My American Dream: New Name, New Job, New Brain injury

Hello again.

First of all, I’d like to send a HUGE thank you to each and every one of you who has reached out in response to my last post, “Two Suitcases and a Desire to Learn: How I Started in Postural Care”. I absolutely love hearing from you all, and believe me when I say that your words of encouragement help tremendously as I feel like this entire blog has me working quite far outside of my comfort zone.

Let’s continue the story, shall we? We still have 24 years to catch up on. That seems like  a lot, but I promise it moves quickly - at least it did for me!

We left off at move number 2, from Canada to the USA.

So, I made it to Boulder, Colorado. Home of the Rocky mountains!

The scenery and weather were simply incredible and so very different from anything I had ever experienced. It’s a high desert where blue sky and sunshine were the norm regardless of the temperature.

My first step into the professional world as a Physical Therapist (what Physiotherapists are known as in the US) was to take the National PT exams. This was necessary for me to register as a PT in Colorado and helped expedite my green card, which would allow me to work in the US and have flexibility as a resident, thus providing a little more security for my family. Irish physio credentials were recognised by the Canadian system during my first move, so thankfully I didn’t need to take an exam at that point - I just needed to register, pay the usual fees and keep up with the annual requirements.

The experience in the US was different for many reasons. Like the fact that I had graduated 12 years prior to arriving in the US. Hello, stress!

I took a refresher course in California to brush up on all things forgotten and added study time somewhere in the schedule amid work, travel and family. You can imagine how grateful I was to have passed the exam, and, with my new PT license in hand, I successfully got through the process of securing my green card. I was ready to roll.

My role with Jay Medical (which was purchased by Sunrise Medical near the time I started with them) was mostly related to clinical education. I was conducting seminars all over the globe, developing educational materials for clinicians and suppliers, and doing hands on assessments with clinicians who wanted to learn more.

I was also part of the product development team, which was truly eye opening for me from both the business planning and the product innovation aspects. I learned volumes of information about the science of materials and testing of the equipment from the engineers who I worked with closely and from being involved in the ISO standards group. I really appreciated that component of my job more than I thought was possible and realized that understanding the products we use everyday with that depth of knowledge really added to what I was able to share with other clinicians and clients.

Taking a leap into corporate America was a big adjustment for me.

As a clinician now working in less familiar territory, I had to make a serious effort to maintain my clinical beliefs while switching gears to the manufacturing and business side of things.

I learned so much during those years. Getting comfortable in this role took time and a lot of guidance. Some influencers for me were clinicians such as Adrienne Bergen, Bengt Engström, Jean Minkel, and industry characters and leaders such as Dan Easley, Terry Mulkey, Tom Whelan, Doug Munsey and Tom Hetzel.

Drawing from the minds of such a diverse group truly helped in gaining the perspectives and appreciation I have for postural care, pressure care and mobility as a total industry today.

Part of what I loved about that job was being a member of the Jay/Quickie team - which really felt more like a family at that time. It was exciting to feel like I was an integral part of a vibrant group where my clinical contribution was valued in ways I hadn’t thought about when I was becoming a physio. For example, whether it was the marketing, sales, product development, product design or reimbursement team getting together to create strategies for success, my clinical input was always considered valuable. I will never forget the Quickie brand marketing buttons-“ Do you remember your first Quickie?” and “Nothing beats a Quickie” . Its fun today, all these years later, to still hear people talking about those marketing concepts with such fond memories.

Attending and working at the 1996 Paralympic Games in Atlanta with the Sunrise team was a highlight for me.

The theme was “Triumph of the Human Spirit” and it’s where I did one of my first presentations on the topic of Active Seating for the Active Person. I decided to do an interesting little observation just before that presentation:

I had my welcome slide showing a picture of a group of active nursing home residents and simply observed the way in which potential participants would react as they entered the room.

Almost all that I observed looked at the name of the presentation (Active Seating for the  Active Person), checked the name of the presentation on the door, and as soon as they saw the picture of older adults in the quite common “basic” wheelchairs on the presentation screen, they doubled back, rechecked the door, and couldn’t help but look confused!

I was watching this experiment from the sidelines and admit that I found it fascinating yet somewhat predictable. This was clearly not the picture people had in their mind to represent “active”. My next slide was more what was expected: athletes playing wheelchair sports. I suppose we were at the Paralympics, after all.

