Who can decifer real from surreal?

This is a fun time, full of busy days and lots of getting back in touch with friends and family as Daniel and I gather addresses. There are lots of tests, papers, and school assignments to do, but I am past the half way point with school. That is a great feeling. I am on a downhill slope towards working full-time in a clinic!

We are having an engagement party on Friday, so there will be fun pictures from that soon!

Middle of the Semester

It's the middle of the semester. I just finished midterms and am getting started with term papers. I am right in the thick of wedding planning. I am busy!

Here are some great things that Daniel and I have been able to do lately:

1. Fiddler on the Roof! Topol's farewell tour. Dan surprised me with tickets on Friday night! It was so much fun. Yummy, yummy Thai food to begin the awesome date.

2. Gather addresses. Please let us know your addresses, everyone! The time is winding down, we have got to get these things out soon.

3. Enjoy people's reactions when they learn we are to be married December 22. Many of our church friends thought we were crazy for dating for 13 months before getting engaged, whereas my classmates are shocked at what they believe to be a short courtship and an insanely short engagement. It surely is a lot to get done in 3 months, but there is nothing I am more excited to do than marry Daniel. The sooner the better!

4. Dinner at Clark and Guinevere's. It is such a wonderful treat to have family close by.

5. Order plane tickets for Thanksgiving. We are going home to each person's respective homes (separately, sadly) for Thanksgiving. I will miss Daniel terribly...

6. Catch up on some movies we have been wanting to watch lately.

7. Went to a great LDS Education Conference in Boston.

8. Seen lots of friends who were in town for various reasons. Great to see you, if you fit in this category and happen to be reading this.

Hope everyone else is doing well!

Here is a link to our facebook group with information about our wedding events, an invitation to leave your address, and some pictures. I hope the link works. Please leave your addresses there, email them to me, or call me.

Thanks everyone!

Claire

Engaged to be married!!

Well, here is the announcement you all have been waiting for... Daniel and I are engaged to be married! Dan proposed to me at a beautiful lighthouse in Gloucester, Massachusetts yesterday evening. It was perfect.

Summer is over. Class has begun again. With one major, exciting change. Dan is in Boston!!! Dan transferred to Boston University to finish up his undergraduate studies in Biochemistry and Molecular Biology. He and I spent the summer in our respective internships, working long hours and enjoying the evenings and weekends together. What a fun summer it was! I spent my August with family, mostly, as I was able to be in San Diego for 2 and a half weeks and was able to spend a lot of time out with Guinevere and my mom in Framingham, MA at the end of the month! Guinevere had an amazingly beautiful boy named Cassius Woolstenhulme. He is so much fun to interact with and I love him so much.

This semester will be as intense as every other one thus far, with 19 credits and a couple of very difficult subjects in Management of Neuromuscular Disorders and "Spine". I will learn how to treat major and minor neurological and spinal insults/injuries of all sorts this semester! I am really excited.

So, there is a very brief update on current affairs.

Love you all!

The New York Times and Physical Therapy

The New York Times has put together an impressive list of articles recently published and pertaining to physical therapy.

Here is the link.

There are some interesting ones such as Physical Therapy and the Camaraderie of Healing, which is a first-hand account from a patient who learned to respect physical therapy after a minor arthroscopic surgery with just a few incisions to repair a torn meniscus. A relatively common surgery, this can be a surprisingly frustrating and painful and debilitating surgery at first. Rehabilitation can be slow, but the prognosis for return to previous levels of activity is very, very good.

Another relates a woman's struggle to cope with losing the ability to walk after the progression of a rare neurological condition. The author discusses the frustrations of having to cope with a chronic illness, discover new ways to perform daily activities, and be grateful for every little gain that she makes.

I am currently deep into a summer internship at Spaulding Rehab in Medford, MA. Spaulding is consistently one of the top 5 rehab hospitals in the country every year. They have a very prestigious chronic pain of neurological etiology program that works wonders in many patients' lives. It allows them to manage the pain that has, in most cases, removed them entirely from their previous activities, brought on other complications such as depression, anxiety, gastrointestinal problems, and psychosocial issues such as divorce or kinesiophobia. They return to functioning with good body mechanics, proper use of pain control modalities other than pain meds, and sometimes return to work and support themselves instead of remaining on disability.

Physical therapy is growing in respect nationwide because of the effects that patients report after an episode of physical rehabilitation care. It is exciting to see.

Therapeutic Exercise Boot Camp

There were 4 days of bliss. I had a 4-day break after a grueling semester. And now I am back in school. For two weeks, I am participating in an intense block of 2 classes, which is something similar to a boot camp for 1) devising exercise programs for patients and 2) teaching patients of all ages.

