One in every one patient has a heart.
Read that again 😀
Overly simplistic, but how many times have you forgotten to ask your patient about their heart health?
Cardiotoxicities are rampant in oncology, affecting patients during active treatment AND for the rest of their life. As in, breast cancer survivors are at significantly increased risk of dying from heart disease years after finishing breast cancer treatment (check out this systematic review from JAMA).
Then consider that many of your patients are moms…who were pregnant…& experienced the cardiovascular effects that commonly accompany pregnancy.
TALK ABOUT A DOUBLE WHAMMY that we are totally glossing over in OncoPT.
In this week’s episode on TheOncoPT Podcast, we dive headfirst into the intersection of pregnancy, oncology, & physical therapy with Drs. Rebeca Segraves, Jenna Segraves, Katherine Sylvester, & Allyson Sutkowi-Hemstreet. In their upcoming CSM session, CP-17761 – Peripartum Cardiovascular Health Disparities and How Physical Therapists Play a Vital Role across Settings, they shed light on the alarming statistics surrounding cardiac conditions, which persist as the leading cause of death during pregnancy and the first year postpartum.
These conditions are particularly challenging for oncology patients, grappling with the double whammy of post-pregnancy cardiac issues and cardiotoxicities from cancer treatments, plus the secondary effects of cancer treatments such as obesity & increased sedentary time.
Physical therapy has a significant role to play with this patient population, considering your vital contributions to risk assessment, triage, prevention, and treatment of pregnancy-related cardiac complications. The question is now: are you going to step up & help address this with your patients?
Listen NOW.
Peripartum cardiovascular health is a critical area in OncoPT
As we discussed with Dr. Segraves back in Ep. 271, pelvic health issues are ONLY ONE PART of the peripartum experience. Cardiovascular health is a much more upstream issue that PT must place more emphasis on (listen to Ep. 271 Pregnancy & Postpartum in Cancer Rehab: How to START Treating These Patients for more).
But the cardiovascular issues don’t just stop once the 4th trimester ends. DVTs, preeclampsia, heart failure, peripartum cardiomyopathy, and myocardial infarction can be life-threatening issues for your patients now & later in life…complicated further by a cancer diagnosis.
Cancer treatments such as chemotherapy can become necessary within weeks of giving birth, adding another layer of complexity to the situation. That’s why it’s so important to focus on comprehensive care to address whole body health (targeting all body systems) to ensure the well-being of your patients.
Collaborating to address peripartum cardiovascular health disparities
Collaborative care is essential in addressing peripartum cardiovascular health disparities, as physical therapists need to work with other healthcare professionals to provide comprehensive care.
As Dr. Sutkowi-Hemstreet said, “It does not serve this patient population for us to be siloed. We really need to be collaborative & working across disciplines, across professions, across niche areas.”
And let’s be clear: this is not about adding more work to your already full plate. This work requires us to re-focus on what is truly important in oncology: patient-centered, collaborative multidisciplinary care. Dr. Sylvester challenges us to be intentional about building the health care team around our patient & identifying which professionals/services are most important to include on the team for this specific patient.
Health care is broken – but you’re part of the solution
Consider this quote from our interview:
“The health care system is broken. But we ARE the health care system. It is on us to change the system. It is on us to be okay to feel the weight of that responsibility.”
-Dr. Allyson Sutkowi-Hemstreet
Maternal health has been in danger for years, centuries. This is not new. In fact, today’s speakers acknowledge how long overdue this CSM session is. So now it’s time for us to step up & implement the knowledge they share into our own clinical practice.
You have the skills & knowledge to work with the peripartum population. You may need more education or training in some areas, but please don’t wait until you’re “ready” or “an expert” before starting to address these rampant issues in your own community.
Your patients don’t have time to wait.
Mark your calendar for CP-17761 – Peripartum Cardiovascular Health Disparities and How Physical Therapists Play a Vital Role across Settings!
This APTA-CSM session will take place on Friday, February 16, 2024 at 3pm.
This session will be available on-demand.
About the Speakers
Dr. Rebeca Segraves
Rebeca Segraves, PT, DPT is a Board-Certified Women’s Health Clinical Specialist and Certified Lymphedema Therapist who has practiced within outpatient, home health, and inpatient settings. She has served diverse populations in critical care, oncology, and inpatient obstetrics across three Level 1 trauma centers. She has extensive experience with optimizing function in the high-risk pregnancy population during long-term hospitalizations and following perinatal loss. In the acute care and home health settings, Dr. Segraves has worked with maternal care teams to maximize early recovery after delivery, including populations at risk for adverse cardiopulmonary events after cesarean delivery and obstetric critical care interventions. She is the founder of Enhanced Recovery After Delivery™, an obstetrics clinical pathway that maximizes pregnancy and postpartum outcomes with occupational and physical therapy before and immediately after birth. Her vision is that occupational and physical therapy will be standard of care before and after birth to optimize mental and physical function around the globe.
