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    Health & Fitness

    Healthy Wealthy & Smart

    The Healthy Wealthy & Smart podcast with Dr. Karen Litzy is the perfect blend of clinical skills and business skills to help healthcare and fitness professionals uplevel their careers.

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    Copyright: © 2010 - 2018 Karen Litzy

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    Latest Episodes:
    455: Dr. Lynn Rivers: Robert's Rule and How to Debate Sep 16, 2019
    Show notes

    On this week's episode of the Healthy, Wealthy and Smart Podcast, Jenna Kantor guests hosts and interviews Lynn Rivers on Robert's Rules. Dr. Rivers is currently the Speaker of the Assembly for the New York Physical Therapy Association (NYPTA) and sits on the Board of Directors for the NYPTA. She strives to facilitate the active engagement of the students in becoming advocates for the patients/clients they will serve and their profession. In this episode, we discuss: -What are Robert's Rules and how debate is conducted at the House of Delegates -Different ways to collect votes from the delegates -Point of Order, Point of Inquiry and Point of Information -Can a guest speak during a meeting? -And so much more! Resources: Email: riversl@dyc.edu Robert's Rules for Dummies For more information on Lynn: Dr. Lynn Rivers has 25 years experience as a clinician and 20 years as an educator in higher education. Her clinical experience has focused on adults with neurological disorders and traumatic injuries such as head injury and spinal cord injury while working in a Level I Trauma Center. Before becoming chairperson of the department in 2001, Dr. Rivers was Director of Clinical Education for the physical therapy program. Dr. Rivers is currently the Speaker of the Assembly for the New York Physical Therapy Association (NYPTA)and sits on the Board of Directors for the NYPTA. She strives to facilitate the active engagement of the students in becoming advocates for the patients/clients they will serve and their profession. For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University's Physical Therapy Program. She is also a co-founder of the podcast, "Physiotherapy Performance Perspectives," has an evidence-based monthly youtube series titled "Injury Prevention for Dancers," is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt Read the full transcript below: Jenna Kantor: 00:00 Hello and good morning. This is Jenna Kantor. I'm here with healthy, wealthy and smart and I get to interview Lynn Rivers who knows so much about Roberts rules. Okay. Robert's rules. You know I'm going to actually hand over the mic because I can already imagine me describing it and Lynn going, well not exactly. So would you mind first just defining what Robert's rules is and where it is in applied within the APTA? Lynn Rivers: 00:26 Sure. Well Good Morning Jen. Thanks for the opportunity. Thank you for the opportunity to be able to share just about 28 years that I have sort of gotten myself involved and love Robert's rules of order. So what is Robert's rules of order? It goes back hundreds and hundreds of years. It is the philosophy and the construct of how do organizations, any organization, whether it's a small church board or it's Congress or its parliament in England, how does a civil society with lots of divergent opinions, how do we conduct our business so that there are two principles that are met and the two principles are that the will of the majority will rule, but we must protect the rights of the minority. So it is for the voices of everyone in whatever society, whatever group, whatever meeting that every opinion gets heard and heard with respect. And that there is civility so that when very strong, strong opinions can equally be heard, both sides of the debate can be heard. Lynn Rivers: 01:41 But there is civility and respect. And then when the decision is reached that the minority will agree that the will of the majority will rule. So that those are the two principles. So then the rules, holy smokes, there's, you know, I'm sure if people have looked into it, the 11th edition is 800 pages long and there are so many minutia rules. But the bottom line is that the rules guide how people make decisions about what gets heard and how we make choices. So there are just the word motions is a tenant of Robert's rules of orders. So what is a motion? A motion is just an ask. It is an idea that someone has, that they want the society, the group, the organization to do. I want to ask that we pursue buying a piece of property or I want my APTA to look into this or work on this legislation, create a document for us to help us write. Lynn Rivers: 02:56 It's an ask and then there's a way to make the ask. And so they give guidelines on how you make the ask. And then there are rules of then how do people debate. So you have to write out your ask. It becomes a motion. And then it's agreed during the meeting. It will be, they call it lay it on the table, but it just means say it right. Make the ask for the whole body to hear. And then there is the leader of the meeting who is neutral and just trying to facilitate the discussion and they have different titles. Then everyone respectfully just raises their hand or makes a motion. They have to be recognized to speak. And then when you speak to the motion there are just rules of civility meeting respect that you aren't shouting that you are just speaking to the facilitator of the meeting and you are making your case but you tend not to speak only about the motion, not who made the motion and don't speak ill of any other opinion. You just state your own opinion and the debate goes back and forth and then there's a vote. Jenna Kantor: 04:16 Actually could we go on this a little bit more with the ask, cause there's some things in this that I think is so fantastic with the civility that you are discussing and you guys, anybody listening, all you new grads, anybody who hasn't done house of delegates or been to any of these type of meetings before. You know how easy it is for things to get heated when it should, when it's a touchy subject. And of course within physical therapy we're extremely passionate about what we do. So those issues can get personal very easily. So would you mind going into the process of who is actually getting the eye contact, when you are standing up to speak about something and say it might be something you are quite passionate about, you have a written out exactly what you want to say. Who do you make eye contact with? And how do you address or refer to somebody who may have spoken before? Would you mind giving an example of that so people can get a better idea of how important and valuable it is to keep this going? Lynn Rivers: 05:18 Be Glad to Jenna. So I'm just going to think back to the most recent house. The American Physical Therapy Association taking a stance against firearm violence. And there are some very passionate opinions in the room. So what will happen is in order to not hurt feelings or offend anyone, what happens is that the individual who wants to now speak passionately against the APTA taking any kind of social stance, they make direct eye contact, the room is full of 400 people, face forward. You're looking directly at the speaker of the house, which is the title of the individual who's standing up in the front, who has recognized you to speak and you say, Madam Speaker, I would like to speak vehemently against this. I respectfully disagree with the previous speaker from Oregon who made this claim. Lynn Rivers: 06:22 And I disagree with that. So you don't say, I think Henry is an idiot. You say, I respectfully disagree and you speak about people in the third person and it's amazing how that sort of takes the emotion out. You can be emotional, you can feel passionate about your stance and you could be angry about the thought of an action being taken, but you are looking at the neutral speaker of the assembly and you are referring only in the third person to previous speakers or to a speaker from another state. And it is amazing how that can really deescalate the emotion. Jenna Kantor: 07:08 And then for such a very important debate and which I'd like to say that, you know, it's nice that there's an opportunity for every single motion to be debated on. So whether or not you think it's important, it still doesn't obliterate the opportunity for other people to debate on that, which I think is wonderful as well. But of course these things can go on forever. So how is it handled to end, you know, as a group cause you have a group of 400 people you know, for us at the house of delegates. So how is it handled, you know, to rightfully decide when it's appropriate to stop the discussion and move on to a vote? Lynn Rivers: 07:48 Yes. So again, what happens is, you know, people have raised their hand or we do it electronically now in the house of delegates with a blackberry, you can put yourself what they call in the queue. So you're in line to speak. And so the speaker will monitor and you must indicate to the speaker whether you're speaking for or against it. So they try to balance debate. And at times after a bit of discussion, the speaker will say, at this time there appears to be no one who is in line or in the queue to speak. Are you ready for the vote? Other times, the speaker that we do have an opportunity and in Robert's rules there is a motion it to what is called call the previous question. And all that means is that person has put a motion to say, I think I've heard enough. Lynn Rivers: 08:38 I have heard both sides of the debate. I am ready to vote. And so then if the speaker of the house, the leader of the meeting, observes that there are many people who think it's time to vote, then he or she will ask the body, that group at the meeting, are you ready for the vote? And if there's no objection, then you move to the vote. So it can either be everyone has stopped talking or there has been a lot of balanced debate hearing both sides of the story and enough people have spoken that the group feels they can make a vote. Jenna Kantor: 09:16 I also saw in the meeting, and we're not gonna hit all 800 pages of the book, but I'm just pointing out some interesting things. Sometimes the voting switched between standing between saying Aye and then also the electronic vote via the device. So how does, in this case, the speaker of the house who was running the meeting, how does the speaker of the house decide which way to do the vote? Lynn Rivers: 09:43 Yeah, so certainly, what happens is each organization has also something that's called the standing rules. So we use set rules at the beginning of the meeting. And one of the key rules you decide is how much agreement does there have to be in order to pass that motion to say it's going to go. So for normal business, the actions of the house, we agree in the house of delegates, a simple majority, so just over 50%, 51% of the group. So the default or easiest for 404 was our voting strength yesterday, that the speaker starts with a voice vote. All those in favor say Aye. So she listens to the volume of the ayes compared to the volume of the no's. And many times it's very clear if 300 people say Aye and 100 say no, then it's pretty clear by voice. Lynn Rivers: 10:42 And that's the simplest and quickest. If it's still a vote for simple majority and she couldn't tell by the voices, then we have to use the electronic voting. Within that everybody has their clicker and they vote Yay or nay and it comes up. The standing vote is typically done when there is a vote that is more precious than just a normal business action. It's any vote that is going to hurt the rights of members. And I'll give the example then if you need to know, if two thirds of the people agree, many times the speaker will do a standing vote because that is much easier to see two thirds clear by standing. And that is when there is an objection to calling the question, meaning stopping debate. And because that is a right of the minority to continue to be heard, that is when the speaker calls for a standing vote. And then there was one time, even in the standing vote, she was not 100% sure it was two thirds. So she had us sit back down and do the clickers. Jenna Kantor: 12:05 This is great. So, you know, it's so funny, earlier you mentioned the word Henry and now I'm thinking of the Henry Bar, the candy. And I'm like, oh my gosh, what do these conferences do to me? I'm like, I need sugar all the time to like stay awake. Can we get into some of the language, just the intro that people say when they say parliamentary inquiry, like why do we say that instead of something else? Does it make it more efficient? Lynn Rivers: 12:35 So again, there is a protocol to how one introduces a motion. And one of the first again for civility is whenever you are recognized to speak, you start by introducing yourself so speakers know who you are. We also ask them to state what component they are from, component or state. So I'm Lynn Rivers from New York would be how I would start. And you must be recognized in order to speak. There are three instances, and someone can shout out and not wait to be recognized. Point of order, point of inquiry and point of information, point of order. They there is shouted out and you are allowed to shout it out if you believe what is happening right now is not following Robert's rules of order. We are not doing it correctly and we believe that we have to ask the speaker that. Lynn Rivers: 13:45 So if someone shouts out point of order, all debate stops immediately and the speaker says state your point and that person comes up to the mic and says speaker, I believe it is not in order for this motion to be heard. And there is a reason why we did not have due notice before this motion came. I don't think it's right that we are hearing it and then they would confer and decide whether that member is correct or the speaker rules. No, I do believe it's in order point and I'm sorry I misspoke. Point of inquiry or point of information are very similar. There is no real difference between that. A point of inquiry is sometimes said because people are really wanting data and facts, point of information. People tend to say they just have a question. They don't really understand why the makers of the motion wrote it this way. They don't really understand the intent of the motion. So they are asking a question to better understand the motion point of is just a little more precise if they want to. If someone wants to ask someone else other than the maker of the motions, they understand the motion but their point of inquiry is we'd like to hear from legal counsel is what the maker of the motion asking us to do. Is that legal in all 50 states? So then the speaker will say, is there an objection? Does anyone object to legal counsel addressing the body and answering this person's inquiry? Jenna Kantor: 15:16 Yes. That honestly makes more sense for me. Now listening to that because there was a motion on creating a virtual historical museum and there was a lot of point of inquiries to the board to find out how much work would this be putting on them. Would this be possible for them…

    Full show notes at the publisher

    454: Dr. Emma Stokes: Leadership, Mentorship and WCPT Sep 12, 2019
    Show notes

