Rachel :
Hi, and welcome everybody to our weekly Cerebral Palsy Foundation live, so our CPF live. We have a really special guest today. We have Lorene Janowski who is an occupational therapist for the Hospital of Special Surgery. And I can see that we've got lots of people already joining. Thank you so much to all of you for tuning in. I am really excited to talk with Lorene today. Obviously, a lot of us now have made the transition to being at home, and that means that sometimes therapy visits can't happen in person. And so it's really great to be able to speak with Lorene and talk about what therapy might look like at home and some of the things and tips and tricks that you can do for yourself.
Rachel :
So as I said, Lorene is at the Hospital of Special Surgery. She's an occupational therapist. She specializes obviously in different OT services, both for children looking to improve their overall quality of life, but also is a specialist actually in aquatic therapy as well. So if anyone has questions today in relation to aquatic therapy, Lorene, please take the opportunity to ask. I'm just waiting for Lorene to join. And then once she does, we'll get started. Please, if you've got any questions, make sure you put them in the comments below. Casey, so excited for you to join us. My future career, that's wonderful to hear. We need more therapists and more physicians and clinicians on the line.
Rachel :
I just got told that Lorene is here. I will have a look to connect her on. Let me just go through. Let me see. Lorene, if you can hear me, if you would be able to just request to join the live, that would be wonderful. Mary, thank you for joining us. I'm so excited, too. And Casey, great to hear that that's why you're passionate about these different things. But as I said, please, everyone make sure you join in below. A question already, so will you be posting any ideas in the highlights or in your feed? Yes, we will. We're really trying to hope to. We will obviously post this as live, but what we're also then going to be hoping to do is do a summary of this video and make sure that anything that's recommended today will be put into another shorter video so you can all go back and have a look. Just waiting to see. I can try to do it this way. Sorry, just going through there. Okay. This is now going to work.
Lorene Janowski:
Great.
Rachel :
Hi.
Lorene Janowski:
Hi, everybody. And we can now see you, but I don't know if I've been lost from the screen. Yes, I do not see you.
Rachel :
And you are sideways.
Lorene Janowski:
Is that better?
Rachel :
Oh, there we go. That is better.
Lorene Janowski:
Great.
Rachel :
We're going to get started because people don't really need to see me anyway. I'm not the exciting one that people need to talk to and have a look. It could just be the connection. So hopefully that will actually come good in a little bit. I'm just going to see if I can make it work. I don't know. I seem to have disappeared but let's keep going anyway. So Lorene, you probably saw that we've got a wonderful group of people already watching today. And as I mentioned, Lorene is joining us from the Hospital of Special Surgery. She's an occupational therapist and I'm just really excited. Do you want to give a little bit of a history of you, of yourself and your background?
Lorene Janowski:
Sure. So I work here at the Hospital for Special Surgery. I've been here for 12 years and we have a wonderful physical therapy, occupational therapy and speech therapy department in the pediatric rehab. We also have several doctors that we work with who specialize in working with children with cerebral palsy. And it's just we really have such a wealth of information and would love to share that with you and offer our resources to people out there. And also just to know what we can do to help make things more of a positive experience and to help to enrich your life.
Rachel :
Can you just for those that are listening who may be not sure what occupational therapists do? Obviously just for everybody listening as well, my background is I'm a physical therapist and I think there's a a good way to split it is that physical therapists sometimes look at the lower limbs and the legs and occupational therapists look at the hands and the arms. But can you just dive a little bit deeper into that? Because there is a little bit more to it than just go too specific.
Lorene Janowski:
So what's so important about, especially when you're working with children or anyone that has either a physical disability, a cognitive disability, occupational therapists work on your everyday function, so looking at the whole picture. But it's really important that you have a good team behind you, so working with a physical therapist, an occupational therapist and a speech therapist really help you get to where you need to be. And we look at the overall picture. So even though occupational therapists, a lot of times people think it's from the waist up, that really is not true. We look at how you're positioning and how you're functioning and how that affects your everyday life. So it's looking at the entire picture to lead your best practical life.
Rachel :
And I think right now I feel like all of us are in these different sitting positions. I've been sitting here at my computer now for the good most of the day. And I know a lot of us are doing that now at home. What are some of the things that we can do to address, as you said, our whole body? So not just our upper limbs and not just our arms and our legs, but what can we do at home to help with that?