Connect with Dr. Rebeca Segraves on Pelvic Health Network.
Dr. Jenna Segraves
Jenna Segraves is an Assistant Professor and a Board Certified Neurologic Clinical Specialist in Physical Therapy. She graduated with her Masters in Anatomy and Clinical Health Sciences from the University of Delaware in August of 2014 and her Doctor of Physical Therapy in December of 2014. Her clinical practice involves a wide variety of settings and populations including outpatient orthopedics, outpatient neurology, and acute care with a focus on neuro/trauma diagnoses, critical care, the emergency department, and inpatient obstetrics. Dr. Segraves is passionate about expanding physical therapy services to the emergency department to optimize patient function/safety and reduce overall hospital costs.
Connect with Dr. Jenna Segraves on LinkedIn.
Dr. Katherine Sylvester
Katherine Sylvester, PT, DPT graduated with her Doctor of Physical Therapy degree from The Medical College of Georgia in 2010. She spent the first decade of her career in an acute care setting where she worked with patients in the neuro, med/surg, ortho trauma, cardiac and pediatric ICUs, as well as in the equivalent units on the regular floors. She also has experience with hospice and has a private practice where she works with clients in their homes and in the community. In 2014, she began working with women with pelvic health disorders. Since then, she developed a continuing education course to teach healthcare providers and students how to comprehensively treat birth givers and founded Operation M.I.S.T.™, a monitoring program that utilizes wearable technology to prevent perinatal mortality and morbidity. Dr. Sylvester is committed to providing birth givers with the team, resources, education, and advocacy they need to avoid unnecessary complications.
Connect with Dr. Katherine Sylvester on Operation M.I.S.T.
Dr. Allyson Sutkowi-Hemstreet
Allyson Sutkowi-Hemstreet, PT, DPT is a Board-Certified Clinical Specialist in Cardiovascular and Pulmonary Physical Therapy with clinical practice experience in outpatient and inpatient settings. She is a current Duke DPT Faculty Development Resident, a Medical Instructor, and a Duke Teaching for Equity Fellow. Dr. Hemstreet routinely treats patients with complex medical & surgical, orthopedic, cardiac and/or pulmonary conditions. She is passionate about health equity and reducing racial disparities, particularly in the cardiovascular and pulmonary realm. Her focus as an educator is entry-level DPT curriculum relating to acute care, patients with complex care needs, as well as those with cardiovascular and pulmonary conditions.
Connect with Dr. Allyson Sutkowi-Hemstreet on LinkedIn.
Transcript
Elise – @TheOncoPT (00:01.078)
Hey, OncoPTs and welcome back to this episode of the OncoPT Podcast. We are continuing our CSM preview sessions with another wonderful session that we actually kind of started this fall, but accidentally, and I’ll let you know and on a little more of that. But the session that we are talking all about tonight is called Peripartum Cardiovascular Health Disparities and How Physical Therapists Play a Vital Role Across Settings. And I’m super pumped because this first guest I’m going to introduce
is the one who kind of kicked off this conversation in the fall. And I’m so excited that she is back. So welcome back. Dr. Rebeca Segraves to the Onco PT podcast.
Dr. Rebeca Segraves, PT, DPT, WCS (00:40.222)
so happy to be here. So happy to be here.
Elise – @TheOncoPT (00:44.482)
So I’m gonna move on kind of across my screen here. So our next speaker that we have today is also a repeat guest, newly of the Onco PT podcast. And again, very excited you’re back. Welcome back Dr. Jenna Seagraves to the Onco PT podcast.
Jenna Segraves, PT, DPT, NCS (00:59.13)
Hi, Elise. Yes, my name is Jenna Seagraves. I’m so excited to be back. To give everyone who’s here just a little bit of background, my primary clinical background has been in acute care. And so that’s really where most of my experience is. And I am a board certified neurologic clinical specialist. So that’s the majority of the patient populations that I have treated. And I’m so excited to weave in how that is related to the peripartum population.
Elise – @TheOncoPT (01:27.302)
Oh my gosh. Welcome back, Jenna. We’re so excited you’re here. And now we have two new speakers to the Onco PT podcast that I am so excited to welcome for the first time. First up Dr. Katherine Sylvester. Welcome to the Onco PT podcast.
Katherine Sylvester (01:40.784)
Hello, thank you so much for having me. I am I was an acute care therapist for a decade and in the hospital I worked with patients with brain injury spinal cord injuries stroke and children and after having my first baby nine years ago really got into women’s health and a couple of years ago after my second one started looking at women in a more I feel more holistic way
than just incontinence and pelvic floor issues and posture and things like that, but really got down to organ systems, vital signs, like how can we really treat the whole woman mentally, physically, emotionally, socially? And so we’re so excited about this topic at CSM. Thank you for having me.
