My Life in Boxes

Have you ever been excited about a box?

I have!

My parents brought me home from the hospital in a box. That's right, a cardboard box. Can you believe that? I can't say that I actually remember that day, but I bet my parents were excited about their box.

They also kept that oh so special box and, until I was 3 or 4,  I loved to watch TV inside of it. That's right, I would get a pillow,  my cold blankie, my favorite Raggedy Ann beach towel and my box and I would watch Planet of the Apes. I got to stay up late on those nights- exciting times!

Life was great in the box!

As I got older, boxes were exciting because they usually meant moving. 

We moved from Texas to Louisiana when I was 8, and once in Luling, we packed all of our stuff into boxes and moved four more times. 

As far as I know, all of the boxes made all of the moves, but I try not to remind my mom what happened to the TV armoir during that last move. 

Hint:  It flew out of the back of the truck and broke into splinters!

Growing up, grandparents, aunts and uncles sent boxes full of Valentine's treats, Halloween goodies, birthday and Christmas presents. No doubt, there was maximum excitement when those packages arrived!

When I was in college, my grandmother was totally in to the Home Shopping Network. She called, late one night, and told me that she was sending me  Dr. Allen's Wonder Baker. 

What in the world?

She assured me it would change my life. The anticipation was almost too much- I thought the box containing the Wonder Baker would never arrive. Can you relate?

As I got older, I excitedly packed my own boxes and moved: from Baton Rouge to Fort Worth to Houston and finally to Corpus Christi.  Each move meant more and more boxes. 

What can I say, I love stuff!

In 2002, I was expecting my first baby and, no matter how hard I tried, I was not able to find all that I needed for a cowboy themed nursery at the local Babies R Us. So, I took my first shot at Internet shopping. 

I ordered cowboy bedding, cowboy curtains and coordinating bandanna fabric to make a diaper stacker and matching pillows. I ordered a hat/coat rack in the shape of a big green cactus and a little table and chairs with...you guessed....cowboys!

Needless to say, the nursery was going nowhere without these things and I could hardly wait for my big purchase to arrive so I could get to work pulling things together.

With absolutely nothing else to do, I kept careful watch for that big, brown truck. Finally...

The day arrived. 
The truck pulled up. 
The boxes were delivered.

Maybe it was those crazy pregnancy hormones, or perhaps it was sheer excitement, but when that UPS man knock on my door, I went nuts.

I gave him a giant hug. 
I invited him in. 
I even took his picture.

 I bet he still talks about me to his UPS buddies- that wacky lady on Sutherland Drive,  waiting for her boxes.

Once that precious child arrived, there were even more boxes in my life, and as the children continued to arrive, so did the boxes. Joy!

Months and years go by but some things never change- there will be boxes.

In fact, I am focused on boxes now more than ever!

Since Spring Break:

• searched the world over for the perfect box size and box shape
• created a mock up box out of scrapbook paper
• worked with designer to create professional box design
• searched the world over to find someone to make my box
• decided Hong Kong has the best box making capabilities in the world
• converted measurements and colors for desired box specifications
• arranged payment for boxes via international wire transfer (scary stuff, I assure)
• received color proof of box from Hong Kong
• returned color proof of box to Hong Kong
• arranged for a split shipment of boxes to meet deadlines
• 100 boxes now via UPS Express
• 400 boxes later on a slow boat from China
• hired a customs broker to clear my boxes through the Port of Houston
• hassled above customs broker to complete shipping forms for boxes by deadline
• waited for boxes

Whew, I'm exhausted!

Well, last Monday, June 15, I received an email from UPS: 

Your package has been sent and will arrive by the end of business, Tuesday, June 16. 

Those nice UPS folks even gave me a tracking number so I could obsessively watch my boxes move around the world-  from Hong Kong to Anchorage, Alaska, then on to Memphis, Tennessee, over to San Antonio, Texas, to down to CORPUS CHRISTI! 

Everyone in the house and neighbors up and down the block were on watch for the big, brown truck...waiting for the boxes. 

Now, unlike the previous UPS experience, this delivery was uneventful, and actually pretty sweaty and gross.

