Vanessa Abraham: The Ugly Truth About Being Speechless in a Hospital Bed

The Missing Link for SLPs Podcast Full Transcript Mattie Murrey 00:02 So, what did you think of the first episode with Vanessa Abraham, The Speechless SLP? I love how her story is starting out. If you missed it, episode one with The Speechless SLP, we talked about why she became an SLP, what her life was like before the medical crisis, we talked about the AAC gaze device, and just the perspective of laying speechless in that Intensive Care Unit bed. In episode two, we're going to be talking about the ugly truth about being speechless, and we're going to venture into the dark. The dark of the ICU. The dark of the lack of communication, and AAC systems in hospitals. The endless blood supplies, late MRIs, no diagnosis, PMVs, barium trials, tracheostomy, PEG tubes, NG tube, strider. Fear, grief, and not being able to be the mother she thought she was going to be. All of these are some of the dark, dark truths of the thoughts that went through Vanessa's mind when she was laying in that ICU bed, speechless. So, welcome to episode two of The Speechless SLP. Welcome back to episode two of The Missing Link for SLPs Podcast Speechless. I'm here with SLP, Vanessa Abraham, and she’s taking us on her ICU journey today. We're going to be talking about the ugly truth about being speechless, and Vanessa is The Speechless SLP. After waking up in an ICU, after coming down with an undiagnosed medical condition, she wakes up in an ICU bed, unable to talk. They have ventilated and trached, and we're going to talk a little bit about that today. So, Vanessa, welcome. Vanessa Abraham 01:52 Hi, thank you for having me back. Mattie Murrey 01:56 So, today we're going to talk about the ugly truth of being in that hospital bed, and we're going to start our journey today with you in the ICU room. Now, I'm a medical SLP, and when I walk into ICU rooms, I have a perspective of beeping sounds and dark lights. Can you explain to us how you feel, what you see, what you hear, what your tastes go through, all of those emotions of being in an ICU bed? Vanessa Abraham 02:28 Oh, gosh. What do I see and feel? I feel terrified, feel a level of anxiety that I've never felt in my entire life. My room had a window. So, I did get some daylight, but I just see machines. Machines beeping, thumping noises. Machines just pumping things, I don't even know what, in and out of my body. I see dozens of people. I don't even know exactly what their titles were. There were so many people walking in and out of my room – collecting blood samples for something, various nurses coming in and out, talking to my husband about things, doctors doing rounds, teams of people. I was at a teaching hospital. Mattie Murrey 30:31 Mhm. Vanessa Abraham 30:32 So, there was a lot of people on my care. I didn't have family coming because they were all out of the area, and honestly, it wasn't appropriate to have a lot of visitors because I was in such a critical state. But it was just a very, very busy atmosphere, very loud with all the people coming and going, and the machines, and all the procedures, people coming in to take me in and out of my room to do brain scans and MRIs. So, it’s a very busy, busy environment. Mattie Murrey 04:06 Was it busy 24 hours a day? Vanessa Abraham 04:08 Boy, sometimes it felt that way. There were some late night MRIs, and some late night procedures being done that I wanted to sleep through, but due to anxiety I wasn't able to sleep through. So, you know they try to minimize distractions at night, but sometimes procedures have to happen at 11:00 o'clock at night… Mattie Murrey 04:31 Mhm. Vanessa Abraham 04:32 … just because of staffing, and the way things work in the hospital setting. Mattie Murrey 04:38 Mhm. Were the lights down low? Vanessa Abraham 04:40 Nighttime, yes. But daytime, it's a bright environment, bright white lights. Mattie Murrey 04:45 Okay. Natural daylight? Vanessa Abraham 04:47 Mhm. Many times I wanted to sleep in the day, but they sure wouldn't let me. Mattie Murrey 04:52 Good, good! Vanessa Abraham 04:54 I wanted to pull the covers over my head, and have them close the blinds, and just sleep the day away, but no. PT, OT, and Speech are there. They're ready to go, and … Mattie Murrey 5:02 Let's go! Sit up! Vanessa Abraham 05:05: Yep, exactly. “Get out of bed”. “No, I can't!” Mattie Murrey 05:09 I don't know if I ever told you, but I was, in 2017, in a really bad motorcycle accident and ended up in a trauma unit, and