Rehabilitation Counseling

Need Help in Telling Your Client’s Story? Here’s One About Bowling & Rehabilitation!

Reading Time: 5 minutes

My husband Randy had his cardiology checkup clearing him to see the doctor every two years now. Thankfully he only had to make visits for a little over three years following his cardioversion and rehabilitation.  

As you may know, anytime work is done on any electrical system there’s a chance something could go awry. Keep track of your system(s) to lessen that chance. Here’s a personal health story which all began with bowling.

2015-01-23 Botkin Bowling Ball

Botkin’s Black Ebonite Bowling Bowl 

I was on a business trip in Mason City, Iowa, providing vocational rehabilitation services to U.S. military veterans with my favorite chauffeur Mr. Botkin during the summer of 2013. On the way out of town we stopped at the Rose Bowl for a little entertainment. There’s a tendency to drive around even hundreds of miles with our bowling balls and yes, safely in the trunk. Ya never know when the mood to bowl strikes!

Randy’s bowling style stirs up quite a racket, especially when his ball wipes out all 10 pins! His posture at the end of his follow through looks like he’s ‘a hoppin’ on one foot ballerina! Along with the noise that emits from his vocal cords and Botkin embroidered on his shirt above his heart, he’s a down right bowling man!


10 pinsI’m more of a slow and steady bowler, aiming for good form, keeping the ball lined up with the directional arrows (the concept similar to how I prefer to golf too) and hope for that distinct feel knowing next will be noise of scattering pins! 

I’ll take any knocked down! I want to let you know one of my dad’s first jobs as a youth was a bowling pin setter in the times before automation in the alley! 

On this summer day Randy and I bowled a couple games and enjoyed the time! I don’t remember scores, and don’t care! Okay, fine I’m sure his score was better than mine.

A few days after the trip, Randy’s neck was tilted. Questions about how he felt and the reason as to why the askew head revealed no valid answer and no comprehension he was even guarding his head. Then came complaints of “feeling out of wack.”

I took his pulse and ahhh…, felt gaps of time before the next beat, and those beats I could feel were not the same strength.  I swear his heart was skipping a beat (and not because he is sooo in love with me), and realized his timing was off (literally)! Randy made a visit to our family doctor who referred him to a specialist. Low and behold came the diagnosis of atrial fibrillation.

Randy went through several tests and was placed on Warfarin with INRs regularly taken. Nutritionally, he had to avoid sources of vitamin K (and I love blueberries and kale!), take good care of his health and not miss any medical appointments!

This is just like my dad, who has chronic AFib. They shared stories about their health. How’s your INR? Pretty darn good, what about you? Well, I could lower it a point or two…! My dad actually does his own INR testing.

Related imageKale, A Superfood!

Dad “can’t eat” kale, but Randy sure missed eating kale, and loves it now (not true!) Back to the summer of the “heart scare”, I remember Randy wearing a holter monitor strapped to his chest. The day it went off with a loud bang (not true either!) we were at an outdoor wedding (very true! and it was hot too)!

It was determined Randy would need to have a heart restart. OMG. He had a cardioversion procedure performed on September 20, 2013. I will never forget waiting and waiting patiently for the patient at Iowa Lutheran Hospital trying to read but not being able to focus on the words in front of me. Finally the nurse came out (the procedure really wasn’t that long) and said I could see him. I couldn’t wait any longer!

I quickly entered the procedure room and saw Randy lying on the table groggily repeating “Did she do it?” “Did she do it?” Dr. Clark, replied, “What are you talking about?” Randy muttered again with some sort of humor (funny man) in his voice, “Did she push the button?”


No I did not push that button. But if he continues to make fun of my bowling posture…and my scores…I might reconsider...

The bottom line of this blog is to be sure to pay attention to signs and symptoms of your health and listen to your body.  People’s bodies do a good share of expressing to its’ owner it’s need and desire to be in balance.  

When your body is out of balance, it will tell you and people who care will notice. Listen to it. Listen to others. Do what you need to do to restore your sense of balance. I can offer recommendations!

Thankfully the cardioversion worked and Randy’s been back in the rhythm ever since. There’s no rhyme nor reason why his heart decided to act up. Frankly, I love to check Randy’s pulse and his heart is really strong!

He brags remarking his blood pressure is perfect (a quote from the nurse!) The beater is good to go for a long, long time! Rehabilitation was successful! (Ahhh, update, Randy had another cardiac scare in November of 2017.)

I could also blog about my son Nick and his blood pressure problems (thankfully much improved; he’s on long-term medication); and my mom’s blood pressure health which is good but needs watching.

Or I could blog about Randy’s dad’s serious heart condition (which ultimately took his life while asleep in 2005). But instead I’m going to end with saying to my readers including my husband of course!,  “I love you with all my writing heart. Please take great care of  your systems and yourself!”


Eating Tip of the Day: Pistachios are Heart Healthy

Let me know what I might do to help with educating your client; or better yet, let me educate others about your client by writing his or her story!

