Welcome to The Dr. JJ Thomas Podcast! Here I'll be talking all things physical therapy, raw and unplugged, giving you the unfiltered insights you've been searching for in your cash-based physical therapy business. If you're caught in the grind of the traditional model, swamped with paperwork, or feeling like you're not reaching your full potential as a physical therapist, this podcast was created just for you.
So in between each patient, how do I get the next set ready? If I have needles that have been opened, I should actually I'm gonna show that right now. Let's say that I had a 5 pack opened. This is important to know because it's important to see. Welcome to the doctor JJ Thomas podcast.
Dr JJ Thomas:Welcome to the doctor JJ Thomas podcast. I'm JJ Thomas. I often get questions about what type of needle do you use, who do you like to buy your needles from, how do you arrange your cart, etcetera. So here it is for those of you asking. I have it all right here.
Dr JJ Thomas:This is our actual cart we use in our facility, and we're gonna go through step by step what we make sure is, you know, is stocked readily in the cart pretty much every day, all the time. Honestly, we I actually will start with even that. We have wonderful volunteers and, you know, people are eager to learn all the time. And because of the cash based practice, I really do discourage, volunteers kind of hanging around and sitting on top of my patient while we're working on them. It's just not something we do in this environment.
Dr JJ Thomas:But, I do give them the opportunity to hear from a distance and, and start to develop a relationship with us through this volunteer opportunity. And one of their biggest jobs is to keep our cart stocked because it's so important. And so what does a stocked cart look like? First of all, I'll start with the cart itself. I this baby, I got when I first opened my brick and mortar shop in 2015.
Dr JJ Thomas:It's an IKEA cart. It was like, I think, $30 at the time. It's been amazing and it's held up beautifully. So so the cart is perfect. It gives me 3 tiers that I can get everything I need on, for needling and for things that I often do around a needling treatment.
Dr JJ Thomas:So, we'll start with I mean, obviously, we need to be clean. We need to use a clean needle technique. Right? So we need the cotton balls, and the nice big fluffy ones are kind of import they they don't have to be super big and dense, but they need to be not the teeny teeny ones that, are gonna be, hard to work with. I prefer this alcohol bin.
Dr JJ Thomas:This one in particular, I've had other ones that don't, that don't press down very easily. I'm gonna move this this way. But essentially, you know, you take your cotton ball, you make sure it's open, and then it presses down nice and easily and I have a nice saturated cotton ball. Again, when our volunteers come around and do our carts though, it's not like oh is there any left and I should fill it. It's every time they come in they're filling it because I again, we we spend minutes with our patient.
Dr JJ Thomas:Every minute counts with our patients. So, when the volunteers come in, they fill this to the room every time. So we have our alcohol. We have our our cotton balls. Now to the needles.
Dr JJ Thomas:I I tend to buy 2 different, needles mainly. I buy from Lasso MS, and oftentimes I buy these needles from LhasaOMS. These are the DBC spring tens. I like them. These are the little ones.
Dr JJ Thomas:These are the 30 by 30. So these are what I use often for, like, you know, for, maybe the masseter if especially if I'm going obliquely. I use this on upper trap. I use this on lower trap if I'm if I'm threading across it. I might use it in the peroneals if it's, not a real meaty peroneal on someone.
Dr JJ Thomas:And then, in addition to that, I'm gonna put these aside over here actually. We have the 5th the very small facial needles we use sometimes. They're only 0.15 in length. So 0.25 by 0.15 as anyone who needles knows. As needles get longer, they get a little bit thicker.
Dr JJ Thomas:So these 0.1 fives don't have to be very thick. They're 0.25, in terms of thickness. So so the this is my small container. I like these. I I should talk about these containers.
Dr JJ Thomas:These are all from the container store. I usually have a trash bin. So let's go to that. So I have I have a trash bin and I have this is my needle bin. So when I needle someone, I, you know, I have my gloves.
Dr JJ Thomas:1st, I swab them. Let's talk about that. If if we're gonna be efficient, and we'll talk about this in our master class. If we're gonna be efficient, I palpate, I know the area I'm gonna treat. But then, right away, I'm gonna I'm gonna swab that area.
Dr JJ Thomas:Let's, let's say it's my arm. I'm not gonna actually need them myself, but swab that area. That goes in the trash container. Right? Then, let's say I'm gonna take a single this is a point this is a 50.
Dr JJ Thomas:So let's take I'm gonna take a single needle and so the trick guys to getting these out, with the ones with the little tabs. This is an eye dry needle needle. These are beautiful needles by the way. They're really smooth when you use them. They're one of my favorites.
Dr JJ Thomas:So you take the tab out before it comes out of the tube, like you don't even take the tube out of the packaging yet. Take that tab out, throw it in the trash bin. Now, I grab my needle and my tube, pinch it, and then I do this. Okay? Then I can use these fingers to pull the trash piece out, so I'm not dirtying any of the any of the other things.
