Thursday, October 17, 2013

Shout Out to PT Professionals for National Physical Therapy Month

A note from Alex:   It is National Physical Therapy Month.     I am interrupting the series on "The Impact of Impact" and will follow up with Part III soon.   In the meantime I wanted to acknowledge National Physical Therapy Month with a shout out to our own PT program.  I also am taking this moment to express some thanks for special attention I have received from the PT profession over the past year or so. I don't usually use this blog for highly personal matters, but I am violating that rule today.   In any case, I hope that you will join me in saluting and thanking our PT colleagues-faculty, students and staff.    We have a phenomenal department here at the IHP, remarkable students and alums, great PT colleagues at Mass General, SRH, and BWH who are all part of our clinical education enterprise.    We are truly privileged to have so many rehabilitation clinicians, educators, and scholars in our midst.  Say thanks to PT!

Dear Physical Therapists,

 
I am taking this opportunity to give a public thank you for your work.   I have worked with great PTs for most of my clinical and academic life.  Since joining the Institute, I have learned more and more about the significant contributions beyond the obvious.  Some of these include the highly creative curricular leadership of the IHP,  the dynamism and maturity of our PT students,  the respect of our programs in PT by others,and the great alumni involvement,  Our PT colleagues at the IHP do so much to contribute to the life of the Institute community.   Our last two Faculty Chairs (Drs. Tracy Brudvig and DJ Mattson)  have come from the Physical Therapy Department, with several more preceding them in earlier years.  Much of the energy and leadership around IPE has come from our PT Faculty, including the current leader of IMPACT, Dr. Mary Knab.   In almost every activity at the IHP, the strong positive, and gifted Physical Therapy "voice" can be heard.     For all of these contributions (and I could go on and on) I am grateful and appreciative.  I know our whole IHP community is so proud of these obvious reasons to shout out "Happy PT month."

However, I want to take a moment to be much more personal.   Over the past year or so I have been the personal recipient of physical therapy.   I was and continue to be "the patient."   I have experienced the continuum of care in PT in a highly individualized and focused manner.   I want to use this experience to share a bit of what I have learned about PT and why I am so grateful  Bear with me.

My first direct experience with PT started over a year or so ago when I experienced a "frozen shoulder."   The pain was the worst part.  I listened to my physician ("let's wait and see"), took some meds for a while, and tried to wait it out.   It improved enough to function, but it hurt all the time. When I finally got around to seeing Mr. Jon Hagan, PT, OCS  at the MGH Charlestown Community Center for therapy, I was quickly amazed.   Boom... a few sessions- no more pain, over time increased range of motion, and some simple follow up visits to make sure all was on track.   At the time, I was so grateful for the relief and the rehab.   I hope that Jon knows how much I appreciate him and the great care.  I also hope he knows that his talent and encouragement are remarkable.  Happy PT Month to Jon Hagan. 

The lessons I learned from Jon provided a simple preface to  a book that is not quite finished.   Last February I had a "little" neurosurgery for an acoustic neuroma at the Massachusetts General Hospital.   Before surgery, I knew that I would be deaf in the left ear, and "might" experience a few other problems.   Due to the size of the tumor, the ultimate complications included a number of of the "mights".  Among those were vision problems (double vision), balance problems, facial weakness, and some "minor" speech and swallowing problems.   Yes, my "benign" tumor hit the sweet spot where all those cranial nerves come together.  Sort of the trifecta for a speech language pathologist, wouldn't you say?   

So, the first chapter of PT, post surgery, was the part where you realize "Dude,  I am in the Neuroscience ICU at MGH and I can't get out of bed.  In fact, I don't want to even try!"   I can't recall the names of the Physical Therapists from the MGH PT Department who came to my rescue.  I wish I could.  They were all so amazingly skilled.   They knew how to get me up (gently at first), help me get into the chair, start walking around the ICU with all kinds of bells and whistles attached, and how to educate the hospital staff about what I needed to do.   Their knowledge of my condition, of the environment, and the link between my health status and what I needed to accomplish in order to get home were all amazing.   While these skills that I am acknowledging have to be the most routine and the most basic for PT clinicians in the acute care setting, they are far from routine from the patient's perspective.   I know that these PT neuro experts were the ones who helped me every day for that week, who pointed out little (and I mean tiny) steps toward the goal of discharge from the ICU and then the hospital, and who reassured me every "step" of the way.   One of the most impressive pieces of all of this was the way that the PT team communicated with each other as I progressed in my stay.   They were skilled at keeping each other aware of all "my"  details and they didn't need to keep asking me the same history questions at every visit.   All clinicians have something to learn from that!  So, to all of the Physical Therapists at Mass General, especially my therapists in the Neurosciences Unit, thanks for helping me to get home safely and with a bit of confidence.  You are all stars in my book.  (Just so you know, I am walking all over Boston now!).

