81.15,"endTime":85.26,"body":"notch. And I think it's pretty"},{"speaker":"Charles Goldfarb","startTime":85.26,"endTime":87.54,"body":"good. And no one's ever"},{"speaker":"Charles Goldfarb","startTime":85.26,"endTime":87.54,"body":"complained about it, except for"},{"speaker":"Charles Goldfarb","startTime":87.54,"endTime":90.84,"body":"one person said that. But we"},{"speaker":"Charles Goldfarb","startTime":87.54,"endTime":90.84,"body":"have seriously upped the game"},{"speaker":"Charles Goldfarb","startTime":90.84,"endTime":93.48,"body":"and I have to share with you but"},{"speaker":"Charles Goldfarb","startTime":90.84,"endTime":93.48,"body":"I'm using a new mic. I got the"},{"speaker":"Charles Goldfarb","startTime":93.48,"endTime":96.12,"body":"sweet new headphones. So I'm"},{"speaker":"Charles Goldfarb","startTime":93.48,"endTime":96.12,"body":"feeling pretty professional"},{"speaker":"Charles Goldfarb","startTime":96.12,"endTime":96.54,"body":"right now."},{"speaker":"Chris Dy","startTime":97.08,"endTime":100.74,"body":"Well, you know, being"},{"speaker":"Chris Dy","startTime":97.08,"endTime":100.74,"body":"a boss will will step it up like"},{"speaker":"Chris Dy","startTime":100.74,"endTime":103.47,"body":"that, you know, I think that and"},{"speaker":"Chris Dy","startTime":100.74,"endTime":103.47,"body":"you're the kind of person that"},{"speaker":"Chris Dy","startTime":103.47,"endTime":106.23,"body":"you know, you'll take that one"},{"speaker":"Chris Dy","startTime":103.47,"endTime":106.23,"body":"bad patient review and change"},{"speaker":"Chris Dy","startTime":106.23,"endTime":110.31,"body":"things to make it better. So one"},{"speaker":"Chris Dy","startTime":106.23,"endTime":110.31,"body":"thing that was kind of"},{"speaker":"Chris Dy","startTime":110.31,"endTime":114.15,"body":"interesting this week, I had my"},{"speaker":"Chris Dy","startTime":110.31,"endTime":114.15,"body":"first clinic yesterday without"},{"speaker":"Chris Dy","startTime":114.15,"endTime":117.0,"body":"wearing a mask. totally weird."},{"speaker":"Charles Goldfarb","startTime":117.51,"endTime":119.49,"body":"Yeah. And we"},{"speaker":"Charles Goldfarb","startTime":117.51,"endTime":119.49,"body":"and we have a guest here, maybe"},{"speaker":"Charles Goldfarb","startTime":119.49,"endTime":121.23,"body":"we should just loop her in"},{"speaker":"Charles Goldfarb","startTime":119.49,"endTime":121.23,"body":"because she's feeling the same"},{"speaker":"Charles Goldfarb","startTime":121.23,"endTime":126.21,"body":"way. So our favorite and most"},{"speaker":"Charles Goldfarb","startTime":121.23,"endTime":126.21,"body":"recurring guest is back by"},{"speaker":"Charles Goldfarb","startTime":126.21,"endTime":129.6,"body":"popular demand, I should say, By"},{"speaker":"Charles Goldfarb","startTime":126.21,"endTime":129.6,"body":"popular demand. I think in fact,"},{"speaker":"Charles Goldfarb","startTime":129.6,"endTime":132.45,"body":"they may want to vote one of us"},{"speaker":"Charles Goldfarb","startTime":129.6,"endTime":132.45,"body":"out off the island and just keep"},{"speaker":"Charles Goldfarb","startTime":132.45,"endTime":135.99,"body":"Macy hear me back."},{"speaker":"Macy Stonner","startTime":136.53,"endTime":139.95,"body":"Hi, everybody. I'm"},{"speaker":"Macy Stonner","startTime":136.53,"endTime":139.95,"body":"glad to be back. And I agree"},{"speaker":"Macy Stonner","startTime":139.95,"endTime":141.15,"body":"about the masks."},{"speaker":"Chris Dy","startTime":141.45,"endTime":146.28,"body":"So our institution"},{"speaker":"Chris Dy","startTime":141.45,"endTime":146.28,"body":"just went to mask or switch was"},{"speaker":"Chris Dy","startTime":146.37,"endTime":149.61,"body":"what's the word situational"},{"speaker":"Chris Dy","startTime":146.37,"endTime":149.61,"body":"masking or masking at the"},{"speaker":"Chris Dy","startTime":149.61,"endTime":152.22,"body":"request of the patient?"},{"speaker":"Chris Dy","startTime":149.61,"endTime":152.22,"body":"Basically, at the request of the"},{"speaker":"Chris Dy","startTime":152.22,"endTime":155.37,"body":"patient based on obviously"},{"speaker":"Chris Dy","startTime":152.22,"endTime":155.37,"body":"different clinical scenarios,"},{"speaker":"Chris Dy","startTime":155.37,"endTime":159.18,"body":"you should be wearing one. But,"},{"speaker":"Chris Dy","startTime":155.37,"endTime":159.18,"body":"you know, I think I wore masks"},{"speaker":"Chris Dy","startTime":159.18,"endTime":161.52,"body":"for one patient. And it's"},{"speaker":"Chris Dy","startTime":159.18,"endTime":161.52,"body":"because I felt weird not wearing"},{"speaker":"Chris Dy","startTime":161.52,"endTime":163.41,"body":"one because they were wearing"},{"speaker":"Chris Dy","startTime":161.52,"endTime":163.41,"body":"one and they said it was fine. I"},{"speaker":"Chris Dy","startTime":163.41,"endTime":167.37,"body":"just put one on anyway. How was"},{"speaker":"Chris Dy","startTime":163.41,"endTime":167.37,"body":"it for you may see."},{"speaker":"Macy Stonner","startTime":168.149,"endTime":170.039,"body":"So at first I was"},{"speaker":"Macy Stonner","startTime":168.149,"endTime":170.039,"body":"a little weary about it and"},{"speaker":"Macy Stonner","startTime":170.039,"endTime":173.069,"body":"decided to keep wearing one. And"},{"speaker":"Macy Stonner","startTime":170.039,"endTime":173.069,"body":"then I was in Dr. Goldfarb"},{"speaker":"Macy Stonner","startTime":173.069,"endTime":175.169,"body":"clinic on Thursday. And I"},{"speaker":"Macy Stonner","startTime":173.069,"endTime":175.169,"body":"noticed that he wasn't wearing"},{"speaker":"Macy Stonner","startTime":175.169,"endTime":178.799,"body":"one and I thought oh, I'll just"},{"speaker":"Macy Stonner","startTime":175.169,"endTime":178.799,"body":"give it a shot. I loved it, I"},{"speaker":"Macy Stonner","startTime":178.799,"endTime":181.439,"body":"really felt like this deeper"},{"speaker":"Macy Stonner","startTime":178.799,"endTime":181.439,"body":"connection I'm able to make with"},{"speaker":"Macy Stonner","startTime":181.439,"endTime":184.019,"body":"patients just being able to play"},{"speaker":"Macy Stonner","startTime":181.439,"endTime":184.019,"body":"off each other's reactions. And"},{"speaker":"Macy Stonner","startTime":184.619,"endTime":187.229,"body":"I don't know, I just felt more"},{"speaker":"Macy Stonner","startTime":184.619,"endTime":187.229,"body":"connected to each patient's and"},{"speaker":"Macy Stonner","startTime":187.229,"endTime":190.049,"body":"loved it. So I'm gonna I think"},{"speaker":"Macy Stonner","startTime":187.229,"endTime":190.049,"body":"I'm gonna keep going."},{"speaker":"Charles Goldfarb","startTime":191.01,"endTime":192.78,"body":"I still been"},{"speaker":"Charles Goldfarb","startTime":191.01,"endTime":192.78,"body":"I've been traveling a little"},{"speaker":"Charles Goldfarb","startTime":192.78,"endTime":196.62,"body":"bit, even after Vegas where"},{"speaker":"Charles Goldfarb","startTime":192.78,"endTime":196.62,"body":"Chris and I recorded a couple of"},{"speaker":"Charles Goldfarb","startTime":196.62,"endTime":201.39,"body":"pods that traveled last weekend."},{"speaker":"Charles Goldfarb","startTime":196.62,"endTime":201.39,"body":"I still wore a mask in the"},{"speaker":"Charles Goldfarb","startTime":201.39,"endTime":205.89,"body":"airport and on the plane, but"},{"speaker":"Charles Goldfarb","startTime":201.39,"endTime":205.89,"body":"man it is it is very few people"},{"speaker":"Charles Goldfarb","startTime":205.89,"endTime":207.33,"body":"with masks on traveling."},{"speaker":"Chris Dy","startTime":207.959,"endTime":211.499,"body":"I will I will say"},{"speaker":"Chris Dy","startTime":207.959,"endTime":211.499,"body":"this. Partially joking, but I"},{"speaker":"Chris Dy","startTime":211.499,"endTime":213.959,"body":"will use situational masking"},{"speaker":"Chris Dy","startTime":211.499,"endTime":213.959,"body":"perhaps when I'm on the plane"},{"speaker":"Chris Dy","startTime":213.959,"endTime":216.119,"body":"and I'm wet anyway see my mouth"},{"speaker":"Chris Dy","startTime":213.959,"endTime":216.119,"body":"open and I'm sleeping."},{"speaker":"Charles Goldfarb","startTime":218.49,"endTime":220.29,"body":"There's"},{"speaker":"Charles Goldfarb","startTime":218.49,"endTime":220.29,"body":"trouble there. There's truth."},{"speaker":"Chris Dy","startTime":220.589,"endTime":222.659,"body":"And I'm realizing a"},{"speaker":"Chris Dy","startTime":220.589,"endTime":222.659,"body":"couple of things about"},{"speaker":"Chris Dy","startTime":222.659,"endTime":226.769,"body":"yesterday's clinic that first"},{"speaker":"Chris Dy","startTime":222.659,"endTime":226.769,"body":"off, like, I have known some of"},{"speaker":"Chris Dy","startTime":226.769,"endTime":229.469,"body":"these people for like three"},{"speaker":"Chris Dy","startTime":226.769,"endTime":229.469,"body":"years and have never seen their"},{"speaker":"Chris Dy","startTime":229.469,"endTime":233.099,"body":"face. I mean, it's amazing. And"},{"speaker":"Chris Dy","startTime":229.469,"endTime":233.099,"body":"they've never seen my face. So"},{"speaker":"Chris Dy","startTime":233.099,"endTime":236.909,"body":"it's, it was quite odd to like"},{"speaker":"Chris Dy","startTime":233.099,"endTime":236.909,"body":"see people's faces, and"},{"speaker":"Chris Dy","startTime":236.909,"endTime":241.109,"body":"especially people that you know,"},{"speaker":"Chris Dy","startTime":236.909,"endTime":241.109,"body":"whom you've operated upon. And"},{"speaker":"Chris Dy","startTime":241.109,"endTime":243.119,"body":"you know, that's a for lack of a"},{"speaker":"Chris Dy","startTime":241.109,"endTime":243.119,"body":"better word, a pretty intimate"},{"speaker":"Chris Dy","startTime":243.119,"endTime":245.429,"body":"relationship to be operating on"},{"speaker":"Chris Dy","startTime":243.119,"endTime":245.429,"body":"somebody. I've never seen their"},{"speaker":"Chris Dy","startTime":245.429,"endTime":248.879,"body":"face. So that was that was"},{"speaker":"Chris Dy","startTime":245.429,"endTime":248.879,"body":"interesting. And you know, I"},{"speaker":"Chris Dy","startTime":248.879,"endTime":250.979,"body":"think that was a nice"},{"speaker":"Chris Dy","startTime":248.879,"endTime":250.979,"body":"connection. It felt really good,"},{"speaker":"Chris Dy","startTime":251.009,"endTime":254.489,"body":"you know? But then I realized"},{"speaker":"Chris Dy","startTime":251.009,"endTime":254.489,"body":"halfway through my clinic that I"},{"speaker":"Chris Dy","startTime":254.519,"endTime":257.849,"body":"could not show all of my"},{"speaker":"Chris Dy","startTime":254.519,"endTime":257.849,"body":"expressions like if I had a mask"},{"speaker":"Chris Dy","startTime":257.849,"endTime":260.789,"body":"on like a patient the downside"},{"speaker":"Chris Dy","startTime":257.849,"endTime":260.789,"body":"of what you're talking about"},{"speaker":"Chris Dy","startTime":260.789,"endTime":264.179,"body":"Maisie like hearing a patient"},{"speaker":"Chris Dy","startTime":260.789,"endTime":264.179,"body":"say something I couldn't purse"},{"speaker":"Chris Dy","startTime":264.179,"endTime":268.979,"body":"my lips I couldn't be like oh my"},{"speaker":"Chris Dy","startTime":264.179,"endTime":268.979,"body":"god because I'm used to keeping"},{"speaker":"Chris Dy","startTime":268.979,"endTime":273.479,"body":"it okay from like, you know,"},{"speaker":"Chris Dy","startTime":268.979,"endTime":273.479,"body":"eyes nose up, but uh yeah, I"},{"speaker":"Chris Dy","startTime":273.479,"endTime":275.939,"body":"have to I have to remind myself"},{"speaker":"Chris Dy","startTime":273.479,"endTime":275.939,"body":"it's kind of like getting"},{"speaker":"Chris Dy","startTime":275.999,"endTime":277.409,"body":"getting back on a bike right?"},{"speaker":"Charles Goldfarb","startTime":277.769,"endTime":279.539,"body":"Yeah, you know"},{"speaker":"Charles Goldfarb","startTime":277.769,"endTime":279.539,"body":"it's a Macy's probably"},{"speaker":"Charles Goldfarb","startTime":279.539,"endTime":282.659,"body":"experiences little kids are"},{"speaker":"Charles Goldfarb","startTime":279.539,"endTime":282.659,"body":"interesting because you really"},{"speaker":"Charles Goldfarb","startTime":282.659,"endTime":285.929,"body":"connect with them with a big"},{"speaker":"Charles Goldfarb","startTime":282.659,"endTime":285.929,"body":"smile and and but I think they"},{"speaker":"Charles Goldfarb","startTime":285.929,"endTime":288.749,"body":"also can realize just like we"},{"speaker":"Charles Goldfarb","startTime":285.929,"endTime":288.749,"body":"can read eyes, we can see"},{"speaker":"Charles Goldfarb","startTime":288.749,"endTime":291.509,"body":"smiling eyes and I think all of"},{"speaker":"Charles Goldfarb","startTime":288.749,"endTime":291.509,"body":"us are gonna be a little more"},{"speaker":"Charles Goldfarb","startTime":291.509,"endTime":296.759,"body":"perceptive about subtleties and"},{"speaker":"Charles Goldfarb","startTime":291.509,"endTime":296.759,"body":"facial expressions. But I'm also"},{"speaker":"Charles Goldfarb","startTime":296.759,"endTime":299.999,"body":"a little worried about getting"},{"speaker":"Charles Goldfarb","startTime":296.759,"endTime":299.999,"body":"sick. Like I haven't had a comma"},{"speaker":"Charles Goldfarb","startTime":299.999,"endTime":304.169,"body":"Cold and three years, and I know"},{"speaker":"Charles Goldfarb","startTime":299.999,"endTime":304.169,"body":"they're gonna start coming back."},{"speaker":"Charles Goldfarb","startTime":304.169,"endTime":306.869,"body":"And that's one huge benefit that"},{"speaker":"Charles Goldfarb","startTime":304.169,"endTime":306.869,"body":"was really nice."},{"speaker":"Chris Dy","startTime":307.829,"endTime":310.409,"body":"Well, Macy knows Macy"},{"speaker":"Chris Dy","startTime":307.829,"endTime":310.409,"body":"knows that life as well in terms"},{"speaker":"Chris Dy","startTime":310.409,"endTime":314.489,"body":"of the the daycare slash"},{"speaker":"Chris Dy","startTime":310.409,"endTime":314.489,"body":"Elementary School germs that"},{"speaker":"Chris Dy","startTime":314.909,"endTime":318.209,"body":"both of us have been fending off"},{"speaker":"Chris Dy","startTime":314.909,"endTime":318.209,"body":"for the last, I guess since the"},{"speaker":"Chris Dy","startTime":318.209,"endTime":320.309,"body":"school year started. So that's"},{"speaker":"Chris Dy","startTime":318.209,"endTime":320.309,"body":"we're ahead of the curve there"},{"speaker":"Chris Dy","startTime":320.309,"endTime":322.859,"body":"for you. Hopefully won't spread"},{"speaker":"Chris Dy","startTime":320.309,"endTime":322.859,"body":"anything to you."},{"speaker":"Charles Goldfarb","startTime":323.699,"endTime":329.069,"body":"So we have a"},{"speaker":"Charles Goldfarb","startTime":323.699,"endTime":329.069,"body":"topic, which on the surface may"},{"speaker":"Charles Goldfarb","startTime":329.069,"endTime":332.039,"body":"not sound like the most exciting"},{"speaker":"Charles Goldfarb","startTime":329.069,"endTime":332.039,"body":"topic, but"},{"speaker":"Chris Dy","startTime":332.22,"endTime":334.05,"body":"it's definitely not"},{"speaker":"Chris Dy","startTime":332.22,"endTime":334.05,"body":"the most exciting topic. I'll"},{"speaker":"Chris Dy","startTime":334.05,"endTime":335.58,"body":"tell you that right now. But"},{"speaker":"Charles Goldfarb","startTime":335.609,"endTime":338.219,"body":"it's filled"},{"speaker":"Charles Goldfarb","startTime":335.609,"endTime":338.219,"body":"with controversy. And you know,"},{"speaker":"Charles Goldfarb","startTime":338.219,"endTime":340.499,"body":"people really feel strongly so"},{"speaker":"Charles Goldfarb","startTime":338.219,"endTime":340.499,"body":"we're gonna talk about mallet"},{"speaker":"Charles Goldfarb","startTime":340.499,"endTime":341.579,"body":"fingers, which you"},{"speaker":"Chris Dy","startTime":341.58,"endTime":343.41,"body":"do, uh, you do have to"},{"speaker":"Chris Dy","startTime":341.58,"endTime":343.41,"body":"talk about it. Like, that's"},{"speaker":"Chris Dy","startTime":343.41,"endTime":345.72,"body":"thing is that like, there's a"},{"speaker":"Chris Dy","startTime":343.41,"endTime":345.72,"body":"conversation in this"},{"speaker":"Chris Dy","startTime":345.72,"endTime":347.28,"body":"conversation that comes up"},{"speaker":"Chris Dy","startTime":345.72,"endTime":347.28,"body":"frequently."