I love to help with litigation regarding work and disability and know it’s incredibly helpful to tell your client’s story in a meaningful and truthful way. I also believe in exercising, eating right and balancing! Give me a call at 515-282-7753 and let’s discuss your case. I offer free initial consultation!


 My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

FCEs and Heart Rates…Where’s the Cardiologist?

Reading Time: 2 minutes

Recently, I read a cover letter accompanying a Functional Capacity Evaluation (FCE) signed by a person with an Ed.D., CRC. In the letter, he writes Ms. So & So “never raised her pulse to an acceptable level of aerobic work of which you would expect to see with lifting activities.”

What’s Up With That?

Recently in one case I noticed the Independent Medical Exam (IME) doctor reviewed the same case file material I did, including “opposing FCEs”. In this case, the physical therapist (hired by the defense) specifically pointed out a “flaw” in the opposing PT’s FCE (hired by the claimant.) I saw this “flaw” as significant considering it made sense to me, however the IME doctor didn’t mention it.

Again, Huh? Who’s Missing Something Here?

I decided to do some research…..and contacted a local physical therapist. This PT educated me that heart rate does not have any practical use in determining level of effort on behalf of the claimant during an FCE.

The therapist educated me more by telling me that he has not been able to find any reference to heart rate as a measure of effort aside from the assertion that “minimally” increased heart rate correlates with minimal effort, “moderately” increased heart rate correlates with moderate effort, and “significantly” or “excessively” increased heart rate correlates with maximum effort.

Me? I’m Working to my Maximum!

Many factors other than effort affect heart rate such as stress, physical conditioning, and medication; and that failure to account for these factors makes use of heart rate unusable as an index of effort.

The therapist continues, “These general descriptors lack any sort of scientific support and there is no formula offered for determining what constitutes minimally, moderately, or significantly increased heart rate. While the measurement of heart rate is objective, the interpretation of heart rate by the evaluating therapist and how this correlates to the client’s level of effort is completely subjective. Furthermore, there is a complete lack of published research which correlates heart rate to effort level during functional testing.”

The only way to determine maximum heart rate is to conduct a maximum exercise test under the supervision of a cardiologist. Do you know any PTs who are also cardiologists??

Although measuring physical capacities in an individual is helpful in return to work situation, how about also gathering details about the person’s health condition in general, and how that may or may not relate to a successful return to work?


My professional rehabilitation counseling practice is focused on helping people find a place in the workforce.


Vocational Resources Plus, LLC * * 515-282-7753  *

Wakin Up Without the Rooster!

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I’ve broken a personal record. I finished four weeks of exercise boot camp. But that’s not the record…drum roll sound please…The record is: I’ve arisen out of bed for all those days at 5 AM! Can you believe it! And now, alas, I wake at that time without needing too. I sure see the goodness in early rising.

Rise and ShineBut I do like to sleep! 

I just paused as I’m writing this in the wee hours and contemplated something I hadn’t completely contemplated before. I don’t use an alarm clock. Do you? My kids are pretty bad at getting up (teenagers, give em break!). Randy is better than me at getting up. But nope, no alarm needed by either of us.

Rooster crowingWhy is that? Because we are a lot like roosters!

Waking up at the same time each day has to do with your biological clock or your circadian rhythm, and the hormones and proteins swimming around in your body. It also has to do with what your body (stomach, brain, etc.) is processing. And what you eat before you go to bed (stay tuned for more on that!) is equally as important to getting a great night’s sleep.

I’ve blogged about my dad (and Randy) both having early morning paper routes. My mom always gets up early. I also remember my grandpa (her dad) told me he always got up at like 4 AM. And Randy’s grandpa and grandma (Cliff and June Yearington, Randy’s mom’s parents) for sure, considering they were Iowa farmers, got up early and worked hard all day.

Randy recalls how his grandma June would grab a chicken early in the morning, wring it’s neck, prepare it and cook it…..all in time for her husband to come in from the fields for lunch. Wow.

Frozen Waffles

My grandma made me frozen waffles for lunch!

Sleep is fascinating. Waking up on time is just as fascinating! So, keep time on your side. Get up on time, be on time, and spend some great quality time wherever you are and whatever you do (at work or at play!)

Happy Memorial Day!

And Happy 17th Birthday To My Beautiful and Talented Daughter Arin (who wishes she could get in more sleep….me to…for her that is.)



My professional rehabilitation counseling practice is focused on helping people find a place in the workforce

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Exercise and Conditioning Help You Heal…Try Rebounding!

Reading Time: 4 minutes

I have blogged in the past about motivators and touched on a physical fitness course I took in my final semester at Iowa State University. This was the spring of 1995. In the course, we focused on conditioning and exercise techniques through personal fitness.

The course taught me a lot, especially to be humble, to not worry about how you look, and to work your hardest.  This is all in consideration that I was the oldest in the class, had to pump the milk out before I did anything, and certainly had the most outdated exercise clothing. But I was not the slowest or the weakest!

Looks just like me back then; even today!

I work with people who are either released to work [following an injury] or are still striving for maximum medical improvement. I know it’s hard to be patient [and a patient] during the recovery process following an injury. It may seem as though your body will never be the same…..but it will, trust me, if you work your hardest.  In fact, your body can become stronger and better than before an injury.