Elise – @TheOncoPT (02:28.398)
Oh my gosh, Katherine, of course, Katherine, you’re already pulling themes out that Rebeca talked about previously on the podcast. So I’m just, this is going to be such a nice continuation of that conversation. I am so excited. And then certainly last but not least, another new guest to the Onco PT podcast, Dr. Alison Sakaui-Hemstreet. Welcome.
Allyson Sutkowi-Hemstreet (02:48.555)
Thank you so much. You did a great job pronouncing my name. So I’m Alison Sakari-Hemstreet. My pronouns are she, her.
And most of my clinical practice has been in acute care, but all sorts of settings from oncologic populations, ICU, critical care, cardiopulm, post-op, med-surge, I’ve worked on the gerosike unit, orthopedics, I’ve been a little bit everywhere in the hospital. I’m a board certified specialist in cardiovascular and pulmonary PT.
And I care a lot about health equity. So those are some of the threads that have helped me get pulled into this group. But I think there’s always so much for us to learn when we talk to people outside of sort of our niche areas. So I love that aspect of this group. It’s been really positive and really educational already.
Elise – @TheOncoPT (03:47.746)
So I have to ask, who started this train? Like who set the snowball rolling down the hill to get this dream team together for the CSM session?
Katherine Sylvester (03:59.544)
Dr. Rebeca Segraves, she gets every snowball rolling. Yes.
Dr. Rebeca Segraves, PT, DPT, WCS (04:03.086)
That would be me.
Elise – @TheOncoPT (04:07.177)
That doesn’t surprise me just based on what I know.
Dr. Rebeca Segraves, PT, DPT, WCS (04:10.782)
At least though, it shouldn’t, right?
Elise – @TheOncoPT (04:14.538)
Definitely not.
Dr. Rebeca Segraves, PT, DPT, WCS (04:19.015)
Yeah, no, after you hear a dream team like that is, to me, it’s just like their bios, their intros introduce themselves, they introduce why we need this kind of team for this population. Right?
Elise – @TheOncoPT (04:32.606)
Absolutely.
So I’m gonna keep going with, yeah, go ahead.
Allyson Sutkowi-Hemstreet (04:36.579)
Yeah.
Dr. Rebeca Segraves, PT, DPT, WCS (04:38.758)
Yeah, so I did, yeah. So I did get the ball rolling with this group. And what I found was that the topic really, honestly, just kind of like presented itself. We were presented with an opportunity to do a talk that reached both acute care and outpatient therapists. And from clinical experience, we all have worked in acute care. We all have worked with patient populations who had a direct…
handoff, if you will, from an acute care standpoint to the home health or outpatient setting. What we decided to do with our background and our experience in acute care, and with populations, whether they were oncology, whether they were cardiology, cardiovascular pulmonary populations, whether it was musculoskeletal, was we decided to focus on a population that does not get that handoff, right? From an acute care setting to that patient population also being followed up in the home.
Elise – @TheOncoPT (05:10.958)
Mm-hmm.
Elise – @TheOncoPT (05:29.99)
Mm-hmm.
Dr. Rebeca Segraves, PT, DPT, WCS (05:37.826)
or the outpatient setting, right? And so we’re hitting this talk at CSM from an educational academia standpoint to DPT students, from the acute care setting to what we can be doing across that setting, and then to all patient settings. It’s in the title, right? Across all settings for this population. And we’re introducing this idea of a handoff for a population that’s being neglected at this time, right? The peripartum population.
Allyson Sutkowi-Hemstreet (06:03.347)
And I think just like one additional piece of that is like, this is a really complex multifaceted problem that cuts across settings and practice areas. And in order to think about.
effectively solving a problem like that, you really need a lot of different perspectives for that kind of systems level thinking. So it does not serve this patient population for us to be siloed. We really need to be collaborative and working across disciplines, across professions, across niche areas. So that’s one of the ways that I think about how we approach some of these really complex and interweaved, these wicked problems.
Elise – @TheOncoPT (06:46.126)
Mm-hmm. And I’m really glad you brought that up too, Allison. So just to give everybody a little context. So first of all, listener, if you haven’t listened to the interview I did with Dr. Rebeca Segraves this past fall, go do that ASAP right after this podcast interview because it was really, really good. And one of the things that we talked about that was a little bit of a, woo, mind shift for me is, you know, these patients come in and, you know, of course we know this, but sometimes we kind of forget about it or we gloss over it. Every one of our patients has a heart.
every one of our patients has lungs, right? Like it’s not just that in my case, they have cancer. Like they have cancer and they also have these other systems we need to be aware of. And a lot of that, especially, you know, being completely honest here, I neglected a lot of that kind of systems thinking, especially with my postpartum patients. And I don’t necessarily see a lot of pregnant patients in my current role and in my career so far, but I see a lot of moms.