It was 5:52 pm when the dolly was flung out of the back of the truck. The UPS man removed 5 boxes, stacked them up, and, with great effort, pushed them straight through the middle of my front yard. (I still can't figure out why he didn't use the sidewalk.)

Anyway...

I greeted him at the door.

He plopped the boxes right in the middle of the foyer.

He left.

He did not smile. I did not want to hear about the exciting journey my boxes had taken. He did not care about my new business. He did not even let me sign my name on his little brown computer thing.

 He left a few drops of sweat on the front porch and he was a gone pecan. 

Nonetheless, the boxes have arrived, and nearly one week later, I am still excited about it!

Take a look at my beautiful boxes...

For most people, boxes come and go without event, but not me- my life, past, present and future, are in these boxes !

I want to show you and tell you more about my boxes, but that will have to wait, so stay tuned!

Thanks for reading...have a great week!

Most people think in the box. Some people think outside the box. I want to create the box. 
Solly Tomari

June is Aphasia Awareness Month!

In 2008, Congress declared June as National Aphasia Awareness Month in an effort to increase public awareness and advocacy for the understanding of a communication disorder that affects approximately two million Americans. While this is a significant step in the right direction, awareness and understanding of aphasia by the general population remains low. 

What do you know about aphasia? Check out this informative video I created.

Still not sure what aphasia is or what it would it be like to have aphasia?

Take a few minutes to experience listening, reading, writing and speaking with aphasia using these neat aphasia simulators.  

I asked my husband to try these simulators before publishing this post, and quite honestly, he did not understand my fascination with this experience. 

him:  This is confusing.
me:   Exactly!
him:  I don't understand this.
me:   I bet you don't!
him:  Does this make sense to you?
me:   Yes. I got all of the answers right.
him:  Are you trying to make me feel dumb?
me:   No, just trying to make you understand what it's like to have aphasia.
him:  Do you work with people like this?
me:   Every day.
him:  I feel sorry for you speech therapy people. I don't know how you do it.
me:  It's the people with aphasia we should be worried about. I don't know how they do it.

No matter what you think of the simulator experience, there is a lot of information provided at this site, and along with it, hopefully, a new perspective  toward those living with aphasia. 

Give it a try and let me know what you think.

In the meantime...

As professionals, SLPs have had experience with aphasia through specialty coursework, research, continuing education and clinical practice. With that experience comes the responsibility to serve our patients,  to educate their family members and to increase public awareness. 

So, as you go about your work this week, please take the time share these resources with others: tell a friend or family member about this blog, promote aphasia awareness by sharing this link on Facebook, or help someone through the aphasia simulators. You will be glad you did.

Thanks for reading... have a great week!

When something bad happens you have three choices.  You can either let it define you, let is destroy you, or let it strengthen you. 

Summertime, and the Living Is Easy Breezy!

I'm not a big Alice Cooper fan, but he and I do agree- when school is out, it's worth singing about!  

Bring on the good times! 

Friday was the first official day of summer vacation and the guys were ready for some fun.  The conversation went something like this:

What are we going to do this summer, Mom? 
I don't know. What do you want to do?
We don't know.
Well, why don't you two go make a list of all of the things we can do this summer. Come back later and let me see what you came up with.

Off they went.

When they came back, they presented this list:

• baseball camp
• movies 
• beach
• sleep overs
• travel/ visit grandparents
• Schlitterbahn
• stay up late

Doesn't look like it's going to be too difficult to keep them entertained this summer, does it?

Since we all know that summer vacation doesn't really exist for most grown ups, I decided I had some planning to do too- I needed to map out my plan for the weekend. It could be the last chance I have to get things in order around the house for a while. Knowing that, I grabbed my legal pad and started writing.  This is the actual list of what I planned to do:

• check mail
• pay bills
• check bank accounts
• file papers
• purchase graduation gifts (x5) 
• write blog for 06/08/15
• return pajamas to Dillard's
• exercise (x2)

With my list complete, I moved on, feeling confident:  I am going to accomplish 8 things this weekend. I can do this!

Well, remember the old saying about the best laid plans for mice and men? Yup, that was me...my plans went awry.

John Steinbeck should have written about the best laid plans for mice, men and women who make lists of things to do.

Anyway... 