Lorene Janowski:
Yeah. So basically, we are all undergoing a lot of stress. So stress can make us a lot more tight, especially when we're sitting for long periods of time with telehealth sessions with school. So we want to move as much as possible, but we want to do it safely in the safety of your own home or the people, the caregivers, that work with you. So our hospital, the Hospital for Special Surgery, one of our mottos is how you move is why we're here. And our job is to help you do that. So I'm going to go through a couple of exercises to help you feel more comfortable with doing some of those exercises from home. So I know I'm talking to a variety of different different levels and you may need to modify what you're doing, but I'm going to give you some tips that you can do within your home.
Rachel :
Okay.
Lorene Janowski:
So you can do these from a wheelchair. You can do them from a supported chair. My big thing when we're doing exercises is to make sure that your feet are secure on the floor so that you have some stability. The worst thing is you can do is when you're sitting on something without stability, it's really hard for you to control everything and things kind of feel like they're moving in all different directions. So I think that's really the number one thing. Also I'd encourage people that are sitting in wheelchairs, especially tilt in space wheelchairs, to make sure that you tilt on the hour to get pressure relief off of your backside and off of your behind.
Lorene Janowski:
So we'll start with the first exercise. I'm actually going to move over here to my chair and I'm going to sit on something that's a little bit more solid and standard. But one of the things I really like to do is to work on shifting your weight to the side and picking up the opposite leg. So again, shifting your weight to one side and picking up the opposite leg. So we're doing some weight shifts to work on that pressure relief so that we're not sitting in one position for such a long time.
Lorene Janowski:
The other thing I really like to work on that everyone can benefit is from their core. We hear a lot about core, the tree trunk of your body. And even just working on tightening your abdominal muscles by doing a tuck in, a little tuck in forward and then straightening up, so tucking in and straight up. We'll really just activate those muscles, especially when we are sitting for long periods of time. But why don't we go through a couple of upper extremity exercises that you can do again with your caregiver or your sibling can help you, or if you have self-range of motion that you can do as well.
Lorene Janowski:
So one of the things I like to do is really to work on the whole body. So we want to look at our shoulder and raising it up in front of us, nice and in front of us or as high as you can get to work on your postural system. I think of my speech therapy friends that work on a lot of speech and breathing and swallowing. So it's really important to have working on bringing your shoulders up so you can have that ability to work on that postural system, as well as the cardiac system and how our lungs help us to breathe. The other thing is you can-
Rachel :
When we're bringing our arms up, how high am I trying to do? Am I trying to come to shoulder level? Or if I can't get to shoulder level, is it okay to just go as high as I can go?
Lorene Janowski:
Yeah, Rachel, that's an excellent question. So do as much as you can tolerate. Obviously you don't want to overdo it, but if you can only get up to here, that's perfect. Okay? Or if you need a little bit of help from somebody else to help you raise it up, that will be even better. So it's going to really work on that postural system.
Rachel :
And when I'm doing that, is the aim to get tired doing this, or is it to feel like a stretch or what am I meant to feel when I'm doing those different things?
Lorene Janowski:
So you really just want to keep moving. So you should feel a little bit of a stretch. I always say don't take it to the point of pain, but you should be a little uncomfortable.
Rachel :
Okay.
Lorene Janowski:
So working on those shoulders are great, but also a big thing with, especially if you have a lot of tone in your arms, to work on extension, so that's straightening out the elbow. And here's where you may want somebody to help you go for the full range of motion, especially those children or young adults that have had Botox that have had to hold off on Botox, to work on that straightening out and see if you can get the full range or whatever you're able to tolerate pushing through, not to pain, but to be a little uncomfortable. And then the other thing is working on that supination. So think of those patterns that CP has us in. We have our elbows are bent, our wrists are many times pronate where our palms are facing down. So by working on opening up that palm to get a little bit more range of motion and supination is going to make a big difference.
Rachel :
And as you said, if you can do it on your own, then obviously trying to do these movements on your own, otherwise having somebody assist and help you is completely fine as well.
Lorene Janowski:
Exactly. And just think if your caregiver is not here, you can use your sibling or your parent, and be very clear with the communication that you give them. But that supination and also bringing the wrist up. Think of if people are using computers or if they're using their power chairs, the toggle or the [inaudible 00:11:58] power chair, really, wrist extension is important. So I'm really working on getting our wrist up and you can get a nice stretch here, just working on bringing our fingers to full extension and open our hand. And also don't forget that thumb. Our thumb plays such a viable role in everything in our precise, in our movement pattern. So really work on getting the thumb out of the palm of the hand. Some of you may have splints that you use, Benik splints or thumb opponents splints, but now is the time just to work on getting the thumb out of the palm of the hand.
