It’s right there in the name: “occupation.” But occupational therapy doesn’t necessarily have anything to do with your job, as St. Tammany Health System Hand Therapist Cassie Cloutet recently explained during a stop at The Lake 94.7 radio studios in Covington.
The following is an edited transcript from an interview originally aired on The Lake 94.7-FM on April 15, 2021.
Charles Dowdy: Our friends from St. Tammany Health System are here. Cassie Cloutet, is that right?
Cassie Cloutet: Yes sir, good morning.
Charles: Good to meet you. How are you?
Cassie: Doing well.
Charles: So, tell me your background. Where did you come from?
Cassie: So, I grew up in Slidell. I am living in Covington now. I went to college up in Shreveport at Centenary. Swam in college for four years.
Charles: Nice, what did you swim?
Cassie: 200 butterfly.
Charles: Do you still swim?
Cassie: Recreationally, yes. Just to stay in shape.
Charles: Just curious, shoulders – we are going to talk about hands; that is what you specialize in – (but), people that do the butterfly, is that a repetitive injury kind of a problem sometimes?
Cassie: It can be.
Charles: How are you, are you doing? Well?
Cassie: They could be better. I have some instability in my shoulders.
Tim: Do they ache in weather like this?
Cassie: They do. Weather changes do make a difference in the joints.
Charles: What do you do outside of work, and did you know you were going to end up doing what you are doing now? Or is this something you found later in life?
Cassie: This is something I kind of came up on. I started out in physical therapy school actually. So I did the first year of that before I switched careers.
Charles: So now you are an occupational therapist.
Cassie: I am an occupational therapist.
Charles: Real quick, tell me the difference between the two. What is the difference between physical therapy and occupational therapy?
Cassie: Yes, we get that all the time. Occupational therapy is more based on a functional goal. So, everything is based on helping our patients return to their occupation. There are eight occupations:
Your ADLs, which are your “activities of daily living”: bathing, dressing, grooming, going to the bathroom, taking a shower, all your basic self-care.
There are IADL’s, which is instrumental activities of daily living, which is like being able to go in the kitchen and cook, being able to make the bed, cleaning – you know, regular household activities.
Then there’s sleep hygiene, being able to position yourself in bed, get comfortable.
There’s work, being able to return to work.
There’s education, and there’s play -- our kiddos, their occupation is play so we work and play with them.
And then leisure, things that you like to do. So, people are able to get back to sports, running and anything like that, even social participation. That is the 8th occupation: being able to return to the community and function.
Charles: And you specialize in what? I want to talk about that.
Cassie: In hands.
Charles: I would think, in this day and age, as I reach around and grab 18 different things -- are there a lot of repetitive hand injuries that we deal with?
Cassie: Yes, a lot. Yes. Probably my top two, I would say, are my carpal tunnels and trapeziectomy, which is the base of that thumb. That thumb joint is so moveable. We see a lot of overuse.
Charles: Say it again. What is that?
Cassie: A trapeziectomy.
Tim: Is that a fancy way of saying I overused my thumb?
Cassie: Yes, that is a fancy way of saying that. It is basically arthritis at the base of the thumb from overuse.
Charles: So, how does somebody end up in front of you? We were talking off the air about some different things you have done to help some people. So how does that happen? What is the process? Do they go to a general doctor first and then they prescribe your treatment, so to speak?
Cassie: Yes, so we do need a doctor’s referral. Usually, they will go see the doctor -- usually it is an injury or a repetitive deal. They will go check in with a hand surgeon or one of our local orthopedists, and then they will send us a referral and they will set us up for an evaluation to treat the patient and find out what the issue is and go forward from there.
Charles: Let’s say I come to you and I have got cell phone hand or something, right -- whatever that is. What kind of exercises are we doing? Or is it exercises or stretches? What do you do?
Cassie: It depends on the condition. So, in hand therapy we do a lot of splinting. So, we fabricate splints for immobilization. We do a lot of wound care. If there is someone with stitches, we will take the stitches out. We will kind of work on the wounds, kind of help the patient understand wound healing and the whole healing timeframe. They need to understand how long they need to be immobilized, when to start moving. We help guide them with that. Then we will progress them into range of motion, strengthening and returning to what they want to.
Charles: So, you are seeing all age of patients.
Cassie: Yes, we are seeing all across the life span.
Charles: And so typically how long is a patient with you? Does it just depend on the injury?
Cassie: It does depend on the injury. Again, typically, it is hard to give even (an estimate). Let’s say if it is a wrist fracture, we kind of go on a time frame. So, it takes about six weeks for a bone to heal. Even after that they might have some stiffness for a while, depending on what level they want to get back to. Are they, you know, a little old lady that just wants to go home and take care of herself, or are they a collegiate athlete who needs to get back to heavy-duty lifting weights and things like that? So, it just depends on the level that they are at and how they are progressing.
Charles: Now where do you work out of? Where as far as with the hospital?
Cassie: Yes, I am at St. Tammany Outpatient Rehab on Highway 21.
Charles: So, I have a question. I am a sissy. You are a little bit of an athlete. Is there a tough love component? Like, if I come in and am like, “Ouch, that hurts!” How do you react to that?
Cassie: Yes, there has to be. You learn the patient. You know some patients have a lot higher tolerance than others. So, just based on their time frame -- if they are still stiff, I really want to get them moving. I want to get them better more than anything, so.
Charles: But movement is the key. I mean you have got to get that started.
Cassie: Yes, move it or lose it, to an extent. Like I said, there is certain protocol. We have to keep them immobilized and protected for a little while. Once we get to that point, we have got to get them moving. We have got to get them back to what we need to do. So you have got to push them a bit.
Charles: Real quick, before we go, because we are almost out of time: Are there things that we should or should not be doing? The repetitive things you see a lot of. I mean where are the pitfalls in terms of our lifestyles right now and things we could be doing better?
Cassie: All of us, we do so many things during our day that are repetitive. Just sitting at a computer, thumbs on our iPhone. Touch pads, that cellphone hand that you said earlier. That base of that thumb. That repetitive movement. That can wear and tear our joints. Anything, just repetitive jobs that you are doing. You have to give yourself breaks, get out of that position you are in. Stretch, go back to it as you need to. It is hard because we work in a forward world. We are on our computers. We are on our phones. It is all forward so; it is just posture.
Charles: Better a standing desk or a sitting desk.
Cassie: Better to stand for the most part. At my station I have a computer that I can move up and down, which I love, so I can do both. I can change my position during the day as I need to. which is awesome. I know not everybody has that, but if you are at a sitting desk you can come out of your position at your computer for a little bit. Just give yourself a two- or three-minute break.
Charles: Well, this has been good. Cassie, it has been a pleasure to meet you. Thank you for this information, and I hope you have a great day.
Cassie: Thank you. Thanks for having me.