Here is a list of what I actually did:

• went to a pool party at the neighbor's house- a great way to kick off the summer!

• went to Coby's baseball game- they lost, but I can't remember the last time I laughed so hard (PS:  next time you see me, but sure to ask to hear the story and/or see the picture of  Dirty Mike- it's sure to give you a good laugh too)

• packed the family up for a trip to the beach-  we took every beach related item we owned and had so much fun we decided to stay till almost 1 in the morning; my crafty husband even built us a bonfire as the sun was going down; we watched a beautiful moon rise as we sat under the stars and marveled at the universe- glorious!

• attended online church (by myself) while I folded 5 baskets of clean laundry (by myself)- it was the low point of the weekend 

• baked a big batch chocolate chip cookies- delicious!

• went to a baseball team party for Mike and Jay- I actually had a great time!

• watched 8 innings of an LSU baseball game- we won!

• took the dog for a walk- enjoyed the cotton candy colored sky as the sun set

• thought about writing an outline for the 06/08/15 blog- but ate a mango popsicle instead

In the end, I did not do a single thing on my list, and  believe me, under ordinary circumstances, this would be major source of frustration, aggravation and disappointment. But, not this weekend, it's summertime and I'm going to do like Jack Johnson- I'm going to move like a jellyfish and go with the flow.

This week, as you go about your work, try to be just a little more relaxed in your approach to life, and take some time to enjoy all that the summer has to offer.

Remember: the tan may fade, but the memories of an easy breezy summer will last forever.

In the meantime, I'm headed to Padre Island...I'll save you a seat!

Thanks for reading...have a great week!

Live in the sunshine. Swim in the sea. Drink in the wild air.  
Ralph Waldo Emerson

Welcome to the Real World! 10 Tips for New Grads

June is a very busy time of year for so many. Which category do you belong to?

A.  Last day of school is right around the corner- yay!
B.  Last day of school is right around the corner- oh my gosh, what now?
C. Graduation- moving on!
D. Summer school- keep going!
E.  Looking for a job- wish me luck!

It was about 21 years ago this month that I had a shiny new diploma from Texas Christian University: a Master of Science in Bilingual Speech Language Pathology. I was on top of the world!

Until....

My dad, the greatest father ever, informed me, "Melissa, effective July 1st, you are officially off the Lawson family payroll."

What?

That's right, the gravy train was leaving the station and in the next 30 days and I was expected to be on my own.  

Knowing that you can never let 'em see you sweat, I took a moment then shot back, "No problem, Dad!"

Long story short, I got to work, found a job, moved from Fort Worth to Houston, and by July 5th, was gainfully employed. Whew!

Over the years, I have learned a variety of very important lessons and I thought I would take a few minutes to share a top ten list of things every new graduate should know. Here goes...

Top 10 Things Every New Graduate Should Know

1.  You will look dumb:  You will learn more in the first 6 months on the job than you did in all 6 years of school. No questions, hands down, there is nothing better than OJT (on the job training). When you finally show up to take the real world by storm, be prepared, you will look dumb. It's happened to all of us. Just keep your chin up, keep on smiling and carry on. Eventually, you will get the hang of things. 


2.  You will never stop learning: The State Board of Examiners and ASHA will make sure of that you spend at least 10 hours each and every year learning something new. It is critical that you broaden your horizons to learn new concepts, diseases, disorders, techniques, equipment and/or interventions. You may not want to read another journal article for the next 100 years, but you must keep learning.


3. Become a specialist:  I recommend you consider a specialty and learn all that you can about one area. I chose dysphagia in the beginning as a means for pure survival. Then, I took every course possible on  documentation. Finally,  dementia was the name of my game. Along the way, I received special certification in accent reduction and neuromuscular electrical stimulation with Vital Stim. Currently, I thinking of a new certification in orofacial myology...sounds like fun, right? Whatever you decide:  focus, focus, focus.


4.  Use your resources:  Take your books to work and reference them without being ashamed. In addition to grad school texts on neurology, voice and swallow, I always have Mosby's Medical, Nursing and Allied Health Dictionary handy. I could not have survived in the hospital without my Medical Abbreviations Dictionary, and, over the years, I also found it helpful to have a thesaurus, a copy of The Pill Book and The Speech-Language Pathology Desk Reference. People will come to you with questions, and this way, you are sure to have the answers. 