This is a paradigm shift that I have been very vocal about over the years- the fact that an elderly person can be and in my opinion should be provided with the same tools as every other population to be very active if they choose . This is particularly true if they are using a wheelchair and seating system that is optimally fitted/configured. I have always despised the stigma that I have seen and felt that goes with ageism in our world - thats another story:)

Let me say that again: Older adults who use a wheelchair that is optimally fitted and configured can, and should, be active.

Okay, let’s move on.

Along with attending and working at events like the Paralympics, part of my job description was to submit papers to relevant conferences. There was a large trade show/conference known as Medtrade that the Sunrise family used to work at annually, similar to RehaCare in Europe and the HCR show in Japan. They were HUGE and fun to attend, albeit hard on the feet from standing and walking around the show floor for several days. The show itself was mind boggling! So many new products – its was a feast for the eye of any clinician and exciting for the manufacturers as they were often the forum for new product launches. And the Sunrise booth was dynamic – all sports and lively it seemed.

The same could be said for our booths at the International Seating Symposium (ISS), which is another conference I became involved in with Sunrise. Back then it was in the US and Canada on alternate years. It has always been an absolutely fantastic clinical resource and experience, as is CSMC in Toronto, Canada. Every year it was my goal to get at least one paper/workshop accepted at ISS, Medtrade and at the CSMC.

One piece of advice I give to every clinician who considers jumping to the manufacturing/business side of life is to keep their clinical skills fresh and their belief system strong.

I was always thankful to be able to do this and to never be forced or even swayed by anyone to make statements about products I didn’t believe myself. I have always presented and practiced totally what I believe clinically and this has stood by me to date.

Settling into a role that involved about 50% travel was a huge adjustment for the entire family. In 1997, my youngest daughter, Charlie was born. Juggling this new dynamic job while being a Mum was - let’s just say - not for the weak hearted. We were able to arrange so that my oldest daughter, Jenn, was home with Dad or in daycare when I traveled and Charlie tagged along with me until she was no longer able to stay put in one place. It wasn’t long before the girls’ dad and I went our separate ways - just to add spice to the mix!

And the journey continued.

I did my best to travel when I had childcare covered and to be home as much as I could while still managing to remain employed, keep a house and pay the bills. My girls certainly had a lot of exposure to travel, clinic days, pelvises and seminars in their lives, and were even showing off their wheelchair skills at a very early age! My work was such a part of their lives that my youngest used to write to Santa Clause every year for a wheelchair. Not to mention, my oldest is now working with me as a recent PT graduate!

Family struggles are certainly not abnormal in this type of work, and having supportive individuals around me who understand some of those struggles has made such a difference.

When clinicians approach me and tell me that they would love to do what I do, I always make sure and share with them the importance of thinking through how they will maintain a work-life balance while travelling, especially with children at home.

I have many wonderful colleagues who travel and do similar work to me. We even had a Facebook group at one point, the “rehab road warriors” so we could share some of our daily travel experiences. I mean – you cant make most of that stuff up! For example, when you arrive at your hotel at close to midnight having worked all day and traveling all evening to be where you need to be for the next day, is it strange to open your hotel room door and find someone already in your bed… and not someone you know? … or to find a lovely little yellow post-it note on the headboard that says :” This bed has been made freshly for you” … certainly made one wonder - ‘if the sticky note is not there - what does that mean?!!’

Many of my colleagues and I have all become like a family to each other in many ways. That’s probably why conferences feel like a big family reunion more so than just another thing that has to be done for work. We support each other in every way possible. Becoming familiar with other clinicians around the world who do similar work has been a critical component of survival during the toughest times. Being on the road and away from family so often can certainly feel lonely and isolating.

Following a nasty skiing accident in 2011 that left me on crutches for several months, I decided it was time to transition to independent practice. I missed working hands-on with clients and had the desire for a little more flexibility with my work-life balance, leading me to depart from the Sunrise family. I was with Sunrise over a span of about 15 years and look back at those years with very fond memories. I am so thankful to have worked with such a great team.

I left this great experience with the same belief system that I began with: to never lose myself, who I am, or what I personally believe.