    LIVE on the Sport Physiotherapy Canada Facebook Page, I welcome Dr. Emma Stokes on the show to discuss leadership. Dr. Emma Stokes BSc (Physio), MSc (research), MSc Mgmt, Phd is the president of World Confederation of Physical Therapy. In this episode, we discuss: -Dr. Stokes' journey to becoming the President of the WCPT -Takeaways from the World Confederation for Physical Therapy Congress -Constructive feedback and the 360 review -How to grow your professional network and the two up, two down and two sideways rule -And so much more! Resources: Third World Congress of Sports Physical Therapy Emma Stokes Twitter World Confederation for Physical Therapy Website WCPT Facebook WCPT Twitter WCPT Instagram For more information on Emma: Emma is the head of the newly established Department of Physiotherapy & Rehabilitation Science at Qatar University. She has worked in education for almost 25 years and is on leave from Trinity College Dublin where she is an associate professor and Fellow. Her research and teaching focus on professional practice issues for the profession. She has taught and lectured in over 40 countries around the world. In 2015, she was elected to serve as President of the World Confederation for Physical Therapy. She was re-elected for a further four years in 2019. She has experience as a member and chair of boards in Ireland and internationally in a diversity of settings including education, health, research and regulation. Read the full transcript below: Karen Litzy: 00:01 Hey everybody, welcome to another interview for the Third World Congress on sports physical therapy, which is happening in Vancouver October 4th and fifth of 2019 and we've been interviewing a lot of the speakers and today we're really excited and honored to have Dr. Emma Stokes who will be in Vancouver with us. So Dr. Stokes, thank you so much for coming on. Emma Stokes: 00:29 Oh, thank you so much for the opportunity to chat with you again, Karen. It's always a pleasure. Karen Litzy: 00:34 I know, I know I just saw you in Switzerland and we'll talk about that in a little bit, but before we get into all of that, just in case, there are some people who are maybe not familiar with you, which may be, there are, I don't know, but can you tell us a little bit more about yourself? Emma Stokes: 00:55 Yes, of course. Well, I'm an Irish physiotherapist and I'm sitting in Trinity College in Dublin, where I have the privilege of spending a lot of my professional life. So I qualified as a physiotherapist in 1990 and let's just fast forward to eight years after I qualified, I went to my first international meeting and you know, I tell this story wherever I go in the world, which is, you know, I went to that meeting and I came home. And in that moment, in those days I really recognized that I wanted to be part of the international physiotherapy community. You know, a lot of people ask me that question. They say, well, you know, how do we become part of that? And you know, honestly then I didn't know what that meant or looked like or felt like or anything like that. But as I tell the story and we can come back to this later on, you know, I decided I was going to make myself indispensable. Emma Stokes: 01:45 So I volunteered for every conceivable opportunity that arose, including within the ISCP, which is the Irish side of charter physiotherapists. And in 2015 I was elected to serve as the president of WCPT the world confederation for physical therapy, the global physiotherapy organization of which the IFSPT, which is the International Federation of Sports Physical Therapy, is a subgroup of which the Canadian physiotherapy association is a member organization. And of course of which sports physiotherapy at Canada is a division of the CPA. So we're all connected in this big family and I got to serve as the president for four years. And then last year I decided that I would seek a second term as the president of WCPT. And there was an election in May and I was reelected, here I am, I'm very, very happy to am honored to be serving a second term as president of WCPT. And it's been a long journey and I'm happy to answer any specific questions about that as I always am. Because you know, I think not because I want to talk about myself, but because I think sometimes people look at you and they say, how'd you get there? And I'm happy to share that journey because I think that's a really important question. When you see someone in a position that you want to be in, then you need ask them how do they get there? Karen Litzy: 03:01 Yeah. So let's talk about that. So you volunteered for everything and anything you could get your hands on it sounds like, and I'm sure that helped get your foot in the door and, open things, a crack here and there. So when did you first decide to be an elected official? Emma Stokes: 03:23 I think physiotherapists are nervous about the volunteering thing and the idea that, oh gosh, it would be terrible to volunteer if you had an end game and you know, 30 odd years ago to be 30 years since I graduated next year as a PT, you know, I don't think we had the whole, I don't know the word networking even existed in the way it does now, but I loved getting involved and things. So I was very involved with the Harriers and athletics club here and lives in trinity and I reckon I spent more time with them than I did and my physiotherapy program. I just loved getting involved and you know, when you're a junior physiotherapist or in your, the early stages of your career in the day job, you know, and you'd know this Karen, right? Emma Stokes: 04:08 You don't always have the opportunity to do the things that you want to do because you're maybe limited sometimes in the organization that you're working in. And in fairness, I worked in St James's Hospital in Dublin and there were no limitations placed on me when I started to get momentum, but it took me a few years to get some momentum. So I became a member of the Irish society and I went to a meeting. They needed a member on a committee and that's where it started. And you know, I was on a committee and then I was on another committee and then in 1996 when I was working in trinity, one of my friends whose office was across the Carto said to me, we're stuck for someone on the international affairs committee. Would you volunteer? And I think I suggest more because I was sort of trying to help her out. Emma Stokes: 04:51 Than I wanted to necessarily do international affairs. And then, you know, it started, I just, I knew then the global physiotherapy was where my, I think maybe I was struggling to find my place in the Irish physiotherapy world or maybe the clinical physiotherapy world rather than the Irish. You see that everywhere, the clinical physiotherapy world. And so when I started to do some international work, so I got involved with my first international research consortium and I started to volunteer and so the first international meeting that I went to was 20 years ago. In 1999 and no one paid me to get there. I paid for myself to get there. I was presenting some of my phd research and I had gotten to know, Brenda Meyers, I'd met her once or twice and I emailed her, I said to her, look, I'm here. Emma Stokes: 05:42 Do you need to volunteer? And I was a teller at the general meeting of WCPT I helped count votes. Now you might not think that that's super important which it is. In the governance meeting of WCPT, I counted the votes in 1999 and then clearly I could count and I stayed involved with European level. And in 2003 the meeting was in Barcelona and I asked you about some time, the Irish societies delegation. But I was there with some of my phd students at that stage and some of my own research. And I went to the general meeting and Brenda said to me, well you would you like to be the chair of the credentialing committee? And that's what I did. So in that, that was the time when you presented your credentials in within paper, you brought your paperwork to the meeting and there was something really elegant about that process. And now we do it electronically and it's a little different. And plus I got to meet the presidents of every member organization and WCPT at that meeting. And then I finally got elected to actually the board of WCPT in 2006 and that was a chance I didn't expect to get elected. I was only running to signal my interest for four years later. But I got elected and I guess the rest is history. Karen Litzy: 07:01 Great. And I think the big moral of the story here is that no one's an overnight success. It's not like you one day said, I'm going to run for president of WCPT and got elected, you have to put the time in and pound the pavement, if you will, in order to kind of work your way up. And I think in the days now of social media and everything happening, having to happen immediately. Yeah, it's hard. So what advice would you give to someone who maybe doesn't have the patience these days to put the work in? Emma Stokes: 07:35 Yeah. So first of all, I think you have to enjoy the journey. So, you know, I never knew it was a journey in many ways. I guess at some point I knew it was a journey. And I think one of the things, because I've done a lot of reading around leadership and, I think what I've been fascinated about is this notion that just because you try once for perhaps an elected position and you're not elected doesn't mean that you walk away. So that in 2006 now, I don't know would I have walked away. I don't know that I did because I actually think I would've because I think what happened was in 2006 I had no expectation of being elected. But my plan then was to say, look, I'm interested. I know that's going to be another four years before I'm elected. Emma Stokes: 08:26 Or I could be elected. And I don't mind if I'm not elected this time. So I was elected and that was pretty amazing. And interestingly in 2011 and it was suggested to me by a number of people that I should run for president. And I decided not to because I wasn't ready now cause that's another conversation which is about when are we ever ready. But I think I'm very objective about my abilities. And so I had sort of decided that I didn't feel ready in 2011 to be elected as the president but by 2015 given what I had done between 2011 and 2015 I knew that I had the experience, I had the capabilities to be a very effective president from the point of view, I think at least I felt I had given the organization the best shot in terms of the experience that I had gathered. Emma Stokes: 09:33 So I had done a graduate business degree. I had done a lot of governance courses. I had been the chair of the board of charity and I just felt, I suppose I felt from a self efficacy perspective and we talked about this, about our patients all the time. I felt confident going in that not withstanding what needed to be done, I was confident that I was able to definitely demonstrate that I had the experience to be the chair of the board of a charity based in the United Kingdom, which is what WCPT is from a governance perspective. But also that I felt that I had enough experience to at least give a fairly good shot of being the president of the global organization. And there are two quite distinct parts of the road. Karen Litzy: 10:21 Well, and that leads me to my next question is as president of WCPT and for maybe the people listening, if maybe one day that's on their list, can you give a quick rundown of the roles and responsibilities of that position? Emma Stokes: 10:35 Yes. And Look, you know, I think let's just use the sort of a nice kind of balanced scorecard approach to this. So to me, when I ran, when I sought to be elected as president in 2015, I said I would look in, I would look out, I will look to the future. And then I had a little small part of the balance scorecard, which is you know, that quadrant system which was about inspiring. And in a way they map onto the two I think quite distinct aspects of the presidency, which is that you are the chair of the board of an organization and a company that's based in the United Kingdom and that brings governance, legal, fiduciary responsibilities. But you were also the president of a global organization. You are the leader in some ways the first among equals. But nevertheless you are in a leadership role. Emma Stokes: 11:21 And my perspective on that is my job is to bring people together in the global community and that's whether it's the physiotherapy part of the global community or the wider collaborative part of the global health rehabilitation community. So looking in was about ensuring that the organization with working with the board and staff and our volunteers was its best version of itself. Looking out was to start looking at who we working with internationally and what are the international organizations that we're working with. Looking into the future is about leadership. It's about creating the next generation of leaders in physiotherapy. And then the other space was about inspiring. And I suppose for me in the four years, I'm sharing something with you that I have probably not shared with very many people. So in my narrative and the work that I do with an amazing coach is around how do you walk with the dreamers and I've given a few talks that talk about what with dreamers, but it's about that idea of how do you inspire people to do something different, to get involved, to be involved in a different way, to just grow. Emma Stokes: 12:30 I guess just to enable us to sort of amplify everything that we do. And I suppose for me that's very, very, it's an intangible, right? It's that sense of how do you measure that when it's very hard to measure it? Right? And you know, now in the next four years, that hasn't changed. So we're still looking. So I believe we need to still look in, we need to still look out. We just need to look out in a bigger, better way. We need to look to the future. And I feel that commitment from me over the next few years is really important in terms of what are we talking about in terms of sustainability, the next generation of leaders, the future of organizations that are just in their beginning part of the journey. And My blog, which just was posted yesterday, is about, I suppose that other quadrant, now I'm talking about the moon landing projects. Emma Stokes: 13:21 So it's 50 years since, you know, since the first Americans landed on the moon. But I think that 1961 speech that JFK gave about this idea of what, asking ourselves the question about what we should be doing, not because it's easy, but because it's hard to me, you know I've got four years, you know, I'll be president for four years and then I go on and I just do a different part of my life. So if I had one thing that I want to do, it's about, we could be asking ourselves the question as an organization and as a community. What should we do because it's hard. What should we do, because it's right. And, we have to ask ourselves the hard questions. And those things are nuanced and they're just this dissonance in them and they're not easy and they're not going to be done in the four years. Emma Stokes: 14:14 So what are the big projects, what does that decade going to look like? And if you look at who they have two big projects that are focused on 2020, 30, which is, you know, it's almost a decade away. And I think we as a global community and as a global organization needs to be thinking about what are we doing to help answer those ques…

    Full show notes at the publisher

    453: Dr. Dan White: The Role of Clinical Practice Guidelines Sep 09, 2019
    Show notes

    On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Dan White on the show to discuss evidence-based practice. Daniel K. White is an assistant professor at the University of Delaware in the Department of Physical Therapy. Dr. White's research focuses on physical activity and physical functioning in older adults, people with knee osteoarthritis, and people after Total Joint Replacement. In this episode, we discuss: -What is implementation science? -Evidence Based Practice and how to use Clinical Practice Guidelines -The latest research findings from the Physical Activity Lab at the University of Delaware -Limitations of physical therapy branding and how we can step into the physical activity space -And so much more! Resources: Email: dkw@udel.edu Academy of Orthopedic Physical Therapy University of Delaware Physical Activity Lab Published CPGs For more information on Dan: Dr. Daniel K. White is an assistant professor at the University of Delaware in the Department of Physical Therapy. Dr. White received his Bachelor's degree in Health Sciences, M.S. in Physical Therapy, and Sc.D. in Rehabilitation Sciences, all from Boston University. He completed a post-doctoral fellow at the Boston University School of Public Health and earned a Masters in Science in Epidemiology from the BU School of Public Health 2013. Dr. White's research focuses on physical activity and physical functioning in older adults, people with knee osteoarthritis, and people after Total Joint Replacement. Dr. White is an Associate Editor for Arthritis Care and Research, and an active member in the American Physical Therapy Association. His research is funded by the National Institutes of Health, and the Rheumatology Research Foundation. Dr. White can be reached at dkw@udel.edu Daniel K. White is an assistant professor at the University of Delaware in the Department of Physical Therapy. Dan's research focuses on physical activity and physical functioning in older adults, people with knee osteoarthritis, and people after joint replacement. His research uses large existing datasets to answer questions related to physical functioning and physical activity. As well, he is also conducting clinical trials to lead ways to better promote and increase physical activity in people with knee osteoarthritis and after joint replacement. Dan is an Associate Editor for Arthritis Care and Research, and an active member in the American Physical Therapy Association, the American College of Rheumatology, and OARSI. Read the full transcript below: Karen Litzy: 00:01 Hey Dan, welcome to the podcast. I'm happy to have you on. Dan White: 00:05 Thanks. Great to be here. Karen Litzy: 00:07 And now today we're going to be talking amongst other things, implementation science. So before we go any further, can you give a definition of what implementation science is? Dan White: 00:19 Absolutely. So implementation science, that definition is the scientific study of methods to promote the systematic uptake of research findings and other evidence based practice into routine practice and hence to improve the quality and effectiveness of health services. So essentially it is bridging the gap between science and practice, and it is taking things that we find in laboratories and in clinical studies and literally implementing them into real world, clinics where most physical therapists work. Karen Litzy: 01:00 Right. So then my other question was why should the average PT care, which I think you just explained that, so we need to care about implementation science because this is how we're getting what researchers do in the lab to our real world situations and our real patients. Dan White: 01:16 Yeah. I think practicing as a physical therapist, you know, you can look around and a lot of people do a lot of different things and a lot of things seem to work. Snd I think, if we want a game changer in our practice, that is going to come from a systematically studying people and understanding what are the underlying critical ingredients of our practice that really work and the best thing we have made up today to answer that sort of question of, you know, what is it that really works our clinical practice guidelines that is the, essentially the best body of evidence that has been reviewed by a panel and vetted and made to be digested by the everyday clinician. And implementing these clinical practice guidelines are really the key element that is going to lead to a game changing opportunity for us as a profession. Karen Litzy: 02:34 And when you talk about clinical practice guidelines, I know sometimes people think that you're doing sort of it's cookie cutter and what do I need to follow a cookie cutter recipe for because all of my patients are different. So can you speak to that? Dan White: 02:52 Yeah, no that is a great point. So on the one hand, there is definitely an art to physical therapy and the clinical practice guidelines and evidence based practice is by no means trying to take that away. It's evidenced based practice in general is not cookbook medicine. It is combining the three things and one is what the evidence says, but two it also combines what the therapist's experiences are and then finally it's what patient's preferences and what their feelings are on the whole thing. And it's a combination of all three. It is literally the definition of evidence based practice and these clinical practice guidelines are definitely consistent with that EBP models. So they are not directions or they're not instructions, they're guidelines. They're ways of helping people make informed decisions. And at a minimum, if you consider yourself an expert clinician and knowing what the clinical practice guidelines are, is a big leg up. And definitely key to helping our profession. It doesn't necessarily mean you ascribe them to every single patient. No, that's not what evidence based practices, but being aware of them is by definition, in my opinion, being a good clinician. Karen Litzy: 08:02 So can you give us an example of one of these clinical practice guidelines? Dan White: 08:21 Sure, absolutely. So one of the common patient populations that people treat is low back pain. And Tony Toledo and his colleagues at the University of Pittsburgh and elsewhere developed a clinical practice guidelines for low back pain, and published this and JOSPT in 2012, their paper described that the purposes of these CPGs, our first to what EBP is for a physical therapy practice. And then also to classify and define common musculoskeletal conditions from this classification criteria specific interventions are devised. So for an example, so I don't treat low back pain. This is not my area. So just forgive me for giving a guess here. Dan White: 09:32 One example, is a lumbosacral segmental somatic dysfunction. And this is associated with the ICF diagnosis of acute low back pain with mobility deficits. And, Tony goes on to saying that there's, certain clinical findings with this, including acute low back pain, a buttock or thigh pain restricted lumbar range of motion and lower back pain and lower extremity related symptoms with provocation. And then from that, there are specific interventions that I'm not going to get into that is unique from a different classification. So a different classification, a low back pain is sub acute, low back pain with mobility deficits, which is basically not acute but subacute patient and the symptoms are produced with ingrained spinal motions and there's a presence of a thoracic lumbar pelvic girdle mobility deficits. Dan White: 10:41 And then he goes on and there's these different classification criteria from which there are very specific interventions you're supposed to do. So it's classification and then intervention based on that. And essentially, that is in an ideal world of what a CPG should do. However you're always gonna have the patient that really doesn't fit into one or the other. Let's have somebody who is not quite acute, but they're not quite subacute. So what do you do? And I think being able to first even make that distinction, you have to be aware of the clinical practice guidelines. So knowing that, okay maybe it's going to be a combination of these two interventions because of this person doesn't fit into either one, but see how that approach is already a leg up from not knowing what CPGs are to begin with and what our common classifications is. Does that make sense? Karen Litzy: 11:38 Yeah, that makes a lot of sense. Thanks so much for using that as a really great example for people. And when you're talking about different CPGs, I know that the Academy of Orthopedics, which used to be the orthopedic section of the American physical therapy association, they have all these different names now. It's just made it all so, so much more confusing. But now obviously big proponents of the clinical practice guidelines, but if I wanted to find the average clinician and I want to find some of these guidelines, where do I go? How do I find them? Dan White: 12:14 Sure. So all the published clinical practice guidelines for orthopedics are on the Academy of Orthopedic Physical Therapy's main webpage, which is Orthopt.org. There's a banner that says CPGs and you just click on that and you can get right to all the published CPGs. Karen Litzy: 12:41 Awesome. And we'll have a link to that in the show notes at podcasts.Healthywealthysmart.com under this episode so that if people need it one click and we'll take you right there. So there's no excuse to not know these CPGs after listening to this podcast then because we're going to make it really easy for you. And now you just gave us a good example of how CPGs can work in clinical practice. Are there times where maybe they don't work so well or is there a downside I guess is what I'm trying to say? Dan White: 13:16 Yeah. I mean, again, going back to your original question of, you know, is this cookie cutter medicine and it's not and again, since EBP is a combination of patient preference, the provider know how, and what the evidence is. I mean, there's going to be situations where, you know, a situation's weighted much more towards a patient's preference. Like they don't want you to do manipulation or maybe they want something specific and you're like, well, that's really not called for in this case. And so you don't do the intervention that's prescribed or that the CPG recommends. And that's okay. We're not here to tell people, to command them what to do. They're coming to us for help. And, patient preference is a large part of evidence based practice. I think that's the best example I can think of. Karen Litzy: 14:16 Yeah. And, and I think another, if you're looking at your clinical experience as one of the legs of that stool, if you will, and the patient doesn't have a preference yet, you're sensing as a clinician that there's some trepidation on the patient's part. There's some fear if you were to, like you said, we'll take a manipulation as an example, then using your provider know how you would say, you know, this is not the right time or place for this. And so I think you've got all of that in. So the CPGs is not a cookie cutter oath just because A B C is present you have to do treatment B or treatment a or B. But instead it's giving you a way to maybe differentially diagnose and a way to, you know, be able to maybe give your patient an explanation as to what's going on and then use your judgment, use the patient preference and the evidence to then guide your treatment. Dan White: 15:21 Yeah, exactly. It's just like, you know, when you just meet somebody, you try to figure out who they are, right. And you try to figure out what kind of personality they are. And there's some sort of structure or rubric people use. Like let's say there's introverts and extroverts, is this person an introvert or extrovert in the CPG the first thing that it does is provide you a framework of saying, well, what kind of types of people are there with this type of pathology? How are they a type of person that has, I don't know, this type of this type of disorder or this type or another type of disorder. And from that diagnosis of providing a classification, you can, there are clear treatments associated, with that so back to the party analogy, you know, if you're dealing with an introvert, you know, you, you know that they're not going to be super bubbly and all over. Dan White: 16:10 You have to kind of bring things out of them and maybe take it easy and you know, take it on the slow road. Versus if someone's an extrovert, maybe are going to be doing all the talking. And, you can just be an active listener and be very interested in what they're saying, because they're the extrovert and perhaps, you know, that that's Kinda how it goes. And the CPGs is essentially just it is in the party analogy, a way of just navigating through our clinical practice, to provide best care. And, you know, I think another, medical example that really, stays fresh in my mind is a sort of lifesaving approaches to acute MIs. And, it wasn't the sort of protocol for or clinical practice guidelines for myocardial infarction, weren't developed, when necessarily, right after science discovered that, you know, look, if you do x, Y and z can actually save someone's life. Dan White: 17:20 It kinda came much, much later. And it wasn't until, the university hospital in Chicago, implemented these sort of CPGs for lifesaving approaches to MI that the death rate for acute MI's went way down. And all the medical residents followed, this CPG for treating acute MIs. And, that systematic approach is what made care better. Obviously in physical therapy we're not talking about life or death, but these CPGs have been vetted and are an approach that is systematically used, will produce a better outcomes. So yes, it's, you know, EBP, I'm not changing my story here. EBP is obviously patient preference, provider experience as well as the evidence, but when applied systematically, which means you'd be at minimum aware of what the CPGs are, they should produce better outcomes system wide. Karen Litzy: 18:27 Yeah. And thank you. I love the party analogy and comparing it to that medical example really kind of makes the CPGs a little bit clearer and hopefully people will now not look at them as some sort of cookie cutter program, but instead, as a way to help inform you of your practice, which I think is, yeah, I think it's great. And now, all right, so let's move on from CPGs. Let's talk about, I'm kind of interested in what you're doing next. So you are the director of the physical activity lab at the University of Delaware. So let us in on some of the things that you guys are working on. If you can, you know, I understand you can't say everything, but what are some things that you're working on that you feel like will be part of future implementation science for the average physical therapists treating patients like myself? Dan White: 19:23 Yeah. Thank you for the opportunity. You know my whole goal is just to get patients better. And, I worked in inpatient, acute, acute Rehab for several years. And I always wondered, you know, after I got people independent with bed mobility, transfers and ambulation, you know, would they actually take those, you know, new found independence, and actually resume their daily activities and be active in the home. And that led me to really thinking a lot about this notion of physical activ…

