Studying for the NPTE: My Plan

So, I've decided upon a plan to study for the NPTE and figured I would share it here... I am not sure if this plan will work, but it's what I'm going to try to do.

I have 6 weeks until test day and plan to allot my time as follows:

Day 1 - 12: Neuro (my weakest topic) (two days will taken off for baking holiday cookies and Christmas Day!)
Day 13: Practice Exam 1
Day 14 - 20: Cardiopulmonary
Day 21: Practice Exam 2
Day 22 - 28: Start Musculoskeletal
Day 29: Practice Exam 3
Day 30 - 36: Finish Musculoskeletal
Day 37: Practice Exam 4
Day 38 - 41: Review weaknesses and other small topics
Day 42: Exam Day

I'm hoping by starting with my weakest subject that I will spend the most time with it and then ending with musculoskeletal will help have the most things in my memory right before test day.

We shall see what happens!

Time to study for the NPTE

Well, now that graduation day is over, it's time to seriously start planning how I'm going to study for the NPTE. I have the TherapyEd course books and plan on using them as my main means to study. I have a classmate that I am planning on studying with from now until test date; hoping we can keep each other motivated.

My rough draft plan is to start with my weakest subject, which is neuro, then move into cardiopulmonary and finish up with musculoskeletal. Although musculoskeletal is the largest section I hope that studying it closer to the test date will help me remember more.

I feel like I didn't really get to celebrate graduation all that much because this test is looming over me. But, I'm also ready to buckle down and get this very last thing done and over with!

The Day I Got My Doctorate

(below is the speech I proudly gave to my fellow classmates, professors, family and friends on graduation day)

Wow, graduation day. I know for myself and the rest of my classmates, we’ve all had moments when we thought this day would never come. It’s been a long journey. While I was thinking about my experience through PT school, I thought about how each of us has encountered countless highs and lows. Obviously, today is the highest high we’ve had yet, probably being surpassed only by the day when we proudly hold onto our licenses. And we aren’t the only ones who have experienced the ups and downs leading to graduation- I know that our families and friends have been beside us through the good and bad. And, they are all sitting here today, ready to celebrate.
When I was trying to find the right thing to say, I came across these words by Nelson Mandela that perfectly describes the journey of PT School. He said, “It always seems impossible until it’s done.”
Mendela’s statement resonates so well, because everyone in this room knows that PT school is not all roses and rainbows. In fact, it’s more like practicals and playing Jeopardy with Dr. Schreiber. The low points happened to everyone, but occurred at different times - things like waiting until the last minute to do our PBL, working endlessly on the matrix,  our blunders on exams, our mistakes during practical- These were all moments for each of us that made PT school seem impossible.
But, for every low, there was inevitably a high. And, so I’d like to remind us of the good times-- things like: remembering the day we got accepted into PT school, the lifelong friends we’ve all made, the first time we aced an exam, our first clinical and our last clinical—these are all moments that made the journey worth it. These moments were when we stood proud, and we said to ourselves, “We can do this.”
And so, we had different personal journeys through school and each one of us has specific events in the past two and a half years that are etched into our memories as the highs and lows. But even though we’ve all had unique experiences, we made it here together today.
So now, I stand proudly in front of my classmates, my fellow doctors of physical therapy, our wonderful professors, our loving families and friends - and I can say- we did it. It doesn’t seem that impossible after all. Congratulations to the Class of 2013!

How did 8 weeks pass by so quickly?!

  This week has been so busy and has been going very slowly. I am thankful, though because it's my last week and I'm not ready to go! I discharged another patient this week, but all the other ones I started saying goodbye to today. Some of them I am really close to because I started treating them as soon as I started and I will miss not getting to know how they finish up. I had a couple of my male patients tell me how much they appreciated my kindness and how much they will miss me.  The same patient that brought me flowers last week told me I took "care of him best". It was so cute! I am really going to miss everyone. I'm not looking forward to saying goodbye to all my pulmonary patients tomorrow, they have been the ones I have had the most fun with! 

     Today I gave my in-service on CHF. It went pretty well and then we all had lunch together for my "farewell" which was really nice. My CI even bought me a cookie cake! Everyone just keeps hugging me and telling me about how much they don't want me to leave. I really feel like I'm a part of their family now! 