5.  Get LinkedIn:  When you're first getting started, you will have a CFY supervisor to hold your hand. But, after that, I suggest you work to develop professional contacts. You can literally create a LinkedIn profile to commiserate with other SLPs, or you can join an ASHA Special Interest Group (SIG) and participate in some great forum discussions. What ever you choose, stay connected with other professionals.


6.  Join a professional organization:  While completely optional, and usually kind of pricey, it is a good idea to join a local, state and/or national professional organization. Membership does have its privileges, including: newsletters, journals, access to job postings, discounts on conference registration, etc. Besides the wonderful perks, it looks good on a resume. And speaking of resumes, 


7.  Keep your resume current:  You just never know what the future brings, so be prepared and have an up-to-date resume ready to go. There are tons of online resources to help you perfect the paper version of who you are. Once you have captured the essence of who you are and what you can do, be sure to make updates each year. 


8.  It's a small world after all:  It's not just the best ever ride at Disney World, it is very true...the (medical) community is much smaller than you realize. That said, be careful: don't burn any bridges. That annoying co-worker may someday be your boss- you never know. Take the high road each and every time...you'll be glad you did!


9.  Get it together: Success in the real world is heavily dependent upon a few important skills, namely organization and time management. Get organized and make the most of your time at work. Productivity is the name of the game, so strive to be the most efficient version of yourself possible. Have a plan, know the plan and work the plan!

10.  Build an arsenal:  Begin building a therapy tool box.  Include flashcards, workbooks, handouts, diagrams, etc. If you are technologically advanced purchase apps for your smart phone or iPad. A variety of treatment materials will benefit your patients from keep you from getting bored at work. 

If you have any other pieces of sage advice, let me know...I would love to hear from you! In the meantime, feel free to share these tips with anyone you may know who is moving on, moving up, or, as was the case with me, moving out.

Thanks for reading...have a great week!

Huh? What? Are You Talking to Me?

As the mother of 4 active children (ages 10, 12, 12 and 14), things in my house are never perfect and communication in my home is rarely optimal.  No matter how I try, we seem to be breaking all the rules for clear and effective communication.  

For example...

We talk to each other through closed doors, from one room to the next, with faces buried in pillows and with backs turned. We try to have conversations while taking showers, when the dishwasher is on and even while mowing the grass. Who does that? 

Just because you're watching tv, talking on the phone or intently staring directly at the screen of a computer, doesn't mean that you are unavailable for conversation. Nope, not at my house- we just keep on talking to each other.

Even if your body language is shouting, "Don't talk to me!", "I'm busy!" or "Leave me alone!"  my family just can't take no for an answer. In fact, we have conversations with people when they are having conversations with other people. It's terrible!

We talk to each other from upstairs to downstairs, from downstairs to upstairs and while going up and down the stairs. Oh brother!

We would never take the time to lower the noise of the TVs, radios or video games in order to have a conversation- we just talk louder. 

And with 3 of those 4 children now in braces, clear speech production is a thing of the past. With mouths full of brackets, rubber bands and the dreaded transpalatal appliance, it seems to me that everyone is mumbling. 

Huh? What? Are you talking to me?

Add to the mix a spouse who has a mild hearing loss in his left ear and it's a wonder we are able to exchange information with one another. In fact...

Communication breakdown occurs every single day! 

I didn't hear you say that. 
I didn't know what you were talking about. 
I didn't know you were talking to me.
I didn't understand a single word you just said.

What's a girl to do?

Well, I might not be able to keep it together at home, but at work, I've got answers!  I can help you solve even your toughest communication problems related to hearing loss. Here is a list of tips I regularly share with my patients and their family members so that they can communicate successfully.

Being that May is Better Hearing and Speech Month, I thought it would be the perfect time to share...