Rachel :
Sure. So there are three or four really exercises that all of us should be doing in a way.
Lorene Janowski:
Tell me about it. I've been slacking a little bit, so please do what you can. But also it's okay if you don't do it as much as you used to. I think this is our time to give ourselves a little bit of a break. I know I have.
Rachel :
And I know all of us may have had, well, not all of us, but some of us may have actually had somebody who was at home assisting us in the past. And having that support that now we don't have that. While some states are now starting to open up and potentially carers and aids could now come into the homes, a lot of us have actually not had support in the house. So how does that look differently? And what are some of your recommendations there if you're doing things on your own?
Lorene Janowski:
Right. And Rachel, that's a really good point is that the audience, you guys may have caregivers that really worked well with you, that just got you. You didn't even have to communicate with them. They know how to transfer you out of the wheelchair. They know how to help roll in bed. They know how to walk with your walker or your assisted device to the kitchen. And now those people are gone, either transportation issues or they're older themselves and they are at risk of picking up something.
Lorene Janowski:
So here's a nice opportunity to really advocate for yourself. And if there's something that you get from this talk today, I really hope, and even just during this pandemic, is how you advocate for yourself, so being clear with your communication. So you may have to speak to your mom or dad a little differently than you had before, or any of your parents, or even your siblings. They may have to step up to the plate and help you transfer. Do some of the things that you were doing before. But be clear with your communication. Be direct. I think sometimes, especially when everybody's under a lot of stress, you can say things that you don't mean. I know I've done that. So just being direct and knowing that everybody is under a lot of pressure right now, so doing the best that you can. [inaudible 00:14:37]
Rachel :
And I think goes to all the parents who are listening right now as well. Even with young children, the demands that are being put on you have increased during this time. There's so many different people that are juggling work, school and then just life. And I think that's such a nice point to say you can give yourself a moment. You can give yourself a break.
Lorene Janowski:
Totally. And one of the things that I've learned during this is also I find that the most successful people, and sometimes the happiest people, are the ones that can adapt, right? So it's being flexible, it's being adapting. And that's really what my profession as an occupational therapist is, how we adapt and how we advocate for ourselves, but how we have to maybe do things a little bit differently. That's the story of our life. Sometimes we don't do them exactly as our friends do. We get them done just a little bit in a different way.
Rachel :
That brings a really good point that someone sent in a question earlier. And it was wanting ways to how they could be creative using everyday items in their home. Because you are not going to the hospital to therapy sessions, and you don't have an OT kit at home, what are some of the ways that people can get creative?
Lorene Janowski:
Okay. That's another great question is think of the things that you use around your home. So many times when you have tight muscles, you want to relax them and try to loosen them up. So one of the things that you can use is something like a foam roller, or if you have a roller that use for baking-
Rachel :
A rolling pin?
Lorene Janowski:
A rolling pin, yeah, a rolling pin for making a pizza. So even just taking either a lint roller, or even you can take a water bottle, and just practice rolling it gently all the way down your arm to relax that bicep muscle and to try to get more extension. You can also do it on your lower extremities. You can do in your hands. Usually things relax more when they're a little bit warmer. So even if something you have is a slightly warmer, but just working on opening up your fingers and rolling it all the way out to get that pressure. I'm sure a lot of you have heard your therapist, your PTs and your occupational therapists say proprioception. So where your joints are in space and how to relax them and how to loosen them up go a long way.
Rachel :
I love the lint roller. I think that's going to be the new therapy tool.
Lorene Janowski:
Yeah. The lint roller, even a spatula, also a foam roller is great if you have people in the house that are using a foam roller, also for positioning. But those are some things that I can think about around the house that just can help you calm and relax your muscles as well.
Rachel :
What are some other fun ways, I suppose, to bring things in? As you said, there's a lot of sometimes stress and anxiety and things like that during this time. How can we make doing this fun?
Lorene Janowski:
That is very, very important. So obviously what's fun for me may not be fun for somebody else. So everybody does things a little bit differently, or everyone finds their own way that they tick. `So some of the things that I have found because at the hospital, we had been doing numerous, numerous telehealth sessions that have been going extremely well. So it's interesting because one of the first things I ask as an occupational therapist is what's one of the things that really makes you motivated to do something? And I'm learning that doing these telehealth sessions on the computer, I've learned a lot more about my students in their own environment and what makes them tick.
