Walter Reed Blog

A Great 6 Weeks in the Nation’s Capital

 

 

Washington, DC Living

If you look beyond my 5am wake up, hour and half commute each way, $16.50 metro ride, and playing Frogger with DC traffic at a stop light that never seems to have a walk sign; I was lucky enough to get a clinical rotation of a lifetime from the University of Pittsburgh. I get to spend everyday at Walter Reed National Military Medical Center (Bethesda, MD) working with our nation’s veterans, their families and friends, and collaborating with medical professionals to provide them to best care possible.

 

Patient Population

I work in the Inpatient unit treating a case-load that includes patients with spinal cord injuries, amputees, cardio-thoracic surgery, total joint replacements, TBI’s, oncology, and a variety of other patient presentations. When I pick up a consult for PT, I never know what I’m going to be getting until I start doing the chart review- which really keeps me on my toes. This past week I was able to rotate through the hospital in a variety of settings including:

  • A day spent in the OR watching a soldier who had just arrived from the Trans-Atlantic flight and went through 12 hours of emergency surgery!
  • A day in Outpatient Traumatic Brain Injury where I was able to see a NueroCom Balance Master in action. And at the end of the day, I was able to be a “patient” and go through a balance assessment myself
  • A day spent in the Outpatient amputee rehab center where patients go after I see them in inpatient and they become medically stable enough to be transferred
  • An afternoon spent in the WC clinic where MD’s, PT, OT, the patient, and a WC vendor hash out the specific long-term needs of a patient.

 

The Action

Pictures can speak louder than words so I will take you through a couple patients who have truly inspired me.

 

Mat to Wheelchair Transfer

This individual above was set to go to medical school after his graduation from the Naval Academy but he decided to defer for 2 years to be an in field medic to see what it was truly like to be in a war and what his future patients would be going through. Unfortunately, he sustained a war injury himself. This is a video of him transferring from a mat to his WC. Pretty impressive!

 

1 Full Mile

This individual is a quadruple amputee who is honestly one of the funniest people I have ever met. Upon being introduced to him, he stuck out his left below-the-elbow amputation to shake hands with me. I greeted him with a shake of his residual limb, for which he promptly screamed out in pain!! Fake pain, of course, but it scared me half to death!! He promptly laughed, stating “gets you new kids every time”. This is a video of him 1 lap from his finish of walking a mile on his “shorties”. (If you look at the gentlemen walking backwards, you’ll notice he had a below the knee amputation. They make quite the comedic pair if I do say so myself).

 

 Return to Sport

   

At Walter Reed the goal for the Wounded Warriors is to get them back to everything they did before the injury. This includes hunting and fishing trips. Adaptive boxing and jiu jitsu zu (pictured above).

 

Sporting Equipment

          

They also adapt “regular” sporting equipment to each patient’s specific needs. The patient seen below is an avid biker who sustained a hemipelvectomy and with the help of a well-fitted prosthetic, is still able to enjoy riding his cycle.

 

Never Far from Pittsburgh!

          

          

And in case you were worried about me losing my Pittsburgh pride, don’t worry I’m getting my Pennsylvania fix in here in Maryland.

Kelsey R

July 25, 2012 |

Italy Blog

Blog from ‘Lo stivale’ or ‘The Boot’

 

 

Ciao!
It’s been 4 weeks now since I arrived in Italy and it is amazing! From the day I stepped off the plane to today, I continue to make new memories and realize how fortunate I am to have this opportunity.

 

Isokinetic Sports Medicine Group
I am doing my clinical in an outpatient sports clinic where I have treated patients from 8 years old to 87years old. Many of the patients are high level or professional athletes, including volleyball players, basketball players, Olympic skiers, and most importantly: “futballers” (or soccer players as we would say). The clinic is certified by FIFA, the regulating body for all international soccer, so players from all over the world are sent to our clinic to complete their rehab. Since the clinic treats professionals and “regular people” it is not uncommon to see a 60 year old women doing exercises right next to an Olympian, which I find to be incredible as I can’t imagine Kobe Bryant or Michael Phelps ever doing this!

