GEAR UP Colorado – Diversity Day at Regis University’s Rueckert-Hartman College

Josue Martinez, SPT Class of 2023

On October 16th, the health professions making up The Rueckert-Hartman College for Health Professions, hosted a Diversity Day event for the GEAR UP Colorado program. The programs involved included the School of Pharmacy, Physical Therapy, School of Nursing, and the Division of Counseling and Family Therapy. The goal of this event was to introduce and inform the many high schoolers who are a part of the GEAR UP Colorado program to the various health professions available to them after graduating high school. The day also provides an insight into what it is like to be a student in the health professions at Regis University.

Back in 2011, I attended my first after school GEAR UP program in Washington. At the time, it was a great after school program where kids could gather to finish up homework, reading assignments, or receive tutoring. In the decade since I last attended, it has evolved into so much more. The federally-funded pre-collegiate grant program now aims to increase the number of low-income students who are prepared to enter and succeed in post-secondary education. The program now includes one-on-one mentoring and advising, college preparatory curriculum, financial aid literacy, STEM programing, college-level examination programs, and college visits, such as the one that took place last weekend.

Diversity Day at Regis kicked off on schedule with students from Arvada High and Adam City High school stepping off the bus at 9:00 am. Upon entry, students dropped off their signed consent and waver forms to participate in various activities from each department. You could feel the excitement in the air. In particular, the students could not wait to get into the cadaver lab as they asked, “When do we got to see the bodies??” Before the day could officially begin, the students were greeted with breakfast and a warm welcome from the Assistant Dean of Undergraduate programs, and our very own, Dean and professor, Mark Reinking.

We began our educational activities with a game of Jeopardy, with questions categorized by health profession. With each question, students would learn more about each profession, the kind of work involved, and the education required. Following Jeopardy, the kids were broken up into groups to explore activities that each health profession had set up. Niko Rodriguez, another SPT from the Class of 2023, and I had the kids participate in an impairment race. They were briefly educated on typical gait and then took a practice lap around the room. Then, we assigned and taught each of them a gait impairment, such as gastroc contracture or weak quadriceps. When the race began, each student struggled to adapt to their gait impairment. Toes dragging along the carpet was a great demonstration of a weak tibialis anterior, along with hyperextended knees as the students attempted to shut off their quads. The result of the activity was a slower gait speed, but more importantly, a visceral insight on what it’s like to live with an impairment.

The Gait Impairment Race Team – SPTs in the Class of 2023

The afternoon had several great activities lined up as well, but students still asked, “When do we get to see the bodies??” Cliff Barnes, our renown anatomist, along with first and second year DPT students, did not disappoint as they educated high schoolers on human anatomy and the invaluable resource that the cadavers provide our program.

The day was concluded with an inter-professional skit: an anxious, hypertensive skier had broken his tibia and while maintaining a prescription drug dependence. This may have been the most enjoyable part of the day for faculty, the students, and me as the patient proved hilariously difficult to manage for the nurse, pharmacist, councilor, and myself, the physical therapist. From the onset of injury to beginning outpatient physical therapy, the students received valuable insight on the care each health profession provides along the line of treatment.

I had the chance to speak one-on-one to a few of the students who attend the event and hear what they had to say about their experience on campus. Lexi, a 16-year-old sophomore from Arvada High said, “I had fun and it was a really inspiring experience. I enjoyed getting around and being active with the impairment race. I may end up looking into physical therapy to help people with their disabilities because of this experience.”

Jorge, a 15-year-old sophomore from Adam City High said, “I play soccer and I’ve had an ankle injury in the past. The recovery was frustrating because it limited me, but physical therapy helped a lot. I really enjoyed this event and thought it was cool and insightful.”

Heidi Eigsti, our Director of Graduate professions gave her thoughts on the event, as well. “I love seeing that we can get kids from underrepresented minority population sand at-risk high schools into our building interacting with our students and seeing what’s possible for their future.”

Sung Yi, a second year DPT student summed up this experience very well: “I didn’t have the opportunity to have this exposure; neither did my friends. Maybe if they had had this exposure things would have been different for them…I think it’s interesting that they always talk about endless potential. They feed that to us and everyone who’s young. But the thing is, potential can only be endless if you have the resources. If you don’t have the resources, potential is very limited.”

On a personal level, helping put together this event was very rewarding. My hope is that each of us who participated in the Diversity Day had the opportunity to be a resource for this underrepresented and under-served community. My hope is that by being part of this event, I helped a kid realize his or her own potential.

Clinical Education I Experiences – Short Stories from the Class of 2023

The Class of 2023 returned from their first clinical rotation at the end of September and had some time to reflect on their experiences. A few of them are written up as short stories of lessons learned below. Take a trip to the Gila River Indian Community, AZ, Oregon City, OR, and Grand Junction, CO.

Carson Ariagno – Gila River, AZ

I was exceptionally nervous going into the beginning of my first clinical. I hadn’t prepared as much as I’d wanted to, I’d had to last-second book new housing as my original plan canceled on me the day before I left, and I’d gotten a speeding ticket while on my 13-hour drive down.  Not my best start. But once I was welcomed into the clinic, all that fear and confusion melted away. I realized relatively quickly that I needed to be a face of calm confidence for many of these patients. This became a personal goal for myself in addition to the spread of more typical academic and professional goals I set with my clinical instructor (CI).

I spent my first clinical experience on Gila River Indian Community land just outside Phoenix, Arizona. This group of tribes have lived in southern Arizona since around 300 BC and have endured aggression and marginalization at the hands of the Spanish and American governments throughout history to this day. Most notably, their primary water source in the Sonoran Desert, the Gila River, was blocked off and dried up in the late 19th century by American farmers. The Gila River tribes were given federal aid in the form of processed and canned foods after almost 40 years of mass starvation on the reservation. These cheap foods may have saved lives from starvation but helped lead to widespread obesity and diabetes, two conditions which still disproportionately affect the community. As of a 2008 study, there was a 47% adult obesity rate, a 50% adult type 2 diabetes rate, and a 20 times higher rate of kidney failure than the general American population. This ongoing health crisis affecting the community creates more complex patient presentations, especially in PT.

Nearly every patient that my CI and I saw in my six weeks was diabetic and about three quarters of them were overweight or obese. A couple had had amputations related to their diabetes; more were threatened with the risk of needing one soon if their condition didn’t improve. This level of additional complication combined with relatively difficult presentations created cases that really challenged me for my first time in clinic. This difficulty and the endless support of my CI made this experience more enriching than I ever could’ve imagined. Along the way, I learned from our patients bits of their language and much of their history as well as many aspects of day to day life for those still living on the reservation. One patient in particular opened up to me with some personal stories on the third or fourth time I saw him. He’d lived a very difficult life growing up in poverty on the reservation, experiencing some tragic losses along the way. He had a variety of health problems begin to develop around the time he turned 30, diabetes and a torn knee ligament among them. He lamented to me about how difficult life had become in the nearly 20 years since then as he gained large amounts of weight while being unable to receive sufficient medical care for so many years. But now that he’d started PT, he felt like he was beginning to regain control. The relatively recently-opened outpatient center our clinic was in gave him access to so many services he really needed and was so thankful to receive. He has now lost his first 50 pounds and is well on his way to successful rehab of his knee and back.

This was a running theme with varying severity for many patients – this health system was their first and most consistent source of care in a long time if not ever. It was wonderful to see the progress many of them finally were able to make and the difference that truly attentive, available care can make for people in need. Every provider was interested in providing as much patient education as they wanted to hear to continue breaking down the barriers of healthcare hesitancy that exist in the older members of the community. Many of them had felt, seen, or heard stories from the not-so-distant American history of medical and governmental mistreatment of their people. Especially now as we tried to promote the COVID-19 vaccine, there were still walls of deep-seeded distrust to be broken down. Progress is being made and more and more people are getting the help they need. The Gila River Health Care organization is doing invaluable service for the community on the reservation and will continue to improve their health outcomes and relationship with healthcare as a whole. My time there was extremely well-spent and I cannot thank them enough for taking me in.

David Shaw – Oregon City, OR

This story is about an ongoing learning process that really took center stage during my first clinical experience. As a developing physical therapist, I am learning how to best utilize my time and attention while working with patients. Having worked in clinics as a physical therapy aide for 4.5 years before beginning physical therapy school, I understand the importance of maximizing time in the clinic. Furthermore, I have discovered the most valuable use of time is often patient education. Whether this entails educating patients about anatomy, tissue healing times, avoiding harm, and/or exercises to do on their own, all forms of patient education should empower people to take matters into their own hands.

I hold a large amount of pride in my work, and I know that a lot of people do; however, the amount of pride I have sometimes leads me to feel like I didn’t provide the best experience possible for a patient. In hindsight, I would like to reflect on one patient interaction that I will remember forever. (I will be leaving out a lot of information for the sake of patient privacy.) 

Before seeing this patient, I was briefed by my clinical instructor (CI) of what his hypothesis was, and how to navigate the patient and their mother while in the clinic. However, my CI emphasized that I should try to create my own hypothesis as it would be great to have a fresh set of skills to provide them with another opinion. The child came into the clinic with their mother, who was curious about the existence of a motor tic disorder and had been seeing a neurologist about it. The tics were few and far between during my time with the patient. I was beginning to question what the real issue was. It seemed as though the patient was consciously producing the tics, and seemed to coincide with pain in their shoulder. I’m not convinced that the child shared this information with anyone before me that day.

After talking with the patient more and performing some examination measures, I conveyed my hypothesis for this patient to them and their mother. My hypothesis was that they were experiencing episodic shoulder pain due to inflammation related to overuse of a specific muscle in their shoulder. However, what this patient really needed was more stability and strength coming from other muscles so the affected muscle and its tendon wouldn’t inflame and cause the patient to be limited in their daily life. What I didn’t consider at that moment is the effect the words that I used would have on the patient, via their mother who works within the pharmaceutical industry.

The words “inflammation” and “inflame” caused the patient’s mother to believe that all they needed was anti-inflammatory drugs and rest. This took a rapid adjustment from me to educate them about working through comfortable motions in order to improve shoulder stability and strength overall, so that their shoulder problem doesn’t become a chronic issue. It took some attention to detail to attempt to change their mindset. Reflecting on how I went about what I said, I know I could have done a better job. When this experience came up with my CI, I was able to begin letting go of the related burden I immediately felt when they left the clinic.

Physical therapists (PTs) can help everyone, not everyone feels that they need help from a PT. It’s our job as PTs to contribute to healthy and positive healthcare interactions for all patients. We should always ask for consent and know when to treat or when to refer. We should always reflect on our approach and methods and continue to improve from within for the sake of others. Finally, we should want people to trust in our knowledge, experience, and honesty, so they may feel comfortable thinking of us as their primary care providers (PCPs).