},{"speaker":"Charles Goldfarb","startTime":347.759,"endTime":351.269,"body":"Yeah, there's"},{"speaker":"Charles Goldfarb","startTime":347.759,"endTime":351.269,"body":"no therapist or hand surgeon out"},{"speaker":"Charles Goldfarb","startTime":351.269,"endTime":354.269,"body":"there who doesn't deal with this"},{"speaker":"Charles Goldfarb","startTime":351.269,"endTime":354.269,"body":"problem regularly."},{"speaker":"Chris Dy","startTime":354.929,"endTime":357.329,"body":"Well, before we get"},{"speaker":"Chris Dy","startTime":354.929,"endTime":357.329,"body":"into it, we should thank our"},{"speaker":"Chris Dy","startTime":357.329,"endTime":357.989,"body":"sponsors."},{"speaker":"Charles Goldfarb","startTime":358.62,"endTime":361.17,"body":"You are so"},{"speaker":"Charles Goldfarb","startTime":358.62,"endTime":361.17,"body":"good. We definitely should thank"},{"speaker":"Charles Goldfarb","startTime":361.17,"endTime":362.07,"body":"our sponsors."},{"speaker":"Chris Dy","startTime":362.459,"endTime":364.679,"body":"The overhead is"},{"speaker":"Chris Dy","startTime":362.459,"endTime":364.679,"body":"sponsored by practice like.com,"},{"speaker":"Chris Dy","startTime":364.679,"endTime":367.499,"body":"the most widely used physician"},{"speaker":"Chris Dy","startTime":364.679,"endTime":367.499,"body":"job search and career"},{"speaker":"Chris Dy","startTime":367.499,"endTime":369.629,"body":"advancement, advancement"},{"speaker":"Chris Dy","startTime":367.499,"endTime":369.629,"body":"resource."},{"speaker":"Charles Goldfarb","startTime":370.08,"endTime":371.94,"body":"Becoming a"},{"speaker":"Charles Goldfarb","startTime":370.08,"endTime":371.94,"body":"physician is hard finding the"},{"speaker":"Charles Goldfarb","startTime":371.94,"endTime":376.29,"body":"right job does not have to be"},{"speaker":"Charles Goldfarb","startTime":371.94,"endTime":376.29,"body":"joined practice link for free."},{"speaker":"Charles Goldfarb","startTime":376.92,"endTime":381.63,"body":"Today at WWW dot practice."},{"speaker":"Charles Goldfarb","startTime":376.92,"endTime":381.63,"body":"lync.com backslash the upper"},{"speaker":"Charles Goldfarb","startTime":381.63,"endTime":384.9,"body":"hand. And, you know, I've"},{"speaker":"Charles Goldfarb","startTime":381.63,"endTime":384.9,"body":"enjoyed our conversations with"},{"speaker":"Charles Goldfarb","startTime":384.9,"endTime":389.1,"body":"practice, Link. I think you and"},{"speaker":"Charles Goldfarb","startTime":384.9,"endTime":389.1,"body":"I owe the founder coffee and"},{"speaker":"Charles Goldfarb","startTime":389.13,"endTime":393.03,"body":"discussion one morning, but it's"},{"speaker":"Charles Goldfarb","startTime":389.13,"endTime":393.03,"body":"a good it's a good group."},{"speaker":"Chris Dy","startTime":393.359,"endTime":395.279,"body":"Right, right."},{"speaker":"Chris Dy","startTime":393.359,"endTime":395.279,"body":"Absolutely. You know, what's"},{"speaker":"Chris Dy","startTime":395.279,"endTime":397.889,"body":"funny is I was talking with"},{"speaker":"Chris Dy","startTime":395.279,"endTime":397.889,"body":"somebody about the podcast and"},{"speaker":"Chris Dy","startTime":397.889,"endTime":400.439,"body":"the sponsorship thing. And he"},{"speaker":"Chris Dy","startTime":397.889,"endTime":400.439,"body":"asked like, Hey, do you guys"},{"speaker":"Chris Dy","startTime":400.439,"endTime":402.599,"body":"just like record that and just"},{"speaker":"Chris Dy","startTime":400.439,"endTime":402.599,"body":"like insert it every time. And I"},{"speaker":"Chris Dy","startTime":402.599,"endTime":407.579,"body":"think how we just flubbed that."},{"speaker":"Chris Dy","startTime":402.599,"endTime":407.579,"body":"That copy totally shows that we"},{"speaker":"Chris Dy","startTime":407.579,"endTime":409.799,"body":"do not just inserted every time"},{"speaker":"Charles Goldfarb","startTime":410.339,"endTime":414.089,"body":"now from the"},{"speaker":"Charles Goldfarb","startTime":410.339,"endTime":414.089,"body":"heart from the heart. All right,"},{"speaker":"Charles Goldfarb","startTime":414.119,"endTime":417.719,"body":"well, let's, let's how should we"},{"speaker":"Charles Goldfarb","startTime":414.119,"endTime":417.719,"body":"start this?"},{"speaker":"Chris Dy","startTime":417.87,"endTime":420.69,"body":"Well, here, let's"},{"speaker":"Chris Dy","startTime":417.87,"endTime":420.69,"body":"let's do a case. Right. So you"},{"speaker":"Chris Dy","startTime":420.69,"endTime":426.63,"body":"know, say you've got a a young"},{"speaker":"Chris Dy","startTime":420.69,"endTime":426.63,"body":"investigator eligible under 40"},{"speaker":"Chris Dy","startTime":426.63,"endTime":428.88,"body":"type dad, who is playing ball,"},{"speaker":"Charles Goldfarb","startTime":429.18,"endTime":430.41,"body":"are you still"},{"speaker":"Charles Goldfarb","startTime":429.18,"endTime":430.41,"body":"under 40?"},{"speaker":"Chris Dy","startTime":431.91,"endTime":436.62,"body":"I got the award,"},{"speaker":"Chris Dy","startTime":431.91,"endTime":436.62,"body":"buddy. So now it's funny because"},{"speaker":"Chris Dy","startTime":436.62,"endTime":439.41,"body":"I've been walking through the"},{"speaker":"Chris Dy","startTime":436.62,"endTime":439.41,"body":"hospital like I apparently it's"},{"speaker":"Chris Dy","startTime":439.41,"endTime":444.24,"body":"been like, people have been told"},{"speaker":"Chris Dy","startTime":439.41,"endTime":444.24,"body":"in the south county or one of"},{"speaker":"Chris Dy","startTime":444.24,"endTime":446.88,"body":"our satellite centers. So people"},{"speaker":"Chris Dy","startTime":444.24,"endTime":446.88,"body":"are like, you're still under 40."},{"speaker":"Chris Dy","startTime":449.1,"endTime":453.12,"body":"I'm holding on for a few more"},{"speaker":"Chris Dy","startTime":449.1,"endTime":453.12,"body":"months. But say it's, you know,"},{"speaker":"Chris Dy","startTime":453.12,"endTime":458.04,"body":"a young dad who is playing ball"},{"speaker":"Chris Dy","startTime":453.12,"endTime":458.04,"body":"with their child, and, you know,"},{"speaker":"Chris Dy","startTime":458.04,"endTime":461.34,"body":"his daughter throws the ball"},{"speaker":"Chris Dy","startTime":458.04,"endTime":461.34,"body":"quite hard. And, you know, he"},{"speaker":"Chris Dy","startTime":461.34,"endTime":463.56,"body":"tries to catch the ball. And"},{"speaker":"Chris Dy","startTime":461.34,"endTime":463.56,"body":"it's been a while since he's"},{"speaker":"Chris Dy","startTime":463.59,"endTime":466.92,"body":"played ball. And there's a"},{"speaker":"Chris Dy","startTime":463.59,"endTime":466.92,"body":"sudden, hyperflexion moment to"},{"speaker":"Chris Dy","startTime":466.92,"endTime":471.27,"body":"his middle finger. And he comes"},{"speaker":"Chris Dy","startTime":466.92,"endTime":471.27,"body":"in and you can't, he can't"},{"speaker":"Chris Dy","startTime":471.27,"endTime":474.57,"body":"straighten out his finger"},{"speaker":"Chris Dy","startTime":471.27,"endTime":474.57,"body":"happened. I don't know a month"},{"speaker":"Chris Dy","startTime":474.6,"endTime":478.14,"body":"or Yeah, it happened. Let's say"},{"speaker":"Chris Dy","startTime":474.6,"endTime":478.14,"body":"a week ago, he went to an urgent"},{"speaker":"Chris Dy","startTime":478.14,"endTime":481.83,"body":"care center got X rays, X rays"},{"speaker":"Chris Dy","startTime":478.14,"endTime":481.83,"body":"were negative. And they put him"},{"speaker":"Chris Dy","startTime":481.83,"endTime":486.9,"body":"in and Illuma foam splint from"},{"speaker":"Chris Dy","startTime":481.83,"endTime":486.9,"body":"the palm extending past the tip"},{"speaker":"Chris Dy","startTime":486.9,"endTime":489.81,"body":"of the finger. It's all co"},{"speaker":"Chris Dy","startTime":486.9,"endTime":489.81,"body":"Bandha. He has moved his finger"},{"speaker":"Chris Dy","startTime":489.81,"endTime":495.06,"body":"in a week. So Macy, how do you"},{"speaker":"Chris Dy","startTime":489.81,"endTime":495.06,"body":"because sometimes, you know when"},{"speaker":"Chris Dy","startTime":495.06,"endTime":497.07,"body":"we're collaborating with you in"},{"speaker":"Chris Dy","startTime":495.06,"endTime":497.07,"body":"clinic, sometimes you'll see"},{"speaker":"Chris Dy","startTime":497.07,"endTime":501.39,"body":"patients for us. So how do you"},{"speaker":"Chris Dy","startTime":497.07,"endTime":501.39,"body":"approach that discussion? And"},{"speaker":"Chris Dy","startTime":501.39,"endTime":503.46,"body":"kind of what are the other"},{"speaker":"Chris Dy","startTime":501.39,"endTime":503.46,"body":"history points you want to take?"},{"speaker":"Charles Goldfarb","startTime":504.0,"endTime":506.16,"body":"Can I before"},{"speaker":"Charles Goldfarb","startTime":504.0,"endTime":506.16,"body":"you answer Can I Can I say one"},{"speaker":"Charles Goldfarb","startTime":506.16,"endTime":509.34,"body":"thing? So for those of us for"},{"speaker":"Charles Goldfarb","startTime":506.16,"endTime":509.34,"body":"those in the outside world who"},{"speaker":"Charles Goldfarb","startTime":509.34,"endTime":512.01,"body":"don't have the benefit of"},{"speaker":"Charles Goldfarb","startTime":509.34,"endTime":512.01,"body":"working with Macy or someone"},{"speaker":"Charles Goldfarb","startTime":512.01,"endTime":517.71,"body":"like Macy, it's like the best"},{"speaker":"Charles Goldfarb","startTime":512.01,"endTime":517.71,"body":"possible situation because often"},{"speaker":"Charles Goldfarb","startTime":517.71,"endTime":521.76,"body":"will have a resident or fellow"},{"speaker":"Charles Goldfarb","startTime":517.71,"endTime":521.76,"body":"who goes in and they may or may"},{"speaker":"Charles Goldfarb","startTime":521.76,"endTime":524.7,"body":"not understand all the issues"},{"speaker":"Charles Goldfarb","startTime":521.76,"endTime":524.7,"body":"and they may or may not get it"},{"speaker":"Charles Goldfarb","startTime":524.7,"endTime":527.73,"body":"right. Macy always gets it"},{"speaker":"Charles Goldfarb","startTime":524.7,"endTime":527.73,"body":"right. Like she's been doing"},{"speaker":"Charles Goldfarb","startTime":527.73,"endTime":530.64,"body":"this a long time. And when she"},{"speaker":"Charles Goldfarb","startTime":527.73,"endTime":530.64,"body":"comes out and says something I"},{"speaker":"Chris Dy","startTime":530.67,"endTime":532.68,"body":"know not that long"},{"speaker":"Chris Dy","startTime":530.67,"endTime":532.68,"body":"track. Not that long. Okay."},{"speaker":"Charles Goldfarb","startTime":533.64,"endTime":538.26,"body":"She's under"},{"speaker":"Charles Goldfarb","startTime":533.64,"endTime":538.26,"body":"42. You're also in a special"},{"speaker":"Charles Goldfarb","startTime":538.26,"endTime":540.87,"body":"state. Can we talk about that"},{"speaker":"Charles Goldfarb","startTime":538.26,"endTime":540.87,"body":"for a second? How do you feel?"},{"speaker":"Macy Stonner","startTime":541.77,"endTime":544.53,"body":"I feel good, I"},{"speaker":"Macy Stonner","startTime":541.77,"endTime":544.53,"body":"feel good. For those who are"},{"speaker":"Macy Stonner","startTime":544.53,"endTime":551.61,"body":"listening. I'm three weeks out"},{"speaker":"Macy Stonner","startTime":544.53,"endTime":551.61,"body":"from having a child and I feel"},{"speaker":"Macy Stonner","startTime":551.61,"endTime":553.29,"body":"good. It's like this pregnancy"},{"speaker":"Macy Stonner","startTime":551.61,"endTime":553.29,"body":"is a little harder because I"},{"speaker":"Macy Stonner","startTime":553.29,"endTime":556.41,"body":"have a toddler to run around and"},{"speaker":"Macy Stonner","startTime":553.29,"endTime":556.41,"body":"chase after but overall feeling"},{"speaker":"Macy Stonner","startTime":556.41,"endTime":559.56,"body":"good feeling ready. feeling"},{"speaker":"Macy Stonner","startTime":556.41,"endTime":559.56,"body":"grateful for all the things that"},{"speaker":"Macy Stonner","startTime":559.56,"endTime":560.25,"body":"come with it."},{"speaker":"Charles Goldfarb","startTime":560.91,"endTime":562.62,"body":"Yeah, well,"},{"speaker":"Charles Goldfarb","startTime":560.91,"endTime":562.62,"body":"I'm glad we snuck snuck this"},{"speaker":"Charles Goldfarb","startTime":562.62,"endTime":565.08,"body":"part in I don't know why I felt"},{"speaker":"Charles Goldfarb","startTime":562.62,"endTime":565.08,"body":"like I hadn't seen you in a"},{"speaker":"Charles Goldfarb","startTime":565.08,"endTime":568.17,"body":"while. And maybe we missed a"},{"speaker":"Charles Goldfarb","startTime":565.08,"endTime":568.17,"body":"clinic or something. But you"},{"speaker":"Charles Goldfarb","startTime":568.17,"endTime":570.99,"body":"were in clinic with me on"},{"speaker":"Charles Goldfarb","startTime":568.17,"endTime":570.99,"body":"Thursday. And I was like, Oh my"},{"speaker":"Charles Goldfarb","startTime":570.99,"endTime":571.5,"body":"god."},{"speaker":"Macy Stonner","startTime":572.1,"endTime":573.78,"body":"You definitely saw"},{"speaker":"Macy Stonner","startTime":572.1,"endTime":573.78,"body":"me your eyes got bigger. You're"},{"speaker":"Macy Stonner","startTime":573.78,"endTime":576.3,"body":"like, whoa, what difference?"},{"speaker":"Chris Dy","startTime":577.44,"endTime":580.71,"body":"We should do a public"},{"speaker":"Chris Dy","startTime":577.44,"endTime":580.71,"body":"congratulations to Macy. This"},{"speaker":"Chris Dy","startTime":581.43,"endTime":583.32,"body":"will get to a baby shower on the"},{"speaker":"Chris Dy","startTime":581.43,"endTime":583.32,"body":"upper hand."},{"speaker":"Macy Stonner","startTime":584.49,"endTime":586.29,"body":"Thank you. Do you"},{"speaker":"Macy Stonner","startTime":584.49,"endTime":586.29,"body":"want me to continue to talk"},{"speaker":"Macy Stonner","startTime":586.29,"endTime":588.6,"body":"about mallet or do you I'm gonna"},{"speaker":"Macy Stonner","startTime":586.29,"endTime":588.6,"body":"keep talking about other things."},{"speaker":"Chris Dy","startTime":588.63,"endTime":590.37,"body":"Well, I think Chuck"},{"speaker":"Chris Dy","startTime":588.63,"endTime":590.37,"body":"was talking about how awesome it"},{"speaker":"Chris Dy","startTime":590.37,"endTime":592.71,"body":"is to have you in clinics, the"},{"speaker":"Chris Dy","startTime":590.37,"endTime":592.71,"body":"price should finish and then we"},{"speaker":"Chris Dy","startTime":592.71,"endTime":594.75,"body":"should get back to well, y'all"},{"speaker":"Chris Dy","startTime":592.71,"endTime":594.75,"body":"are very"},{"speaker":"Macy Stonner","startTime":594.75,"endTime":599.13,"body":"sweet. Thank you."},{"speaker":"Macy Stonner","startTime":594.75,"endTime":599.13,"body":"But regarding that patience. I"},{"speaker":"Macy Stonner","startTime":599.13,"endTime":600.84,"body":"feel like one of the first"},{"speaker":"Macy Stonner","startTime":599.13,"endTime":600.84,"body":"things I want to address is"},{"speaker":"Macy Stonner","startTime":600.84,"endTime":603.72,"body":"like, Hey, isn't to not say, Oh,"},{"speaker":"Macy Stonner","startTime":600.84,"endTime":603.72,"body":"you've been doing this wrong,"},{"speaker":"Macy Stonner","startTime":603.72,"endTime":606.03,"body":"you need to be moving these"},{"speaker":"Macy Stonner","startTime":603.72,"endTime":606.03,"body":"joints and your splints wrong."},{"speaker":"Macy Stonner","startTime":606.03,"endTime":608.85,"body":"And you know, you're mismanaged"},{"speaker":"Macy Stonner","startTime":606.03,"endTime":608.85,"body":"in some way, I'd say, Nice job,"},{"speaker":"Macy Stonner","startTime":608.85,"endTime":612.09,"body":"you've been splitting for a week"},{"speaker":"Macy Stonner","startTime":608.85,"endTime":612.09,"body":"full time. But you know, we"},{"speaker":"Macy Stonner","startTime":612.09,"endTime":615.33,"body":"really want to customize that"},{"speaker":"Macy Stonner","startTime":612.09,"endTime":615.33,"body":"splint a little bit more, give"},{"speaker":"Macy Stonner","startTime":615.33,"endTime":620.19,"body":"you more freedom at some of the"},{"speaker":"Macy Stonner","startTime":615.33,"endTime":620.19,"body":"more proximal joints, support"},{"speaker":"Macy Stonner","startTime":620.19,"endTime":622.29,"body":"your tip of the finger a little"},{"speaker":"Macy Stonner","startTime":620.19,"endTime":622.29,"body":"bit better. So we're probably"},{"speaker":"Macy Stonner","startTime":622.29,"endTime":624.81,"body":"going to send you over to"},{"speaker":"Macy Stonner","startTime":622.29,"endTime":624.81,"body":"therapy today to have a"},{"speaker":"Macy Stonner","startTime":624.81,"endTime":627.21,"body":"different brace made and kind of"},{"speaker":"Macy Stonner","startTime":624.81,"endTime":627.21,"body":"go through some specific"},{"speaker":"Macy Stonner","startTime":627.21,"endTime":632.37,"body":"education and instructions on"},{"speaker":"Macy Stonner","startTime":627.21,"endTime":632.37,"body":"what to do for the next, you"},{"speaker":"Macy Stonner","startTime":632.37,"endTime":635.34,"body":"know, six weeks or so. And kind"},{"speaker":"Macy Stonner","startTime":632.37,"endTime":635.34,"body":"of educate them a lot on the"},{"speaker":"Macy Stonner","startTime":635.34,"endTime":638.13,"body":"anatomy. Because a lot of times"},{"speaker":"Macy Stonner","startTime":635.34,"endTime":638.13,"body":"I've been taught that"},{"speaker":"Chris Dy","startTime":638.13,"endTime":640.77,"body":"it's like totally"},{"speaker":"Chris Dy","startTime":638.13,"endTime":640.77,"body":"Birmingham nice the way the"},{"speaker":"Chris Dy","startTime":640.77,"endTime":645.78,"body":"teachers Well, good job on"},{"speaker":"Chris Dy","startTime":640.77,"endTime":645.78,"body":"splitting for a week. But I love"},{"speaker":"Chris Dy","startTime":645.78,"endTime":647.73,"body":"that I'm sorry to interrupt you,"},{"speaker":"Chris Dy","startTime":645.78,"endTime":647.73,"body":"but how would you educate them"},{"speaker":"Chris Dy","startTime":647.73,"endTime":648.42,"body":"on the anatomy?"