Chapter II moves to my home.  About a week before my operation, I was contacted by two of our faculty members, both neurology PT specialists (Janet Callahan, PT, DPT, NCS and Anne McCarthy Jacobson PT, DPT, NCS).  They generously volunteered to check in on me after discharge and to see if there was anything I would need.   (Ha!  They didn't know what they were in for).    I was grateful (so grateful) for the attention, but assumed that after surgery I would need some rest, but why would I need PT?  Those balance problems were a possibility but I had confidence I wouldn't need them.    My first words, on the way home from the hospital, to my wife were " could you see when Janet could come over?"  Most fortunate for Anne and not so much so for Janet, her schedule allowed her to be "the one."   Janet spent several hours with me over the next few weeks.   In terms of symptom management for double vision and balance, she is a pro.   In terms of kindness, humor, clinical skill, encouragement, and generosity she is gifted.    I will spare the details about all we went through, but my progress was swift and within 10 days or so, I was starting to take a walk outside along the harbor.   My gratitude to Janet is immeasurable.   While some of those balance exercises, could qualify me for the flying Wallendas if mastered, I learned so much about the neurological system, balance, and about physical therapy.   I am still using what Janet helped me learn and practice.   P.S-  I would put the day that the double vision cleared among my best life rewards!   So Janet, Happy PT month.  You are remarkable!   Anne Marie, thanks for making yourself available too.   For both of you, your advice and support to people with balance and other neurological problems is a gift to rehab.  Our students are so fortunate to learn from you!  

Chapter III (apologies for length, but my PT story is sort of like Harry Potter-lots of volumes).   I mentioned my facial weakness, similar to Bell's Palsy.   There was very limited movement on the left side of my mug.   My surgeons (and they are the best) recommended that I wait for about six months before starting therapy for my facial muscles.   There is a rationale (I am still arguing with them about the rationale), but I waited.  That was a very long six months.   In late July, I began to see a new therapist, Mara Robinson, PT, MS, NCS at Mass Eye and Ear Infirmary.    Notably, (Mara is a 1997 graduate of the MS program at the Institute) Mara is a facial PT specialist and sees patients in the Facial Nerve Department at MEEI.   She is a star.  My guess is that she has seen more folks with acoustic neuroma complications and Bell's Palsy than about anyone else. Her knowledge of the unique and challenging facial musculature is beyond belief.  She knows it all.   We started with some facial exercises (again I will spare the details) .  Doing these exercises daily in the mirror is somewhat comical, yet highly logical.  At times, when I am exercising I feel like a facial contortionist .   However, within a few weeks of starting, I started to see lots of improvement.  Do you know what it feels like to lose a smile and get it back?  Do you know what it feels like to again feel comfortable when you are out or have to meet strangers?  Do you know how good it is to hear from family and colleagues that you look so much better?   For all of this and so much more, Happy PT month to Mara.   

I am happy to celebrate PT month this year and I will be for every year to come.   I say this as I walk, smile, and see more clearly.   I know that I am better for having had the opportunity to benefit from the expertise offered by my physical therapists.  Thanks (and Happy PT Month) to all Physical Therapists!

Tuesday, October 1, 2013

Part II: What Impact Means To the IHP


In my last post I described the IMPACT program.   Anyone who has been at the IHP for the past two semesters has certainly heard of IMPACT and what we are trying to accomplish.   This interprofessional set of experiences for our students, clustered under this new logo, is providing a fresh  and welcomed approach to our long time commitment to interprofessional education.    

For the IHP community, and the larger community, this new image and new set of activities is designed to impact all of us by imprinting within our lexicon and within our day to day teaching and learning a highly principled approach to our practice.   Our long standing discourse about "working together" has taken on a new level of commitment that is far reaching.  

For our newest students, IMPACT means that they were being approached (electronically) about interprofessional issues prior to their arrival on campus.   Their enrollment in the new HP course assured that from day one they were exposed to this new hybrid curriculum as the centerpiece for the development of their new professional choice as a nurse, nurse practitioner, physical therapist, or speech-language pathologist.   Next year, occupational therapists and then physician assistants will join the mix.   Every new student, assigned to an online group of 10 colleagues from diverse backgrounds and disciplines will have the chance to work together to develop knowledge and skills in leadership, communication, patient focused care, and ethics.   As a kickoff this year, over 260 new students joined IHP faculty and staff in providing community service all over Charlestown and beyond on Friday August 20.   Pictures and a detailed story about community service day are available on the web site (www. mghihp.edu).

A week later, these same entry level students participated in the Institute's Annual Infant Development Day organized by the Physical Therapy Department.   This event, now in its 17th year provides the opportunity for entry level students to interact with typically developing children and their families, while learning to assess/observe motor, cognitive, language, and social development in very young children.  This hands on interprofessional experience is one that students find enjoyable and memorable.   I should add that it's one that their faculty members find exhausting!

Beyond this focus on first year students, the discussion that has begun has brought faculty members together, has generated discussions with colleagues from  the Boston Architectural College and the Harvard Medical School about the future of health care education.

In addition to our core values in diversity and in quality education, this area of interprofessionalism is emerging as both essential and distinctive in the IHP experience.    While the IMPACT curriculum is the central mark of the IPE student experience,  the "impact" goes well beyond this curricular focus.  Examples of the IHP interprofessional focus are seen in our Interprofessional Dedicated Units at Mass General Hospital (increasing to two this year), particpation by our NP students in the Crimson Care program with HMS students, the interdisciplinary grand rounds conducted by SHRS,  monthly Schwartz Rounds for compassionate care,  our own IHI chapter which has representation from several disciplines, and on and on.  Faculty members are busy planning multidisciplinary global travel and education experiences and research projects.

 Out distinctiveness will be seen and felt in our unique ability to produce remarkable new professionals who can practice "at the top of their professional license" while working with individuals from all health disciplines in putting the patient front and center.   That's the impact of IMPACT.