We Named the Salad

" We're fortunate that our patients wanted to get these plants started in the dead of winter - relatively speaking. It's now May, and our first crop of salad greens is ready for harvest! OK, now: let's review what is going to happen in the group today. Ellen?"
"John is going to harvest enough Swiss chard for our first salad - but, how much is that?"
"Let's see - we're not cooking it but dressing it, so - there are six of us working, patients and trainers, and we'll probably eat 1 tablespoon each (gotta be realistic!) so - 6 tablespoons!" But, can John see it?"
"Sure! I marked the boundary around the chard bed with red colored duct tape; he can't help but zero in on it."

John's treatment plan for 5/7/16: John will cut 6 Swiss chard plants within his line of vision, with no more than moderate verbal and gestural cueing, and with 83% (accurate-delayed) accuracy. 

"OK - good plan; his field of vision is better but this will help him focus on the job. Becky - will Mary Anne have any difficulty pulling the radishes?"
"If I am not there for the entire time she can pick enough enough radishes, then she may go on a tangent and rip out a red light bulb from the night lights!"

Mary Anne's treatment plan for 5/7/16: Mary Anne will pull 6 radishes from the raised bed, with constant verbal, gestural and tactile cues, and with 60% (repeat prompt) accuracy. 

"OK then! I think you know what to do. And I am working with Celeste today; her job is to follow John and Mary Anne, and check that they have completed their jobs before we all head to the kitchen".

Celeste's treatment plan for 5/7/16: Celeste will record the performance of both John and Mary Anne on their garden assignments, and report to both Ellen and Becky on their execution of the plans - with occasional cues, and with 93% accuracy. 

"But, but - that means we have only chard and radishes for the salad?!?!?! BLecccchhhhhh....; BORING".
"OOPS"
"We'd better then go for more: I don't cook that often. How about, then....after John gets the chard, he can also cut some arugula. Then Mary Anne can....get some shears and cut some butter lettuce. That should be ready, too - right, Becky?"
"Right! And I will keep an eye on Mary Anne using shears; maybe, tell her she has only 15 cuts allotted from these shears today!"
"I agree. There is a head of iceberg lettuce from the grocery in our refrigerator; we can use it to add the "crunch" that many salad eaters tend to crave. Also, can both of your clients swallow nuts without problems?"
"Yes"
"O Yes!"
"Great. The creamy dressing should help hold everything together in a good bite to swallow.  There's crunch, and there's sweetness. There's pepper in the arugula, and there's pepper and crunch in the radish. Anything left?"
"No, Doris".
"Let's go".

The call came in....

I was working the day watch out of swallowing division, and was about to go out on a call when the desk sergeant caught me: "there's a new case up on 2nd floor; go check it out". Just as I thought, as I moved to the electronic medical record and started to skim the material. Don't ever plan ahead. But the flip side of that is: you are NEVER bored here!

Minutes later, I was interviewing the suspect about the alleged swallowing incident. "Just the facts, ma'am", and so she gave me the facts. Then I talked to the persons taking care of her, asking them for the same facts. They gave me different facts. My partner gave me some facts from a book. Those facts kinda said: maybe A, but it could be B as well. Should I call forensics in on this one?

The evidence had to be procured, and so I started to work the crime scene. "Try a bite of this", then "How about a drink of ______?", followed by "Would you like to try this, or THAT??"; and then finally, "Tell me what you would like next". Always, pacing the presentation of the spoon - so the suspect had to exert active control over the material; always, awaiting her subtle bloop of the hyoid up and forward, so then another bite/sip could be offered. Always, keeping that subtle but vital communication flowing throughout the meal, so that the suspect could eat and drink to the best of her ability.

Case closed. There was to be, at least today, no end of the shift with hearing a sentence pronounced: "mechanical soft, nectar thick- THIRTY YEARS TO LIFE". This is the city. I carry an IOPI.

Happy Better Hearing and Speech Month

May has been known as Better Hearing and Speech Month in the United States since 1927. During that year, the Holland Tunnel opened to feed traffic into and out of New York City. The Marines invaded Nicaragua and stayed until 1933. Heisenberg developed a theory of physics, but he was uncertain. The movie "Metropolis" premiered, and it certainly set the screen world on its ear. In the same vein, the American Speech-Language-Hearing Association (ASHA) set out that year, to tell the public about disorders of communication. ASHA also started to tell the story on what speech-language pathologists can do for the individuals afflicted with these disorders. So much has changed since 1927, but Better Hearing and Speech Month has not. This year's theme is titled "Communication Takes Care". Activities, events, and public relations tools are used to spread the word about what SLP's do for the persons we serve.

How do I want to commemorate the month? Above all, I want to say "thanks" to my current and former employers, for giving me the chance to serve persons in need. I have grown tremendously as a professional, from the wise experience and advice I had received from patients, their families, my colleagues and my peers. Following is a list of those employers.

* Kindred Rehabilitation Services, Streamwood IL
* Payne Wellness Center, Schaumburg, IL
* Brookdale Senior Living, Des Plaines IL
* Independence Plus, Inc., Oak Brook IL
* Elmhurst Memorial Hospital, Elmhurst IL
* Michael Reese Hospital, Chicago IL
* Allendale Association, Lake Villa IL
* Exceptional Persons, Inc., Waterloo IA
* University of Northern Iowa, Cedar Falls IA
* Covenant Health System, Waterloo IA
* State of Idaho Dept. Health and Welfare, Rupert ID
* State of Louisiana Dept. Health and Welfare, Thibodaux LA
* Assumption Parish School Board, Napoleonville LA
* University of Iowa Healthcare, Iowa City IA
* St Luke's Methodist Hospital, Cedar Rapids, IA
* University of Iowa, Iowa City IA
* Mississippi Valley State University, Itta Bena MS
* Veterans Administration Medical Center, Gulfport -    Biloxi MS
* University of Mississippi, Oxford MS

Happy Better Hearing and Speech Month, everyone!