Kintinu'd Conversations
You’re listening to Kintinu’d Conversations. We’re healthcare providers working at Kintinu Telerehab out of Omaha, NE. We provide physical, occupational, speech, and psychological therapy to help individuals around our country get back to life. This podcast is designed to engage a variety of listeners on topics that matter to us-- whether at work, in life, or in our relationships.
Kintinu'd Conversations
S3E21 - ASCIP Conference Highlights
Backed by decades of experience producing exceptional clinical outcomes, Kintinu Telerehab connects recovery to everyday life. In this podcast, we explore hot topics in rehabilitation, the keys to personal growth and recovery, and how to apply it all to the real-world.
In this episode of Kintinu’d Conversations, Brad Dexter sits down with physical and occupational therapists Connor Davis and Sara Waid to share their highlights following their experience at the 2023 Academy of Spinal Cord Injury conference.
They'll cover topics ranging from recreation and education for individuals with spinal cord injury, to advocacy and cognition/learning challenges and finding ways to acquire new skills after SCI.
Listen to the episode on Spotify, Amazon Music, Apple Podcasts, and Buzzsprout, or on your favorite podcast platform.
Welcome to continued conversations where we explore hot topics and rehabilitation, the keys to personal growth and how to apply it all to the real world. Hey, welcome back to continued conversations. This is Brad Dexter, and I have a couple of guests in the studio today. Connor Davis is a physical therapist for QRI's inpatient program and Sarah Wade without an H is one of our occupational therapists for our inpatient program at QRI.
Speaker 1:Each of these folks are working with our spinal cord injury program and we recently had the opportunity to go out to San Diego for a conference a few weeks back, and so, in line of spinal cord injury awareness month here in September, I just thought it would be good to sit down and talk through some of our takeaways from that conference. The conference itself was ASCIP, which is the Academy of Spinal Cord Injury Professionals, a great conference for folks that are maybe jumping into the spinal cord injury profession or have been in it for a long time and are looking to network, grow in their clinical skills or even grow in their advocacy for spinal cord injury population in the US here too. So that's kind of just TN up the conversation for the day here, but before we really jump into it, you guys, I would love to just hear you know with the San Diego Sarah. You told me earlier it was your first time in San Diego, connor, and I had been there before. Maybe just one of your favorite things about the area, sarah go?
Speaker 2:We went over to Coronado Island and went on the beach and I had never been to a California beach before. I had been to Florida many times and there was something different about the beach. I loved it. I was just. Everyone was. You know, dogs were out there playing catch and little kids were running around. Not many people were in the ocean. The waves were huge, so I understand why you didn't really want to be in the ocean. The water was pretty cold. But yeah, it was just fun and I think the atmosphere was something different than I had seen before. So, yeah, nice San Diego had been on my bucket list for a long time, so I did check it off, but might have to go back.
Speaker 1:I mean, granted, like you're only getting those little windows after 7 o'clock at 9. I guess you went out a day early, yeah, yeah.
Speaker 3:Nice. Yeah, I had been to San Diego probably 10 years ago so it's been a minute. But one thing I do remember was the fish tacos. Best fish tacos I've ever had were in San Diego. So that was one thing on my bucket list I had to figure out while we were there and the blind burrow really came through. So restaurant out there, went there a couple times, got to know the serving staff Pretty much a local guide.
Speaker 1:You made friends and everything.
Speaker 3:Yeah.
Speaker 1:When you stole mine. The blind burrow was fantastic. It was Street tacos. That was a great location. I just love the weather. Yeah, you know, you can't beat it in San Diego, and it's nice, you know, getting up early in the mornings and going for a run or just going for a walk outside, and, yeah, that's a nice little break away from the conference and sitting inside all day long too. But we're not here to talk about how great you've seen the Diego guys. We're actually going to talk about what we took away from those times where we were sitting in the conference. And so, sarah, I might just kick it off with you. You can kind of come prepared with a few takeaways and, sarah, I thought some of what you were processing through was pretty insightful too. Why don't you just give us, you know, bullet point fashion, give us a few takeaways and let's dive into the content.
