The Missing Link for SLPs Podcast Full Transcript
Vanessa Abraham 00:00
So, today I would like to talk about the friends and the family that we've lost during critical illness. Some family and friends just don't know how to help, I found. So, the way that they help is kind of by walking away. They don't know what to say. They don't know what to do. So, they tend to kind of just leave your side. And a lot of them do this, I found, because they don't want to make you cry, and I find that's really sad, because as critically ill patients that have gone through trauma, we need to cry, we need to talk it out. Crying is healing, I found. And when loved ones and friends leave your side, it doesn't give you that opportunity to heal, and that's been really, really hard for me to deal with. A lot of friends and family just don't know what to say. They don't know what to say to somebody that was vibrant and working and active, and then all of a sudden, she wakes up and she's paralyzed. So, that's been quite a learning experience. Something that, again, we've talked about that we don't learn in grad school.
Mattie Murrey 01:16
Hi, everyone, and welcome to the Missing Link for SLPs podcast. I’m Mattie, your host, speaker, and very passionate speech language pathology advocate. You are listening to The Speechless SLP series with Vanessa Abraham, and you get a unique perspective in each one of these episodes on her journey being the speechless SLP in the ICU bed, unable to talk. So, welcome to this series of the Missing Link for SLPs podcast. Glad you are here. Sit back, take a listen.
So, we all have best friends, right? True friends that we hope are just going to stick with us through thick and thin. In this Speechless series with Vanessa Abraham, she has learned that when she went through her medical crisis, and one of the greatest challenges of her life, who her real true friends were. And today, we're going to be talking with Ashley Reed, and Vanessa Abraham. Ashley is Vanessa's true friend that stuck with her through everything, as Vanessa went from a thriving mom, a speech pathologist, to an intensive care bad, unable to talk at all, and on her way out of everything. So, let's welcome Ashley and Vanessa to our program.
So, welcome to this episode of the Missing Link for SLPs podcast. This is our Speechless series. I’m here with Vanessa Abraham and Ashley Reed, and I just recently found out Ashley's a speech pathologist as well. So, I just couldn't be happier about that! This is our episode of The Speechless Real True Friend, and the Gift of Paying it Forward. And these two SLPs have formed a very unique friendship coming through a very unique medical crisis.
So, let's jump on into our episode now, and welcome Ashley. And Vanessa, you already gave us our introduction. So, welcome.
Vanessa Abraham 03:11
Thank you. Thank you for having me back.
Ashley Reed 03:13
Yes, and thanks for having me. I'm very excited to be a part of this.
Mattie Murrey 03:16
We're happy you're here. This has been such a unique series rolling out. Vanessa and I chose the guests. Vanessa led the way, and I added my input.
Ashley, we would love to hear how you know Vanessa, and how your journey with her came to be.
Ashley Reed 03:34
So, Vanessa and I met in the fall of 2018 when we were working together at the school district. I had just started working for the school district, coming from a background of acute care – transitioning from a background in pediatrics – or, I'm sorry, in adults, where your patients aren't always stable, to pediatrics, where they're just kind of running amuck. It was difficult, but Vanessa was definitely there to kind of help with that transition.
And then in the spring of 2019 was when the bond started to grow because that was when Vanessa got sick. And so, we really only had from August to March to get to know each other. And I feel like we actually grew closer, March of 2019 to today, which is interesting, because that was the time where she was sick and then recovering.
Mattie Murrey 04:41
Sometimes it's those events that really can create a bonding relationship.
Ashley Reed 04:46
Absolutely. For sure.
Mattie Murrey 04:49
Vanessa, what do you remember?
Vanessa Abraham 04:51
I remember pretty much the same thing. From August to March, we were all in survival mode as SLPs. We were trying to get assessments done, meetings done in time.
Mattie Murrey 05:04
Vanessa Abraham 05:05
We were all just – I always say that we're treading water from day one, your first day of school to the last day of school. We're just busy, busy, busy, and just trying to – for Ashley, she's trying to navigate transitioning from the medical field into the schools. It's a crazy, crazy time. And then, as I said, in my previous podcasts, March came, and boom! It just – it hit me, and the next thing I know, I’m in ICU.