Although healthcare is a large system, I have seen that a PT being someone’s PCP is possible. But just because it is possible, doesn’t mean it is necessary. After all, we should be advocates for people seeking to improve their health, physical therapy or not. We must continue let go of our burdens to learn from prior experiences and move on to help the next patient. For some this may require a regularly scheduled vacation, meditation, and/or further education. But one metaphor must remain in the back of our minds: “You can lead a horse to water, but you can’t make it drink.”

Alan Scheuermann – Grand Junction, CO

In August and September of 2021, I spent six weeks at a clinical rotation working in the outpatient unit of Community Hospital in Grand Junction, CO. This was my first clinical experience and was full of so many unknowns and new and challenging experiences that parts of it feel like a dream instead of a formative professional and personal journey. While the overall experience was undoubtedly positive, there were certainly difficult and uncomfortable experiences, both anticipated and unexpected.

I spent the week leading up to clinical trying to review information I thought would be relevant in order to have as much information fresh in my mind as I could. My greatest anxiety in the days before my first shift was looking silly in front of my clinical instructor (CI) because I forgot what nerve innervates a specific muscle or couldn’t remember the normal range of motion values for a shoulder patient. What I came to realize fairly early on was that there is a chart for everything, and while there are certainly specific values and landmarks that it helps to be familiar with, the world would not explode if I had to look something up. Besides, I was happy to discover that I retained much more information that I thought I had from my first three semesters of PT school. I felt that I could carry myself in such a way as to give patients confidence that I had rationale for exercises I would ask them to do, and that they would ultimately benefit from my care, despite being a student. I found my CIs to be incredibly supportive, thoughtful communicators, and overall good people who I enjoyed spending time with and working under.

Apart from my CIs and patients at the clinic, I had relatively little social contact with other people during my clinical. I was in a town where I knew only one other person, a childhood friend’s brother, and felt so burnt out at the end of most days that more social interaction was the last thing on my mind. I usually consider myself to be someone who does fairly well being alone, but I had to admit to myself that by the end of my rotation, I was ready to be back in Denver with my girlfriend, cat, family, and friends. I found myself wishing for the comfort and ease of hanging out with old friends or having a quiet night at home that I was unable to recreate in Grand Junction. I took advantage of the world class mountain biking and trails in the desert surrounding Grand Junction and loved every minute of it but would find that there was a need for social support that was going unmet in the time between bike rides and work shifts. As I begin to rationalize what my second clinical will be like, I know that developing relationships in an unfamiliar city will be key to enjoying and growing from my experience to the fullest extent.

One of the highlights from my clinical rotation was working with a patient who I’ll call Cheryl, which is not her real name. She was an older patient who had fallen while out walking and broken both of her kneecaps, one of which required surgery to repair. Despite this significant trauma, Cheryl was generally upbeat, excited to be at therapy, and was very validating towards me as a student PT. Naturally, we were working on lots of balance work with Cheryl, and she frequently commented that she felt safe performing difficult balance tasks with me guarding her to prevent her from falling. She approached PT as a way to find things that she did not feel comfortable doing and working to improve in those areas. She was always eager to challenge herself. On my last day of clinical, Cheryl took several minutes at the end of her session to look me in the eye and tell me that she enjoyed working with me and truly believed I will go on to be a great PT. The sincerity and thoughtfulness of her comments acknowledged the professional transformation I had undergone during my first clinical and helped to push back the soft voice of insecurity lurking in the back of my mind, and I will forever be grateful.

Looking for more stories from CE I? Find a second year on campus and ask, there are so many more to tell.

A Letter From A DPT Student, And A Survivor

trigger warning: this post contains descriptors of sexual assault

Dear reader, 

Thank you for taking the time to make your way here. This letter was a months-long process with much of that time being spent staring at a blinking cursor through my blue light glasses. I stepped away for a good while‒eight weeks to be more precise. While my classmates were hunkering down and crushing their practicals before our second clinical, I was wrestling with the heavy weight of my trauma. This was a familiar fight, and I felt myself succumbing to this monster that I grappled with for so long. 

The journey of healing is harrowing. Some days I am climbing and distancing myself further and further away from the dark depths below me. Other days, the ground disintegrates beneath my feet and I tumble down into what I fought so hard to stay away from. This is when I feel the most alone…the defenseless. I am not alone though, and I do not want you to feel like you are alone. I am here too, and I want to share my story with you. 

I’ll take you back to Fall 2019‒when the Class of 2022 was in the midst of anatomy group presentations. Five of my classmates were detailing the anatomy, physiology, and implications of the pelvic floor and perineum. With a topic as intimate as this, beads of sweat began forming on my hairline as a cold clamminess filled my palms. The tears lining my eyes morphed everything into blurry pixels, and one blink allowed my mind to focus sharply onto the slide detailing physical therapy implications: “sexual trauma survivors”. 

As my classmate described the correlation between sexual abuse and pelvic floor dysfunction, I was shutting down. I trembled in my seat, and like a volatile fault line, the quake I felt caused the room to collapse around me. When the walls crumbled down, I felt scared and exposed. Everything I felt during my sexual assault bombarded me: panic, fear, confusion, and helplessness. Here I am learning to help others while desperately needing help for myself. Am I strong enough to be here? The doubt was overwhelming, but it was not forever. 

 
Some mornings I wake up and invite the warm sunshine into my body and allow my spirit to be nurtured‒these are better days. Other times I feel as though the sun becomes a lighthouse‒salvation that is desperately seeking me out in the darkness overpowering me. These are days when I feel delicate and more susceptible to triggers. These are days when I feel just as paralyzed as I did during the night when I was nothing more than just a body.

Have you ever been somewhere that was so dark that you could see more light when your eyes were closed? Imagine an innocuous fly landing on your cheek and the sudden panic felt as your mind frantically eliminates the malignant possibilities for the unforeseen startle. Your brain swiftly concludes the threat as merely a harmless fly, allowing your body and mind to settle in a matter of minutes. This is the best analogy I can offer to illustrate the triggers for a sexual trauma survivor. Please keep in mind, every survivor’s story and recovery is different; however, a parallel can be drawn amongst many survivors for the petrifying dread accompanying a trigger. The mind is violently dragged into painful memories where trauma admonishes the survivor for seeking safety‒even if the initial shock following the violation has dwindled. But it is never truly gone, and that is where recovery resources for survivors of sexual assault is crucial. 

Chanel Miller (courageous and compelling author of survivor memoir Know My Name) communicates the complexity of trauma recovery eloquently: 

“Trauma provides a special way of moving through time; years fall away in an instant, we can summon terrorizing feelings as if they are happening in the present.”

It almost sounds like a super power, doesn’t it? But we never asked for this nor could we fathom possessing something so fickle and toxic in our bodies. You may need help mitigating the noxious jolt of trauma, and that is 100% okay. It’s normal, and the acknowledgement is powerful. Maybe you will find solace with a counselor, support group, or something else that works for you. Take it from me, healing is exhausting‒It is still exhausting. Remember to be patient and forgiving with the healing process, and be gentle with yourself. You have endured so much distress‒now, you will experience kindness and peace. 

Physical therapy is a very hands-on profession. Chances are you have heard this a million times in physical therapy school. While it is certainly true, this statement has a lot more depth for trauma survivors. In my case and that of many others, that trauma stems from a touch influenced by violence and control. When the body is forcibly taken to be nothing more than something to pleasure a monster, the world changes. Author of The Body Keeps the Score, Bessel Van Der Kolk, articulates this devastating shift:

“After trauma, the world becomes sharply divided between those who know and those who don’t.”

Those who understand the pain and those who don’t. Those who live in the same nebulous shadows and those who don’t. Sometimes the depths are so deep and so dark, it’s nearly impossible to see the light that physical therapy can bring. Trauma-informed care is one tool we can use to shine our light for survivors of sexual assault and rape. With that, we have a responsibility to manifest the physical therapy profession as one embedded in our unparalleled ability to rekindle compassionate and benevolent touch. As Regis’s Blessing of the Hands ceremony draws near, we know our hands are the strongest tools we have to validate the distinguished value of our profession. Let us be the amazing healthcare providers we know we can be. 

Sincerely, 

Arianna Armendariz, A 3rd year DPT student, a sister, a daughter, a friend, and a survivor.

Acknowledgements:

Thank you to our wonderful blog director, Suzanne Peters, for sharing my writing on this platform. 

Thank you to my family, especially my mom and sister, for your endless patience and support as I heal.

Thank you to my boyfriend for your incredible patience and fortitude over the last five and a half years. The gratitude I feel for you is insurmountable. I love you.  

Thank you to my current therapist and former therapists for helping me gain back my strength and self-worth. 

Thank you to my friends for your graciousness: Camille, Alyssa, Lauren, Ashley, Shannon, and Jess. 

Thank you to the many wonderful Regis faculty members who have shown tremendous kindness and understanding: Shelene, Mary, Heidi, Jean, Larisa, Mel, Rebecca, Amy, Wendy, Nancy, Rachel, Stacy, Drew, and Erika.

Finally, thank you to the entirety of my Class of 2022. You know you are ReSiLiEnT. 

Resources:

  1. Regis Center for Counseling and Family Therapy

303.458.3507

  1. CCASA – Colorado Coaliton Against Sexual Assault

www.ccasa.org

  1. Rape, Abuse, and Incest National Network (RAINN)

1-800-656-HOPE

www.rainn.org

  1. One in Six

www.1in6.org

  1. National Domestic Violence Hotline

1-800-799-7233

www.ndvh.org

  1. Stalking Resource Center

www.ncvc.org

  1. Anti-Violence Project

Bilingual hotline: 212-714-1141

www.solcolorado.org

  1. Safe Helpline

877-995-5247

Regis DPT spends the day with Porter-Billings Leadership Academy students

On June 16, Regis University Doctor of Physical Therapy (DPT) students of the Class of 2022 and 2023 had the opportunity to introduce the physical therapy profession, in all its forms, to the students of Porter-Billups Leadership Academy (PBLA). The Porter-Billups Leadership Academy is an organization started by former Regis University Men’s basketball coach, Lonnie Porter, and NBA star, Chauncey Billups. This organization serves over two hundred and fifteen 4th-12th grade students with the intent of providing academic and leadership training to at-risk inner city students in Denver.

With the goal of introducing the profession of physical therapy to students of all ages from a wide range of racial and cultural backgrounds, Regis University DPT students spent two hours sharing their love for physical therapy with PBLA students through various physical therapy related activities. Students of every age group participated in activities designed to demonstrate the integral roles our muscles, brain, and cardiovascular system play in our day to day life and in our overall health. From getting their heart rate up during ultimate frisbee to receiving electrical stimulation to get muscles activating, students were immersed in all things physical therapy.

Fourth through seventh graders received instruction on how to apply kinesiotape and athletic tape to help reduce pain at different joints, how to measure grip strength and improve balance, and understand the important role our heart plays in our health. Eighth through tenth graders analyzed the different phases of overhand throwing, practiced with electrical stimulation to facilitate muscle activation, discussed strategies to manage mental health, and conversed with Regis University students about college life. Eleventh and twelfth graders were able to participate in a weight lifting session, participate in a guided activity in the cadaver lab, and discuss how to choose a college and a major.

