Summary Reflection-April 29, 2011

     I finished all of my hours within the third quarter and thus did not need to attend my mentor site during the fourth marking period. During my mentorship experience I learned not only about Physical Therapy as a profession but also that of independence and a persepective of college life.

    Since about the time I was in sixth grade I wanted to become a physical therapist so that I could help people by rehabilitating them back to the normal state they were supposed to be in. At this time in my life I was still struggling through therapy as no one knew what was wrong with me or how to fix the problems but instead aimed to improve my position through therapy. After surgery in eighth and ninth grade however my motive changed as for the first time in my life I saw the true miracle therapy could be. As eleventh grade came around and we were all supposed to have an idea of what we wanted to "be when we grew up" I began wondering whether I wanted to be a therapist or not. My mom kept pushing it where my siblings would tell me I couldn't. Confused, as any teenager is reluctant to following their mother's wishes, I chose to do the mentorship program in an effort to find out whether this profession was the right thing for me or not. At first I found therapy boring but was told to stick with it because volunteer work is never exciting. After a while I chose CHT (certified hand therapy) and really began to enjoy it as I met many cases and many different people. After a full year of shadowing however I have decided I want something knew; I grew up as a patient and followed mentorship for therapy without even realizing all of the other careers out there. Could I tell you even remotely in a general sense what I want to do with my life? No probably not, but I can say that I will be attending Virginia Tech in the fall where I will see the hundreds if not thousands of opportunities out there and experience, maybe roughly at first, something new and unknown to me.

    College is a lot different from high school, both in good and bad senses. Every senior will tell you mentorship is amazing because you legally get to ditch school an hour early everyday just like college but it is also a lot of work. Mentorship has taught me independence and forced me to become organized as well as learn who I can trust and who I cannot trust. I have never missed an assignment due date in my life unless absent from school yet in high school teachers reminded me of these due dates daily, multiple times. In college, a professor will give you a list the first day of class and expect that every single thing is turned in on time without reminders--exactly what mentorship does. Not only have I found how to be independent, but have also learned the importance of "colleagues" as Mr. Ashcraft would say. I have a few friends in mentorship and have learned the hard way which friends are there for you and which don't actually care. My one friend and I began reminding eachother of due dates and criticizing eachother's work without worrying about hurting one another's feelings, however other friends tell you not to worry about it. In college I will find those I can study with and have critique my work because mentorship has shown me that that technique has made me successful.

Summary Reflection-March 16, 2011

Throughout the third marking period I have successfully completed my research paper, virtual abstract, and the required hours (145 hours) for the year for a one credit class. My project in designing an online forum intended to inform and provide professionals in the physical/occupational therapy area with input and information gathered from other professionals based on their experience and education deemed successful. Based on anecdotal points and research on other online forums for the physical and occupational therapy field, a site created for this purpose could be successful and useful. In doing the research project final paper this quarter I learned not only a lot about my topic of physical therapy but also about the internet and online service and popularity and usage increase over the past couple of decades. From my research in updating and revising my rough draft I discovered other physical therapy sites that support a question-answer system for professionals, thus my idea could be legitimate and successful as a forum.

This quarter I wrote my first full blown research paper since almost seventh grade and not only got to touch up on the aspects included in a research paper and learn the difference between literary essays and research papers but also went in depth in order to create a project intended for college students. The virtual abstract also allowed me to put my research and writing skills to a technological setup, which I have always struggled with. The virtual abstract laid out my project in an easy form and interesting setup so that others can view the work I have done over this year. The online portfolio/digication also helped add to my technology learning as I have been documenting my journals, updates, and assignments online.