went through some of that. Where I remember the OT and PT walking in, and they’re like, “Let’s go!” and I'm like, “What? Don't you realize I was just an accident, and like all of this is broken?” And they're like, “Oh, let's go!” Vanessa Abraham 05:32 Oh, my gosh. Mattie Murrey 05:33 Oh! Not an intensive care unit, but it was a teaching hospital. And I was grateful they had an inner door and an outer door, and I just cherished the quiet. Vanessa Abraham 05:44 Yep. I remember in the middle of the night too asking the nurse, “Can you put a sign on the door just please be quiet”. Mattie Murrey 05:51 Mhm. Vanessa Abraham 05:51 Because I just wanted to sleep. But I can sympathize with that. I remember in the daytime too, people walking in and around – PT, and I'm thinking, ‘No, look at me. I'm paralyzed. I don’t … Mattie Murrey 06:03 Mhm. Vanessa Abraham 06:04 … I don't want four or five people to help me get out of bed. This is humiliating and…’ Mattie Murrey 06:08 Going to the bathroom with help? Vanessa Abraham 06:11 Yeah. All of that. Mhm. All of that. And I think ‘No, I just …’ you know. And that's when those dark, dark suicidal depression thoughts hit you. Mattie Murrey 06:19 Mhm. Vanessa Murrey 06:19 And you’re just like, maybe I'm better off being dead. I don't know. This – is not the life I want to live, or would ever have imagined living. Mattie Murrey 06:26 Well, when you don't know the answers to questions, your mind does go down those rabbit trails, and you did not know the answer to what was going on. Vanessa Abraham 06:34 No, I didn’t. Nope. I did not have a diagnosis at this point. I didn't know what the future would hold for me, or my family. So, of course, naturally, your thoughts – your mind starts thinking, wow, this could be the rest of my life, maybe forever, and my husband is going to have to push me around in a wheelchair, or I'll be bedridden forever, or speechless. Mattie Murrey 06:59 Or speechless. And you’re not speechless, because you're on the podcast. Vanessa Abraham 07:02: Yep, I’m here. Mattie Murrey 07:03 So, we know you recover. Vanessa Abraham 07:04 Yeah. Mattie Murrey 07:04 A spoiler alert, kind of ! Vanessa Abraham 07:06 Yeah! I can talk. I don’t need AACs. Mattie Murrey 07:04 No, not anymore. While you were in the ICU, what was one of the kindest things you remember somebody doing? Because I remember one of the kindest things somebody doing for me in my trauma state. Vanessa Abraham 07:22 Oh, my goodness. There's more than one, but I will never forget my nurses giving me a spa day. Yes, I just had a spa day. Mattie Murrey 7:31 Mm, mhm. Vanessa Abraham 7:32 Spa day, like a full blown pedicure, washed my hair. I was in a reclining chair, and I really couldn't move, but they reclined me. They washed my hair, did my toenails, shaved my legs, which – that was a pretty gruesome project, right there! But my husband told me many times, he goes “You were such a different person after they gave me that spa day”. It just made me feel human again. Mattie Murrey 08:05 Yeah. My favorite time was when somebody cleaned my hair. I had a helmet on, thank goodness, but they cleaned and brushed my hair and braided it for me. And I swear, I cried the whole way through it, because I was feeling – and this story is about you, but you're bringing out emotions in me. So, I'm sure you're bringing out emotions in our listeners who have also gone through traumatic events. The touch of kindness, the touch of compassion is so, so, so important in those who we work with. Vanessa Abraham 08:36 Yep. That hour or so that they spent doing that. Yes. It lifted my spirits. Mattie Murrey 08:41 Mhm. Vanessa Abraham 08:34 It took me from a level zero right up to a 10. I was starting to feel human again, and feeling hopeful. They gave me a sense of hope, just by shaving my legs, and washing my hair. It made me feel human again, and I will never forget that feeling. Mattie Murrey 09:01 Mhm. So, the perspective of lying in the bed, and not feeling human. Or, as you say, the endless blood samples, the late night MRIs, not having that diagnosis. Now, you mentioned, you also had told me earlier as we were preparing for this interview, that you had a PMV, a Passy Muir Valve. Vanessa Abraham 09:21 Mhm. Mattie Murrey 09:22 So, tell me a little bit about that journey, and your respiratory journey. Vanessa Abraham 09:26 Wow, that was all part of the terrifying experience. Again, you know how critical you are when a speech therapist walks in and starts talking to your husband about