Lorene Janowski:
So I have several students that I work with that love music. So doing the exercises, by doing what we did before, this and bring your arms up, really wasn't motivating for him. So what we decided, it was actually his dad's idea, it was brilliant, was we did the YMCA. So we had the music playing and we did the YMCA, and he loved the song and it was just something that made him tick. He loves music. If you like to bake, if you like to cook, just think of even just making a pizza, rolling out the dough, that's a great thing to make to be fun, but you can get a lot of benefit out of straightening out your elbows, getting your wrists into extension, keeping your fingers open, and then taking tomato sauce. I like to make my own, but financial disclosures, I will open up a jar of Rao's and I'll put it on the pizza and then with some cheese or whatever toppings you want, but that's a great way to work on elbow extension, wrist extension, and opening up your hands.
Lorene Janowski:
Also, those of you that are into gaming. I'm personally not into gaming, but Microsoft has this great adaptive controller. It's for the Xbox One. And it was designed for children that have limited use of their hands. Kids that love gaming can really get involved and be interactive with their friends in a different location. So Xbox and Microsoft, again, no financial disclosures, have really gone a long way with that.
Rachel :
Yeah, so the Xbox adaptive controller, the foundation actually had quite an input into the development of that and gave a lot of feedback while that was getting made, and yeah, absolutely. Anybody who wants more information on that, we've got lots of different resources around the Xbox adaptive controller. It's great.
Lorene Janowski:
Great. The other thing also is with a crafts idea. There is a website called PSIMadeThis for different crafts. Also, singing is great to work on your abdominal muscle. Our speech therapists love when our kids are singing because it works on a variety of different interests as well as some of the areas that they're working on specifically with their speech therapist. Gardening is great, especially to work on our sensory motor skills, to get our hands wet and dirty. And also you're making something that has a lot of impact into our society. You're working on building something. And then other things like listening to books, audible books, or some things that can be important or what's fun for certain people.
Rachel :
Yeah. I think that's great. And I think this is where occupational therapy, as you said, really is all encompassing. It's not just about doing specific exercises and the movements. It's thinking about yourself as this whole body and what do you need to relax or to feel stimulated or to do those things that you enjoy?
Lorene Janowski:
Totally. And like I said, for everybody it's different. Again, our hospital, the Hospital for Special Surgery, one of our mottos is we're here for how the world helps you get back into the game. So where everyone's game is different and how we help you get back into your game can be your game of life. So again, that's why we are here to help you with that.
Rachel :
I love that. So then another question for you. If we are looking at performing activities of daily life, we all have to do it. It's part of all those different things as far as getting up, getting dressed, going to the bathroom, having a shower. What can, as some tips, that can potentially make people less tired. That can be really exhausting to get those different pieces done each day. Do you have any tips for people on thinking about those different activities?
Lorene Janowski:
Yes. So like I said before, especially the children on this audience or the young adults and the younger children, everyone is a little bit different. So it's really great to have this conversation with your individual therapist, but some of the strategies that I can help you with is even something as simple as taking a shower in the evening as opposed to the morning so it doesn't exhaust your day. Or getting dressed, laying down in your bed with side rolling or log rolling to help get on your pants, or is it easier by putting your pants on in a wheelchair by tilting back the wheelchair all the way? So it's really adapting and problem solving. And again, like we spoke about before is adapting. What what's easier for you? And obviously that's going to change when you change as you get older, as your body gets bigger, it's going to change.
Lorene Janowski:
But I love, there is a website called performancehealth.com. Again, I do not have any financial disclosures to the company, but I love the website because I think it's really easy to use. And I'm actually just going to walk you through even how to get onto it. So it's www.performancehealth.com. And if you go to Shop, which is at the top, and you go to Home Care or Daily Needs, there are so many varieties of different things that you may not even know exist. I mean, as a therapist, I thought I knew a lot of products out there, but when I scroll on it, I said, "This might be good for my friend that needs help with dressing or this could be good for bathing."
Rachel :
And what we'll do is after this is we'll make sure any of the resources that Lorene's recommending we'll have in a separate post as well so people can go and click on it directly.
