OCS exam

I am finally finished my exam!  Yipeeeee!!!

To back up, because I know it's confusing, this was the OCS exam to become an 'Orthopaedic Certified Specialist'.  For me, passing the exam would be a great personal achievement because it is a nationally recognized title in the USA.  I started a fellowship in manual therapy in Canada and completed 3/5 of it, gaining the title of 'Resisdent' or RCAMPT, but that means nothing in the USA, and will become meaningless in Canada in the upcoming years also.  I finished the 4/5 part here in the USA, but completing the whole fellowship process would have been extremely expensive and difficult.  There are not a lot of manual therapists in the Boulder area, which has been a real disappointment for me as a PT since moving here.

So this exam seemed like a great plan B.  A way to get recognition for all the courses I have done, without doing a full expensive/intensive fellowship program.

Paying for membership dues and exam fees amounted to about $2000, of which my company paid $1000.  Then I had to decide what material to study and if I would take a formal prep course.  I decided to study on my own from two resources: 'Secrets of Ortho PT' book and an at-home study course called 'Current Concepts in Orthopaedic Physical Therapy'.  These cost about another $750.  The first book was full of  a lot of random details that did not seem applicable (types of anemia, for example) and I don't think it was a good investment.  The 'Current Concepts course' was very helpful and prepared me decently for the exam.  I also felt like I learned a lot doing that and that it has made me a better clinician.  Each week I would tackle a new body part: neck, shoulder, thoracic spine/ribs, elbow, hand, jaw, lumbar spine, pelvis, hip, knee, foot/ankle.  I ignored the 'clinical reasoning' section, which I think was just fine, although there were certainly some research questions I did not know the answers to.  Also, studying the jaw was quite silly because I don't treat the jaw often and there were only a few questions on the jaw that I still wasn't confident in.  At the end of the 'Current Concepts' course, there was an online exam, which I completed, but it was not very similar to the OCS exam.

So the big OCS exam was scheduled at a Prometric testing site, where you register ahead of time and pick a time and location (available across the country) and I could pick my date between Mar 2-16.  I picked March 9, which happened to be a day that the front range of Colorado was scheduled to get anywhere from 5-18 inches of snow!  I wasn't entirely sure that the center would be open if such a storm materialized, but they did.

I did not know much about the exam itself and what to expect.  I had not attended any of the 'in person' prep courses that are held around the country because the travel would be so much extra money.  I didn't know anyone who had taken the exam.  There are no practice exams.  The syllabus you are given is very vague (eg. anatomy 10%, cervical spine 10%, etc).  I knew we had 7 hours to sit at a computer and complete 200 questions.  I knew each question was based on a patient case 'vignette' that required some reading, which is why so much time is given.  I knew that a passing grade was a scaled score of 600, but have no idea what formula gets you to that scaled score.  I knew we would be allowed breaks after we secured answers in at the end of a testing 'block', but I didn't know how many blocks or breaks there would be.  The idea of sitting at a computer for 7 hours without many breaks while 6 months pregnant and a snowstorm outside was not appealing.

I drove down to Denver Friday night to get a hotel room for $47.99 including everything.  I studied, had an ok sleep, and got up early for last minute review.  I arrived at the testing center at 7:30am for an 8:00 exam, and there were already many folks there.  I would guess 30 people had an 8am time slot for testing for various exams.  Unfortunately, checking us all in (metal detector, take our picture, sign in, check papers, get computer test to start) took quite a long time, and I didn't start my exam until 8:30am.  That already meant an extra hour of sitting around and waiting!

We had 2 blocks scheduled of 3 hours each with one 40 min break allowed for lunch.  I was disappointed to learn that and wasn't sure I could sit still and focus for 3 hours without a break.  After one hour I had ants in my pants and was dying for a break, but had only completed 40 questions of the first 100.  Ugh!  Anyway, I made it through my day and spent less than 5 hours actually completing the questions, and then drove home in the storm.  The storm wasn't so bad in the end, and the roads were ok despite poor visibility of blowing snow.

As I had read online by others, I'd say 80% of the exam was fair in the sense that it reflected ortho practice. The other 20% seemed random, and many questions were strangely written and confusing.  It reminded me very much of the Canadian and USA national licensing exams.  A lot of studying, stress, and hard work, and then after the fact wondering if I would have done the same whether I had bothered studying or not.

I won't find out my results until June.  I'm honestly not sure what to think, and I have no idea what makes a pass or a fail.  If a pass required a grade of 95% or more, I'd be confident that I failed.  If a pass was 70%, I'd be confident that I passed.  But who knows?  I'll have to wait and see if I get those letters behind my name or not.