I also left with a huge bank of knowledge that I would possibly never have known about had I continued with my plan of being a sports physio! I left with a much deeper understanding and appreciation of:

  • Materials used in the manufacturing of wheelchairs and seating

  • ISO standards and how they relate to the products we prescribe everyday

  • How to get products onto government contracts and tenders

  • Writing a business plan

  • Logistics involved with continuing education provision in many areas of the globe

  • Working with teams with diverse backgrounds

  • Travelling globally on my own

  • Managing the guilt of travel and work while juggling the responsibilities of working full time and being a single mother

It was an adventure and thankfully one that I made it through with no regrets, & the next adventure was underway: Self-employed single mom in the US…with a broken leg. Of course, at this point I recognised that being self-employed meant having my own business. And thankfully, my many years of experience had led to numerous professional relationships with my family of colleagues who were supportive of the entire process.

And so began Seating Solutions, LLC.

This was really the beginning of a lot of things, as you might expect. It was the beginning of University visits with Jenn, which is partially why the flexibility of self-employment was so lucrative. You can bet that she wanted to get the heck away from home. As far away as possible. And of course we had to visit every one of her choices together. Eventually she settled on a small university in Northern California, surrounded by ocean and a beautiful Redwood Forrest.

Soon after Jenn’s decision was made, I was on an unexpected flight from NY to Denver that will not be forgotten quickly. I was working at the Abilities show in the New York/New Jersey area and received a phone call that I needed to be home a day earlier than planned. Lucky for me, United Airlines was able to get me standby on a last minute flight to Denver (not often do things go so smoothly).

Of course, the only seat available for me was a window seat next to this gentleman who was almost asleep. I had to daintily hop across him (those who know me know there is no dainty in me) and there it was, the beginning of what was to be a future romance!

For those of you wondering, the winning pickup line used was: “so what’s your story green eyes?”

That got him. Hooked and reeled. We never stopped talking the whole way. There was even a one-hour ground delay that we were not actually aware of - we were so engrossed with dynamic conversation! We covered pretty well most of the highlights and lowlights of our lives on that flight, and I learned that he had graduated (many moons prior) from the same university that Jenn had just committed to! The chances of that were beyond slim, but he had great memories and, as a mom, I was relieved to hear that people actually do graduate from that school.

We exchanged contact details and had no idea what the future would hold, both with a feeling that we would see each other again. I still don’t think Scott truly realised what he was getting himself into. Not many can handle an Irish woman who is fiercely independent with two teenage daughters carrying many of the same qualities!

Not to mention, this Irish woman had an incredibly atypical work schedule including days and sometimes weeks on the road away from home.

Similar to today, I was doing contract work with various organizations through Seating Solutions, LLC, which meant a lot of travelling was still taking place. I did a lot of work with Ottobock in the US mostly focusing on custom seating and paediatric interventions. Ottobock in the US also represented Leckey and Krabat products. This consulting role provided me with the possibility of doing not only educational seminars and training days, but also clinic days.

Any day in the clinic was a good day for me.

This allowed me to apply myself hands-on around the US in collaboration with clinicians who wanted to enhance their hands-on skills, especially those who worked with people presenting with more complex shape distortion and postural asymmetries as well as those working in paediatric early intervention. It was fantastic!

Consulting with Ottobock gave me the opportunity to work within another fabulous team that was led by Matt Swiggum. The following 6 years flew by – I was travelling a lot (kind of defeating the work-life balance attempt) doing this clinical work and again was learning from the engineers and clinicians on that team. Kim Chaney, an occupational therapist, Sarah McCarvill, an engineer and Ryan Shaffer an account manager stand out for me as key influencers during that period with regard to understanding the Ottobock way for designing, testing and prototyping product, as well as transitioning to scanning during the molding process in custom seating.

I did a lot of training for their sales team on the clinical relevance of their products and helped the newer sales professionals understand why it is so critical to have a thorough hands on assessment completed in supine and sitting before a seated alignment strategy is agreed upon and the shape capturing is done while creating a custom molded seating solution. One of the early adopters of this concept who absolutely excelled in this area is my colleague-turned-friend, Darrell Burnette.

During this time I also had the pleasure of doing some work with RAZ, a Canadian company. This created a slightly different twist for me. My role was in examining the different types of shower and commode chairs on the market and understanding what clinicians consider when prescribing such pieces of equipment.