And I see a lot of patients who have given birth and not once did I ever stop to think about the cardiovascular and the pulmonary impact that we can see in these patients. And so when I saw this session title, I mean, it was an automatic, oh, need to get them on the podcast ASAP. So Rebeca, I’m going to bring it back to you. Can you tell us a little bit more about your CSM session and kind of some of the things we’re going to go over in your session?
Dr. Rebeca Segraves, PT, DPT, WCS (08:18.686)
Yeah, so we’ll be starting off talking really about the statistics of the issue, right? Just to bring everyone up to speed, because I don’t think that many of us, even in academia, are bringing this information into the classroom and kind of enabling our students to understand of the cardiovascular, of the pulmonary issues specific to the pregnant postpartum population. In my DPT experience,
I had one day on this population. Whereas that’s not systems-based education, right? Because if you’re thinking about how we’re approaching DPT education, we’re approaching it from a systems lens. And this patient population has every system that’s been impacted. So we’re going to start off just with basic education that really our acute care, our outpatient across settings, therapists should know, and then give it in the context of
where we are as a nation in terms of maternal health, you know, so that they’re just familiar with gaps in care that we can be filling from the hospital to the home to outpatient clinics, all of it. Then we’re going to actually get into case studies. And that’s where I’ll pull in kind of some of my colleagues to kind of flesh out some of the education that we’ll be giving there, because I think it’s really powerful that
we have a speaker with us on the panel that not only works with this population as an acute care therapist, but that will be sharing her own story of preeclampsia and then coming back to the hospital as a readmission, not once, but twice a lease. And so people will actually see the continuum of care of what this population is actually encountering in some cases, not all, but in those cases.
how we could actually be filling that gap in care in the first six weeks, not after. And so I think I would pass it on to Dr. Sylvester to kind of fill in a little bit of what we want the audience to take away when we’re presenting this information.
Katherine Sylvester (10:28.408)
So what we want them to take away is that the things that happen to women, to birthgivers, during pregnancy and following delivery will continue or can continue to have a negative impact decades later if they’re not taken care of right away. So in my case, I had preeclampsia as well, but it happened postpartum. And so just like you said, I was already a mom.
Elise – @TheOncoPT (10:56.558)
Mm-hmm.
Katherine Sylvester (10:58.382)
things that I wasn’t prepared for as a physical therapist, but because of the knowledge that we have and some of the things that I had to research, you know, I was able to recover kidneys, blood pressure issues, and just in reading that 10 years down the line, someone with preeclampsia has a risk of chronic kidney disease, and years after that of stroke and congestive heart failure. And so if we are encountering women during this time, we should
into those issues because they may not be aware of how stress, diet, the way they’re moving, their environment, their work responsibilities could be impacting their health. And when we talk about collaborative care, I love that Dr. Allison brought that up. You know, it is not just that people need physical therapy, but they also need cardiologists, kidney doctors, social workers,
Katherine Sylvester (11:58.242)
social workers, their community-based organizations, resources that…
I’ve heard there are so many women now, and I can’t believe it, that they have been told by their doctors, you have broken heart syndrome. Their heart rates are through the roof, blood pressure really high after they’ve experienced a loss. And the doctors don’t look at them and say, let me put you on blood pressure medication. They look at them and say, let’s figure out how we can get your nervous system back under control. And so we just have to start being aware of those things and how we play a really integral role,
Elise – @TheOncoPT (12:26.582)
Mm-hmm.
Katherine Sylvester (12:34.13)
because they see us, but because we’re some of the people that are following up with our patients between visits. And I don’t even call my mom’s patients. We remotely monitor them using a smart device through Operation MISS, so that’s the name of my company. But MISS stands for monitor, intervene, survive, and thrive. And it really is in the relationship building that we’re really able to make the biggest impact. And we’re the ones doing that. Three years down the line, someone is saying, wow, my blood pressure shot up. Three years later.
and we’re able to get them help because we stayed connected. So I think that we do that better as a profession than anybody else, honestly.
Elise – @TheOncoPT (13:13.846)
That gives me some really nice warm fuzzies. All right, Jenna, keep going.
Jenna Segraves, PT, DPT, NCS (13:18.438)
Something else that I’m really excited about this presentation that I think others will get some really great information is that it’s not just for the practicing clinicians. It’s also for the educators in the audience, and it’s for the students who are there as well. And so some of the things that we will also do as sort of a deeper dive is figuring out, well, what are the current barriers? Why is this a population that we just don’t really have a lot of information about? Why is it not taught more in school?