Until then, I need to get the rest of my life in order.  Start exercising again. Put the house back together.  Not study!

A more fun blog will be posted shortly with all the adventures we've had with this storm, including playing in the snow with Rachel.

Things are looking up

Happy Valentine's Day!

Pregnancy - almost 21 weeks and doing well.  Everything with the baby looks great.  Everyone around me seems shocked at how little I am showing: it seems more like I have a beer gut than a baby in there.  I haven't gained as much as I did with Rachel at this time, but I've been exercising way less and not eating as well - go figure!  Rachel is getting more excited about the baby and is pretty sure she is having a sister.  In fact, I think it might be a bit difficult for her if it turns out to be a boy!

We have signed up for a birthing class in May/June and have decided to go with a bit of an unusual tactic.  I will write more as I learn more, but we've chosen to have a 6 week 'hypnobabies' class.  Our hope is to actually learn some techniques around partial hypnosis, so that I can have a mindset change around labor and some coping strategies.  I still plan to be aware, able to move around, and feeling the typical feelings, but I plan to practice changing my perception of what I am feeling so it's more comfortable.  We'll see!

Potty Training - is going pretty well.  Many days without accidents.  Night time diaper and diaper at nap time at school.  Seems like familiar people lead to less accidents, and less familiar people lead to more.  All in all, it's going well.

All the cool kids and stuffed animals wear big girl panties

Valentine's Day - we took 18 valentines to school and cookies.  Rachel helped make sugar cookies in the shapes of hearts, polar bears, snow flakes, penguins and seals.  We received many other treats and valentines from school mates, including several temporary tattoos.

Studying and work - studying for my big exam is going well.  Last weekend we had a responsible stay-at-home weekend where we took turns with Rachel while the other one got work done.  It wasn't much fun, but it was productive.  The house got cleaner, meals got prepared, studying and work got done.

Telling time/numbers/letter - Rachel is very interested in looking at face clocks and trying to tell the time.  We have a few books from the library where she gets to put the hands to the right number.  She's very interested in telling us how many minutes things will take, or what time a store will open, or what time the pool closes.  We were recently given a lovely train set by friends as a hand me down and she'll say 'It will take 4 minutes for Thomas to get from the police station to the airport'.  (It takes him about 6 seconds.) The hilarious thing is that she is really good at all this with the numbers she can recognize in print.  She knows 2,4,6,8,10,12 quite well but doesn't seem to know odd numbers (this is because of the way one of our books goes).  So recently we've been talking a lot about numbers more so than letters.  As far as ABCs go, Rachel can tell you about 10 things that start with the letter R.  She can recognize A,B,C,D,O,R,T,W, and sometimes others but not as well.

Names: Rachel loves to name everyone and everything.  Popular names for toys/blankets/cans/stuffed animals/characters in books include Donner, Blitzen, Cupid, Teagan, Griffin, Cooper John, Daddy, Physical, Donder.

Big Girl Bedroom: Since we know Rachel can climb out of her crib and she continues to sleep on the carpet, it seems like a good time to switch over to a big girl room/bed and make that a fun thing.  This way, when the baby needs most of Rachel's current furniture, we're hoping it won't seem like the baby took it away from Rachel.  So my procrastination time recently has been addicted to craigslist.  Rachel has decided that she would like a big girl bed in a new bedroom and the baby can have her current room with the crib in it.  This current room will remain with stars/moons/planets theme, and Rachel's new room will take on an animal/jungle theme with monkeys, elephants, giraffes, etc.

So today I finally found an affordable twin bed in Boulder on craigslist.  Plain pine wood, sturdy, mattress included, and less than $100.  It's no race car bed or fire truck bed or really cool bunk bed set up, but it also didn't cost $600 like many of the cool ones do.  And I wasn't crazy about medium brown pine wood... but I think it will blend in if the rest of the room is fun or maybe we'll paint the pine.  Fitting the bed into the Subaru wagon next to Rachel's car seat and then driving back to Lafayette was an adventure.  Poor Rachel napped in the car on the way home with half a headboard in her lap.

Next projects: moving queen bed out of the guest room, putting together twin bed, finding fun sheets, finding animal wall decals, finding a dresser and some kind of chair, and then moving Rachel into the new big girl bed in one exciting sweep that will not disturb her sleeping!

Sleeping: has been significantly better.  Not all nights are perfect, but we have had a handful of nights where Rachel has slept from 8pm-7am.  She's never slept 11 hours until now, and it's lovely.  We've had to wake her up to get ready for school on several mornings.  I think a few things helped us get out of the dark gloomy place we were living and start sleeping again: bedtime snack, bedtime visual schedule with sticker reward for sleeping through the night, being consistent about what we said yes and no to in all of her many requests, letting her scream it out consistently for a few nights without changing plans/answers/parents.