Speaker 2:Yeah, I think one of my takeaways we the pre-conference this year was about adaptive sports and I think it really opened my eyes to just the importance of getting giving people experiences outside, getting outside their comfort zone, getting getting something new kind of to their day to day and helping them find a social network of sorts, and so I think providing the experience was a big, a big piece for me.
Speaker 2:I think the education that was a big takeaway of from the conference last year for me as well and have worked to find ways to implement that here. But I think just it's just continual, that's a continual growth area, I think for me and just finding ways to continue to empower individuals after their injury to understand their, their body, what's going on. One of the presentations I really loved was one on cognitive supported learning and knowing that a lot of our folks don't necessarily have a diagnosed cognitive deficit but there is a lot, of, a lot of things when it comes to having a traumatic injury and that that can really impact learning and so really, how do we help support that learning? I think that was a big one and and that kind of wraps into like that trauma informed care, which I know we've had some conversations recently around here as well, and in terms of what, what is trauma, informed care and what does that look like for us as a team to be more mindful of that?
Speaker 1:So I have a couple questions for you guys, just off of some of those bullet points. So maybe the providing an experience for people so you're talking about that in the context of adaptive sports and, first and foremost, like our adaptive sports guys are incredible at, armstrong is amazing. We've done another podcast with Ed where he kind of highlights his philosophy around recreation and adaptive sports and giving people those experiences. But maybe can you guys talk about just from like a clinician perspective? Right, you guys are, you're in it. There's a lot of planning that's going on. You're trying to move people toward community living again. You know, after QLI, why is it so important to get them those experience, to slow down and to understand who they are, what makes them take, what makes them get out of bed every single morning, and to give them experiences that might be purposeful to them.
Speaker 3:Yeah, I can, I can start. I think it's super important to just motivate with meaning. I mean we can drill transfers all day but if the only reason to transfer from point A to point B is to get back into bed, like, how meaningful is that to somebody? If we're working on transfers to ultimately get in a kayak or on a bike or, you know, a track chair so someone can go back to hunting, that's super meaningful to them, you know. So that's powerful because it's motivating for them to then do. I mean that's therapy in itself and then they show more progress that way. You know, I know for me just to work out to be in shape, it doesn't motivate me very well, but like to work out so that I can play with my son and not get hurt on the bouncy castle over the weekend.
Speaker 3:You know, that's a goal for me, you know.
Speaker 3:Even though he's still dead, Even though I did tweak my back a little bit yesterday but I got some work to do, but anyway, just creating that environment that gives people hope, or even showing them a new thing that maybe they didn't know they wanted to get into, and so I think that's the takeaway, too, that I had, sarah, from the conference was let's show people all the options, like, if you weren't into skiing before, let's try it out. If you weren't into this, let's go for it. You know, because they might find something that they liked, that they didn't know or they didn't have time for before, you know.
Speaker 2:So yeah, I think piggybacking off of the motivate was meaning.
Speaker 2:You know, one thing Ed talks a lot about that I really appreciate is just everyone kind of comes to adaptive sports for a different reason, and so for some people it's I just need you know my goal is to gain strength in my arms or to get better core balance, and so, you know, being able to work on that.
Speaker 2:Some people it's kind of what you said is I want to get back to those activities, and some it's like I just want to connect with my family or those that are close to me. I think that's a big piece, for adaptive sports and recreation is just that opens up a lot of avenues. We all have some sort of recreation that we enjoy doing in our day to day, and so I think that's huge. One takeaway that I from the conference was there was a gal that she had been injured for probably over 20 years at that point and she had never really been introduced to the adaptive sports world and she was introduced to adaptive skiing and she said that she really loved just the feel of like the wind whipping through her hair.