     And, we talked a bit about the possibility of maybe me having a job there when I graduate... It's very unofficial now because they weren't planning on hiring anyone, but it was really exciting to think that I may have a small lead on something already! 

     This has been a really rewarding clinical experience and I have really loved the chance to work with cardiac and pulmonary patients. I will definitely miss it!

Friday the 13th! No wonder things have been "off"

This week has been a little rough with my CI coming back from vacation. I was used to my expectations from her and then got used to the expectations of me by everyone else while she was gone and now she's back and it's been a transition. She's been commenting on everything that I do, or what order I should do particular things. (Like, "Make sure you put patient 1 on the treadmill so you can finish patient 2's manual!") I know she's just trying to be helpful, but I've got it under control! ;) Well... for the most part. 

Well, after two really rough days, today was GREAT! :) :) I was so glad to have a good day. I had a couple of rough ones and was feeling down. One of my pulmonary patient's perked me up right away in the morning. The respiratory therapist will bring donuts in periodically for the patients on Fridays and there were some donuts on the table. My patient looked at the donuts and looked at me and said, "Sister... in the game of life you've got to keep your eye on the donut and not the hole." It made me laugh and made me realize that I was worrying over two "bad" days and really, I've been doing really well overall at this clinical. Then, we got a patient with congestive heart failure and he is high risk for exercise (his cardiologist sent him to us!) so I have been working with him. Basically, we do a functional activity (like stairs) and then I take his pulse and blood pressure. Then we will do another activity, then vitals, and back and forth for the whole session. So, it's a lot of work just to make sure he is doing well. Beyond his congestive heart failure, this patient has a long psychiatric history including paranoid schizophrenic. I was able to sort of teach everyone a few tips on dealing with him based on one of our lecture's from neuro, which was awesome!  Basically, I just make sure I fully explain everything we are going to do and what we are doing and why we are doing it. His therapy session is very structured and I make sure to not whisper around him (we do try to discuss his vitals to the side from time to time). So, if we do have to discuss something, I always come back and tell him what we are talking about, so that he doesn't feel paranoid and feels safe. So far, everything has been fine and he is actually one of my favorite patients (and the source of my in-service)! After he left today, my CI told me she was really impressed with how I was handling him and that I was doing really well with him. That made me feel good! And then, my patient at the end of the day, who is a little hard to warm up, told me she thought I was really empathetic and she can tell how much I care about her and my other patients and that I've been very patient and kind to her and she thinks I will be a great therapist! It made me feel awesome!! Especially after a couple crappy days!! Finally! A good day and I'm feeling great again!

Gettin' the hang of things...

 Another week down! It's been a transition to get back into out-patient after acute care. I'm not used to juggling patients, but I'm already starting to get better at handling more than one patient at a time. On Tuesday my CI left for Australia and she will be gone for almost 2 weeks! I'll be a completely different student when she gets back. In the meantime, I get to work with the owner and the other clinician, which will be nice. They both have more experience and so it has been good to get input on things. On Thursday morning the owner was filling in and I ended up seeing almost all the patients in the morning. I'm not sure if he did it on purpose to see if I could handle multi-tasking, or if it was because he isn't familiar with everyone. I think I did pretty well with trying to keep multiple people going at once. But, like I said, it's a transition from being in acute care and seeing one patient at a time. It's been a source of stress for me and I'm beginning to feel like I'm never going to get the hang of it again!

     I also got to spend some time with the respiratory therapist to see how she works her half of the pulmonary rehab. This has been really cool. I have gotten to sit in and help with two evaluations so far. It's really neat to see how they use the 6 minute walk test to determine how to start an exercise prescription for a patient. Although, they do the walk test on the treadmill, which is sort of odd. The clinic also got a new telemetry unit on Thursday afternoon and only myself and the owner were there to learn how to use it, so on Friday when the owner wasn't in the office, I got to teach the respiratory therapist how to use her new system. 

     Another neat thing that's going on while my CI is on vacation is that some professors from my school are filling in!  It was nice to see one of my professors in the clinic. He's really good with patients. I hope that when he is in on Wednesday he will get to see me work with more patients and see how much I've grown as a therapist. (I was with the respiratory therapist for most of the day on Friday, so I didn't get to work much on the "PT side" as I was helping with aerobic exercise and vitals!) And next week two other professors will be coming in as well. This is the first clinic I've been in that has had a relationship with the professors at my school and it's so nice to see my professors with their clinician hats on!