It is intense, but it is fun. 60-100 pages of reading per night, with 1-2 chapters and multiple articles assigned for each class. And 8-9 hours of class per day. We also get a LOT of hands on practice. I am beginning to feel much more comfortable with my decisions. I feel more confident that I am influencing effectual changes. It is good preparation for the endurance that will be needed this summer in my internship, when I am in a physical therapy clinic for 8-10 hours a day!

In other news, the weather is amazing and I am able to play BASKETBALL again! My knee is doing well and I am beginning to be able to run and do some side-to-side motions! YAY!

What is everyone doing for the summer? Anything fun?

Spring and Finals

So, another semester is nearing its end. And I am starting to stress, as is often the trend in the last two weeks of school. But the stress is more of a controlled stress than it has been in the past. Perhaps I have become slightly conditioned to the stress and I am just now finally learning that the best strategy when the amount of work increases is to pace myself and stick to a plan. Education is not only about learning material, but it is also about learning the skills needed to master the amount of work for each class. Intelligence may be the innate ability to pick up new concepts, but patience, planning, collaboration with others, and enduring to the end are learned behaviors that are essential for survival. I have had to work hard at learning these.

In the research paper that has consumed my entire semester, I am discussing the role of exercise on patients 55 or older who already have a diagnosis of mild to moderate heart failure (congestive, classified by the New York Heart Association as Class II or III). Up until 15 years ago, clinicians (doctors and physical therapists) were scared to exercise these patients for fear that increasing the workload on an already inefficient heart would be detrimental and even fatal. However, groundbreaking new research shows that exercise is absolutely essential to maintaining heart function and that if the exercise is performed below an ischemic level, it can actually reverse some of the characteristics of a failed heart. Ischemia is a lack of blood flow to the heart, which can kill heart tissue and conducting cells, causing myocardial infarctions (heart attacks). In exercising individuals, ischemic levels are subjectively felt by the patient as angina, chest pain that is specific to the individual and is felt in different ways by every single patient.

I mention this research because it has become something very intriguing to me and also because it illustrates the great benefit of managed stress. The ability to push past our limits of comfort is part of makes us human. Physically, we have the ability to overpower what our muscles and joints are telling us because of the highly sophisticated brain that we have. Few species can claim this ability. Pushing on in schooling, work, recreation, exercise, and in every other area of our life causes an increase in amount of stress we have to handle, sometimes beyond what we are currently able to do.

When controlled, this is classified as eustress (verses distress), or good stress. It is essential for us to develop good habits of spreading out our stress out over time so it does not occur all at once. Just like exercising a heart, if we have an onset of stress all at one time, we will have a figurative heart attack, or manifestation of a failed system of control. Instead, gradual increases in stress will lead to increased performance, decreased limitations, and seemingly exponential outcomes of success.

If we could educate teachers, bosses, coaches, etc. on this principle of gradually increased stress, then we would all be better off. The phenomenon of it all is that even though it is proven to be more healthy to do all we can to gradually increase stress over time, we procrastinate dealing with anything stressful because it is seen as "hard". We remember the last bad experience we had with something "hard" (usually something involving unhealthy amounts of distress around a time of a final, project, or two-a-days in soccer) and associate poor thoughts and emotions with those stressful experiences.

Excessive amounts of stress cause unique and reproducible symptoms in different people, just like angina is a different feeling that is reproducible in the same way for every person with congestive heart failure. Angina is described by some as a pressure in the chest. Some feel aches in the abdomen or stomach. Some develop pain in the upper extremities. On the other hand, stressful situations cause some people (hopefully who don't have heart failure to also complicate things--lack of heart disease is always at least one thing to be grateful for) to become very tired, others to become mad, and yet others to feel worthless, incompetent, or inferior. In order to refrain from pushing into a level of inefficiency of the heart in patients with heart failure, the exercise is stopped. The patients rest until the angina goes away, and then can continue, with less intensity than was previously pushed to. It is called a symptom-limited exercise stress test.

Maybe it would be beneficial for all people (myself included) to have something similar to a symptom-limited exercise stress test, broadly measuring the effects of all stressors. It can familiarize one what symptoms are felt at unhealthy levels of stress. Knowing what types of situations stress one out, what signs are present when stress is too intense, and when to stop pushing so hard will save people from continuing into dangerous zones where inefficiency sets in.

Good luck to everyone with your tests, projects, papers, work loads, and recreational stresses! The challenge is to keep the stress gradual. That is my goal!