Lorene Janowski:
Yeah. And also the other thing I like about that website, besides the description, if you're unsure how to use it, there is a chat box that you can ask a question to the company for. And I went through the website and I just picked out a couple things that I thought were very helpful to see just for people out there. So for example, helping you feed yourself, so something that has a little bit a thicker handle, so for easy for self feeding. If you have a tremor or you have some extra movement patterns, something weighted may be helpful. But also something like a long handled brush or comb to make easier combining your hair.
Lorene Janowski:
As well as even a button hook, if doing small manipulatives are hard, a button hook is a nice modality to use. As well as this is the last thing. I love this. I use this for a lot of different things. It's called Dycem. It prevents things from sliding. So sometimes it's even great for transfers putting that on the floor, so your feet are on the floor, or putting things on your plate when you're feeding yourself so it doesn't slide away. So like I said, I use this resource a lot and even when I'm directly working with a child and everything's in one spot and they do a nice job at designating.
Rachel :
That's great to know. And we'd love to hear, obviously if anyone has any questions, there's a couple on here that we will definitely go through. I'm not ignoring you. Don't worry. But if anyone has any questions about any of these different pieces of equipment or resources, shoot us a question in the comment section below. The other thing is obviously, HSS and what you've been doing at the Hospital of Special Surgery. We know obviously, are teletherapy visits a thing? Obviously telehealth visits, we've all heard about them, but I think all of us think they're quite a static visit potentially. How does therapy work in this telehealth model?
Lorene Janowski:
And I have to say the hospital in general, as well as specifically our rehabilitation department, has done an excellent job of putting things together very quickly. I mean, we really spend a lot of time, resources and putting this together and the end product is really super. So our speech therapists, our PTs and our OTs are all seeing patients via telehealth. And what we do is, the parents do need to be present. And we consider the parents the extension of our hands of what we are doing. They are our hands. Everything is a learning process. But what we've realized is that especially for occupational therapy, we look at the natural environment. So this is a no brainer. We're seeing the patients in their natural environment. Sometimes children will come to us in our therapy gym, which is wonderful, and the child acts very differently here than they do at home and now we're actually seeing it. When the parents would say things that we wouldn't necessarily see here, now we're seeing how different it is in their home. So that's a huge, big added benefit.
Rachel :
You got a lot of likes from that comment just then, by the way. And I'm sure a lot of parents would probably say that time and time again, "This is not how my child usually acts at home." And it's either both. They're either perfect in a therapy session and following absolutely every instruction or they're mucking up potentially and what they need help with is not what they're getting. So I think that's wonderful being able to actually take you to the home.
Lorene Janowski:
And even to see the types of chairs that the child is sitting on when they're doing their session. And even just some of the goals. Obviously when we went to telehealth, we had to adjust our goals because it was a different environment. So I got a lot of typing goals. I want to be able to type quicker for my online sessions. Or a dad said to me, "I want to be able to have the child play video games with me," or, "I want the child to be more independent with self-care in the morning so they can get ready without so much help because I'm really busy with my online job." So it's been very eye opening, but it's been going well.
Rachel :
That actually brings up a wonderful point about goal setting. I think all of us sometimes when we're thinking about setting goals, what are your best tips about how to set goals?
Lorene Janowski:
So the number one thing for setting goals is to get a patient's input, right? So what's important to me may not be important to a child or whoever the person that I'm working with. So get the input from the child. Then after you get the input from the person you're directly working with, then ask the family, "What are some things that are important to you to work on?" But it has to be meaningful. If somebody set a goal for me to be able to be the best mathematician, that's not something that makes me tick so I wouldn't work toward that goal. But if somebody said to me, "I really would like you to be able to be independent with getting dressed, getting on time for school," that would be meaningful so that I could spend more time with my friends. So always ask the child. And then you have to modify. Sometimes when you do an evaluation for the first time and I'm sure the therapists are out there that we may have undershot or we may have overshot so we can always update.
Rachel :
And I think that's coming back to, and I'm sure a few people in here have heard this before, that just right challenge. So what does that look like? And trying to find that goal that is achievable but also not too easy that it's done quite quickly. There you go, Casey. Know you can. It doesn't matter your pace. Love that.
Lorene Janowski:
Yes. So true. And like I said before, you might have to do things differently. But it's okay. You'll get there, with some modifications, but you'll get there if it's important to you.
Rachel :
And just for any other resources, are there any other specific resources say that the Hospital of Special Surgery has made or any other things that you're aware that's out there?