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    452: Dr. Kathleen K Mairella: Becoming an APTA Official Sep 05, 2019
    Show notes

    On this episode of the Healthy, Wealthy and Smart Podcast, Jenna Kantor guests hosts and interviews Kathy Mairella on how to get elected to the House of Delegates and other APTA positions. Dr. Mairella is Assistant Professor and Director of Clinical Education at Rutgers University. Dr. Mairella has served in a number of leadership positions, including service on the American Physical Therapy Association Board of Directors, and terms as president and chief delegate of the American Physical Therapy Association of New Jersey. In this episode, we discuss: -How to make yourself known to the Nominating Committee as a potential candidate -Referencing the candidate's manual and seeking guidance from your campaign manager -Candidate interviews and Kathy's experience with election day -The continual pursuit for leadership experience -And so much more! Resources: APTA Engage Website Kathy Mairella Twitter For more information on Kathy: Kathleen K Mairella, PT DPT MA, received a Baccalaureate degree in Physical Therapy from Boston University, and a Master of Arts in Motor Learning from Columbia University. She received a Doctor of Physical Therapy degree from the MGH Institute. Dr. Mairella is Assistant Professor and Director of Clinical Education. She teaches Professional Development I, and Health Care Delivery I and II. Her professional interests include health policy, professional leadership, and clinical education. She has presented on these topics on the national and state level. Dr. Mairella has served in a number of leadership positions, including service on the American Physical Therapy Association Board of Directors, and terms as president and chief delegate of the American Physical Therapy Association of New Jersey. For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University's Physical Therapy Program. She is also a co-founder of the podcast, "Physiotherapy Performance Perspectives," has an evidence-based monthly youtube series titled "Injury Prevention for Dancers," is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt Read the full transcript below: Jenna Kantor: 00:00 Hello, this is Jenna Kantor with healthy, wealthy and smart. And I'm here with Kathy Mairella and we are at the house of delegates and going to talk about the process, the election process for people who are running for positions within the APTA. And I know nothing. So first of all, Kathy, thank you so much for coming on. Kathy Mairella: Thanks. This is fun. I'm looking for to talking about this. Jenna Kantor: So for those who haven't listened to any of the interviews that I've done before that were kind of similar, I am totally beginner and I'm just going to be asking step-by-step and learning with you the listener about this process. So let's start from the very beginning. And honestly, I don't even know what that is. So Kathy, would you start, how does it just even start in the first place? Is it a piece of paper you signed? Do you raise your hand in a meeting? Like how do you get the opportunity to run for a position within the APTA? Kathy Mairella: 00:49 So that's a great question. So many, many of the leaders who run for positions at the APTA level started the component level and they often, it means state component mainstay or it can be an academy section as well. Those are also components. So every state has a chapter and then your sections are also considered components. So most candidates who run at the national level have had some level of leadership experience at the component level. And so you start there simply by showing up and getting involved in different activities. Usually if you have a leadership interest, somebody will notice and give you some direction and it helps to get that direction if you ask for it. If you're doing some work on a committee level or a task force level, you can ask the people who are more engaged. Kathy Mairella: 01:55 How did you do this? How did you get started? I started as a New Jersey component leader. I started as a secretary and moved through vice president and president and then to chief delegate. And so I got to know people on the national level through my work as a chapter president and as a chief delegate because that's where you come to a national meeting and you start to connect with people beyond your component. You start to meet people who are either other delegates or serving on the national level. And you develop connections, you develop relationships. When I went to my first delegates, I looked at the candidates who ran and I thought I would never in a million years do that, but I was a delegate and I watched and then people came to me and said, we think you have some leadership, would you be in check? Kathy Mairella: 03:00 And I was totally floored. I did not expect that at all. In fact, I was a member of APTA's nominating committee. So nominating committee members are elected to slate the candidates who run and they start years ahead of time identifying those who are interested. And so I was approached and I thought, not really, no, I don't think I really want to do that, but it gave me the idea of perhaps in the future serving at a national level. Jenna Kantor: I want to pause you just very briefly. Would you mind saying what a delegate is for those who don't know what that means? Kathy Mairella: Sure, absolutely. So each state chapter elect delegates who go to the house of delegates to vote on motions which are ideas, ideas for action. Really the house of delegates is considered a representative body, just like Congress as a representative body. So you are elected by your state or there are also section delegates, but you're elected to represent them in the house of delegates. Kathy Mairella: 04:21 And the house of delegates has about 402 delegates. And so the states with larger membership have more delegates, states with smaller memberships have at least two. They will never have fewer than two. So they call that apportionment. Jenna Kantor: So you're bringing up the delegates cause they're the people who vote for you. So it's important to be introduced to them because it can help your candidacy if you should run. Kathy Mairella: Correct. And when you decide you want to run, it's important to get a sense from people. Is this a good idea? You don't want to put in all the work and then not be successful. So you really do start to observe people who have been elected or people who are doing work within the association that inspires you, that interests you and you know, you can observe them, you can ask them questions. Kathy Mairella: 05:24 You can start to connect with people. And then running for offices really a matter of experience. But it's also a matter of timing. We all have work life integration and we figure out the timing that works best for us. And in my case, I had three growing children. I knew I wanted to serve at a point where they were a little bit more independent. So that determined my time frame. So again, I had been a chapter president, a chief delegate, and then at the end of the time I was a chief delegate. My youngest child was graduating from high school and I thought, okay, this is the time for me to start pursuing that. So, I would observe then you need to know what the positions are. You need to know. Jenna Kantor: So just to run for say, secretary or President or director, you need to know what it means that you would need to know what to do. Kathy Mairella: 06:29 Correct. So, the board of directors at the APTA level is 15 members. You have nine directors and then you have house officers, speaker and vice speakers. So those are two board positions that actually run the house of delegates. And then you have president, vice president, secretary and treasurer. So you would need to know, you know, kind of the roles and responsibilities of each of those. And you can also run for the nominating committee, which I mentioned earlier. So those are the people who are elected by the delegates to determine who the candidates are each year. So, you know, you run through a process that starts immediately after each house of delegates. So we literally just finished the house of delegates today on June 12th, and the next cycle starts for the 2020 election today. And it starts by forms that are available on the APTA website that any member can complete. Kathy Mairella: 07:34 They don't need to be done. You don't need to be a delegate. You don't need to be a leader. You can go on the APTA website and you can put in what's called an NC1 form, which stands for nominating committee one form. And you put that in and as an individual and you recommend someone that the nominating committee should contact as a possible lead for them to slate for office and you can you choose, I think this person would be a great secretary. I think this person would be a great treasurer. And you put in the recommendations for the offices that are up for election in the following year and the nominating committee collects all of that information. They also keep an ongoing spreadsheet of people who have expressed interests cause sometimes people will say, yes, I'd like to do this in the future, on completing a residency now and I'm getting married the year after that and I'd like to practice for three to five years and then maybe I'll be ready. Kathy Mairella: 08:47 They start to keep that spreadsheet and they turn that over every year from nominating committee to nominating committee so that they have a database of potential candidates. Jenna Kantor: I have a question. I have a question about that. I'm definitely a person who wants to work on the board one day. Definitely a dream of mine. And what if I'm in a position where I don't have somebody saying, Oh, I submitted for you. Like what if you don't have something like that? Does that look low upon yourself? I would love to know that perspective. Kathy Mairella: Sure. So the volume of those NC1 forms really doesn't make a difference. It's important to have a few people say, yeah, it would be nice for nominating committee to talk to that person. You're not committing to anything. It simply gives your information to the nominating committee as someone that they should talk to and it just gets you in kind of in the system. Kathy Mairella: 09:47 So, I think for anyone who is interested, you can contact someone on the nominating committee directly. Their list of names and contact information is on the website. And usually they're assigned to a region. So who's ever assigned, you know, if you're from New York, from the northeast, you know, you can directly contact, you don't have to have NC1 forms until you're actually ready to run for office. So once you decide you are ready to run for office, it usually is a good idea to ask a few people. Would you be willing to put in an NC1 form for me? And talk to people kind of before you're ready, you know, do you think this is a good idea? Cause as I said earlier, you don't want to put in all the work and then find out that you're not successful. Kathy Mairella: 10:35 You're spending this time looking at your leadership skills. Learning about leadership. Always growing, always growing. There are some resources. APTA has opened, a new platform called APTA engage. And they are in the process of transferring some of their leadership development resources to that place. When I was on the APTA board, I chaired the leadership development committee and we came up with some core competencies of leadership. So, they were self function, which is how an organization works people, which is managing people's skills and visions. So knowing how to be visionary. And so I would recommend that you would look at all of those areas and they're always, they're not linear. It's not as if you develop self first and then people and then they're cyclical. Right? So you can be, you know, you can work on all of those things and constantly come back to developing yourself as a leader. Kathy Mairella: 11:43 You're always developing yourself no matter how experienced you are. So the nominating committee, these NC1 forms are available between now, which is June and November. Usually it's around November 1st they close and then the nominating committee takes those forms. They look at who the possible people are that might be good to be slated for these positions and they actually reach out to these people. They interview people, to figure out who should be slated for this next year's offices. And they come up with a slate and what they decide how many candidates to slate. So usually if it's an officer position, president, vice president, secretary, they try to slate two people because there's one position. And for director there's usually three positions. They try to slate six individuals for those three. So two for each position is the goal. And that's what they would consider a full slate. And sometimes that's a challenge to get a full slate to get people to commit to run and you have to consent to run. They will call you to say, do you consent? They don't just put people's name on a list. Jenna Kantor: 13:15 So for you, you went through this whole process yourself and several times. Oh my gosh, this is for those who do not know, Kathy, she has the stamina of wonder woman just doing the whole process. So you knew you were going to run. Is there a meeting to teach you about principles or how are you trained for what is to come. Kathy Mairella: And that's a really great question. So the nominating committee members are mentors or guides for you. They're not your advocates because they remain neutral in the election process. But they will assist you with some resources. But then APTA staff who work in the governance department become your assistants as well with the process. There is a candidate manual that contains much of the information and that's available to anybody. You don't have to wait until you're a candidate. Kathy Mairella: 14:16 Any member can go on the website and locate the candidate manual and read lots and lots of information about this whole process. And it really describes the nominations process, the candidacy process, and the elections process. So once the nominations process ends, the candidacy process begins and the nominated committee publishes the slate and the slate goes up on the website. And that's when people find out, it's usually early in December. They usually find out these are the people who are on the slate and then the campaigning begins. And as candidates, you are given a question to answer that goes in written form that goes on the website, on your candidate page. You also have to have your CV that gets posted there and that becomes available to the delegates and to the members to look at who are t…