Ashley Reed 05:35
Well, and what's wild about it is in March of 2019, we actually had the opportunity to go to CSHA. Our district was paying for us to go to CSHA, and get our continuing education hours, and courses, and hold a booth there for recruitment. And a lot of us are, “What?” Because we're like, we need a break! And so, we went to CSHA, and I actually was with Vanessa at CSHA, just what – days, or even like a week before she went down. So, it was just – it was wild seeing her in that capacity, and then not even less than two weeks later she was in ICU intubated.
Mattie Murrey 06:22
I love how your friendship starts off with Vanessa giving to you, Ashley. Helping pull you on to this setting. And then when the tables turn, it seems like without a hesitation you were there back for her. And those are some of the best friendships. The genuine I give to you, you give to me.
Ashley Reed 06:44
Vanessa Abraham 06:44
That’s what I was saying before. Some people don't know how to help.
Mattie Murrey 06:48
Vanessa Abraham 06:49
And I think Ashley – or not think, I know she's one of those people that knows how to help. She knows how to rise to the challenge, and wants to help. Saw a need, and she knew too that her knowledge and her expertise would help my family.
Mattie Murrey 07:04
Ashley Reed 07:05
Well, I think as an SLP, when one of your own goes down, it hits you in a totally different way.
Mattie Murrey 07:14
Ashey Reed 07:15
Because they're then placed in the position of going from a clinician to a patient, and that alone is a transition, but then going from a walking and talking clinician to a nonverbal, and just paralyzed patient, that, in itself is just – it rocks your world. And then when it's somebody that is so close to home, it hits even harder. And then as a mother, you're like, oh my gosh, that's another layer. Like how many layers is this cake? Like it's –
Vanessa Abraham 07:56
Ashley Reed 07:57
I have that vision of Sleeping Beauty, when the fairies are trying to hold up all those layers of the cake with the broomstick –
Mattie Murrey 08:05
Ashley Reed 08:06
– because it’s just getting so high. And like that's what it was like. It was just like there was one layer after another, after another, when it came to Vanessa's illness. And it was just everything hit so hard. And there were a lot of tears from the team who had been there for a long time, and it was really intense.
Vanessa Abraham 08:30
I think my medical SLPs kind of felt that way too, of seeing me laying there. Even though they didn't know me prior, but the whole thought of, wow, that could be that could be me.
Ashley Reed 08:42
Vanessa Abraham 08:42
And how easily that could be me. You wake up one day, and you're fine, and you're busy working mom, and the next day you wake up, and wow, I don't feel very good – to paralysed.
Ashley Reed 08:55
Right. And that was another piece of it that I just remembered. So, when I worked at the hospital, during my clinical fellowship year, there was another SLP that had just finished her clinical fellowship. So, I came on right after her, and her and I became close, and we would hang out. We'd have lunch together every day. We'd hang out outside of work. And then she actually moved to San Diego, and she had moved to one hospital, and then she had gotten hired on at UCSD Medical Center, but her and I stayed connected. And I don't know if it's just the SLP way, or what, but we make so many connections along the way –
Mattie Murrey 09:45
Ashley Reed 09:45
– and for me personally, I like to continue to keep up with people that I've met along the way. And so, with this SLP, I stayed in contact with her when she went to San Diego. And just not too long later, Vanessa gets this diagnosis, and then we find out that she's getting transferred to San Diego – and not just San Diego, to UCSD. And so, I contacted my friend, and I just said, “Hey, here's what's going on. We have – one of us is coming. One of us is being taken there. Please…” Like I have the chills by just saying it, like –
Mattie Murrey 10:28
Yeah. You gave me goosebumps!
Vanessa Abraham 10:28
Ashley Reed 10:29
– “She is one of us. So, take care of her”. And she was on it. And she was – and she's an amazing SLP. And she just listened, and grabbed on, and never looked back, and she was super helpful in that process too
But it was just that things coming full circle of it never would have happened had I not left there, left the hospital, and joined the school district, and kept in contact with her. And then, it was just really neat how everything kind of came together in a way to help one of our own, just those connections.
Vanessa Abraham 11:10
And that SLP, that is at UCSD that Ashley is referring to, will be on the show. So, that's exciting.
Mattie Murrey 11:20
Vanessa Abraham 11:21
So, that's going to come full circle.
Mattie Murrey 11:25
Yep, another podcast as part of our series.