Personally, this event furthered my pride in being a member of the Regis University School of Physical Therapy. Following a year of minimal interaction with our peers and the community, this event showed the value of gathering with the intent of furthering the good of our neighbors and ourselves. As students, we have a deep sense of gratitude for the opportunity to interact with the PBLA community and share our love for our profession. Regis University students reflected on the experience saying:

“I grew up in an area that would have benefitted from a program like PBLA. It’s heartening to see young people of color have the opportunity to thrive. I am thankful to have been part of this experience and hope to help out again next year!” -Sung Yi, Class of 2023

“Having lived in Denver for over 4 years now, I strongly identify with the greater Denver community. PBLA was a great experience for me to show up as a leader in the community, and represent Regis University and the DPT program. Getting the chance to interact with the students gives me great confidence that the students will become leaders in their life, in their own way. I hope they learned something of value from us, and I can’t wait to participate again!” -David Shaw, Class of 2023

“Volunteering in the cadaver lab for PBLA was such a fun experience! I loved being able to help the students discover the different parts of what their future could hold and show how unique of a learning experience the cadavers are!” -Sam Snyder, Class of 2023

“PBLA has been one of the most fulfilling service-learning experiences I have had at Regis. Being able to engage, play, and create with the students reminded me of how valuable such experiences are for young students. I am so proud of the team and fellow students who made this opportunity possible and looking forward to see our relationship with PBLA grow.” -Victoria Patton, Class of 2023

“It was so fun to work with the kids and learn about what they are excited about and interested in so that we could cater what we wanted to teach them to what they cared about. I loved having an opportunity to connect with and learn from an age group that I ordinarily wouldn’t have much opportunity to work with.” -Micah Boriack, Class of 2022

“It was so fulfilling and rejuvenating to share my love for physical therapy with the students and allow them to experience what our profession has to offer. Seeing the students get excited about modalities like functional electrical stimulation and start to think about ways to utilize modalities for various impairments was so incredible to see, and my hope is that we have planted the seed and have gotten the students excited about potentially pursuing a career in physical therapy one day.” -Brittney Martinez, Class of 2022

We want to extend our gratitude to the PBLA leadership, teachers, and students for allowing us into their community. We hope to further this relationship in the coming years and continue to share our love for physical therapy with the many talented and joyful PBLA students who experience Regis University each summer.

Check out PBLA’s website here! https://www.porter-billups.org/

Reflection by Annie Fleming, Class of 2022

Couch to 5k 2021

One of the mainstays of the Regis DPT program is the Move Forward 5k/10k race that is hosted every fall by current SPTs. It was created as a community outreach program and benefits Canine Companions for Independence, the puppy training volunteer organization the DPT program works with to help train future service dogs (read more about our newest puppy, Clover). Recognizing that not everyone is ready to jump up from their desk and run a 5 or 10 kilometer race, students have put together a couch to 5k training program that is free to the community to help prepare for the race and generally be more active. This initiative is spearheaded by Kelly Stevens and Tanner Williams of the Class of 2023.

The training program is a 9-week evidence-based training program developed by the National Health Service (NHS). This specific program was designed for beginners to gradually build up their running ability so they can eventually run 5 kilometers without stopping. The training program is embedded in the Couch to 5k website and has a free downloadable app to go with it on your phone. The team has also created a Strava community (run tracking app) where interested individuals can upload their run logs and interact with others who are in the same training program. There are even suggested routes to run if you’re unsure of where to start in the real world. And, starting Tuesday, June 22nd for three consecutive weeks, three 20-minute running workshops will be posted to the website to help get people into the world of running. Workshops will cover everything from nutrition to gear to warm up and cool down so you’ll have a good overview of how to train even beyond the running itself. The workshops will culminate in an hour-long live Q&A session with a panel of students running the training program on Tuesday, July 13th in the evening.

You might be thinking, “Wow, this sounds like a big commitment. I don’t know that I am a runner.” You’d be surprised by the number of people who share the same sentiment. Even Kelly Stevens, the program’s Outreach Chair, who plans to do the training program right along side you, wouldn’t call herself a runner, per say. She approaches running from a different perspective than the mile-counting, second-checking intense runners you see training for ultras on the side of 36 on the way to Lyons. Her plan for this program is to end it feeling like part of something bigger than she was before starting it; to feel like she accomplished something the days she does training runs; to meet people in her community. “Activity plays a large part in my own well-being and interaction with people.” She is excited to find a way to use technology to connect people to an activity that is inherently physical and thinks that the outreach portion of this operation will be a challenge coming out of the Covid-induced isolation we have all been experiencing. Now that the world is opening up again, she is hoping to connect others to running who have not seen themselves as stereotypical runners. Kelly believes running is not always about having to top your PR or win the next race, that it’s more than that. Her approach is less competitive with no expectations and just doing what you can where you are right now. It’s not about having the best shoes or the most aerodynamic clothing. “Some people don’t even run in shoes!” Kelly says. “People need reassurance that they can do it and it doesn’t have to be how they see other people doing it.” So if you’re looking for a reason to give this a shot, Kelly will be cheering you on the whole way from right next to you (virtually).

Tanner has taken a less running-centric approach to his role as part of the leadership of Couch to 5K. He doesn’t identify as a runner himself but understands how running can become a shared interest, which is where he intends to spend most of his energy. Tanner is big on community connection and finds exercise is a great way to make those connections. He is passionate about engaging community members and creating a healthy community in an organic manner through shared interest. He is hoping that people in the Regis community and neighboring areas will meet on their running journey and create new connections, expanding their social resources and getting to know their neighbors. Tanner’s plan for Couch to 5k is that families who are unfamiliar with others in their immediate area will have the opportunity to get to know each other and be active at the same time, creating sustainable long-term relationships. “Running is simply the vessel for bringing families together,” he says.

So dust off those trainers, check out the Couch to 5K training page, and let’s get running!

“What does it mean to be American?” A Reflection by Sung Yi, Class of 2023

Home - The Asian American Pacific Islander Heritage Month of Learning

May is AAPI Heritage Month, a time in which we honor Asian American, Native Hawaiian, and Pacific Islander communities.

However, it cannot be limited to a single month out of the year. As we acknowledge and celebrate the influence and contributions of AAPI leaders in this country, we also must call out the alarming rise in anti-Asian discrimination and hate crimes. Given the history of this country’s failure to protect and stand with the AAPI community, these recent acts of targeted violence are neither new nor acceptable. According to Stop Asian Hate, there have been 6,603 hate crimes from March 19, 2020 to March 31, 2021 and these are only the incidents reported online.

AAPI Frontline: Essential workers during Covid-19 | NBC News

Here I reflect on the incredibly diverse languages, cultures, migration stories, and multifaceted identities that make up generations of our AAPI community. One question that I kept coming back to was, what does it mean to be American? I was born and raised here in the United States, I pay taxes every year, I have a dog, I am married, and I speak English. Does this make me American? Do these characteristics earn me the right to feel safe in MY own country? At what point will I no longer be seen as an outsider and be accepted as an American? When will I or other AAPI individuals finally be welcome to be a part of this country, rather than navigating this society feeling like an “other”?

Documents show that the first Asian Americans arrived during the late 1500’s in present day California. Chinese and Filipino Americans fought for the Union in the American Civil War. Chinese Americans were the predominant labor force in building the transcontinental railroad. The Page Act of 1875, prevented Chinese women from immigrating to the United States, marking the first restrictive immigration law in this country. The Chinese Exclusion Act of 1882 prevented any individual of Chinese descent from immigrating to the United States, the only law in US history to exclude a specific group of people based on their ethnic/racial background. The Immigration Act of 1924 restricted all Asian immigration and Alien Land Laws prevented land ownership. Executive order 9066 called for the incarceration of all 120,000 Japanese Americans and approximately 75% of those incarcerated were United States citizens. The brutal murder of Vincent Chin by two white Americans only serving three years of probation. The LA Riots of 1992 which led to over $1 billion in destruction to Korean American owned businesses because law enforcement abandoned this community. The World Trade Center attacks on 9/11 led to the alarming increase of hate crimes committed against the South Asian Sikh community because of their turbans. These moments in history repeat itself until we as a collective can reckon with the harm caused, the healing that must be done, and the compounded generational trauma yet to be unpacked. The AAPI community once again fears for their safety, fights for the humanity of their elders’ livelihoods, and demands that this country confront this history of xenophobia and racism that continues to persist.

I share these examples to portray a common theme: a country with a deep-rooted history of scapegoating and dehumanizing Asian Americans, Native Hawaiians, and Pacific Islanders. AAPI’s have been blamed for labor shortages, poor wages, poverty, and a threat to western values and the safety of all Americans. I became aware of the AAPI experience in the United States as an American Ethnic Studies (AES) major during my undergraduate studies. Up to that point, my education of American history did not include me or anyone else that looked like me in the textbooks. The first AES class I took gave me a sense of belonging that I had never felt before. I realized then the power and necessity of representation. Diversity is great but it cannot be all that we strive for; when we push for inclusivity, we give everyone a seat at the table to influence decisions that affect their communities. 

There is an ongoing, concerted effort to ban AES in US education because they incorrectly believe that it promotes divisiveness and hatred toward white Americans. I saw this quote online that is true to my experience as an AES graduate. “Ethnic studies did not teach me to hate white people. It taught me to love myself. It didn’t instill anti-American values in me, it showed me that I had been a part of American history all along.” But it also showed me a history of atrocities rooted in discrimination and pitting communities of color against one another that has fueled the hatred we are forced to confront today. 

I never thought that I would live during a time where I would have to relive the trauma of previous generations. I never thought that I would fear for the safety of my parents or my wife’s parents and grandparents for these reasons. I never thought that a family with roots in this country since the 1890’s would have to fear walking down the street to their dentist appointment. My wife is a 5th generation Japanese American as well as a 3rd generation Chinese American. My wife’s grandfather was placed into an incarceration camp at 12 years old, he served in the United States Airforce, and worked for Boeing over 30 years. For better and worse, he is a part of this country’s history. Yet, my wife and I felt immense pain having to inform him, as well as the rest of our family about the potential dangers of going outside – even in broad daylight. Could today be the day someone decides my family is less worthy to live a life free of harm than their own grandmother, mother, grandfather, or father?

I am not the reason there is COVID-19. China is not the reason there is COVID-19. The fault falls on incompetent leadership and an inadequate response that instead decided to once again put the AAPI community in harms way as evidenced by the 63 elected officials that voted against the COVID-19 Hate Crimes Act. Regardless, the passing of the COVID-19 Hate Crimes Act is nothing more than a mirage, an empty promise that will not deter these attacks until these crimes are persecuted more severely. I can only hope that meaningful substantive change awaits the AAPI community in the near future.