I can tell you that we certainly need to pay close attention to the type of commode/shower chair/seat that is being used by the people we are assessing, working with or living with. I took the presentation “The Other Seat”, which was all about this topic, to many conferences around the globe. Let me tell you - I absolutely loved the conversations this generated among clinicians and carers.

If a person is considered to be at risk from a skin or posture perspective in their wheelchair set up, they are also at risk everywhere they sit and that includes the bathroom.

This means that the same effort and knowledge needs to be applied to selecting a seating solution in the bathroom as it is when selecting a seating solution for the wheelchair.

If you’ve been to any of my seminars where skin integrity comes up, then you know that this is something I am still passionate about to this day.

Years in Colorado continued to pass and I continued my cherished clinical work and travelling around the globe. New Seating Symposiums emerged in Latin America, Asia, Europe, and Australia, and I aspired to attend and present at them all. 

I had several great work trips to Argentina where I met so many wonderful clinicians. Silvana, Diego, Orestes, and Gustavo are just a few of those who gave me tremendous support. Of course my colleague and friend Sebastian Salice always ensured I had everything I needed to make these trips successful and safe.

I spoke at the Latin American Seating Symposium (LASS) several times and went back a few times to do more in-depth clinical hands-on training, where I had the privilege of meeting and working with many individuals who needed assessments. Argentina has a very special place in my heart as a result of my clinical experiences and interactions with beautiful people.

In August 2013, Scott and I got married on a cliff in Oregon.

One may wonder – why Oregon?

Well it was close to northern California (where Jenn was now in University) and it is one of both Scott and my favorite coastlines. It always reminded me of the west coast of Ireland!

We had no particular spot in mind. We just drove, parked and walked up the coast in the area we thought we liked. Our dear friends had also flown in from Colorado and when we reached “the spot” we knew immediately! The name “Sharon” was written on the sand (not by us), which was obviously an indicator that “the spot” was near. When we saw the peace sign made in the sand with rocks and sticks - That was it! There was a rope right there that we climbed up along from the beach which took us to the cliff top. We decided, there and then, where we would be married the next day.

And that, my friends, is how and when I became Sharon Sutherland: married by Jenn, given away by Charlie, and witnessed by LeighAnn and Jeff!

In early 2014, I was invited to contribute to a book that was being written about seating and mobility. I was very hesitant as I have NEVER considered myself a writer! With much persuasion and perseverance combined with mega encouragement (and editing) from the leaders of this fantastic project, Michelle Lange and Jean Minkel, the mission was accomplished! To say that I was relieved is an understatement! I wrote chapter 4 “Postural Support and Pressure Management Considerations for Hands-Dependent Sitters” in the book “Seating and Wheeled Mobility A Clinical Resource Guide.” You can find a link to purchase the book under our Clinical Resource tab (I don’t actually make any money from this, just so you know, but I do believe its a great resource!).

Soon I found myself in the “empty nest” phase. Charlie headed to California after high school graduation to pursue her education and dreams in Los Angeles. It was bitter sweet, of course – the excitement of not having anyone in the house other than my wonderful husband and dogs while also experiencing the constant worry, curiosity about daily life, and missing every little thing that probably drove me batty before!

Not far into this new, unfamiliar phase in March 2016, I had an accident while attending ISS in Vancouver. It was one of those accidents that was over and done so quickly at a time and place where there was so much going on - it took a while for me to process what actually happened. I believe I am still recovering in many small ways, even though I find it difficult to acknowledge.

On my way to the conference venue on a beautiful bright morning (which is spectacular in Vancouver) I was walking with my usual heavy backpack down a steep hill (one of the beautiful aspects of Vancouver). I wasn’t in a rush or surrounded by city distractions. I was simply trying to get to the venue with enough time to hear my colleague and friend Ginny Paleg speak and to set up for my presentation later that morning. Instead, I found myself falling to my right and accelerating towards the ground at an uncontrollable speed.

The result: gravity won.

I was down. And my face caught my fall. Because, of course, my hands had flown back to the backpack to protect my precious laptop.

A stranger had picked me up off the street and taken me to a walk-in clinic. After a little clean up and triage I insisted on continuing to my destination – the conference. I couldn’t be late for my own presentation after all…

Well, I later learned that I was apparently quite the sight! The whole right side of my face was traumatized. I had been stitched up in the clinic so of course I was going to do my presentation. I should note that I had intentionally been avoiding mirrors to further convince myself that all was okay (it was not!).