Why is this not something that therapists come out just feeling really comfortable working with this population? And then not only what are the barriers, but we’ll also give some ideas of how to bypass those barriers and what we can do to actually improve the future of our profession and help improve the recovery for this population. So that I think is another really big piece that people will walk away from this talk.
Elise – @TheOncoPT (14:19.694)
So I’m going to pull back to something that Katherine said previously, which was I had no idea that genuinely that these patients who have given birth can experience such long standing complications and risk of these complications when it comes to cardiovascular and kidney issues. And again,
I learned live on air, y’all. My listeners know this. But now I’m even more mind blown because some of my patients, again, who are mothers who have given birth, are on cardiotoxic chemotherapies and are on nephrotoxic treatments. And I’m just kind of mind blown about…
Oh my gosh, there’s this whole other series of layers to what these patients are experiencing even before they get to me and they’re on the Cardiotoxic Chemotherapy and the Nephrotoxic Chemotherapy. I mean, I’m a little mind blown right now and it just highlights how important this session is and how badly I need to attend so I can learn this information. So we’ve obviously set the stage for how important this is but I kind of want to go into
Why now and why this CSM session? What is kind of, I mean, this is obviously very important, but what is kind of the urgency or the thought process y’all had behind, why do we need to present this at CSM this year?
Dr. Rebeca Segraves, PT, DPT, WCS (15:53.726)
I think that’s an excellent question. I think for me, I was going off of what the lessons learned from the last two CSMs when we presented on similar topics, but very like focused on the patient’s journey within the hospital. And they’re just, the audience left me honestly with a deeper understanding that I really needed to follow this patient’s journey beyond the hospital setting.
right? Because there were these long-standing issues that even I wasn’t familiar with. I had never treated a mom on ECMO or a mom with an LVAD or a mom in the ICU until I was in it and then realizing, wow, I’m sending them home, but are they going to have the same access to home health therapy as my other patient populations?
Are they gonna have the same access to an outpatient therapist who’s not necessarily a pelvic floor PT, but someone who can really understand the systems that are being affected by just maternal care, by a newborn care, by caring for other children, will they be given that person who also understands body systems as a whole of how pregnancy and postpartum has affected them, right? Because…
I was an outpatient PT before all of this and I treated primarily oncology. And I learned so much beyond my pelvic floor training, right? Just by being immersed in that patient population and their experience. And I couldn’t find providers like that. So I realized from the first two CSM presentations, this presentation, this CSM, it had to be different and it had to include a broader team.
someone who was specialized in cardiovascular and pulmonary diagnoses, someone who was on the frontline monitoring moms in their home and following up with them and communicating with their care team. We have a doula on the panel this year. We didn’t even mention that. We have a doula presenting with us at CSM whose work a lot of it is with perinatal loss.
Dr. Rebeca Segraves, PT, DPT, WCS (18:05.646)
and grieving and supporting that person on the care journey, no matter what birth experience they had. We have Jenna, who’s worked in academia and worked with students. I mean, this panel is so dynamic and it’s just representative of a person’s experience no matter where they are on their care journey. And so it gives a touch point for everyone in the audience to take a role, to have a seat at the table.
Jenna Segraves, PT, DPT, NCS (18:30.926)
Elise, I loved your question about like, why now? You know, what’s the urgency? And to be honest, I feel like, well, this really should have happened decades ago. You know, I feel like we’re actually late. It’s not, you know, it’s not necessarily an urgent, it’s urgent because we’re late. We’re late to this. And this really should have been brought up. It should have been on the forefront for years, for years and years.
Elise – @TheOncoPT (18:44.171)
Yeah.
Allyson Sutkowi-Hemstreet (19:00.251)
Can I add one thing? I was just, I was thinking about this, that issue of sort of urgency and like the same with me. I don’t feel like I was exposed very much to this topic in any aspect of my training. And I think that is just, it’s beyond a shame. Like this is a huge issue. It is rife with inequities and we are not.
Elise – @TheOncoPT (19:01.694)
Yes, please do.
Allyson Sutkowi-Hemstreet (19:27.263)
engaged in it deeply as a profession. And that is wrong. And we have an opportunity, there is so much potential for us to think about all the ways that we can contribute to this really serious health crisis. And, you know, we are a profession where we can position ourselves to help mitigate some of these huge health disparities. And we are doing it in sort of fragmented here in their ways, but like,
think about what Dr. Sylvester does. Her work is literally groundbreaking. It is mind blowing. She is saving people’s lives. And we don’t think about ourselves like that as a profession, out in the community, right? We might think about that maybe on the hospital side, but not out in the community. But that work is so impactful. And I just think about, well, if we’re not talking about it as a profession,
How many other people might be in the audience who are like, well, God, I could do that. How many people have we yet to engage on this issue? And that’s why a big platform at CSM is really powerful. It’s a huge opportunity to connect with people who might just same thing. They might get their minds blown and be like, God, I never thought about that, but why the hell can’t I do it? Sorry, I probably shouldn’t say hell in your podcast, but.