18 Tips for Maximizing Comprehension

During Conversational Exchange

1.  Shhhhh! Quiet: reduce or eliminate unnecessary noises- put the TV on mute, turn down the radio, ask the host/ hostess at a restaurant for a table in a quiet location

2.  Keep your hands away from you face: nearly all listeners are able to make some use of lip reading, besides, a hand in front of your mouth will muffle the sound of your voice- just don't do it

3. Make things clear: rapid rushes of speech are sure to lead to misunderstanding, or worse, communication breakdown; focus on clear, precise pronunciation

4.  Pay attention: prepare the listener for interaction by saying their name or touching their hand, arm or shoulder; establish good eye contact to make sure everyone is ready

5.  Get up close and personal:  it is best if communication partners are no more than 3-6 feet away from each other; move the furniture if necessary; no matter what, you should always be in the same room

6. Get on their good side:  if a "better ear" is known to exist, position yourself on that side whenever possible

7.  Keep an eye on things: maintain eye contact- this is a great conversational technique under any circumstance, but facing the person with hearing loss allows them to get important visual cues, like facial expressions, that can add vital information to the exchange

8.  Slow down: a slow, deliberate rate of speech with intermittent pauses increases understanding and allows extra processing time, it's a win-win solution

9.  Go deep:  lower the pitch of your voice a bit; persons with hearing loss typically have the greatest difficulty distinguishing high frequency sounds, making a woman's voice harder to comprehend; so ladies, do your part and drop it down a notch 

10. Rephrase rather than repeat: if a listener didn't understand the first or second time, it is likely they won't get the third time either; when repeating, it may be necessary to find a different way of saying what's on your mind

11. Flick the switch: a light, bright environment can actually increase comprehension as it allows listeners to clearly see your face, so check to make sure that there is good overhead lighting before sitting down to have a talk

12. Preferential seating: when going to a restaurant, ask for a table away from the kitchen, server stations or large parties; at a meeting, sit closest to the main speaker; in school or at church, sit on the front row

13.  Get acquainted: introduce the listener to the general topic of the conversation in advance to enhance comprehension; avoid sudden changes of topic

14.  Repeat it back:  when giving specific information to someone who is hearing impaired, have them repeat specifics back to you to make sure they understood

15. Put it in writing:  whenever possible, provide pertinent information, such  as directions, numbers, times, schedules or assignments, in writing

16. Pay attention:  a puzzled look on the face of your listener usually indicates misunderstanding; tactfully ask the hearing impaired person if they understood to make sure you get the message across

17. Take turns:  avoid interrupting other speakers so that messages can be shared in entirety and without confusion

18. Everything is worse when you are sick and tired:  recognize that everyone, especially a hearing impaired person, has a harder time hearing and understanding when ill, or in the the later part of the day


Whether you are using these strategies during a therapy session with a 96 year old patient or when talking to your grandpa, I think you will find this list to be comprehensive and very helpful. 

If you suspect you have a hearing loss, use these techniques to reduce your difficulties during interactions with others, and be sure to see an audiologist for a complete audiological assessment. 

As for me and my gang- we are a work in progress.  I'll keep you posted.

Have a great week...thanks for reading!




Courage is what it takes to stand up and speak. Courage is also what it takes to sit down and listen.
Winston Churchill 

Spot the Signs of a Stroke- FAST

I am the last person in the world you want around in the event of emergency. I just never seem to know what to do. 

For instance...

When I was younger, my friend Catherine and I volunteered to wash the windows at our pastor's home. Standing on nothing but a narrow brick ledge, she scrubbed the large picture window in the front of the house.  All was going well until she lost her balance and fell backward into a hedge of  thorny holly bushes. There she was, sinking deep into the hedges, flat on her back and feet  up in the air.  It was a sight to see!  Covered in scratches and starting to bleed, she was screaming and crying, but attempts at pulling her out only brought her more pain and made me start cracking up laughing. All I could do was leave her there and run for help. 

A few years later, I was babysitting a bunch of kids- I think there were 6 altogether. I was personally responsible for 3 of the children and a few neighbors had come over to play. I was certainly out of my league in terms of crowd control, and it was becoming obvious that I was outnumbered by little people. They were running all around the house, jumping on the sofa, acting like kids,when I decided to take control. "Hey everybody, let's go outside!" 