So here I am again wondering what does it mean to be American? What can I do or say to no longer be blamed or pushed aside? Nothing. I cannot do anything more nor should I have to do more to prove my worth as an American. It is up to the members of society to fight with the AAPI community. I ask you to go beyond a month-long celebration and to see how you can show up for our AAPI students, staff, and the local community. Together, it is up to us to create the change our communities need and deserve.

City College events celebrate Asian American and Pacific Islander Heritage  Month

Four-Legged Clover: A Canine Companion for Independents

You know her, you love her, but what do you really know about her? Here’s the inside scoop from our own Andy Littmann on life with his four-legged Clover.

Clover came to live with Andy this year on January 6th at the age of eight weeks old. As a first-time dog dad, Andy says the experience has been just as much about training him as it has been about training Clover. As a volunteer puppy raiser for Canine Companions for Independents (CCI), Andy went through a rigorous application and vetting process over the course of a number of months that included a home assessment and a whole year of waiting once he was approved. With five days’ notice, he was informed that CCI finally had a dog who needed a trainer and a home. And that is how Regis’s puppy training program gained its eighth puppy.

The Regis puppy team is made up of four HES undergrads and two DPT second years, led by Andy and mentored by Shelene Thomas. The two SPTs, Erin Brown and Joseph Shaffer, have previous experience on the puppy team working with Nubbin when they were HES undergrads. Nubbin is one of Regis’s success stories – she has grown up to become part of the Fullerton County Police Department in California (look her up under K9 Nubbin). It may come as a surprise, but only about 40% of all the dogs who enter the CCI program are placed as fully trained professionals. After 18 months with a puppy raising team, each pup goes to the CCI facility where he or she trains with a professional for an additional six months prior to testing for placement. The dogs are placed into one of four categories based on temperament and ability: a companion dog (not the same as an emotional support dog) like one of Regis’s first dogs who was placed with a young man in a wheelchair; a facility dog, like Nubbin, who works with families undergoing trauma (she’s laid back and great for loving on); a hearing dog, who can alert a hearing-impaired owner to alarms, phones, or sirens; or a full-on service dog who can perform tasks for an owner with impaired function.

While Clover is here with the Regis puppy team, she spends her weekdays primarily with her undergraduate trainers either in class or lab, or helping with homework. Clover lives with Andy most weekends, but wherever she is, she has daily training sessions. Training can be done in as little as two-minute bursts throughout the day, randomizing what she works on. As she grows older and more accustomed to her training, she is exposed to more open environments with greater distractions and variables so that she will be ready to stay focused on her task when she is working. Recently, Clover has started accompanying Andy to the store and to businesses, as well as public parks. Andy maintains that the same tactics he teaches in Movement Science are applicable to training a puppy.

When the vest is off, Clover is just a regular puppy. Andy describes her as “a 35-pound bowling ball doing laps around my house.” Andy reports she is very friendly with other animals, doesn’t chase squirrels or bark at other dogs, but is very excitable and playful when she meets new people or pups. She often plays with Juliet, the puppy Shelene is training, and other dog friends of the PT school. Clover enjoys going to the park, playing fetch, and generally “crashing around” like puppies do. Clover has also been the catalyst for Andy meeting more people when they’re at the park or out for walks.

Have you ever wondered what the pink lead around Clover’s muzzle is? It’s called a Gentle Leader and is a training tool. If Clover is pulling or needs a physical cue, the Gentle Leader puts a little pressure on her nose and redirects her head back around so that she can focus on her handler. Clover has other standardized cues like “Don’t”, “Sit”, and “Down” which everyone on the team uses for uniformity of training. Others have picked up on her well-behaved nature – some hikers Andy encountered one weekend while out on the trails said Clover was the best behaved puppy they had ever seen. Granted, dogs in the CCI program are bread for their temperament, intelligence, and obedience, so if you’re going to train a dog, Clover is a good bet (she’s half golden retriever, half lab).

Now that you know more about her, say hi to Clover and the team when you see them in the hallways or around Claver, but do make sure that Clover sits before you pet her!

Special thanks to Andy Littmann for the photos and interview.

DPT Family Style

There are a few brave souls in the Regis DPT program who have taken on the challenge of a doctorate program while also filling the role of parent. We reached out to some of them to hear how they balance training to be a physical therapist with home life.

Charlie (left), Jason (left center), Noah (right center), and Emily (right)

My name is Emily Seidelman and I am currently in my second year of the DPT program at Regis University. My family includes our two children (ages four, Charlie, and seven, Noah), my husband, Jason, myself, and an eleven-year-old lab/border collie mix.  

I started out mildly terrified at what I initially believed to be the daunting commitment of being a mom in grad school, but Regis students and faculty quickly connected me with another mom in the program. It helped knowing someone else had survived what I was diving into at Regis. I will forever be grateful to Sarah Spivey (from the Class of 2020) for all of her encouraging words of advice.  

The hardest part has been adapting to the constant change that comes with having children (which is certainly amplified during a pandemic). However, I think parents are uniquely positioned to fielding grad school curve balls because they already have experience with navigating brand-new circumstances. Logistics are never particularly easy, but things always seem to work out with the right amount of planning and readjusting coupled with a strong support system. 

I think the best part about being a parent in grad school is knowing my kids have been watching me work hard to achieve smaller goals leading up to my big goal of becoming a PT. I know this will instill the importance of work ethic and plant the seed for a love of higher education. The hard work for school never stops but I try my best to prioritize things so that my family always comes first. This typically takes a fair amount of pre-planning and creativity, especially when big exams are looming. Focusing on my priorities has helped me to always see the bigger picture. This means identifying key content that allows me to be the best PT I can be to future patients, doing “good enough” in school, and not sweating the small stuff.  

This journey has taught me that I can continue to expand the depths of my flexibility and that change, which might feel scary, can be a really good thing. Throwing COVID into the mix has obviously been a whirlwind, but our current hybrid schedule (online lectures and in person labs) has been a game-changer for me. There are fewer days that I have to commute from Colorado Springs and this equals more time I can spend with my family. I know things are ever-changing, but I will take the breaks where I can get them and adjust again when the next change comes.  

The biggest thing I learned about myself is that I have trouble asking for help. I am FINALLY learning how to do this! This sometimes looks like checking in with classmates to make sure I haven’t missed any assigned class prep work. Other times it means using a study guide a friend has already shared to direct my studies. Often it means frequent communication with faculty regarding any anticipated problems.  

To any parent who is considering pursing a DPT—Regis is a fantastic place to do it! You will have a ton of work cut out for you, but I will cheer you on alongside the rest of the ENTIRE Regis family. 

David (left), Landen (center), and Telisha (right)

My name is Telisha Quezada and I am a first year in the program. I have one child, Landen, age 3 and a husband, David. 

The hardest part of being in school is knowing that my child misses me based off his behavior and not being able to do anything about it. Often times I have to decide to have him be watched outside of our home or remove myself from our home in order to get work done in addition to being gone for classes when I know he misses me. He tells my mom that he wants to go home or that he wants to see me and it sucks because there’s not a lot I can do about it. I set aside Saturdays so that I can be 100% present with him but one day a week isn’t enough for a little guy. It breaks my heart, but I also know it will be a part of his growing up and becoming an independent, well-adjusted member of society. 

The best part is having him see me be a “doctor” and wanting to emulate that. I think one of the most rewarding parts of being a parent is seeing your kids have good healthy habits and I think “doing homework” and “being a doctor” aren’t bad ones to have. Also, my husband took on the responsibility of doing the laundry and it is quite literally the best thing ever. I never want to do laundry again! 

COVID was obviously unexpected but even more so was the blessing that it became in my life. It really helped me with the transition of being a stay-at-home mom to a student. I think it made the transition so much gentler for all of us and helped me figure out the beast that is childcare. I didn’t have to hire childcare until my second semester because of the way our schedules were which was a huge blessing. 

I don’t know if I learned anything new about myself, but I definitely cemented the knowledge that I am not/was not made to be a stay-at-home mom and my experience has enhanced my ability to go with the flow, take things as they come and trust other people with my life and my family’s life. That can be challenging for a lot of people, but I believe it is essential to survival. I could not survive if I didn’t trust the people in my support system and relinquished my control over everything to them. 

If we are being honest, cereal is my go-to week-night dinner. I don’t typically eat dinner which makes it hard for me to prepare it most of the time. So cereal and eggs are good choices. And my son often helps himself to granola bars. I know it’s terrible but again there’s only so much I can control or care to. On a good night (maybe once a week) it’s grilled chicken or steaks with Colombian rice (with a mushroom cream sauce).

Sinjin (left), Astrid (center), and Zoie (right)

My name is Sinjin Altobelli and I am a first year DPT student. My family consists of my wife, Zoie, my four-year-old daughter, Astrid, and myself.

The hardest part about being a parent while in the DPT program has been time management and adapting to a new environment. As an undergraduate I generally took 3-4 classes as a full-time course schedule and would do 1 class in every summer session but having 5-6 classes has been very challenging. I have much less time to prepare and content knowledge requirements increased. Workload increased and the COVID times have been a contributor as well. I really do not enjoy online learning in any form and would say that has also been a difficult adjustment.

The best part about the program has been all of the intelligent people I have had the pleasure of working with. It has helped me think about things in ways I normally would not and helped me grow both as a Student Physical Therapist and as a person. What has been unexpected about the program at Regis is that the level of difficulty increased from undergraduate studies to graduate studies definitely caught me by surprise. One thing that I have learned about myself is where my learning threshold is, and PT school has pushed me to it. My capabilities for learning are high when I immerse myself in something but PT school forced me to spread my self a bit thinner and make better use of my time. My go-to weeknight dinner is chicken and rice with broccoli.

A Look At the Paths Less Traveled – Non-Traditional Students on Why Regis

One of the many great things about the Regis DPT program is its wealth of different students. We celebrate diversity in all of its many forms, including those who may have taken a less traveled route to getting here. Below is quick look at a handful of some of our non-traditional students in the Class of 2023 and their take on how they became part of the class.

Betsey Geerdes

Age: 32

Undergraduate major/minor/previous degrees: BFA Painting and Drawing

Former profession: Sign artist, clinic and surgery scheduler

I realized during my last year of art school that I really wanted a career working with and for people rather than by myself in a studio. I also realized that I spent most of my time and energy moving my body as much as possible and that I wanted to know more about the human body and how it moves. I spent some time in PT for amateur running injuries and was super motivated by that experience to help people find hope and healing in moving their bodies well for the rest of their lives.

I picked Regis because it’s in Colorado and I love to ski/run/be outside in the mountains as much as possible. I’m glad to be here at Regis because while they clearly uphold academics and excellent practice, they also care about the whole person, for us as students, and in teaching us as practitioners to think and care in a like manner.