Elise – @TheOncoPT (20:48.662)
Oh, you can say that on this podcast. 100%.
Katherine Sylvester (20:53.6)
And I was just gonna say, thank you, Dr. Allison. I was gonna say too, why now? Because women are dying. They’re dying from cardiovascular issues 35% of the time. So the maternal mortality review committee came out with their report. Cardiovascular issues are right at the top. And then there is infection and there is bleeding too much following delivery. And we know that with all of those things, vital signs are tied to them.
Katherine Sylvester (21:23.414)
We know the implications of someone walking around with half of the blood volume that they would normally have and yet taking care of three or four children in addition to their newborn. We know those things. And so the answer, the solution to the problem is really low hanging fruit. And I think that the reason the audience should be super excited is because a lot of PTs are women. So yes, we’re learning this as students, we’re learning it as physical therapists, but we’re also learning it for ourselves.
so that if it takes forever for the system to be fixed, then we can do what we need to do to protect those that we know and everybody else that we touch or that they touch, and then also to protect ourselves. So thank you all.
Elise – @TheOncoPT (22:10.646)
That might be your clip from this episode. And again, continuing on that.
We don’t have to wait for this. I would love for the system to be fixed. I would love for our healthcare systems to be fixed. But also I think we in PT are very acutely aware of how broken the system is and how many patients of ours fall through the cracks. And what a great opportunity to fill in some of those gaps, or at least kind of like help catch people as maybe they are falling through those cracks. I may not, as an outpatient therapist, I may not see patients in the hospital.
but they may wind up in my clinic.
and they may wind up seeing me or someone else in the community who can maybe start to catch those things. And Jenna, I know we already talked about this in our other interview, but I just want to kind of like hype y’all up a little bit. So I went to my very first CSM in 2016 and I happened to wander into an oncology session and there is literally Elise pre-CSM and there is Elise post-CSM And it was literally that session. It was the first session of the very first day of CSM.
and never looked back and was like, this is exactly what I’m doing with the rest of my life. And I bet there are going to be some people who show up to your session and who have the exact same experience. And that makes me really, really excited for this.
Jenna Segraves, PT, DPT, NCS (23:37.966)
I think it’s safe to say we all share in that excitement, Elise. Yes.
Yes, we need a larger team. Currently, there are five of us in this room. There are six of us at the talk. That’s not enough. We want everyone to join the team, and we want everyone to get on board and just recognize the important work that really we as physical therapists can play with this population.
Dr. Rebeca Segraves, PT, DPT, WCS (24:12.666)
Elise, you just gave me goosebumps. Really, I had the same, I do. I have these recollections of just attending a conference and just the one talk, and I can just remember the one talk from a conference that set off this domino effect. And it makes me realize, I’ve taken what, CPR training every couple years or whatever, to keep up my certification. I remember one,
Elise – @TheOncoPT (24:34.352)
Mm-hmm.
Dr. Rebeca Segraves, PT, DPT, WCS (24:43.082)
uh, like class in particular, the person was talking about the first time they saved someone’s life, you know, like it was a EMT by background. He was teaching the CPR training. He was talking about how it felt to save that one person’s life. And I go back to time and time again, when I’m presenting, right. And either it could be in front of a, you know, a class.
of DPT students or at CSM. And I almost feel kind of like this, like responsibility that I have to set the standard because this topic is so new. Like I have to set the standard and I have to get everyone on board. But I go back to that talk with the CPR class and the EMT that was talking about the one life he saved. And I think if I could get one person to save one person’s life, that made this worth it.
I don’t think I really am trying to at CSM with this dynamic of a team change the world. I think that would be a lot on our plates and I really don’t like to burn people out who are so needed in our profession. But if I could have a team like this affect one person in our audience to say, I’d like to help, I’d like to change and impact care for this population, we’ve done our job.
Elise – @TheOncoPT (26:12.742)
Oh my god, that makes me so happy.
Katherine Sylvester (26:13.712)
I love that you said that. I know, I know, because I was just thinking about just how easy it is to do what we do when we look at it from a team standpoint. So the other day a PT text me and said, I’m working with a lady, she has really high blood sugars. Her doctor that she has access to is only in the office once a week and they forgot to write the prescription for her insulin. And so she was going to go to the ER
because she has four children and she has to work. And so I looked at the text message and I immediately was like…
my best friend is an MD and she’ll take care of her. And I messaged my best friend and I was like, hey, can you possibly get this lady in today? And she was like, possibly, absolutely. And she said, have her call the office. I will get her in. She got her in, got her meds, got her taken care of. And I thought, this has gotten so easy over the years. Just build a team. I needed a pharmacist. My other very good friend is a pharmacist. I needed a kidney doctor. I know.