Dr JJ Thomas:Now this small container I use for my other needles that I'm gonna use within that session. Or if I open a 5 or a 10 pack, I put it there so I don't get it confused. Okay? Then I use this needle. Boom.
Dr JJ Thomas:Boom. Boom. Tap it. Throw the tube in here. Throw the needle in the needle container.
Dr JJ Thomas:And then this is still my trash bin. This is still my my needles that I'm working with bin. Okay? So that's just a sequencing thing that will, again, save you minutes, but every minute counts when we're working with our patients. And then this again goes back in the trash bin.
Dr JJ Thomas:So we have our nice little trash bin. Let's talk more about the needles again. So I moved these over here, but I went from, 30 millimeter in in length. This is my 40 where my glasses. I'm pretty sure it's my 40.
Dr JJ Thomas:Yeah. 30 by 40. These are the iDry needle, single single single needles. Right? But in the same 40 millimeter bin, I have my 10 packs if I want them.
Dr JJ Thomas:If I have somebody that I'm like, this is the DVC spring 10. If I have somebody that I know I'm gonna need more than like 5 needles, then I'm gonna pull out the the 10 pack likely. Or, if I think I'm only gonna use a few, I'll choose these because they're really smooth and really nice. The other time I choose this over, over the 10 pack is if somebody had a recent surgery. You know, I want every single I want every needle be single use then.
Dr JJ Thomas:Or if they're just generally not quite, if I'm a little worried about their health in general, and and if I'm really worried about their health then I'm not going to needle them. Right? But if I feel like, you know what? I think they might be a greater risk for some type of infection even though risk of infection is very low. I'm still gonna go with the single needle rather than using the same tube in, like, a 10 or a 5 pack.
Dr JJ Thomas:So like I said, these are my favorite. But for speed, sometimes I'll use the, the DBC spring tens. I I use these a lot, like I said, when I use a lot of needles. The next bin has my fifties. So again, I have the option of the single needles.
Dr JJ Thomas:I also I don't have them in this container, but on the sixties, I have the 5 packs by Idry needle, which I also really like. So this is Idry needle needles, and they're a 5 pack. So a single tube with 5 needles in a pack. I have them as an option as well, which I really love. On the 50 side, I have the 10 packs here.
Dr JJ Thomas:And then it goes up to the sixties, 10 pack, 5 pack. And then I have behind here, I have sixties that are the professional dry needling series singles. Okay? Then I have the 75 PDN series by Idryneedle. Boom.
Dr JJ Thomas:Boom. And then I have back here the undies as they call them. They're a 105 in length. These are for my NFL guys. My, my big legs.
Dr JJ Thomas:My, mostly big legs and quads and hamstrings and butts and things like that. Yeah. Usually those guys. So that's it as far as the needles go. Another important thing on my cart is this was given to me by a patient of mine.
Dr JJ Thomas:I'm gonna tag you in it. Years years ago at my old facility. Again, it was like one of the first patients I had at my old facility, and, it's a sewing needle magnet. And I kept dropping my needles, and I was like, oh my god. Where did it go?
Dr JJ Thomas:Where did it go? And she came in one day with this sewing needle, sewing magnet, and it's great. So I I like to have one of these on every cart if possible. So the nice IKEA cart, it sticks to it. If I drop a needle and I can't find it because my eyes are like, I don't see it.
Dr JJ Thomas:They're hard to see. I just kinda wave it around and I find it. And this thing is like, you know, dollars and it saves a lot of stress. So it's great to have a magnet on there. Obviously, we have our gloves here.
Dr JJ Thomas:And then lotion, I tend to use the BioTone, mainly if I'm not doing like the wind back treatments or something like that. It has the Arnica which I really like. But mostly I really like the pumping mechanism because I just think it's gross to be sticking your hand in like, you know, in in a tub. So the pumping mechanism is really nice. And then I do have my Naked Warrior CBD cream for, like, I use this, I use this a lot if, like, if a patient, if I needle them and oftentimes it happens with patients who haven't been needled a lot yet before, and I feel like maybe they're gonna be pretty sore from our treatment, then I'll end the treatment, the needling treatment with a massage using the the naked warrior warrior CBD cream.
Dr JJ Thomas:You can use whatever you like. I tend to really just I like this. It's made of, good quality ingredients. I have a lot of faith in the owner of the company. He's, he's a leader, and a veteran himself.
Dr JJ Thomas:And, I just have a lot of respect for him and his company. So, so shout out to those guys at Naked Warrior, and their product's awesome. It helps patients feel better. It helps dissipate the soreness from the needling. So I like to have this on my card as well.