Lorene Janowski:
Yeah. So, so what we did during this pandemic is we pushed things together. And if you go to our main website, so it's www.hss.edu, if you look at the very bottom of the page, there is something that says, "Feel better from home." So it's in a box. There's three boxes across. It's in a box. "Feel better from home." And I love this saying. It's actually four things to really focus on. It's stay strong, work smart, live well and stay safe. So if you go under each of those items, it gives you specific activities. And there are some videos from physicians, from therapists or some takeaway home messages from a nutritionist. We have a great thing in there on posture, so working with children and posture. So that's a nice resource. That was done by one of our occupational therapists, our pediatric occupational therapists here.
Lorene Janowski:
Our pediatric department put together a list of resources, and again, it really covers a variety of different ages, but we put together a list of resources on what you can do for home activities, and even how to structure for parents, how to work with their children, just simple things that you can say that go a long way, especially for communication. So we'll put that on at the end to have the link as well. And for the older children out there, there are things in there of resources. So for example, there's this Scholastic link go to to read aloud Scholastic books. The New York Public Library, and I know this call, this is throughout the country, but here in New York City, the New York Public Library, and I'm sure many libraries, you can do E-readers or library readers that you can do online, which is a free resource from libraries. And really utilize that. They have a nice selection.
Rachel :
Yeah. I would encourage that as well. There are so many free resources that are getting developed right now. So please look at them. The foundation itself, we also have an incredible free resource called CP Channel. It's an app based platform that pretty much has all these expert videos. So I've got over 150 physicians on lots of different topics and they're 90 seconds, 60 seconds each, so they're quick and easy. So if you get a chance, download CP Channel as well, and it's available on iOS as well as Google play. Because yeah, these are free and that's the wonderful thing is that there's a lot of different pieces out there that you can utilize and you can use. So we've got another question. So what age do you get the child to be part of goal setting?
Lorene Janowski:
So excellent question. And again, it varies. So if a child is able to communicate with me what they want, I ask them that. And if either they're too young or from a cognitive standpoint, they're not able to articulate that, I would obviously use a communication device so that they can give that to me. But I start off with the parents, "What does your child like to do at home?" It's really important especially when the child is having a hard time connecting to the therapy sessions. So that goes a long, long way. I recently was working with somebody who was having a little bit of a hard time with following directions on the telehealth session. He did really well when he came here, but I said, "What really makes him tick?" And it was Curious George.
Lorene Janowski:
So we ran with Curious George, talked about the man with the yellow hat, and he lit up, no more monkeys jumping on the bed. It became this big thing because he had buy into it. So you have to know what's important. And if the child can verbalize what's important to them, you have to go with that. I will tell you though. I worked with one of our hand surgeons here at the hospital several years ago and we were doing research on how the child was before surgery and after surgery. It's interesting. And this was for a young adult, is that the child's perception and the parent's perception could be completely different especially in the teenage years. And I'm sure a lot of you can relate to that. What's important to your parents may not be important to you and vice versa. So just keep that in mind. Again ask what's important.
Rachel :
Yeah. I think that's where that comes down to that communication and having all parties in the room and all stakeholders in the room when you're discussing goal setting, and if there's discrepancies, having somebody there that can talk people through it. We've got another question, too. Due to COVID-19, wearing gloves is critical. Due to my spasticity, athetosis in my hands, I'm finding putting on gloves very difficult. Any suggestions for different types of disposable gloves that may be easier or anything that might help obviously put on gloves? This is a tricky one.
Lorene Janowski:
Yeah. That is a tricky one. So what I would do is I would do some exercises on your hands before you put on gloves. So work on those gentle [inaudible 00:34:35], straightening out your hands beforehand to work on just to loosening up some of that muscle tone. I think gloves though, the surgical gloves that people use, I think that's going to be a little bit of a challenge, especially if you have a lot of fluctuating tone. I would even use a pair of winter gloves if you're going outside. I mean, I know it's not ideal because it's getting warmer out, but if gloves are important to you for the spread, and again, there is mixed views on that.
Lorene Janowski:
Now gloves outside, they're saying that really is not as effective. Just don't touch your face. Don't touch your eyes and your mouth. But if that's something that's important to you, I would use gloves that are a little thicker and gloves like winter gloves that would be easier for you to put on. Or even mittens outside, the individual finger is not aligned. A mitten would protect your hand. Basically the whole point is to keep your hands away from your face.