Elise – @TheOncoPT (27:13.934)
Oh my God.
Katherine Sylvester (27:22.859)
I had a PT monitoring me. It was like, as a PT, I know these people exist though. And I think about these other people who had she not wandered into Dr. Jessica Thompson’s office, then-
she wouldn’t have been able to connect her with me. And then I wouldn’t have been able to connect her with my, but it’s like, people shouldn’t have to land there. But can you imagine if they just landed on a bunch of PTs who came to CSM? Everybody’s going to be like, oh, you need that? Here you go. I mean, it can be so simple. It’s not us doing more work. It’s us doing what we would love to do anyway. We just have to be intentional about building the team and know who needs to be on our team when we need it.
Elise – @TheOncoPT (28:05.766)
You queued up Allison’s comment perfectly. Allison, I see it in the chat. Would you mind verbalizing that on air? Because that fits so nicely here.
Allyson Sutkowi-Hemstreet (28:17.124)
Well, you know, you said like our health care system is broken and there are some serious, serious problems, you know, and there are some serious things that it does not serve everyone equally, not even close. But we are the health care system. We are providers. We have a license.
It is on us. If you don’t like it, you can still be impactful. Look at how much Dr. Segraves has done as like one person. Right. Like you can make a big difference. And it is on us to be OK to feel the weight of that responsibility. It is not OK for us to say, like, well, that’s not like really my super special area or like, oh, I didn’t really learn about that in school. Like I’m done learning about that or what?
No, get involved, like this matters so much. And like Dr. Sylvester was saying, we need as many people engaged in this as we can, because that is how we are gonna serve this population best.
Elise – @TheOncoPT (29:25.846)
Man, y’all, I dream of the day when I can just be a fly on the wall during the conversations I know are happening as you’re preparing this session. My God, like incredible. So as we kind of wrap up, I want everyone to say what is one thing, what is one takeaway that you hope attendees come out of your session with?
Jenna Segraves, PT, DPT, NCS (29:58.526)
One thing I hope that attendees walk out with is the realization that who they are, where they are, whether they’re still in school, whether they’re one year out, 10 years out, 20 years out, is that they have the skills to be able to work with this population. But how do they best tap into it? And maybe it’s just coming to this talk and having sort of a simple reminder of all the things that are involved.
that you need to be looking at and looking into. That’s one thing that I hope they get.
Katherine Sylvester (30:35.448)
hope that they realize that anything they need to know is out there. All of the information is available. They just have to seek it out and then choose to apply it even if research or the system hasn’t caught up with them yet.
Dr. Rebeca Segraves, PT, DPT, WCS (31:00.118)
I think one thing that I hope people take away from is that they are not responsible for all of it. They’re just responsible for being a part of it. Right? And so instead of looking for the missing link, just owning your responsibility as a link really actually just teaches people to not put so much pressure on themselves.
but to really work within a team for any patient population, but specifically for those around the time they’re giving birth.
Allyson Sutkowi-Hemstreet (31:45.851)
I feel like this is a hard question for me because I think there are a lot of important pieces to this topic. And one of the pieces that I’m going to spend a little more time on is really thinking about how right in our talk, we’re talking about health disparities, we’re talking about the fact that this is not a problem that is equally prevalent.
Elise – @TheOncoPT (31:48.374)
Hehehehehehe
Allyson Sutkowi-Hemstreet (32:13.067)
in our population and we have to contextualize that information. And I think we can often do better at really being clear about these bigger pictures. We are talking about social determinants. We are talking about power imbalances. We are talking about root causes of health inequities.
and we see it all the way down at the end of the line in our patient care, but like, I really want people to think about groups that are at higher risk for adverse outcomes in this population, that is a consequence of racism. Race is not an independent risk factor for these outcomes. We live in a racist structure and a privileged and biased structures.
that do not serve all of our patients. And we are not victims to that. We can make it better, even if it’s in a small way, right? You really have to think about, you know, there’s lots of Venn diagrams about how do we think about ourselves and solving problems, right? What am I good at? What are my skills? What are my resources? And what work needs to be done? And thinking about.
Elise – @TheOncoPT (33:28.304)
Yeah.
Allyson Sutkowi-Hemstreet (33:37.535)
how can you position yourself and what you’re good at and what brings you joy and what is sustainable work for you and how you can contribute to some of these really distressing problems and be impactful in whatever way that is, whether it’s big or small, you can still make a positive impact.
Elise – @TheOncoPT (33:59.186)
Oh my God, y’all. This might be one of my favorite CSM preview sessions I’ve done. Like, whoa. Okay, when is your CSM session so everybody can mark it on their calendar ASAP?