getting you for a Passy Muir Valve. I work in the school setting, so I don't really work with PMVs very often, ever, and I'm so unfamiliar with the concept of a PMV. And that was just beyond terrifying when they start telling me that this is what they're going to use on me, and help me communicate again. I thought this can't be my life. You’ve got to be kidding me. Mattie Murrey 10:05 And you were trached. What’s that like? Vanessa Abraham 10:08 Terrifying. Horrible. Secretions. Suctioning. I wouldn't wish that process on anybody. I think due to the nature of my illness, and the way things progressed, I had a higher level of secretions than typical, and it was just horrific trying to manage all of that. Mattie Murrey 10:32 Were you able to say, “Hey, I need to be suctioned”? Or did you just have to wait? Vanessa Abraham 10:37 I would. At that point, it was relying on an alphabet board. Mattie Murrey 10:42 Okay. Vanessa Abraham 10:42 Or I would have – it was written down on a piece of paper, and I would just point to it. Mattie Murrey 10:47 Point to that paper. Those pre-made communication exchanges. Vanessa Abraham 10:52 Yeah. Yeah, and I used that word often. Mattie Murrey 10:56 Okay. Okay. And it was handwritten paper, right? Vanessa Abraham 11:00 Yeah, I had some handwritten. And I had like a qwerty keyboard, an alphabet board on a piece of paper. Mattie Murrey 11:07 Mhm. Vanessa Abraham 11:08 And then, as slowly progressing from that point as I made slow gains, but that's only because I was an SLP. Mattie Murrey 11:18 Mhm. Vanessa Abraham 11:19 I knew that there's more out there than just words on a piece of paper. Mattie Murrey 11:23 Mhm. Vanessa Abraham 11:24 I could write, eventually. I could progress from IDs, where I started out, and I knew that there were different levels of AAC. There's your low tech AAC, and there's your mid tech AAC, and then there’s your high tech AAC, but I knew all of this because of my background, and only because of that. Mattie Murrey 11:43 Thank goodness. Vanessa Abraham 11:45 Yeah. Thank goodness is right. And I knew also because of my background that this was going to take a lot of work. Mattie Murrey 11:52 Mhm. I'm working on a project getting more AACs into the medical setting, and hoping to reach out to you and collaborate a bit as well just on the need for that, and what it feels like to lay there in the bed and not be able to speak. Jumping back to the Passy Muir Valve. I've been the SLP who's put a Passy Muir Valve for the first time on somebody, and asked them to now – and train them on using that valvel. What was that like from your perspective? Vanessa Abraham 12:25 It was surreal. And there's so many thoughts that – it’s again, one of those things that it's indescribable until you walk through it. Again, it’s one of those things you don't learn in grad school about how hard it is to vocalize with that on. Mattie Murrey 12:42 Mhm. Vanessa Abraham 12:43 And I don't know if it's just the nature of the disease that I had, and the way the nerves innervating my lungs, how they were damaged in the illness, that made it more difficult for me. That I don't know, because I haven't had strokes or other things. Mattie Murrey 13:00 Mhm. Vanessa Abraham 13:00 I just know my diagnosis, and what it felt like for me. But it was a lot of work. It took a lot of will and strength, and I didn't have a lot of will and strength. But to be able to produce that sound was exhausting. Mattie Murrey 13:18 So, getting that pressure below the Passy Muir Valve, to build it up, to come through the Passy Muir Valve is what took a lot of effort. Vanessa Abraham 13:30 Yeah. Mattie Murrey 13:31 How long, approximately, were you in the hospital before they first placed a Passy Muir Valve on? How many days had you had to decondition? Vanessa Abraham 13:41 I would say by a week. Well, maybe over a week or so. Mattie Murrey 13:47 Okay. So, outline your stay for us. You go to the emergency room, and then you're in the emergency room – I mean, the intensive care unit. How long were you in the intensive care unit? Vanessa Abraham 13:59 About a month. Mattie Murrey 14:02 Oh, wow. Vanessa Abraham 14:02 Yeah. Mattie Murrey 14:02 And then where were you after the intensive care? Vanessa Abraham 14:05 After that I was sent to two different rehab facilities. One was an LTAC, where they decannulated me. And then the last one was kind of like my final rehab facility before I came home. That's where I just did the intensive every day, one hour of each therapy session. Mattie