Dr JJ Thomas:Moving on, we need to talk about some other things like stim. So we have our point stimulator, which, we in our office, we usually keep this. I'm sure if you're using a point stimulator, you do the same thing. We keep it wrapped up like this, but we also keep it rubber banded here with a with a tube. So that because my hands are not as big as I'd like them to be sometimes, so it's always been awkward for me to, like, do this and hold on to this, etcetera.
Dr JJ Thomas:So this way, this just holds it down for me and then we can just use the the, the winder thing to to adjust our level. So the point stimulator is great when you don't have a lot of time to set up like a 6 channel. Let's go to the 6 channel though because I found some don't mind my coffee. So this is another IKEA purchase. This was a recent IKEA purchase.
Dr JJ Thomas:I was actually in there shopping for something, with kids and I was like, oh my god, this could work. I was always searching for something to organize these lines because if you use this, this, if you use this unit, the s 180, then you know these wires are great because they're nice and long, but the problem is that they get they're like birds nest. They get wound up and they're so, you know, they're so hard to keep from getting tangled. So, I bought this and then my staff had a great idea of buying these little magnet clipper things. So you can keep them kind of, keep them wound in the magnet clipper thing, and then you can clip it to the sides if you want.
Dr JJ Thomas:And it just and you could even do it. So we do usually 2 on this side, and then I'll flip this around so you can see we'll do it has a pocket on the other side. So again, this just helps us keep the wires a little bit more organized, in between treatment sessions. And, and then when you wanna set it, there's enough room to just set it. Usually, we end up setting it on our lap, turning it on, and and and adjusting it that way.
Dr JJ Thomas:So this this IKEA thing let me turn this off. This IKEA thing was like, I don't know, $15 I think? And, I've tried all kinds of kinds of ways of, you know, different holders, and this has been the best thing. You can also buy little they have little, like, you know, those little tab things that you could wind them on that if you want. So I just thought I'd share that that solution with you.
Dr JJ Thomas:This is what we use in here. Last couple things on the needling cart. Obviously, I have well, I'll say while we're talking about soft tissue stuff, well, hand sanitizer, but I I prefer to go wash my hands in between treatments. A instrument assisted, device tool, either Graston or or, I forget what the other one's called right now. So I'll just take out the take out the formal names.
Dr JJ Thomas:So I like this sometimes before or after dry needling treatment. Also, always have a reflex hammer and a pinwheel because if you're assessing, the neuromuscular system well and targeting, the right gonna target the right areas, you're gonna need to check neurological pieces like reflexes and pinwheel and sensation and myotomes and dermatomes and all that good stuff. Stuff that we review in our, we review we review in detail and heavily in both our primal integrations and primal foundations courses. Another thing I really like to have on all of my carts is just an instant cold pack. This is great if, you know, every once in a while you're gonna have someone who gets vasovagal on the table with needles.
Dr JJ Thomas:And, when you have this right next to you, it's great. Just pop it, you know, snap it to activate. Pop it on the back of their neck. It'll settle down their nervous system so well. And in addition to that, another thing that's great to have on hand that we always do is like Hershey Kisses or some type of quick sugar.
Dr JJ Thomas:Because again, if they just like when you go give blood and sometimes you might get a little woozy, they try to give you chocolate or give you sugar. That's why it really helps settle the nervous system, and and you'll see their pupils change immediately with just a little Hershey Kiss. So it's different than, like, the sticker in the doctor's office, but but kind of a similar similar, concept and it works every time. So, keep a little thing of chocolate. It's a nice, like, nice thing to have on hand just in case a patient gets a little vasovagal on you.
Dr JJ Thomas:Everything is is set up in a way that I'll have a nice clean environment. All the needles are kept well organized, so that I can quickly get the needle at so that I can quickly access the needle I need for each treatment. I have my trash. I should actually go through that real quick. So in between each patient, how do I get the next set ready?
Dr JJ Thomas:If I have needles that have been opened, I should actually I'm gonna show that right now. Let's say that I had a 5 pack opened. This is important to know because it's important to see. So let's say I used one of these needles on someone. And then, oop, they were all better, so I didn't need to use anymore.
Dr JJ Thomas:But I have 4 left. But their motion's perfect, so they don't need anymore. I had set these needles there in case I needed them for that patient. That patient's done. Have a great day.
Dr JJ Thomas:I'll see you next week. Guess what? These are no good. And it doesn't matter. It's not a waste because the patient's better, but we throw these 4 needles back in the or or throw them in the sharps container.
Dr JJ Thomas:This is now trash, and then we just dump this whole thing into the trash can. Nice and easy. And that's it. So it makes setup for the next now that's all ready for the next patient. All the old needles are away.
Dr JJ Thomas:I don't have to worry about using somebody else's pack of needles on someone else. The cart is ready to go for the next treatment, and I have everything I might need. So that's it. I hope that helps you guys. If you have any other questions or you wanna join one of our master classes, the last one of the year is tonight, but, I'll be hosting some more in 2025.
Dr JJ Thomas:So make sure you check-in. Take care.