Back in the clinic! ClinEd 3 begins!

Today was my first day of my clinical experience at my new placement, which is an out patient clinic that specializes in pulmonary rehab. It was a long one (10 hours!) Big shift from doing acute back to out patient. The clinic is small, but it seems nice. My CI is young (she graduated from the same school as me 3 years ago!) and is actually a year younger than me in age. That doesn't bother me as long as I can learn from her.  The clinic serves about 50% out patient and 50% pulmonary rehab. I'm really excited about the pulmonary rehab aspect.The respiratory therapists work on aerobic conditioning (they work the patients up to 20 minutes on 3 different machines TWICE a visit [2 hours of aerobic work!!!]) then PT works on strengthening, balance and reiterating what the RT's teach (like breathing techniques, energy conservation, etc.) I had forgotten that Medicare Part B does not allow students to provide treatment to patients, so I was a little bummed because a lot of the patients today (especially the pulmonary patients) were Medicare and so I wasn't allowed to treat them. Although, it was nice because I did get to sort of observe and see how things happen. I am just hoping that there will be a good number of non-Medicare patients in the pulmonary rehab program for me to treat, since it was the reason I wanted to come to this clinic. Besides that, the day was ok. I got a little prepping on the computer documentation (which is, of course, a new program than I've dealt with previously) and some more information on billing. My CI had me write down three goals for this experience... I said that I wanted to become comfortable and competent with cardiopulmonary patients in this setting (since I am competent in the acute setting), to become independent with orthopedic patients (again), to become better at time management and multi-tasking, and to continue to excel with documentation. My CI seems very open and told me that I can ask her any questions or if I get overwhelmed or not challenged enough to let her know.  I think I am her first student, so it should be interesting for both of us as this goes. 

Back to school...

Ugh... Back into the classroom today. Although I am glad that acute care is over, there are certain things I will miss about being in the clinic. Just a few more classes and then I am done with all of my schooling! This semester is supposed to be a whirlwind, it's only 7 weeks long and there's a lot to fit in. I have Dysfunction of Multiple Systems (lovingly referred to as Multi-Systems) and my final Research course (time to write that systematic review!), as well as a professionalism course.

It looks like a ton of busy work, but I was happy to see my friends. I'm looking forward to getting these next few weeks out of the way so that I can go on vacation!

Oh! The best part about today is... I'M A THIRD YEAR STUDENT!

So excited to have that designation... Woohoo! :)

It's over! No more acute care!

Holy cow! My LAST day. At times, this clinical seemed to be dragging, but really, overall it went by so fast. I really can't believe it. I'm done with my second clinical! Only two more to go before graduation! WOW! Today was a really good day. Yesterday, my CI and I started going over my final evaluation and then we finished it up today. I was really happy with all of her comments and suggestions. I really have grown a lot and she definitely recognized my hard work and I definitely feel rewarded for it. I did have a good experience, it was a little hard at different times, but overall it was good. I learned a lot, and the staff at the hospital are so nice and helpful. 

The best part of today was one of my patients was also discharged! Much like my lady who was post-open heart with complications, so was this particular patient, although much worse. He ended up having sepsis and multi-organ failure, including the need to be on continuous dialysis for awhile. It was really sad for quite some time because it appeared he was maybe not going to pull through. But within the last week or so he has been doing so much better medically. He is starting to talk to us a little and today he got his foley cath out, the last line.tube holding him back! So, we went in to see him and I told him it was my last day and we talked a bit and I told him how proud I was of how far he had come, etc. It was a really nice, special "goodbye" (He has been in the hospital since May 9!!!) Well, later in the afternoon when my CI went to check off my progress note for him it came up he had been discharged to the nursing home!!! It was so exciting!! And perfect timing! :)

Well, I guess it's time to put another experience in the books and call it a day. I had a nice experience, but I'm glad to be done and ready for the next step! 

Substitute CI for the day...

Today my CI was off, so I got to be with a different therapist for the day. I got to work with one of the part-time therapists. It was a really good day. She is really nice and kept telling me how impressed she was with my skills/knowledge. It felt good! She even bought me a coffee at lunch time! ;) I was proud of myself because I fought for a patient who hasn't been doing well in the ICU and she wanted to discharge him, but I convinced her not to, since he isn't normally her patient. I keep hoping that he will make a turn and come around the other side, but it seems like every day he is worse. My CI and I had discussed discharging him last week, but we were worried that he may fall through the cracks if he does get better and then he will lose out on therapy he desperately needs. 