Murrey 14:26 How long was your LTAC stay? Vanessa Abraham 14:29 LTAC was another two weeks, and then the final rehab was an additional two weeks. Mattie Murrey 14:33 Okay, so a month in ICU, a month in rehab, and then you came home? Vanessa Abraham 14:38 Yeah. Mattie Murrey 14:40 And home health care? Vanessa Abraham 14:40 Yeah, home health from there, for about a week or two, and then I started outpatient. Mattie Murrey 14:46 All right. And you are now about three years post everything? Vanessa Abraham 14:50 Yeah. It’s now – this is about my three year anniversary mark. Mattie Murrey 14:53 Okay. So, let's jump back to our hospital visit. Thanks for rolling that out, and giving us the bigger picture. So, we’re going to talk next about the barium trials, tracheostomy, NG tube, PEG tube. Tell us a little bit about that. What was that like? Vanessa Abraham 15:11 Barium trials take me back to grad school, when they had just try a barium for fun! Mattie Murrey 15:18 Mm. It does not taste like marshmallow cream. Vanessa Abraham 15:22 Yeah. And then I thought, well, this is so different than trialing it in grad school for fun, when you're actually doing it to see if you can pass. Mattie Murrey 15:30 Mm. Vanessa Abraham 15:30 Because I didn't do well on those barium trials, and that was another thing that was just – it was just terrifying. I think about my SLPs, and then how terrifying, and how sad it was, probably, for them to look at my husband and I - Mattie Murrey 15:42 Mhm. Vanessa Abraham 14:42 - say, look, she's still NPO. Mattie Murrey 15:48 Mhm. The beauty of everything today is, and my approach in bariums, it’s not been a pass or not pass, but look what we're learning. Vanessa Abraham 15:55 Yeah. Mattie Murrey 15:56 And look how we can compensate, and help you improve your overall safety with the swallowing challenges that you have, and the change in the mechanism of the swallow. So, you're sitting in the chair. You're doing the barium swallow trials, and I'm sure it is the stress of passing or not passing. What was it like receiving the ‘Let's keep you non-oral for a little while?’ Vanessa Abraham 16:20 Oh, depressing. I just shut down. I just – I felt like a failure. I wanted to get better for my family. I wanted to get better for my husband, so he didn't have to tube feed me. Mattie Murrey 16:33 Mhm. Vanessa Abraham 16:34 And I just felt like a complete failure to everyone, and I felt bad for my SLPs too. I know that seems crazy, but I felt bad for them because I thought, ‘Oh, poor girls have to sit here and do another barium swallow study with me, and how hard it is for them to look at me and just say, ‘Oh, no, you’re still not -’, you know. I felt bad for them because I know as an SLP how hard those conversations are, and how gut wrenching they can be to look at this caregiver, and the emotions tied up with it. And not only that, but they're treating another SLP, these poor girls, and my heart broke for them too. Mattie Murrey 17:13 Did they seem sad? Vanessa Abraham 17:16 I think they were trying to be professional. Mattie Murrey 17:20 Mhm. Vanessa Abraham 17:21 I honestly think that when they probably left the room, they probably thought, ‘Oh, gosh’, you know, and they were trying to keep it together. I can't speak for them, but I think they were trying to maintain a level of professionalism, and do their job, and execute it being professional. But I can't – I can't imagine that they wouldn't walk out of the room, and just – because I know that's how I would be. Mattie Murrey 17:48 Mhm. Vanessa Abraham 17:49 I know if another SLP came into my room, and presented with the case that I had an undiagnosed medical condition, or PMV, all of this stuff, that I would just probably go home at night and crash with emotion. Mattie Murrey 18:07 Hmm. What was it like when you started eating again, when you were cleared to? Well, let's back up. So, your NP, and I'm sure you just followed dysphasia therapy, and they were giving you oral trials, and teaching you strategies, and things like this. What was it like being a patient of dysphasia therapy? Vanessa Abraham 18:26 Again, the best word I can describe is just terrifying. I keep going back to the word terrifying, and those things that you don't learn in grad school. Mattie Murrey 18:36 Mhm. That's why this series is so important. Vanessa Abraham 18:38 You just don't learn these things in a textbook. What these patients go through emotionally, you know, it’s- Mattie Murrey 18:47 Mhm. Vanessa Abraham 18:48 I had a