Tag: travelingoccupationaltherapist

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Blog Out in Healthcare

Out in Healthcare: Jonas Raider, MOTR

Name: Jonas Raider

Pronouns: He/him/his

Identity: Gay/Queer

Background: I grew up in the suburbs outside Philadelphia, and have spent the past 5 years living all over the US and Europe between grad school, travels, and a year teaching American culture in Spain. I was recommended OT by my older sister who is also an OT, and it came naturally as I wanted to find a profession that focused on helping individuals to increase their independence through collaboration and open dialogue. Outside OT, I value learning about languages, street photography, thrifting, cooking, biking, hiking, and house/techno music.

Profession: Occupational Therapist Turned User Experience (UX) Researcher

Area(s) of Practice or Interest: I love advocating for OT in non-traditional settings and paving the way for our role in areas we haven’t previously existed. Refugee resettlement, community health, and the design world are my preferred areas of practice, and I hope to continue expanding upon this and advocating for our importance!  

What does being ‘Out in Healthcare’ mean to you?: Unfortunately, many within the LGBTQIA+ community have experienced and continue to experience difficulties in accessing affirming healthcare services. Although I plan to work outside of direct client care in the healthcare sphere, being out means advocating for queer clients’ and coworkers’ voices in the design world to address more inclusive products and experiences. It also means setting an example for younger generations to see themselves represented and thriving, something I didn’t have many models of when I was younger.

What is one thing everyone should know about your identity?: Since coming out publicly at 16, I’ve been fortunate to have the opportunity to learn and grow in the ways I connect to the queer community over the years. I think it is important to realize that just like other aspects of life, your queer identity fluctuates in the role it plays! Years ago due to internalized homophobia, I would distance myself from queer people as I felt the proximity would take away from my perceived idea that living closer to a “straight passing” identity was important. Although this may work for other individuals and I in no way look down upon people who feel that needs to be an important theme intertwined with their queerness, it was liberating over the years to unlearn this perceived necessity, and just exist. My queerness is as integral to who I am as the fact that I love spending time outdoors.

How do you feel when your identity is included?: When I see other cisgender people put their pronouns in their profiles, emails, or other spaces, it makes me happy to see that it is finally becoming more of a movement. It is on us cisgender people to normalize this so that our trans and non-binary friends, coworkers, students, and clients don’t have to put in extra emotional energy to advocate for their livelihood. I feel whole when the actions of my peers allow my trans and non-binary friends to feel safe, heard, and seen.

What does “taking up space” mean to you?: Taking up space means showing up in straight spaces with confidence and remaining unapologetic in how I present my queer identity and exist. It also means constantly questioning the systems that exist that center whiteness and heteronormativity and making room for others who deserve a seat at the table. Taking up space in queer spaces means realizing the privileges I embody in being white and cis-gendered, and taking a step back to center, hear, and listen to the lived experiences of Trans, Non-Binary, and BIPOC (Black, Indigenous, People of Color) within the community.

What is one piece of advice that you would give to healthcare workers who aren’t sure how to honor the identities of their patients?: If you’re unsure of how to interact or honor your patients, be honest with them and ask questions! Honesty in admitting when you don’t know something and a commitment to seeking out information to expand your expertise goes a long way in terms of affirming the care, safety, and trust of your clients. If you want to validate your clients, ask them what their lived experiences and preferences are, take criticism when you are corrected or informed, and go from there. 

Has your identity influenced healthcare that you’ve received?: Returning to the suburbs where I grew up to see a doctor for check ups occasionally, there have been (many) frustrating moments of internalized homophobia and unnecessary awkwardness that have been displayed by healthcare providers towards me.

Where can people find you?: You can find me on LinkedIn or contact me via email at Jonasianraider@gmail.com! 

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Blog Out in Healthcare

Out in Healthcare: Madison Kirkpatrick, SPT, M.S, CSCS, LSVT BIG

Name: Madison Kirkpatrick

Pronouns: She/Her/Hers

Identity: Pansexual and asexual cisgender female

Background: I was born and raised in Eureka, CA. I grew up in an extremely conservative household that made me feel unsafe and forced me to repress my emotions and my identity. I completed my B.S. in Kinesiology: Pre-Physical Therapy with a Health Education minor in three years and then earned my M.S. in Kinesiology: Exercise Science in one year, after which I published my thesis research. I was accepted into the Doctor of Physical Therapy program at the University of St. Augustine for Health Sciences- Austin, TX campus. I will graduate with my DPT at the end of November 2020. I met my now wife during my M.S. and we got married in 2019. In my free time I enjoy spending time outdoors with my wife and our two puppies.