Speaker 2:Like she was never really a big into sports per se, but just kind of that adrenaline rush that skiing gave her was really life giving. And now she's, you know, going around helping them do presentations with this ski that she gets to ride, and so, yeah, I think I think it, you know. Back to your original question, brad. I think that you know there's a. There's so many reasons why someone might enjoy that recreation, that adaptive sports, and you don't know why.
Speaker 2:You don't know what's going to connect with them. I've had individuals who, yeah, it getting involved in those kinds of things actually jump starts their therapy and it really allows us to push deeper in our therapy goals, because they start to see how this might, you know, correlate to getting back to something they really enjoy doing, and so, again, I think that motivate with meeting is definitely a big piece.
Speaker 1:Yeah, I'm gonna maybe throw you guys for a loop a little bit, but do you remember the ICF model? Right, okay, how much do you think about the ICF model now?
Speaker 3:Well, it kind of just comes with the territory. I mean it's a little more naturally right.
Speaker 1:Yeah, you kind of just build it in. I was helping to teach on the ICF model recently, right, and it's not like the most thrilling thing to learn, but as I was prepping for that, I was just thinking about a lot of the things that I've learned in these regards over the years. Some of it's just what QLI has programmed into me, right, it's part of our culture and what we do, how we look at people. We talk about, you know, picking up the shattered pieces of life and helping people to put those back together again. And I was reminded of Simon Sinek's book.
Speaker 1:Start With why, right, and we often talk about that.
Speaker 1:You know what's that person's why, what are they value, what motivates them. There's a lot of different language around that, but I think as a student's perspective or as a neuro grad and sometimes clinicians over time can lose sight of this too where you focus on what's wrong with the person and not what they're able to do, right. And so what happens is you started that body function and structure part of that model where you're just focusing on what's wrong, what's impaired, instead of thinking about what is their why, what is their purpose, what do they wanna get back to? Is it bouncing on the bouncing pad thing with your son so that you, in a way that you're never gonna get hurt, right? Or is it being able to get back down onto the floor again with a grandchild? Is it being able to walk over that grass to get to your nephew's soccer game, whatever? That might be right, but if you start there right, that's a really natural entry point into adaptive sports and kind of recreation like you were talking about, sarah.
Speaker 2:Yeah, I think that highlights our tridimensional care and the importance of the life path side of our program and I think a big piece that makes what we do here unique. And yeah, I think that's huge when we start with the why and then that really allows us to be able to make a program truly client centered and, yeah, more impactful.
Speaker 1:Okay, I wanna jump to education, right. So we've generally just kind of talked about gosh. The more we educate, the more you empower people to kind of reclaim life again. Right, You'll lose a lot of control after having a spinal cord injury, and education is part of the process of getting some of that control back. So what kind of stood out to you in those regards, sarah?
Speaker 2:Yeah, I think last year the big takeaway for me was gosh, I gotta be educating more. And what does that look like? Doing a lot of informal education, but how do we make that a little bit more formal, a little bit more streamlined, obviously still tailored to the person. But I think that's been a big part of this last year kind of implementing. I think this year I just really saw the importance of understanding what resources are out there and we serve as people from all over the US and so, yeah, I can really get to know the Omaha area resources, but that only serves a very small portion of the people I serve, and so how am I using this network that ASCIP provides of people that are all over the US? How do we use that to learn more about the resources and get them connected?
Speaker 2:I think that's been a big piece for me to grow over the next years, just to understand where can I find those things, how can I connect with people that can connect my residence with those resources? And I think, even if someone's not and this is, I think, another takeaway was, even though sometimes people aren't always ready for getting involved with an adaptive sports camp or getting back into the community to do, maybe, some things they used to. But how do you then on the back end, kind of behind the scenes, provide some research and get some resources to them that they can take with them or that you can have ready to send to them months down the road when they're ready for that? I think that's a big piece because we know some people aren't ready necessarily to tap into all of those resources. But that education piece of what else is out there, I think is going to be a big part of this next year for me.