child, on top of it, that I was worried about. I was terrified of what her future was going to be like if this was my forever. Mattie Murrey 18:57 And thankfully, you progressed through your dysphasia. You began consistent oral intake. What were some of those first bites like? Vanessa Abraham 19:10 Oh, so much anxiety. Is it going to be successful? Am I going to choke? Some of those, I'm sure, very common fears of most people with swallowing disorders. Is this going to go down the wrong tube? Am I going to have to be readmitted? Or is somebody going to have to do the Heimlich on me here? The thoughts that go through your mind with speech swallowing and communication disorders, it's just – again, you don't learn these in grad school. They're very dark, dark, scary thoughts. Mattie Murrey 19:43 Mhm. How did you press forward through those thoughts? How did you remain as positive as you could be, and being brave? Vanessa Abraham 19:52 I would say my outpatient speech therapists were very uplifting for me. She was like my little bit of sunshine. Mattie Murrey 20:02 Mhm. Vanessa Abraham 20:03 Her smile was just contagious. And she made me feel safe during those trials. Mattie Murrey 20:08 Mhm. Vanessa Abraham 20:08 But those thoughts, those thoughts can easily drift right back into your head, and back to self-doubt, and it’s real. Mattie Murrey 20:19 Yeah. The suicidal ideation, you said you struggled with that a little bit. Vanessa Abraham 20:25 Oh, big time. Not just a little. It’s terrifying. Your life gets flipped upside down overnight. And I think it would – it’s one of those things too, if I was 70 or 80 it might be – you know. I don’t want to say easier, but you expect it more. Mattie Murrey 20:46 Mhm. Vanessa Abraham 20:46 And I – this just came out of nowhere. Like I said in my first podcast, I was never sick. I always had just the common cold, and you know, but nothing that ever wound me up in an emergency, not even like an urgent care setting. I would always just fight through any sinus infections with some NyQuil, and sleep it off, and I was fine within a couple of days. Mattie Murrey 21:10 Right, right. Much less the journey that you have embarked upon. Vanessa Abraham 21:15 And this wasn't just a little journey. This was from the state of being very active, to being – limb paralysis, swallowing, PTO, to all of it, so. Mattie Murrey 21:28 So, when I have a patient where I do a video swallow study, and I might recommend something that the patient I know is not hoping for, I try to prevent it in the most positive way I can. “Look what you can do. By following these recommendations, this minimizes your risk.” What else? What other words of wisdom would you give to the speech pathologist who is working with somebody who's starting to eat again, and making them feel safe? Vanessa Abraham 22:01 I think that is huge right there. Because I remember my outpatient therapist saying that to me too, and saying, “Look, two weeks ago, you were only eating this. Look where you are now”. A lot of that cognitive behavioral therapy of reframing your thoughts. Mattie Murrey 22:16 Mhm. Vanessa Abraham 22:17 Because my thoughts, and this is probably who I am, but my thoughts naturally just gravitate to the negative, the bad. And instead of saying, “Well, I can't do this”, reframe that to “I can”. “I can eat.” One of the first things she had me eating, or – and obviously with her it was the applesauce, and the crackers, and things like that, trialing those. But “I can eat applesauce now”, or “I can eat this cracker. I can eat this hard boiled egg”. As opposed to, “I can't”. You really need to hear the positives, and naturally, your brain hears the negatives, and that's where you get in trouble. Mattie Murrey 23:03 Mhm. And that's been a mental wellness approach I've heard you say several times. Where when your mind does start going down some of those dark trails, in an ICU bed, in a barium swallow study chair, where you're able to say, “Nope, I'm going to reframe this”, and muscle it back into being positive. Vanessa Abraham 23:25 Yep. And think about what you're grateful for, the good things that are going on in your life. Mattie Murrey 23:30 Mhm. Vanessa Abraham 23:31 Journaling, writing a gratitude journal of things that have happened to you. I did that in ICU, and even reading through that now, that’s a big, big part of recovery, is your mental well being. Mattie Murrey 23:44 Was there ever a time when a therapist told you you're going to be doing this – and I’m trying to think