New Year, New Location, New Travel Rotation

Well, my apologies, ladies and gentlemen.  It turns out that I'm a pretty terrible Blogger.  I was quite a good little Blogger years ago when I wrote about my Semester in Spain.  And I did a reasonable job of posting updates when I lived abroad in Australia, especially since I didn't have internet services half the time!  But this time around?  I just let life get in the way....

So I'm going to try again, and we're going to keep the expectations low!

First, a quick summary of what I've been up to since I last put fingers to keyboard on this site.... I mentioned that I extended my contract an extra 5 weeks in order to finish just before the Christmas holidays.  As part of the deal, however, I took a week off and zoomed down the coast to Los Angeles, Newport Beach, and San Diego, then drove inland to explore the desolate beauty of Joshua Tree National Park.

Over Thanksgiving, my mom and dad and sister came to visit!  They did some day trips up and down the coast while I went to work, but I managed to join in for some wine tasting and beach walking here and there. On Thanksgiving Day we built up an appetite exploring the Oceano Dunes atop rented ATVs (a massive area as been set aside as a 4x4 playground) and our Trader Joes  turkey dinner turned out surprisingly well.  My mom and sister and I also spent a lovely weekend driving up the coast along Highway 1 to explore Big Sur, Monterey, Carmel, and the beautiful coastline in between.

After I wrapped things up in Santa Maria, I flew home to Charleston for Christmas with the family. I had hoped to secure my next travel position before the holidays started, but I had to mix some job-hunting in with the holiday-ing- and actually ended up excusing myself from a Christmas party to do a phone interview! Stephanie and Jonathan headed back to NYC and London, respectively, so I drove up to Raleigh for New Years to catch up with my North Carolina friends and (ex) co-workers. It ended up being a really lovely finale to an already lovely holiday fortnight.

I was pleased to accept a travel position at Sanford Medical Center out in Palo Alto, California- and I'm already two weeks in!  They have me working on the Neurology and Neurosurgery units so the work is really interesting. While Palo Alto is part of the Bay Area, I'm a good 30 miles from San Francisco, and am instead living in the area known as Silicon Valley, home to lots of big tech companies and many more start-ups.

Unfortunately, I don't have any post-worthy photos of Stanford or Palo Alto yet because, although California is in a terrible drought, it is an El Nino year- and we've had nothing but cloudy skies and drizzling rain since I arrived!  My co-workers have been really welcoming and Eileen, the lady I'm renting a room from, is easy to get along with, so I seem to have landed on my feet!

Hi Yosemite, so nice to finally meet you!

I have two announcements- and then a little update.

Announcement #1:  I extended my contract here in Central California.  Instead of finishing on November 8^th, I will now be here until December 20^th.  This not only gives me more time to explore the area (venturing farther afield to Los Angeles, San Francisco, etc), it will also allow me more time at home with my family over the holidays.

Announcement #2:  I have been diligently making my payments and was able to pay off the last of my student loans last month.  Considering that student debt has reached crisis levels in this country, I’m very pleased to have it behind me!

This past weekend, I made the 4.5 hour drive out to Yosemite, one of the jewels of our National Park System.  I had my sights set on climbing Half Dome, perhaps the most iconic rock formation in the park.  It is such a popular challenge, however, that they have imposed a limit on the number of hikers allowed up it each day in order to manage our environmental impact on the landscape.  300 is the magic number.  Most of these permits were allocated through a lottery process back in March.  50 permits are reserved for a last-minute lottery 2 days before.  I entered the lottery twice but was unsuccessful both times.  Sad face.

I also managed to slip on a rock during a baby hike that first day. The resulting banged-up knee had me hobbling around as I set up my tent that night.  Each campsite is equipped with a bear box- a bear-proof metal container in which to store all of your food. Well, my neighbors either didn’t get the memo-  or they chose to ignore it.  Either way, I was awoken in the early morning hours by a loud crash less than 10 feet from my tent.  I lay frozen in place while imagining a black bear prying off my back bumper. Local law enforcement is not above scare tactics, you see. They post photographs of bears sitting IN cars with doors that were ripped off their hinges lying battered and scattered on the ground! I finally decided that the creature didn’t sound hefty enough to be a bear and I cautiously opened up my tent flap to take a peak. Lo and behold, it was a family of possums having a field day in an overturned garbage can filled with my neighbors’ food scraps. A lot of crunching and rustling sounds later, the party finally disbanded and I fell back asleep.