I can't believe I'm in week eight. I will be so glad to finish this clinical because it has been a lot of hard work and I've learned a lot! I have been working really hard on my in-service and I think it's going to be really informative for everyone. We've had so many patients (my CI as well as other therapists) with brachial plexus symptoms following open heart and it has been a really long process of researching over everything and I'm currently trying to find some treatment ideas now. I feel like I'm sort of "stuck" but I haven't given up yet! My CI seems like she is pleased that I'll be doing my in-service on this topic and I hope that she enjoys it (as well as everyone else) when I give it. We still need to pick a date to do it, though. 

Well, two more days til the weekend! :) Then, onto week 9!

I made it through the week!

 This whole week ended up being pretty good. I was excited because yesterday and today we randomly were assigned some evaluations on the Transitional Care Facility (it's a short term skilled option for some patients instead of going to a different facility... sort of like a subacute/nursing home setting.) And it just so happened that the two patients we were assigned to evaluate were two patients I had evaluated acutely and recommended for TCF. So, the evaluations were pretty smooth and I actually got to do MORE testing! I did some balance testing and the TUG with both patients. The patient today I did the TUG with and without an AD and you would've thought I won a million dollars. And, I got to do "real therapy"! Real exercises! It was a lot of fun! I think I may like that better than acute, but there are some positives of acute. Regardless, after feeling a little down and tired I had a pretty good week. I am excited that this is the end of week six and I'm working on applying all of the suggestions my CI and I discussed over midterm, so I hope that I continue to grow. We have another patient that is my favorite, she is a sweet older lady who had open heart surgery and then had a questionable stroke. They have yet to determine that she had one but have decided she has had a clinical stroke. She was nonverbal and really low-level for quite some time and in the past few days she is really starting to come around. Today, when we went in her room I asked her how she was and without skipping a beat she answered "ok". I almost fell over! :) They are working on getting her medically stable to go to a nursing home and I am really going to miss her when she goes. She was admitted on April 30th, so I feel like I have been treating her almost the entire time I've been at the hospital. But, it's also exciting to see her finally beginning to make (very slow) progress. Happy Memorial Day weekend!

Well, still going strong...

  Today I had a pretty good day, and since I've been feeling blah, I thought I'd write in this journal. Overall, the day was busy. The few consistent patients we have were all out for testing or up for discharge (hurray!) so we did a lot of "checking in" and talking with the nursing staff. One of our regular patients that wasn't at testing fell asleep when we sat him up on the edge of the bed. I didn't know that was possible, but I guess he wasn't kidding when he said he was tired today. We had some evaluations too and most of them went well. We had the first patient with wrist restraints this morning (dementia, combativeness, hitting/biting and trying to pull out lines), but luckily when we got into her room she wasn't using them and was really calm for us. She has a 1:1 staff with her and she will do anything that girl asks her to do, so we just worked through her to see how she was moving around. We ended the day with an interesting evaluation... the patient was asleep when we got there and we tried to wake him up but he never really did wake up the entire time and ended up singing a song that we couldn't understand all of the words in answer to every question we asked him. It was pretty interesting and we decided we would let him go back to sleep and we will try to see him again tomorrow. The day went by pretty fast and I hope that the rest of this week does and the next 5 weeks til it's time to move forward. :)

HALFWAY Through ClinEd Two!!

Yesterday I had my midterm review with my CI. Overall, it went pretty well. We had a really nice discussion about things, but I felt like she rated me much lower than what we talked about as to where I am currently. Oh well. I know I have room to grow and that's always a goal to work on. To be honest, I am getting a little tired this time around with clinical. I am just feeling burnt out and tired. I am trying very hard to stay very positive, because I don't want to be negative, but I'd be lying if I said I wasn't excited every time Friday rolls around. I never felt that way with my first clinical, and it's not that I don't like acute care, I just don't love it...

     Here's to hoping the rest of the clinical goes smoothly and it's week 10 before I know it! 

Could this rotation go any slower?

 Whew. This was a long week! It was a weird one too, lots of running up and down stairs with people wanting us to come back later, being at testing, etc. Nothing really special happened. 