},{"speaker":"Macy Stonner","startTime":648.6,"endTime":650.91,"body":"Sure. So I'm just"},{"speaker":"Macy Stonner","startTime":648.6,"endTime":650.91,"body":"gonna give my spiel a little"},{"speaker":"Macy Stonner","startTime":650.91,"endTime":654.66,"body":"bit, I'll take out our anatomy"},{"speaker":"Macy Stonner","startTime":650.91,"endTime":654.66,"body":"book, and I'll sure it shouldn't"},{"speaker":"Macy Stonner","startTime":654.66,"endTime":658.68,"body":"like the extensor tendons on my"},{"speaker":"Macy Stonner","startTime":654.66,"endTime":658.68,"body":"hand, and describe it like, you"},{"speaker":"Macy Stonner","startTime":658.68,"endTime":661.56,"body":"have a rubber band on the back"},{"speaker":"Macy Stonner","startTime":658.68,"endTime":661.56,"body":"of your finger that got jammed"},{"speaker":"Macy Stonner","startTime":661.56,"endTime":663.99,"body":"or overstretched. And if you"},{"speaker":"Macy Stonner","startTime":661.56,"endTime":663.99,"body":"have a hair tie or rubber band"},{"speaker":"Macy Stonner","startTime":663.99,"endTime":666.54,"body":"that gets stretched out, it's"},{"speaker":"Macy Stonner","startTime":663.99,"endTime":666.54,"body":"hard to get back to that tight"},{"speaker":"Macy Stonner","startTime":666.54,"endTime":669.45,"body":"tension than it once was. And so"},{"speaker":"Macy Stonner","startTime":666.54,"endTime":669.45,"body":"then I kind of showed them my"},{"speaker":"Macy Stonner","startTime":669.45,"endTime":673.11,"body":"finger and explain if we got to"},{"speaker":"Macy Stonner","startTime":669.45,"endTime":673.11,"body":"keep this really straight for"},{"speaker":"Macy Stonner","startTime":673.26,"endTime":677.73,"body":"six weeks or so through"},{"speaker":"Macy Stonner","startTime":673.26,"endTime":677.73,"body":"dedicated splinting, because as"},{"speaker":"Macy Stonner","startTime":677.73,"endTime":680.46,"body":"it heals in that straight"},{"speaker":"Macy Stonner","startTime":677.73,"endTime":680.46,"body":"position, think about a lot of"},{"speaker":"Macy Stonner","startTime":680.46,"endTime":682.89,"body":"scar tissue that gets built up"},{"speaker":"Macy Stonner","startTime":680.46,"endTime":682.89,"body":"on the back of your finger and"},{"speaker":"Macy Stonner","startTime":682.89,"endTime":685.62,"body":"it tightens up in a good way."},{"speaker":"Macy Stonner","startTime":682.89,"endTime":685.62,"body":"And then after six weeks, you"},{"speaker":"Macy Stonner","startTime":685.62,"endTime":688.26,"body":"take a splint off, and hopefully"},{"speaker":"Macy Stonner","startTime":685.62,"endTime":688.26,"body":"it magically stays straight like"},{"speaker":"Macy Stonner","startTime":688.26,"endTime":692.58,"body":"that. And I explained it like"},{"speaker":"Macy Stonner","startTime":688.26,"endTime":692.58,"body":"it's splitting with a"},{"speaker":"Macy Stonner","startTime":692.58,"endTime":695.97,"body":"commitment. Because if you take"},{"speaker":"Macy Stonner","startTime":692.58,"endTime":695.97,"body":"it off for showers or for"},{"speaker":"Macy Stonner","startTime":695.97,"endTime":699.21,"body":"intermittent activities, you"},{"speaker":"Macy Stonner","startTime":695.97,"endTime":699.21,"body":"have likely let your finger"},{"speaker":"Macy Stonner","startTime":699.21,"endTime":703.32,"body":"droop. And we want to keep it"},{"speaker":"Macy Stonner","startTime":699.21,"endTime":703.32,"body":"tight for six weeks. So it's"},{"speaker":"Macy Stonner","startTime":703.32,"endTime":706.5,"body":"definitely a commitment. And"},{"speaker":"Macy Stonner","startTime":703.32,"endTime":706.5,"body":"we'll kind of go through some"},{"speaker":"Macy Stonner","startTime":706.5,"endTime":709.17,"body":"strategies of how to take it on"},{"speaker":"Macy Stonner","startTime":706.5,"endTime":709.17,"body":"and off to clean your hand to"},{"speaker":"Macy Stonner","startTime":709.17,"endTime":711.9,"body":"monitor for laceration without"},{"speaker":"Macy Stonner","startTime":709.17,"endTime":711.9,"body":"letting your finger droop."},{"speaker":"Macy Stonner","startTime":712.35,"endTime":714.0,"body":"That's kind of like a little bit"},{"speaker":"Macy Stonner","startTime":712.35,"endTime":714.0,"body":"of my schpeel."},{"speaker":"Charles Goldfarb","startTime":714.51,"endTime":716.16,"body":"Your Spiel is"},{"speaker":"Charles Goldfarb","startTime":714.51,"endTime":716.16,"body":"great. There's a lot we have a"},{"speaker":"Charles Goldfarb","startTime":716.16,"endTime":719.73,"body":"lot of different angles, or"},{"speaker":"Charles Goldfarb","startTime":716.16,"endTime":719.73,"body":"leads we need to pursue. Sure."},{"speaker":"Charles Goldfarb","startTime":720.3,"endTime":724.47,"body":"So number one, Chris, does every"},{"speaker":"Charles Goldfarb","startTime":720.3,"endTime":724.47,"body":"patient deserve an x ray?"},{"speaker":"Chris Dy","startTime":725.64,"endTime":728.91,"body":"No, but I think that"},{"speaker":"Chris Dy","startTime":725.64,"endTime":728.91,"body":"Nova in terms of decision"},{"speaker":"Chris Dy","startTime":728.91,"endTime":733.53,"body":"making, and what to do, yes, in"},{"speaker":"Chris Dy","startTime":728.91,"endTime":733.53,"body":"terms of, dare I say"},{"speaker":"Chris Dy","startTime":733.56,"endTime":738.78,"body":"therapeutic, or XR t in terms of"},{"speaker":"Chris Dy","startTime":733.56,"endTime":738.78,"body":"showing them like a lot of times"},{"speaker":"Chris Dy","startTime":738.78,"endTime":742.8,"body":"patients will think like they"},{"speaker":"Chris Dy","startTime":738.78,"endTime":742.8,"body":"didn't even do an x ray. So and"},{"speaker":"Chris Dy","startTime":742.8,"endTime":747.15,"body":"that honestly contributes to"},{"speaker":"Chris Dy","startTime":742.8,"endTime":747.15,"body":"kind of patient satisfaction. So"},{"speaker":"Chris Dy","startTime":747.15,"endTime":750.03,"body":"I think getting an x ray,"},{"speaker":"Chris Dy","startTime":747.15,"endTime":750.03,"body":"especially one that can be done"},{"speaker":"Chris Dy","startTime":750.03,"endTime":752.82,"body":"quickly, and with very low"},{"speaker":"Chris Dy","startTime":750.03,"endTime":752.82,"body":"radiation in terms of the floor"},{"speaker":"Chris Dy","startTime":752.82,"endTime":756.81,"body":"skin is beneficial in terms of"},{"speaker":"Chris Dy","startTime":752.82,"endTime":756.81,"body":"the relationship, but I don't"},{"speaker":"Chris Dy","startTime":756.81,"endTime":759.75,"body":"need it to make the diagnosis"},{"speaker":"Chris Dy","startTime":756.81,"endTime":759.75,"body":"and to guide management pretty"},{"speaker":"Chris Dy","startTime":759.75,"endTime":763.17,"body":"much every time unless I have a"},{"speaker":"Chris Dy","startTime":759.75,"endTime":763.17,"body":"high suspicion for a bony"},{"speaker":"Chris Dy","startTime":763.17,"endTime":767.1,"body":"mallet. You know, so that I"},{"speaker":"Chris Dy","startTime":763.17,"endTime":767.1,"body":"think is what how I think about"},{"speaker":"Chris Dy","startTime":767.1,"endTime":767.85,"body":"how do you think about it?"},{"speaker":"Charles Goldfarb","startTime":768.63,"endTime":770.43,"body":"I think every"},{"speaker":"Charles Goldfarb","startTime":768.63,"endTime":770.43,"body":"one of these patients should"},{"speaker":"Charles Goldfarb","startTime":770.43,"endTime":773.52,"body":"have an x ray. And part of it is"},{"speaker":"Charles Goldfarb","startTime":770.43,"endTime":773.52,"body":"for the reason you said and part"},{"speaker":"Charles Goldfarb","startTime":773.52,"endTime":777.33,"body":"of it is occasionally I'll be"},{"speaker":"Charles Goldfarb","startTime":773.52,"endTime":777.33,"body":"surprised there'll be a larger"},{"speaker":"Charles Goldfarb","startTime":777.33,"endTime":780.6,"body":"than expected fragment, there"},{"speaker":"Charles Goldfarb","startTime":777.33,"endTime":780.6,"body":"might be joint subluxation. And"},{"speaker":"Charles Goldfarb","startTime":780.6,"endTime":783.3,"body":"I had this conversation with"},{"speaker":"Charles Goldfarb","startTime":780.6,"endTime":783.3,"body":"jazz on Thursday that, you know,"},{"speaker":"Charles Goldfarb","startTime":783.3,"endTime":786.24,"body":"sometimes, you know, you come to"},{"speaker":"Charles Goldfarb","startTime":783.3,"endTime":786.24,"body":"the orthopedic surgeon at a at a"},{"speaker":"Charles Goldfarb","startTime":786.24,"endTime":789.36,"body":"big referral center and you just"},{"speaker":"Charles Goldfarb","startTime":786.24,"endTime":789.36,"body":"kind of get the X ray, even if"},{"speaker":"Charles Goldfarb","startTime":789.36,"endTime":792.21,"body":"you don't really need it like"},{"speaker":"Charles Goldfarb","startTime":789.36,"endTime":792.21,"body":"CMC, arthritis is another"},{"speaker":"Charles Goldfarb","startTime":792.21,"endTime":795.27,"body":"example, you know, from across"},{"speaker":"Charles Goldfarb","startTime":792.21,"endTime":795.27,"body":"the room, whether they have CMC"},{"speaker":"Charles Goldfarb","startTime":795.27,"endTime":797.4,"body":"arthritis, and sometimes you"},{"speaker":"Charles Goldfarb","startTime":795.27,"endTime":797.4,"body":"just gotta get the X ray."},{"speaker":"Chris Dy","startTime":798.299,"endTime":799.859,"body":"Yeah, I think there"},{"speaker":"Chris Dy","startTime":798.299,"endTime":799.859,"body":"there certainly isn't"},{"speaker":"Chris Dy","startTime":799.859,"endTime":804.299,"body":"expectation, you know, going off"},{"speaker":"Chris Dy","startTime":799.859,"endTime":804.299,"body":"topic for the CMC thing. I think"},{"speaker":"Chris Dy","startTime":804.299,"endTime":806.549,"body":"we've talked about this before,"},{"speaker":"Chris Dy","startTime":804.299,"endTime":806.549,"body":"I usually will get the X ray for"},{"speaker":"Chris Dy","startTime":806.549,"endTime":809.519,"body":"getting the surgical planning."},{"speaker":"Chris Dy","startTime":806.549,"endTime":809.519,"body":"But I tell the patients"},{"speaker":"Chris Dy","startTime":809.519,"endTime":812.399,"body":"specifically why I'm not getting"},{"speaker":"Chris Dy","startTime":809.519,"endTime":812.399,"body":"an x ray. And that's part of the"},{"speaker":"Chris Dy","startTime":812.399,"endTime":815.729,"body":"initial counseling spiel for"},{"speaker":"Chris Dy","startTime":812.399,"endTime":815.729,"body":"that particular condition. may"},{"speaker":"Chris Dy","startTime":815.729,"endTime":819.059,"body":"see I love the rubber band"},{"speaker":"Chris Dy","startTime":815.729,"endTime":819.059,"body":"analogy. I have not heard that."},{"speaker":"Chris Dy","startTime":819.449,"endTime":822.809,"body":"And I will probably start using"},{"speaker":"Chris Dy","startTime":819.449,"endTime":822.809,"body":"it. You know, in terms of how I"},{"speaker":"Chris Dy","startTime":822.809,"endTime":825.089,"body":"counsel patients, I love that"},{"speaker":"Chris Dy","startTime":822.809,"endTime":825.089,"body":"especially the tension part of"},{"speaker":"Chris Dy","startTime":825.089,"endTime":825.929,"body":"it and everything."},{"speaker":"Charles Goldfarb","startTime":826.59,"endTime":829.68,"body":"So Macy, I"},{"speaker":"Charles Goldfarb","startTime":826.59,"endTime":829.68,"body":"think, Chris and I feel strongly"},{"speaker":"Charles Goldfarb","startTime":829.71,"endTime":836.4,"body":"that the splints that you custom"},{"speaker":"Charles Goldfarb","startTime":829.71,"endTime":836.4,"body":"make for patients are perfect,"},{"speaker":"Charles Goldfarb","startTime":836.4,"endTime":840.09,"body":"you know, are really good and"},{"speaker":"Charles Goldfarb","startTime":836.4,"endTime":840.09,"body":"they make sense. I think some of"},{"speaker":"Charles Goldfarb","startTime":840.09,"endTime":843.57,"body":"our listeners probably don't"},{"speaker":"Charles Goldfarb","startTime":840.09,"endTime":843.57,"body":"send their patients to a"},{"speaker":"Charles Goldfarb","startTime":843.57,"endTime":847.08,"body":"therapist for a custom spine."},{"speaker":"Charles Goldfarb","startTime":843.57,"endTime":847.08,"body":"And they get by with a Luma"},{"speaker":"Charles Goldfarb","startTime":847.08,"endTime":853.53,"body":"phone or fax but or stack"},{"speaker":"Charles Goldfarb","startTime":847.08,"endTime":853.53,"body":"splint. Exactly. Can you and I'm"},{"speaker":"Charles Goldfarb","startTime":853.53,"endTime":856.38,"body":"asking you to sell your services"},{"speaker":"Charles Goldfarb","startTime":853.53,"endTime":856.38,"body":"a little bit. Can you explain"},{"speaker":"Charles Goldfarb","startTime":856.38,"endTime":860.7,"body":"why you think a custom splint"},{"speaker":"Charles Goldfarb","startTime":856.38,"endTime":860.7,"body":"matters? And can you describe"},{"speaker":"Charles Goldfarb","startTime":860.73,"endTime":864.0,"body":"the splint or splints that you"},{"speaker":"Charles Goldfarb","startTime":860.73,"endTime":864.0,"body":"may design for a patient?"},{"speaker":"Macy Stonner","startTime":864.51,"endTime":867.63,"body":"Absolutely. So in"},{"speaker":"Macy Stonner","startTime":864.51,"endTime":867.63,"body":"clinic Thursday was in your"},{"speaker":"Macy Stonner","startTime":867.63,"endTime":871.62,"body":"clinic I there was a little boy"},{"speaker":"Macy Stonner","startTime":867.63,"endTime":871.62,"body":"that had a mallet injury, he had"},{"speaker":"Macy Stonner","startTime":871.62,"endTime":874.86,"body":"a little foam splint to the poem"},{"speaker":"Macy Stonner","startTime":871.62,"endTime":874.86,"body":"just like you described. And"},{"speaker":"Macy Stonner","startTime":874.86,"endTime":877.44,"body":"when I went in there, I"},{"speaker":"Macy Stonner","startTime":874.86,"endTime":877.44,"body":"evaluated the positioning of"},{"speaker":"Macy Stonner","startTime":877.44,"endTime":881.55,"body":"this finger in that splint. His"},{"speaker":"Macy Stonner","startTime":877.44,"endTime":881.55,"body":"tip was in hyperextension and"},{"speaker":"Macy Stonner","startTime":881.55,"endTime":885.51,"body":"his tip was in a little bit of"},{"speaker":"Macy Stonner","startTime":881.55,"endTime":885.51,"body":"flexion and you know I think"},{"speaker":"Macy Stonner","startTime":885.51,"endTime":888.9,"body":"that it requires a hand surgeon"},{"speaker":"Macy Stonner","startTime":885.51,"endTime":888.9,"body":"softserve his eyes to monitor"},{"speaker":"Macy Stonner","startTime":888.9,"endTime":892.23,"body":"that and to ensure a remote you"},{"speaker":"Macy Stonner","startTime":888.9,"endTime":892.23,"body":"know, lateral view looking in"},{"speaker":"Macy Stonner","startTime":892.23,"endTime":895.89,"body":"the splint that everything is"},{"speaker":"Macy Stonner","startTime":892.23,"endTime":895.89,"body":"positioned perfectly and you"},{"speaker":"Macy Stonner","startTime":895.89,"endTime":899.37,"body":"know you can get by with a"},{"speaker":"Macy Stonner","startTime":895.89,"endTime":899.37,"body":"prefab, resplendent or other"},{"speaker":"Macy Stonner","startTime":899.37,"endTime":903.12,"body":"things but The details of a"},{"speaker":"Macy Stonner","startTime":899.37,"endTime":903.12,"body":"finger can be so different for"},{"speaker":"Macy Stonner","startTime":903.12,"endTime":906.72,"body":"everybody. And I think that"},{"speaker":"Macy Stonner","startTime":903.12,"endTime":906.72,"body":"being able to customize"},{"speaker":"Macy Stonner","startTime":906.72,"endTime":910.74,"body":"something is important. So for"},{"speaker":"Macy Stonner","startTime":906.72,"endTime":910.74,"body":"example, I will ensure that the"},{"speaker":"Macy Stonner","startTime":910.74,"endTime":915.18,"body":"PAP joint is exposed for free."