Speaker 1:Can you guys, maybe just Connor feel free to jump in on this, but can you guys set up so? Qi lives in the post-hospital realm and so maybe just talk through the process that someone might go through before they get to us at QLI. How long has it been since they've had their injury? How long do they stay with us? Those types of things?
Speaker 3:So generally after a traumatic injury someone will go into the ICU for a few days to get stabilized, and then an acute care hospital and then inpatient rehab facility for length of stays getting shorter, but anywhere from one to three months hopefully, and then at that point they're able to hopefully come to QLI where things are a little bit more stable medically, potentially have generally have a good prognosis to gain some function. That's why they're here to get some intensive rehab. But yeah, that's generally the route that someone takes, like we get them maybe three months after injury generally. I mean, there's some exceptions to that rule, but I just I didn't want to change gears too much here, but I wanted to piggyback off what you said, sarah, about education.
Speaker 3:I looked at it in the light of not only educating our patients that are residents, but also the payer sources, while these insurance companies don't know what a spinal cord injury is they see on a piece of paper that they had a L2, 3 laminectomy infusion, they're like, oh, that's just the back surgery, but they don't see that the spinal cord was inflamed and now the person doesn't have any use of their legs.
Speaker 3:And so we get mad at the funding sources because, oh, they're shortening the length of stay, but do they even know the extent of it? Like, we need to educate them and we need to advocate for our patients, because we're the ones who know the impact that this injury is going to have down the road. And having a spinal cord injury is expensive. So you talk about resources. Yeah, we need to give resources and reach out to funding sources, whether it's vocational rehab or funding for transportation or even medical devices. But one way that we can do that is through the payer sources and educate them on why it's so important that these people get the funding that they need after such a traumatic injury.
Speaker 1:Yeah, that's good and that maybe even ties in. I know one of your takeaways was advocacy and I kind of love where you were going with that too, because I was thinking about not only we need to advocate for the individual themselves, but we need to educate and advocate for them with their payer sources too, and oftentimes, if you look at it maybe from a payer source perspective, you might be thinking it's been three to six months, how have they not been educated? And we get people that come from really great places and I know what the education process looks like there and we'll come around to this in a little bit as to why it's hard to pick up that new information after spinal cord injury. But yeah, we get people that maybe are holding on to 20% of what they've learned by the time that they get to us further down the line, like you were describing. Connor, Can we dive in just a little bit more into that advocacy part and maybe just some of the things that you picked up on from the conference?
Speaker 3:Yeah, I think the overarching theme of the conference was advocacy. The presenters tied that into everything that they spoke about and, honestly, it just recharged my batteries. I felt like we do a really good job of advocating for our people. But it was comforting, maybe as a word, to see other people around the country struggling with the same things that we're struggling with, whether that's length of stay or getting DME approved and just some of the tactics that they're using to advocate for their people and just having that network of like-minded individuals that are also trying to be there for their patients.
Speaker 3:So I think a main takeaway for me is continue to reach out to the payer sources and ask and write the letters of medical necessity and call and if we get a denial, appeal and if we get denied again, appeal again. Be resilient in that for our patients, because this is lifelong and this is super important. Whether that's just the DME side or also accessibility the world is not accessible. There's so many things we can jump on and pursue. We'll see what the email says in a month when I get for the advocacy group meetup.
Speaker 3:Because, I'm super excited to see what the subgroups are, because it's a lot to tackle, but if we can all just focus on certain aspects of this, I think we can take it somewhere.