Profession: Physical Therapist

Area(s) of Practice or Interest: Pelvic floor PT with an emphasis on the LGBTQ+ population and outpatient orthopedics so I can treat other types of impairments beyond the pelvic floor.

What does being ‘Out in Healthcare’ mean to you?: Being out in healthcare means being visible to others so the future generations have the representation I did not have growing up, and it means fighting for health equity, justice,  and healthcare inclusion for all marginalized communities. As someone that understands what it is like to have to deal with healthcare disparities simply based on my identity, being out in healthcare is taking on the system full force to improve the lives of my community and the lives of all marginalized communities.

What is one thing everyone should know about your identity?: I don’t like labeling my identity. I label my identity for the people that “have” to know. I am asexual, an identity that doesn’t get a lot of attention, and where I am on the asexual scale personally is that I have never been attracted to anyone I have ever met other than my wife. I am theoretically attracted to all identities of humans, hence why I use pansexual, but in reality, my asexual identity and my lack of interest in the labels another person uses are more who I am at my core (I respect everyone’s labels, but that doesn’t influence whether I am attracted to them or not).

How do you feel when your identity is included?: I feel seen and respected when my identity is included. I feel like my identity is as valuable as the heterosexual identity has been systematically respected historically.

What does “taking up space” mean to you?: Taking up space means taking ownership of the space that has historically given to heterosexual people but denied to members of the LGBTQ+ community. It means demanding that my identity and needs get as much attention as anyone else and it means fighting for more and more space for those that come after me. It is advocacy, it is radical, and it is vital to equity and justice for the LGBTQ+ community.

What is one piece of advice that you would give to healthcare workers who aren’t sure how to honor the identities of their patients?: Put the work in to find the answers to the questions they have about how to honor the identities of their patients. It is not the job of a marginalized community to educate the majority, but there are a number of people from marginalized communities that do fill the role of educator and their resources are plenty and widespread. All it takes is a little Google searching and/or social media perusing. Once they have answers to their questions, it is time to put in the work and put those answers into action. Once the action is being taken guess what? It’s time for more work. It is time to continue to learn and grow, and it is time to teach others and fight for the rights of their patients. The work never stops.

Has your identity influenced healthcare that you’ve received?:  My identity has caused me to deal with subpar care from my primary care provider who asked me about my sexual activity and then spent a lot of time asking if I could be pregnant (multiple questions about this, to which I answered no every time), didn’t ask me if I was using protection, and then was shocked when I told him I was in a relationship with a woman, which I only told him because he wouldn’t stop grilling me about pregnancy. The visit was really uncomfortable after that, and it felt like he was rushing to get my visit done as quickly as possible. Ultimately, I was not educated on STIs, asked if I felt safe in my relationship (thankfully my wife isn’t an abusive person), or anything else that would normally be routine.

Where can people find you?: I am on Instagram @lgbtqphysicaltherapists and my email is lgbtqphysicaltherapists@gmail.com.

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Blog Out in Healthcare

Out in Healthcare: Caroline Cuyler, LMSW

Name: Caroline Cuyler, LMSW

Pronouns: She/Her/Hers

Identity: Pansexual Cisgender Female

Background: I was born and raised in a suburb of Rochester, NY. I went to the University at Buffalo for my bachelors in psychology and did 1 year of my masters in social work at Hunter College in New York City and my 2nd year at the University at Buffalo. I now live in Rochester with my fiancé and our fur children. I have spent my career working with many different populations beginning with survivors of sexual assault and domestic violence.  I am newly out as of about 2 years ago and it was a rollercoaster ride of an experience but, overall, quite positive. In my free time I enjoy camping, traveling and playing video games.

Profession: Medical Social Worker

Area(s) of Practice or Interest: I pretty much do it all in the inpatient medical world. The main unit that I work on is an adult medicine unit that is staffed by resident medical teams.