of how I want to ask that question, because I don't promise false hope. And I believe when I work with the people I work with, I have a good idea of where they can go, what their prognosis is. Was there ever a time though, when you worked with somebody and they said, Vanessa, we're going to do this, and you were like, “Nah, no way. I'm not going to. I'm not going to get back there”. Was there ever a time you didn't believe somebody? Vanessa Abraham 24:19 I think I always had my doubts with all of my providers, and it’s, again, my brain going towards the dark side. Mattie Murrey 24:28 Mhm. Vanessa Abraham 24:28 I remember my husband having conversations with me, and saying that “You're going to do this, and you're going to do that” and I love him immensely, and the things he did for me were just amazing, but sometimes I just wanted to slap him over the head, as crazy as that sounds. I was so grateful, but in the same sense, it was when I’d look at him, and I’m thinking “ Honey, look at me. I can't even get out of the car. I can't even toilet myself. How am I going to climb that mountain?” I guess I just climbed that mountain with my outpatient SLP a couple of weeks ago, just as an anniversary of where we are together now. But yeah, many times that I remember my husband trying to be encouraging over the years, and saying like, “Look what you're doing now. Look where you are. And you'll do this, you'll do that”. And sometimes, I just wanted to be negative, and just be in my dark place. Mattie Murrey 25:25 So, when we work with somebody as a therapist who is negative, and they’re in their dark place, what would you recommend we do? Vanessa Abraham 25:32 That’s a really good question. Just help them keep the faith. Find something to be hopeful for in their life. Try to see what it is in their life that can give them hope, a reason to continue on, a reason to keep fighting. Mattie Murrey 25:54 Mhm. Vanessa Abraham 25:55 For me, it was young. I have a family. So, I wanted to be able to retire with my husband, and I live a great retirement life. I want to be there for my daughter when she graduates from school, and I want to see her grow up. And, to me – and even today, those are the reasons that I keep fighting. And I believe every patient, or everybody, has something that they want to fight for. Mattie Murrey 26:21 I love that. I love that mountaintop. I'm planting my flag, and this is what I'm fighting for. And on that flag is my daughter, and my family, and my husband, and me, because this is where I'm going. Vanessa Abraham 26:39 Mhm. And you mentioned more about like a vision board of goals. Mattie Murrey 26:42 Mhm. Vanessa Abraham 26:43 This is what I want to accomplish. This is where I see myself, because it’s – it’s so – I’ve said it before, but it's easy to go down that other path. Mattie Murrey 26:53 It is. Vanessa Abraham 26:54 You need to look to the future, and say this is where I visualize myself, this is what I want from my life, and this is where I'm headed. This is not my forever. This is temporary. Mattie Murrey 27:05 Oh, yeah. More goosebumps. I do vision boarding – because I do coaching for SLPs on the side, and I believe in vision boards, because after my husband died, and my world got turned around, I was lost. Where am I going to go? What am I going to do? And I created that vision board. And until we have the clarity, sometimes, of where we want to go, it's hard to picture us getting there. So, I love the vision boarding. I love the visual flag. Vanessa Abraham 27:39 Love it. Mattie Murrey 27:42 Mhm. Vanessa Abraham 27:42 It should almost be incorporated into a therapy session, that you have each patient just spend that 30 minute session making a vision board. Because without the mental – without them being in a positive mental state, I don't know my - Mattie Murrey 27:57 Right. Vanessa Abraham 28:58 They could still make progress, but that mental state is so important for their healing. To want to die, and not want to continue to fight, it's counterproductive to the healing process. Mattie Murrey 28:10 Mhm. And you've been there. Vanessa Abraham 28:11 Yep. Mattie Murrey 28:12 You've had those thoughts. Vanessa Abraham 28:14 Yep, I’ve had to fight through those. Mattie Murrey 28:15 And you've made that choice to plant that flag on top of the hill. What an interesting concept, vision boarding with our patients. I find vision boarding to be incredibly powerful, an incredibly powerful tool. And I know as SLPs we, “What do you want to do? Where do