      We have a patient in the ICU that is really having a hard time bouncing back from her CABG and it's been a huge mystery. She is just extremely lethargic and not really responsive other than moaning or occasionally saying one-two words. You have to constantly give her verbal and tactile cuing to stay awake and most of the time when her eyes are open she will focus on you and then all of a sudden lose her focus and have that look of "nobody's home". It's very odd and it has taken all week for the surgeon to finally consult neurology. They had thought it was medication related and so they have taken her off of all her pain meds, she has a UTI (which could be playing into it) and some other issues. But it's just very puzzling. Every day I keep hoping it's medication related and we'll go in and she will be completely awake and alert, but it hasn't happened yet. Her family is questioning the nurses constantly about what has happened and I feel bad because no one really has an answer for her. They finally did a CT scan to check for stroke signs, but it was all negative. I hope when I go on Monday she's made a miraculous recovery!

     I can't believe that this coming week is week five! It is going by fast! I like that it's going by fast because I go up and down about my experience, some of it is good but some of it is just ok so I keep making the best of the situation I'm in! And I'm getting excited for December to get closer and closer, of course! But, I am trying not to wish this experience away because the freedom of what "real life" will be like is great! I am still undecided about acute care. I definitely think that I could like it, but I think I would like it better if I were calling the shots and could do things in the order I'd like too! But, it's nice to see how other therapists work and to get the experience of trying new ways of doing things because I feel like even though I want to resist it (because it's not how I "practiced") I can still learn something from it.

Cardiac Surgery

     This week has been a little bit of a roller coaster ride... At the beginning of the week I was feeling really frustrated, but yesterday and today were better. On Wednesday I got to observe a CABG and aortic valve replacement. Seeing an open heart surgery was probably one of the greatest moments of my life. Being a heart patient myself, I was really looking forward to the experience and it definitely lived up to my expectations (and then some)! Best of all the perfusionist (the person in charge of the heart lung machine) used to work at Children's Hospital in Pittsburgh. We got talking and he asked when I had my surgery (June of 1989) and my surgeon's name... it just so happened I had my surgery during the time that he worked there and I also had my surgery with one of the surgeons he worked with! So, there's a very good chance that he was MY perfusionist long ago! So cool! I told him thank you, just it in case it was him. So neat! 

     Yesterday and today I have been doing more evaluations and treatments and it went a little smoother. She even told me that my notes a really good this afternoon before I left, so that made me feel good! So, overall- up and down and hopefully things will continue to be up and stay up. ;)

Observing my first surgeries!

     Last Friday and today I had the opportunity to go and see my first surgeries! Both were total knee replacements, but I got the opportunity to see two different surgeons to see if any of their techniques were different. They worked about the same way, although the surgeon I saw today moved much faster than the surgeon I observed on Friday. I was really glad I got the chance to see both because the surgeon I observed on Friday was a little slower and took the time to explain everything he was doing, which was really helpful. It was even more helpful when I went today since the surgeon today moved much faster, I felt like I had an idea of what was going on. The OR is a really interesting place... I was surprised how many people were present and how they are professional, but it is not stressful. I was explaining everything to my dad and he said, "So it'd be like you coming and talking to me while I'm working on a car!" and that describes it perfectly! They are able to do their job but also are having casual conversation at times during the procedure! It blew my mind! Really awesome! I'm excited because I am also going to get the opportunity to observe a total hip replacement as well as a cardiac surgery. My CI has been really nice about trying to find some times for me to go to observe surgery and so I'm really thankful for that because it's really interesting and it's a nice break from the day.

     

     Today my CI let me take the lead for the whole time for two evals instead of us tag teaming like we had been. Overall, they went ok. I'm sure I'm my own worst critic! It's funny how I had all of these plans for certain things when I was in class but it doesn't really apply and everything can change so quickly in real life. It just makes me nervous because I feel like I know the right things to do, it's just the way the hospital works is so different than I expected.  I feel like if I did the evaluations that I practiced in school I would feel a lot more confident, but trying to adapt to how things are run at this hospital has been stressful for me. I almost wish we would've spent the extra time in neuro to do the write ups after patient sims like we did in musculoskeletal and cardiopulm, especially the deciding where the patient should go next... That's the hardest part, is evaluating someone and having one snapshot and basically having to make a call on where they should be discharged to and if they are a good candidate for therapy. But, I feel like I'm already starting to get a little better and hopefully with more and more practice I will get even better.  I just wish I could feel more confident, but I'm taking it one day at a time and my CI seems to be fine with where I am and where we need to go next. 