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    451: Drs. Sneha Gazi & Maria Muto: Physical Therapy International Service Aug 29, 2019
    Show notes

    On this episode of the Healthy, Wealthy and Smart Podcast, Jenna Kantor guests hosts and interviews Sneha Gazi and Maria Muto on Physical Therapy International Service. Dr. Sneha Gazi is a physical therapist based in Manhattan who specializes in orthopedics and pelvic health. Sneha's desire to bring her skills beyond her immediate reach drove her to start PTIS in the hopes of bringing PT services to underserved populations. Dr. Maria Muto is a physical therapist based in Manhattan who specializes in orthopedics. In this episode, we discuss: -How Sneha and Maria started Physical Therapy International Service as students -The logistics around organizing a volunteer event abroad -Roadblocks Sneha and Maria encountered along the way -Advice for those interested in following in Sneha and Maria's footsteps -And so much more! Resources: #PTIS #PTInternationalService #CerveraDelMaestre #Spain PT International Service Website Email: pt.internationalservice@gmail.com For more information on Sneha: Dr. Sneha Gazi, DPT earned her Doctorate of Physical Therapy from Columbia University with a focus on orthopedics and pediatrics. She holds a BA in Honors Developmental Psychology from New York University where she completed a Concentration in Dance and published a scientific article on infant motor learning and development. Dr. Gazi worked at clinical rotations in both outpatient orthopedic practices and acute care hospitals, gaining knowledge on high-level manual therapies and evidence based exercises to help her patients return to the activities they loved. She's treated pelvic pain in pre/post-partum women, rugby players in New Zealand's sports training facility and helped many NY's Broadway and Off-Broadway dancers, actors, vocalists, and instrumentalists to get back on stage. She combines her knowledge of how to rehabilitate lower back pain, neck pain, TMJ dysfunction, sports and dance injuries along with a compassionate energy. Sneha is also a certified yoga instructor and professional Indian classical dancer. She integrates yoga asanas, breathing techniques, guided mediation, and mindfulness exercises into her treatment sessions to enhance her patient's recovery process. Sneha has a strong passion for service overseas and pioneered the first ever Physical Therapy International Service trip to Spain with Dr. Maria Muto. For more information on Maria: Dr. Maria Muto is a physical therapist based in Manhattan who specializes in orthopedics. Maria received her Doctorate of Physical Therapy at Columbia University where she began to analyze runner's running mechanics. In recent years, Maria has worked with the athletic population as a personal trainer. She hopes in the near future to obtain her certified strength and conditioning specialist certification (CSCS) to practice both training and rehab with high level athletes. As a physical therapist, Maria's treatment approach is team-based between her and her patients. She believes that getting to know and involve her patients as much as possible within his or her care is the best way to optimize function and maximize movement mechanics for a true recovery. This belief of involving patients within his or her care at this level persuaded Maria to expand herself to this world and discover how to truly connect with others of varying conditions, cultures and fortunes. Maria has now practiced in Italy and Spain. Overall, Maria is excited and eager to continue to learn more about the world and her profession by these experiences. For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University's Physical Therapy Program. She is also a co-founder of the podcast, "Physiotherapy Performance Perspectives," has an evidence-based monthly youtube series titled "Injury Prevention for Dancers," is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt Read the full transcript below: Jenna Kantor: 00:04 Hello. This is Jenna Kantor. I am partnering as a host with healthy, wealthy and smart. And today I get to interview Sneha Gazi and Maria Muto. And they are the creators of physical therapy international service, which is PTIS, where they led the first ever international service trip in Spain, which is incredible. So I'm extremely excited to be interviewing these two. One they're good friends of mine, two their big goal getters. Literally this wasn't any teacher or any mentor telling them to create this service trip. This is something they just found a real hardcore desire to create from scratch. So this podcast is extremely valuable because they are going to be sharing exactly how they did it, maybe a little bit of obstacles, and then hopefully put a fire in your flame if you're considering doing something like this yourself. So the topic for today is very simple. It's just creating a service trip. All right, so first Sneha, would you just mind just saying hello one more time so people can really hear your voice. And Maria, would you do the same? Perfect. Alright, so first question, why did you decide to create a service trip? Sneha Gazi: 01:31 So we had multiple reasons to create a service trip, but two of the main reasons were, one, we wanted to provide physical therapy services to a group of people in a different country who didn't have that opportunity already. So we chose a small town in Spain. They have no physical therapy services in that town and the closest medical services they have to travel quite far to obtain even basic medical services. So physical therapy is sort of a luxury treatment for them in that town. And these are also people who work high levels of labor, their agriculture workers, they do a lot of physical demanding work, so they end up having a lot of physical stressors. So, that's one main reason we wanted to provide a service to people who didn't have it. And then the second reason, our main reason to join with two folds. Sneha Gazi: 02:23 The second one was to provide an opportunity for students to learn in a different setting. So this provides cultural awareness. This provides an opportunity for students to bring things outside of a classroom setting, even outside of a clinical affiliation setting where they have, you know, very structured environment into sort of the blue and an environment where they won't have a chance to, you know, readily look something up on the Internet, but they have to think on their toes. They have to know how to modify a treatment. They have a licensed physical therapist there to guide them throughout to make sure everything is safe and everything is moving forward very well for the patient to have the patients' interests in mind. But it's to provide these students an opportunity where they're kind of thrown out of their comfort zone. Jenna Kantor: 03:05 That's excellent. So, okay, you started from scratch. How did you guys fundraise for this trip? Maria Muto: 03:14 Yeah, so we had three separate events. These were a happy hour events, that we advertised to people that we knew in the local area to come hang out with us downtown, come out and support this service trip. We had great turnout the first two times. It was so much fun to just gather with these people to help promote this amazing trip. Super supportive. It was a true gift, honestly. So, you know, we hope to continue doing this. Jenna Kantor: 03:49 That's great. Yeah. Sounds so simple that you guys were just able to create these social nights and you're able to just make money from that. Was it difficult just to follow up a little bit more money? Yeah. So was it difficult putting together these fundraising events or was it rather simple? Maria Muto: 04:04 Well, the simple fact that we are housed in Manhattan kind of make it easy because there's so many opportunities to go out and explore the city. So, you know, between Sneha and I, and a third member, we kind of were just thinking about, you know, where do we want to be? Thinking about the audience that we were targeting, like young 20s, let's think about the area and location. So we did our research, we contacted, the coordinators of these local areas that we were interested in and things, you know, led to another. And we were talking about deals and we got really great offers and apparently our audience loved it too. So, it wasn't really that difficult. You just have to kind of reach out and speak to the right person. Jenna Kantor: 04:50 That's great. I like how you say it. It almost sounds like boom, Bada Bang. It happens. Maria Muto: 04:56 New York is a land of opportunities so it is put yourself out there and you never know what you're going to get. Jenna Kantor: 05:03 Yeah. So we learned right here, moved to New York is a good suggestion. Did you choose a location then for your actual service trip? Sneha you start to go into this a little bit saying all the benefits of Spain, but I'm sure you must have explored other locations as well. So would you mind telling me that journey? Sneha Gazi: 05:24 So, I actually had the wonderful opportunity before joining PT school to do a Yoga Shiatsu program where I got my yoga teacher certification in this very town. So the way I found that was I just looked up yoga teacher certifications in Europe because that's where I wanted to do it. And I know a little bit of Spanish. So I knew that that would be a little bit easier for me to mingle in with the folks in the town and have a good time and get to know different cultures. So I chose Spain, I ended up going there, made some amazing connections, you know, the smaller the town, the lovelier the people in a lot of ways. Everyone is so humble in that town. Everyone is so open and warm and you know, willing to let you into their homes and their town in their community, which is already so small to begin with. Sneha Gazi: 06:11 So I made some really good friends there and when I was thinking about places, Maria and I were discussing, that was one of our many options. And it also was the one that flew the quickest for us because of that connection that I already had there. So it wasn't easy to do the communication and you know, do the long distance back and forth, emails, thousands of emails, thousands of things to coordinate. But at the end of the day, that was the best route for us to go to because I already had been there before and I had known that it was a safe place. The people were wonderful and I knew that this would benefit both the town in the students and the licensed therapists who are coming along with it to make it a safe working environment and a safe learning environments. And that's why we chose that. Jenna Kantor: 06:52 Yeah. Yeah. That's great. Oh so good that you knew that it was a safe area to cause I know for people traveling overseas that would be a concern. So having that background with Yoga, by the way, power to you being a physical therapist and knowing yoga. Wow, that's definitely given you a leg up for sure. But being able to have that experience before that, that's great. What a great way, how your life and kind of led you to creating something more in this area that you fell in love with through yoga. Jenna Kantor: 07:53 So we talked a little bit about fundraising. Now my mind's going to how much would this cost if I was a student now I wanted to participate. How much did it cost for a student to go and be part of this service trip? Maria Muto: 08:17 So, because this was the first event, we kind of hope that the next following will be similar into what the expenses were for this one. But you know, as a student, finances can be very difficult. So, you know, trying to keep that within our minds. We calculated a fair of 450 euros, that would be per students. So kind of just thinking of the numbers, we were, you know, that's why we had those three fundraising events to try to cover for those costs. So, you know, we were planning accordingly. We did tell the students, which we have three students with us and two licensed PTs, we did tell them that their airfare would be on them. Because we wouldn't be able to cover that. Hopefully as we grow as an organization, we will be able to, you know, create larger fundraising events and have, you know, even more money to, you know, help us move this opportunity along and help you know, out the students, or whoever's participating more. But for the first time, that was pretty much what we had the students pay. So, you know, we'll see what happens in the future. But, it wasn't really that expensive. When you look at a larger scale of what it actually could potentially be per person. Sneha Gazi: 09:46 We have to say what the fundraising money went to. So we have to say that we covered the entire cost for the licensed therapists. 450 euros for two people. Maria Muto: 09:56 The 450 was covered like we provided coverage for the PTs and then everything, the airfares and all that stuff was on their own. Jenna Kantor: 10:17 Selecting students and selecting mentors, I feel like this is almost like a raffle, you know, like who gets it? How did you do this? Was there some sort of like people wrote in letters and mentors. I mean, you were students at this time. So how many professionals did you know at this point to be able to pull in the ideal people to guide you over in Spain? Sneha Gazi: 10:40 Yeah, so the licensed PTs who came on this trip, the way we approached that was we emailed, texted, Facebook message called, kind of in any way, a form of communication to every license PT that we knew and our contacts list, and then ask our friends to give us more context. We had many people show interest, but we knew that we were asking a lot from them because they weren't getting paid to go on the trip. All we were able to do was completely cover they're living, food, transportation in Spain, which was the 450 euros that Maria mentioned, but we weren't going to be able to cover their airfare. So what these therapists had to do, and we are forever grateful for you, Patty and Michelle for doing this. They actually took off of work and paid their airfare to come to be a part of this trip. Sneha Gazi: 11:32 And the two therapists who came in were the ones who were able to give us a commitment as soon as, and we knew that everybody who we reached out to was a reliable, intelligent and wonderful therapist who we knew would be an amazing form of guidance for the students and for ourselves because we were students while we went on the trip. So we knew whoever came in and whoever signed our contract and said they were on board. And you know, there were many who are very enthusiastic about this. But whoever came in first were those. And then in terms of the students, we reached out to several schools. We did not want this to be a school trip. You know, never really was a school trip. This is an independent project. So we reached out to several schools outside of our own school. Sneha Gazi: 12:18 Maria and I go to the same…

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    450: Prof. Evert Verhagen: Qualitative Research in Sports Medicine Aug 26, 2019
    Show notes