Speaker 1:Yeah, the way I've always kind of thought about it is in terms of advocacy. Here You've got individual base, you have local base and you have national base, and so we've talked through some of the individual level stuff. Or like, hey, I've got a patient, I've got to help advocate for X, y and Z for them At a local level. It's hey, how do I build relationships with our vendors in different ways that helps the people I'm working with to get the equipment that they need in the right amount of time? How do I maybe create relationships with people that might influence builders or the housing market in our area so that we can start maybe influencing more universal design make up that's more locally based. It could even be like a United Spinal group, which Chad Arnold from QLI and a few others have started up recently.
Speaker 1:That's a heavy lift to kind of get off of the ground and get going, but it's a good place to have a voice and to begin making some strides there too, on a local or statewide basis and then nationally. I mean we heard some of the conversations about durable medical equipment and power wheelchairs and how things just don't. Parts don't last as long as they used to and it's costing more and more money, and there's plenty of other topics along those lines too. But yeah, that's a great one. It's hard to know where to jump in, where to start, where to put your time. But you were kind of talking about strength in numbers kind of really becomes really important with that too.
Speaker 3:Yeah, and you think about just how many times we write a letter of medical necessity, of why a C elevator is important on a power wheelchair. Well, it finally Right. You know, last spring, finally, medicare started approving it. Well, that's the first step. So you know, a plug for all those clinicians out there, if the resident or the patient needs that thing, keep writing letters of medical necessity for them, because how is insurance companies going to know if that's medically necessary if we don't say it is?
Speaker 3:So don't shy away from writing it just because you know it's not going to get funded, you know.
Speaker 1:Yeah, for sure. Let's come back to Sarah. You were talking about the cognitive supported learning, and I think we all had some different takeaways around that that we can put together here too. But what did you kind of pull away from that presentation?
Speaker 2:Yeah, I think, in terms of the cognitive supported learning, you know the presenters really started framing this idea of, yeah, we might not see a diagnosed cognitive deficit, but with any traumatic experience you're going to see some slow processing speed, you're going to see some difficulty with memory. You're going to see even just attending to what is presented to you and just being overwhelmed. Right, there's all the emotional components, there's all the things that come along with that as well, and so they really shared with the group of how do we then support these people and how do we help them with the learning process, and I thought it was really insightful. They had kind of used the model of the speech therapist in their hospital system that assisted kind of with like almost like a pre-learning activity. I would say so they would.
Speaker 2:If they knew that someone was going to be working on retraining bowel program, then they would come in and they would provide different models, different pictures, a lot of visual hands on activities that really directly related to using bowel tools or something to that effect, and then that would be about a week before they would actually jump into the task itself, and so they got quite a few repetitions prior to doing the actual task within its context and they really saw a lot of positive outcomes that way and I think it also kind of broke down some of those barriers to learning, because they got a lot of the repetition, they got to see it in different environments and contexts and then were able to actually perform the activity.
Speaker 2:And so and that's just one example of what they had shared was the bowel program. But again, I think that just highlights the importance of that interdisciplinary team right, because you've got the with them. They had the speech therapist, you have the OTs, the nurses, you have maybe even psychology jumping in to be helpful from kind of what they're working through emotionally too. So yeah, I think that model really highlights the importance of that interdisciplinary team.
Speaker 1:Well, I mean just to jump back to what we were talking about earlier too. We get people that are three, six months down the line. You might ask the question why have they not learned everything they need to learn at this point? How would you answer that, sarah Orkoner?
Speaker 2:Well, I mean go ahead.
Speaker 3:Yeah, there's a trauma that just happened and studies show it takes years to overcome not even overcome the trauma, but to be able to cope day to day with a traumatic event. Cortisol levels in the brain are increased after something like that, always on flight or fighter flight but sometimes that part of the spinal cord is affected so they're not able to access that. You're having hypotension chronically potentially at this point. So oxygen is not getting to your brain, which I know you want to touch on, brad, but I think not to mention a lot of like. This is our world. We know this stuff.