 By 6:45am, I was back in the park.  I had researched a back-up hike that promised equally breathtaking views of Yosemite-  I even drove to the trail head and gazed longingly at it.  Given the pain involved in bending my knee to get out of the car, however, I decided that a long hike in Yosemite was just not in the cards this time around.  It was certainly not how I had envisioned my first trip to this beautiful place, but I spent a few hours cruising around to various lookout points instead- and still encountered some spectacular scenery! My knee, by the way, is recovering very nicely.

First glimpse up the valley from Tunnel View Point. El Capitan is on the left and Half Dome is in the way back.

A similar view the at sunrise with the first rays hitting the top of El Capitan

El Capitan in all its glory- my other campsite neighbors had their gear all laid out in preparation to go climb this!

I actually saw a bear earlier in the day!

And one to prove that I was actually there.  This is the view of Half Dome from Glacier Point.

A Place Called Pismo

Let me tell you about this temporary little home of mine.  Pismo Beach is located on the central California coast, about 240 miles south of San Francisco and 180 miles north of Los Angeles. While the official population is measly 7655, there are a large number of vacation rentals around and multiple RV parks outskirts of town, so I’m guessing that the temporary and transient people in the area bump the population up by at least a thousand! 

 

My clothes are neither beach-y enough nor bohemian enough to give off the impression that I belong here. The town looks like it had its heyday in the 1950s and it continues to channel that vibe with its beach bungalow motels and neon signs.  Almost all of the chain stores have been kept at a distance. You won’t find a full-sized grocery store, a bank, or movie theater.  You WILL find motels, eateries, stores selling kitschy beachwear, 2 tattoo parlors, and a palm reader, among other things.

 

The Pacific Coast Highway (also known as Highway 1) runs along 650 miles of the California coast and passes right through Pismo Beach- 2 blocks from my front door, in fact! I see long-distance road bikers with their fully packed panniers riding through on a daily basis.  There are also a number of vineyards in the area, although the much more well-known regions of Napa and Sonoma lay a few hours further north.  I have yet to visit any of the wineries here but am hoping to make them the subject of a future post.

‘Pismo’ is a Chumash Indian word roughly translating to ‘tar’ and it refers to the natural asphalt that bubbles up through fissures in the ocean bottom and washes ashore along the beaches of central California.  This material combines with the extremely fine sands here to create beaches that are hard enough to drive on.  (At least 3 different people have assured me that even my 2-wheel drive can have its beach time as long as I stick to the hard-packed parts… still not sure I’m willing to chance it.)

The Pismo clam was once prolific along the beach.  Thanks to some serious overharvested by beach-goers past, and there are now some strict regulations in place and few clams to be found.  Nevertheless, there is a Pismo clam festival coming up in a couple of weeks.

There is a fairly visible-and fairly young- homeless population here.  I’ve been awoken by people going through the dumpster across the street, I’ve had my flip-flops stolen during a beach walk, and I’ve stumbled across numerous homeless camps in the woods while out on a run.  I suppose, if you have to be homeless, might as well pick a place with a mild climate and sea views….

There is also an increasingly visible shark population here.  People love flying their ‘drones’ out over the ocean to look for them!  Notices are regularly posted about shark sightings in the area.  It doesn’t stop the surfers but it certainly makes the casual beach-goers among us a little more weary!

 

 

Part of what makes this area so beautiful is the fact that you have sandy beaches combined with rocky cliffs and, beyond the cliffs, you have mountains in the distance.  It makes for some awfully pretty sunsets!

 

 

                                                    

Patients say the darndest things....

Before I start the work week tomorrow (they've got me on a Tuesday-Saturday schedule now), I wanted to share a few quick highlights from my patient interactions last week:

A 90-something year-old WWII vet parked his wheelchair next to me and said, "Okay, let's do some pumpin'!" (as in 'pumping iron').  He then dutifully proceeded to count out reps with his 2lb hand weights.