    On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Evert Verhagen on the show to discuss qualitative research and how the outcomes can be useful for clinical sports practice. Evert Verhagen is a human movement scientist and epidemiologist. He holds a University Research Chair as a full professor at the Department of Public and Occupational Health of the VU University Medical Center and the Amsterdam Movement Science Research Institute. He chairs the department's research theme 'Sports, Lifestyle and Health', is the director of the Amsterdam Collaboration on Health and Safety in Sports (one of the 11 IOC research centers), and co-director of the Amsterdam Institute of Sports Sciences (AISS). In this episode, we discuss: -The difference between qualitative and quantitative research -How qualitative research influences sports medicine and injury prevention research and clinical practice -How to design a qualitative research study and control for biases -What is in store for the future of qualitative research in sports medicine -And so much more! Resources: Evert Verhagen Twitter Email: e.verhagen@amsterdamumc.nl Sports Lifestyle and Health Research Website IOC World Conference Prevention of Injury and Illness in Sport For more information on Evert: Evert Verhagen is a human movement scientist and epidemiologist. He holds a University Research Chair as a full professor at the Department of Public and Occupational Health of the VU University Medical Center and the Amsterdam Movement Science Research Institute. He chairs the department's research theme 'Sports, Lifestyle and Health', is the director of the Amsterdam Collaboration on Health and Safety in Sports (one of the 11 IOC research centers), and co-director of the Amsterdam Institute of Sports Sciences (AISS). His research revolves around the prevention of sports and physical activity related injuries; including monitoring, cost-effectiveness and implementation issues. He supervises several (inter-)national PhDs and post-docs on these topics, and has (co-)authored over 200 peer-reviewed publications around these topics. Read the full transcript below: Karen Litzy: 00:00 Hi Evert. Welcome to the podcast. I'm so happy to have you on. Evert Verhagen: 00:04 Yeah, thank you very much. I'm really happy to be here as well. Karen Litzy: 00:08 All right, so today we're going to be talking about qualitative research in mainly sports medicine. But before we even start, can you give the listeners the definitions and perhaps the difference between quantitative research and qualitative research? Evert Verhagen: 00:30 Sure. I think that is a really valid question to start with. I believe most people are familiar with quantitative research. It is what we do like in the word already, quantification of a problem by counting, by having numerical data or data that we can transform into statistics. And then we can quantify attitudes, opinions, define variables. And we can generalize that across the whole group of our population. So we can generate averages in given populations and we can compare averages between populations. Qualitative research on the other hand, doesn't go by numbers, it's more exploratory. And we try to get an understanding of reasons, opinions, motivations and instead of quantifying a problem. So, giving a number to it, giving a magnitude to it, we get insight into the problem and it helps us to develop new ideas and our policies. And that can be a precursor to do a bigger quantitative study in which you have an idea of where to look and where you would like to quantify and get some more thought. But you can also do it afterwards, where you have a quantifiable outcome and you want to understand better what that outcome actually means and what it means to your population and in the population. I think that is in essence the big difference. Karen Litzy: 02:06 Yeah. Thank you for that. And, now you have had over 200 peer reviewed articles in different journals and you yourself had done a lot of quantitative research. So why the shift now for you into more qualitative research? Evert Verhagen: 02:22 Oh, it's not the first time I get asked that question. I'm a trained quantitative research. I'm an epidemiologist. I'm a human movement scientist. So I kind of live and swear by numbers. If I can't measure it for me, it shouldn't count that many people think. Now, I learned that through the years, if you can count it, it still doesn't mean anything. It still needs to have a meaning. So a difference between two groups in a trial, it just gives you the difference between the groups in a trial. It doesn't tell you how the individuals within that trial actually experienced it. The same with trying to get your head around an injury problems so you can capture an injury problem in incidences in prevalences, in severity, in numbers of days, lost availability during games. But what does it actually mean for the individual athlete? Evert Verhagen: 03:23 What does it mean for the patient? And the same maybe with treatment outcomes, rehabilitation outcomes. It's nice to know that, you know, you reach a certain degree of range of motion after rehabilitation or reduced level of pain on a visual analog scale. But what is actually the opinion of, of that patient, does that actually align with what you can measure? And if not, where does the different come from? And if you do, it kind of shows you that you're in the right direction. And over the years I learned that quantitative research can only help so much in solving the bigger issues we have where it concerns, prevention targets for presumed prevention. It stops at your number and then you need to do something with it. And the only way to do something with this, it's to understand where it comes from and also to understand what it means. That's where my interest kind of started. Karen Litzy: 04:23 Yeah. And that makes a lot of sense coming from myself from the clinical side of things. And I'll use the VAS scale when you're looking at pain as let's say one of those quantitative points. And I think this is a good example. Looking at the VAS scale, a four or five for me is a very different experience for someone else with the four or five out of 10 pain. Right? And so just looking at that number from quantitative research saying, well, this proves that this treatment, whatever it may be reduced pain by, I don't know, four points on the vas scale. Well, okay, that's great, but then what does that mean for the individual person and that you're just moving it because qualitative someone's opinion. This is an opinion of what my pain is and then we take it to quantitative data, but then it doesn't say how that patient is living with that pain. The pain has decreased, but I still can't walk to the store. I still can't play with my kids. So what does it mean? Evert Verhagen: 05:27 Exactly. I think that what you just said that is purely qualitative talks about what does it mean, what impact does it have as one little, one little thing I would like to specify is that a VAS scale in essence, which is a subjective outcome measure, is still a quantifiable objective measure. It's not qualitative and that is something I run into every now and then in a discussion where people seem to think that a subjective outcome on a scale or a subjective outcome measure in a survey is qualitative. It is not you have to look behind those measures. So why does someone report a reduction from eight to four on a visual analog scale? That is what we're looking at and you're completely right from eight to four in someone who has a seating job for instance. Mostly behind the computer means something completely different than someone who moves from eight to four who has a really active job and we have four is still really limiting for them. Evert Verhagen: 06:35 We may go to athletes, for instance, a pain of four today in preseason maybe or at the end of season when there's no big competitions around, I'm okay, I can skip the training, but a pain of four during competition when has a big game coming up? You probably will suck it up. And even though the pain level is the same, your experience and the burden it gives you is completely different. And those are the things we do work capturing in numbers. And those are the things that make the big difference for the individuals we do our research pool and our target population. Karen Litzy: 07:14 Yeah. And that actually leads nicely into the next thing I wanted to talk about and that's, how does qualitative research manifest itself in sports medicine or injury prevention? Evert Verhagen: 07:25 From the research perspective you mean? Or the practical perspective? Karen Litzy: 07:28 Let's take research perspective first. Evert Verhagen: 07:31 On a research perspective, I think it adds a new layer of information to what we already know. And you can think that in multiple ways. It gives you direction to where you would like to go with future research because you understand better your population, you understand their needs, their wishes, their opinions, their fears. You understand, their foci and based on that you can have more targeted either interventions or more targeted outcome measures to chart a problem or to monitor a problem. So it will guide quantitative research in that sense, which I would say is also really interesting in regards to machine learning and the complexity theories that are out there. We can't measure everything but if we get a sense already based on the public, the population where we should focus on it will gives direction to those novel technologies where we do data mining and all that. Evert Verhagen: 08:38 Also on the other hand, if we do interventions or if we do objective measures of what we try to assess in research, we need to find a way to translate that to the population. Research of course it is about putting it in a nice article and publish it in a high impact journal if at all possible. But in the end, and I'm speaking for myself here, I do research because I want to help people, I do research because I have a general question that I feel is valid to ask in relation to an issue or problem I see in athletes. So I want that number to come for athletes as well. And in order to do so, I need to talk to them and get their opinions about how they feel about this number, how they feel they can use it, how they feel they may not be able to use it. Evert Verhagen: 09:38 And based on that I can develop my next steps and I understand better what I did right, what I did wrong. I understand better what it means actually because I have my own opinion. And that's why I think qualitative and quantitative are synergetic to each other. Let me give you a clear example, which may be a bridge also to more the practical side of it. Maybe that's injury definition. If I ask athletes or students and fellow researchers how they would define an injury. Usually they come with the technical definitions. We also have in our manuscripts, like it is tissue damage. It leads to pain. That pain may lead to a diminished performance, maybe a limited availability, which is all fine. And if you ask athletes like, when are you injured? The elite athletes will say, well, pain is actually part of the game. Evert Verhagen: 10:34 I always have pain. I'm used to that and I know how to deal with that. And I will not think this pain is a problem unless my performance is limited, which is already a little bit of a different injury definition. So the problems we see and we have in terms of pain and availability may not even be the problems they perceive to be problems. So we solving maybe something they don't even see to be an issue. Now if you translate the same thing to maybe recreational athletes or novus athletes, people who sit on the couch and say, okay, let's be a bit more active. They're not used to pain, they're not used to how their body reacts to physical activity. So we think they have more injuries, but maybe their perception of injuries is simply different from the perception of injuries we see in most of the papers we read. And I think there's a clear clinical message there is that, perspective, context, experience of the patients you have in front of you determines their perception of the issue they have. But it also determines for you as a clinician what you need to do and how you need to approach that. Because the numbers you see in the quantifiable manuscript that's all based on averages and not on that one single person in front you. And this is where qualitative research can help a lot to understand that. Karen Litzy: 11:59 Yeah, and that makes a lot of sense to me. And as a clinician, I think sometimes we can get caught up in the quantitative data and those numbers and lose sight of the person in front of us. Meaning sometimes we may say, and I see this on social media threads and things like that, which I'm sure you've seen as well. Well this is the study and this is what the study says. This is what you should be doing with your patient. Yeah. Well, there are a lot of nuances to that because like you said, you're talking about averages and not the person in front of you. And, I love the example you gave. What is an injury and what does that mean to different stakeholders within, let's say, injury prevention realm if we will. So the athlete versus the average person versus the clinician? Karen Litzy: 12:56 Well we have three different definitions of what an injury is. So how can we fill those gaps to be a little bit closer? I mean I can say, let's say I'm the average person who's working out. I know I am not anywhere near a professional athlete, but the problem is, and you alluded to it a little bit, is that when people have an injury, they read about an athlete that has an injury and they say, well, this athlete had the injury and they were back at their sport in four weeks. How come I have to wait four months? And I think that's a big disconnect. And maybe that's where getting some better qualitative research and around these definitions can actually help with the perception of what an injury is across the board. Evert Verhagen: 13:49 Yeah, it's sort of framing but it's framing from both sides. It's framing for the patient so you can even better, why it takes for them four months instead of four weeks. Right. And usually in all honesty, by the time a professional athlete is already back training again, a recreational athlete maybe hasn't even seen a therapist. How then can you take a protocol or a guideline based on evidence that shows that on average after four to six weeks you need to be at a certain stage in the rehabilitation phase where that one single person in front of you as already been looking three weeks for a proper therapist to treat the injury and then they come in and they've seen this evidence like you said, but then you would like to know a bit better where they come from, what their context is and what they need to do, which is not shown in evidence is also not what the patient thinks about. Evert Verhagen: 14:55 So having some knowledge about such perceptions and where they come from and what they mean I think can really help to support you in your clinical practice to use the evidence to a better extent. You know, in some of the issues we have in objective quantifiable research also apply here. I would say there is, for instance the discussion started a couple of years ago about we should screen or not to predicting injury actually to see if someone's at an increased risk. And one of the main arguments in there is, well basically wha…

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    449: Dr. Brenda Walding: Holistic Approach to Chronic Illness Aug 19, 2019
    Show notes