Speaker 3:We've gone to school for a long time to understand spinal cord injury. These people have never thought about a spinal cord injury in their lives a lot of times. So when you say bowel program, what does that mean? It's going to take repetition, a lot of education for years to master some of this stuff. So I think it's important to recognize that this isn't something that a person who has experienced a spinal cord injury is accustomed to. So it's going to take a lot of time, a lot of repetition, patience and learning that we can help facilitate.
Speaker 1:Yeah, actually I think about the fact that, for any of us that are around this on a regular basis, you've learned a lot of that information and it's something that you're dealing with or coaching or teaching others over and over and over again. But for the person that you're working with Gosh they haven't maybe had a lot of reps with it it's hard to learn and and put your put yourself in In their shoes, right in their position too, or I mean even as you are now. If you're listening to this, when do you learn best? Is it when you're tired, right? Is it? Is it when you're stressed out? Um, is it? Is it when you've had some drastic change in a relationship? Is it when you've lost your job? Is it when you're questioning what your future is going to know like? Those are not great environments to Facilitate new learning, not to mention some of the, the internal physiological stuff that you're mentioning to Connor, which you know.
Speaker 1:I've been working on spinal cord injury for a long time and it just it hit me in a different way in one of the presentations Just hearing about the changes in cognition, uh, over time, with chronic low blood pressure.
Speaker 1:Well, we know, especially for cervical level injuries, that the autonomic part of the nervous system that helps regulate blood pressure Is affected, and so there's so many people that we work with that have those cervical level injuries that it may be going from lying down to just, you know, getting up into their chair in the morning.
Speaker 1:Um, their blood pressure drops drastically right, and they might take a medication to help bring that up. Or, in our therapies, trying to get them into a standing table right so that we can help them change position and help their Uh cardiovascular system kind of adjust to a new position in that way as well. But what they're seeing in some of the research is that there's there's actually some cognition changes in the long term with those individuals that are chronically running at low blood pressures because, again, you think about the the brain just isn't, it's not getting as much oxygen to it, um, and so that just hit me in a new way of like how do you, how do you continue to facilitate, um, those therapeutic things that are happening within this rehabilitation environment over the long term, and how do you coach individuals with that information so they have that and they're educated and kind of Uh can kind of take that on with them to.
Speaker 2:So yeah, I think that that, too is, is the importance of how we're. How are we giving them resources that you know, like credible spaces to go look for that information too, so that maybe they, you know, maybe it is past our, our time of care and they're really curious about something specific to their injury and Remember that they kind of heard something back, you know, when they were in rehab, but, gosh, I don't really remember all of it and so, oh, but I was given this credible source that I can go look into and so Providing those, those networks too. I think the other thing I was going to say that really affects learning too is the medication.
Speaker 2:There's so much, so much medication that um can really alter fatigue levels and Um that can really really cause changes. I know, to your point, right, I'm, if I'm tired, I'm kind of spaced out, I'm not picking up half of the words that someone's talking to me in that moment. So I think that's a big, a big limiting factor too.
Speaker 1:Yeah, absolutely, um, okay, anything that we missed that you wanted to chat about? No good I know you have a couple more, connor.
Speaker 3:Yeah, sure, I Can't get out of here without talking about dry needling.
Speaker 3:Um, I was super excited to see a presenter do a case study Well, uh, multiple studies on dry needling and actually get some, some data down so that we can get some research going for dry needling individuals with spinal cord injury and Acute spinal cord injury. So he's, he's doing this dry needling in the inpatient rehab and sometimes the acute rehab hospital setting, and so a super pump to watch his presentation. What he found was that dry needling had an immediate effect on spasticity, um, following spinal cord injury. Obviously, that's not long lasting, but what he, what he did, was, after he performed the dry needling then loaded the, the joint or the muscle, whether that was gate training or using the armaio or some sort of way of moving through that new um less spastic muscle to hopefully induce lasting change. And so it was super fun for me to see him present that, because this is something we've been doing, you know, and there's just not enough research on dry needling for spinal cord injury in general, but I know it works, you know, I, I know totally yeah, yeah.