you want to go?” We pull that patient and client input in. But to have a more focused vision, of where do you want to go? And that is the important part of buy-in with the people we work with. We need them to buy into what we're asking them to do. Vanessa Abraham 28:52 Mhm. And trust you. Trust you as an SLP. Mattie Murrey 28:55 Mhm. Vanessa Abraham 28:56 I was very fortunate. I trusted my providers. Mattie Murrey 29:00 Mhm. Vanessa Abraham 29:01 I was very fortunate that I was in a setting that had wonderful, wonderful people working underneath me, and working with my family. And I have so much respect, and so much trust in them and their care. Mattie Murrey 29:19 Mhm. That's important. Vanessa Abraham 29:20 Mhm. Mattie Murrey 29:21 What did they particularly do that contributed to that trust building? Vanessa Abraham 29:28 Gosh, if I had to think of one thing that they did - Mattie Murrey 29:33 Or two or three. Vanessa Abraham 29:34 Well, I can think of the way that they approached, and took in my whole family. I think they recognized that I was worried about my husband. I was worried about his mental state, and they looked after him. Mattie Murrey 29:47 Mhm. Vanessa Abraham 29:48 They were always there for him, educating him, making sure he had enough sleep, he was eating. And the fact that they were looking after him, who I care immensely about, and they were also asking about my child, my parents. They were asking the right questions. Mattie Murrey 30:08 Mhm. Vanessa Abraham 30:09 It gave me a lot of peace, and I think that's probably what led to me trusting them like I did. Because they could sense that, okay, we need to address the whole person here. Mattie Murrey 30:23 Mhm. And her family, and everybody else in the journey along with her. Vanessa Abraham 30:27 Yeah, the big picture here. It's not just her. Yes, she's in a critical stay in bed, but she has a family here. Her husband's very involved. He's – oh, my husband was wonderful. He attended the doctor rounds, and they could see that I was going to – I required a lot, and they rose to the challenge, and I can see that. Mattie Murrey 30:52 You mentioned earlier that you had a lot of fear and grief about not being able to be the mother that you had envisioned for yourself. How did you turn that around? Was that through some of those conversations and relationships you have built with your providers? Vanessa Abraham 31:08 I've had a lot of counseling, a lot. From the minute I got out of the medical setting, out of rehab, I've had various forms of counseling – cognitive behavioral therapy, EMDR, hypnosis, a lot of different treatment approaches to work on some of that. So, it's been a whole body experience – healing the mind. Mattie Murrey 31:37 Healing the mind, as well as the body. Vanessa Abraham 31:38 Mhm. Mattie Murrey 31:40 I think – you've mentioned several times – we have another podcast series, What I Didn't Learn in Grad School, which you keep saying, “I didn't learn this in grad school. I didn't learn this in grad school!” One of the things that I did not learn in grad school was the mind-body connection. And when you have a body or a mind that goes through trauma, and you’re laying in an ICU bed is trauma, it’s traumatic. We're going to talk in our future episodes about PICS, Post Intensive Care Syndrome, and I'm looking forward to – we're going to be pulling on a counselor there, or somebody you've worked with there as – right? As well? Vanessa Abraham 32:17 Yes. Yes, she is one of the social workers that I was referred to at a different hospital, and she addresses PICS, Post Intensive Care Syndrome. So, that's a very interesting and new topic. Most people that I talk to, when I mentioned PICS, they say, “Well, what is that?” They don't have any idea of what that is. And I love talking about it, because nobody knows what it is, and it’s something - Mattie Murrey 32:41 I didn’t. I didn’t know. Vanessa Abraham 32:42 Yeah. It’s so real. And so many ICU patients experience this, but it's not talked about. So, I'm very excited about that episode, I think that's going to be great for SLPS to hear. Mattie Murrey 32:59 We have some great, great episodes coming. Before we stop for today though, I want to talk briefly about being an AAC user, and what that was like. You mentioned you were trying to be so patient with your providers by trying to slow down, and typing on the alphabet board, but you got frustrated because they couldn't understand and readily understand what you were saying or trying to