},{"speaker":"Macy Stonner","startTime":910.74,"endTime":915.18,"body":"That's difficult to do with the"},{"speaker":"Macy Stonner","startTime":915.21,"endTime":919.05,"body":"prefabricated splint. Because I"},{"speaker":"Macy Stonner","startTime":915.21,"endTime":919.05,"body":"don't want them to start Swan"},{"speaker":"Macy Stonner","startTime":919.05,"endTime":923.85,"body":"decking or get stuck there. And"},{"speaker":"Macy Stonner","startTime":919.05,"endTime":923.85,"body":"a lot of times, they're really"},{"speaker":"Macy Stonner","startTime":923.85,"endTime":927.93,"body":"swollen, and we have them come"},{"speaker":"Macy Stonner","startTime":923.85,"endTime":927.93,"body":"back at, you know, seven to 10"},{"speaker":"Macy Stonner","startTime":927.93,"endTime":930.72,"body":"days and have it remoulded to"},{"speaker":"Macy Stonner","startTime":927.93,"endTime":930.72,"body":"accommodate for those changes in"},{"speaker":"Macy Stonner","startTime":930.72,"endTime":935.88,"body":"swelling. Because oftentimes,"},{"speaker":"Macy Stonner","startTime":930.72,"endTime":935.88,"body":"you put them in the splint and"},{"speaker":"Macy Stonner","startTime":935.88,"endTime":938.85,"body":"you haven't been a little bit of"},{"speaker":"Macy Stonner","startTime":935.88,"endTime":938.85,"body":"tip hyperextension have them"},{"speaker":"Macy Stonner","startTime":938.85,"endTime":942.15,"body":"come back, their swellings down,"},{"speaker":"Macy Stonner","startTime":938.85,"endTime":942.15,"body":"they've kind of shifted in their"},{"speaker":"Macy Stonner","startTime":942.15,"endTime":944.25,"body":"splint a little bit, and then"},{"speaker":"Macy Stonner","startTime":942.15,"endTime":944.25,"body":"they're in a little bit of"},{"speaker":"Macy Stonner","startTime":944.25,"endTime":947.28,"body":"flexion on accident, and they go"},{"speaker":"Macy Stonner","startTime":944.25,"endTime":947.28,"body":"to the next five weeks in"},{"speaker":"Macy Stonner","startTime":947.28,"endTime":952.02,"body":"flexion. Or, you know, kind of"},{"speaker":"Macy Stonner","startTime":947.28,"endTime":952.02,"body":"takes quite a bit of"},{"speaker":"Macy Stonner","startTime":952.02,"endTime":955.77,"body":"understanding. Health literacy"},{"speaker":"Macy Stonner","startTime":952.02,"endTime":955.77,"body":"might be a good term for this"},{"speaker":"Macy Stonner","startTime":955.8,"endTime":959.37,"body":"diagnosis to be successful."},{"speaker":"Macy Stonner","startTime":955.8,"endTime":959.37,"body":"Because sometimes people will"},{"speaker":"Macy Stonner","startTime":959.37,"endTime":963.15,"body":"come back and they're spot on"},{"speaker":"Macy Stonner","startTime":959.37,"endTime":963.15,"body":"upside down a lot of times, and"},{"speaker":"Macy Stonner","startTime":963.15,"endTime":966.18,"body":"they're being positioned"},{"speaker":"Macy Stonner","startTime":963.15,"endTime":966.18,"body":"inflection. So I guess I'm"},{"speaker":"Macy Stonner","startTime":966.18,"endTime":968.64,"body":"getting at, you know, the"},{"speaker":"Macy Stonner","startTime":966.18,"endTime":968.64,"body":"importance of a follow up to"},{"speaker":"Macy Stonner","startTime":968.64,"endTime":971.37,"body":"ensure everything's going okay."},{"speaker":"Macy Stonner","startTime":968.64,"endTime":971.37,"body":"But the splint going back to"},{"speaker":"Macy Stonner","startTime":971.37,"endTime":976.02,"body":"that is something that can be"},{"speaker":"Macy Stonner","startTime":971.37,"endTime":976.02,"body":"volere, to push them up into a"},{"speaker":"Macy Stonner","startTime":976.02,"endTime":981.27,"body":"little bit of hyperextension."},{"speaker":"Macy Stonner","startTime":976.02,"endTime":981.27,"body":"Not too high on the sides,"},{"speaker":"Macy Stonner","startTime":981.27,"endTime":984.78,"body":"because sometimes that allows"},{"speaker":"Macy Stonner","startTime":981.27,"endTime":984.78,"body":"the finger to droop down, we"},{"speaker":"Macy Stonner","startTime":984.78,"endTime":986.97,"body":"have to be very careful with"},{"speaker":"Macy Stonner","startTime":984.78,"endTime":986.97,"body":"your strapping system to make"},{"speaker":"Macy Stonner","startTime":986.97,"endTime":989.01,"body":"sure that they're supported."},{"speaker":"Macy Stonner","startTime":986.97,"endTime":989.01,"body":"Well. This is all kind of hand"},{"speaker":"Macy Stonner","startTime":989.01,"endTime":992.43,"body":"therapist lingo. And then we"},{"speaker":"Macy Stonner","startTime":989.01,"endTime":992.43,"body":"always make two at our clinic,"},{"speaker":"Macy Stonner","startTime":992.43,"endTime":995.7,"body":"at least one on the bowler side"},{"speaker":"Macy Stonner","startTime":992.43,"endTime":995.7,"body":"and one on the dorsal side to"},{"speaker":"Macy Stonner","startTime":995.91,"endTime":999.48,"body":"distribute pressure over six"},{"speaker":"Macy Stonner","startTime":995.91,"endTime":999.48,"body":"weeks and prevent, you know,"},{"speaker":"Macy Stonner","startTime":1000.56,"endTime":1003.44,"body":"skin breakdown and too much"},{"speaker":"Macy Stonner","startTime":1000.56,"endTime":1003.44,"body":"pressure on one side. So they"},{"speaker":"Macy Stonner","startTime":1003.44,"endTime":1008.54,"body":"have options to go from one to"},{"speaker":"Macy Stonner","startTime":1003.44,"endTime":1008.54,"body":"the other. But it's definitely"},{"speaker":"Macy Stonner","startTime":1008.54,"endTime":1011.54,"body":"one that I feel strongly that"},{"speaker":"Macy Stonner","startTime":1008.54,"endTime":1011.54,"body":"you can't really get a"},{"speaker":"Macy Stonner","startTime":1012.17,"endTime":1014.78,"body":"prefabricated off the shelf one"},{"speaker":"Macy Stonner","startTime":1012.17,"endTime":1014.78,"body":"to support you. Well."},{"speaker":"Chris Dy","startTime":1016.039,"endTime":1018.259,"body":"I love that. And you"},{"speaker":"Chris Dy","startTime":1016.039,"endTime":1018.259,"body":"know, I think the multiple"},{"speaker":"Chris Dy","startTime":1018.259,"endTime":1021.019,"body":"splints is key, I think it's"},{"speaker":"Chris Dy","startTime":1018.259,"endTime":1021.019,"body":"probably the biggest advantage"},{"speaker":"Chris Dy","startTime":1021.409,"endTime":1025.879,"body":"among all of the ones that you"},{"speaker":"Chris Dy","startTime":1021.409,"endTime":1025.879,"body":"described, I didn't realize that"},{"speaker":"Chris Dy","startTime":1025.879,"endTime":1028.939,"body":"you had patients come back for a"},{"speaker":"Chris Dy","startTime":1025.879,"endTime":1028.939,"body":"visit, I kind of thought it was"},{"speaker":"Chris Dy","startTime":1028.939,"endTime":1030.559,"body":"a one time deal. So can"},{"speaker":"Macy Stonner","startTime":1030.56,"endTime":1032.93,"body":"be for some"},{"speaker":"Macy Stonner","startTime":1030.56,"endTime":1032.93,"body":"patients like you kind of feel"},{"speaker":"Macy Stonner","startTime":1032.93,"endTime":1037.1,"body":"out the patient. And you know, I"},{"speaker":"Macy Stonner","startTime":1032.93,"endTime":1037.1,"body":"had this physician the other"},{"speaker":"Macy Stonner","startTime":1037.1,"endTime":1039.11,"body":"day, he just needed a splint."},{"speaker":"Macy Stonner","startTime":1037.1,"endTime":1039.11,"body":"And I was like, No, normally we"},{"speaker":"Macy Stonner","startTime":1039.11,"endTime":1041.12,"body":"come back in seven to 10 days."},{"speaker":"Macy Stonner","startTime":1039.11,"endTime":1041.12,"body":"And he was like, No, I'm good."},{"speaker":"Macy Stonner","startTime":1041.36,"endTime":1045.44,"body":"Like I get it, you know. But"},{"speaker":"Macy Stonner","startTime":1041.36,"endTime":1045.44,"body":"typically, that visit is really"},{"speaker":"Macy Stonner","startTime":1045.44,"endTime":1047.72,"body":"important because you just make"},{"speaker":"Macy Stonner","startTime":1045.44,"endTime":1047.72,"body":"sure that they are well equipped"},{"speaker":"Macy Stonner","startTime":1047.72,"endTime":1049.94,"body":"with all their splinting needs,"},{"speaker":"Macy Stonner","startTime":1047.72,"endTime":1049.94,"body":"you give them a little bat and"},{"speaker":"Macy Stonner","startTime":1049.94,"endTime":1053.27,"body":"velcro and different types of"},{"speaker":"Macy Stonner","startTime":1049.94,"endTime":1053.27,"body":"devices Cauvin or whatnot, to"},{"speaker":"Macy Stonner","startTime":1053.27,"endTime":1057.98,"body":"ensure that they are set with"},{"speaker":"Macy Stonner","startTime":1053.27,"endTime":1057.98,"body":"all their stuff for six weeks to"},{"speaker":"Macy Stonner","startTime":1057.98,"endTime":1060.71,"body":"accommodate for changes in"},{"speaker":"Macy Stonner","startTime":1057.98,"endTime":1060.71,"body":"swelling or an older one and the"},{"speaker":"Macy Stonner","startTime":1060.71,"endTime":1063.2,"body":"dorsal one and nine times out of"},{"speaker":"Macy Stonner","startTime":1060.71,"endTime":1063.2,"body":"10. They hate the lower one and"},{"speaker":"Macy Stonner","startTime":1063.2,"endTime":1065.3,"body":"they just want the dorsal one."},{"speaker":"Macy Stonner","startTime":1063.2,"endTime":1065.3,"body":"So I end up making a second"},{"speaker":"Macy Stonner","startTime":1065.3,"endTime":1070.13,"body":"dorsal one for them. And so just"},{"speaker":"Macy Stonner","startTime":1065.3,"endTime":1070.13,"body":"kind of making sure that they"},{"speaker":"Macy Stonner","startTime":1070.13,"endTime":1075.8,"body":"understand the program I"},{"speaker":"Macy Stonner","startTime":1070.13,"endTime":1075.8,"body":"document that I can I watched"},{"speaker":"Macy Stonner","startTime":1075.8,"endTime":1078.74,"body":"them transition from one splint"},{"speaker":"Macy Stonner","startTime":1075.8,"endTime":1078.74,"body":"to the other without breaking"},{"speaker":"Macy Stonner","startTime":1078.74,"endTime":1081.26,"body":"precautions or without laying"},{"speaker":"Macy Stonner","startTime":1078.74,"endTime":1081.26,"body":"the finger droop because some"},{"speaker":"Macy Stonner","startTime":1081.26,"endTime":1084.5,"body":"people just don't get it."},{"speaker":"Macy Stonner","startTime":1081.26,"endTime":1084.5,"body":"They'll put on one splint, like"},{"speaker":"Macy Stonner","startTime":1084.5,"endTime":1086.36,"body":"they're in the shop like to"},{"speaker":"Macy Stonner","startTime":1084.5,"endTime":1086.36,"body":"mimic that they just come out of"},{"speaker":"Macy Stonner","startTime":1086.36,"endTime":1089.15,"body":"the shower and it's all wet. And"},{"speaker":"Macy Stonner","startTime":1086.36,"endTime":1089.15,"body":"then I'll have them show me they"},{"speaker":"Macy Stonner","startTime":1089.15,"endTime":1092.42,"body":"can put the other one on. And"},{"speaker":"Macy Stonner","startTime":1089.15,"endTime":1092.42,"body":"then they let their finger rest"},{"speaker":"Macy Stonner","startTime":1092.42,"endTime":1094.97,"body":"up supported. And then they"},{"speaker":"Macy Stonner","startTime":1092.42,"endTime":1094.97,"body":"droop. So it's a lot of"},{"speaker":"Macy Stonner","startTime":1094.97,"endTime":1097.91,"body":"reinforced education. Sometimes"},{"speaker":"Macy Stonner","startTime":1094.97,"endTime":1097.91,"body":"the people just really aren't"},{"speaker":"Macy Stonner","startTime":1097.91,"endTime":1099.95,"body":"getting it, you know, those"},{"speaker":"Macy Stonner","startTime":1097.91,"endTime":1099.95,"body":"people that come back, you know,"},{"speaker":"Macy Stonner","startTime":1100.01,"endTime":1103.01,"body":"three or four times, but"},{"speaker":"Macy Stonner","startTime":1100.01,"endTime":1103.01,"body":"typically it's two visits."},{"speaker":"Charles Goldfarb","startTime":1103.79,"endTime":1107.12,"body":"All right, I"},{"speaker":"Charles Goldfarb","startTime":1103.79,"endTime":1107.12,"body":"love it. I have one comment and"},{"speaker":"Charles Goldfarb","startTime":1107.12,"endTime":1113.57,"body":"two questions. My comment and"},{"speaker":"Charles Goldfarb","startTime":1107.12,"endTime":1113.57,"body":"Chris and and Macy, I'm curious"},{"speaker":"Charles Goldfarb","startTime":1113.57,"endTime":1118.25,"body":"as to your thoughts. I see a lot"},{"speaker":"Charles Goldfarb","startTime":1113.57,"endTime":1118.25,"body":"of athletes, and this is one"},{"speaker":"Charles Goldfarb","startTime":1118.25,"endTime":1121.88,"body":"that's hard for me because I"},{"speaker":"Charles Goldfarb","startTime":1118.25,"endTime":1121.88,"body":"don't know of many sports that"},{"speaker":"Charles Goldfarb","startTime":1121.88,"endTime":1125.81,"body":"you can play during the healing"},{"speaker":"Charles Goldfarb","startTime":1121.88,"endTime":1125.81,"body":"process with a mallet splint on."},{"speaker":"Charles Goldfarb","startTime":1126.95,"endTime":1130.25,"body":"So for I'm trying to think of an"},{"speaker":"Charles Goldfarb","startTime":1126.95,"endTime":1130.25,"body":"exception, but this is one of"},{"speaker":"Charles Goldfarb","startTime":1130.25,"endTime":1133.55,"body":"the ones that frustrates me and"},{"speaker":"Charles Goldfarb","startTime":1130.25,"endTime":1133.55,"body":"I know it frustrates families"},{"speaker":"Charles Goldfarb","startTime":1133.55,"endTime":1137.12,"body":"and patients and athletes. I"},{"speaker":"Charles Goldfarb","startTime":1133.55,"endTime":1137.12,"body":"generally don't let people play"},{"speaker":"Charles Goldfarb","startTime":1137.15,"endTime":1139.52,"body":"with a mallet injury because I"},{"speaker":"Charles Goldfarb","startTime":1137.15,"endTime":1139.52,"body":"don't think we can keep the"},{"speaker":"Charles Goldfarb","startTime":1139.52,"endTime":1142.4,"body":"splint on effectively. We can"},{"speaker":"Charles Goldfarb","startTime":1139.52,"endTime":1142.4,"body":"try and we can tape it on but it"},{"speaker":"Charles Goldfarb","startTime":1142.4,"endTime":1145.73,"body":"comes with risks. Is that a fair"},{"speaker":"Charles Goldfarb","startTime":1142.4,"endTime":1145.73,"body":"statement? Or do you guys"},{"speaker":"Charles Goldfarb","startTime":1146.06,"endTime":1146.63,"body":"disagree?"},{"speaker":"Macy Stonner","startTime":1147.86,"endTime":1149.3,"body":"Doctor, did you"},{"speaker":"Macy Stonner","startTime":1147.86,"endTime":1149.3,"body":"want to go first or do you want"},{"speaker":"Macy Stonner","startTime":1149.3,"endTime":1149.9,"body":"to go first?"},{"speaker":"Chris Dy","startTime":1150.17,"endTime":1151.22,"body":"You should go first"},{"speaker":"Chris Dy","startTime":1150.17,"endTime":1151.22,"body":"place?"},{"speaker":"Macy Stonner","startTime":1151.52,"endTime":1155.63,"body":"Okay. I think I"},{"speaker":"Macy Stonner","startTime":1151.52,"endTime":1155.63,"body":"agree. For the most part, I"},{"speaker":"Macy Stonner","startTime":1155.63,"endTime":1158.39,"body":"think there's a few cases that"},{"speaker":"Macy Stonner","startTime":1155.63,"endTime":1158.39,"body":"could probably be okay."},{"speaker":"Macy Stonner","startTime":1159.05,"endTime":1162.8,"body":"Depending on the sport, I guess"},{"speaker":"Macy Stonner","startTime":1159.05,"endTime":1162.8,"body":"and how protected the finger is."},{"speaker":"Macy Stonner","startTime":1163.28,"endTime":1167.0,"body":"But if it's a small finger, and"},{"speaker":"Macy Stonner","startTime":1163.28,"endTime":1167.0,"body":"there's not a lot of real estate"},{"speaker":"Macy Stonner","startTime":1167.0,"endTime":1170.33,"body":"there and those are really tough"},{"speaker":"Macy Stonner","startTime":1167.0,"endTime":1170.33,"body":"to splint. And I feel like the"},{"speaker":"Macy Stonner","startTime":1170.33,"endTime":1173.03,"body":"splint comes off a little bit"},{"speaker":"Macy Stonner","startTime":1170.33,"endTime":1173.03,"body":"more frequently if it's a long"},{"speaker":"Macy Stonner","startTime":1173.03,"endTime":1176.06,"body":"finger and it's, I guess,"},{"speaker":"Macy Stonner","startTime":1173.03,"endTime":1176.06,"body":"thinking like a guide as a"},{"speaker":"Macy Stonner","startTime":1176.06,"endTime":1179.81,"body":"really long hand and it's pretty"},{"speaker":"Macy Stonner","startTime":1176.06,"endTime":1179.81,"body":"solid on there and I koban it"},{"speaker":"Macy Stonner","startTime":1179.81,"endTime":1183.5,"body":"really well to his finger and"},{"speaker":"Macy Stonner","startTime":1179.81,"endTime":1183.5,"body":"piece comfortable and so I think"},{"speaker":"Macy Stonner","startTime":1183.5,"endTime":1186.98,"body":"there's probably a case where"},{"speaker":"Macy Stonner","startTime":1183.5,"endTime":1186.98,"body":"like that would be okay. But I"},{"speaker":"Macy Stonner","startTime":1186.98,"endTime":1192.74,"body":"think it would require the right"},{"speaker":"Macy Stonner","startTime":1186.98,"endTime":1192.74,"body":"person who gets it, I guess."