Just as I was scooting the last one out the back door, the craziest thing happened:  one of the boys was impaled with a wire coat hanger. It was as if the thing jumped out of the clear blue sky and into the skin covering his knee cap. So gross! Like a fish hook, the curved part of the hanger went in at the bottom of his knee, it came back out at the top of his knee, so that, as he stood there, the hanger actually hung from his knee. I didn't even want to look at it more less try to remove it, and having no idea what to do, I left him there on the back steps with clear instructions not to move and ran for help.

Do you detect a trend here?

Over the years, there have been other emergencies where I was totally useless: the afternoon my mom got run over by a horse, the morning our pontoon boat began sinking in the lake and the night the barbecue pit caught fire and exploded. I could go on, but the point is, life is scary, painful and  dangerous...and you better not count on me to help.
Of course, everyone reacts differently in emergency situations, but clearly, I am useless in the event of accident, bodily injury, catastrophe or fire.  Or so I thought...

I was just a few months out of grad school, working at a nursing home in Wharton, Texas, when I had an opportunity to redeem myself.

It was lunch time and I was seeing a patient for dysphagia therapy in the dining room. As my patient ate his Salisbury steak, mashed potatoes and spinach, he started slurring his words. The food he was eating began seeping from the corner of his mouth and dripping down his chin to his neck. His left eye was nearly closed shut, and he began to lean to the side. It could only be one thing: he was having a stroke!

I jumped right up, alerted the kitchen staff, got the nurse, called 9-1-1 and in less than 10 minutes, the man was being loaded into an ambulance. Yay for me! Now, I'm not trying to make myself into a hero, but I do believe that, had I not recognized the signs of stroke and taken action, the outcome would have been very different. 

So, here we are, recognizing American Stroke Month, and  come to find out, the American Stroke Association, in their 2015 campaign, would classify me as a hero- a stroke hero. 

Stroke heroes are ready to spot stroke signs and act quickly by calling 9-1-1. They might help make the difference between life and death, or between full recovery and permanent disability. 

You too can become a stroke hero just by knowing the stroke warning signs.  

If you have 60 seconds,  NBA star Paul George can give you a quick run down of the basics:  Spot a Stroke- FAST. 

Now for the specifics:

Face Drooping:  Does one side of the face droop or is it numb? Ask the person to smile. Is the smile uneven?






Arm Weakness:  Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?





Speech Difficulty:  Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?




Time to Call 9-1-1:  If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you'll know when the first symptom appeared.



Next, take time to learn the other signs of stroke:





Sudden numbness or weakness of face, arm or leg, especially on one side of the body.



 

Sudden trouble walking,dizziness, loss of balance or coordination.

Sudden confusion, trouble speaking or understanding.

Sudden trouble seeing from one or both eyes.

Sudden headache with no known cause.






Over the course of my career, I have been a stroke hero a total of 5 times. My kids say that qualifies me for being a stroke super hero.  I'm not so sure about that, but one thing is certain, you can count on me to recognize a stroke and get you the help you need.

I hope you'll join me by learning the FAST signs and sharing them with as many people as possible. Teach your family, friends and coworkers to spot a stroke FAST and call 9-1-1 immediately. 

Because anyone can have a stroke, everyone should be ready.  American Stroke Association

Build Your Caseload with New Referrals

How do you handle a dramatic change in your caseload?  Do you:


A.   panic, then have an emotional breakdown
B.   start looking for another job
C.   spend your extra time shopping at the mall
D.   consider a change of careers
E.   roll up your sleeves and do something about it

One of the agencies I contract with has slowly but surely stopped sending referrals over the last few months. At first, I was okay with it and took the, "Good. Now I can go on vacation during Spring Break" attitude. But, almost 2 months later, it's much more of a concern than it was back in March. My caseload has dwindled from about 20 visits each week to only 2 visits scheduled for this week. Yikes! 





I found myself asking, "Why isn't the phone ringing? I'm going to be unemployed next week if I don't get some new patients. What am I going to do?" I contemplated my options and then used the process of elimination to help me find the best answer. 





Option C- ELIMINATED.  I learned years ago that shopping is a bad idea. Even though there is more time for picking out new shoes to coordinate with your new outfit, you are spending money.  When there is less work,  that also means that there is less money. Now, I was in remedial math until 8th grade (seriously, I'm not kidding), but I have figured out that the money coming in needs to be more than the money going out. Using the old test taking strategy of eliminating the obviously wrong choice first, I moved on.