Kathryn Marr

Age: 30

Major: Biology           Minor: Environmental Science           Post-graduate degree: Master of Science in Geological Engineering

Former profession: U.S. Army Officer (Captain, Engineer)

For as long as I can remember I wanted to be an “Army doctor.” Before graduating high school I signed an ROTC contract, and my freshman year decided to major in biology. I wasn’t too far into my undergrade degree when I realized I wasn’t mature enough to go straight into a graduate program, so I commissioned and entered the active duty Army. I enjoyed my time in the Army, but when it stopped being intrinsically fulfilling, I started to explore options in the medical field. I chose PT because I enjoy learning about biomechanics and how the body moves. For me, PT is a career field where I feed my own interests, and use that to improve the lives of others.

Throughout the interview process, I felt that Regis cared about who I was, not just what I looked like on paper. By taking this approach building their student body, Regis is able to form a wholistic class rather than a group of individuals. The best part is, they take the same approach while recruiting their faculty. During my interview day, a first-year student commented that the faculty weren’t putting on a show to make Regis “look good,” but they truly were excited we were there and wanted to get to know the future student body. Now having started my second semester, I still feel the passion and excitement from the faculty in developing us to be future DPTs.

Sung Yi

Age: 31

Major: American Ethnic Studies        Minor: Diversity Studies

Former profession: I was a transit operator (bus driver) for a major metropolitan transit system for 8 years.

As a child, my parents worked labor-intensive jobs and in many instances, my dad would get injured and never sought treatment. Part of the problem was a lack of information but mostly a deficiency of equitable healthcare representation in our neighborhood/area. It wasn’t until I was injured in a car accident at 16 and subsequently received treatment at physical therapy that I realized I wanted to join the profession. Fortunately, I saw a significant reduction in symptoms but also realized why my parents never sought physical therapy, the lack of accessibility in the profession (culture, language, geography, socioeconomic, etc). My experiences since that time have been dedicated to strengthening communities and acknowledging the unique individual needs of each member. Physical therapy is one of the few fields in healthcare that gives the patient the skills, knowledge, and confidence necessary to uplift themselves. Ultimately, as a bilingual first-generation American, I hope my presence will help people overcome this barrier and encourage more folks to seek out physical therapy.

I lean into growth opportunities and I felt that Regis University was the best option for several reasons. I had never lived outside of the Pacific NW so having the opportunity to get away from the dreary cloudy days of Seattle was a huge motivation. As an older SPT, I wanted to join a program that cherished individuals that may not have taken a linear path but paths that offer richness and diversity to a program, something I believe Regis DPT strives to accomplish. In my experience, Regis was most adept at welcoming prospective students in comparison to other programs. I was most impressed with the continued communication from current students and faculty after my interview. I did not experience this with any other program and it was this level of follow-through that led to my decision to attend the Regis DPT program.

Nicole Tesson

Age:  The Big 4-0.

Major: Dance  Minor: Education

Former profession:  Pilates and Gyrotonic Instructor primarily, Dance Educator in elementary schools, nonprofit administration

I’ve thought about PT since my undergraduate degree, and chose the more affordable path of Pilates instruction at the time because it fulfilled my desire to teach movement.  Over the years while working alongside PT’s, I’ve continually come back to wanting to pursue this career and gain a deeper knowledge base.  PT also opens the door to working with a more diverse population than I’m typically able to reach in studio settings.  After the birth of my second son, there didn’t seem any better time to work toward these goals!  (half sarcasm and half true)

My experience at interview day at Regis felt so welcoming, faculty were open and communicative, and I was able to connect with another non-traditional student.  I resonated with the concepts of serving people holistically as well as the opportunities for self-reflection embedded in the curriculum.  My family is here to stay in the Denver area for the foreseeable future, so I feel incredibly fortunate to be a part of the Regis community.  It’s been a wild ride to get to this point, but I can’t imagine a different journey for me. 

Sara Taube

Age: 33

Majors: Earth and Environmental Sciences, Studio Art        Minor: Economics      Post-graduate degree: Master of Science in Environmental Sciences

Former profession: Environmental consultant

I studied geology because I loved natural sciences and being outside; I became a consultant because I didn’t want to get a PhD. After a short time into my five years in industry, I became disillusioned with the way things worked. I wanted to be saving the world one bad patch of land at a time, when really, that’s not at all what we were doing out there. One of my life goals has always been to have a profession that goes beyond the paycheck, to bringing good into the world. Physical therapy had done so much for me as a young adult, on and off other DPTs’ plinths, that I wanted to be able to bring that kind of healing to others. In the end, it was a matter of logistics because I knew where my heart was.

Regis has heart and it is abundantly present in so many of the things that happen in the DPT program. I love the idea of approaching patients with cura personalis, caring for the whole person, which is one of the five pillars of Regis’s Jesuit teaching. I instantly connected with a number of the SPTs I met on interview day and what they said about the faculty and their fellow classmates resonated with me. I met people who had the same ideals and interests – I was able to see myself as part of this body.

Thoughts of a First Year Student on Hybrid DPT Learning

By Erin Lee, Class of 2023

First, let’s just acknowledge that none of us chose to be here like this. No one decided this was a good idea or that anything “good” beyond surviving should come of this. In fact, if you’re reading this it’s safe to say that most of your plans for 2020 and possibly 2021 have been upended, or at the very least, dramatically changed.

And I want you to know that is okay, you are not alone in this experience.

My reflection is broken down into two parts – each an idea that I personally feel has helped me be successful through my first semester and be “successful” through a pandemic.

Perspective

“Is the glass half full, or half empty…or maybe it just has water in it.”

-anonymous

Sometimes, perspective means being objective and not rating an experience positive or negative, but simply that it is.

As a first year, I had the advantage of entering school mid-pandemic, not yet knowing how PT school was “traditionally” taught. And so, though some experiences were awkward and definitely not ideal, it was not as much the complete culture shock as I imagine the second and third years must’ve experienced. And honestly, transitioning from the workforce into some kind of structured organization, and a safety net mid-pandemic was a relief of sorts.

I found myself clinging to this mantra during my first semester navigating the pandemic – “we do what we can, and we do what we must.” Our class had to get through the semester; in my mind there was no other option. Well, we didn’t really HAVE to, I suppose any one of us could’ve quit or taken time off…but I think there was a shared vision to accomplish something in a time of uncertainty. That shared desire and shared adversity to simply put our heads down and survive got us through much more than we realize. We not only got through one semester on a hybrid system, we did so with only one classmate contracting COVID-19 in a cohort of 83. Now, that may not seem like a big deal, but it took a ton of teamwork and coordination, and mutual participation and the cooperation of 83 people to work towards the same goal. It’s a small win in the grand scheme of things, but it’s the win we needed. A boost of energy to propel us into the upcoming semester with a larger perspective on what we can accomplish. 

Our goal is shared, and it is simple, to graduate as competent Doctors of Physical Therapy. But our bigger goal is why we all chose this profession in the first place: to help others. And if anything, this pandemic has zoomed (see what I did there) in on how we can better help on the micro level; within ourselves and amongst ourselves. Our class has come up with creative ways to stay connected online, through book clubs, running clubs, and other special interest virtual or outdoors groups. We’ve hosted group study zoom sessions. We persuaded professors to provide us additional help such as cadaver videos, deadline extensions, assignment/exam adjustments. We’ve also unified over some inside jokes and frustrations that are truly “once in a pandemic” moments.

This was not easy experience. Our class has had to have some tough conversations. There have been many tears. I found that it has been necessary to allow space to grieve. Grieve lost expectations; grieve missed experiences; grieve change. Our cohort probably will never be “as close knit” as previous classes. Chatting over zoom and slack is not the same as grabbing a beverage with a new crew of friends. Some learning and service experiences are forever missed. Some things were not ideal. Actually, most things were not ideal. This has not been fun. But like I said earlier, it has been necessary. It is what it is.

Adaptability

“It is not the strongest of the species that survives, nor the most intelligent that survives. It is the one that is most adaptable to change.”

– Charles Darwin

While I do not wish this experience on any student or any human being, this is what I do know. The faculty at Regis University have been nothing short of superheroes. They fought hard to transition our first semester into a hybrid model. They preserved our cadaver lab (which is the holy grail of every PT students’ experience). They made sure to be as accessible and remain personable albeit virtually. The teaching faculty had to completely overhaul their curriculum and recreate content (to make it virtual friendly) that probably took years to create in the first place.

Our workload was intense as the school had to condense material into a shorter semester.  So, while this meant I was spending some (most) late nights listening to an AEP (audio enhanced presentation) in preparation for a class, this in turn meant double, if not triple the time requirement professors needed to put in to churn out relevant and appropriate material for our hybrid lectures. While there were some cracks in the fluidity of a hybrid model, I personally did not feel like any essential content was lost through the transition. On top of that, our school was very transparent on the COVID-19 progress within our Regis community and was clear on expectations and protocols implemented within the school and on state level. The program has been extremely proactive in its action plan for any and every COVID-19 scenario.

They say that adversity shows one’s true colors. I have seen my classmates impressively adapt to the ever-changing schedule and study situations – classroom one day, virtual the next. I have seen professors adapting to technology, being willing to try new ways of teaching and communicating.

I chose this program based on intuition, and it has been reinforced through these first few months. This is a group of people and program I can trust. If they’ve showed me anything, it is to accept the imperfect nature of humans, the unpredictability of life, and that kindness is within all of us. In my opinion, this summates to the ideas of adaptability and keeping a true perspective on life and our journey through it.

First year students in cadaver lab

Mountains and Valleys of CEI, 2020

This post is dedicated to our Clinical Education Team. This all-star squad is made up of Dr. Nancy  Mulligan, Dr. Alice Davis, Dr. Shelene Thomas, Dr. Stacy Carmel, Dr. Denise O’Dell, and Dr. Laura LaPorta. They navigated our first clinical experience with admiral perseverance and continue to work hard in the face of adversity for future clinical experiences. In addition, Addison Rodgers, the student clin-ed representative for our class, continues to serve with excellence. We thank you all for your commitment to our education!  

Last month, my peers in the class of 2022 and concluded our first clinical experience, where we were mentored by a physical therapist who served as our clinical instructor in various clinics and hospitals scattered across the United States. As you can imagine, the experience was complicated due to… unprecedented circumstances. Yet, despite last minute unavailability of sites, alarmingly rising COVID-19 statistics, and record wildfires, adaptable professors and clinical instructors and creative travel arrangements made it possible for everyone to arrive safe and prepared to begin their first clinical experience.

My clinical experience took place in rural Virginia. In just one weekend, I traveled from Denver to the east side of the Appalachian Mountains, which served as a frequent vacation destination growing up for this Hoosier. I felt pieces of home as I began to drive through the winding deciduous forest as the leaves boasted the shades of a fall bonfire, filling me with gratitude at every turn that I got to spend my favorite season among such nostalgia-inducing beauty. At the same time, I felt nervous, rushed, and geographically alone. I never imagined my first time working with patients as an SPT would be with two masks and a face-shield between us. I had only practiced on two bodies since March, due to our precautionary lab trios that served as a quarantine bubble from my 79 other peers. I was suddenly in a long-distance relationship, again, after establishing a blissful routine with my partner in a snug rental in Denver for the past two months. I did not know a soul within a 120 mile radius of this small town. I was eager for this experience, but simultaneously uneasy about how it would play out. As I was having this inner dialogue in my head, the late Tom Petty sang through the speaker of my  Suburu:  

“Some days are diamonds, some days are rocks. Some doors are open, some roads are blocked.”