},{"speaker":"Chris Dy","startTime":1193.489,"endTime":1196.339,"body":"Yeah, I kind of just"},{"speaker":"Chris Dy","startTime":1193.489,"endTime":1196.339,"body":"tell them you can do whatever"},{"speaker":"Chris Dy","startTime":1196.339,"endTime":1198.679,"body":"you want in the splint. Just"},{"speaker":"Chris Dy","startTime":1196.339,"endTime":1198.679,"body":"make sure the splint stays on"},{"speaker":"Chris Dy","startTime":1198.949,"endTime":1203.299,"body":"and it's your risk. And I don't"},{"speaker":"Chris Dy","startTime":1198.949,"endTime":1203.299,"body":"see the I'm not as fancy as you"},{"speaker":"Chris Dy","startTime":1203.299,"endTime":1206.899,"body":"in terms of seeing the elite"},{"speaker":"Chris Dy","startTime":1203.299,"endTime":1206.899,"body":"athletes, or just many athletes."},{"speaker":"Chris Dy","startTime":1206.899,"endTime":1209.449,"body":"I mean, I see some kind of a"},{"speaker":"Chris Dy","startTime":1206.899,"endTime":1209.449,"body":"high school kind of amateur kind"},{"speaker":"Chris Dy","startTime":1209.449,"endTime":1213.079,"body":"of thing. But, you know, I guess"},{"speaker":"Chris Dy","startTime":1209.449,"endTime":1213.079,"body":"the next I'd love your thoughts"},{"speaker":"Chris Dy","startTime":1213.079,"endTime":1216.559,"body":"on that, Chuck. But then also,"},{"speaker":"Chris Dy","startTime":1213.079,"endTime":1216.559,"body":"I'd love to ask you like, what"},{"speaker":"Chris Dy","startTime":1216.559,"endTime":1220.909,"body":"if it was a surgeon, and they"},{"speaker":"Chris Dy","startTime":1216.559,"endTime":1220.909,"body":"needed to scrub? Are you just"},{"speaker":"Chris Dy","startTime":1220.939,"endTime":1223.219,"body":"going ahead and pinning the"},{"speaker":"Chris Dy","startTime":1220.939,"endTime":1223.219,"body":"joints? And do you think that's"},{"speaker":"Chris Dy","startTime":1223.219,"endTime":1225.709,"body":"reliable? And would you ever do"},{"speaker":"Chris Dy","startTime":1223.219,"endTime":1225.709,"body":"that in an athlete, but because"},{"speaker":"Chris Dy","startTime":1225.709,"endTime":1227.029,"body":"of the pin breaks? That's a"},{"speaker":"Chris Dy","startTime":1225.709,"endTime":1227.029,"body":"problem?"},{"speaker":"Charles Goldfarb","startTime":1227.9,"endTime":1230.45,"body":"Yeah, I think"},{"speaker":"Charles Goldfarb","startTime":1227.9,"endTime":1230.45,"body":"it's a good point. And in"},{"speaker":"Charles Goldfarb","startTime":1230.45,"endTime":1234.47,"body":"general, I just tell them that"},{"speaker":"Charles Goldfarb","startTime":1230.45,"endTime":1234.47,"body":"if it's a elite high school"},{"speaker":"Charles Goldfarb","startTime":1234.47,"endTime":1236.51,"body":"athlete or a college or"},{"speaker":"Charles Goldfarb","startTime":1234.47,"endTime":1236.51,"body":"professional athlete, I think"},{"speaker":"Charles Goldfarb","startTime":1236.51,"endTime":1240.41,"body":"they're just down unless they"},{"speaker":"Charles Goldfarb","startTime":1236.51,"endTime":1240.41,"body":"get it pinned. And I do think"},{"speaker":"Charles Goldfarb","startTime":1240.41,"endTime":1242.45,"body":"painting is reasonable. And"},{"speaker":"Charles Goldfarb","startTime":1240.41,"endTime":1242.45,"body":"sometimes you go with a larger"},{"speaker":"Charles Goldfarb","startTime":1242.45,"endTime":1244.91,"body":"pen, because I don't think the"},{"speaker":"Charles Goldfarb","startTime":1242.45,"endTime":1244.91,"body":"forces across that DAP joint are"},{"speaker":"Charles Goldfarb","startTime":1244.91,"endTime":1248.03,"body":"all that great. And I would try"},{"speaker":"Charles Goldfarb","startTime":1244.91,"endTime":1248.03,"body":"to have them wear a splint. But"},{"speaker":"Charles Goldfarb","startTime":1248.03,"endTime":1251.33,"body":"even the the weekend warrior who"},{"speaker":"Charles Goldfarb","startTime":1248.03,"endTime":1251.33,"body":"just can't imagine wearing that"},{"speaker":"Charles Goldfarb","startTime":1251.33,"endTime":1257.3,"body":"splint, I have pinned and you"},{"speaker":"Charles Goldfarb","startTime":1251.33,"endTime":1257.3,"body":"know, it's a fine line. I do"},{"speaker":"Charles Goldfarb","startTime":1257.3,"endTime":1261.71,"body":"bury the pin, I leave it in for"},{"speaker":"Charles Goldfarb","startTime":1257.3,"endTime":1261.71,"body":"six weeks. I try to insert it"},{"speaker":"Charles Goldfarb","startTime":1261.71,"endTime":1264.26,"body":"under a local only anesthetic."},{"speaker":"Charles Goldfarb","startTime":1261.71,"endTime":1264.26,"body":"And I try to leave it proud"},{"speaker":"Charles Goldfarb","startTime":1264.26,"endTime":1268.94,"body":"enough that I can take it out in"},{"speaker":"Charles Goldfarb","startTime":1264.26,"endTime":1268.94,"body":"the office. But it's a great"},{"speaker":"Charles Goldfarb","startTime":1268.94,"endTime":1273.14,"body":"solution. But it does have"},{"speaker":"Charles Goldfarb","startTime":1268.94,"endTime":1273.14,"body":"problems may see."},{"speaker":"Macy Stonner","startTime":1274.58,"endTime":1277.46,"body":"Did that patient"},{"speaker":"Macy Stonner","startTime":1274.58,"endTime":1277.46,"body":"ever get stiff with Tip flexion?"},{"speaker":"Macy Stonner","startTime":1277.46,"endTime":1279.92,"body":"Was that ever an issue regaining"},{"speaker":"Macy Stonner","startTime":1277.46,"endTime":1279.92,"body":"movement?"},{"speaker":"Charles Goldfarb","startTime":1280.88,"endTime":1283.34,"body":"It's not I'm"},{"speaker":"Charles Goldfarb","startTime":1280.88,"endTime":1283.34,"body":"not seeing that issue? Yeah, I"},{"speaker":"Charles Goldfarb","startTime":1283.34,"endTime":1283.76,"body":"haven't either"},{"speaker":"Macy Stonner","startTime":1283.76,"endTime":1285.05,"body":"up the"},{"speaker":"Macy Stonner","startTime":1283.76,"endTime":1285.05,"body":"conservative route. So I was"},{"speaker":"Macy Stonner","startTime":1285.05,"endTime":1285.68,"body":"just wondering,"},{"speaker":"Charles Goldfarb","startTime":1287.21,"endTime":1288.71,"body":"my two"},{"speaker":"Charles Goldfarb","startTime":1287.21,"endTime":1288.71,"body":"questions not to belabor this"},{"speaker":"Charles Goldfarb","startTime":1288.71,"endTime":1293.87,"body":"too much. Number one, when do"},{"speaker":"Charles Goldfarb","startTime":1288.71,"endTime":1293.87,"body":"you include the PRP in one of"},{"speaker":"Charles Goldfarb","startTime":1293.87,"endTime":1295.85,"body":"your splints? And I say it"},{"speaker":"Charles Goldfarb","startTime":1293.87,"endTime":1295.85,"body":"carefully because I think"},{"speaker":"Charles Goldfarb","startTime":1295.85,"endTime":1298.61,"body":"usually when we have a splint"},{"speaker":"Charles Goldfarb","startTime":1295.85,"endTime":1298.61,"body":"that includes the PAP joint, we"},{"speaker":"Charles Goldfarb","startTime":1298.61,"endTime":1302.6,"body":"also have one that does not. And"},{"speaker":"Charles Goldfarb","startTime":1298.61,"endTime":1302.6,"body":"the second in our colleagues"},{"speaker":"Charles Goldfarb","startTime":1302.6,"endTime":1305.99,"body":"from across the seas who are"},{"speaker":"Charles Goldfarb","startTime":1302.6,"endTime":1305.99,"body":"listening are probably curious"},{"speaker":"Charles Goldfarb","startTime":1306.02,"endTime":1310.37,"body":"cost in our system doesn't"},{"speaker":"Charles Goldfarb","startTime":1306.02,"endTime":1310.37,"body":"manage cost well, and it's not"},{"speaker":"Charles Goldfarb","startTime":1310.4,"endTime":1312.53,"body":"inexpensive to send a patient."},{"speaker":"Charles Goldfarb","startTime":1310.4,"endTime":1312.53,"body":"So you may say,"},{"speaker":"Macy Stonner","startTime":1313.61,"endTime":1315.26,"body":"unfortunately, you"},{"speaker":"Macy Stonner","startTime":1313.61,"endTime":1315.26,"body":"were right. And I wish that I"},{"speaker":"Macy Stonner","startTime":1315.26,"endTime":1318.95,"body":"had a say in that. So cost. I"},{"speaker":"Macy Stonner","startTime":1315.26,"endTime":1318.95,"body":"don't even know if I'm allowed"},{"speaker":"Macy Stonner","startTime":1318.95,"endTime":1321.59,"body":"to say this on the air. But I'm"},{"speaker":"Macy Stonner","startTime":1318.95,"endTime":1321.59,"body":"going to at our clinic, we do"},{"speaker":"Macy Stonner","startTime":1321.59,"endTime":1326.36,"body":"not charge for mountains."},{"speaker":"Macy Stonner","startTime":1321.59,"endTime":1326.36,"body":"They're not free. But we like"},{"speaker":"Macy Stonner","startTime":1326.36,"endTime":1329.63,"body":"when we submit our time, I mean,"},{"speaker":"Macy Stonner","startTime":1326.36,"endTime":1329.63,"body":"our charges, we submit how many"},{"speaker":"Macy Stonner","startTime":1329.63,"endTime":1333.47,"body":"minutes or like the time it took"},{"speaker":"Macy Stonner","startTime":1329.63,"endTime":1333.47,"body":"to take it. So it's like called"},{"speaker":"Macy Stonner","startTime":1333.5,"endTime":1337.31,"body":"initial orthotic management. So"},{"speaker":"Macy Stonner","startTime":1333.5,"endTime":1337.31,"body":"it's not an L code, meaning you"},{"speaker":"Macy Stonner","startTime":1337.31,"endTime":1340.4,"body":"don't get charged hundreds and"},{"speaker":"Macy Stonner","startTime":1337.31,"endTime":1340.4,"body":"hundreds of dollars. So that's"},{"speaker":"Macy Stonner","startTime":1340.4,"endTime":1342.95,"body":"something that's changed over"},{"speaker":"Macy Stonner","startTime":1340.4,"endTime":1342.95,"body":"the years, we've kind of"},{"speaker":"Macy Stonner","startTime":1342.95,"endTime":1346.46,"body":"modified our fee schedule. I"},{"speaker":"Macy Stonner","startTime":1342.95,"endTime":1346.46,"body":"can't speak for every clinic on"},{"speaker":"Macy Stonner","startTime":1346.46,"endTime":1346.73,"body":"that."},{"speaker":"Chris Dy","startTime":1347.15,"endTime":1349.34,"body":"But I mean, just"},{"speaker":"Chris Dy","startTime":1347.15,"endTime":1349.34,"body":"before you go on, there are some"},{"speaker":"Chris Dy","startTime":1349.52,"endTime":1352.82,"body":"health systems where this injury"},{"speaker":"Chris Dy","startTime":1349.52,"endTime":1352.82,"body":"is initially evaluated and"},{"speaker":"Chris Dy","startTime":1352.82,"endTime":1355.43,"body":"completely managed by hand"},{"speaker":"Chris Dy","startTime":1352.82,"endTime":1355.43,"body":"therapists. I think that happens"},{"speaker":"Chris Dy","startTime":1355.43,"endTime":1356.06,"body":"in the UK."},{"speaker":"Macy Stonner","startTime":1356.84,"endTime":1359.18,"body":"And then the other"},{"speaker":"Macy Stonner","startTime":1356.84,"endTime":1359.18,"body":"question was, oh, pap. So"},{"speaker":"Macy Stonner","startTime":1359.18,"endTime":1362.09,"body":"there's two cases in my mind,"},{"speaker":"Macy Stonner","startTime":1359.18,"endTime":1362.09,"body":"I'm thinking why am I going to"},{"speaker":"Macy Stonner","startTime":1362.09,"endTime":1365.72,"body":"pap number one is if they are a"},{"speaker":"Macy Stonner","startTime":1362.09,"endTime":1365.72,"body":"little bit further out from"},{"speaker":"Macy Stonner","startTime":1365.72,"endTime":1368.87,"body":"their injury, or they've got a"},{"speaker":"Macy Stonner","startTime":1365.72,"endTime":1368.87,"body":"lot of laxity in their swan neck"},{"speaker":"Macy Stonner","startTime":1368.87,"endTime":1372.86,"body":"and quite a bit. So I will make"},{"speaker":"Macy Stonner","startTime":1368.87,"endTime":1372.86,"body":"a splint for nighttime or as"},{"speaker":"Macy Stonner","startTime":1372.86,"endTime":1375.38,"body":"needed during the day that keeps"},{"speaker":"Macy Stonner","startTime":1372.86,"endTime":1375.38,"body":"our tip joint and a little bit"},{"speaker":"Macy Stonner","startTime":1375.38,"endTime":1379.7,"body":"of flexion and the tip joint and"},{"speaker":"Macy Stonner","startTime":1375.38,"endTime":1379.7,"body":"hyperextension. So that's one"},{"speaker":"Macy Stonner","startTime":1379.7,"endTime":1383.66,"body":"reason why I'll make a tip"},{"speaker":"Macy Stonner","startTime":1379.7,"endTime":1383.66,"body":"included when the other one is"},{"speaker":"Macy Stonner","startTime":1383.66,"endTime":1386.18,"body":"if it's a pinkie, like I"},{"speaker":"Macy Stonner","startTime":1383.66,"endTime":1386.18,"body":"mentioned earlier, there's not a"},{"speaker":"Macy Stonner","startTime":1386.18,"endTime":1390.26,"body":"lot of real estate. And so if"},{"speaker":"Macy Stonner","startTime":1386.18,"endTime":1390.26,"body":"you have a tip on the splint, a"},{"speaker":"Macy Stonner","startTime":1390.26,"endTime":1392.51,"body":"lot of times the patient doesn't"},{"speaker":"Macy Stonner","startTime":1390.26,"endTime":1392.51,"body":"feel secure, or they feel like"},{"speaker":"Macy Stonner","startTime":1392.51,"endTime":1396.77,"body":"it's going to fall off. So I'll"},{"speaker":"Macy Stonner","startTime":1392.51,"endTime":1396.77,"body":"make an additional one about"},{"speaker":"Macy Stonner","startTime":1397.1,"endTime":1399.71,"body":"that goes to the entire length"},{"speaker":"Macy Stonner","startTime":1397.1,"endTime":1399.71,"body":"of the pinkie with the caveat"},{"speaker":"Macy Stonner","startTime":1399.74,"endTime":1402.38,"body":"that, hey, don't wear this all"},{"speaker":"Macy Stonner","startTime":1399.74,"endTime":1402.38,"body":"the time. You know, I don't want"},{"speaker":"Macy Stonner","startTime":1402.38,"endTime":1405.59,"body":"your Pap joint to get stiff, but"},{"speaker":"Macy Stonner","startTime":1402.38,"endTime":1405.59,"body":"at night, when you feel like"},{"speaker":"Macy Stonner","startTime":1405.71,"endTime":1408.23,"body":"it's gonna fall off, or you're"},{"speaker":"Macy Stonner","startTime":1405.71,"endTime":1408.23,"body":"going to be doing heavy"},{"speaker":"Macy Stonner","startTime":1408.23,"endTime":1410.42,"body":"activity, feel free to wear this"},{"speaker":"Macy Stonner","startTime":1408.23,"endTime":1410.42,"body":"big one because you feel more"},{"speaker":"Macy Stonner","startTime":1410.42,"endTime":1413.03,"body":"comfortable in it. And then I"},{"speaker":"Macy Stonner","startTime":1410.42,"endTime":1413.03,"body":"put them in that and like, Oh,"},{"speaker":"Macy Stonner","startTime":1413.03,"endTime":1416.06,"body":"this feels so much more"},{"speaker":"Macy Stonner","startTime":1413.03,"endTime":1416.06,"body":"supportive. And then they kind"},{"speaker":"Macy Stonner","startTime":1416.06,"endTime":1418.13,"body":"of alternate back and forth"},{"speaker":"Macy Stonner","startTime":1416.06,"endTime":1418.13,"body":"between the two."},{"speaker":"Charles Goldfarb","startTime":1419.24,"endTime":1421.1,"body":"I think that's"},{"speaker":"Charles Goldfarb","startTime":1419.24,"endTime":1421.1,"body":"well said. And just to be clear"},{"speaker":"Charles Goldfarb","startTime":1421.1,"endTime":1425.84,"body":"for maybe some less experienced"},{"speaker":"Charles Goldfarb","startTime":1421.1,"endTime":1425.84,"body":"listeners, part of the goal of a"},{"speaker":"Charles Goldfarb","startTime":1425.84,"endTime":1430.46,"body":"good D IP joint immobilizing"},{"speaker":"Charles Goldfarb","startTime":1425.84,"endTime":1430.46,"body":"splint is maintaining the PAP"},{"speaker":"Charles Goldfarb","startTime":1430.46,"endTime":1432.77,"body":"joint. Because I say this to"},{"speaker":"Charles Goldfarb","startTime":1430.46,"endTime":1432.77,"body":"patients all the time, I don't"},{"speaker":"Charles Goldfarb","startTime":1432.77,"endTime":1436.28,"body":"really care about motion at the"},{"speaker":"Charles Goldfarb","startTime":1432.77,"endTime":1436.28,"body":"tip joint in I'd like you to"},{"speaker":"Charles Goldfarb","startTime":1436.28,"endTime":1440.06,"body":"regain full motion. But I really"},{"speaker":"Charles Goldfarb","startTime":1436.28,"endTime":1440.06,"body":"care about motion at the PAP"},{"speaker":"Charles Goldfarb","startTime":1440.06,"endTime":1443.0,"body":"joint. And so the beauty of this"},{"speaker":"Charles Goldfarb","startTime":1440.06,"endTime":1443.0,"body":"system is that you can keep your"},{"speaker":"Charles Goldfarb","startTime":1443.0,"endTime":1448.37,"body":"PRP moving and not worry too"},{"speaker":"Charles Goldfarb","startTime":1443.0,"endTime":1448.37,"body":"much about the DAP. What Chris,"},{"speaker":"Charles Goldfarb","startTime":1448.37,"endTime":1452.18,"body":"how do you think about so let's"},{"speaker":"Charles Goldfarb","startTime":1448.37,"endTime":1452.18,"body":"say six weeks comes up or eight"},{"speaker":"Charles Goldfarb","startTime":1452.18,"endTime":1455.42,"body":"weeks comes up and the patient"},{"speaker":"Charles Goldfarb","startTime":1452.18,"endTime":1455.42,"body":"comes back and and you say okay,"},{"speaker":"Charles Goldfarb","startTime":1455.42,"endTime":1458.27,"body":"now it's time to get rid of this"},{"speaker":"Charles Goldfarb","startTime":1455.42,"endTime":1458.27,"body":"one? What do you tell them? And"},{"speaker":"Charles Goldfarb","startTime":1458.27,"endTime":1461.24,"body":"I'm curious what you tell them?"