Vanessa Abraham 11:28
Mattie Murrey 11:29
So, two other speech pathologists coming on.
Vanessa Abraham 11:34
So, they were talking – they were talking behind the scenes while I was in my first ICU setting. So, they were talking behind the scenes. Ashley was letting her know that this is what’s going on, so.
Mattie Murrey 11:47
Ashley Reed 11:48
Yes, with permission, of course!
Vanessa Abraham 11:51
Mattie Murrey 11:51
Ashley Reed 11:53
You know, as always. So, it was just there was enough information being shared that was allowed to be shared, because in those situations it's really hard. You don't want to cross any ethical lines and ethical boundaries.
Mattie Murrey 12:06
Ashley Reed 12:07
So, I mean, that was hard too.
Mattie Murrey 12:10
Ashley Reed 12:11
When you know somebody that's treating your friend, but you can't like share all of that information – I mean, that was a whole other layer.
Mattie Murrey 12:20
Vanessa Abraham 12:22
Yeah. My husband was very involved too at this point, talking with people –
Ashley Reed 12:26
Vanessa Abraham 12:27
– keeping the communication open. Because he knew that my SLP team back at my school site was a valuable source of information. He knew that, wow, a lot of these girls have, like Ashley, worked in the medical setting. So, he was leaning on them for a lot of advice as well.
Mattie Murrey 12:48
Mhm. [crosstalk] Go ahead.
Ashley Reed 12:51
We had a group text going on with Vanessa's husband, and three or four of us other SLPs in the school district. We actually all worked at the same trauma center in [crosstalk], so.
Mattie Murrey 13:06
[crosstalk] It's a small world. Dale is also coming on. Dale is Vanessa's husband. He's coming on as a guest on the podcast as well.
So, I love these stories. And people have asked what's the best thing about podcasts? And it's like meeting people like you who have these lives, and these passions, and they do. They feel, they love, they care and they give.
Ashley Reed 13:33
Vanessa Abraham 13:34
So, Ashley, you helped Vanessa's husband navigate the rehab world?
Ashley Reed 13:41
Yes. So, I kept in contact with Dale partly because of just some of the care that she was receiving when she left UCSD.
Mattie Murrey 13:58
Ashley Reed 13:59
She was sent to a facility where it was like, of all the places that you would want your family member to go, this was not necessarily the place that you would want them to go to.
Mattie Murrey 14:15
Ashley Reed 14:16
For lack of better terms, I was a little bit fearful when that happened.
And so, I spoke with Dale and I said, “I need to know what your insurance is. I need to know what – where exactly Vanessa is in her recovery. What – let me know what type of level of assist she is. What was she doing with her eating?” I need to know all of these things because I'm going to do everything that I can to get her to the facility in Palm Springs so she is near her family. She's going to get great care. We know all the people over here. And so, I was working with Dale. I contacted the Rehab Director over at the hospital, and we were able to work it out, and we got Vanessa transferred out of there and brought back to her home, to where her family could come and visit, to where friends could come and visit.
And so, it was a great connection, and it was really nice to be able to work with Dale. Because when you are working in acute care, and you're working with these families where you don't know the patient, you don’t know their families.
Mattie Murrey 15:30
Ashley Reed 15:31
You still do whatever you can –
Mattie Murrey 15:35
Ashley Reed 15:36
– to help them feel comfortable, to help them feel a sense of peace in a very chaotic storm. And with Dale, it was the same thing, only intensified, because, again, Vanessa was one of us.
Mattie Murrey 15:50
Ashley Reed 15:51
And so, it was I'm going to do whatever I can to get her to a place where she will receive great care. But also, Dale, like we are here for you too. Like we are here as a team to help you navigate through this process because you need some help, you have some questions. Like whatever it is, so any time day or night, like you contact us, and we'll be there.
Mattie Murrey 16:18
Vanessa Abraham 16:18
I remember you coming to visit at the rehab facility, and it was really touching to me because I was so worried about him.
Mattie Murrey 16:27
Vanessa Abraham 16:27
I was worried about his mental state. And I remember, Ashley, you looking at him, and it was – it still hits me in the heart. But you looking at him, and saying, “What do you need?”. And of course, him,, he goes, “I don't need anything. Just take care of Vanessa”. That’s the type of person he is, a guy, he wants his wife taking care of, and he wants everything fixed. But I was so grateful for that because that took a little bit of the load off of me, thinking, “Okay, I don't have to worry about him. Ashley's asking him what he needs. Now I can focus on making sure my daughter is taken care of with my parents”.