Allyson Sutkowi-Hemstreet (34:02.339)
long answer to your question.
Dr. Rebeca Segraves, PT, DPT, WCS (34:23.671)
Yeah, Friday, February 16th at 3pm.
Elise – @TheOncoPT (34:27.37)
like the perfect time. I feel like y’all are just gonna like bring down the house and shut out Friday on such like a powerful note. And then last question, is your CSM session going to be available on demand?
Allyson Sutkowi-Hemstreet (34:27.951)
Don’t miss it.
Jenna Segraves, PT, DPT, NCS (34:41.732)
Yes.
Elise – @TheOncoPT (34:44.562)
even better. Holy cow y’all this was such a wonderful episode. I’m so thrilled that I got the four of you on here and if the four of you are this awesome I cannot wait to hear from the other speakers at CSM because I feel like I can’t even comprehend at this point just how like
Dr. Rebeca Segraves, PT, DPT, WCS (34:44.966)
Yes.
Elise – @TheOncoPT (35:05.07)
powerful these two hours are going to be that y’all are going to have. So, whoo. Okay. Last thing, and I know I didn’t actually prepare y’all for this question. If there is someone listening out there who is like, man, these people are really cool. Where can they connect with you or follow you on social media? If you’re on the social medias.
Dr. Rebeca Segraves, PT, DPT, WCS (35:31.09)
For me, Rebeca Segrave’s Pelvic Health Network is where I hang out most of these days, and that’s on all platforms.
Jenna Segraves, PT, DPT, NCS (35:44.926)
Jenna Seagraves, I don’t have a very exciting thing to share, but I am on LinkedIn if anyone would like to connect.
Elise – @TheOncoPT (35:53.098)
Love that.
Katherine Sylvester (35:56.064)
that Operation MIST on all platforms.
Allyson Sutkowi-Hemstreet (36:06.332)
I am on Twitter. I don’t even know what my Twitter handle is because I’m not cool. And I think it has like 400 letters and numbers on it. But I’m also on LinkedIn and you can always email me. I work at the University of Minnesota. My email is up on their website. So yeah, reach out. Come talk to us.
Elise – @TheOncoPT (36:09.687)
Hehehe
Elise – @TheOncoPT (36:25.742)
Perfect. And I will link to all of those in the show notes too, so that way listeners have a place where they can go to and find all of that.
Oh my gosh, y’all, this was so wonderful. I’m so thrilled that I got you on the podcast. I cannot wait for your CSM session. Again, it’s happening Friday, February 16th at 3 p.m., the three to five session. It is going to be the best way to close out your Friday of the conference. So make sure, mark your calendar, put it on your CSM app calendar that we have, and I cannot wait to see y’all there. So thank you, each of you, so much for coming on the podcast today and talking about this
very important topic.
Allyson Sutkowi-Hemstreet (37:07.945)
I know you’re trying to close this out. Can I make one other comment? I’m a slow thinker. But like, can we talk about how diversity and representation matters? Because this topic
Elise – @TheOncoPT (37:09.879)
That’s fine. Absolutely you can. Please do.
Elise – @TheOncoPT (37:21.046)
Yes!
Jenna Segraves, PT, DPT, NCS (37:21.685)
Mm-hmm.
Allyson Sutkowi-Hemstreet (37:25.663)
wasn’t at CSM 20 years ago because our profession is slowly and gradually diversifying itself in different ways. And that is one example of like, if we don’t intentionally bring diverse perspectives into our profession, we are losing out and it is a patient care quality issue.
Jenna Segraves, PT, DPT, NCS (37:33.883)
Yes.
Allyson Sutkowi-Hemstreet (37:53.931)
So let’s keep working on all the other DEI efforts across the profession because it matters for patient care. If you don’t care about it for your social or political beliefs, it matters for patient care. And this is a great example of that.
Elise – @TheOncoPT (38:01.566)
Yes. Yes it does.
Elise – @TheOncoPT (38:09.814)
Yes.
Dr. Rebeca Segraves, PT, DPT, WCS (38:16.07)
Drop the mic on that, yes.
Jenna Segraves, PT, DPT, NCS (38:16.302)
I think Allison has two mic drops actually during this.
Elise – @TheOncoPT (38:21.17)
Y’all have made it very hard on me. I’m gonna have to go back through and listen too because there were so many clips of just mic drop moments in this interview that listen, it’s a good problem to have, but each one of you at some point, I was like, oh crap, I need to be making notes. Like, I’m gonna have to go back and listen to this and find all these clips again. Oh my God, Alison, thank you for ending on that. I think that’s a perfect way to end the interview. And again, you know, it’s for our patients, y’all.
We are the healthcare system. Let’s make this happen. There’s no excuse anymore, period. Thanks guys.
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