},{"speaker":"Charles Goldfarb","startTime":1458.27,"endTime":1461.24,"body":"What may see my time and whether"},{"speaker":"Charles Goldfarb","startTime":1461.24,"endTime":1463.16,"body":"we are the same? Sure. I"},{"speaker":"Chris Dy","startTime":1463.16,"endTime":1465.44,"body":"mean, so you know, I"},{"speaker":"Chris Dy","startTime":1463.16,"endTime":1465.44,"body":"guess from the beginning of the"},{"speaker":"Chris Dy","startTime":1465.44,"endTime":1468.59,"body":"initial conversation, I tell"},{"speaker":"Chris Dy","startTime":1465.44,"endTime":1468.59,"body":"them we're going to split this"},{"speaker":"Chris Dy","startTime":1468.68,"endTime":1471.8,"body":"for six weeks. And I guess we"},{"speaker":"Chris Dy","startTime":1468.68,"endTime":1471.8,"body":"could ask like why six weeks?"},{"speaker":"Chris Dy","startTime":1471.8,"endTime":1474.59,"body":"Why eight weeks? I think it's"},{"speaker":"Chris Dy","startTime":1471.8,"endTime":1474.59,"body":"total orthopedic. You know,"},{"speaker":"Chris Dy","startTime":1474.59,"endTime":1479.3,"body":"dogma, six weeks should be"},{"speaker":"Chris Dy","startTime":1474.59,"endTime":1479.3,"body":"enough, right? And I tell him at"},{"speaker":"Chris Dy","startTime":1479.3,"endTime":1482.33,"body":"the beginning that everybody"},{"speaker":"Chris Dy","startTime":1479.3,"endTime":1482.33,"body":"ends up with a droop. We're"},{"speaker":"Chris Dy","startTime":1482.33,"endTime":1484.7,"body":"going to do this for six weeks"},{"speaker":"Chris Dy","startTime":1482.33,"endTime":1484.7,"body":"and let it scar tissue build up."},{"speaker":"Chris Dy","startTime":1484.73,"endTime":1487.79,"body":"But I remember every time and in"},{"speaker":"Chris Dy","startTime":1484.73,"endTime":1487.79,"body":"Ryan Kalfas clinic just him kind"},{"speaker":"Chris Dy","startTime":1487.79,"endTime":1490.04,"body":"of showing them everybody ends"},{"speaker":"Chris Dy","startTime":1487.79,"endTime":1490.04,"body":"up with just kind of comes down"},{"speaker":"Chris Dy","startTime":1490.04,"endTime":1491.81,"body":"to your startup here. After you"},{"speaker":"Chris Dy","startTime":1490.04,"endTime":1491.81,"body":"come out of your splits then"},{"speaker":"Chris Dy","startTime":1491.81,"endTime":1495.02,"body":"you'll end up just with about a"},{"speaker":"Chris Dy","startTime":1491.81,"endTime":1495.02,"body":"maybe a 15 to 30 degree"},{"speaker":"Chris Dy","startTime":1495.08,"endTime":1500.0,"body":"extension lag and he calls it a"},{"speaker":"Chris Dy","startTime":1495.08,"endTime":1500.0,"body":"droop and people get that so you"},{"speaker":"Chris Dy","startTime":1500.0,"endTime":1502.4,"body":"No. And I think that that's"},{"speaker":"Chris Dy","startTime":1500.0,"endTime":1502.4,"body":"something that you got to tell"},{"speaker":"Chris Dy","startTime":1502.4,"endTime":1505.01,"body":"people from the jump. So you"},{"speaker":"Chris Dy","startTime":1502.4,"endTime":1505.01,"body":"know, when we have the initial"},{"speaker":"Chris Dy","startTime":1505.01,"endTime":1507.68,"body":"conversation, I tell them that"},{"speaker":"Chris Dy","startTime":1505.01,"endTime":1507.68,"body":"when they come back to the"},{"speaker":"Chris Dy","startTime":1507.68,"endTime":1512.66,"body":"office, I love asking them, Hey,"},{"speaker":"Chris Dy","startTime":1507.68,"endTime":1512.66,"body":"how's it gone? How's it split?"},{"speaker":"Chris Dy","startTime":1512.66,"endTime":1515.33,"body":"Ben, show me your finger. And I"},{"speaker":"Chris Dy","startTime":1512.66,"endTime":1515.33,"body":"know who's been wearing their"},{"speaker":"Chris Dy","startTime":1515.33,"endTime":1517.73,"body":"splints properly, and who has"},{"speaker":"Chris Dy","startTime":1515.33,"endTime":1517.73,"body":"not the awareness been properly"},{"speaker":"Chris Dy","startTime":1517.76,"endTime":1521.6,"body":"because the guy who just goes,"},{"speaker":"Chris Dy","startTime":1517.76,"endTime":1521.6,"body":"Oh, there you go, it just rips"},{"speaker":"Chris Dy","startTime":1521.6,"endTime":1524.39,"body":"it off, clearly has not been"},{"speaker":"Chris Dy","startTime":1521.6,"endTime":1524.39,"body":"properly wearing their splint,"},{"speaker":"Chris Dy","startTime":1524.6,"endTime":1527.72,"body":"then there are the patients who"},{"speaker":"Chris Dy","startTime":1524.6,"endTime":1527.72,"body":"are wonderful, who appropriately"},{"speaker":"Chris Dy","startTime":1527.72,"endTime":1530.3,"body":"like on the little hand table"},{"speaker":"Chris Dy","startTime":1527.72,"endTime":1530.3,"body":"that we have will take out their"},{"speaker":"Chris Dy","startTime":1530.3,"endTime":1533.51,"body":"hand and put it on the edge and"},{"speaker":"Chris Dy","startTime":1530.3,"endTime":1533.51,"body":"appropriately take off their"},{"speaker":"Chris Dy","startTime":1533.51,"endTime":1535.79,"body":"splint. And when, and then when"},{"speaker":"Chris Dy","startTime":1533.51,"endTime":1535.79,"body":"you ask them to move it, they're"},{"speaker":"Chris Dy","startTime":1535.79,"endTime":1539.0,"body":"like, really want me to move it?"},{"speaker":"Chris Dy","startTime":1535.79,"endTime":1539.0,"body":"That's the right patient. And"},{"speaker":"Chris Dy","startTime":1539.0,"endTime":1542.0,"body":"you could totally tell where"},{"speaker":"Chris Dy","startTime":1539.0,"endTime":1542.0,"body":"this this is gonna go. And I put"},{"speaker":"Chris Dy","startTime":1542.0,"endTime":1544.76,"body":"that into my note that you know,"},{"speaker":"Chris Dy","startTime":1542.0,"endTime":1544.76,"body":"when patient took off the split"},{"speaker":"Chris Dy","startTime":1544.76,"endTime":1547.37,"body":"and took off the split didn't"},{"speaker":"Chris Dy","startTime":1544.76,"endTime":1547.37,"body":"seem to follow precautions and"},{"speaker":"Chris Dy","startTime":1547.37,"endTime":1550.25,"body":"whatever. But then I'll tell"},{"speaker":"Chris Dy","startTime":1547.37,"endTime":1550.25,"body":"them well, you know, at this"},{"speaker":"Chris Dy","startTime":1550.25,"endTime":1553.01,"body":"point, I want you to I have them"},{"speaker":"Chris Dy","startTime":1550.25,"endTime":1553.01,"body":"wear the splint for another two"},{"speaker":"Chris Dy","startTime":1553.01,"endTime":1556.19,"body":"weeks at night. And I don't know"},{"speaker":"Chris Dy","startTime":1553.01,"endTime":1556.19,"body":"why that was one of the faculty"},{"speaker":"Chris Dy","startTime":1556.19,"endTime":1560.81,"body":"that was Ryan does that too. And"},{"speaker":"Chris Dy","startTime":1556.19,"endTime":1560.81,"body":"he may not still do it. But he"},{"speaker":"Chris Dy","startTime":1560.81,"endTime":1564.2,"body":"did it when I was in training."},{"speaker":"Chris Dy","startTime":1560.81,"endTime":1564.2,"body":"And then I tell them kind of get"},{"speaker":"Chris Dy","startTime":1564.2,"endTime":1566.33,"body":"back to using things where it at"},{"speaker":"Chris Dy","startTime":1564.2,"endTime":1566.33,"body":"night or when you're doing heavy"},{"speaker":"Chris Dy","startTime":1566.33,"endTime":1569.93,"body":"activities for two weeks. If you"},{"speaker":"Chris Dy","startTime":1566.33,"endTime":1569.93,"body":"feel comfortable, keeping them"},{"speaker":"Chris Dy","startTime":1569.93,"endTime":1571.76,"body":"more comfortable keeping your"},{"speaker":"Chris Dy","startTime":1569.93,"endTime":1571.76,"body":"arm when you're playing sports"},{"speaker":"Chris Dy","startTime":1571.76,"endTime":1574.52,"body":"or whatever, go do that, too."},{"speaker":"Chris Dy","startTime":1571.76,"endTime":1574.52,"body":"You'll probably end up with a"},{"speaker":"Chris Dy","startTime":1574.52,"endTime":1577.16,"body":"little bit of a droop. Usually"},{"speaker":"Chris Dy","startTime":1574.52,"endTime":1577.16,"body":"most people don't have a problem"},{"speaker":"Chris Dy","startTime":1577.16,"endTime":1581.12,"body":"with that. But if you do, let me"},{"speaker":"Chris Dy","startTime":1577.16,"endTime":1581.12,"body":"know. How will you check what's"},{"speaker":"Chris Dy","startTime":1581.12,"endTime":1581.57,"body":"your spiel?"},{"speaker":"Charles Goldfarb","startTime":1582.2,"endTime":1584.6,"body":"Well, most"},{"speaker":"Charles Goldfarb","startTime":1582.2,"endTime":1584.6,"body":"feels the same. I do like the"},{"speaker":"Charles Goldfarb","startTime":1584.6,"endTime":1587.63,"body":"concept of two weeks at night,"},{"speaker":"Charles Goldfarb","startTime":1584.6,"endTime":1587.63,"body":"two weeks with sports. I just"},{"speaker":"Charles Goldfarb","startTime":1587.63,"endTime":1591.74,"body":"think it feels better to the"},{"speaker":"Charles Goldfarb","startTime":1587.63,"endTime":1591.74,"body":"patient. Rather than okay is six"},{"speaker":"Charles Goldfarb","startTime":1591.74,"endTime":1593.51,"body":"weeks you're free. See you"},{"speaker":"Charles Goldfarb","startTime":1591.74,"endTime":1593.51,"body":"later. You know you've been"},{"speaker":"Charles Goldfarb","startTime":1593.51,"endTime":1595.52,"body":"wearing this splint religiously"},{"speaker":"Charles Goldfarb","startTime":1593.51,"endTime":1595.52,"body":"for six weeks now you're free."},{"speaker":"Charles Goldfarb","startTime":1595.7,"endTime":1598.4,"body":"The one other thing I tell them"},{"speaker":"Charles Goldfarb","startTime":1595.7,"endTime":1598.4,"body":"and make a big deal about this"},{"speaker":"Charles Goldfarb","startTime":1598.58,"endTime":1603.74,"body":"is no passive flexion of the DLP"},{"speaker":"Charles Goldfarb","startTime":1598.58,"endTime":1603.74,"body":"joint. Oh, yeah. Because and I"},{"speaker":"Charles Goldfarb","startTime":1603.74,"endTime":1606.08,"body":"just say, Look, don't worry"},{"speaker":"Charles Goldfarb","startTime":1603.74,"endTime":1606.08,"body":"about getting your flexion back,"},{"speaker":"Charles Goldfarb","startTime":1606.11,"endTime":1609.62,"body":"you will get it back, I promise."},{"speaker":"Charles Goldfarb","startTime":1606.11,"endTime":1609.62,"body":"Just use your hand, don't push"},{"speaker":"Charles Goldfarb","startTime":1609.62,"endTime":1612.35,"body":"down on it, you'll get your"},{"speaker":"Charles Goldfarb","startTime":1609.62,"endTime":1612.35,"body":"motion back. And before we hear"},{"speaker":"Charles Goldfarb","startTime":1612.35,"endTime":1615.62,"body":"from AC The one other thing, I"},{"speaker":"Charles Goldfarb","startTime":1612.35,"endTime":1615.62,"body":"think that's really important is"},{"speaker":"Charles Goldfarb","startTime":1616.34,"endTime":1621.08,"body":"your point about conversation,"},{"speaker":"Charles Goldfarb","startTime":1616.34,"endTime":1621.08,"body":"initial conversation. And"},{"speaker":"Charles Goldfarb","startTime":1621.08,"endTime":1624.62,"body":"expectation of a droop is super"},{"speaker":"Charles Goldfarb","startTime":1621.08,"endTime":1624.62,"body":"important. Because there will be"},{"speaker":"Charles Goldfarb","startTime":1624.62,"endTime":1627.95,"body":"patients that are unhappy. And"},{"speaker":"Charles Goldfarb","startTime":1624.62,"endTime":1627.95,"body":"it doesn't matter what you tell"},{"speaker":"Charles Goldfarb","startTime":1627.95,"endTime":1631.13,"body":"them, but at least if you tell"},{"speaker":"Charles Goldfarb","startTime":1627.95,"endTime":1631.13,"body":"them when you start, you've told"},{"speaker":"Charles Goldfarb","startTime":1631.13,"endTime":1634.49,"body":"them and if you did, if you"},{"speaker":"Charles Goldfarb","startTime":1631.13,"endTime":1634.49,"body":"don't tell them when they start"},{"speaker":"Charles Goldfarb","startTime":1634.64,"endTime":1637.25,"body":"that they may have a little"},{"speaker":"Charles Goldfarb","startTime":1634.64,"endTime":1637.25,"body":"droop, it increases the risk of"},{"speaker":"Charles Goldfarb","startTime":1637.25,"endTime":1641.09,"body":"frustration, even if it's"},{"speaker":"Charles Goldfarb","startTime":1637.25,"endTime":1641.09,"body":"irrational frustration, may see"},{"speaker":"Charles Goldfarb","startTime":1641.09,"endTime":1644.6,"body":"how to Chris and I do with our"},{"speaker":"Charles Goldfarb","startTime":1641.09,"endTime":1644.6,"body":"therapy recommendations in care"},{"speaker":"Charles Goldfarb","startTime":1644.6,"endTime":1646.73,"body":"recommendations post six weeks"},{"speaker":"Charles Goldfarb","startTime":1644.6,"endTime":1646.73,"body":"of splinting"},{"speaker":"Macy Stonner","startTime":1647.06,"endTime":1649.28,"body":"totally agree, I"},{"speaker":"Macy Stonner","startTime":1647.06,"endTime":1649.28,"body":"typically say between two and"},{"speaker":"Macy Stonner","startTime":1649.28,"endTime":1651.74,"body":"four weeks, depending on your"},{"speaker":"Macy Stonner","startTime":1649.28,"endTime":1651.74,"body":"desire and like how tight they"},{"speaker":"Macy Stonner","startTime":1651.74,"endTime":1654.77,"body":"look like if they show me their"},{"speaker":"Macy Stonner","startTime":1651.74,"endTime":1654.77,"body":"finger and they look so rock"},{"speaker":"Macy Stonner","startTime":1654.77,"endTime":1657.86,"body":"solid and extension. Yeah, I"},{"speaker":"Macy Stonner","startTime":1654.77,"endTime":1657.86,"body":"think two is great. If they're a"},{"speaker":"Macy Stonner","startTime":1657.86,"endTime":1661.04,"body":"little sore, a little bit more"},{"speaker":"Macy Stonner","startTime":1657.86,"endTime":1661.04,"body":"flexible, and they kind of drip"},{"speaker":"Macy Stonner","startTime":1661.04,"endTime":1663.38,"body":"a little bit and might say, you"},{"speaker":"Macy Stonner","startTime":1661.04,"endTime":1663.38,"body":"know, this is up to you. If"},{"speaker":"Macy Stonner","startTime":1663.41,"endTime":1665.21,"body":"you're satisfied with this, you"},{"speaker":"Macy Stonner","startTime":1663.41,"endTime":1665.21,"body":"can live your life like this,"},{"speaker":"Macy Stonner","startTime":1665.21,"endTime":1668.51,"body":"it's fine. But depends on what"},{"speaker":"Macy Stonner","startTime":1665.21,"endTime":1668.51,"body":"your desires are. And I think"},{"speaker":"Macy Stonner","startTime":1668.51,"endTime":1670.58,"body":"two to four weeks is great still"},{"speaker":"Macy Stonner","startTime":1668.51,"endTime":1670.58,"body":"wear it during heavier"},{"speaker":"Macy Stonner","startTime":1670.58,"endTime":1673.73,"body":"activities. Or if you're nervous"},{"speaker":"Macy Stonner","startTime":1670.58,"endTime":1673.73,"body":"during something, I totally"},{"speaker":"Macy Stonner","startTime":1673.73,"endTime":1677.75,"body":"agree. I have them maybe make a"},{"speaker":"Macy Stonner","startTime":1673.73,"endTime":1677.75,"body":"slip a few slow fists open and"},{"speaker":"Macy Stonner","startTime":1677.75,"endTime":1680.81,"body":"close just to kind of help"},{"speaker":"Macy Stonner","startTime":1677.75,"endTime":1680.81,"body":"loosen things up. But again, no"},{"speaker":"Macy Stonner","startTime":1680.81,"endTime":1683.27,"body":"forceful gripping no passive"},{"speaker":"Macy Stonner","startTime":1680.81,"endTime":1683.27,"body":"flexion, that kind of thing."},{"speaker":"Charles Goldfarb","startTime":1684.14,"endTime":1686.51,"body":"So I love it."