The role of exercise and conditioning is incredibly beneficial when healing your body from an injury.  It is important to do what it takes to reach the goal MMI. A vocational rehabilitation program needs to incorporate a well-balanced exercise plan for the patient.  In fact, the healing benefits of exercise are well-known and should never be overlooked.  Following is a list of benefits of exercising (I’ve had this list for awhile and do not have the original source!), please… on!


1. Exercise increases the blood flow to the injury, which increases oxygen flow to promote healing. It also sweeps some debris away from the injury site and brings in immune-system cells to clean up the rest.

Water Aerobics!

2. Exercise keeps neighboring joints limber. Another healing benefit of exercise is that it keeps an injured joint or the joints surrounding a sprain or fracture moving, which prevents the body from creating excessive scar tissue. Scar tissue can anchor a joint in place, causing permanent stiffness. Exercising to keep joints limber and scar tissue at a minimum is especially useful after a marathon or other high-intensity exercise. 


3. Exercise prevents muscle atrophy. When we injure a joint or limb, we tend to avoid using it until it’s “healed,” but keeping the muscles surrounding the injury in shape are as important to the healing process as setting a bone or reducing swelling. Keeping the surrounding muscles in shape can also eliminate the need for a brace or splint.    

4. Exercise can also help wide variety of chronic conditions. Exercise can help prevent chronic conditions like heart disease and diabetes and can also help keep these conditions from getting worse. A good exercise program for a chronic condition will include cardiovascular exercise to strengthen the heart and strength training to increase endurance. Benefits of exercise, both cardiovascular and strength-building, include burning fat, which alleviates unnecessary strain on the bones, muscles, and joints.

5. Regular cardiovascular exercise strengthens the heart. A benefit of exercising the heart is protecting it against heart attacks and other complications. Overall, however, those who get regular cardiovascular exercise have a lower resting heart rate, which helps prevent damage to the blood vessels by allowing the blood to move more freely through the system. Both cardiovascular exercise and strength training improve circulation in all parts of the body, decreasing the risk of heart attack, stroke, and even impotence. Exercise also improves balance and coordination, which are crucial to preventing a fall and the injuries a fall can cause.

Brisk Walking!

The healing benefits of exercise inspire the body to heal itself more quickly and stay in the game for another round. Even gentle exercise (walking, yoga…more on in a future post….) while recovering from an injury or illness can speed up healing and bring you back stronger than before.

Of course, it’s always recommended to talk to your doctor before starting any exercise program. It’s great to team up with people who also want to exercise….and you’ll find additional benefit through having new friends!

My role as a health educator allows me to help you and your clients (mine too) in many ways. Contact me for more information! Also, if you need a life care plan for your client, I will likely include some sort of exercise plan and the costs (if any), of such to help your client continue rehabilitation efforts. Oh, yoga, is a personal favorite and I couldn’t exercise without including yoga!


My professional rehabilitation counseling practice is focused on helping people participate in the world around them, particularly in their own world of work.

* Vocational Resources Plus, LLC  * *




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Fall 1994, ISU and a New Baby Boy…Life!

Reading Time: 3 minutes

Back on March 12, 2012, I wrote about How My Past has Brought Me to The Present! Part 18 ~ The Student with 2 Brains.  I am continuing the story….stepping further back into time.

Jacob Alan entered our world on Friday, August 19, 1994. My fall semester at Iowa State University started on Monday, August 22, 1994. I sooo wanted him to be born on his due date, but alas the 8 pound 10 ounce bundle of joy took his dear sweet time arriving – being 10 days over due.

We thought new baby Jacob resembled Winston Churchill (tho much cuter)

Needless to say I was a bit preoccupied the first couple of days after giving birth….so…on August 22, new father Randy traveled up to Ames to fill in for me, explain the situation and to get syllabi for the 12 credits I had registered for. Thank you Randy!

I returned to class (yes the walking with a healing episiotomy, fun!) on Tuesday, August 23, 1994.  I was a breast feeding mother (with lactating breasts 4ever filling up). This  made college life interesting.

My little insulated bag, along with my heavy backpack. No leaving home without either!

 I would pump and study at the Farm House. I just did some research and found out the Farm House was the first building completed in 1861 on campus.  It certainly was my sanctuary!  

Jacob loved his milk….and he would kill me if he knew I just wrote this….I highly promote breast feeding!!!

Image result for images breast milkGood Stuff Maynard!  

The course work I took that fall at ISU included: School Health Programming, Health Promotion, Aging & The Family, and Principles of Public Relations.

For the Health Promotion Course, I designed a newsletter titled Baby Basics.  I had plenty of first hand knowledge to share with the 20 year old kids in class.

I will continue on next week with my fall semester at ISU.  Another reason (besides recycling old papers) for my writing is to relearn from myself and to share with you my views on health and education.  I hope you enjoy reading my writings. Let me know if I can answer any questions for you or help connect you with health or educational resources!


My professional rehabilitation counseling practice is focused on helping people find a place in the workforce.