This quarter I observed Anne Edmonds, PT, CHT, for the most part and Nicole Bickhardt, OT CHT, occasionally as I went mostly on Mondays and Wednesdays this quarter versus my previous Tuesday and Thursday schedule. Anne has mostly the same philosophies as Nicole and uses mostly the same procedures for like cases. This quarter I followed the progress of one of Anne’s patients that I remember most. The patient was a middle aged woman who worked at a bar and had a younger child. Around Halloween time she sliced the tendon in her pinky finger open with a knife while carving pumpkins. She had surgery and was given a prescription for a large amount of physical therapy sessions. Following this patient not only allowed me to view the therapy applied to such an injury but also let me see many other aspects of patient-therapist relationships and the struggles a patient has to go through. In order to breakup scar tissue while still mobilizing the pinky, Anne started the patient on calm, gentle stretches and eventually worked the patient up to exercises to regain strength and full mobilization. The patient began using putty instead of rice, and Velcro pads instead of calmly stretching the pinky. It was interesting to see the patient’s tightness and lack of mobilization after a stressful week as the inability in keeping up with exercises daily at home began to dramatically affect her movement.

Patients attending therapy have to receive permission from doctors, insurance agencies, and their place of employment before coming to a therapy session. The patient does not decide how many sessions would be most effective but instead is limited to what the insurance agencies and doctors are willing to provide. This quarter at therapy I witnessed several cases where the patients struggled with getting sessions approved, creating stress in therapy right away.

Summary Reflection-January 3

            Through the past couple months at Physiotherapy Associates in Clarksville I have decided that I am interested in following a career in Occupational Therapy as a Certified Hand Therapist. My mentor, Nicole Bickhart has shown and taught me not only what the occupation entails through shadowing her at work, but has also given me advice on how to become a CHT through schooling. I have viewed a variety of cases since I began at Physiotherapy Associates and have evaluated and noticed the similarities and differences between therapy applied to each case presented to Nicole and the other CHT’s in the hand clinic.

            Over the past couple of months I have been observing a case on Tuesday and Thursday for about an hour each time and have seen the progress the patient has made over time. I have been able to get to know the profession from a professional standpoint and also have experienced the immensity of my ability to connect with the patient on an emotional level specifically within my exposure to this specific patient. The patient had a joint replacement surgery within the base of her thumb and experienced only difficulties and problems along the way within the first marking period of school however during second quarter has shown mostly progress. After many doctors and constant effort in therapy, I have witnessed how, with time, a patient can overcome an injury and work towards healing and functioning hands. Everyone told me I couldn’t become a therapist because of my own issues and past surgeries, however my current mentor and other therapists at Physiotherapy Associates always told me otherwise and urged me to shoot for my dreams even before I presented the idea of a mentorship to their facility. When this patient I mentioned told me in her own words the pain, discomfort, inconvenience, and downright frustration of the failure of the first surgery she had, I knew what she meant. I have been through something similar and just as disheartening as just about every patient that visits the clinic and can connect with every patient on how it feels to be handicapped in your hands. My mentor has taught me this quarter that my disability is not a disadvantage to this job but rather a great advantage and will separate me above the rest.

            I recently emailed several professionals employed in Physical Therapy clinics around the area asking their opinion of my public online forum intended to provide therapists with intell from one another as they correlate and coordinate the most effective means of therapy for different cases. I plan to use these comments/quotes on an anecdotal point for data within my paper and am waiting for responses.

            Therapy is all about routines and goals—about setting a final idea of success and working at small increments to achieve it. Through second quarter I have observed the patterns within therapy sessions on individual cases and also throughout most cases involving the hand. The same idea is presented to each however some undergo different programs then others while still overlapping many of the same routines. Stretching, massaging, stem, and ultra-sound repeat themselves within almost every case however Nicole has been teaching me how to go about exerting each to different cases. I look forward to the future of my mentorship and have been/am happy with where I am at within the Mentorship program at Glenelg. 