I found deep comfort in the familiar tune in that moment. I was reminded that there are  highs and lows, diamonds and rocks, mountains and valleys in everything we do in this life. I reassured myself I had the tools to make this the positive experience I had worked so hard for. I found comfort in the thought that despite being so far away from my classmates and professors for those few weeks, in the midst of a pandemic, we were all in this together.  In an attempt to connect us and provide a platform for our voices, I asked my class about their personal “mountains and valleys” from clinical.  

The Valleys – the tough stuff, the learning opprutunities, the lows, the rocks:

  • “Meeting a patient with terrible chronic pain, who was hurting her entire appointment. She cancelled the rest of the week…it was a reality check that not every patient will feel better after one session.”
  • “Watching a patient with Huntington’s Disease get worse instead of better throughout my time there”
  • “I felt alone at times. I had not been hugged for a while. But one day there was a big cockroach on my wall, and I smushed it with my Doc Marten. It was disgusting, but I proved to myself I did not need anyone to come and save me.”
  • “I found self-care challenging. The first week I just wanted to kick my feet up at the end of the day, which is exactly what I did. I was neglecting to reflect, exercise, and rejuvenate. I joined a yoga studio (within social distancing guidelines) and discovered that committing to showing up on my yoga mat regularly was the form of self-care I needed all along.”
  • “There was a shock-factor to the overall health-literacy of the population. We are in such a bubble with PT students. It was also sad to see people in so much pain they could hardly move.”
  • “It is difficult not knowing how to proceed with more complicated cases.”
  • “I saw a lot of college students with back and neck pain, pointing to endless hours on Zoom as the culprit. It was too relatable…”
  • “Wildfires.”
  • “Subtle reminders that we never know what the person in front of us is dealing with. It was a reminder to me that we should try to be kind to all those who we encounter.”
  • “It was hard to bear witness to the realities of being a healthcare professional, like calling emergency services, addressing pain in my patients, and accepting that I cannot fix everything.”
  • “Hearing the frustration of my patients as they work through their pain, discomfort, and injury.”
  • “Feeling inadequate during times where my skills were not where I felt they should be, or not being able to understand/ participate as much because we haven’t gone over that material in the program yet. This was both humbling and sad in a way, as it allowed me to really comprehend and see how much the pandemic is impacting our education and the clinical care we will be able to effectively provide to our future patients. “

The Mountains – the good and the great, the highs, the “this is why I’m here,” the diamonds:

  • “Watching my patients grow and express pride in their progress.”
  • “I felt so supported by my CI. The staff was all there for me when my ballot was tampered with.”
  • “Exploring the hidden nature of Kentucky, playing at the climbing gym, making slow dinners, and reading books.”
  • “I was my CI’s first student, and he gave me a lot of autonomy with treating patients. We had so much trust between us – I built so much confidence and started to really believe in myself.”
  • “I loved getting cookies, cupcakes, and treats at the office. We dressed up on Fridays too. I worked with a patient who was non-verbal at the start of therapy and began to speak during the later weeks. Also, I played patty-cake with a three year old and they showed my their rock collection.”
  • “My clinic was always one-on-one patient to PT which resulted in getting to know patients more. Everyone was excited to have a student there and they always let me watch interesting sessions like vertigo, prosthetics, and post-op.”
  • “It was great to finally practice the techniques we have learned. I got to work on a lot of manual techniques, which was amazing.”
  • “I was in home health, and loved getting to know the patients including their families, pets, house, and hobbies. Their openness, vulnerability, and grit are so special!”
  • “I was in Maine, and loved the community. My patients gave me great hike and restaurant recommendations, which I loved to explore on the weekends then talk about it with them the next week.”
  • “A patient with PD who I had been working with on neuro re-education gave me a hug at his last appointment and told me to keep working hard and he would really miss me! It was cool to really experience effective change in patient care when using the things we are learning.”

My clinical experience ended up being refreshing and informative. It reminded me of my “why.” It was marked with diamond days, like the day I ran my furthest ever (thank you, sea-level oxygen levels), the day a patient brought me a detailed list of her favorite fly-fishing spots in Virginia (sharing your secret spots is a big deal in the fly-fishing world!), and the day I spent hiking through Shanendoah National Park with an old college friend. And of course, there were rocks – like the solo road-trip that seemed to last forever but was crammed into a weekend, and the discouraging feeling when a patient expressed their right to not be treated by a student.

Now that we are back in classes, we are seemingly barely holding on to the in-person component and constantly having to be prepared to slip. We are counting down the tests and practical exams left until our long-anticipated winter break. This general stress is combined with individuals fighting their own battles. Yet, there is still joy. For instance, Dr. Shelene Thomas spends the beginning of every zoom-class playing her favorite tunes. This small tradition serves as a great example of playing the hand you’ve been dealt; she coordinates her virtual class with grace, empathy, and transparency. It reminds me of how the song “Walls” settled my anxious thoughts on my drive to my clinical and how I am always surrounded by “hearts so big.” 

Overall, I am thankful for my professors and classmates who I can lean on in my valleys, but celebrate with on my mountains. Our class boasts an overwhelming triumph of learning in any environment as we discover who we want to be as therapists.

By Suzanne Peters, along with my peers in the class of 2022 

The “mountains and valleys” concept was inspired by the beautiful scenery we got to take in across the United States.

On Taiwan during the Pandemic – And What Our Profession Can Learn

By Peter Lee, Class of 2022

Over the course of the COVID-19 pandemic, I have written, edited, deleted, then re-written about this topic more times than I would like to admit. This year has been challenging on many fronts, especially on the topic of justice. Through it all, I have asked my community for a lot, and now I ask for more. This blog post might ruffle some feathers – good. I want to talk about the harmful effects of politics during a global health crisis; to do so, I have to talk about the country I emigrated from. 

Taiwan, the island nation closest to the origin of the pandemic in Wuhan, China, is home to nearly 24 million residents. It has been a shining example of health care excellence throughout the pandemic. The government trusted its best scientists, it was transparent with information, the citizens were responsible, and success was found with cross-industry collaborations. Rapid tests and digital contact tracing have led to Taiwan having a rare economic growth during a pandemic. Today, life goes on as usual in Taiwan with no lockdown, no economic downfall, no coronavirus. 

Since the beginning of this pandemic, there have been 618 cases recorded in Taiwan, with 7 total deaths from the virus that has killed more than 1.39 million people globally. As I write this blog, Taiwan has gone 224 days without a single locally transmitted case of COVID. The Taiwan model has been followed by nations such as New Zealand to successfully control outbreaks. Despite its miniscule stature in the international community, Taiwan, a nation ⅛ the size of Colorado, has donated hundreds of millions of masks to disease stricken countries like the United States, Canada, Iraq, Eswatini. The list goes on; in fact, Taiwan has donated PPE to nations on every continent, including sovereign native nations in the US that have largely been ignored by our government. 

“Taiwan has been a shining example of healthcare excellence throughout the pandemic. “

So far this sounds like a success story, but unfortunately, Taiwan did not have an easy path to success with the coronavirus. The island nation’s close proximity to Wuhan ensured that it had one of the highest risks for an uncontrolled outbreak. Moreover, the WHO excluded Taiwan from receiving important data regarding the pandemic during its beginning stages. The “World” Health Organization put 24 million Taiwanese lives at risk with its refusal to include Taiwan in its organization and communication. It continues to censor the word Taiwan from its interviews and even has blocked users from commenting the word Taiwan on their livestreams. They REALLY went through the effort of censoring out the word Taiwan in every language. Just this week, Taiwan was kept out of the WHA (World Health Assembly) despite support from the United States, Japan, New Zealand and many others. The nation with one of the best pandemic response models, the nation that continues to allies around the world with their respective battles against this deadly disease, the only nation that has seen gross GDP growth in 2020, was excluded from the single most important global health meeting about… the pandemic… Why? 

If you ask Google why Taiwan is not a part of the WHO, you might find explanations claiming that China and Taiwan have “internal” exchanges of information regarding the pandemic. You might even encounter Chinese propaganda claiming that Taiwan is a runaway province of the People’s Republic of China without claims to sovereignty. Some of you reading this might even think the economic benefits China provides is sufficient to ignore its human rights violations. I will be the first one to tell you about Taiwan’s complicated history with colonization efforts from the likes of Portugal, Spain, and Japan. But let’s set the record straight: Taiwan has never been a part of China, nor will it ever be. Pandemic response is not the only thing separating Taiwan from its communist neighbors across the strait. It also boasts a vibrant democracy that celebrates freedoms of speech, religion, and press. Taiwan has Asia’s only female head of state, Dr. Tsai Ing Wen. It is the first nation in Asia to guarantee equal marriage rights and it is not currently committing genocide by putting ethnic Muslims in “re-education” camps. I know, the bar is on the floor. 

The most dangerous aspect of allowing politics to interfere with global health initiatives is that it affects more than the nations being oppressed. Taiwan is lucky, it has a combination of technology, community support, and one of the world’s best universal healthcare systems; but Taiwan is not the only nation under intimidation by global powerhouses. Somiland in East Africa is another prime example of the dangerous effects of using pandemic response as a political pawn. In the beginning stages of this pandemic, Taiwan shared important findings about the mechanism of transmission of COVID, that information was withheld from communication by the WHO. While citizens in Taiwan all wore masks to protect themselves, major western nations still believed face coverings to be an ineffective way to curb the Coronavirus. Of course, they cited the WHO. 

As Rev. Martin Luther King said, “injustice anywhere is a threat to justice everywhere”. Right now, people who might not know about Taiwan or its struggles on the international stage are suffering from the fact that the Chinese Communist Party, along with the WHO, continue to make a habit of playing politics with Taiwanese lives. How many of the 1.39 million people who have lost their lives  this pandemic would still be around this holiday season if nations were given accurate information? How many more can be saved if Taiwan was allowed to participate in the WHA to share its knowledge and resources? In order to provide true patient-centered care and create policy that centers around the care of populations, the WHO has to be held accountable.  

“Change starts with Doctors of Physical Therapy who hold space for and validate, patient experiences, even when it is uncomfortable. “

The purpose of this blog is not to say that we all have to care about every injustice around the world, I don’t think we have the capacity to handle such tremendous amounts of trauma. Instead, I hope it serves as a reminder that ignorance is not bliss. Just because we are not aware of the oppression that someone else is facing, does not mean the repercussions of that oppression will not affect us personally. I hope this serves as a reminder to always seek to learn more from one another. The very nature of our profession calls us to advocate on behalf of our patients, in order to do that, we cannot choose to remain ignorant to the world around us, in some instances, we cannot remain apolitical. This was an example on a global scale, but injustices like this happen at every level of health care. It is my hope that this blog inspires you to research Chinese oppression in Taiwan, Hong Kong, Mongolia, or Xin Jiang. Or read into the roles PTs can play in the violence happening in Armenia by the hands of Azerbaijan and Turkey. We can’t solve every injustice, but we can always do more (Magis, nice). Change starts with Doctors of Physical Therapy who hold space for and validate, patient experiences, even when it is uncomfortable. 