What does being ‘Out in Healthcare’ mean to you?: Being out in healthcare for me is about visibility and representation. I wear a rainbow pin on my nametag every day as visibility but also to signal to other LGTBQ folks that this is a safe space. I also see LGBTQ folks in all different roles in the hospital and it really creates a culture of inclusivity.

What is one thing everyone should know about your identity?: When trying to find the “right” identity for me, bisexual never felt right because it excluded folks that didn’t fall into the gender binary. I felt pansexual really suited me and my attraction to people for who they are rather than based on their gender. My fiancé is non-binary and is starting the first steps with top surgery and low dose hormones. I am proud that she is becoming the person she always knew she was.

How do you feel when your identity is included?: When my identity is included I feel seen. There is nothing better than when your identity is not something you have to explain or review over and over with others. That is why I focus so much on educating staff on practices such as asking for preferred pronouns and not assuming a patient is in a heterosexual relationship.

What does “taking up space” mean to you?: Taking up space is really about being your most authentic self, whatever that means for each person. I think it can be easy to shrink down who you are to make a situation feel more “comfortable” for everyone but when you take up space it paves a path for others to be able to also take up space. It’s a form of activism and advocacy for others as well as yourself.

What is one piece of advice that you would give to healthcare workers who aren’t sure how to honor the identities of their patients?: This is a part of my role every day as a social worker. Constantly educating staff about how to honor patient’s identities. My number one piece of advice is ASK QUESTIONS. Our patients are the experts on their own lives. You can never assume anything about anyone’s identity and just ignoring or not seeing parts of someone is not treating the whole patient. If you make a mistake about someone’s identity, apologize. We are all humans who make errors but it’s important to commit to correcting the mistake. I think it’s also important to take an intersectional approach to honoring our patient’s identities. Each person’s experience is unique and much of that has to do with how the different parts of our identity shape how we experience the world.

Has your identity influenced healthcare that you’ve received?: I have only been out for 2 years but even in that short amount of time some things have come up. Specifically around sexual health there is always the assumption that I am in a heterosexual relationship and constantly having to correct my providers can get a little exhausting.

Where can people find you?: I am on Instagram (private account) @cecuyler and if you are ever at Strong Memorial Hospital, I am sure you will see me floating around!

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Blog Out in Healthcare

Out in Healthcare: Emma Baldwin, OTS

Name: Emma Baldwin

Identity: Cisgender gay/lesbian woman, White, Anti-racist

Pronouns: She/her/hers

Background: I am a 23-year-old born and raised in Oak Park, Illinois (the first suburb West of Chicago). I have been in Indiana for my years in higher education and I am ready to take on a new place following graduation! I studied kinesiology and studio art in undergrad, and was a life-long student-athlete. I love hiking, making art, and traveling, but I am the most passionate about advocating and learning. 

Profession: I am currently a 3rd year Occupational Therapy Student (3rd year), and an artist on the side.

Area(s) of Practice or Interest: Pediatric or adult home health, early intervention, hospice home health, sexuality and mental health, neuro… primarily emerging practice areas and places where I can take on leadership roles.

What does being ‘Out in Healthcare’ mean to you?: To me so far (newbie to healthcare over here), it has meant learning how to advocate for myself and others in my school, on my fieldworks, and beyond. I found ways in my school to advocate for bias-free language, better LGBTQIA+ client education, and many more purposes, all by trying to foster inclusive conversations and providing resources. I recognize that I don’t have all the answers but I sure do have a lot of ideas, and being ‘out in healthcare’ or ‘out’ at my school allows me to advocate first-hand. Shoutout to the Coalition of Occupational Therapy Advocates for Diversity (COTAD) for helping support us students in doing so!

What is one thing everyone should know about your identity?: I think the interesting thing about my identity is that I can blend in. It can be a blessing at times and a curse in others, but it is definitely a privilege. It is challenging for me still to own who I am and vocally identify myself as queer in healthcare because no one asks. Sometimes breaking apart from the assumptions is more challenging than simply stating how I identify awkwardly off the bat… but it’s still a balancing game that I am working to figure out. 

How do you feel when your identity is included?: I think that goofy smile, one that you couldn’t wipe off my face if you tried, says it all. There is really no feeling like it.