Week Two of Acute Care

Well, this week has been a little rough at times for me. Monday was a frustrating day because I got my log-in information, but the documentation program is very tricky and it took me over an hour to document an evaluation. I was so frustrated afterwards at the things that I missed from my subjective information and how long it took me. My CI wasn't upset and told me that I will get the hang of things and not to be too hard on myself. It was still really frustrating! I came home on Monday night and made a note card of all the questions I need to be sure to ask to be able to fill out the correct information on the evaluation form, so hopefully that will help me not to forget. Luckily on Tuesday and today I have done much better with documentation and remembering all the information we need. My CI is currently on the floating rotation so we have been doing a little bit of everything and yesterday we got two total knee replacements. I was excited because I didn't get to deal with any replacements in my first clinical rotation. It's been nice to be able to see the same patients two times a day for the past two days. Most of the patients we have seen are either already discharged or have gone to another facility except for one. We currently have a patient who had a BKA and just had a BKA done on her other side. She has been having good and bad days (she had the surgery last Friday) and they seem to not have her pain medications quite figured out. She was very lethargic on Monday and today, but did really well yesterday. She will be going to a long term care facility when she gets discharged from the hospital but no one is saying when that will be, so I have a feeling we will be working with her for awhile longer. She is a very funny lady and has a pretty good attitude about her situation, which is always helpful. 

I made it through week one!

               Well, I made it through my first week of acute care! And, by day three I really have started to like it. Today we had orders to go treat a cardiac patient in the ICU. I was so excited! It was a co-treat with occupational therapy as well, so there was quite a crowd of us that went. Throughout the week my CI has been easing me into more interaction with patients, but in this instance I didn't really get to help much. I was so excited because the patient was a cardiac patient and also had a lot of different lines, tubes and drains. I wasn't taken aback by any of it because I remembered everything from cardiopulm and was ready to rock and roll. Unfortunately, all I really got to do was sort of help with keeping the lines under control, which I know is important! But, I was really dying to get in there and help the patient with standing and everything. (Later this afternoon I told my CI I am ready to jump in and do more, but that I appreciated that she allowed me to get accustomed to the hospital this week; I like to learn by first watching and then doing, so it has worked nicely for me, but I am ready to DO!! She was really receptive to this and I feel like we are both on the same page, so I’m looking forward to the coming week!)

                I haven’t gotten my log in information for the electronic documentation, but my CI had me hand-write my notes while she typed them and then we compared. I have been doing pretty well with it. Basically, I am definitely including all of the important details and just need to work on being concise and writing everything clearly. My CI told me she would much rather that I write more than necessary and then edit then not have enough, so it has been working out well. One thing that I am struggling with is keeping track of time. We have to document the time that we spend reviewing the electronic medical record, the handwritten chart, the actual treatment time, and the amount of time we spend documenting. I am doing well at remembering to write start times and not so good at remembering the end times! I think that I will get better at this though, it’s just a new thought process that I’m not used to yet. 

               I am glad that I am really starting to appreciate and like acute care! I’m excited for what the next 9 weeks will bring and how much I will learn from my CI and all the other staff. 

First Day of ClinEd II: Acute Care

Today was my first day of acute care for ClinEd II. I can’t believe I’m out on clinical again! It seems like it has been such a long time since I was able to be with real patients. I was nervous, but not as nervous as before I started my first clinical. This time I felt confident that I could interact with patients and was more nervous about getting there early, having a good CI and liking my placement. 

Lucky for me, I did all those things. I got a quick orientation as far as being introduced to everyone and my CI oriented me to the electronic documentation system as well as our orders for the day. We ended up seeing six patients. This is a huge difference from out-patient when I was used to seeing 10-13 patients. It seemed slow, but we weren't really sitting around doing nothing either.