 

 

 

The entire building is “one stop shopping” for the patients, as their doctor is just down the hall from the PT gym. There is also a swimming pool and  many soccer fields at the clinic which are used by the patients  Treatment consists of a certain number of sessions in the pool, gym, and field, dictated by the doctor and the patients progression. As for specific treatment, this is also dictated by the doctor with a detailed list of modalities (and they use a lot of them!), massage, type of strengthening and stretching. Due to the many modalities used and the high number of reps for TE’s (8×20 or 6×30), patients are at therapy for at least 2 hours, often 3 hours, which I guess is necessary at the cost of 80 euros per session. (Many patients don’t have insurance and pay out of pocket.)

 

Today I got to spend the morning on the field, playing soccer with some of the pros – ‘the Azzuri’. Including time on the field as part of the PT treatment is very interesting and beneficial to the patients. It allows the patient to get back into sport while still under the treatment of the doctor and the PT. The treatment progresses as any other treatment we are familiar with: starting off with basic running and walking exercises, then advancing to sport specific exercises with the ball, including shooting and agility drills. I was told the average time spent on the field after an ACL reconstruction is 6 weeks, ensuring the player is completely ready to return to competition with the team

 

Life the Italian Way
Life in Italy is seemingly much more relaxed: 2 hour lunch breaks, wine and limoncello during work , and laid back evenings with  dinner not until 10:00! I’ve spent my weekends trying to soak up everything Italy has to offer: Saturday morning market in Bologna, going to the beach in Rimmini and exploring Rome. My next stops will be Cinque Terre, Florence, and Venice.

 

 

 

The family I’m renting my apartment from is extremely nice, always making me feel welcome. They invite me over for drinks and delicious homemade Italian meals. As for the language, learning some more Italian would have been a good idea but it’s amazing what simple hand gestures and google translate can do!

 

I can’t believe how fast the time is going, but I miss everyone back home in Pittsburgh! Hope everyone is enjoying clinic!

 

Kaitlyn F
July 19, 2012 |

Newcastle Blog

Clinical Abroad – Newcastle, England

The turnaround time between our summer finals and my flight to the UK didn’t leave much room for last minute preparation. In fact, the reality that I was about to complete my first full time clinical abroad didn’t set in until I was descending into London. I’m happy to report that everything is going even better than I had hoped for!

My Clinical

My placement is at the Galleries Day Unit, an outpatient facility which specializes in falls prevention for older adults. Most patients have a history of falls, however others simply have identifiable risk factors that lead them to our clinic. We work with patients across the spectrum from basic balance and strength deficits all the way to advanced Parkinson’s and vestibular dysfunction. It’s an exciting place to be as a student and the people here are really committed to creating a positive learning environment.

 

The staff have gone above and beyond to make sure I am experiencing as much as possible while I’m here not only from a physiotherapy standpoint, but also across the continuum of care. Last week, I observed a physician in a syncope clinic where we refer a lot of our patients who have unexplained falls due to loss of consciousness. Yesterday, I spent the day with the ENT team who do in depth vestibular assessments. I even had caloric testing done. (If given the opportunity, never do this. Instant nausea.) Before I leave, I’ll even have the chance to do home visits. All of the effort and planning that went in to setting up this international experience has come back to me two fold. I’ll be very sad to leave when it’s over.

 

It’s obvious that our education over the last year has been extraordinary. The foundation that we built have has given me the confidence to make suggestions in clinic that have been very well received. Everyone at Pitt will be happy to know that I suggested measuring gait speed in our patients and I think we’re going to start doing it!

 

Life Abroad

There’s something so liberating about moving to a completely different place, especially when you know you have a limited amount of time to experience it. For better or worse, everything is an adventure. I spent the last three weekends exploring Northeast England. I hiked part of Hadrian’s Wall on Saturday and plan to do a lot more camping/hiking in a few weeks. There are so many castles to see and not enough time! I have also met some amazing people who are making sure I have all of the “proper” English experiences before I leave. They threw me a birthday party, took me to Sunday lunch, showed me a proper English pub with proper English ale, etc. I didn’t expect to connect with so many people so quickly and I definitely expect to settle in so quickly.