    On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Brenda Walding on the show to discuss Whole-Hearted Living. Dr. Brenda Walding is a Women's Holistic Wellness Expert & Coach, Doctor of Physical Therapy, Functional Diagnostic Nutrition Practitioner and HeartMath certified coach. Brenda specializes in supporting women health/wellness professionals in overcoming burnout and health challenges in order to truly thrive and give their gifts to the world. In this episode, we discuss: -Brenda's incredible story of illness and recovery -The 9 Essentials to Whole-Hearted Healing -The importance of the biopsychosocial model in healthcare -And so much more! Resources: Sick of Being Sick: The Woman's Holistic Guide to Conquering Chronic Illness Brenda Walding Website and a Free Gift: Dr. Walding is offering a complimentary 45-minute consult for any woman dealing with burnout or health challenges that has a deep desire to THRIVE. Schedule your consult and see how she may be able to support you in creating a life you love. Brenda Walding Instagram Brenda Walding Facebook Email: risetoradiance@gmail.com Heart Math Website Women in Physical Therapy Summit 2019 Outcomes Summit: use the discount code LITZY For more information on Brenda: Dr. Brenda Walding is a Women's Holistic Wellness Expert & Coach, Doctor of Physical Therapy, Functional Diagnostic Nutrition Practitioner and HeartMath certified coach. Brenda specializes in supporting women health/wellness professionals in overcoming burnout and health challenges in order to truly thrive and give their gifts to the world. She currently resides outside of Austin, Texas on the beautiful Lake Travis with her husband and dog. Brenda loves spending time in nature, connecting with her family and friends, dancing, facilitating women's circles, and learning about holistic wellness. Read the full transcript below: Karen Litzy: 00:01 Hey Brenda, welcome to the podcast. I'm happy to have you on. Brenda Walding: 00:06 Oh, thank you so much for having me, Karen. I'm excited to be here today. Karen Litzy: 00:11 And like I said in the intro you are a recently published author of the book sick of being sick, the women's holistic guide to conquering chronic illness. So without giving away the entire book, can you give the listeners a little bit more about your background and your story of illness and where you are and how that led you to where you are today? Brenda Walding: 00:36 Yeah, sure. I'd love to. You know, it's really, I'll give you do my best to give you the cliff notes. It's spans the time period of over a decade. So really I grew up seemingly really healthy and vibrant. I was a collegiate athlete. I played soccer at TCU in Fort Worth. And then I went on to physical therapy school to get my doctorate in physical therapy. And then after that moved to Austin, Texas with my now husband. And during that time we passed our licensure exam, got new jobs, moved to a new city, got engaged, got married, and then after this whirlwind of all these major life events, my health started to rapidly decline. And you know, I was in a busy physical therapy practice and seeing a lot of patients, and you know, all of a sudden I'm just getting weaker and more tired and getting sick more frequently. Brenda Walding: 01:35 And then it got to where I could hardly even get up and down the stairs. I was experiencing chronic fatigue and experiencing, I broke out into these rashes that literally covered my entire body for two and a half years. No one could really figure out what was going on and I just kept getting more and more sick and I was seeing specialists all over trying to figure out what was wrong with me at this time I didn't really know much about natural health nutrition, holistic wellness. I was just kind of in the conventional medical model, taking the steroids and the pills and you know, my blood work had come back pretty normal, so they couldn't really figure out what was wrong. But literally I had oozy itchy rashes, like covering my entire body where I had to pack my body full of ice in the evening to fall asleep and eventually developed in a systemic infection that led me to going on disability from my job as a physical therapist. Brenda Walding: 02:40 And granted, this is, you know, I am in my late twenties, not even 30 yet, so very young. And you know, I got to the point where I thought like doctors kept giving me antibiotics and they were worried that the infection would get into my bloodstream and I thought I was dying. I was really, really at that point of like, okay, I think this is it. And by the grace of God, I had, I took four rounds of antibiotics and a month and a half, kept being sectioned, kept coming back, had pus all in my mouth and throat, couldn't swallow, couldn't hardly eat. So this was a pretty intense experience. And I found this article I was looking, researching and found this article called natural solutions to drug resistant infections. And it caught my eye and I thought maybe I have a drug resistant infection. And it talked about wild Mediterranean, Oregano oil and how it was, you know, healing people with malaria and different, you know, chronic. Brenda Walding: 03:45 Very, very severe illnesses. So I thought I would try it. It's like $20 and I know bought it online and in, within a few days the infection went away. And for the first time in years I got some relief from the pain and itching on my skin. And so that really was the portal to opening me up to natural healing. And I thought, what is it? What do I not know? What else do I not know, you know, about this? And so that really became this entry point into studying natural healing and nutrition. And I started seeing more alternative and holistic type practitioners. And that over time started to gradually heal. I started to get some answers. I was full of toxins. Had lots of infections and a poor ability to really clear toxins from my system. So I started to get more answers, started to change my diet, slow down my life a little bit, you know, as that type a over achieving, you know, hardcore athlete and academic. Brenda Walding: 04:54 And I realized that also was part of the puzzle here ever learning to slow down and then, you know, so for eight years I really focused on healing my body. Like it was a full time job. I was able to go back to physical therapy after a while and start working again. But it really opened up my passion into natural healing and started a nutrition lifestyle company with my husband and helping people heal their bodies through nutrition and lifestyle changes. And you know, it was a slow and gradual process and I started, you know, getting better gradually and then almost to the point where I felt okay, I think I'm almost ready to, you know, start a family. I had a few lingering symptoms but I was like, you know, I'm doing pretty well. Got my strength back. This is eight years later. And then I was diagnosed with breast cancer. Brenda Walding: 05:51 And so this was a few years ago. So this was like, what am I missing? What am I not getting? Cause I was really, you know, dialed in my diet lifestyle. I started meditating. I was really, you know, spent hundreds of thousands of dollars on healers and treatments, natural remedies. You couldn't find somebody more committed to their healing. And it was like a full time job. And I wasn't really living, I was just trying to get better and feel better. And then the cancer diagnosis came and so I had to step back and go, what am I not getting? And I really, you know, I share this in my book. I had to step back and I was in, this is actually, I found the mass in my breasts right before this, we had planned this epic trip to Italy where we were going to start our family. Brenda Walding: 06:50 So it was this tragic, you know, oh my gosh, you know, why is this happening to me? And then, yeah. And so, you know, in the middle of the night at 3:00 AM I'm, you know, tears coming down my face going like, God, what do you want me to do? Because I knew that conventional chemotherapy and radiation was not going to be my path. I just didn't know what I was going to do. And you know, I heard this, I call it the divine whisper that said, if you're going to survive, you're going to have to learn to listen to your heart. And I just felt this immediate peace. And then I started to kind of panic because I thought, I don't know how to do that. I really don't know how. I don't know, like maybe like so many of the listeners and people and my clients that I work with, we're really stuck in our heads so much of the time. Brenda Walding: 07:42 And, you know, my immediate reaction to a challenge would be to research it, to try to figure it out, to strategize. And this was like, no, no, Brenda, it's time for you to really go within and listen and allow your heart to guide you. And, so I knew there was a level of emotional and spiritual, you know, healing too that needed to take place. And so I committed at that point to learn to listen to my heart. And over the next few years I had a pretty interesting and incredible journey through healing, holistically and wholeheartedly I should say from cancer. And it really became the catalyst for me to live in even more extraordinary life. Now I can say that I can access joy and just living a life of purpose and wholeheartedness that I'd never experienced before cancer. And so now that's really why I'm, you know, I kinda quit physical therapy and I'm focusing on helping women, especially women, wellness professionals, to truly heal and thrive so that they can give their gifts fully to the world. So that's kind of my story in a nutshell. Karen Litzy: 08:56 And are you now cancer free? Brenda Walding: 09:01 Yes. So I'm doing great. And yeah I'm doing awesome. And that's really where my focus is now, is helping women to heal and thrive and connect more fully to their hearts. Karen Litzy: 09:15 And quick question on, you know, so you're diagnosed with cancer, you did not do traditional cancer treatments. Brenda Walding: 09:24 I did sort of a mix. I didn't do traditional chemotherapy and radiation, but I did do surgery. So I went to a couple of different clinics in the United States that focus on holistic and alternative cancer treatments. And so I did. It was a pretty wild ride. So we spent our entire life savings and did this treatment but then I also had a mastectomy. Karen Litzy: 09:56 Okay. I guess sort of a combination. Yeah. Cause I just don't want to give the listeners the impression that you don't have to go through traditional medicine when you have a very serious diagnosis as cancer and that, you know, sometimes that is the route that one needs to take. And like you said, combining it with other holistic treatments I think is perfectly reasonable. But I don't want people to think that we're saying no shun traditional treatments. Brenda Walding: 10:27 Exactly. And you know, for me, this is what I do. What I do know to be true is that, you know, a decision made out of fear is never the highest best choice. So when I work with women, where you're working with people on their healing journey is like learning how to really access the heart to be able to tune in to that guidance to make decisions. So yes, you get the tests and get the information from doctors and healers and then trust your own heart to lead and guide you down that path. And that might look like conventional therapy for some people and that might look like alternative therapy for others. And that might look like a combination. So it's really, you know, definitely not shunning conventional medicine. But I knew for me in my heart that in this particular moment, you know, chemotherapy and radiation wasn't going to be my choice, that I was going to do a combination. And it really does differ for each person. And that's the thing is, you know, oftentimes we get scared into, you know, doing things because someone else tells us that we have to do this and we have to do that. And you know, my recommendation is to take the information but also really listen within and let your heart guide your journey as well. Karen Litzy: 11:42 Right. Yeah. Yeah. And I think in combination with your physicians and other practitioners that you're working with as well. Brenda Walding: 11:53 Yes. It's important to have an amazing support team. Karen Litzy: 11:54 Yeah, I just don't want people to think that we're saying, no, don't, don't listen to your doctors, because that would be really irresponsible. But yes, you have to, and it's like what we say within physical therapy as well as you as the practitioner and wanting to give the patient all the available information and guidance that you have and then along with the patient, you make those decisions on what is best. And I think that that is what every healthcare practitioner strives to do and strives to educate patients as best as they can. Give them the knowledge, give them the odds, give them pros and cons and then along with the patient and their support team and physicians and nurses and whoever else you have working with you kind of make that decision on what is best for you. And, those decisions aren't always easy. Brenda Walding: 13:01 No. Yeah. And Yeah, work with people, you know, work with people on your support team that you feel good about. That you feel supports you fully and is in alignment with your values. You know, I definitely navigating this path, you know, I definitely had practitioners that, you know, were trying to force me into something or I just had a gut feeling that didn't feel good. And so to really follow that and find, you know, doctors that are really on board with you and are listening to what you desires are. Because they exist, they exist for sure. Karen Litzy: 13:31 Yes, of course. Of course. Okay. So you've obviously gone through a lot, over a full decade plus it sounds like, of your life. So let's talk about kind of what you're doing now and how you're helping other, like you said, mainly women kind of navigate through a healing process. Brenda Walding: 14:00 Yeah. So like Karen mentioned earlier, that I felt really called to write a book. And so this book really is my love letter to all women and it's applicable to men as well. But you know, it's really all the information I wish I would have had 10 years ago to really truly to heal and to really thrive. Cause it's, I spent eight years really focusing on the physical aspect of healing. And I think that's where we're naturally inclined to as sort of these physical beings is that we're like, okay, nutrition, lifestyle, medication, you know, the various things, focusing on our physical body. But, what I've come to find out that, you know, really looking at ourself holistically, taking into account our mental and emotional and spiritual bodies, so to speak and healing on those levels are equally as important as the physical. Brenda Walding: 15:00 And then this sort of heart centered approach of really learning to get out of the head and allowing the heart to lead. So that is where I call it, like this whole hearted healing or this whole hearted living approach. And so that's what I share in my book along with my story. And, I did research on, you know, what, who are these men and women that were not only healing from catastrophic illness but that were really thriving and using that illness as an opportunity to create an even more extraordinary life and what did they all have in common? And so that's really how I, you know, navigated my journey. And also, you know, takin…

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    448: The Oxford Debate from APTA Next Conference Aug 12, 2019
    Show notes

    LIVE from the NEXT Conference in Chicago, Jenna Kantor guests hosts and interviews the teams from the Oxford Debate which covered the question: Is Social Media Hazardous? The Pro team consisted of Karen Litzy, Jimmy McKay and Jarod Hall. The con team consisted of Ben Fung, Jodi Pfeiffer and Rich Severin. In this episode, we discuss: -How each of the debaters prepared and crafted their arguments -Bias and how to research a question openly -The importance of respectful debate on controversial subjects -And so much more! Resources: Jimmy McKay Twitter Rich Severin Twitter Ben Fung Twitter Jarod Hall Twitter Karen Litzy Twitter Outcomes Summit: Use the discount code LITZY For more information on Jimmy: Dr. Jimmy McKay, PT, DPT is the Director of Communications for Fox Rehabilitation and the host of five podcasts in the category of Science & Medicine. (PT Pintcast, NPTE Studycast, FOXcast PT, FOXcast OT & FOXcast SLP.) He got his degree in Physical Therapy from the Marymount University DPT program and a degree in Journalism and Mass Communication from St. Bonaventure University. He was the Program Director & Afternoon Drive host on the 50,000 watt Rock Radio Station, 97.9X (WBSX-FM). He has presented at State and National Conferences. Hosted the Foundation for Physical Therapy research fundraising gala from 2017-2019 and was the captain of the victorious team in the Oxford Debate at the 2019 NEXT Conference. Favorite beer: Flying Dog – Raging Bitch For more information on Rich: Dr. Rich Severin, PT, DPT is a physical therapist and ABPTS certified cardiovascular and pulmonary specialist. He completed his cardiopulmonary residency at the William S Middleton VA Medical Center/University of Wisconsin-Madison which he then followed up with an orthopedic residency at the University of Illinois at Chicago (UIC). Currently he is working on a PhD in Rehab Science at UIC with a focus in cardiovascular physiology. In addition to research, teaching and clinical practice regarding patients with cardiopulmonary diseases, Dr. Severin has a strong interest in developing clinical practice tools for risk assessments for physical therapists in a variety of practice settings. He is an active member within the APTA and serves on the social media committee and Heart Failure Clinical Practice guideline development team for the cardiopulmonary section. For more information on Karen: Dr. Karen Litzy, PT, DPT is a licensed physical therapist, speaker, owner of Karen Litzy Physical Therapy, host of the podcast Healthy Wealthy & Smart and creator of the Women in Physical Therapy Summit. Through her work as a physical therapist she has helped thousands of people overcome painful conditions, recover from surgery and return to their lives with family and friends. She has been a featured speaker at national and international events including the International Olympic Committee Injury Prevention Conference in Monaco, the Sri Lanka Sports and Exercise Medicine Conference, and various American Physical Therapy Association conferences. For more information on Jodie: Jodi Pfeiffer, PTA, practices in Alaska, where she also serves on the Alaska Chapter Board of Directors. For more information on Jarod: Jarod Hall, PT, DPT, OCS, CSCS is a physical therapist in Fort Worth, TX. His clinical focus is orthopedics with an emphasis on therapeutic neuroscience education and purposeful implementation of foundational principles of progressive exercise in the management of both chronic pain and athletic injuries. For more information on Ben: Dr. Ben Fung , PT, DPT, MBA is a Physical Therapist turned Digital Media Producer & Keynote Speaker. While his professional focus is in marketing, branding, and strategic change, his passion is in mentoring & inspiring success through a mindset of growth & connectivity for the millennial age. For more information on Jenna: Jenna Kantor (co-founder) is a bubbly and energetic girl who was born and raised in Petaluma, California. Growing up, she trained and performed ballet throughout the United States. After earning a BA in Dance and Drama at the University of California, Irvine, she worked professionally in musical theatre for 15+ years with tours, regional theatres, & overseas (www.jennakantor.com) until she found herself ready to move onto a new chapter in her life – a career in Physical Therapy. Jenna is currently in her 3rd year at Columbia University's Physical Therapy Program. She is also a co-founder of the podcast, "Physiotherapy Performance Perspectives," has an evidence-based monthly youtube series titled "Injury Prevention for Dancers," is a NY SSIG Co-Founder, NYPTA Student Conclave 2017 Development Team, works with the NYPTA Greater New York Legislative Task Force and is the NYPTA Public Policy Committee Student Liaison. Jenna aspires to be a physical therapist for amateur and professional performers to help ensure long, healthy careers. To learn more, please check out her website: www.jennafkantor.wixsite.com/jkpt Read the full transcript below: Jenna Kantor: 00:00 Hello, this is Jenna Kantor with Healthy, Wealthy and Smart. Super excited to be talking here because I am at the NEXT Conference in 2019 in Chicago, Illinois. And there was an awesome debate an Oxford debate and I'm with almost all the team members. So that being said, I want to just interview you guys on your process, especially because everyone here is either extremely present on social media or uses social media. So it's funny that we had these two opposing teams really fighting different arguments here where everyone pretty much is on the same page that we all use social media. It's great for business. There's no denying. So as I ask my questions, would you guys say your name because people aren't going to necessarily, well maybe for some recognize your voice and also say what team you were on, whether it was team hazardous, which was correct me, Jimmy, which was the pro argument. The pro argument was saying that social media is hazardous and then the Con team was team Blues Brothers, which I've learned from Ben Fung it would have been the star wars theme except it had already been used in the past and they needed to be original. So that being said, I want to start off with #teamhazardous. What was your individual processes with finding your arguments since each of you are very present on social media? Jimmy McKay: 01:39 Jimmy McKay team #hazardous. I think first of all, this was a very difficult argument for our opponents because, well, first of all, we didn't get to pick which sides. A lot of people think that we've vied for the sides. We were literally just asked if we wanted to do the Oxford debate and then been given a side and given a team. So I want to make that very clear. I think they did a great job. I was keeping track of all the points that I would've hit if I were on that side, I thought that was the uphill battle. Because people, when they found out we were pro social media it was like, oh, you don't like social media. But if you read the prompts for a debate very closely, it's like, is it hazardous? Jimmy McKay: 02:18 Not is it good or bad? Right? So we agreed like all the things that the con side said, we agree with it's fantastic. It should be utilized. But just like PT why do we take the NPTE for example? Because if improperly used physical therapy could be hazardous. So that's why we take a test that makes sure that we're a safe practitioner of physical therapy. So, my thought process was I went on social media and wanted to grab all the kits, right? Like emojis and gifs and videos and Beyonce doing dances because that's what people resonate with. But then focus on the things where I think it falls short. Everything falls short, right? There's no Shangri-la and social media is no different. So just focus on the issues that stood out, right. Jimmy McKay: 03:01 So all I had to do is can I just ask, what do you love about social media? Like what irks you, you know, what are things that you wish were better? And as you heard from tonight, I think in past Oxford debates, sometimes it was hard to get four or five speakers to ask questions. And I think they had to cut them off because everybody, it resonates with everybody and it's super personal, right? I mean, what was the stat? How many people, I mean minutes that people spend a day, 140, 116 minutes a day Jimmy McKay: 03:29 It's probably hard, so it's super personal for people but I think again, the argument from the other side was just is really hard. I mean, I think you guys were put in a corner. But here's the funny part. Like you defended it, I think you defended that corner pretty well. So that was my process. Karen Litzy: 03:50 Hi, Karen. Let's see, #teamhazardous and yes, this is also my podcast, so that's, yeah. Karen Litzy: 04:00 So my process was pretty easy because I had just spoken about social media and informatics at WCPT in Geneva. So I was able to use a lot of that research and a lot of that information to inform this debate. And what I wanted to stick to was, I wanted to stick to the idea of fake news, the idea of misinformation versus disinformtion because there are different and how each one of those are hazardous. And then the other point I made was that it's not individual people, it's not individual groups, it's not even an individual platform. But if put all together, all of the platforms add in misinformation and disinformation, add in people who don't know the difference between something that's factual and not. So if you put it all together, then that's pretty hazardous. But the parts in and of itself maybe aren't. And then lastly that social media is a tool we need to really learn how to use it as a profession because it's not going anywhere as the team concept. It's not going anywhere. So the best way that we can reach the people we need to reach is by using it properly and by making sure that we use it with integrity and honesty and good faith. Jodi Pfeiffer: 05:22 Hi, I'm Jodie Pfeiffer. I was for the con team blues brothers. I got to be the lead off person as well. So I really just kind of wanted to set the tone. It was a hard argument. Everybody uses it. I would like to think most people try and use it well we know this isn't always the case and it is a really useful tool for our association and for our profession. But there are times when it is not, we were trying to just, I was trying to set the stage for my other team members to give them things to work off of, give everybody a little introduction of the direction we were going. And I also tried to play off of our opponents a little bit as well because you know, really their argument that they made so well kind of proved both sides, how good it is and the hazards. So yeah, that was the direction that I went. Jarod Hall: 06:20 This is Jarod Hall. I was on the pro team #teamhazardous and I remember when I was asked to be on the Oxford debate panel, the same day I was scrolling through social media of course, and I saw Rich Severin on Facebook saying, Hey, look, I was selected to be for the Oxford debate. And I thought, man, he's super well-spoken. This dude knows his stuff. He's going to come in strong. And then like I checked my email an hour or two later and I had been asked as well and I was pretty floored. I didn't know what to say. And they're like, do you want to do this Oxford debate and what side do you want to be on? And of course I said, I'm super active on social media. It's been helpful for me to find mentors and it's really positively influenced my career. I want to be on the side that's pro social media. And they said, cool, you're on the opposite side. Jarod Hall: 07:21 And I thought to myself, oh, ouch. Okay, I need to look at this subjectively. You know, I need to, I need to step back away from the situation and look at ways that either I myself have been hazardous on social media or things that I've seen that were hard for me to deal with on social media. And, when Karen and Jimmy and I were strategizing, you know we kinda came up with a couple of different points. We wanted to 8 mile, you guys, we wanted to 8 mile the other team and kind of take the bullets out of your gun. We wanted to address the points that we knew you would address. And Karen did a really awesome job of that because we knew you guys were gonna come with such a strong argument and so much fire that we had to play a little bit of defense on the offense. Jarod Hall: 08:07 And Karen got everybody hyped up and then our strategy was maybe, go the opposite way in the middle with me and maybe bring a little bit of the emotional component the other side of emotions and have people reflect on what does it feel like to feel not good enough? What does it feel like to see everybody else's highlight reel on social media when in reality, you're doing the day in the day out, the hard grudge, the hard trudge, you're putting in so much hard work and all you see is everybody's positive stuff around you. And it can, it can be a really defeating feeling sometimes. So we wanted to emphasize, you know, a lot of the articles that have been coming out across the profession about burnout and how that could potentially be hazardous. And you know, obviously we're all in favor of the appropriate usage of social media and when done the right way. Jarod Hall: 08:55 But to take the pro side of this argument, we had to reflect on how could this really actually pose a hazard to us both personally and professionally. And, you know, I think that that's one of the things that directed our approach. And it was a hard thing to do to take the opposite side of, you know, how I position myself. But, all of my own errors on social media were really good talking points and learning points to drive home the discussion. And, you know, we just knew that the other team was going to have such a strong argument. We knew that it's really hard to ignore the fact that social media has connected us. It has allowed me to meet everybody sitting at the table with. It's allowed me to have learning opportunities and mentorship and it's allowed me to have business opportunities that I wouldn't have had otherwise. So we knew that the argument was just, it was going to be tough to beat. And, you know, I think that the crowd just resonated with everything that was said from both teams. And at the end of the day we were able to shed light from both sides on a really difficult topic and have people, you know, reflect on it and really have some critical thought. Ben Fung: 10:10 Ben Fung here. I was a part of the con team. So that was so difficult. Pro Con. So I mean like it was interesting. I had a very similar experience when they asked me to be on the Oxford Debate. They're like, hey, you know, we'd like you to captain the team. I was like, okay, great. What am I debating? Or like, then when they would actually did tell me, they're like, oh, it's about social media. I was like, okay, yes, I'll do it. And then they're like, okay, you're on the con team. And so immediately I thought like, Oh, I have your job. Like I have the team, you know, #Hazardteam, I needed to somehow slam on what much of my success had been attributed to, you know, and I was like, okay, that'll be a tough job. Ben Fung: 11:01 Right. And then what's interesting is that, you know, then they sent me the prompt and I was like, oh no, no, no, I'm against the against statement. So I'm pro social media and, you know, then the other side I can promote this. And it was actually only in retrospect that I was like, oh, it can…