Mattie Murrey 16:59
Vanessa Abraham 17:00
I think that was just huge, because as SLPs, we treat the whole family in some of these situations.
Mattie Murrey 17:06
Ashley Reed 17:08
And I think that's where the uniqueness of being an acute care therapist comes in, because when you're in that place where you have your patient in the ICU bed, like pre-COVID, those patients weren't alone. They had family members present. And so, you are not only there to help rehab the patient, but you're there to also educate the family, and be there for the family. And so, you're having to split your knowledge, your emotions, everything between the patient, and the family. And so, when you come from that background, there is that heavy emphasis on helping the family members as well. And so, the family education is a huge part in recovery for the patient because if the family member doesn't know how to help the patient, then they're going to – they could potentially walk out of there feeling lost and confused, and just even more burdened than when they went in.
Mattie Murrey 18:18
Mhm. Since this is the Speechless Podcast, what was it like working with Vanessa and her family, in this comprehensive way that you do, when she was speechless and couldn't communicate?
Ashley Reed 18:31
So, it was really cool in seeing everybody come together in that moment. When the speech team – when we found out that Vanessa was intubated, but asking for an AAC device through like written communication because at the time she was still able to write, we all jumped on it. And so, in the moment of creating a low tech AAC board for her, it was, “Oh, my gosh. Like this person has no other way to communicate”. So, it really brought in that personal component of “We know her, and we know she's vocal”, and now she has lost that ability. So, especially when it's somebody you know, you do whatever you can to provide a means of communication for her. So, it's, “Okay. How are we going to help her to communicate? How many pictures are we able to put on a page?” And so, it's like, “Well, let's just make a book. Here's for hygiene needs. Here's for this need. Here's that for that need”. And so, I think our lead speech pathologist went and dropped off a laminated AAC board for Vanessa back when she had like first been admitted into the ICU in the Valley.
And then when she transferred to UCSD, it was, again, she – Vanessa wanted to communicate. She was like so adamant about communicating and recovering. And it was – we all kind of had to come together, and helping her understand, like, “We know you want to like get up and do like five laps around the ICU station, but you also need to rest a little bit in between.” She’s such a go-getter! But everybody came together so she was not alone. We did everything we could to help her feel like she wasn't alone in the process. And everyone was willing to drop whatever they were doing in that moment to provide her with a way to communicate, no matter what that was.
Vanessa Abraham 20:47
What comes to my mind is the phrase “Teamwork makes the dream work”.
Ashley Reed 20:53
Vanessa Abraham 20:54
I had a great team. And as awful as this whole journey was, I’m glad I had the expertise and knowledge of speech pathology –
Mattie Murrey 21:06
Vanessa Abraham 21:07
– and speech pathologists –
Ashley Reed 21:08
Vanessa Abraham 21:09
– not only for me, but my husband. I think that was very comforting to him, to know that, “Okay, I've got Ashley's number. She understands the system. She understands the insurance. She understands swallowing”. We had people to rely on, and that is just huge.
Mattie Murrey 21:29
And she understands pulling you back into the working realm. Tell us a little bit about what it was like helping her return to work given the cognitive deficits, and the COVID virtual services, and all of that.
Vanessa Abraham 21:42
It was a scary time. It was very challenging coming back to work after a long period of time. There's a lot of anxiety. A lot of triggers walking back down the halls, seeing things again – a lot of those PTSD triggers. A lot of deficits with attention, and especially – I don’t know if you have a lot of acronyms, but I was having a hard time remembering what all of these acronyms meant.
I was very fortunate when I did come back on, that Ashley was assigned to split the caseload with me at the school. So, I was very fortunate in the fact that I had her to rely on, and I could call her and ask her questions, “Hey, how do we do this again? Am I missing something? Did something change?” Things change every three weeks, sometimes. So, it was nice to be able to text her and just say, “Hey, do I check this box on this? Do I do this? How do I – know”. So, that was a blessing.