What does “taking up space” mean to you?: To me, taking up space means being visibly unapologetically who I am. It means paving the way for future generations of me’s & you’s who don’t see ourselves represented in our fieldwork educators, healthcare providers, clients, and professors (etc.) as often. To me it means constantly navigating how to come out, when to come out, and how to feel okay with how people view me… yet it seems like the big key to all of that, is feeling okay with how I view myself. Doing this interview is just one step towards me being sure that I show my true colors and be my true self in my future work settings, for myself and for others.

What is one piece of advice that you would give to healthcare workers who aren’t sure how to honor the identities of their patients?: Simply asking questions and giving me the space to answer, before assuming literally ANYTHING. That is the difference between making me want to come back and avoiding it at all costs. It really is true that sometimes LGBTQIA+ individuals may not feel comfortable in receiving care from someone after assumptions are made. I recognize that healthcare is crucial and that seems crazy to say, but even knowing all of that, I have avoided seeing specific doctors or changed providers due to discomfort. To be as researched and well-informed as possible on how to make your LGBTQIA+ patients comfortable and feel included will go so far. There are so many resources out there.

Has your identity influenced healthcare that you’ve received?: Yes, and you don’t want to listen to the long uncomfortable stories. Simply asking questions at the very beginning (even on a form) could have prevented these unfortunate incidents.

Where can people find you?: You can email me at embaldwin00@gmail.com or follow me on instagram at @em.baldwin.00 & @emmabaldwindesigns. Really, feel free to reach out!!

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Blog

OT and Transfeminine Equipment: Breast Forms, Gaffs, and Tucking Oh My!

Transfeminine equipment or equipment for those with feminine gender expression among people assigned a male sex at birth, particularly transgender and gender non-conforming individuals may include: prostheses, breast forms, gaff, tape, tucking, padding.

Padding: Padding refers to the use of undergarments to create the appearance of larger breasts, hips or buttocks. Padding may also assist in minimizing dysphoria.

            Some padding-specific garments include:

–       Padded undergarments: Typically, useful for facilitating appearance of wide hips or full buttocks

–       Bras with pockets: Also known as mastectomy bras, they are designed to accommodate breast forms and other associated prostheses

–       Padded bras: May be preferable if breast growth is present but not at the desired size.

Prostheses: An artificial body part(s), typically made from plastics, lightweight metals, or composites. May be formed to represent a breasts, penis, scrotum, or other anatomy.

Breast forms: Prostheses that have the appearance of breasts. Typically made of soft silicone gel and adhere to one’s body or are placed in a bra. Can be considered a form of padding.

Tucking: Tucking is the practice of arranging and supporting external genitals between the legs, including the penis, scrotum, and testicles so they are not visible in clothing. There are many ways to tuck, such as pushing the penis and other anatomy between your legs and then pulling on a pair of undergarments, to tucking the testicles inside of you. People tuck for many different reasons. One might tuck in order to feel more at ease in their body (minimize dysphoria), to feel more comfortable in their clothing, or to facilitate affirmation as one’s gender. There is minimal research on the safety of tucking.

Gaff: compression underwear that minimizes the appearance of a penis, scrotum, and testicles.

Tape: tape may be used with or instead of a gaff to “tuck” or minimize the appearance of the penis, scrotum, and testicles.

Important gaff considerations:

o Choosing the right size gaff is like choosing the right size underwear. One can also measure the circumference of their waist, just above the hips for correct sizing.

o Safe tucking/gaff techniques mirror those of binding:

o Minimize frequency of wearing, take breaks throughout the week (although it may not be ideal, it is particularly important for involved anatomical and physiological systems). Reducing the intensity of wearing (daytime donning) can also reduce risk of negative effects, though not as significantly as reducing the frequency.

o Minimize duration of wearing, as in reducing the wear time throughout the years. Bottom surgery is an alternate to tucking, however it is important to note that not every individual that tucks will want bottom surgery, nor will all individuals have access to the procedure (cost, access to healthcare, etc.)

o Unsafe tucking can affect the circulatory system, musculoskeletal anatomy, fertility issues, sex and intimacy, and skin integrity.