Snow: Front Range weather in Colorado is interesting.  The mountains have been having an ok time after a terrible start to the season.  We've seen many days of dusting, but hardly a day where we've had more than 1".  Thursday in Boulder we got about 2", in Lafayette we got a dusting, and today is was 60 degrees and wonderful.  Most people in Boulder want a good dumping of 3 feet of snow-us-in-so-we-can't-go-to-work snow, or else let's get on with Spring and make it warm already.  Every time we go out, we take a hat/gloves/puffy over a tshirt because you just never know.  We haven't made a single snowman or gone sledding with Rachel once in town.  Neither of us has missed any work due to weather.  Bor-ing.

What's next? Jason is away this weekend skiing with male colleagues in Steamboat Springs at a fancy cabin with a snowmobile and a cat to take them skiing.  It's an annual staff trip called "Man Camp".  I gather it's a lot of fun.  Next weekend he leaves Sat night and will be gone for 3 nights/4 days with students to a DECA state competition in Colorado Springs.

My work schedule changes this week, so I will work shorter days Mon-Thurs and add Friday mornings for 5 hours at our Lafayette clinic, which is just down the street.  I'm looking forward to this change because it will mean no evenings of work later than 5pm and should help our evenings run much smoother.  Working Fridays will mean that I don't get a chunk of time for housework or studying.  But Jason will get more time after school to work and will only have to get Rachel one night per week.

I am hoping to start a prenatal yoga/exercise class asap.

We leave for Mexico with Nana and Grandma in one month to go to Playa del Carmen!  Wo-hooo!!

February Intro

Rachel gets a get well card with Mickey Mouse

Sleeping... is finally improving.  Not sure quite what has changed, and I won't say it's great yet, but we have had some better nights.  Thank goodness!  Cross your fingers it will continue to improve.

Potty training... started and generally speaking, peeing on the potty has gone quite well.  Poops are a different story.

Pregnancy... 19 weeks, ultrasound today, can feel baby kicking around more all the time.  Not fitting into too many of my normal pants and love whoever invented maternity pants.  Trying to do things like look into baby names, but it's not easy.  For example, a patient suggested a name: "Blya" which means 'light breeze', or so she told me.  So I looked it up to learn about it... and learned that it's a cuss word in Russian!  oops!

Fun things... we went to the zoo one Saturday and rode the train

Rachel says this picture has "Rachel the monkey and Daddy the coat" in it!

Rachel's favorite things include lining up cans, putting a zillion blankets over her stuffies, using her crib to hang up clothes

Potty training starts again!

 Going skiing
Colorado recently got some snow for the first time in a while. It's been very mild and feels like Spring on the Front Range, but the mountains seemed ready for skiing.  We packed up and headed out Saturday morning, only to get stuck in traffic on I-70.  Rachel did a great job of peeing on the potty in the car when we had to pull over and let her!

Eating trail mix on the potty, in the car, pulled off the interstate

On Saturday we took turns with Rachel in town while the other one skiied.  I (Meggan) skiied first while Rachel and Jason went swimming at the rec center.  The lift lines were long but the snow was pretty decent and it was fun to get out again.  In the afternoon Jason skiied while Rachel napped in the car (Meggan studied some) and then we went to the library.  We were pretty hungry so we went out for a steak dinner!  mmmm

 Sunday we had Rachel in the lodge for the day while we took turns skiing. Rachel seemed to be coughing again, quite sniffly, and running a bit of a fever.  The new snow was getting skied off and blown off in the wind, but it was still fun.  Superbowl Sunday made the crowds go away from the slopes in the afternoon, which was awesome.  Unfortunately, I-70 was still really crowded for our drive home and we were pretty exhausted by Sunday night when we got home.

Monday morning Rachel's cough was persistent so Jason came home at 10am to let Meggan go to work and Jason and Rachel spent the day home together catching up on some rest.  On Tuesday we had 'in home sick child care' from one of her teacher's, and we think finally she is ready to go to regular school again.

Studying is going very slowly.  I have completed studying sections on the neck, shoulder, elbow, hip, knee, and foot/ankle.  I still need to review the hand, jaw, thoracic spine/ribs, lumbar spine, pelvis, and review all my PT degree to remind myself on things like histology, anatomy details, machine settings, etc.  My exam is March 15.

Work for Meggan has had one very fun perk recently, as I am treating a very high level athlete.  I'm very excited about this and am working hard to try and help him get back into competition.  I can't say much more than that, but it's a very cool opportunity.