This is where the “industry family” I mentioned became critical.

Kendra Betz was all action and had me “cocooned” while I prepared myself to speak (much against her advice). Carlos Kramer sat in the front row and provided much-needed encouragement during my presentation. I kept my left side forward and, knowing that no pictures were allowed, continued with the presentation.

Upon reflection, I really don’t know how I did that – any of it. How I fell or how I presented to a room full of professionals afterwards.

One way or another, it happened. And then I had to get back to Colorado. A clinician from Denver, Cindy Duff (who I will forever be thankful to) escorted me to the airport in Vancouver and got me safely through security and back to my home state. The entire experience is still a blur. Much of my memory from that time period is still lingering just out of reach.

I do remember, however, that it was not a pleasant flight. It was miserable. My head pounded but I was on my way home and that was all that mattered. Scott was there for me in Denver.

After medical checks, I was told that I had sustained a traumatic brain injury. Thankfully I had not fractured my orbit. Good news!

As you can imagine, this information was not taken lightly and it was not taken well. I was self employed, responsible for two wonderful young ladies and a mortgage, and I needed to work. So work I did. Some might say that I was in denial about what had happened and the severity of the injury. I was incredibly frustrated with the symptoms I was experiencing and would often get upset with myself for not always understanding the symptoms that were to continue.

As a health care professional, one might wonder why I never had any formal treatment interventions other than self-directed. In hindsight, I wonder that, too. I was not referred to PT, OT, or SLP and I didn’t have the self-awareness, for whatever reason, to see what I needed for myself. Regardless of which treatment interventions I might have unknowingly had access to, the sheer denial and stigma that I felt was associated with my injury and subsequent symptoms left me in a lonely place where I didn’t feel like I could ask for help. I didn’t know how.

A lot changed for me after that.

I am not sure that I can pinpoint what the changes were but I know with certainty that I had a lot of work to do on me while juggling the rest. I continued to work (of course) and would ask close friends/colleagues if my performance was up to my usual standard. No one was aware of anything different, so I forged forward.

I was back working in Ireland in 2017 as I did most years during my life in North America. This time I was working in Limerick and Dublin thanks to Simon Hall at CRC, and it dawned on me: “It’s time to come home.”

I always wanted to come home to be closer to my own family but there was always something I allowed to be in the way. Not this time!

After returning to the US and breaking the news to Scott, Jenn and Charlie, things moved quickly. Very quickly! Just like that - our home was sold. That took some major decluttering (32 years worth to give perspective!). 6 weeks later I arrived home to my parents.

This time, with three suitcases and delivered by Charlie!

Scott followed a few weeks later and there it began! The next stop on this journey.

Since starting my own business in the US and practicing as a private and independent clinician, the takeaway messages that I hope to convey the importance of are below:

  1. Developing your professional mantra and establishing boundaries to respect your ethical and professional responsibilities is important. My mantra is:

    To never lose myself , who I am or what I personally believe

  2. The seated posture clinical presentations that I see in the individuals I work with, regardless of age or diagnosis (I work with all ages and all diagnoses) are often a direct reflection of how that person lies down and sleeps. I realised during this time in clinical practice that I had not been paying enough attention to every persons favoured sleep position. I made a commitment to myself…

    If I want to make a difference in seating outcomes – My care plan and recommendations must also include lying down positioning strategies and solutions and this I needed to implement consistently and immediately

  3. The value of early intervention. By early intervention, I am not only talking about postural care for babies who for whatever reason are not developing from a postural sense themselves but also related to traumatic and acquired diagnoses. If we don’t do something about postural support in lying, standing and sitting as early as possible we are missing opportunity to mitigate shape distortion, enhance/preserve; hip integrity; spinal alignment; respiratory and digestive functions as well as skin integrity.

Wow. We made it through. I know, that was a lot. And we have one more leg of the journey, which can be found here.

I know that a lot of you have some incredibly diverse experiences in the world of postural care and mobility. How great would it be to share a bit about who you are and where you’re coming from in the professional world in a comment below?! Imagine being a young professional stumbling through comment after comment of resources and reassuring stories.