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    447: Andrew Tarvin: How to Use Humor in the Workplace Aug 05, 2019
    Show notes

    On this episode of the Healthy, Wealthy and Smart Podcast, I welcome Andrew Tarvin on the show to discuss humor in the workplace. Andrew Tarvin is the world's first humor engineer, teaching people how to get better results while having more fun. Combining his background as a project manager at Procter & Gamble with his experience as a stand-up comedian, he reverse-engineers the skill of humor in a way that is practical, actionable, and gets results in the workplace. In this episode, we discuss: -How to construct humor and learn the skill of humor -The benefits of humor for the individual and the organization -Types of humor that are appropriate for the workplace -The importance of the "Yes, and" mindset -And so much more! Resources: Andrew Tarvin Website Andrew Tarvin Twitter Andrew Tarvin Facebook Andrew Tarvin LinkedIn The Skill of Humor TedX Video Humor That Works Website For more information on Andrew: Andrew Tarvin is the world's first humor engineer, teaching people how to get better results while having more fun. Combining his background as a project manager at Procter & Gamble with his experience as a stand-up comedian, he reverse-engineers the skill of humor in a way that is practical, actionable, and gets results in the workplace. Through his company, Humor That Works, Drew has worked with more than 35,000 people at over 250 organizations, including Microsoft, the FBI, and the International Association of Canine Professionals. He is a bestselling author; has been featured in The Wall Street Journal, Forbes, and Fast Company; and his TEDx talk has been viewed more than four million times. He loves the color orange, is obsessed with chocolate, and can solve a Rubiks Cube (but it takes like 7 minutes). For more information, please visit, www.drewtarvin.com and connect with Drew (@drewtarvin) on Twitter, Facebook, Instagram, YouTube & LinkedIn. Humor That Works is available on Amazon and wherever fine (and funny) books are sold. Read the full transcript below: Karen Litzy: 00:01 Hi Andrew, welcome to the podcast. I am happy to have you on. And now today we're going to be talking about humor and why humor is important in the workplace and in life. So the first question I have is you say humor is a skill, so how is it a skill and can that really be learned by anyone? Andrew Tarvin: 00:28 I think a lot of people have this question or this belief, like, you know, humor is just an innate ability, right? You're either funny or you're not. I will say that I've done over a thousand shows as a standup comedian and spoken word artist, storyteller, et cetera. I have spoken or performed in all 50 states and 25 countries and on one planet. This one. But when I went to my high school reunion and people found out that I did comedy, they're like, but you're not funny. And that's because, you know, growing up I was never the life of the party or the class clown. My senior year. I was voted teacher's pet. So much more of an academic, much more quiet. You know, I'm a very much an introvert. And then I started doing Improv and standup in college and admittedly was terrible when I first started out. Andrew Tarvin: 01:22 Like we often are in a new skill that we try, but with practice and repetition I got better. And so I realized that, you know, really there there's an art and science to humor. And so what we do with our organization, with humor that works is we teach people the science. So we teach things like comedic structure, things like a comic triple things like timing and understanding how to like position things in different, you know, strategies that humorous use between say association or incongruity or a story, et cetera. All of this kind of science stuff that's easy to, you know, this conceptually you can learn and then there's an art, there is an art piece to it, right? There is, you know, some of that comes from your own perspective, the thing that you like and that you improve with practice and repetition. And so what we say is, you know, with the skill of humor, we can help to teach anyone to be funnier not necessarily, you know, across the board. Funny. It's not like, you know, you can magically teach someone to be so funny, they're going to magically have a Netflix comedy special, but you can learn certain things that are gonna take whatever your base level, you know, ability to use humor is now and take it up to the next level. Karen Litzy: 02:30 Okay. So let's break this down a little bit because I know the listeners love to get these little nuggets of knowledge that we can start applying today in our life and in our workplace. So you said that with your company that you can teach people what is comic structure and timing. So can you first tell me, cause I don't even know the answer to this question, but what is comic structure? Andrew Tarvin: 02:55 Yeah. So there's certain things that, you know, there's certain ways that you can structure a sentence or a joke that make it more effective. So, one of the big things is, is learning to put the funny part of the punch line of something at the end. So a great example of this is, I think it's a George Burns quote that says, 'happiness is having a caring, a close, tight knit family in another city' right? Which I think is a pretty funny, you know, a humorous line. That line doesn't work if you say, 'happiness is having a family in another sitting who is in another city who is carrying and close and tight knit, right? So you put the funny part, the unexpected, the surprise piece at the end, right? So that's just a simple structure thing. It's kind of the structure of set up and punchline another example of that is something called a comic triple. Andrew Tarvin: 03:52 And so a comic triple is anytime when you have a list of three things, the third item is something unexpected. So, for example, when I give my, you know, when I'm talking about some of the clients that we've worked with, we'll say, you know, we've worked with organizations such as Microsoft. The FBI and the International Association of Canine Professionals. And so that last one is just something different, something unexpected where it's like, okay, Microsoft, okay. Corporate FBI, all that's kind of interesting. They seem serious. That's kind of cool. International Association of Canine Professionals. What does that mean? Right? So it, and again, we put that at the end. So simple things like structure or things that you know, kind of anyone can learn. And that's a starting point. The other thing that's kind of important to understand, maybe not necessarily specifically about comedic structure, but about the skill of humor, is that humor is more broad than comedy. Andrew Tarvin: 04:46 So a lot of times when we think of humor, we do think of comedy. We think of funny, we think of laughter, we think of jokes. But humor is defined as a comic absurd or Incongruence, quality causing amusement. So it could be a joke or it could be just something a little bit silly or something a little bit different that you do that doesn't necessarily make someone laugh, but maybe it makes them smile. And that broader definition means that, you know, maybe you're not a great joke teller, but maybe you're good at telling stories or maybe you're not going to storytellings or jokes, but you're really good at drawing interesting visuals that will get people to pay attention. Right? So that's, that's part of what we mean by this skill. Karen Litzy: And what about timing? How do you teach timing? Andrew Tarvin: 05:33 It can be a tough one to do, but that's, that's where the practice and repetition comes from because even as standup Comedians, like, you know, Seinfeld or, Ellen or that kind of thing, when they're doing new special, when they're going to new materials, they have to get it in front of people to see, okay, where do people actually laugh and how long of a pause should it have. Cause sometimes the difference between getting a big laugh and no laugh at all is how long you pause or how long you allow someone to get something. So, one example within timing is a lot of times when people are first starting out with humor, they'll say something that's actually pretty funny. And they'll leave a brief pause and then they'll start talking again right away. And this is something called stepping on your laughter is if someone starts to kind of laugh, but then you start talking again, people will stop laughing, they'll shut down the laughter response because they want to hear what you say next. Andrew Tarvin: 06:25 And so sometimes one of the hardest parts is a brand new comedian to learn. And sometimes you have to be quiet a little bit longer because it takes the audience a second to actually get the joke to then process that it is a joke process that it is funny and then start to laugh. And that, you know, you need to be comfortable kind of in that short silence to allow them to then laugh and then also to not talk while they're laughing so that, they kind of finish that laughter out as opposed to stopping at short. Karen Litzy: 06:50 And I would imagine if you're up on stage and your, you know, telling the story or joke that time from the end of you finishing your sentence to a little, maybe pause to laughter building must feel like it's an hour. Andrew Tarvin: 07:10 Yeah. It can feel like a really, really long time, especially as you've, if you do a certain joke over and over again or one that you know, that works because as you went, you think about it and like, oh, that's funny. I want to share that you've already thought about and processed why it's funny. And so you're like, oh, if they don't get it immediately, they must not think it's funny and it's they've never heard that construction of those ideas together before. So for example, I love puns and wordplay and I recently tweeted out, you know, that I'm a pale person. The only time I get Tan is when I do trigonometry. Andrew Tarvin: 07:47 And that joke, particularly when said verbally is it's talking about get Tan. So Tan being short for Tangent. Exactly. So the only time I get there is, you know, it takes a while. It takes a moment for people to be like, wait, why is that funny? Is that a joke? That doesn't, you know, what is what is, you know, that has to do with trigonometry. Oh wait, 10 to there was like cos sign and tan like, yeah. So it takes time for that to happen and you have to get comfortable kind of in that silence. The other thing to, to recognize though is that that's true specifically of, kind of planned humor. Things like conversational humor. They don't necessarily, one you may not have, it might not be a preplan thing, but even conversational humor, something that can be learned and something that can be practiced through, you know, drawing on some principles from improvisation. Karen Litzy: 08:40 Right. So now I actually took a number of Improv classes to help me with the podcast to help me, like you said, just carry out a better conversation and to yes. And, and all of that. So can you a little bit about improvisation and how that can help with general conversations, especially let's say at work. Andrew Tarvin: 09:05 Yeah. So, you kind of mentioned the fundamental mindset of improvisation. The key that really helps with a lot of that in that is the mentality of yes and, where yes. And is really about kind of taking whatever was offered and building off of it. And so that can be fantastic for conversations. In fact, if you're ever in a conversation and you don't know what to say next, you can just simply yes. And the last thing that was said, so like you can even take, you know, the stereotypical small talk example of, how, how about this weather, right? So I'm in New York. It's sunny, it's 85 degrees. Someone asked me, how about this weather, if I'm say at a networking event, right. Or say one-on-one with a client, how about this weather, I can be like, yes, it is, it's beautiful out. It's, it's sunny out now. You know, if you weren't at this meeting, if we weren't interacting right now, how would you be out enjoying, you know, 90 degree weather? Right. And then so that gives him a chance to be like, oh well, you know, I'd go swimming because it's hot out or I'd stay indoors because it's too hot. Or I'd go out on the bike, you know? And that turns a conversation that was about weather into something more interesting about like in getting to know that person in terms of things like their hobby. Karen Litzy: 10:16 That's great. I love that because that networking and going to those kinds of events is always so daunting. And especially as an entrepreneur or a small business owner, you kind of have to do those things. Andrew Tarvin: 10:30 70% of jobs are found through networking and, and to your point, entrepreneurs, I'd say it's a way that a lot of people drum up business. And I learned that pretty early on as an introvert, you know, going to networking meetings, like you said, is daunting. It's a little bit awkward. And so for me, I developed a three step process for being able to network with people. And that yes, and piece is the third step is how you continue the conversation is just to continue to build off of what was said. Karen Litzy: Nice. What is step one? Andrew Tarvin: Step one is to ask interesting questions. And so, you know, if we think about Dale Carnegie and how to win friends and influence people, you know, great quintessential business book, he said that you will get, you'll make more friends and a month by getting people interested, by being interested in other people than you will in an entire year in trying to get people interested in you. Andrew Tarvin: 11:24 And so what that translates into is basically getting other people to talk and then shutting up and then listening to them. And you know, if we go to a networking event and we have the same kind of boring questions, the same, you know, what do you do type questions and at least the same boring answers. And that's not distinguishable. That doesn't stand out to anyone. And so instead of you, if you ask more interesting questions, so simple questions, you know, what's the coolest thing that you've worked on in the last three months? That a lot of times people, you will end up answering the question of what do you do, right? They'll say, oh, when I was working at blank. But it gets him to think a little bit differently. It gives him a more interesting response and you can actually kind of connect a little bit closer. Andrew Tarvin: 12:11 And that's an example of something that's a little bit in congruent. So maybe it's not laugh out loud funny, but it is something a little bit different that maybe gets people to smile a little bit more or at least thinking a little bit differently. So that's step one is to ask interesting questions. The second step is to tell a compelling stories. So when someone asks you a question, right? Sometimes we hear this advice of like, Oh, you've got to ask people questions. That's how you build rapport. But if all you ever do is ask them questions and never answer anything that they say, it starts to feel like a weird interrogation. Or like why is this person being so closed off? And so when someone asks you a question rather than just giving a yes or no answer, you can give a little bit of a story or a little bit of a background. Andrew Tarvin: 12:54 So if they're asking, you know, why did you get into hea…