Gaff/ tucking garment maintenance: First and foremost, follow the washing/care instructions on the packaging/garment. In general, hand washing is the best. Avoid using bleach and/or a dryer as they accelerate material breakdown/ reduce integrity of the material. Pay special attention to skin folds, folding in the tucking garments (gaffs), bulging skin adjacent to the gaff or selected garment, redness, skin abnormalities, and prolonged indentations. Pay extra attention to the effects of the trans affirming/generally affirming care that you provide.  

The risks and contraindications are 𝕒𝕝𝕞𝕠𝕤𝕥 𝕒𝕝𝕨𝕒𝕪𝕤 𝕒 𝕣𝕖𝕤𝕦𝕝𝕥 𝕠𝕗 𝕦𝕟𝕤𝕒𝕗𝕖 𝕥𝕦𝕔𝕜𝕚𝕟𝕘 and 𝕒 𝕣𝕖𝕤𝕦𝕝𝕥 𝕠𝕗 𝕒 𝕙𝕖𝕒𝕝𝕥𝕙 𝕤𝕪𝕤𝕥𝕖𝕞 𝕥𝕙𝕒𝕥 𝕗𝕒𝕚𝕝𝕖𝕕 𝕒𝕥 𝕞𝕖𝕖𝕥𝕚𝕟𝕘 𝕒𝕟 𝕚𝕟𝕕𝕚𝕧𝕚𝕕𝕦𝕒𝕝𝕤 𝕟𝕖𝕖𝕕𝕤. We need to have the knowledge based to educate our clients on safe tucking practices as healthcare provides and 𝕖𝕤𝕡𝕖𝕔𝕚𝕒𝕝𝕝𝕪 as occupational therapists. HELLO!! ADLS!! DRESSING!! Anotha time for the people in the back: we alllll know that our professors/we talk about dressing all of the time throughout our programs and throughout providing care 𝕒𝕔𝕣𝕠𝕤𝕤 𝕥𝕙𝕖 𝕝𝕚𝕗𝕖𝕤𝕡𝕒𝕟. That’s right peds friends, I’m calling you in on this too. You may have a child, adolescent, or young adult that is going to need 𝕪𝕠𝕦 to educate them on safe tucking practices.

Sources:

http://www.phsa.ca/transcarebc/care-support/transitioning/bind-pack-tuck-pad

https://www.gendergear.ca/pages/all-about-gaffs

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Blog Travel OT

LSVT and Me

Picture property of https://www.lsvtglobal.com/
Citation

What is LSVT/ LSVT LOUD?: “LSVT LOUD is an effective speech treatment for people with Parkinson’s disease (PD) and other neurological conditions.  Named for Mrs. Lee Silverman (Lee Silverman Voice Treatment [LSVT]), a woman living with PD, it was developed by Dr. Lorraine Ramig and has been scientifically studied for over 25 years with support from the National Institute for Deafness and other Communication Disorders within the National Institutes of Health (NIH) and other funding organizations. LSVT LOUD trains people with PD to use their voice at a more normal loudness level while speaking at home, work, or in the community. Key to the treatment is helping people “recalibrate” their perceptions so they know how loud or soft they sound to other people and can feel comfortable using a stronger voice at a normal loudness level.” (LSVT GLOBAL)

“While LSVT LOUD treatment has helped people in all stages of PD, the majority of research has been on those in moderate stages of the disease. LSVT LOUD has also helped people with atypical parkinsonisms, such as progressive supranuclear palsy (PSP), and has recently shown promise for adults with speech issues arising from stroke or multiple sclerosis and children with cerebral palsy or Down syndrome. Beginning your work with LSVT LOUD before you’ve noticed significant problems with voice, speech and communication will often lead to the best results, but it’s never too late to start. LSVT LOUD has the potential to produce significant improvements even for people facing considerable communication difficulties.” (LSVT GLOBAL)

(Direct quotes from LSVT GLOBAL)

What is LSVT BIG?: “LSVT BIG trains people with Parkinson disease (PD) to use their body more normally.  People living with PD or other neurological conditions often move differently, with gestures and actions that become smaller and slower. They may have trouble with getting around, getting dressed and with other activities of daily living. LSVT BIG effectively trains improved movements for any activity, whether “small motor” tasks like buttoning a shirt or “large motor” tasks like getting up from sofa or chair or maintaining balance while walking. The treatment improves walking, self-care and other tasks by helping people “recalibrate” how they perceive their movements with what others actually see. It also teaches them how and when to apply extra effort to produce bigger motions – more like the movements of everyone around them.” (LSVT GLOBAL)