Healing Hands – A Clinical Inservice by Lindsay Pendleton

For their first clinical experience, our students have the option to present an inservice, or mini-presentation about something they are interested in, to the clinic. Lindsay had the unique honor of being published in WGH Heartbeat, the official publication of Wilbarger General Hospital, where she just completed CEI. We congratulate Lindsay on this achievement and thank her for sharing with the Regis community as well!

“My interest in Physical Therapy came from the personal interaction we get to have with patients. It is arguably one of the most unique relationships in healthcare. In order to be able to do our jobs effectively, it is of the utmost importance that we convey empathy and maintain a relationship that does not lack sensitivity. The patient that has sought our services has to share what is likely their biggest fears, worst insecurities and greatest mistakes. It is our job to be receptive to that and create an environment in which they feel safe to do so. How we create this bond with others is personal and will vary from patient to patient. One of the best ways we can do this is through touch. Touch is now recognized as a cross-modal sensory system transmitting signals through proprioceptive, exteroceptive and interoceptive pathways.

The one which is the most familiar is proprioception. This is the basis of skilled manual therapists to overwhelm the nervous system, desensitize an area or acquire much needed information on soft tissue integrity and joint mobility.

Less well known is the exteroceptive touch pathway which gives the patient ownership of their body. It is how they relay information on what the touch means. Is the touch threatening, is it comforting, how does it make them feel? This pathway is associated with ownership of self and the ability to see their problem, their pain as within their control. Touch promotes positive emotional responses such as feelings of safety and relaxation and reduces negative affective feelings, avoidance and stress-related biomarkers.

The third and least well known is the interoceptive networks which convey emotionally relevant information through low mechanical threshold unmyelinated C fibers. This has been linked with pain inhibition, ANS regulation and an increase in pleasant sensations. In short, touch connects us to our patients in a physical, cognitive and emotional way. This can make us uncomfortable as we seek boundaries to keep us safe and distanced from potential transgression. Yet, as a collective, therapists at times are not adapting in a manner that fits the current needs of patients, especially during COVID.

Finally, perceptions regarding touch incapacitates us and limits our ability to treat. As touch without a the widely accepted researched justification is beyond the scope of practicing therapists. This could not be more backwards. Touch conveys a kindness, a kindred spirit to another person that improves mood and life satisfaction. When there are instances, where you can either touch the patient or use a machine, consider the power of your touch. When there are patients that baffle you, or refuse to get better despite your best efforts, consider that you can help them with the gift that is human contact.”

Sources:

1. Gutiérrez, Abbey. Interoception, mindfulness and touch: a meta-review of functional MRI studies. Int J Osteopath Med. (2019).

2. Bishop, Torres-Cueco, Gay, Lluch-Girbés, Beneciuk, Bialosky. What effect can manual therapy have on a patient’s pain experience? Pain Manag. (2015).

3. Geri, Viceconti, Minacci, Testa, Rossettini, Manual therapy: Exploiting the role of human touch. Musculoskeletal Science and Practice. (2019).

4. Nicholls, Holmes. Discipline, desire, and transgression in physiotherapy practice. Physiotherapy Theory & Practice. (2012).

September is Alopecia Awareness Month

Before we say good-bye to September (already?), we want to highlight second-year DPT student Conner Weeth and his journey with Alopecia. Conner is known for his hilariously dry sense of humor, kindness to others, and his #gains. Conner offers us an educational bit about Alopecia and provides a lens into living with the disease.

September is alopecia awareness month. Alopecia is an autoimmune condition that attacks a person’s hair follicles. This condition can vary from patches of hair loss to complete hair loss over the whole body. Some treatments may be helpful and hair may occasionally grow back, there is no cure for alopecia. Many people have never heard of alopecia, but it affects 200,000 Americans per year. Approximately 6.8 million Americans and 147 million people globally have or will develop alopecia in their lifetime. 

People of all ages, races, and genders can develop alopecia but it often appears during childhood. As young children with alopecia get older it may become more difficult for them to accept their condition leading to issues with self confidence and building relationships. 

I myself have alopecia universalis- total hair loss over the whole body. I was diagnosed with alopecia three years ago and for a year and a half afterwards I wore a hat wherever I went. I hated the way I looked and wanted to avoid the lingering eyes of people’s stares. This isn’t an uncommon reaction for people with alopecia. However with time and support many people come to find the condition liberating. They come to terms with the fact that who they are is not defined by the way they look.  

It is likely that you will eventually meet somebody with alopecia during your lifetime and there are resources available for you to help support them. For more information about alopecia please visit the National Alopecia Areata Foundation at Naaf.org. 

-Conner Weeth, class of 2022

Is Conner’s hair loss really from Alopecia, or from training so hard? The world may never know.

Physical Therapy during COVID-19: reflections from Regis DPT Faculty

Regis DPT faculty Alicia Lovato, Amy Rich, and Jenny Logan share their experiences practicing during COVID-19 in both home health and inpatient settings.

Thank you so much for your tremendous service, your mentorship, and your vulnerability in sharing your experiences. We miss seeing you in person so much and are so proud to call you our faculty and mentors.

~Alicia Lovato, DPT, North Rehab Lead, SCL Home Health~

This Pandemic… Has established fierce leaders

  • Has brought valid fear and anxiety.
  • Has demonstrated the strength and resilience of our team.
  • Has excelled our Telehealth innovations.
  • Has promoted critical thinking on how to keep our Home Health clinicians and patients safe (have to get creative when you don’t have that lovely PPE bin set up for you in the hospital hallway). 
  • Has increased my knowledge and awareness of how to treat patients diagnosed with COVID.
  • Has taken its toll emotionally and taken me outside of my comfort zone.
  • Has made me so grateful for my health and ability to work.
  • Has amplified my fierceness for this profession.
  • Has reminded me to have compassion for myself and others.

I miss seeing all of your faces at Regis. I can’t imagine the feelings and emotions that this has brought up in your education and personal life. Like good ole Dolly Parton said, “Storms make trees take deeper roots.”  Hopefully by the end of this we will be like Wild Fig Trees (per Google search these tree roots can dig down 400ft!). 

 

Working as an inpatient acute care physical therapist during COVID-19: A perspective

~Amy J. Rich, PT, DPT, NCS, Senior PT, University of Colorado Health~

*this opinion reflects the perspective of the individual and not necessarily that of the organization*

It’s 11:15am and I’m getting ready to call into my daily COVID-19 phone call from the rehabilitation team leadership in order to get updated on daily changes and progress, personal protective equipment updates and the number of patients in house who have tested positive for COVID-19.  While I await to virtually connect into our meeting, I reflect on 5 words that seem to define my experience of watching COVID-19 flip all perspectives within my healthcare institution upside-down:  Anxiety, Grief, Compassion, Empathy and Innovation. Never in my 20 years of practicing in the hospital and ICU setting have I seen such circumstances as I have now due to COVID-19.  One vivid memory I will recall is working the Sunday after our Governor instituted a “stay at home” policy due to the Coronavirus.  It was such an odd sensation to be driving TO work in an environment where patients were positively infected with COVID-19 while the rest of the community stayed home.  I entered the hospital donning my newly mandated mask, keeping my head down, noting that the hallways were eerily silent.  Just a few days before, the hospital had mandated a “no visitor” policy in an effort to protect the safety of our patients.  This invisible virus, over the span of a few weeks, progressively took away our outpatient clinic visits, our non-emergent surgical procedures, our visitors, our administrative assistants and our cafeteria workers among others.  The hospital went from a bustling “city” of people and procedures and socialization to a quiet empty space where essential healthcare workers, with masks on at all times, prepared for the surge.  The surge of the virus bringing the sickest of the sick to our doorstep. 

During this time, my perspective was of an environment filled with anxiety and fear of the unknown mixed with a strength and courage to combat the COVID-19 virus.  It is difficult to feel calm when everyone around you is wiping all surfaces with cavi-wipes, keeping a 6-10 foot distance from one another and wearing masks at all times.  It is an odd feeling to practice social distancing with your peers, but then walk into a patient’s room to perform a max assist transfer with them to enable them to get out of bed to a chair.

As the days progressed and the rules for social distancing tightened, I felt a bit of grief surround our hospital community. Grief over losing our “normal,” grief over watching family members have to say their goodbyes and stay at home instead of by their loved one’s bedside, grief over watching our bustling hospital community slowly become quieter as we prepared for the surge.

But in the midst of this extreme fatigue and anxiety and grief, I also saw signs of hope.  Leadership gave constant reminders to show compassion for our patients and advocate on their behalf to their family members and compassion for ourselves during this time.  One such memory is facilitating ambulation for the first time with a patient who had a severe traumatic brain injury.  His wife had been at his bedside every day up until the moment she was asked to stay home due to COVID-19.  She needed to be a part of this milestone of walking.  As I prepared the patient for ambulation, the nurse was able to facetime his wife via iPad.  While this patient would not look up and out from under his helmet for myself or the nurse, he was able to stand upright, attend to task, and take steps under the encouragement of his wife from the iPad shown in front of him.  Another bright spot of hope is the unimaginable outpouring of support from within our organization and from our community.  We have had offers for home-made masks and food, free access to meditation smart phone applications and even free coffee!  Peers are offering to donate vacation pay and individuals without work can apply to be placed in a resource management pool in order to earn a paycheck during this stressful time. 

From an inpatient rehabilitation perspective, I feel this COVID-19 virus has bound my rehabilitation team in a way I could never have anticipated.  As the COVID-19 surge preparation began, our rehabilitation team leadership asked for volunteers to be on the COVID-19 “A” team.  These are the physical therapists, occupational therapists and speech language pathologists that have volunteered to step INTO the rooms to provide essential health care for patients with COVID-19. These therapists are working with these patients providing essential rehabilitation in order to maximize functional outcomes while also reducing the risk of their colleagues being exposed to this virus.  This self-less act has put me in awe of my team members.

The innovation seen during these times is also amazing.  For example, I was able to provide PT intervention for a patient intubated via endotrach to a BiPAP machine!  This innovation brought forth by an interprofessional team of physicians, nurses and respiratory therapists allowed for appropriate ventilation for the patient while saving a mechanical ventilator for those that have no other option.

Through the leadership of our Inpatient Rehabilitation Educator and fellow Regis graduate, Jennifer Gunlikson, the rehabilitation staff received constant and pertinent information along with a platform to be innovative.  Her efforts in combination with our entire organization’s leadership has kept us informed, safe and calm.  One of the greatest pieces of education was for all patient care employees to understand how and which personal protective equipment should be used with patients who have COVID-19 and for patients who need to be protected from the virus.  As information brought forth by the CDC was ever-changing, so was our education.  Detailed information frequently and in various platforms was provided so that use of PPE was safe, effective, and efficient.