communicate. Vanessa Abraham 33:24 My poor providers were so frustrated with me, and I had so much to say. So, I was cognitively aware. Mattie Murrey 33:32 Mhm. Vanessa Abraham 33:33 So, therefore, I had a lot of questions. I wanted to know what was going on. What are you doing? What procedure is this, and why are you doing this? And why do they keep taking blood? And all these questions. And my questions were very lengthy in length. So, for me to type letters was just – it was so frustrating for them. They’d get frustrated. I’d get frustrated, but I wanted to know what was going on. So, it was a very frustrating process for all of us, but they were so patient. Mattie Murrey 34:05 What words of wisdom, then, do you have for somebody who is waiting for a patient to use their AAC system? Vanessa Abraham 34:13 Just keep being patient. Take some deep breaths and just wait for them to get their words out. Because your patients that are aware of what's going on, they’re terrified. Mattie Murrey 34:25 Mhm. Vanessa Abraham 34:26 They want to know. Like my anxiety was so high that I wanted to know every procedure, and what time people were coming and what they were going to do, what they're looking for, what the results of tests were. I wanted to know. And my providers, again, were wonderful. They were so patient with me, but I could tell that they would say, like, “Slow down. Slow down. What was that?” Or they would try to word predict what I was saying, and like, “No, no, no, that's not the word!”. And so, it was a very, very frustrating process for all of us. But now that I look back, it's kind of like a memory and I can find some humor in it, and some – I can smile about it now. Whereas then, I just wanted to throw my papers out the window of the 10th floor, or wherever I was! Mattie Murrey 35:12 I would imagine laying in the bed, you felt such a loss of control. And not even – I mean, as a professional, you know when your next student is. You know when your meetings are. And all of a sudden, your world is so tipped upside down, and you don't even know who or where's – who's walking through the next – your door next, and why and where your bed is being whisked off to. I remember just laying on my gurney, and I see the ceiling going by, and I'm like, “Where am I going?” So, maybe, from your perspective, what we’ve learned from you is also to help ease our patients’ journey, is to fill in some of those missing blanks. Give them some of that control back, where they can look at a schedule and know who's coming in. Vanessa Abraham 35:57 Loss of control is huge. Mattie Murrey 35:59 Mhm. Vanessa Abraham 36:00 I had no control. I went from [inaudible] – but having the most control in my family. I was in charge of everything, scheduling, planning, executing, and booking everything from birthday parties, to work events, to IEP meetings at school. And then to be unable to do any of that,and not even like get myself to the bathroom. It's hard to accept. Mattie Murrey 36:28 Yeah, yeah. Well, I look forward to more episodes with you. Right now, we are still working on pulling everybody's schedules together. But we have your husband coming on, Dale Abraham. We have Dr. Rosen coming on. Your PICS social worker, Anna Lewis. Vanessa Abraham 36:45 Yep. Mattie Murrey 36:36 And we have your nurses coming on, Shannon Cotton and Laura Davis. Jess O'Brien is your PT. Danielle Torrez and Sherry Ewing coming on as your SLPs. Ashley Reed is your pay it forward best friend. We've got your mom coming on. And then we've got the episodes wrapping everything up. So, Vanessa, this is a great series. Thank you very, very much for coming on and sharing your story. Vanessa Abraham 37:13 Thank you. I look forward to more. Mattie Murrey 37:26 I hope today's conversation has created some aha moments for you, and motivated you to become a better SLP, continuing to connect some of those missing links between what you know and how to use that knowledge. Thank you for downloading The Missing Link for SLP’s Podcast, and if you enjoyed the show, I'd love you to subscribe, rate it, and leave a short review. Also, please share an episode with a friend. Together, we can raise awareness and help more SLPs find and connect those missing links, and get the information needed to help them feel confident in their patient care every step of the way. Follow me on Instagram and join the Fresh SLP community on Facebook. Show Notes are always available. So, come learn more at freshslp.com Let's make those connections. You got this!