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!

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.

Last Day :(

I can't believe it has been 10 weeks. Today was my last day at my first clinical! :( I think back about how scared I was with day one and how nervous I was to start and now I am so sad it's over. I feel like I learned SO MUCH from my CI and the clinic I was placed in was absoutely perfect for me! I would honestly recommend where I went to any of my classmates/students because it was that awesome. Everyone was great to work with and having the extra worker's compensation piece was super interesting. I feel like I definitely utilized my #1 lottery pick well without even really knowing it. (Thank God!)

It was hard to say goodbye to my patients, but I know they are in good hands. I will really miss them! So many wished me good luck at school and how I will be a great PT some day. It was so validating even though it was bittersweet. I know Monday will be hard when I am sitting in class and not treating patients.

I am so proud to say, "I did it!", though. :) Now, to keep the momentum going...

Where has the time gone?

The last time I posted it was in January!! It's July! I can't believe it. Time has been going by so quickly and obviously school has kept me really, really busy.

My spring semester ran from January-April and I had a large course load with my first PBL experience. It was a lot of work, but I really enjoyed my small group and I thought that we worked really well together and I learned a lot. I also had Neuroscience which was a big challenge, but it was really rewarding to understand everything (thank goodness we had our amazing physiology professor to teach us Neuro as well!). We also spent a lot of time in the lab learning all kinds of things like modalities and e-stim and a bunch of other things that I can't even think back far enough to remember!

Today I'm taking my last final of my third semester and the end of my first year. I can't believe it!! We took an 11 credit course all about musculoskeletal dysfunction. Needless to say, it was a LOT and I am so glad that I passed all my tests and have been deemed "ready" to go to my first clinical experience.

I'll talk more about that in another post, because I've got to get my study guide finished for my last final!

Interdisciplinary Day

On Friday we ended the week by being required to attend an interdisciplinary event. Basically, students from the graduate school health programs all came together and were able to meet, mingle and then we were broken up into small groups and given a case study. We had to discuss what each of our roles would be within the case study and listen about each others' careers. There were DPT students, MOT students, Nursing students, PA students, and clinical psychologist students present.

For the most part it wasn't that great; it wasn't organized very well and it was very hard to hear the members within your group because there were around 20 groups all in a huge auditorium all talking at the same time.

After we finished reviewing the case study, talking about our roles, etc we had a speaker... Surprise (ok, not really) the person that was the speaker was the person that the case study was built on. (A C6-C7 spinal cord injury; he is categorized as a quadriplegic but has pretty good movement in his upper limbs/body, although in the past couple of years he has lost some fine motor control; his accident was 28 years ago). It was a great story, got me teary-eyed a few times and thankful for everything in my life as well as excited to be able to help make a huge impact on someone's life, much like the doctors/therapists made an impact on him.

The real reason I'm posting this is, though, I was APPALLED by the members in my group and their attitude towards PT/OT. One girl outright asked us "What exactly do you do?" and seemed insistent that we had absolutely no role from the beginning in the patient and was more concerned about what she and her classmates (PA students) would do in the ER.

My fellow DPT student and I, as well as an MOT student did our best to educate those within our group, but honestly.... The profession has GOT to do something about this.

I really couldn't believe the attitudes that came out today and I hope that after meeting me and my classmate that the students we were in contact with can understand that we play a huge role in the patient's well-being.

I'm also hoping that as we all go through schooling, everyone is able to recognize the roles that various healthcare providers play and then acknowledge those roles as being important in their own independent way; not in a competitive format.

A nursing student did make a comment about when being out in clinical (a hospital/in-patient setting) she said that the members of the healthcare team rarely acknowledged each other as humans; they rarely even made eye contact and said "Hello" to each other and she hoped that as we all went through our schooling that we would be able to remember that each and every one of us is first off, a human being, that at least deserves the respect of a handshake and a greeting. Needless to say, everyone applauded after her comment and I truly hope that this is the attitude of all of those in the programs at the university I'm attending, as well as elsewhere.

I Did It: Week One

Well... As I'm sitting on my couch, watching a special on UFO's (trying not to think about the anatomy and physiology I should be studying) I can say I'm officially finished with my first week of DPT school.

It's definitely interesting... in lots of ways. The content is interesting, the way my classmates are all starting to interact is interesting and my mental/emotional state is definitely "interesting". Most mornings start off with me feeling extremely enthusiastic and ready to learn and end with me either almost in tears/wanting to be in tears, anxiety-ridden and thinking, "What the hell am I doing?"

All of my classmates are really nice, and I'm starting to form relationships with most of them and so having people to relate with will be good to lean on when the going gets tough. I'm sure that I'll stick with this, I just want all the fear and anxiety to disappear so that I can remember why exactly I wanted to do this, since I feel like I made the decision years and years ago. (Ok, it was just 2 years ago, but whatever!)

So... what did I learn in my first week?

• Some people have never seen a cadaver before DPT school
• DPT Orientation is very long and is full of the 700 ways you can fail out of the program
• Some of my classmates appear to be light-years ahead of me
• But, when I talk to them, they feel the same way as I do
• I probably should have studied anatomy over the summer even though everyone told me not to worry about it
• I need to learn how to get over my dislike of physiology so that I can do well in the course
• Anatomy is already kicking my ass

So, one week down... only 14 more in the semester! ;)

My First Day

Well, I survived my first day of PT school and am already wondering if it is too early to start a countdown. ;) There are 36-37 students in my class and we spent the morning in anatomy lecture, followed by physiology lecture and then a 4 hour long orientation session that left me literally exhausted.

My classes are definitely going to be very demanding and I'm already dreading September 26-27 because I have my first anatomy exam followed by (back to back, no less!) my first physiology exam and then my lab practical on the next day. The work seems rigorous, but I'm excited to get started to see if I can rekindle the passion I had for this as much as when I decided to go back for my pre-requisites.

Our orientation consisted of having lunch with our advisors, another tour of the facilities (that's three I've had in total; I think I know my way around!) and introductions by all of the faculty and all of my classmates and a lot of going over the rules, expectations and overview of the program.

It was a lot to take in on one day, but I am happy that I am not the only "older" student, as there are a handful of people my age and slightly younger/older that are not coming directly from our undergrad degrees, or related fields.

I feel like so much happened today, but honestly my brain feels like it can't anymore at the current moment, but I just wanted to post and say "I did it! I survived the first day!"