Tuesday, November 17, 2009

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!

Sunday, November 8, 2009

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!


Sunday, September 27, 2009

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.

Sunday, September 6, 2009

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!

Wednesday, July 8, 2009

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.

Wednesday, May 6, 2009

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?

Sunday, April 12, 2009

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!

Tuesday, March 24, 2009


I am so excited to be an aunt! Now and later (again)! Like the candy... ooooo, I need to find some Now and Laters for Lena and Ben to try.

Life is busy! But the semester is going smoothly, and even more miraculously, it's nearly over!

I find out where I will be at for my summer internship sometime in the next 2-3 weeks. So many things are in limbo right now until I find out where I will be. My contract for my apartment terminates at the end of May, so I need to know if I should try and extend for a couple/few months or find something else. Dan is heading out to Boston in the beginning of May, so I am hoping that I can still be in the city so we can actually spend time together. There is a small chance I could get assigned to a clinic in Maine, but I don't like to think about that.

Spring break was spent out in Utah, which was excellent. I miss the weather in Utah. Surprisingly, it is mild compared to Boston. It changes more within the course of a 24 hour segment in Utah than in Massachusetts, but it is still a little nicer on average. I enjoyed being able to study with Harold again, I sure have missed him and his wonderful Periodical section catacombs. I got to stay with Evan and Hannah, play lots with Lena and Oliver, see lots of friends, eat lots of yummy food, spend lots of time with Dan, and take a brief respite from the restless rigors of grad school.

The last two weeks, we have been learning the various tests and measures for the hip joint. Anyone ever realized how much a leg weighs before? I feel like I have been getting a full body workout each class session as I attempt to position the lower extremity as I want it and then manipulate joints, bones, muscles, and other structural components. It's fun! I initially decided that I wasn't a big fan of using a belt because it looks like you are torturing a patient, but I am now a believer in belts! They help tremendously! With some things. The patient feels more comfortable, you save your back a few more years before you have an L4-L5 disc herniation, and the body mechanics are much better for allowing you to manipulate what you want to. Some examples of some varieties of usage of belts:

Sorry it's been a while since I have written. I've been having lots of fun, but also spending lots of time working hard. The trick is to have fun while you are working hard. One way to to do this is to go and study at the Boston Public Library (BPL). The BPL was the first to do just about everything in the United States, as far as libraries are concerned. Much like everything else in Massachusetts, for some odd reason...

From Wikipedia, "The Boston Public Library is the largest municipal public library in the United States. It was the first publicly supported municipal library in the United States, the first large library open to the public in the United States, and the first public library to allow people to borrow books and other materials and take them home to read and use.The Boston Public Library is also the library of last recourse of the Commonwealth of Massachusetts; all adult residents of the state are entitled to borrowing and research privileges, and the library receives state funding. According to the American Library Association, the Boston Public Library, with over 15 million book volumes, is the third-largest library in the United States after the Library of Congress and the Harvard University library system." http://en.wikipedia.org/wiki/Boston_Public_Library

Saturday, March 7, 2009

Spring Break!

I'm in Utah for spring break! For a whole 9 days... Somehow, I survived the craziest midterms ever last week and not I have a week off. I love having a spring break!

Saturday, February 7, 2009

Wearing Red

Yesterday, almost all of my classmates wore red to participate in National Wear Red Day, raising awareness of women's heart disease. It was pretty neat to see everyone sporting their red, similar to St. Patrick's day with green, but for a real cause and not just to justify a night of partying that will follow.

Here is some more information on this very interesting, national holiday:

I am working on writing a systematic review for a class seeking look at the literature and compare data on the question, is aerobic exercise an effective intervention for patients with congestive heart failure?

It is sad to learn about the severity of the symptoms of heart disease, its fatality rates, and how debilitating it can be. After all, it is often our heart that stops in the end (regardless of the end-stage disease) -- heart failure is the most common cause of death. There is extensive research to show that early and frequent aerobic exercise AND resistive exercise minimize the risks of heart disease/heart failure before onset. I encourage all to get into aerobic exercise and resistive training BEFORE you develop heart disease! At a certain point, aerobic exercise is too intense for the heart to sustain.

Wednesday, January 14, 2009

Knee is great, class again

I am back in Boston and back in the normal routine. I was welcomed by COLD weather and ice everywhere, which makes walking not too fun. I have realized the truth behind the popular line that "Boston is a walking city." Things are very walkable which makes tourists happy, but when you live here and don't have a car, the public transportation requires much walking, whether you like it or not. I actually enjoy the walking after a long day of sitting in class, but I also am sometimes extremely scared of the combination of the ice and the instability of my knee.

My knee is doing well! I have to keep reminding myself that I got surgery 3 weeks ago and that even though I have my range of motion back, I still don't have the muscle strength or the ligament stability to do everything that I want to. I attempted to do some skills practicing that required a minimal amount of pivoting in a lab class on Monday, and I definitely felt it afterwards. My knee is very good at telling me when I have done too much.

I am excited to be able to get back into a routine! The cold weather does have one positive - it motivates one to get going from one place to another and not be idle/slow in transportation. It also limits the amount of social activities going on and makes one want to curl up on a blanket in front of a fireplace. There is a fireplace at a Marriott lobby close to my school, so hopefully I can turn the desire to curl up by/in warmth into some quality studying time.

The snow is also absolutely beautiful, in some places. The contrast between the snow and the gray water that I see out the window of my school every day is breath-taking. Boston is beautiful. I love the east coast!

This weekend I am going to Chicago, where it is supposed to be in the single digits and 10s. Guess I can't complain much about Boston (yet)...