},{"speaker":"Charles Goldfarb","startTime":1684.14,"endTime":1686.51,"body":"And I love the fact that this"},{"speaker":"Charles Goldfarb","startTime":1686.51,"endTime":1689.51,"body":"conversation has been primarily"},{"speaker":"Charles Goldfarb","startTime":1686.51,"endTime":1689.51,"body":"about non surgical care, we"},{"speaker":"Charles Goldfarb","startTime":1689.51,"endTime":1693.35,"body":"should touch on surgery. It's a"},{"speaker":"Charles Goldfarb","startTime":1689.51,"endTime":1693.35,"body":"huge minority of patients, they"},{"speaker":"Charles Goldfarb","startTime":1693.35,"endTime":1696.77,"body":"ended up going to the ER, Chris,"},{"speaker":"Charles Goldfarb","startTime":1693.35,"endTime":1696.77,"body":"I'll put you on the spot. What"},{"speaker":"Charles Goldfarb","startTime":1696.77,"endTime":1700.7,"body":"are your surgical indications"},{"speaker":"Charles Goldfarb","startTime":1696.77,"endTime":1700.7,"body":"for soft tissue or bony mallet?"},{"speaker":"Chris Dy","startTime":1701.48,"endTime":1704.33,"body":"I very rarely have a"},{"speaker":"Chris Dy","startTime":1701.48,"endTime":1704.33,"body":"surgical indication, I don't"},{"speaker":"Chris Dy","startTime":1704.36,"endTime":1709.19,"body":"think I've ever operated for a"},{"speaker":"Chris Dy","startTime":1704.36,"endTime":1709.19,"body":"soft tissue mallet. You know, we"},{"speaker":"Chris Dy","startTime":1709.19,"endTime":1712.22,"body":"talk about the kind of the"},{"speaker":"Chris Dy","startTime":1709.19,"endTime":1712.22,"body":"person who will not tolerate or"},{"speaker":"Chris Dy","startTime":1712.22,"endTime":1715.13,"body":"cannot tolerate the splints for"},{"speaker":"Chris Dy","startTime":1712.22,"endTime":1715.13,"body":"various reasons. So the surgeon,"},{"speaker":"Chris Dy","startTime":1715.13,"endTime":1717.53,"body":"the athlete, you know, so I"},{"speaker":"Chris Dy","startTime":1715.13,"endTime":1717.53,"body":"guess that'd be a reason to pin."},{"speaker":"Chris Dy","startTime":1718.61,"endTime":1721.55,"body":"You know, I have not primarily"},{"speaker":"Chris Dy","startTime":1718.61,"endTime":1721.55,"body":"repaired the extents of the"},{"speaker":"Chris Dy","startTime":1721.55,"endTime":1725.27,"body":"terminal tendon back to the base"},{"speaker":"Chris Dy","startTime":1721.55,"endTime":1725.27,"body":"of the distal failings based on"},{"speaker":"Chris Dy","startTime":1725.27,"endTime":1727.28,"body":"how I was trained, and a number"},{"speaker":"Chris Dy","startTime":1725.27,"endTime":1727.28,"body":"of studies that have"},{"speaker":"Chris Dy","startTime":1727.28,"endTime":1730.58,"body":"demonstrated, you know, no"},{"speaker":"Chris Dy","startTime":1727.28,"endTime":1730.58,"body":"substantial difference in any"},{"speaker":"Chris Dy","startTime":1730.58,"endTime":1734.06,"body":"outcomes. I do tell patients"},{"speaker":"Chris Dy","startTime":1730.58,"endTime":1734.06,"body":"from the initial counseling when"},{"speaker":"Chris Dy","startTime":1734.06,"endTime":1736.34,"body":"we're dealing with a soft tissue"},{"speaker":"Chris Dy","startTime":1734.06,"endTime":1736.34,"body":"now that there is no good"},{"speaker":"Chris Dy","startTime":1736.34,"endTime":1738.98,"body":"surgical solution that's going"},{"speaker":"Chris Dy","startTime":1736.34,"endTime":1738.98,"body":"to make this better than if we"},{"speaker":"Chris Dy","startTime":1738.98,"endTime":1740.81,"body":"treat you in a splint. And I"},{"speaker":"Chris Dy","startTime":1738.98,"endTime":1740.81,"body":"think that's important because"},{"speaker":"Chris Dy","startTime":1740.81,"endTime":1744.98,"body":"they're coming in to see a hand"},{"speaker":"Chris Dy","startTime":1740.81,"endTime":1744.98,"body":"surgeon. So like when they come"},{"speaker":"Chris Dy","startTime":1744.98,"endTime":1747.38,"body":"in for that that's their"},{"speaker":"Chris Dy","startTime":1744.98,"endTime":1747.38,"body":"expectations. The first thing"},{"speaker":"Chris Dy","startTime":1747.38,"endTime":1750.59,"body":"and you totally wouldn't score"},{"speaker":"Chris Dy","startTime":1747.38,"endTime":1750.59,"body":"points when you're like, It's"},{"speaker":"Chris Dy","startTime":1750.59,"endTime":1753.56,"body":"great news. You don't need"},{"speaker":"Chris Dy","startTime":1750.59,"endTime":1753.56,"body":"surgery. Right? Yeah, really"},{"speaker":"Chris Dy","startTime":1753.56,"endTime":1757.19,"body":"gets the conversation off to the"},{"speaker":"Chris Dy","startTime":1753.56,"endTime":1757.19,"body":"right on the right tone. And"},{"speaker":"Chris Dy","startTime":1757.19,"endTime":1760.7,"body":"then in terms of indications for"},{"speaker":"Chris Dy","startTime":1757.19,"endTime":1760.7,"body":"bony mallets I think that you"},{"speaker":"Chris Dy","startTime":1760.7,"endTime":1764.33,"body":"know, there was a lot of talk"},{"speaker":"Chris Dy","startTime":1760.7,"endTime":1764.33,"body":"and then in the literature and"},{"speaker":"Chris Dy","startTime":1764.33,"endTime":1767.24,"body":"the class of teaching about the"},{"speaker":"Chris Dy","startTime":1764.33,"endTime":1767.24,"body":"size of the fragments, but I"},{"speaker":"Chris Dy","startTime":1767.24,"endTime":1771.11,"body":"think more papers have"},{"speaker":"Chris Dy","startTime":1767.24,"endTime":1771.11,"body":"demonstrated recently, including"},{"speaker":"Chris Dy","startTime":1771.11,"endTime":1773.66,"body":"some meta analyses. I think"},{"speaker":"Chris Dy","startTime":1771.11,"endTime":1773.66,"body":"Julie's some more did one"},{"speaker":"Chris Dy","startTime":1774.44,"endTime":1777.77,"body":"looking at it's more, it's not"},{"speaker":"Chris Dy","startTime":1774.44,"endTime":1777.77,"body":"so much about the fragment size,"},{"speaker":"Chris Dy","startTime":1777.77,"endTime":1780.65,"body":"it's really more subluxation of"},{"speaker":"Chris Dy","startTime":1777.77,"endTime":1780.65,"body":"the tip joints. So that volar"},{"speaker":"Chris Dy","startTime":1780.65,"endTime":1784.82,"body":"subluxation of p3 or the distal"},{"speaker":"Chris Dy","startTime":1780.65,"endTime":1784.82,"body":"phalanx relative to the middle"},{"speaker":"Chris Dy","startTime":1784.82,"endTime":1786.17,"body":"failings. How about you?"},{"speaker":"Charles Goldfarb","startTime":1788.06,"endTime":1791.03,"body":"Yeah, I like"},{"speaker":"Charles Goldfarb","startTime":1788.06,"endTime":1791.03,"body":"what you said I don't recall the"},{"speaker":"Charles Goldfarb","startTime":1791.03,"endTime":1794.12,"body":"last time I repair the terminal"},{"speaker":"Charles Goldfarb","startTime":1791.03,"endTime":1794.12,"body":"tenant back to the distal"},{"speaker":"Charles Goldfarb","startTime":1794.12,"endTime":1796.73,"body":"phalanx. I don't that's not"},{"speaker":"Charles Goldfarb","startTime":1794.12,"endTime":1796.73,"body":"really indicated in my hands"},{"speaker":"Charles Goldfarb","startTime":1796.73,"endTime":1800.6,"body":"very often, if ever, I will"},{"speaker":"Charles Goldfarb","startTime":1796.73,"endTime":1800.6,"body":"occasionally pin joined for the"},{"speaker":"Charles Goldfarb","startTime":1800.6,"endTime":1803.54,"body":"reasons you stated. So then it"},{"speaker":"Charles Goldfarb","startTime":1800.6,"endTime":1803.54,"body":"gets down to really bony"},{"speaker":"Charles Goldfarb","startTime":1803.54,"endTime":1806.45,"body":"mallets? And what are the"},{"speaker":"Charles Goldfarb","startTime":1803.54,"endTime":1806.45,"body":"surgical indications? And I"},{"speaker":"Charles Goldfarb","startTime":1806.45,"endTime":1809.3,"body":"don't think there's anything"},{"speaker":"Charles Goldfarb","startTime":1806.45,"endTime":1809.3,"body":"less clear in my world than that"},{"speaker":"Charles Goldfarb","startTime":1809.3,"endTime":1815.3,"body":"question. Dr. Wall and the wall,"},{"speaker":"Charles Goldfarb","startTime":1809.3,"endTime":1815.3,"body":"who's my partner sees a ton of"},{"speaker":"Charles Goldfarb","startTime":1815.3,"endTime":1819.02,"body":"adolescents. And that population"},{"speaker":"Charles Goldfarb","startTime":1815.3,"endTime":1819.02,"body":"may be a little different, maybe"},{"speaker":"Charles Goldfarb","startTime":1819.02,"endTime":1822.95,"body":"a little more forgiving, and she"},{"speaker":"Charles Goldfarb","startTime":1819.02,"endTime":1822.95,"body":"really almost never operates"},{"speaker":"Charles Goldfarb","startTime":1823.04,"endTime":1826.1,"body":"even some mild subluxations, I"},{"speaker":"Charles Goldfarb","startTime":1823.04,"endTime":1826.1,"body":"believe she'll skip the surgery."},{"speaker":"Charles Goldfarb","startTime":1826.28,"endTime":1831.8,"body":"For me, the absolute indication"},{"speaker":"Charles Goldfarb","startTime":1826.28,"endTime":1831.8,"body":"is a subluxated joint. And I do"},{"speaker":"Charles Goldfarb","startTime":1831.83,"endTime":1835.13,"body":"get nervous based on the size of"},{"speaker":"Charles Goldfarb","startTime":1831.83,"endTime":1835.13,"body":"the fragment and the"},{"speaker":"Charles Goldfarb","startTime":1835.13,"endTime":1838.85,"body":"displacement, whether that's"},{"speaker":"Charles Goldfarb","startTime":1835.13,"endTime":1838.85,"body":"rational or irrational based on"},{"speaker":"Charles Goldfarb","startTime":1838.85,"endTime":1843.14,"body":"the literature or not. If I have"},{"speaker":"Charles Goldfarb","startTime":1838.85,"endTime":1843.14,"body":"a fragment, that's 50%. And I"},{"speaker":"Charles Goldfarb","startTime":1843.14,"endTime":1845.42,"body":"think most of our listeners will"},{"speaker":"Charles Goldfarb","startTime":1843.14,"endTime":1845.42,"body":"say, 50%, I would definitely fix"},{"speaker":"Charles Goldfarb","startTime":1845.42,"endTime":1849.62,"body":"that. I still hem and haw a bit,"},{"speaker":"Charles Goldfarb","startTime":1845.42,"endTime":1849.62,"body":"especially when there's a gap at"},{"speaker":"Charles Goldfarb","startTime":1849.62,"endTime":1853.34,"body":"the joint. And and when you"},{"speaker":"Charles Goldfarb","startTime":1849.62,"endTime":1853.34,"body":"treat that surgically, you feel"},{"speaker":"Charles Goldfarb","startTime":1853.34,"endTime":1856.52,"body":"pretty good about it. But I"},{"speaker":"Charles Goldfarb","startTime":1853.34,"endTime":1856.52,"body":"don't I just don't know that"},{"speaker":"Charles Goldfarb","startTime":1856.52,"endTime":1859.31,"body":"it's the size of fragment, as"},{"speaker":"Charles Goldfarb","startTime":1856.52,"endTime":1859.31,"body":"you said, I'm just not sure"},{"speaker":"Charles Goldfarb","startTime":1859.31,"endTime":1861.02,"body":"that's a real surgical"},{"speaker":"Charles Goldfarb","startTime":1859.31,"endTime":1861.02,"body":"indication."},{"speaker":"Chris Dy","startTime":1861.41,"endTime":1863.27,"body":"Well, so let's say you"},{"speaker":"Chris Dy","startTime":1861.41,"endTime":1863.27,"body":"have a 50% fragment, but the"},{"speaker":"Chris Dy","startTime":1863.27,"endTime":1866.84,"body":"joint is not subluxated will"},{"speaker":"Chris Dy","startTime":1863.27,"endTime":1866.84,"body":"really still go after it"},{"speaker":"Charles Goldfarb","startTime":1868.28,"endTime":1870.71,"body":"depends on the"},{"speaker":"Charles Goldfarb","startTime":1868.28,"endTime":1870.71,"body":"age depends on the family"},{"speaker":"Charles Goldfarb","startTime":1870.71,"endTime":1872.78,"body":"depends on the car, but you"},{"speaker":"Charles Goldfarb","startTime":1870.71,"endTime":1872.78,"body":"know, it's just there's a lot of"},{"speaker":"Charles Goldfarb","startTime":1872.78,"endTime":1875.66,"body":"factors. It's not an automatic"},{"speaker":"Charles Goldfarb","startTime":1872.78,"endTime":1875.66,"body":"yes or no would be my would be"},{"speaker":"Charles Goldfarb","startTime":1875.66,"endTime":1876.59,"body":"my lousy answer."},{"speaker":"Chris Dy","startTime":1876.86,"endTime":1879.68,"body":"So then when you treat"},{"speaker":"Chris Dy","startTime":1876.86,"endTime":1879.68,"body":"this surgically, are you"},{"speaker":"Chris Dy","startTime":1879.86,"endTime":1883.1,"body":"primarily just pinning across"},{"speaker":"Chris Dy","startTime":1879.86,"endTime":1883.1,"body":"the joint? Are you going after"},{"speaker":"Chris Dy","startTime":1883.1,"endTime":1885.23,"body":"that tempting, juicy fragments?"},{"speaker":"Charles Goldfarb","startTime":1886.01,"endTime":1887.9,"body":"And I'd love"},{"speaker":"Charles Goldfarb","startTime":1886.01,"endTime":1887.9,"body":"Macy's thoughts on a couple of"},{"speaker":"Charles Goldfarb","startTime":1887.9,"endTime":1891.89,"body":"things. I'm about to say number"},{"speaker":"Charles Goldfarb","startTime":1887.9,"endTime":1891.89,"body":"one, yes, I'm hopefully going to"},{"speaker":"Charles Goldfarb","startTime":1891.89,"endTime":1895.73,"body":"reduce the fragment pen across"},{"speaker":"Charles Goldfarb","startTime":1891.89,"endTime":1895.73,"body":"the joint. It's a bit of a pipe"},{"speaker":"Charles Goldfarb","startTime":1895.73,"endTime":1899.33,"body":"dream to put a longitudinal K"},{"speaker":"Charles Goldfarb","startTime":1895.73,"endTime":1899.33,"body":"wire through the fragment. So"},{"speaker":"Charles Goldfarb","startTime":1899.33,"endTime":1901.79,"body":"usually, you're just paying the"},{"speaker":"Charles Goldfarb","startTime":1899.33,"endTime":1901.79,"body":"join, and sort of trying to get"},{"speaker":"Charles Goldfarb","startTime":1901.79,"endTime":1905.03,"body":"that fragment down. I will"},{"speaker":"Charles Goldfarb","startTime":1901.79,"endTime":1905.03,"body":"sometimes use a dorsal block pen"},{"speaker":"Charles Goldfarb","startTime":1905.03,"endTime":1908.54,"body":"to try to improve the"},{"speaker":"Charles Goldfarb","startTime":1905.03,"endTime":1908.54,"body":"positioning. But I hate leaving"},{"speaker":"Charles Goldfarb","startTime":1908.54,"endTime":1912.44,"body":"that dorsal pin in because my"},{"speaker":"Charles Goldfarb","startTime":1908.54,"endTime":1912.44,"body":"experience has been those the"},{"speaker":"Charles Goldfarb","startTime":1912.47,"endTime":1916.01,"body":"most likely to get infected and"},{"speaker":"Charles Goldfarb","startTime":1912.47,"endTime":1916.01,"body":"most likely to drag the patients"},{"speaker":"Charles Goldfarb","startTime":1916.01,"endTime":1919.76,"body":"crazy. Sometimes I'll just"},{"speaker":"Charles Goldfarb","startTime":1916.01,"endTime":1919.76,"body":"manipulate the fragment with a"},{"speaker":"Charles Goldfarb","startTime":1919.76,"endTime":1923.99,"body":"pen. But I don't like to leave"},{"speaker":"Charles Goldfarb","startTime":1919.76,"endTime":1923.99,"body":"dorsal pens in. Chris, I don't"},{"speaker":"Charles Goldfarb","startTime":1923.99,"endTime":1926.54,"body":"know what your thoughts are on"},{"speaker":"Charles Goldfarb","startTime":1923.99,"endTime":1926.54,"body":"dorsal pens versus just the"},{"speaker":"Charles Goldfarb","startTime":1926.54,"endTime":1929.9,"body":"joint immobilizing pen and Macy,"},{"speaker":"Charles Goldfarb","startTime":1926.54,"endTime":1929.9,"body":"I'd love to hear your thoughts"},{"speaker":"Charles Goldfarb","startTime":1929.93,"endTime":1931.73,"body":"on those dorsal pens."},{"speaker":"Chris Dy","startTime":1932.57,"endTime":1935.33,"body":"My thoughts will be"},{"speaker":"Chris Dy","startTime":1932.57,"endTime":1935.33,"body":"quick. So I'll go first. I love"},{"speaker":"Chris Dy","startTime":1935.33,"endTime":1937.97,"body":"the little joystick to help get"},{"speaker":"Chris Dy","startTime":1935.33,"endTime":1937.97,"body":"everything lined up. Make sure"},{"speaker":"Chris Dy","startTime":1937.97,"endTime":1941.57,"body":"the joints perfect. So dorsal"},{"speaker":"Chris Dy","startTime":1937.97,"endTime":1941.57,"body":"pin in the fragment I've I don't"},{"speaker":"Chris Dy","startTime":1941.57,"endTime":1945.38,"body":"think I've ever left a pin in. I"},{"speaker":"Chris Dy","startTime":1941.57,"endTime":1945.38,"body":"know there might be some are"},{"speaker":"Chris Dy","startTime":1945.38,"endTime":1948.05,"body":"tempted to put a little screw in"},{"speaker":"Chris Dy","startTime":1945.38,"endTime":1948.05,"body":"there. It's probably overkill,"},{"speaker":"Chris Dy","startTime":1948.05,"endTime":1951.11,"body":"you blow apart the fragment"},{"speaker":"Chris Dy","startTime":1948.05,"endTime":1951.11,"body":"don't do it. So Mesa, your"},{"speaker":"Chris Dy","startTime":1951.11,"endTime":1951.53,"body":"thoughts?"},{"speaker":"Macy Stonner","startTime":1953.9,"endTime":1956.45,"body":"Sure, I think that"},{"speaker":"Macy Stonner","startTime":1953.9,"endTime":1956.45,"body":"Emily honestly treated a handful"},{"speaker":"Macy Stonner","startTime":1956.45,"endTime":1964.31,"body":"of these before. And I think my"},{"speaker":"Macy Stonner","startTime":1956.45,"endTime":1964.31,"body":"feedback is that they endure."