“Because LSVT BIG treatment is customized to each person’s specific needs and goals, it can help regardless of the stage or severity of your condition. That said, the treatment may be most effective in early or middle stages of your condition, when you can both improve function and potentially slow further symptom progression. Beginning your work with LSVT BIG before you’ve noticed significant problems with balance, mobility or posture will often lead to the best results, but it’s never too late to start. LSVT BIG can produce significant improvements even for people facing considerable physical difficulties.” (LSVT GLOBAL)

(Direct quotes from LSVT GLOBAL)

Method: Completed the online certification program (also an in-person program with same materials) I would personally would have done the in-class program if it were available to take around me and with the changes associated with COVID I was limited to the online course. I am a hands-on learner but still feel prepared to implement a LSVT program via the online certification course. Certification acquired by completion of LSVT Global’s LSVT BIG Online Course Modules (40) while achieving an 85% or higher on the final examination.

Time: 12.5 hours of course material with average of 16 hours of completion for clinicians, over 90 day period. If you need extra time, you can purchase extensions in 30 day increments. I used almost all of the 90 days (83 days total) to complete the course. Some barriers were working full time, traveling between multiple areas (travel therapy), and lack of motivation to start. Once I completed the first 5 or so modules, I was able to speed through multiple modules at a time. 

Cost: $580.00, $50.00 every two years for renewal. Fortunately, with a bonus from extending my travel placement, I was able to cover the cost of the certification.

Program: At least 4 1-hour sessions per week for 4 weeks, with daily exercises and tasks to completed outside of clinic time. If a patient requires additional time then you continue the program, with supportive documentation and assessment. Consists of 7 daily exercises, functional component tasks, carryover tasks, and hierarchy tasks. Facilitation of the program includes specific and simple cues from the clinician, with the use of modeling and tactile cuing techniques. There is daily homework for the patients that must be completed for the best outcome. 

Why I chose to pursue the LSVT BIG certification as an Occupational Therapist: I have always loved all thing neuro/neuro rehab! I have started the quest to enhance my knowledge in neuro-focused areas through continuing education unit courses (CEUs), certification programs, books, journal articles, podcasts, and research articles. In my year and a half long career thus far as an OT, I have worked with many individuals who live with a diagnosis of Parkinson’s Disease (PD). I briefly learned about the certification course (LSVT BIG) in college and also know friends/colleagues that had already obtained the certification. I have always heard positive reports about the LSVT program and decided to look into in further. An online course was the best option for me and I was in a financial position to purchase the course so I decided to go for it. I am also looking into the Impact OT (ITOT) certification and the Certified Brain Injury Specialist (CBIS) certification for the near future to continue on my neuro-focused journey!

Pros of LSVT Certification/Program: Set protocol to follow, but also individualized based on client’s goals and functional needs. Can be completed in multiple settings, and initiated by a LSVT certified OT in SNF and completed by LSVT OT in HH. The program is evidence-based. The exercises and task are modifiable to patient performance level, with multiple options on grading the activities up/down as absolutely needed. When the certification program is purchased, one receives an LSVT resource book with the modules, exercises, and handouts inside (also available online). I started with re-writing all of the notes from the modules by hand because I didn’t want to wait for the resource book to arrive, as I usually start with this method for studying. I would recommend just waiting for the book or taking online notes if that’s more your style, because re-writing by hand definitely slowed down my completion of the modules. The program has a ton of built in repetition so if you have to complete it in chunks like I did then this is really helpful. There is also a quiz at the end of each module to check for learning of objectives and course material. The repetition and quizzes made it so I had minimal final exam prep to do. The LSVT BIG program is able to be generalized to other neuro populations as long as they meet certain criteria. 

Cons of LSVT Certification/Program: A patient must complete at least 4 weeks, with 4 1-hr session per week, as the evidence only supports a program of this length or more. Program is more affordable than a lot of certifications, but cost is still a barrier to obtaining certification. Program not yet available via telehealth.

Overall, I think the LSVT BIG certification program for Occupational Therapists is worth it!