    Full show notes at the publisher

    446: Dr. Leda McDaniel: Holistic Approach to CRPS Jul 29, 2019
    Show notes

    On this week's episode of the Healthy, Wealthy and Smart Podcast, I welcome Leda McDaniel on the show to share her experience with persistent pain. Leda McDaniel is a Physical Therapist in Atlanta, GA. As a physical therapy student, Leda published a book that chronicled aspects of her three-year battle with chronic knee pain and ultimately led her down a path of discovery on her way to healing with a holistic approach. In this episode, we discuss: -Leda's experiences with Complex Regional Pain Syndrome (CRPS) and how it impacted her life -Pain neuroscience education and a holistic approach to treatment for CRPS -How Leda's approach to patient care has shifted to a biopsychosocial framework -The importance of listening to the patient's story and being a voice of hope -And so much more! Resources: Sapiens Moves Website Email: LedaMcDaniel1@gmail.com Painful Yarns Book Moments from a Year of Healing: A Book of Memories and Essays Leda McDaniel Facebook Sapiens Moves Instagram The Outcomes Summit: use code LITZY For more information on Leda: Leda McDaniel is a Physical Therapist in Atlanta, GA. She earned her Doctorate of Physical Therapy from Ohio University and holds a B.A. in psychology from Trinity University, in San Antonio, Texas where she also played Basketball and ran Track and Cross Country for the NCAA Division III School. As a physical therapy student, Leda published a book that chronicled aspects of her three-year battle with chronic knee pain and ultimately led her down a path of discovery on her way to healing with a holistic approach. It was this experience that motivated her to become a physical therapist in order to help others recover from chronic pain. Her book is entitled: "Moments From a Year of Healing: A Book of Memories and Essays" and can be found on Amazon: https://www.amazon.com/dp/B07CWGH7X6/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1525656733&sr=1-1&keywords=moments+from+a+year+of+healing Leda's Professional Blog: https://sapiensmoves.wordpress.com/ Read the full transcript below: Karen Litzy: 00:01 Hi Leda welcome to the podcast. I'm happy to have you on and a big congratulations to you for being a new physical therapy graduate. So welcome to the field. And you know, longtime listeners of this podcast will know that I often have people on the podcast who have struggled through persistent pain, who maybe are still having persistent pain issues and you are one of those people. So what I would love for you to do is just let the audience know who you are and tell your story and then we'll take it from there. So I will throw it over to you. Leda McDaniel: Thank you. Yeah, so I just recently graduated from physical therapy school and I'm entering my clinical practice as a physical therapist. So I'm in Atlanta, Georgia and I'll be starting residency at Emory university for Orthopedic Physical Therapy in August. Leda McDaniel: 01:03 So I'm really excited about that. A little bit about what got me into this field and interested in being a physical therapist. I had an ACL injury that I suffered in my mid twenties, tore my ACL playing soccer and then I had surgery, reconstructive surgery, to repair that ACL. And the recovery from the surgery didn't quite go as planned, so I had had a prior ACL surgery, so it kind of knew what to expect. What's this time it was not quite so good and it was a little bit different and challenging in that the physical therapist I was working with kept pushing me to strengthen my muscles and try to get my range of motion back and all those things that I was familiar with, but I knew it wasn't really responding as you might expect it would after surgery. So I had this chronic pain and inflammation that developed over the next six months to a year. Leda McDaniel: 02:04 And both my physical therapist that I was working with at the time, and then, a handful of orthopedic doctors, including the surgeon who did the surgery, they were a little bit puzzled as to what was going on because I had a repeat MRI. They couldn't find any structural issues. At the time I was really focused on that idea of well I still have pain, what is wrong structurally? And I just had this feeling that something is wrong. It didn't feel right. It was always painful and it was always swollen and I really couldn't it over the hump to the extent that I was even limping when I was walking about a year after surgery. So I continued to try to rehab and over the next additional year and two years out of ACL surgery I had a second surgery. Leda McDaniel: 03:00 The idea that they clean out some of the scar tissue in there. It's the joint capsule is scarred up a little bit and try to get things work in a little bit better or feeling a little better after that surgery. Again, that kind of made my situation worse and I developed this mirror pain cause I knew I was hypersensitive at that point and had after that diagnosis of complex regional pain syndrome and just really severe nerve pain to the extent that not only was it painful to walk, but I really couldn't walk and I couldn't put pressure on that knee. I couldn't touch the knee without it being painful. And kind of just spiraled into it's really bad situation where I was pretty disabled. I wasn't able to work at the time. And in that time period had gone back to school for physical therapy because I'm flattered by this injury and wanting to help other people regain their health. Leda McDaniel: 03:59 I had some really excellent physical therapists along the way who really try their best to work with me even though things weren't going in an ideal direction. So, anyway, so I had to take time off school. I couldn't work. All of this really pursuing or being fixated on this idea of what structure is injured. And it really, the course of my injury and health didn't really change until my perspective or kind of switched my focus to more of a treating pain based on what were currently understanding is more of a progressive approach to chronic pain, which is pain neuroscience education where we're understanding that there are many components to pain not just structural ones and a lot of these inputs can contribute to these situations where you have this over sensitivity or hypersensitivity. Leda McDaniel: 05:05 And that's kind of the place I found myself in. So I really started to self treat based on some of those principles and try to reduce the sensitivity that built up within my nervous system. And over the course of about a year, I was able to turn things around and get back to the point where I was walking. I was back to school, working, functioning in society like I wanted to and my pain levels were significantly decreased. And gradually, gradually got to the point where I was pain free. Karen Litzy: And can you talk about what specifically you did during this time in order to treat the pain? Obviously not treat the structural issues, but to treat the pain just so the listeners have an idea of what you did. Leda McDaniel: Sure, absolutely. So it's not a quick fix approach by any means, and it's not a singular approach by any means. Leda McDaniel: 06:08 So I really had the perspective of creating as many positive inputs to my life as possible. And I was really diligent about addressing all the different components as we know, pain really has this bio, psycho social, construct. And so I really wanted to have positive inputs physically, mentally, and emotionally and socially. So physically, I was eating a really nutrient dense diet, so lots of full foods, real foods, fruits, vegetables, bone broths, collagen stocks, things like that. So really preparing foods from scratch and eating a lot of nutrient dense foods. I was meditating to decrease my sympathetic activation or over sensitivity work on the mental component. I was doing a psychological therapy at the time. So cognitive behavioral therapy to try to just that psychological component. I was using visualization to try to incorporate the lowest level input that I could to that system and really start preparing for movement in a joint that couldn't really take movement in the beginning, but trying to retrain my brain to prime it for the movements I want it to be able to do. Leda McDaniel: 07:42 So I did a lot of visualization on walking, moving my knee. When I got a little bit better, I would visualize myself doing higher level athletic activities such as running or jumping or those sorts of things. Karen Litzy: 09:44 So over the year plus time that you started incorporating all of these different kinds of inputs into your system, did you start doing everything all at once or did you sort of slowly pepper things in? Leda McDaniel: Yeah, so there was definitely kind of a gradual addition of different components. As I learned more, I was trying to incorporate different types of movement to try to make a difference. So, for example, I'd started a mindfulness based stress reduction meditation course online. That was free. Because I had found out about that and that helped quite a bit. But I gradually added other things in. And one of the things I wanted to mention as well is I was doing, it's hard to mention every single treatment I was doing cause I was really trying to address all these little pieces and I think addressing all those little things really made the difference to turn the tide. Leda McDaniel: 11:07 So one of the other important things that I was doing not overly relying on but definitely helped me get out of the most acute and serious pain so that my nervous system could reorganize was pharmacological treatment. So I was taking so medications to get me out of pain. And I think that as an adjunct treatment to the other things I was doing, it was actually really important. So you have these periods of not being in such severe pain that I had the ability to you some of these other treatments. Karen Litzy: Yeah, and I mean I don't think that there's anything wrong with pharmacological interventions, especially for people with CRPS. I mean this is really painful and I think that you're right, you kind of need the medications as a bit of a reprieve for your systems so that you can get to all this other stuff. Karen Litzy: 12:08 Now the question is, is are you now on the same medications that you were on in the sort of height of this pain process? Leda McDaniel: I am not. So I was pretty resistant to taking medication in the beginning. And I really used it for the smallest duration that I could to get me out of that really severe pain. Once I was on my way with this combination of lifestyle factors and I'd really seen the pain decrease to the extent that I could walk without being in pain, or I could touch my knee without having a severe pain reaction, I really started to taper off these medications with the guidance of the prescribing physician. Karen Litzy: Right. So I think for listeners is just important to remember that if you have pain, we're not saying do all of this other stuff and don't go a pharmacological route because sometimes that's necessary, but you have to make sure that you go that pharmacological route with your physician and that when you're ready to kind of taper down that you do that also under the guidance of your physician. Leda McDaniel: 13:31 Absolutely. That's a great point. I think also it's important to mention that, and this has been mentioned by others in the field that are doing this work, really trying to get patients to take an active role in their treatment. So just taking medication but not doing these other active components such as meditation, the prescribed loading if that's appropriate. And really addressing lifestyle factors and taking ownership of those in addition to these more passive treatments I think is really important. Karen Litzy: Yeah, and I think when you're talking about people with persistent pain issues like CRPS, you kind of, I think it's okay to have that combination of active and passive treatments. But yes, the patient has to know that they're not coming to the healthcare practitioner to be fixed, but instead they're coming to be guided and that they need to, like you said, take an active role because all of this, you know, nutrient dense diet, meditation, psychological therapy, visualization, progressive loading, exposure training. Karen Litzy: 14:49 So exposure to movement, exposure to activities that maybe you have fear avoidance behaviors around. All of this requires active work from the patient, active work from you. Right? And if you're not doing that as the patient, I think that you're not giving yourself an advantage. Would you agree? Leda McDaniel: Yeah, absolutely. Well said, Karen. Karen Litzy: Yeah. And so let's talk about timeframe here. So obviously changing your diet. We know that diet does have a huge ramifications to overall health, the psychological training, the meditation, the gradual loading, exercise, movement, visualization. This all takes time. So people will probably be thinking how many hours a day were you working on this stuff? Leda McDaniel: Well, for better or worse, I wasn't able to work or go to school at the time. And so really regaining my health over this year period, I actually deferred a year from physical therapy school. Leda McDaniel: 16:00 I had started and completed my first semester, but then wasn't able to continue sequentially, but my program allowed me to defer a year. So for that year my fulltime job was getting back to health and I really took that seriously as a full time job. So, a majority of my time was spent trying to create these positive inputs. I was doing a lot of reading and trying to learn as much as I could about pain and physical therapy related things, because that's developed into one of my passions and I really felt like it was important to maintain this engagement in intellectual pursuits as well, so that I could have some connection and some purpose to my future, even though I wasn't actively in school at the time or actively working at the time. So really to answer your question I was working on this pretty diligently. Karen Litzy: And what was, and maybe you didn't have one, I don't know, but did you have this sort of Aha moment at any point? So from the first surgery to where you are now, can you say there was one point where you reached this crescendo and then things started to fall in place? Leda McDaniel: 17:24 Yeah. Thinking back, I think, I can't pinpoint a specific time point that I would say generally it was about the time when I was forced to take a break from school. So it was almost at the lowest point where I wasn't able to walk on my leg, wasn't able to touch my knee because a sensitivity pain had gotten so bad that it really taken me out of a normal functioning, productive life. And somewhere around that point I was researching and reading as much as I could on my own. And I really stumbled upon this pain neuroscience education approach and some of the work of Lorimer Moseley and Butler and Lowe. And this idea that the pain that I was experiencing didn't necessarily have a structural cause. And to me that was the time period when I really changed my approach from this fixation on trying to find a healthcare practitioner who would tell me what is structurally wrong and how can we fix it to an approach of my nervous system. Leda McDaniel: 18:42 My brain is just creating this maladaptive signaling, maladaptive pain response and I really need to target my nervous system sensitivity versus trying to pinpoint what is wrong structurally for me, that seems like the turning point, where I was able to really start making gains and g…

    Full show notes at the publisher

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