Energy Conservation for Summer and Vacations

As I have written before, Energy Conservation is a topic that I really enjoy and love to educate about. It's close to my mind often, since I love for tasks to be efficient and simplified. In this post, I want to discuss energy conservation tips applicable to the summer months and also to vacations. Though technically the first day of summer here was a couple of weeks ago, it's been in the high 80s and 90s for what feels like several months. Energy conservation is especially important in the summer months because for many folks who need to think about conserving energy, life gets harder in the heat. Harder to breathe and easier to fatigue are typical signs of the summer, and especially among those with cardiac and respiratory diseases and also the well elderly (If you are having these symptoms in summer or anytime, talk to your doctor!). That doesn't mean that life has to take a backseat during the summer months- just that conserving energy should come into play so you can enjoy and participate in all desired occupations.

Here are some tips:

• --Minimize time in the heat- try to be outdoors in the mornings and evenings, when it's cooler, and stay out of the sun and hottest part of the day when you can
  
• --Don't live on grueling pace in vacation spots- So many people take a trip somewhere exciting (such as Disneyworld) and then run themselves to death during the trip. Don't be afraid to take breaks and naps, you'll enjoy whatever trip you're on more if you're not run down. Also make sure to take some seated breaks in the shade during your outdoor adventures.
  
• --Take stretch breaks while traveling- Try to avoid driving for overly long stretches. Take a break every hour or 2 to keep yourself fresh and cramp-free.
  
• --Rotate driving- in the same vein, try to rotate the driving responsibilities so that no one person is worn out from the stress
  
• --Plan small, close trips- shorter trips can be less stress to plan and easier on the family
  
• --Go to places that are air conditioned- trips to museums and movie theaters can be easier to tolerate in the heat.
  
• --Get your exercise in the morning or evening- summer isn't an excuse to stop exercising, but try to do it in the cooler times of the day
  
• --Use a scooter at parks- if you're planning a big trip at an outdoor park, consider using a scooter or transport chair to save energy. Make sure you spend time in the shade as well
  
• --Use a backpack (well adjusted) or rolling cooler to transport water and snacks
  
• --Plan day trips for times when you have the most energy- run your errands and take your trips at the time of day that you have the most energy. For many people, this is the morning.
  
• --Nap after pool time- swimming always seems to wear me out extra, so I just allot time afterwards to take a nap
  
• --Consider making smaller meals that are simpler and have less to prepare- saves you energy and prevents any extra heat from accumulating in the house
  
• --Know your limits, and how to cool down- recognize what you need to do after activity to cool down. Sometimes, a seated rest break is insufficient, and you may need to drink or coat yourself with water, or lay down in a cool room. Lifehacker ran a piece on using your pulse points to assist in quick cooling.
  

What are some other tips you have to get the most out of summer while conserving energy?

Some sad times

My time at work has been sad lately.
My current rotation has been a mighty mishmash of cardiopulmonary pts on intensive and progressive care units, orthopedic pts, and frequent floating back to the neuro floor and ICU. In short, my pts have been much more acutely ill than on my other rotations.

It's very depressing seeing pts on multiple admissions for severe COPD or CHF exacerbations. People who are far past where cardiopulmonary rehab can be beneficial. I've had several pts travel back and forth from the regular floor to the ICU, but I have a couple that I'm concerned aren't likely to come out. I've had to get much more diligent about checking with nurses even for follow up sessions since my pts fluctuate considerably from day to day. Got as close as I care to get to a pt coding... me throwing on a contact isolation gown and slapping a vitals machine onto a lady who was hyperventilating, desatting, and gasping in pain. Fortunately the doctor and charge nurse were right behind me, so I was able to excuse myself and let them perform the rapid response and take her to the ICU.

My neurology pts aren't faring much better. Someone I evaluated several weeks ago while on that rotation is now nearing a full 2 months hospitalized and has just gotten progressively functionally worse. I wonder if she would have been happier if the surgeons left her brain tumor in and let her live out the rest of her life still able to walk and talk and recognize her family. Her shoulder now has a finger width subluxation that I feel personally responsible for.

She is one of several people we've had with GBMs lately, a particularly nasty type of brain tumor with very poor prognosis. Also had the readmission of a young CA pt that I worked with prior, who was intubated, had to get a PEG tube, and generally declining. I couldn't even look toward the back corner of the unit without choking up.

I've also had some personal disappointment lately, and have felt pretty bad for being swayed by that at all, having any negative emotions over this minor speed bump in life when I still have life and many of my pts are losing theirs. So it's been a very emotional time, a lot of tears at home, some at work. Not such a great time lately, but it will improve, I hope.