 

This really is the adventure of a lifetime and I’m so grateful that Pitt lets us have this opportunity. I’m happy that I can have such an amazing experience and yet miss everyone at home so much. It just reinforces that I’m in the right place.

 

I hope all is well back in Pittsburgh. Until next time, Cheers!

Lauren R

July 16, 2012 |

Buenos Aires Blog

Una Yankee en Buenos Aires

 

Hola todos!  Here’s a little update on how clinic is going here on this side of the world:

 

A New Country

So, it’s been a little over two weeks here and I still can’t believe how much I’ve learned or even really that I’m here in the first place.  I had no idea until about this time last year that we could even do a clinical abroad at U of Pitt.  The opportunity of this abroad clinical is just one more reason why deciding on Pitt was the right choiceDr. Susan Whitney graciously offered to call a vestibular therapist she knows (picture below), Daniel, and through more arranging and calls to friends on his part I’m now living with his mother-in-law, Nelly (my real life fairy godmother who is taking such unbelievably good care of me), having dinners with his family and friends a few nights a week, and observing in one of the best rehabilitation centers in Latin America.  I really couldn’t have asked for anything more, especially since this experience has already been so much more than I could have even imagined.

 

The Warm Welcome (Both People and Weather)

The people in Argentina are really incredible.  They’re very warm, inviting, thoughtful, and filled with energy to live that they love to share (which really reminds me of DPT 2014).  This translates to everyday life here in clinic and at home.  I already felt like part of the family on day one when his wife, Samantha, picked me up from the airport and I met their two sons ages 2 and 5 who are absolutely the cutest nenes ever.  I may be a little biased since we were all dancing together in the kitchen within hours of meeting them, but a couple of you have met them on skype and can attest to the absolute cuteness.  It has also been perfect to have the chance to hang out with them and learn a couple songs and games in Spanish that have already been helpful in clinic.

 

 Lauren and Daniel at the Course

 

Pediatric Clinical Experience

Clinic has been amazing so far.  I’m really only observing, but since it’s my first pediatric clinical and it’s all in Spanish it’s really been enough to take notes, ask questions, and help out when I can.  The facility is amazing and the way they care for their patients is pretty exemplary.  It’s a private rehab center so they have the opportunity to spend hours in intensive therapy with the kids and have the tools they need to help out in any way they can.  Here is the website with a couple pictures of the facility to check it out:       http://www.fleni.org.ar/multimedia/144     There aren’t any photos of the pediatric area or the gait lab but I’ll see if I can snag some of those before I leave in mid-August.

 

 Working Together

From what I’ve seen at FLENI, they put a lot of energy and time into practicing interdisciplinary care between specialties and being sure to use each other as a resource throughout the rehab process.  So far I’ve been mostly in El Laboratorio de Marcha (Movement Analysis Lab), where gait studies are conducted for patients as part of determining treatment plan, and outpatient pediatrics.  There’s so much about it I’d like to share, but I’ll send that soon.  Let’s just say though that it’s a really good thing we just had our first ped’s class and a biomechanics course before I got here.  My Spanish is alright, but without the background information in these areas I’d be totally lost.

 

Never Far from Pitt Family

What I wanted to share though was that yesterday I attended the II Encuentro Nacional de Terapistas Vestibulares headed up by Daniel.  It included a full day of classes on themes related to vestibular therapy, tests and measures, and fall risk in the older adult population.  It was extremely informative and it was great to be part of what turned out to be an international discussion of about 50 physical therapists.  I understood about 95% of what was said (thanks again to the year of education we’ve got going for us more than my language skills).  Also, I was pretty excited to see Pitt being talked about in Buenos Aires.  Dr. Whitney’s vestibular research was somewhere within each of the courses that had to do with anything vestibular.  It was quite impressive and if definitely made me miss all of you back in Pittsburgh!

 

Hope clinic is going amazing back at home!! I’m sure everyone is doing an amazing job and loving a lil break from classes.  Talk to you soon!

 

Muchos abrazos de oso y besos de Buenos Aires,

 

Lauren B 

July 15, 2012 |