As a rehabilitation team, we banded together to make innovative discharge plans and identify key needs for ongoing education surrounding the COVID-19 virus.  We came together as a team to facilitate quick and safe discharge plans for patients who were not positive with COVID-19 in order to get them out of the hospital.  We increased treatment times and frequencies, we increased family training (including virtual training over iPad and smart phones) in order to maximize function and facilitate a safe discharge out of the hospital.  We also came together to share our individual expertise to the rehabilitation team, providing increased mentoring of therapists for practice in the ICU and increased training on mechanical ventilators and respiratory equipment.  With collaboration from our community Doctor of Physical Therapy programs at Regis University and the University of Colorado, we were able to develop a training video on respiratory pathology and common interventions to maximize ventilation and mobilize secretions.

The battle to contain COVID-19 and care for our patients is not yet complete, and the future is still uncertain.   We will continue to feel anxiety, grief, compassion, empathy and innovation as we navigate these unexpected times.  But in the meantime, we hope we have flattened the curve, we are prepared, we are strong and we will overcome.

 

A Day in the Life of a PT Treating Patients with COVID-19: true stories from the front lines

~Jenny Logan, PT, DPT, NCS, Senior PT, University of Colorado Hospital~

I park my car in the parking lot of the University of Colorado Hospital and begin my walk into the hospital. I pass night shifters leaving the hospital still wearing a mask. I momentarily feel exposed and naked without a mask. I head to the small office that the COVID therapy team has been relegated to in order to decrease exposure. I grab my surgical mask and begin to chart review.

Patient A (55 y/o male, no past medical history, anesthesiologist), day 29 of hospital stay, 21 days in ICU, mechanically ventilated x 18 days. Per chart, patient is medically ready to discharge when cleared by PT.

Patient B (26 y/o male, no past medical history) 34 days in the ICU, 31 days on mechanical ventilation, decannulated from ECMO 6 days ago, extubated yesterday

Patient C (37 y/o female, history of HTN, DM, obesity, Spanish speaking, undocumented, no insurance), 27 days in ICU, trach placed five days ago, still mechanically ventilated. Decannulated from ECMO 10 days ago.

Patient D (65 y/o female, no past medical history, Spanish speaking, undocumented, no insurance), 18 days in the ICU, still mechanically ventilated x 15 days.

Patient E (39 y/o male, no past medical history), hospital stay x 32 days, mechanical ventilation x 28 days, trach placed 7 days ago.

Patient F (53 year old male, no past medical history, Spanish speaking, undocumented, no insurance). 37 days in ICU, trach placed 4 days ago. PEA arrest x 3.

 Patient G (45 y/o female, history of HTN and obesity), 18 days in ICU, 12 days on mechanical ventilation.

I grab my N-95 mask that was reprocessed yesterday using UV light. Is it really still effective? I can’t think about this too much. I have work to do.

I head to see my first patient, Patient A. I don my N-95 mask, yellow gown, gloves and face shield. Immediately my nose begins to itch. Why does this always happen the moment I put on my mask?

The patient is sitting in bed, chatting on his phone but immediately hangs up when he realizes that I am from PT. I assist him to ambulate in the room without a walker. He is very unsteady on his feet and but he only loses his balance twice which is an improvement from yesterday. He can only tolerate 30’ to the door and back twice before needing a rest break. Despite his shortness of breath, his SpO2 remains above 90% on room air. I ask if we can call his wife to discuss discharge planning. Once she is on the phone, I explain that her husband is ready to discharge home today. She begins to cry tears of joy. It has been 29 days since they have seen each other. I explain that he will need to quarantine himself at home for 14 days to avoid exposure to his family. This means that we will need to send him home with a walker because he cannot walk safely or independently without it. Neither seems bothered by this despite the fact that he was working as an anesthesiologist prior to contracting COVID and was an avid cyclist and skier. I also explain that she will need to assist with his medications at home. This is for a man who managed medications for a living but now has cognitive impairments that will prevent him from doing this safely on his own. I review the home exercise program that I have created for him and provide a few TheraBands. He will likely be unable to receive home health PT as he has yet to test negative for COVID. I exit and wish him well at home. “Thank you for everything you have done for me,” he says.

I head to the Neuro ICU, which has been transformed into a COVID ICU. I catch a nurse as she heads from one room to the next.

“How is Patient B doing this morning? Stable after extubation? Can I work with him?” I say. Yes, please, says the nurse as she rushes into her next room where the patient is crashing.

The patient is drowsy but wakes easily when I say his name. I introduce myself and explain that I am here to help him get moving. His eyes widen and he whispers, barely audible, “ok.” His voice is very weak likely due to the amount of time spent on a ventilator. I administer a CAM-ICU, which is positive for ICU delirium. He does not know why he is in the hospital and he thinks that the date is in April. He was admitted in April but it is now May. He looks shocked when I tell him the date and that he is in the hospital for coronavirus. I explain that he has been very sick in the ICU for weeks and on many medications that have made him lose track of time and forget everything that has happened to him. I ask him to raise his arms and he can barely lift them past 30 degrees of shoulder flexion. He cannot lift his legs off the bed in a straight leg raise. I help him move to the edge of the bed with maximal assist. He feels very dizzy. His blood pressure drops initially but stabilizes quickly. He seems to have forgotten how to use his arms to help support him while sitting on the edge of bed. After several minutes, he finds his equilibrium and can sit up with only a minimal amount of assist. He whispers, “This is so cool.”

Periodically someone knocks on the glass door and gives a thumbs up. It is a question. Am I doing ok in the room? Do I need anything? Usually the answer is no. I’ve got this. This is what I do – working in an ICU to help patients regain function. But it’s nice to know that I am part of a team that has my back and is working to help each other.

I move on to the next patient, Patient C, who I have been working with for a few weeks. “Do you want to try standing today?” She vigorously nods her head. She can’t talk because she has a tracheostomy but she can write. She writes that she has been waiting for me all day because she can’t stand being in the bed any longer. She also writes that she feels sad today. She misses her family and really wants to talk to them, especially her sister. I tell her that her sister went to rehab today (her sister also has COVID and our rehab has been to converted to a COVID only rehab) so maybe we can try to arrange a Face Time session later. She needs less help to sit up at the edge of the bed today. With help from me and the nurse, she stands but can only stand for ~ 30 seconds. She sits back down and looks frustrated. “Why can’t I walk?” she writes. I try to explain that she has been in the hospital and very sick for weeks. It has made her muscles very weak and her lungs unable to provide enough oxygen to her body. She will have to re-learn how to do just about everything.

As I walk down the hall to take a short break (ie remove my mask, breath some fresh air, scratch the itch I’ve had on my nose for hours), a physician assistant stops me. “We would really like for you to work with this patient because we think she is too weak to wean off the ventilator.” Roger that. Mask back on, no time to rest. This patient, Patient D, is on spontaneous settings on the ventilator, meaning that she is doing all of the work to breath on her own. Her respiratory rate is high so I cue her to breathe deeply and slowly. I show her the numbers on the telemetry monitor as visual feedback and she is able to slow her respiratory rate. I assist her to the edge of bed just as her medical team walks by. They wave at her through the glass and she waves back. After the session as I leave the room, the respiratory therapist tells me that the team was so impressed with how she did while mobilizing that they are going to extubate her today. “Yesssssss!” I think to myself.

I meet up with my OT colleague to see our next patient together, Patient E. He is too deconditioned to tolerate two separate sessions. He is awake but fidgety. I walk in and remind him who I am. He says, “Hey, how are you?” He has a speaking valve over his trach and I am hearing his voice for the first time in a week. “It’s so good to hear your voice,” I say. “Can I have a diet coke?” he asks. I explain that he has not yet been cleared to swallow by the speech therapist because his muscles for swallowing are weak just like the rest of his body. Once sitting at the edge of the bed, he asks again “Can I have a diet coke?” I explain again why this is not yet possible. OT and I assist him to stand and pivot onto the bedside commode. After he catches his breath, “Can I have a diet coke?” We stand and pivot into a chair. “Can I have a diet coke? Please let me have a diet coke. Can I talk to the diet coke boss?” I assure him that I will speak to the diet coke boss (ie SLP) when we are finished. Outside of the room, I say to OT, “He really presents like someone with an anoxic brain injury – so perseverative and unable to remember from one minute to the next.”  “Yeah, that’s tough. He’s so young,” she says.

As I gear up to head into my next patient’s room, someone walking by yells that the neighbor is disconnected from the ventilator. I already have on PPE so I go in. The patient has self-extubated and I suddenly find myself alone in a code-like situation. I scramble for the ambu bag and begin giving breaths to the patient manually. It takes a few minutes for nurses and doctors to get all of their PPE on. Once in the room, they take charge. The patient’s oxygen saturation is dropping quickly so I help to restrain the patient while the physicians quickly and expertly re-intubate him.

After my tachycardia subsides, I decide it is time for a break. I grab food that someone has donated to the hospital. Once back in the office, my OT colleague on rehab tells me “Remember that patient you worked with that had a brachial plexus injury from poor positioning in prone? She is getting some return in her arm and is now walking.”  “What?!? That’s awesome!” I say. “ I’m so happy she is making such good progress. She was a hot mess when I evaluated her in the ICU.”

I check in with the nurse for my next patient, Patient F. “I don’t know,” she says. “He has been really agitated and tried to pull out his trach a little while ago. But I guess you can try.” As I walk in, the patient is restless and attempting to get out of bed. I calmly begin speaking to him in Spanish, reminding him where he is and why he’s here. His body begins to relax a bit. His sheets still have bloodstains from when he tried to pull out his trach earlier today. I help him move to the edge of the bed and he is suddenly very calm. I notice photos of his family in the room so I bring them over and we talk about his family. I don’t recognize the patient from the photos as he has lost at least 50lbs from his time in the hospital. Like so many others, he has been in the ICU for weeks, most of that time on a ventilator with a trickle of nutrition going into his stomach from a tube in his nose. Today he takes his first steps. He is like a newborn learning to walk again, feet too narrow and then too wide, hands holding him up on either side. After the session the patient is calm in bed, his agitation having ceased. The nurse is amazed and grateful.

My final patient of the day, Patient G, is a nurse who works at a rehab facility. She has a gentle southern drawl and a great sense of humor. Her arms are so weak that she cannot bring her hand to scratch her face or feed herself or hold her phone to talk to her family. Her sister calls while I’m in the room and I hold the phone to her ear so she can talk to her. She is able to stand for the first time today with the Sara Stedy. She does a little shimmy while standing because she is so excited. We laugh. It feels good to laugh.

At the end of the day, back in my car, I breathe a sigh of relief. It’s been another good day of work but I’m exhausted. As I drive away, I see signs saying “Thank you healthcare workers.” I feel grateful to have chosen a career that allows me to fight this pandemic from the front lines, giving the gift of function back to my patients.