Option D- ELIMINATED. I've invested 21 years of my life working as an SLP, and changing course right now would be an even worse idea than going to the mall. Better keep going down the list.

Option A- ELIMINATED. The thought of getting all worked up and crying just seemed like it would not be worth the effort. Besides, people would certainly think twice about sending new referrals to the  teary-eyed therapist who was struggling to keep it together. Tears pouring out of my eyes are not going to result in new referrals, so, I'll keep going.

Option B- ELIMINATED...for now. I haven't had to look for a job in years and I really don't want to start now. The entire HR process you have to go through as a new hire for most companies is long.  It typically involves watching a bunch of boring videos about HIPPA requirements (again), demonstrating your ability to follow Universal Precautions (again), taking tests to prove you really do understand blood borne pathogens (again), updating the resume (again) and worst of all, peeing in a cup. Yuck! Who really wants to do all of that stuff...again? Right now, not me.

Option E- this is the only option that has not already been eliminated, so, I'm going to roll up my sleeves and do something about this pesky problem of mine.  Here goes!

After commiserating with my OT and PT friends, I made a few phone calls to talk to the bosses and the CEO. The common response was, "We're just not getting the referrals we used to." Hmmm- that can only mean one thing: someone is not doing their job! I'm not going to sit around waiting for someone else to do something about this situation, I'm going to get involved. 

I know exactly what to do...remind everyone how important Speech Therapy is!  After all, it is Better Hearing and Speech Month,and the timing could not be more appropriate. Now, how will I spread the news?

I remembered a handout I created before I did a presentation at the Corpus Christi Parkinson's Support Group not too long ago. I pulled up the document, made a few small adjustments for my new audience and printed it on some bright paper. 

I've been known to pop in to speak to agency staff during weekly case conference meetings, and that's my plan again.  Watch out nurses, here I come!

Making a Referral to a Speech-Language Pathologist

Common Diagnoses:  Referral to an SLP is usually justified with any of the following medical diagnoses:                                                                                                

• ·        Stroke, TIA
• ·        Parkinson’s Disease
• ·        Alzheimer’s and Related Dementias
• ·        Altered Mental Status
• ·        Dysphagia
• ·        Cancer of the Head or Neck
• ·        Head Injury
• ·        Amyotrophic Lateral Sclerosis
• ·        Pneumonia
• ·        Head Injury (Closed Head Injury, Traumatic Brain Injury)

Dysphagia:  70% of geriatric patients are experiencing difficulty swallowing

• ·        History of aspiration or aspiration pneumonia
• ·        Alternative feeding methods are being/ have been used
• ·        Weight loss: gradual or sudden, usually unexpected
• ·        Poor appetite
• ·        Altered diet:  changes to solids or liquids
• ·        Pneumonia- usually in the lower lobes
• ·        Dehydration
• ·        Malnutrition
• ·        Nutritional supplementation required (Ensure, Boost)
• ·        Difficulty swallowing medications
•          Coughing, choking

Justification:

• ·        Promotes continuity of care
• ·        Provides cost effective treatment
• ·        Enables functional activities in a functional setting
• ·        Diminishes social isolation
• ·        Maintains quality of life
• ·        Allows for medical acuity and frailty at home
• 
  

You don't have to be a marketing expert to get your point across, just put on a big smile, pass these handouts around the room and let the enthusiasm you have for your job pour out of you. 

By the way, if anyone is interested in the complete, extended version of this document, contact me and I will be happy to share.

Over the years, I have found that information like this, given to the right people, can really make a difference in the amount of referrals you get. You are providing information and raising awareness, all at once- so efficient! 

Whether you're a speech language pathologist or not, the moral of the story still the same:  take responsibility, take charge and stop waiting for someone else to do the job. 

This week, consider situations that could be improved based on the actions YOU take. 

Post a comment to share your success story- I would love to hear from you!  In the meantime, don't forget to continue the celebration of Better Hearing and Speech Month.

  

Hope it's a great week....thanks for reading!

If it is to be, it is up to me.  William H. Johnsen