 I came home a little worried because I am really hoping that I like this experience and I had an “ok” day. Nothing horrible happened, but nothing really exciting happened. But, I am keeping my hopes up that I will begin to like it more as I get used to how everything works. My CI was really good about explaining everything to me and told me she obviously doesn’t expect me to remember everything all at once. I observed for most of the day, but did get to assist with a couple people with walking. I felt fairly comfortable and I’m definitely ready to jump in, but I was also glad that my CI did not throw me to the wolves and instead allowed me to observe and get used to how everything works. 

So, here's to hoping things can only go up from here!

Clin Ed V... wait, what?

So, today when I got home, I had some pretty exciting mail. I had a letter from my fifth clinical instructor! I don't start my last clinical until October, so it is a little far out, but I was excited to open the letter. My future CI sent me a little note just saying hello and just some very basic paperwork on what is appropriate dress, expectations, how things will work, etc. Really awesome!

The reason why I'm so excited about this particular placement is because it is in a setting that I didn't think I'd be able to get a chance to experience... early intervention. For those who may be reading that don't know early intervention services are started prior to preschool for those children who are having developmental delays or other types of delays. In the state that I reside, children are eligible for physical therapy early intervention if they have at least a 25% delay in gross motor development or they have a medical diagnosis that can lead to gross motor developmental delays (such as Down Syndrome or Cerebral Palsy). Now, most of you may know, especially if you will take a look at the banner on the top of this blog, that I used to be a teacher.

Obviously, pediatric physical therapy is something that I have toyed with and thought about, since I do have a little bit of a background in children. However, this semester I have learned that pediatric physical therapy is definitely something more than what my skills as an educator were, and I expected that; what I didn't expect was how much I'd love thinking about pediatric PT, almost as much as I loved thinking about my teaching days. (I do have fond memories, it's just some things aren't meant to be...)

So, given that I've had some years dealing with children and teaching, I really wanted to get into pediatrics with an age group and a setting that I didn't have any exposure to and EI was that opportunity. So, of course when I found out that I did get the placement, I was so excited. And, today, getting that letter made me realize how much I am looking forward to rounding out my PT school days with that clinical.

It seems like so far away, and in just a couple of weeks I'll be heading off to Clin Ed II at the hospital, so I have a ways to go before I can really start dreaming about my days with the kids... But, it was a great surprise in the midst of finals week to see that there is hope that I will make it to the end of this year and will FINALLY graduate. :)

Great resource for free, legal music AND it can help patients with Parkinson's Disease!

We've been learning about Parkinson's Disease in Neuro this semester and have done a little bit of learning on Rhythmic Auditory Stimulation (RAS).

I'm sure there aren't too many people that don't know, or at least have heard of, Parkinson's disease.  But, if I may be brief, here' s a very simplistic explanation... Parkinson's disease (PD) is a disease where the body's dopamine levels are compromised. For some reason, there is degeneration (or break down) of the substania nigra (which is within the basal ganglia of the brain, which in turn helps us to plan and execute movement) and it results in less dopamine release. Dopamine is a neurotranmitter that is essential for executing movement. This is why Parkinson's Disease has manifestations in movement dysfunction such as tremors, inability to initiate movement and trouble with walking.

The great thing about research is, they discover things that can help people with different issues. PD research is working hard on a cure, although there isn't one yet. And physical therapists are prime healthcare providers that may be requested to work with this patient population, either directly or indirectly when seeing a patient for another reason who may also have PD. Thus, it's important for us PTs to know about PD and what we can do to help it. Which, brings me to the main point of this journal entry- RAS and even more fun, a free, legal music source!

So, I've mentioned RAS, but I haven't explained it. RAS is using a fixed-tempo to assist those with PD (and maybe other diagnoses) to walk easier, more efficiently, and most important, safely. By giving these patients a beat to walk to, it helps to bypass the basal ganglia and use other parts of their brains to execute movement. I'm sure none of us are totally immune to a great beat, and research has shown that RAS can be really helpful in improving gait patterns.

So, that brings me to the website, steady130.


www.steady130.com (opens in new window) is an amaaaaazing music resource, not only potentially for patients but for yourself as well! It features remixes of current, as well as "older" music, set to specific beats. You can browse by speed, genre, artist, etc. and you're sure to find something perfect. I use this resource A LOT for my own workouts and also when I am teaching cycling classes. And, the best part is that this resource is completely FREE of use for listening online or downloading the tracks, and it is 100% legal.

So, I hope you find this source valuable, whether it is for physical therapy treatment or for your own personal use.