My therapy session with a 90 -something year-old lady involved working on her morning dressing and bathing routine.  Things were going smoothly until she realized that her family had forgotten to pack a critical piece of her wardrobe- her shoulder pads.  "I just feel lost without my shoulder pads!  I don't feel properly dressed!"  I had to take every cardigan out of her closet so that she could feel the shoulders and convince herself that they really weren't there.

While working on simple range-of-motion and strengthening exercises with a pleasantly confused lady with dementia,  I explained that we were going to do some punches- and suggested she imagine that someone she didn't like was standing in front of her.  That's not a suggestion that I usually make but, given her dementia, I wanted to make the instructions a little more concrete.  The patient replied, "I don't think that's a good exercise."  I backpedaled and said, "Its okay, you won't really be hitting anyone."  She shook her head at me and said, "Yes- but its still negative."  So I scrapped that visual and we ended up picking imaginary apples from imaginary trees instead!

The last little vignette I want to share is not a humorous one, but rather a proud therapist moment for me.  A patient with a recently replaced shoulder stated, "I like working with you because you make me do everything for myself."  You see, when helping him to the bathroom, the nursing assistants would always pull down the sheets for him, lock and unlock his wheelchair brakes, open the door and flip on the light, prepare the toilet paper, and flush the toilet for him afterwards.  None of these helpful gestures actually help prepare this patient for a successfully return home.

Occupational therapy is most definitely a 'helping' profession, but the challenge and the skill lay not in helping a patient out-right, but in grading an activity and providing the 'just right' challenge in order to foster independence and enable that patient to help himself.

Have a great week!

This is the front entrance to Marian Medical Center- faux belltowers and all. While I spend most of my time at Marian Extended Care (I am standing in front of the Extended Care to take this picture), I help out over at this hospital on Fridays and Saturdays.

Weekend Wildlife Adventures

I sprang into exploration mode during my first two weekends here.  

There are two other travel OTs working at the same facility as me and I have them to thank for my early adventuring.   Jenny and Mary invited me to join them for a weekend trip to Santa Cruz to stay with some travel PTs that Mary had met on a previous assignment.  Instead of unpacking my apartment, I threw together an overnight back and road-tripped a couple of hours up the coast.  Overall, Santa Cruz is a little on the grimy side.  It has a pier and a boardwalk that are reminiscent of Atlantic City with its shops and amusement park and foot-long hot dogs.  For me, the two most memorable parts of the weekend were seeing all of the bonfires on the beach at night and watching a colony of sea lions sunbathe on a platform under the pier.

I joined a couple of local MeetUp groups in an effort to get out and, well, meet people.  So the next weekend I set out for the Bishops Peak trailhead in order to meet up with a group of rock climbers who were happy to share their gear.  (Sadly, the bag containing my harness and climbing shoes was in the ‘if room’ pile when I was packing my car to drive out here and it didn’t make the final cut.)  It has been a number of years since I did any climbing outdoors so this made for a really fun morning.  I hiked to the summit of Bishops Peak for a super view out over San Luis Obispo before heading back home. 

The next day, Jenny and I hopped in the car for a shorter trip up the coast to San Simeon.  It is a very small town but it boasts two things that we wanted to see.  The first was Hearst Castle, an enormous home built by the newspaper mogul William Randolph Hearst and spectacularly positioned with a commanding view over the surrounding countryside and coastline. The property itself is a working cattle ranch. There used to be hundreds of exotic species roaming the property and, while most of them are gone now, we did manage to see a herd of zebra off in the distance. The mansion is lavishly decorated with antiques collected in his travels- including multiple hand-carved wooden ceilings shipped over from Europe in their entirety. The Roman Pool was my favorite part of the tour by far- take a look at this photo!