Summary Reflection-October 25

            I chose Physical Therapy as my topic for mentorship because I have been through it personally for about fifteen years along with intensive therapy at Physiotherapy Associates after four major tendon transfer surgeries starting in 2006. When I asked Ron Spicer, PT and Physiotherapy Associates coordinator, and the end of junior year if I could mentor at his facility he was excited to inform the staff that had all known me for so long that I had returned, however on the other side of the table looking for a career rather than as a patient. The section of the building for therapy in Clarksville town center is divided into two sections: the main area and the hand therapy area. Over the summer I put in about ten hours shadowing in the main area, taking notes and learning about cases involving injuries that had to do with large sections of the body. Within these few hours I learned specifically about ACL tears, shoulder, spinal, and back pain, and how to treat different cases. Most importantly I learned that in physical therapy the entire section of the body around the injured region has to be treated as well. Physical therapy involves mainly strengthening through exercises to build up around the injury to fix the current problem and help prevent further problems.

            After only a couple of visits I asked Ron Spicer if I could spend some time on the hand therapy side as I was a patient there for quite some time and wanted to see how therapy is treated differently for a specific region of the body. I began working with Nicole Bickart around September 23 and decided from there that I would like to continue the rest of my hours with her as my mentor as an occupational hand therapist. Occupational therapy differs from physical therapy where the treatment given works towards specific goals in getting the patient back to doing activities requested where physical therapy works towards strengthening and rebuilding in general. For example, I have been observing one of Nicole’s patients who had a joint replacement in the bottom joint of her thumb after a severe case of tendonitis. As a nurse’s assistant, the patient spends her career pulling charts and writing. Nicole has been prescribing a program that focuses on getting the patient back to being able to write while still strengthening and healing from surgery in order to return the patient to her occupation.

            I have found with hand therapy for anything from surgery to sports injuries to something as great as rehabilitation for a digit that has been completely chopped off the hand and sewn back on, that a program begins with heat and minimal stretching followed by strengthening and eventually forced movement. Forceful stretching right away in any injury can cause more damage and failed results to surgery; the patient is told to at first try to stretch and move the finger/thumb without any outside force while the wound heals completely. However, especially after surgery, minimal movement may result in more stiffness and damage as the scar tissue within the hand holds the tendons in place, disabling movement unless stretched and removed through massage. Thus, therapy is required to be exact and give the wound time to heal without allowing scar tissue to stiffen the region too much over time.

            As the hand specialists, Nicole, Ann, and Tracy, have informed me, the best way to go about becoming a hand specialist in therapy is to become a physical or occupational therapist first, then work on specializing in a subject. Keeping their advice in mind and after discussing my plans with each of my mentors, I have decided to plan on receiving a B.A. in biology, then transfer to three years of PT/OT schooling and become a physical or occupational therapist without specializing in hands for a couple years. Nicole advises that the best way to approach a career in therapy is to get a feel for what you will be doing before going back into school and an internship for specializing in hand therapy. To become a hand specialist, the student must take specific classes and shadow someone in the field of hands for a certain amount of hours before passing an exam for hand therapy.

            For my project this year I have decided to focus on finding the most effective ways for rehabilitation for common cases based on experience and opinion from both therapists and patients. I have found through shadowing at Physiotherapy Associates that the therapists tend to coordinate with one another on what treatments should be given to each case by deciding as a group rather than leaving the treatment to one opinion. This is similar to any medical field; for example, if you were told you had a heart failure and the only way to cure it was to perform a risky surgery with a 50% fatality rate you would almost definitely seek out a second, third, and even fourth opinion before laying down and putting your life on the line. The same goes for therapy, therapists everywhere have been through different experiences and learned different skills due to where they went to school or where they have worked. To allow therapists to coordinate ideas and put in their personal opinions on effective ways to rehabilitate different cases I plan to create a public online forum where therapists along with the public may view and put in ideas and methods for rehabilitation. So far I have come up with a list on how to organize the website, found a source to help with the technical aspects of the project, and presented my idea to my mentors for their opinions. I plan on completing the setup of the forum over second quarter and begin visiting different facilities and advertising in order to get the program up and running. I hope eventually my website or even just idea can be used in the future to better the system of physical therapy and even in other fields of medicine.