And then on top of that, coming back into a COVID world where everything was virtual. Sitting down at the computer all day, your body aches and it’s sore from sitting down staring at a screen. So, I’d frequently have to get up, stretch, walk, move. It was just a different environment to come back to.
Ashley Reed 22:59
Yeah, we spent a fair amount of time, not just texting, but on the phone, as well as meeting on Zoom, sharing the screen. “Okay, here's how this works. Step one, step two, step three”.
But then when we returned in the fall, I will not forget this moment. So, we don't split a caseload anymore because I'm just part time now, and just at one school. And so, but what's great is my school is right across the street from her school. So, she's at the high school, I'm at the elementary school. And so, when we returned in August, Vanessa and I are – I mean, we talk just about every single day, whether it's like a workday or on a weekend, like we talk just about every day.
And so, we returned to school going from virtual, to a little bit of in person, to now we're fully back in person. I mean, and it was a transition, for sure. So, she texted me and she said, basically, like “Nobody has used my office in two years, and there is stuff everywhere”. And she's like, “I don't even know where to start. I don't know what to do”. And I could hear it in her voice, like just the overwhelming sensation was starting to kind of rear its ugly head, and I could just hear what was happening. And so, I just said, “I'll be there in five minutes”. And so, I just kind of drove across the street and got to her school, and I mean, it was a mess, for sure. I could see how anybody would feel overwhelmed with what she had walked into. And so, we just kind of worked together, and worked through it, and moved some tables out of the way. I’m like, “You just sit here”, and I’m like “Where – just tell me where you want this stuff”. She was like “I don't even know”. I’m like, “Okay, then I'm going to put it there, and if you don't like it, you can move it -- you know, we can move it later, but let's just at least get some of this stuff out of here”. So, moved tables and boxes because it was like a storage room in there, and like who needs 500 pounds of hand sanitizer in one spot?
Vanessa Abraham 25:13
Yeah. I remember that. The great big bottle hand sanitizer.
Ashley Reed 35:16
Vanessa Abraham 25:27
Yeah. All of that is so true. I came back, yeah, and it was just so frustrating. Every summer, it seems like I come back, and like Ashley said, my room hadn't been used in years, and there were just tables in there, and it was just turned upside down. And for me to come back to work and see that, I just sat down and I collapsed and I cried. I just sat there staring at a wall, crying. And I remember, yeah, I reached out to Ashley and I was like, “I don't even know where to begin”, and I just couldn't even find the words to describe how frustrating and overwhelmed, and again, Ashley rose to the challenge. The next thing I know, she's walking down the hall, and said, “All right, put me to work”.
Mattie Murrey 25:59
Vanessa Abraham 26:01
And she moved tables, and – because I looked at all of this stuff thinking “I'm not strong enough to lift these tables and move these”. I can't be bending down and moving this stuff around and lifting”. So, again, she just rose, the challenge. Within 10 minutes it was all cleaned up and moved, and I was able to move forward, but one step at a time.
Ashley Reed 26:21
Yeah, and it's still a process. It's been really neat to just kind of watch the progression of recovery with Vanessa.
Returning to work after being gone for a year, almost a year and a half, and coming back into a realm where you're an in-person SLP, and now you have to be a virtual SLP. That alone is challenging for the everyday speech language pathologist.
Mattie Murrey 26:52
Ashley Reed 26:53
But then you bring in some of those cognitive deficits, and those like mental health things that occur following a significant life change that Vanessa had encountered, that brings a whole other piece to it.
And so, just helping her navigate through it. Even just, in the beginning, kind of helping her like find standard scores. Looking through the manual, and converting a raw score into a standard score. It was like, “Okay, well, let’s –”. You're starting back, almost like going back to graduate school at that point.
Mattie Murrey 27:31
Ashley Reed 27:33
And now, she's able to not only find those standard scores on her own, but write the reports and manage, and do all the case managing abilities. And so, she went from not being able to score a protocol, to now being able to test and score the protocols.
Mattie Murrey 27:54
Ashley Reed 27:55
And so, it's been really neat to have a front row seat to her recovery, and such a blessing and an honor to walk alongside her in it. And to, “Hey, I have a quick question”. “Okay. Call me”. And helping her walk through that. She has persevered through so much, and it's been really – it's been amazing to see how far she has come. And I know that there are days where she just doesn't feel like she's enough or adequate, but it's like, “No. Like you are so much more than where you think you are”. And she alone has changed the way that I practice.