In order to check item #2 off our San Simeon bucket list, we headed over to the pier.  In order to verify a little piece of insider information we had been given, I talked to the park ranger on duty there. He confirmed that the nice man Jenny and I had met at the Avila Farmer’s Market a couple of nights earlier had been correct- there was indeed a baby humpback whale hanging out in the harbor.  Apparently the whale had been there for about 4 weeks already and no one knew how much longer it would be there before the mother deemed it big enough to head out into the open ocean.  I was WAY more excited about seeing a baby whale than about seeing Hearst Castle.  So I asked the ranger to point me at the whale- and he handed me his binoculars.  The baby didn’t put on any impressive displays of breaching or tail-slapping, and it didn’t swim over to the pier to say hello.  It would just lazily surface every few minutes far off in the distance, sending a little flurry of seagulls up into the air each time.  So technically I’ve seen a baby whale!  Although it was not as up-close-and-personal an encounter as I would have liked, it still made for a great day. 

An Introduction to Marian Extended Care

I'm almost 2 weeks into my travel rotation and it's time for an update! 

I wrote my last post from a motel room.  After 4 days in the motel, I was finally able to move into my little cottage at Pismo Beach and now I get to write to you from the comfort of my kitchen table.

Let me tell you briefly about my work setting and my experiences there thus far:

I arrived to California last Sunday and presented myself at Marian Extended Care Center in Santa Maria on Monday morning for orientation.  Orientation lasted 4 hours, 2 of which involved computer modules- and then they had me on the floor treating patients all afternoon! I thought I might get one day to settle in, but clearly they expect people to hit the ground running!

Unfortunately, I wasn't granted access to the patients' electronic medical records until that Thursday- so I ended up with an impressive 4-day backlog of unwritten progress notes. It all got sorted out in the end and I'm settling into more of a routine now.

The patients here are mostly older (70s, 80s, 90s) and, when they discharged from the hospital, they were essentially deemed unready and/or unsafe to return home.  Part of my job at Duke Raleigh Hospital was to make recommendations regarding who was ready to go home and who would benefit from ongoing, in-patient therapy services.  For many patients, facilities like Marian Extended Care serve as the next step along the rehabilitation continuum.  (For any of you in the therapy world, as far as I can tell, 'extended care' and 'skilled nursing facility' are interchangeable terms). Marian Extended Care has 4 wings- 2 of those wings house permanent residents- essentially a nursing home- and the 2 wings where I work house temporary residents.

The majority of patients I see here are able to do so much more and move so much faster than their counterparts in the hospital.  In many ways it is easier than the acute care environment- generally speaking, I'm not so worried that these patients are going to pass out on me or fall over every other second- but it does mean that I need to work on a slew of higher level skills, activities, and exercises with them- and come up with fun and functional ways to do so!

And, just as I'm starting to get the hang of things at Extended Care, I'm getting shipped over to the main hospital tomorrow to get oriented to acute care (the setting I worked in at Duke Raleigh) so that I can eventually float back and forth between the two- wherever they need me most!  Thankfully, the two buildings are just across the road from each other.

Greetings from California

And just like that, I'm on the West coast!

I had planned on taking 'Before' and 'After' pictures of my odometer but the silly thing somehow reset itself along the way.  You'll just have to trust that I did the math correctly as I tell you- with some pride- that I drove 3028 miles during my coast-to-coast road trip.  I have yet to calculate how much money I spent at the gas pump, although my little Ford Focus does pretty well for fuel efficiency.

Many thanks to the friends that hosted me and made time to catch up along the way.  I made strategic stops in Chattanooga (thanks Whitney!), St Louis (thanks Lisa, Greg, Anna, and Ashley!), Hays, Kansas (turns out I don't know anyone in Kansas...), Denver (thanks Robin, Brian, and Julie!), and Las Vegas (thanks Anna and Joel!), before arriving yesterday afternoon in Santa Maria, California.

Unfortunately, my little cottage at Pismo Beach won't be move-in ready until Wednesday. In the meantime, I'm camped out at a motel near the hospital. I've got my bike stored in the bathroom and my dinner consisted of a Trader Joe's deli sandwich in a local park watching kiddos playing soccer.

 

 

When taking a long, solo road trip, you too may find yourself parking your car strategically for photo ops with beautiful backdrops.  (I might have done it more than once!) Here's a photo of the little cutie that carried me across the country- I've decided to call her Roxie.