Speaker 3:I needle all of my residents if it's appropriate, which most of the time that it is um, and so, once again, it gave me just like fuel to continue doing what we're doing at a high level and to Actually write down some data points and maybe for me to just start taking, uh, some measures to Get my own data down and then someday maybe I could present on Kind of what we've been doing at qli and why, why, maybe Three months, six months down the road, dry needling is still a good modality to use, whether it's pain, spasticity, activation, um, I think there's there's fertile ground to move forward with. Dry needling in this population is super exciting and had a great conversation with that presenter as well, yeah, so I'm going to jump in with a Example of that that.
Speaker 2:I think ties a lot of the conversation we've had together. Um, I have a resident who um, after a cervical fusion just has some limited range of motion, had a C collar for a while, um, at this point, four or five months post injury, and he um Really needs some, some more neck extension in general, but especially for rugby, which is a big passion of his right now, and so We've done all sorts of things to try to get that, that movement back. And then I brought someone into dry needle and had the best Session in rugby of getting keeping his head in in that um cervical extension.
Speaker 2:And so Maybe that's a maybe that's a case study you can bring on to your Perfect, yeah, so yeah.
Speaker 1:Um, and then I know you really kind of connected with the keynote speaker, yeah, who was talking about his kind of Journey to stoicism.
Speaker 3:Yeah, so yonik, yonik benjamin Um man, I got so excited that morning. He, he really relates with the stoic principles and that's what his whole presentation was about was Essentially, how to use grit and resilience to get through a difficult time. And this man, uh, was hot and was big in the restaurant scene in new york and was planning on opening up his own restaurant and then he got in a car accident where he ended up paralyzed from the waist down and uh, you know, right away, he, he knew that he had to get through this, you know. And so he had this baseline of Okay, this happened to me, but where am I gonna go from here? And and it's pretty rare that you see that, right away after an injury like that happened, and he goes on long story short. He goes on to, you know, build this restaurant up during covet in a wheelchair, making his restaurant one of the first accessible restaurants in new york and one of the a five-star Place, and he's is super into wine and I don't know he was, he was so, his energy was so passionate and it just Made me realize how important it is to have grit through a process of injury and and, to, you know, take on some of these stoic principles, for example um, the obstacle is the way some of these hard things that, um, someone with spinal cord injury is facing day in and day out.
Speaker 3:Embrace it. Attack that obstacle, because you're not gonna get stronger if you don't. If you don't, you know, go through it. If you take the easy way out, you know life's gonna get harder for you. So you got to just keep attacking that obstacle. Um, to build grit and resilience and I think that's a lot of what we do at qli is have those tough conversations, you know, build up our residents so that they're ready to take on this challenging future that lies ahead of us. And yeah, I was just super inspired by Yannick because he wakes up every day, he has his routine and if something happens that he wasn't prepared for, he said, okay, that happened, it's in the past. Now how do I move forward? So it was inspiring for me in my own life. But I think we can use a lot of those principles to teach our residents that hard things are going to happen. We need to reframe the way we look at those problems and maybe attack them head on.
Speaker 1:Some of what I hear in that in his journey that was an overnight thing for him. Some of what I'm hearing is just that concept of building resiliency with people. That's a team effort. Some people come with more of that than others too, but we also think that it's a skill that can be grown in people and whether that's the path for them, maybe some of those principles are helpful or maybe it's something else. I think you're on the right track of just how do we help connect with this person's values into principles or ways of thinking that might be helpful to what they do in their life, how they carry themselves?
Speaker 3:It doesn't necessarily have to be stoicism by any means, but some sort of whether it's faith-based, or something that people can look to when things are hard, because life is hard and life is very hard after a spinal cord injury. So we need to find ways that one can cope and successfully navigate the obstacles that inevitably are going to be there.