Mattie Murrey 28:43
I was just going to ask that.
Ashley Reed 28:45
Mattie Murrey 28:45
How has this changed the way you approach being a speech language pathologist?
Ashley Reed 28:50
Yeah. So, as I've said many times, when it's one of your own that goes through something like this, it really changes your outlook and your perspective, and it makes you so much more grateful for the things that we have.
As a speech language pathologist, there is a lot of power that comes with that role, whether it's in acute care, or in public education, or in private practice. We are not just treating patients. We are evaluating. We are diagnosing, and then we are coming up with appropriate treatment plans for them.
But what this experience has done for me personally, is I feel like it's made me even more empathetic, and has brought in a more personal component as far as just being more sensitive to having those difficult conversations, whether it's an adult patient, or a family member. It's really helped me to explain things in a way where the person understands the diagnosis. But then, also, it has helped me to remain more patient while having those difficult conversations, and building in additional time to allow for those moments of tears, and those moments of questions, so.
Mattie Murrey 30:31
Mhm. So, final question, this time has gone by fast. From each of your perspectives as true friends, what advice would you give to another friend – friendship that's going through trials like this? What do you want others to know about how to feel, and how to help? Not how to feel – how to help, what to say, what to do?
Ashley Reed 30:56
Honestly, I think just your presence alone goes a long way.
Mattie Murrey 31:02
Ashley Reed 31:03
I feel like we feel like we have to say something, right?
So, I think if Vanessa texts me and says, “I'm having a really hard day”. instead of trying to think of something to say back as far as like, “Oh, every day is a little bit different”, like really validate the feelings of “I'm really sorry you're having a hard day, and what can I do to help you?” But, also, I think a good way to do it is sometimes don't even give an option, and like, “I'm bringing you dinner tonight. Your options are chicken or beef!” Don't be afraid to be silent, but be present.
Mattie Murrey 31:54
Mm. Silent, but present.
Vanessa Abraham 31:57
You nailed it.
Murrey Murrey 31:59
Yes, she did.
Vanessa Abraham 32:00
She really nailed it.
The only other thing that I would add to that would be allowing that person to cry. Sometimes that patient just needs to cry. And a lot of people, friends, family, “Oh, gosh, they cried. Let's not talk about this. This is a trigger for them. I don't want to make her cry. So, let's not talk about it. Let's talk about the weather. Let's talk about politics. Let’s talk about anything other than the illness because I don't want to make her cry”. But that's counterproductive. Allow them to cry. Be present. Be present while they cry. Let them get that out. Crying is healing.
Mattie Murrey 32:36
Vanessa Abraham 32:37
And I think if you deny them the opportunity to cry, or talk it out, by being present in their life you're not helping them achieve their goal of ultimate healing, because part of healing is letting out, talking about it, crying.
Mattie Murrey 32:55
Mhm. Well, thank you both for coming on to this episode today.
Vanessa Abraham 32:58
Thank you so much.
Mattie Murrey 32:59
A goosebump episode again, Vanessa!
Vanessa Abraham 33:03
I know. I’ve got them too.
Mattie Murrey 33:08
And Ashley –
Vanessa Abraham 33:04
Mattie Murrey 33;08
Yeah, yeah. This is excellent. Thank you.
Ashley Reed 33:10
Thank you so much. I appreciate it. And Vanessa, I am just so proud of you.
Vanessa Abraham 33:15
Thank you. Thank you for being there by my side, and being one of my teammates that's helped with me to where I am today. It really takes a village, and I'm grateful for my village.
Ashley Reed 33:26
Of course, of course.
Vanessa Abraham 33:30
Thank you, Mattie.
Mattie Murrey 33:31
Ashley Reed 33:32
Mattie Murrey 33:37
So, hey, SLPs, that concludes this episode of the Missing Link for SLPs podcast. Please visit my website at fresh slp.com. Follow me on Instagram, or jump on Facebook to connect in our safe and friendly Fresh SLP community where we are empowering new and transitioning SLPs. If you found value in this episode, or in any way had an aha moment, or I gave you a fresh perspective, please show me some SLP love, and support me on iTunes or the Apple podcast app or subscribe to me on YouTube. You got this!