},{"speaker":"Macy Stonner","startTime":1964.34,"endTime":1968.06,"body":"Anecdotally speaking, they"},{"speaker":"Macy Stonner","startTime":1964.34,"endTime":1968.06,"body":"probably at the end, maintain a"},{"speaker":"Macy Stonner","startTime":1968.06,"endTime":1970.1,"body":"little bit more rock solid"},{"speaker":"Macy Stonner","startTime":1968.06,"endTime":1970.1,"body":"extension, but lose a little bit"},{"speaker":"Macy Stonner","startTime":1970.1,"endTime":1974.75,"body":"of reflection I would imagine."},{"speaker":"Macy Stonner","startTime":1970.1,"endTime":1974.75,"body":"But I think that any patient"},{"speaker":"Macy Stonner","startTime":1974.75,"endTime":1978.17,"body":"that has pins in are freaked out"},{"speaker":"Macy Stonner","startTime":1974.75,"endTime":1978.17,"body":"to move their finger, whether"},{"speaker":"Macy Stonner","startTime":1978.17,"endTime":1980.6,"body":"it's a P one fracture or"},{"speaker":"Macy Stonner","startTime":1978.17,"endTime":1980.6,"body":"metacarpal fracture whatever it"},{"speaker":"Macy Stonner","startTime":1980.6,"endTime":1983.39,"body":"might be. So then they're a lot"},{"speaker":"Macy Stonner","startTime":1980.6,"endTime":1983.39,"body":"more worried about moving the"},{"speaker":"Macy Stonner","startTime":1983.39,"endTime":1987.08,"body":"Pap. And sometimes I think that"},{"speaker":"Macy Stonner","startTime":1983.39,"endTime":1987.08,"body":"like just by default, it gets a"},{"speaker":"Macy Stonner","startTime":1987.08,"endTime":1988.94,"body":"little bit stiffer and they're"},{"speaker":"Macy Stonner","startTime":1987.08,"endTime":1988.94,"body":"just a little bit more freaked"},{"speaker":"Macy Stonner","startTime":1988.94,"endTime":1992.09,"body":"out. But overall, I really don't"},{"speaker":"Macy Stonner","startTime":1988.94,"endTime":1992.09,"body":"have a ton to say about this"},{"speaker":"Macy Stonner","startTime":1992.09,"endTime":1994.91,"body":"population because I treat the"},{"speaker":"Macy Stonner","startTime":1992.09,"endTime":1994.91,"body":"majority 99% I would say non"},{"speaker":"Macy Stonner","startTime":1994.91,"endTime":1995.72,"body":"operatively."},{"speaker":"Charles Goldfarb","startTime":1995.96,"endTime":1999.14,"body":"My last point"},{"speaker":"Charles Goldfarb","startTime":1995.96,"endTime":1999.14,"body":"for this conversation and you"},{"speaker":"Charles Goldfarb","startTime":1999.14,"endTime":2002.59,"body":"both may have other points you"},{"speaker":"Charles Goldfarb","startTime":1999.14,"endTime":2002.59,"body":"want to close with. When a"},{"speaker":"Charles Goldfarb","startTime":2002.59,"endTime":2007.27,"body":"patient has a chronic untreated"},{"speaker":"Charles Goldfarb","startTime":2002.59,"endTime":2007.27,"body":"mallet that's resting in 45"},{"speaker":"Charles Goldfarb","startTime":2007.27,"endTime":2010.45,"body":"degrees of flexion and they are"},{"speaker":"Charles Goldfarb","startTime":2007.27,"endTime":2010.45,"body":"unhappy. They often have"},{"speaker":"Charles Goldfarb","startTime":2010.45,"endTime":2014.29,"body":"accompanying hyperextension of"},{"speaker":"Charles Goldfarb","startTime":2010.45,"endTime":2014.29,"body":"the PAP joint. And my favorite"},{"speaker":"Charles Goldfarb","startTime":2014.29,"endTime":2018.4,"body":"treatment for that and it's not"},{"speaker":"Charles Goldfarb","startTime":2014.29,"endTime":2018.4,"body":"even close is to ignore the DAP"},{"speaker":"Charles Goldfarb","startTime":2018.4,"endTime":2020.98,"body":"joint as long as it's flexible"},{"speaker":"Charles Goldfarb","startTime":2018.4,"endTime":2020.98,"body":"meaning as long as we can"},{"speaker":"Charles Goldfarb","startTime":2021.01,"endTime":2025.57,"body":"passively move the DAP joint. I"},{"speaker":"Charles Goldfarb","startTime":2021.01,"endTime":2025.57,"body":"love a central slept anatomy. I"},{"speaker":"Charles Goldfarb","startTime":2025.57,"endTime":2030.55,"body":"think it rebalances the dorsal"},{"speaker":"Charles Goldfarb","startTime":2025.57,"endTime":2030.55,"body":"finger, and it's simple. It's"},{"speaker":"Charles Goldfarb","startTime":2030.55,"endTime":2033.94,"body":"effective is one of my favorite"},{"speaker":"Charles Goldfarb","startTime":2030.55,"endTime":2033.94,"body":"surgeries. Of course they don't"},{"speaker":"Charles Goldfarb","startTime":2033.94,"endTime":2036.07,"body":"see that many patients that need"},{"speaker":"Charles Goldfarb","startTime":2033.94,"endTime":2036.07,"body":"it, but it is one of my favorite"},{"speaker":"Charles Goldfarb","startTime":2036.07,"endTime":2036.52,"body":"surgeries."},{"speaker":"Chris Dy","startTime":2036.7,"endTime":2038.92,"body":"Then you do that under"},{"speaker":"Chris Dy","startTime":2036.7,"endTime":2038.92,"body":"Local. Right you were doing that"},{"speaker":"Chris Dy","startTime":2038.92,"endTime":2041.83,"body":"under Local fire before the"},{"speaker":"Chris Dy","startTime":2038.92,"endTime":2041.83,"body":"Woodlawn stuff started right."},{"speaker":"Charles Goldfarb","startTime":2042.58,"endTime":2046.06,"body":"I was and I"},{"speaker":"Charles Goldfarb","startTime":2042.58,"endTime":2046.06,"body":"and I will. And patients"},{"speaker":"Charles Goldfarb","startTime":2046.06,"endTime":2048.01,"body":"tolerated really well. Yep."},{"speaker":"Charles Goldfarb","startTime":2046.06,"endTime":2048.01,"body":"Yeah, there's"},{"speaker":"Chris Dy","startTime":2048.01,"endTime":2050.83,"body":"one. There's one"},{"speaker":"Chris Dy","startTime":2048.01,"endTime":2050.83,"body":"surgery that Dr. Marty Boyer"},{"speaker":"Chris Dy","startTime":2050.83,"endTime":2055.21,"body":"always talks about in in our"},{"speaker":"Chris Dy","startTime":2050.83,"endTime":2055.21,"body":"anatomy labs. When we talk about"},{"speaker":"Chris Dy","startTime":2055.21,"endTime":2057.67,"body":"the extensor mechanism session,"},{"speaker":"Chris Dy","startTime":2055.21,"endTime":2057.67,"body":"he always mentioned that you're"},{"speaker":"Chris Dy","startTime":2057.67,"endTime":2061.81,"body":"the one that that showed him the"},{"speaker":"Chris Dy","startTime":2057.67,"endTime":2061.81,"body":"way instead of doing the oblique"},{"speaker":"Chris Dy","startTime":2061.81,"endTime":2063.64,"body":"retinacular ligament"},{"speaker":"Chris Dy","startTime":2061.81,"endTime":2063.64,"body":"reconstruction."},{"speaker":"Charles Goldfarb","startTime":2064.81,"endTime":2067.69,"body":"Yeah, that is"},{"speaker":"Charles Goldfarb","startTime":2064.81,"endTime":2067.69,"body":"crazy. And obviously not my"},{"speaker":"Charles Goldfarb","startTime":2067.69,"endTime":2071.41,"body":"surgery has been around for 50"},{"speaker":"Charles Goldfarb","startTime":2067.69,"endTime":2071.41,"body":"years. But it is a good one. And"},{"speaker":"Charles Goldfarb","startTime":2071.41,"endTime":2074.71,"body":"yeah, for those who think about"},{"speaker":"Charles Goldfarb","startTime":2071.41,"endTime":2074.71,"body":"an O RL reconstruction, oh my"},{"speaker":"Charles Goldfarb","startTime":2074.71,"endTime":2077.41,"body":"god, don't do it. Macy. Take us"},{"speaker":"Charles Goldfarb","startTime":2074.71,"endTime":2077.41,"body":"home."},{"speaker":"Macy Stonner","startTime":2078.759,"endTime":2081.459,"body":"Yeah, I think that"},{"speaker":"Macy Stonner","startTime":2078.759,"endTime":2081.459,"body":"those surgeries are fun to rehab"},{"speaker":"Macy Stonner","startTime":2081.459,"endTime":2084.969,"body":"as well. There's kids. It's very"},{"speaker":"Macy Stonner","startTime":2081.459,"endTime":2084.969,"body":"satisfying, like you mentioned,"},{"speaker":"Macy Stonner","startTime":2084.969,"endTime":2088.209,"body":"and I think that it works out"},{"speaker":"Macy Stonner","startTime":2084.969,"endTime":2088.209,"body":"well. I've only treated a"},{"speaker":"Macy Stonner","startTime":2088.209,"endTime":2091.389,"body":"handful of those. I also think"},{"speaker":"Macy Stonner","startTime":2088.209,"endTime":2091.389,"body":"maybe from you and Dr. Cathy and"},{"speaker":"Macy Stonner","startTime":2091.389,"endTime":2095.739,"body":"maybe, but I don't think that"},{"speaker":"Macy Stonner","startTime":2091.389,"endTime":2095.739,"body":"there's any issues that I've"},{"speaker":"Macy Stonner","startTime":2095.739,"endTime":2098.649,"body":"seen with them and yeah, that's"},{"speaker":"Macy Stonner","startTime":2095.739,"endTime":2098.649,"body":"pretty much it. Thank you so"},{"speaker":"Macy Stonner","startTime":2098.649,"endTime":2099.969,"body":"much for having me again."},{"speaker":"Charles Goldfarb","startTime":2100.72,"endTime":2102.64,"body":"We're grateful"},{"speaker":"Charles Goldfarb","startTime":2100.72,"endTime":2102.64,"body":"you're here. I think we've taken"},{"speaker":"Charles Goldfarb","startTime":2102.64,"endTime":2105.4,"body":"a boring topic and made it super"},{"speaker":"Charles Goldfarb","startTime":2102.64,"endTime":2105.4,"body":"exciting, right."},{"speaker":"Chris Dy","startTime":2106.66,"endTime":2108.73,"body":"Hey, Chuck, I do have"},{"speaker":"Chris Dy","startTime":2106.66,"endTime":2108.73,"body":"one more question just the"},{"speaker":"Chris Dy","startTime":2108.73,"endTime":2112.0,"body":"closed loops just for the"},{"speaker":"Chris Dy","startTime":2108.73,"endTime":2112.0,"body":"listeners. So you have your pin"},{"speaker":"Chris Dy","startTime":2112.0,"endTime":2114.55,"body":"in the joint across the joint."},{"speaker":"Chris Dy","startTime":2112.0,"endTime":2114.55,"body":"How long do you leave it in? And"},{"speaker":"Chris Dy","startTime":2114.55,"endTime":2116.44,"body":"what's your postdoc protocol"},{"speaker":"Chris Dy","startTime":2114.55,"endTime":2116.44,"body":"after the pin?"},{"speaker":"Charles Goldfarb","startTime":2118.21,"endTime":2120.91,"body":"So the pen,"},{"speaker":"Charles Goldfarb","startTime":2118.21,"endTime":2120.91,"body":"this is one of those six weeks."},{"speaker":"Charles Goldfarb","startTime":2121.99,"endTime":2124.42,"body":"You know, again, why I don't"},{"speaker":"Charles Goldfarb","startTime":2121.99,"endTime":2124.42,"body":"know but six weeks is the"},{"speaker":"Charles Goldfarb","startTime":2124.42,"endTime":2128.62,"body":"number. I see to pay. I do the"},{"speaker":"Charles Goldfarb","startTime":2124.42,"endTime":2128.62,"body":"surgery, I had them go to"},{"speaker":"Charles Goldfarb","startTime":2128.62,"endTime":2132.22,"body":"therapy to get a custom splint"},{"speaker":"Charles Goldfarb","startTime":2128.62,"endTime":2132.22,"body":"post surgery to cover the pin. I"},{"speaker":"Charles Goldfarb","startTime":2132.22,"endTime":2135.58,"body":"see them back in the clinic at"},{"speaker":"Charles Goldfarb","startTime":2132.22,"endTime":2135.58,"body":"six weeks. I do get a mini CRM,"},{"speaker":"Charles Goldfarb","startTime":2135.58,"endTime":2138.85,"body":"but I don't really care what it"},{"speaker":"Charles Goldfarb","startTime":2135.58,"endTime":2138.85,"body":"looks like. I removed the pin"},{"speaker":"Charles Goldfarb","startTime":2138.88,"endTime":2142.51,"body":"and it's exactly the same"},{"speaker":"Charles Goldfarb","startTime":2138.88,"endTime":2142.51,"body":"protocol. active motion only no"},{"speaker":"Charles Goldfarb","startTime":2142.51,"endTime":2144.16,"body":"passive motion of the DLP joint."},{"speaker":"Chris Dy","startTime":2144.49,"endTime":2146.05,"body":"Is that kind of work"},{"speaker":"Chris Dy","startTime":2144.49,"endTime":2146.05,"body":"right away or?"},{"speaker":"Charles Goldfarb","startTime":2146.83,"endTime":2149.5,"body":"Good question?"},{"speaker":"Charles Goldfarb","startTime":2146.83,"endTime":2149.5,"body":"Probably not probably two more"},{"speaker":"Charles Goldfarb","startTime":2149.5,"endTime":2150.76,"body":"weeks and then back to sport."},{"speaker":"Chris Dy","startTime":2151.27,"endTime":2153.55,"body":"Yeah, I think for me"},{"speaker":"Chris Dy","startTime":2151.27,"endTime":2153.55,"body":"back to sport usually is when"},{"speaker":"Chris Dy","startTime":2153.55,"endTime":2157.51,"body":"you can make a full fist of it."},{"speaker":"Chris Dy","startTime":2153.55,"endTime":2157.51,"body":"It's just a general goal for you"},{"speaker":"Chris Dy","startTime":2157.51,"endTime":2158.68,"body":"know, a lot of the hand stuff."},{"speaker":"Charles Goldfarb","startTime":2159.19,"endTime":2161.74,"body":"Yeah, Macy's"},{"speaker":"Charles Goldfarb","startTime":2159.19,"endTime":2161.74,"body":"heard me say this, I think my I"},{"speaker":"Charles Goldfarb","startTime":2161.74,"endTime":2165.04,"body":"have three criteria for return"},{"speaker":"Charles Goldfarb","startTime":2161.74,"endTime":2165.04,"body":"to sport in general number one"},{"speaker":"Charles Goldfarb","startTime":2165.04,"endTime":2168.97,"body":"full motion. So your point is"},{"speaker":"Charles Goldfarb","startTime":2165.04,"endTime":2168.97,"body":"well taken. Number two strength"},{"speaker":"Charles Goldfarb","startTime":2168.97,"endTime":2172.72,"body":"which is good and symmetrical,"},{"speaker":"Charles Goldfarb","startTime":2168.97,"endTime":2172.72,"body":"hopefully to the upside, or at"},{"speaker":"Charles Goldfarb","startTime":2172.72,"endTime":2176.11,"body":"least pretty close. And three is"},{"speaker":"Charles Goldfarb","startTime":2172.72,"endTime":2176.11,"body":"no pain. Those are my three"},{"speaker":"Charles Goldfarb","startTime":2176.11,"endTime":2178.81,"body":"criteria for most things as far"},{"speaker":"Charles Goldfarb","startTime":2176.11,"endTime":2178.81,"body":"as return to sport."},{"speaker":"Chris Dy","startTime":2179.74,"endTime":2182.29,"body":"I cannot believe we"},{"speaker":"Chris Dy","startTime":2179.74,"endTime":2182.29,"body":"just talked for 40 minutes about"},{"speaker":"Chris Dy","startTime":2182.29,"endTime":2183.01,"body":"mallet fingers."},{"speaker":"Charles Goldfarb","startTime":2183.76,"endTime":2185.05,"body":"Let's do it"},{"speaker":"Charles Goldfarb","startTime":2183.76,"endTime":2185.05,"body":"again sometime."},{"speaker":"Chris Dy","startTime":2185.26,"endTime":2188.56,"body":"Definitely. Thank you,"},{"speaker":"Chris Dy","startTime":2185.26,"endTime":2188.56,"body":"Macy for joining us. Always fun."},{"speaker":"Macy Stonner","startTime":2188.77,"endTime":2190.72,"body":"Thank you very"},{"speaker":"Macy Stonner","startTime":2188.77,"endTime":2190.72,"body":"much. See you next time."},{"speaker":"Charles Goldfarb","startTime":2191.11,"endTime":2194.26,"body":"Thank you."},{"speaker":"Charles Goldfarb","startTime":2191.11,"endTime":2194.26,"body":"Hey, Chris, that was fun. Let's"},{"speaker":"Charles Goldfarb","startTime":2194.26,"endTime":2195.19,"body":"do it again real soon."},{"speaker":"Chris Dy","startTime":2195.46,"endTime":2197.98,"body":"Sounds good. Well, be"},{"speaker":"Chris Dy","startTime":2195.46,"endTime":2197.98,"body":"sure to check us out on Twitter"},{"speaker":"Chris Dy","startTime":2197.98,"endTime":2200.38,"body":"at hand podcast. Hey, Chuck,"},{"speaker":"Chris Dy","startTime":2197.98,"endTime":2200.38,"body":"what's your Twitter handle?"},{"speaker":"Charles Goldfarb","startTime":2200.74,"endTime":2203.59,"body":"Mine is at"},{"speaker":"Charles Goldfarb","startTime":2200.74,"endTime":2203.59,"body":"congenital hand. What about you?"},{"speaker":"Chris Dy","startTime":2203.74,"endTime":2207.22,"body":"Mine is at Chris de MD"},{"speaker":"Chris Dy","startTime":2203.74,"endTime":2207.22,"body":"spelled dy. And if you'd like to"},{"speaker":"Chris Dy","startTime":2207.22,"endTime":2211.0,"body":"email us, you can reach us at"},{"speaker":"Chris Dy","startTime":2207.22,"endTime":2211.0,"body":"hand podcast@gmail.com."},{"speaker":"Charles Goldfarb","startTime":2211.54,"endTime":2213.7,"body":"And remember,"},{"speaker":"Charles Goldfarb","startTime":2211.54,"endTime":2213.7,"body":"please subscribe wherever you"},{"speaker":"Charles Goldfarb","startTime":2213.7,"endTime":2214.78,"body":"get your podcast"},{"speaker":"Chris Dy","startTime":2214.81,"endTime":2217.03,"body":"and be sure to leave a"},{"speaker":"Chris Dy","startTime":2214.81,"endTime":2217.03,"body":"review that helps us get the"},{"speaker":"Chris Dy","startTime":2217.03,"endTime":2217.42,"body":"word out."},{"speaker":"Charles Goldfarb","startTime":2217.81,"endTime":2220.12,"body":"Special thanks"},{"speaker":"Charles Goldfarb","startTime":2217.81,"endTime":2220.12,"body":"to Peter Martin for the amazing"},{"speaker":"Charles Goldfarb","startTime":2220.12,"endTime":2224.08,"body":"music. And remember, keep the"},{"speaker":"Charles Goldfarb","startTime":2220.12,"endTime":2224.08,"body":"upper hand. Come back next time"}]}