Tis the season for changing

3 months has gone by, neuro rotation is over.
This month, I begin on a new floor, the last "new" floor possible (NICU/peds does not count into the rotation). So I will now be working with cardiopulmonary pts, some in ICUs, and orthos. I don't find any of these superbly interesting but hope to find some fun stuff to do. Little worried from a productivity standpoint since I suspect we'll be taking a lot of rest breaks, lots of breaks to check vitals, and probably a lot of advance planning to separate OT/PT sessions into morning/afternoon. I haven't ventured fully into the ICUs yet... we are starting an effort for early mobility and decreased sedation (similar to this) so that will be interesting but it is also stressful to make sure that I know enough about what is going on and protecting my pts, not pushing them too far.

My neuro rotation was good... it was split with surgery, which was not so much fun. Rounds for both are kind of demanding, and first thing in the morning which can make it hard to get a jump start on the day. I did learn a lot on the rotation... I am no longer scared to be in the neuro ICU despite intra-ventricular catheters and pts who have to be monitored very closely. Worked with one lady for 5-6 weeks in total over 2 admissions, she might make a good case study later. I got over my splinting fears for the basic stuff- had a period of 2 weeks where I felt like I made at least one splint everyday. Luckily there are good experienced people around me who are willing to give advice on whether to splint or not, whether adaptations need to be made. even made a resting hand splint around an arterial line.

Had several interesting cases, but lately it's been more sadness and disappointment. Some people really stick with you and it's hard to leave at the end of the day knowing that there's really no reason your pt wound up in the hospital, and that same freak accident/diagnosis that happened to them could just as easily happen to you. Life can seem random when otherwise healthy people wind up hospitalized for something no one could have seen coming. I had a lady in her 80s who had never had any illness before, but had neuro symptoms, came to the ER, and found that she has had a large brain aneurysm that was leaking. What are the odds? It's not right, but there's other diagnoses where you assign a fault, make yourself feel better- I won't get this, I don't smoke/use drugs/I wear a seatbelt- but too many things on this rotation could happen to anyone. It's a scary world out there, and unpleasant to have to contemplate mortality so often.

The switch has me working with some new OTs/PTs that I'm not familiar with so that is interesting. At least one is working on clinical ladder for cardiopulmonary, so I expect to learn a lot. I am reminded of when I was playing on a basketball team with 9 players and I was the 5th player, so there were times when I was the worst player on the court, and times when I was the best player on the court. I remember asking my dad about that situation and he said not to feel bad about being the worst player because everyone around you can teach you and make you better. So that's sometimes how I feel right now, being the newest OT hire and only 2 years experience, but I do feel that I'm learning and getting better.

I've gotten better at writing goals for ICU pts and conducting tx sessions, suspect that will continue to improve during this rotation and hopefully I will have a good update with ideas for everyone.

Aerobic Exercises in the Pool

I've had interest in aquatics since I finally conquered the water (6th grade?). My research project in OT school was on aquatic therapy for CVA pts at a local rehab, and I also spent a fair amount of time lifeguarding. But the spur for this article is more personal... my dad had a heart attack 2 years ago at a young age and has been working hard at galvanizing the men around him to be proactive about heart health. My uncle has been resistant, saying that he can't do regular cardio due to his knee replacement... so here's some low impact cardio exercises you can do in a family sized pool. As always, consult a doctor before beginning an exercise regimen of any kind, especially if you have risk factors for cardiac disease. Seriously. Also, be careful in the heat, since that could aggravate a cardiac condition. Again with the checking with doctors.

Treading Water- an easy exercise that can be done for a long time. For variation, try arms only, legs only, or holding a weight above your head.

Walk Laps- good for a shallow pool, you can add resistance through leg bands, such as these from Speedo

Jumps/Skips/ Bobs- simple enough, more demanding than just walking. Jumps or skips in the shallow end, you can do bobs up and down in the deep end trying to get high into the air and deep to the bottom of the pool. Be careful not to over exert, especially if you are holding your breath.

Underwater Laps- build lung capacity by swimming progressively farther underwater. Slow your breathing during your rest breaks.

Side push ups- plant your hands on the pool wall and practice lifting yourself out of the pool. Be careful with this, keep your head back and away from the wall or your teeth are in peril. As an alternative, if you have a diving board, you can do pull ups while in the pool, you can also do these from starting blocks if your local pool has them and allows them to be used for this purpose.

Crunches- with your back to the pool wall, stretch your arms so they support you and let your feet dangle straight down. (this is 90* shoulder abduction for those who are anatomically inclined) Then, you can do oblique (side to side) crunches.

Stepping- if you have an aerobic stepping program that you are familiar with but have a hard time tolerating the impact level, weighted steps can be used in a shallow pool.

If you have access to a lap pool in your community, swimming laps is good cardiovascular exercise and can also help you work on expanding lung capacity and strengthening. To mix up the routine, consider using a buoy to force you to swim only with your arms, or a kickboard for the opposite. Also, many local community centers offer aqua aerobics... if you're already paying for membership, you can take advantage of the class.

Some resources:
http://www.exercisegoals.com/water-aerobic-exercises.html
http://squidkid.org/2008/03/19/water-aerobics-for-very-smart-dummies-pool-workouts-101/

ps- again, go to the doctor!! use these tips at your own risk.