Speaker 2:And then I think our job then, as the team, is to support them for success in that right. And how do we come alongside them when they are attacking those things head-on and knowing? You know, I think that starts with building that trust relationship and allowing them to know that it's a safe environment to do those things, and so I think that's a big part of our role and getting connected with their support network, because ultimately, those will be the individuals that will continue to help support them as they leave rehab and go back to life.
Speaker 1:Yeah, Well, I might leave this with just one more takeaway that I had. I know, at last year's conference there was a speaker who did a presentation on polarity partnerships. Okay, and we just encourage you guys, listeners, to look that up. I think you can go to polaritypartnershipscom and you can see what I'm talking about a little more. There's YouTube videos, but very basically, you know it's thinking about, you know, instead of putting an either or on a situation, it's thinking about a bullfand, and so they have polarity maps which, if you can imagine, you know kind of a square with four quadrants to it, and then on the up and down line you kind of have like on the up part it's hey, what's the kind of the positive outcome, and on the bottom part of that vertical line, it's what would be the negative outcome. You know, one example that I see used a lot is hey, the positive outcome would be I finish a marathon and the negative outcome would be I do not finish.
Speaker 1:Well, you have to balance work and rest to get there. But if you do too much work, right, there's a there's a negative part to that. If you do too much work, you could get injured. The right amount of work is going to lead to increased strength and endurance. The and connector with work is rest, so it's not an either work or rest. It's work and rest right, Because rest then positively can lead to muscle recovery, but too much rest can lead to muscle weakness and poor health, and so you can kind of see some of the maps.
Speaker 1:But what the presenters this year did with that concept was they said, what if we think about that in terms of an aging population with spinal cord injury? What if we think about that in terms of what equipment or DME a person might need? And instead of saying either or giving an either or answer, we create this both and concept to it, and so I wish I could talk a little bit more about that right now, but it's something I'm still processing. Even even after seeing that again, I want to look into it a little bit more and study it a little bit more too. So I'm trying to get a few more reps with it, so to say, and just like practice with it in my, in my head. I think we maybe do that innately in some ways, but it can be a tool that I think can be helpful to processing some of the situations that we come across on a regular basis too. You guys have anything you want to add to that?
Speaker 2:No, I love the process.
Speaker 1:Yeah, I know it's been sitting with. I sat with it for a year and then it's not again.
Speaker 1:It was like gosh, everything that we just talked about, I love thinking about it in light of humanized mission to deliver life changing rehabilitation and care, to protect dignity, to instill purpose and create hope and to commit to excellence, right, I think having opportunities to go represent your company and go to a conference like this and pull away that information just kind of exemplifies, you know, clinicians in a company that are invested in growing what we understand and how we're improving the care for the people that we serve with spinal cord injury. That's the life changing rehabilitation and care part, right? And then how do we get that information to the rest of our team members right, from an educational standpoint, it can't just be about Sarah knowing it or about Connor knowing it or about Brad knowing, or whoever right. You've got to disseminate that information to as many people as you possibly can so we can get as many touch points for for the folks that we we serve and a lot of this is coming back to instilling that purpose and creating hope for individuals with spinal cord injury that we serve to.
Speaker 1:So, gosh, I just love, I love that concept of, hey, I got to know the resources, that I can pass them on to others, right, I think that's a big deal and thank you guys for sitting down and just sharing some of the things that you've learned and listen, and hopefully this was helpful to you as well, whether you are internal to our company at QLI or external, and if you are working in the world of spinal cord injury, we encourage you to check out a skip and to get involved there so that you you might be able to influence the people that you're serving in a better way too. Alright, thanks for joining the conversation. Thanks, brad.
Speaker 2:Thanks for joining the conversation with us today. If you found it helpful, please share with your family and friends. You can learn more about us on our website at continuetelleriehabcom, or check us out on YouTube, instagram and Facebook.