Rachel :
Yeah. And I suppose though, if you're in a work environment where you are wearing gloves because you're in the workplace and you're handling lots of different pieces, for example, if you work at a grocery store or something like that. Someone else is putting a recommendation to blow into the glove. It creates space within it.
Lorene Janowski:
Great idea.
Rachel :
Sometimes powders and things like that can help slide a hand in the glove. But yeah, I think your suggestions as far as thinking about alternatives to the disposable gloves might be a good option.
Lorene Janowski:
Yeah, there's things you could do. Besides the stretching, you can also do some weight bearing. So putting again that pre-test or that pre-exercise to do before, the warm up.
Rachel :
Yeah. No, that's a great idea. So something probably we wouldn't think about less warm up to put our gloves on, but-
Lorene Janowski:
Exactly.
Rachel :
But it's probably really appropriate.
Lorene Janowski:
So true.
Rachel :
Now just think, does anybody else have any other questions for Lorene? Lorene, do you have any other comments or anything that you'd like everyone to go? I'll go through to make sure we haven't missed anything. But please, if anyone else has got any questions or comments, please put it below. There was one thing that I read in your bio that I have a question about and that's aquatic therapy.
Lorene Janowski:
Yes.
Rachel :
And what that looks like. Obviously, can you do anything like that at home? And what could that be or is that something that having to wait to actually when hospitals and therapy centers are back open?
Lorene Janowski:
So unfortunately to really get the benefit of the water, and I worked with a wonderful organization called Angel Fish Therapy, who we did a lot of work with who they have been doing some excellent ideas online, some online exercises of different positions that you would do without being in the pool. But unfortunately right now for safety, the pools have been closed. But being creative, so think of filling up your bathtub with water, again, supervised, having somebody with you. Obviously it's not going to be the same effect, but it's something. You're not getting a whole viscosity and the fluidity of the water and the buoyancy because it's not as tall as you are, but it's something.
Lorene Janowski:
And also, depending on where you live, people that live in Florida that have their own private pools where it's not a public area, you can still use that. Or if you have a tub that's deep like a jacuzzi tub, it all depends on your height. But that's really the best thing that we can do now. But aquatic therapy, once things get up and running and we manage this pandemic, aquatic therapy is a wonderful, wonderful resource. And I highly encourage all of you to do it in an adjunct to your land-based therapy. They work hand in hand.
Rachel :
I think that's a wonderful suggestion. As a therapist who worked a lot in the pool, I completely agree with you on that one.
Lorene Janowski:
Yeah. It truly is magical because you move in ways that you can't move when you're walking on land. So it gives people a nice opportunity to get that feeling.
Rachel :
So my final question to you. You mentioned obviously the teletherapy telehealth visits that you are all doing. Can anyone make an appointment with you to do that and what's the process that people go can go through to do that?
Lorene Janowski:
Yeah, so anyone can do it. You have to get a doctor's prescription just like for any PT, OT or speech therapy session. And then you can contact, if you're interested, at the Hospital for Special Surgery, our Pediatric Rehab Department. You can get more information online, but you can also contact us at 212-606-1137. And you will speak to one of our lovely ladies at our reception area who will walk you through the process to see if you're eligible to participate in the telehealth sessions.
Rachel :
Wonderful. And as we said, everything that's been spoken about today, resources, recommendations, and then obviously how to contact Lorene at HSS, we will make sure it is in the comments section when we put this live.
Rachel :
But I just wanted to thank you again, obviously for taking the time and your recommendations. You've got a lot of fans on this page who have come and seen you personally. And I think it's wonderful now that more people can have the opportunity to have access to your knowledge and learn from you, so thank you so much.
Lorene Janowski:
Yes. And I just wanted to just say one last thing is just remember all of you, you're all a rainbow of possibilities and don't let anyone tell you can't do something. It's finding a way to do it and also finding the right person to do it with. So you work with a variety of different people in your life and some people really get you. So find those people and help them to help you build you up and to help you find what you need.
Rachel :
That's wonderful advice. I think all of us can do that in every aspect of our lives. So thank you again. And please, everybody stay well, stay safe. If you've got any other questions, put it in the comments section on the post and we'll reach out to Lorene to get someone to answer for you.
Lorene Janowski:
Great.
Rachel :
All right. Wonderful. Thanks.
Lorene Janowski:
Thank you. Bye-bye, everybody.