Joey Wahler (Host): It helps many children in need, so we're discussing physical and occupational therapy. Our guests, Sally Moeggenberg, a physical therapist, and April Trenaman, who's an occupational therapist, both with Shriners Children's Portland.

This is Healing Heroes PDX, the podcast series, specialists at Shriners Children's Portland. Thanks for joining us. I'm Joey Wahler. Hi there, Sally, April. Welcome.

Sally Moeggenberg: Hello.

April Trenaman: Hello.

Host: Great to have you aboard. So first for you, Sally, as a physical therapist for children, tell us a little bit about your specialty.

Sally Moeggenberg: Well, the main thing I work on is promoting mobility in children. So generally, they have different conditions that are limiting that. And I try and zone in on what their greatest limitations are, and work on strengthening and different forms of training to get them as independently mobile as I can.

Host: Gotcha. So for you, it's all about movement primarily. And April, how about you? As children develop, what does occupational therapy do for them?

April Trenaman: So, occupation includes things that people need, to want to, and are expected to do, and anything that occupies their time. So for children, it includes anywhere from self-care or ADLs, play and then work, which for them is school.

Host: And why don't you tell those of us unfamiliar what ADL stands for again?

April Trenaman: That's activities of daily living. It includes dressing, bathing, feeding or eating , things like that. And as an occupational therapist, I'll help individuals engage and participate in their desired activities that they'd like to participate in.

Host: Gotcha. And so, for both of you, to take a quick step back, how about telling us a little bit about your experience? And what first drew you to pediatric therapy in the first place? How about you, Sally?

Sally Moeggenberg: I've always just been drawn to working with kids. They're typically very positive and willing to try new things. And as I went through physical therapy school and began my internships, that was just the direction I knew I needed to go.

Host: And April, what piqued your interest in this field?

April Trenaman: Well, Sally and I are a lot alike in this way, in that I always knew that I was going to do something with pediatrics from a very early age. And when I got into OT school, I went on every possible field trip there was to Shriners, and this was actually my dream job while I was in school.

Host: To be able to perform your dream job is really a gift, isn't it?

April Trenaman: Yeah. I was very fortunate.

Sally Moeggenberg: April and I both got our starts at Shriners as students.

Host: And so, you've just stayed and got on from there, huh?

April Trenaman: Yep.

Host: And it sounds like you both knew what you wanted to do early on, which also, again, is something that not everyone can say. So, definitely a tip of the cap to each of you in that regard. So, what are some of the most common reasons you see kids and also adolescents in your therapy room, Sally?

Sally Moeggenberg: Well, it's frequently strength or lack of mobility issues. So with small kids, you're promoting strength with play and activities that challenge them, because they're not going to do traditional exercises. So with them, motivation is essential.

Host: And April, what are some of the mean things that kids come to you with or for?

April Trenaman: So, most of the things I'm looking at and that the kids have limitations in are, again, the ADLs or activities of daily living, being independent with those things and caring for themselves. But also, fine motor skills, being able to use their hands for tasks, because we use our hands for everything, and including upper extremity weakness and range of motion limitations. We also will assist with technology needs, being able to have the children engage with activities that are using switches maybe to play a game or to help in those areas that they're limited with.

Host: Okay. And Sally, how about patients with overlapping needs in both these specialties? How do you and yours work together to meet their goals?

Sally Moeggenberg: Well, April and I-- the populations that we work with are generally kids that they have cerebral palsy or neuromuscular conditions, pretty much lifelong conditions. So, we overlap a lot , and we work together a lot. So with balance and learning to use alternate forms of mobility, we work as a team to promote as much independence as possible for each child.

Host: Yeah. I'm sure that's eventually one of the main goals here, if not the number-one goal. April, what makes the physical and occupational therapy experiences for kids different at Shriners Children's Portland than at other facilities? How do you guys stand out?

April Trenaman: Well, like Sally said with the last question, we work closely together and we have access to a multidisciplinary team and care in a supportive environment. So, we don't necessarily see each other as having boundaries. We work together and we work on similar things to make sure that the child is well taken care of and we look at the whole child and even their families to make sure that everybody's needs are getting met. And we have a great system here that allows us to provide care even if the families aren't able to financially fund it. We will see kids, even if they're not able to pay or don't have insurance.

Host: And so, let me ask you about that last point, because Shriners has been doing that, helping kids in need financially and their families, of course, for generations. How freeing is it, if you will, to know that money often isn't an issue at your facility and that you can just deliver whatever services are needed?

Sally Moeggenberg: Well, definitely, the generosity of our system gives us much more flexibility. We are free to try as many options as we have available to improve these children's lives. And again, as April said, we can work together with physical therapy, occupational therapy, speech therapy, recreational therapy. All of these are important contributions that a lot of places do not have access to.

April Trenaman: And we have direct access to our medical providers as well to communicate with them and get orders when we need them. And it makes things so much more smooth here and as well as having POPS right on in our building, which is our orthotics and prosthetic department. So, it is a very well-rounded medical--

Sally Moeggenberg: Multidisciplinary care team.

Host: It definitely sounds like it's a team indeed, and a lot of collaboration at all times. Sally, you've been at Shriners Children's Portland for many years, as has April. You've both seen great changes during that time. How would you say services there have most evolved during your tenure?

Sally Moeggenberg: I would say that we remain focused on each patient's needs and, again, family centered care. Healthcare in general is increasingly more challenging to navigate. But the generosity of Shriners gives us the best case scenario for our ability to address those needs.

Host: Well, family has been mentioned already during our conversation. April, how important a part of this whole situation for the two of you and yours is dealing with loved ones who often are going through what their child is every step of the way, both literally and figuratively, right?

April Trenaman: Yeah. It's important to include the family, because they're the ones that are giving the 24/7 care. And anything that we are doing in our treatment sessions needs to be continued at home for the child to improve, because being seen once or even twice a week for an hour isn't going to fix things completely. There's things that need to be continued to work on. It's like if you or I went to the gym once a week, we're going to start over each week when we go back, because we haven't built up the strength or endurance or whatever it is we're working on by only doing it once a week. So, the families are very important in the care of these children.

Host: Absolutely. Great analogy there with the gym. I'm sure many of us can relate to that as well. Couple of other things before we let you go. In summary here, April, you've surely seen and helped many children be prepared to enter adulthood largely because of your care. So, how rewarding to see children you help make that big transition in life?

April Trenaman: It's really great to be able to see them transition into their next adventures when they grow out of our system. And it's nice when we can really stay in touch with some of them through what their continued growth is and see them get jobs and have their own families and just do some great things.

It, however, can be sad when, as they age out of our system, that we lose touch with them, and then we don't know if they continued to improve or if things didn't work out very well for them for whatever reason. So, it's exciting and can be also a little bit heartbreaking when we lose touch.

Host: Yeah. But Iit sounds like it's often very emotional for you both, for sure. And Sally, speaking of that, how about telling us a little bit in the update department about Scott Hatley, who recently was on this very podcast and how you both helped him transition his way into college. That must have been something.

Sally Moeggenberg: Yeah, Scott is a remarkable man and was a remarkable teenager and young man as well. I don't think we had as huge a role as it might sound. We had a very small role. His family was phenomenal about preparing him for college. But we did get to go to the University of Portland. This was especially exciting for me because I went there as well. So, I was happy he was going there. And before he started school, we went to the dorms with him and we took a good look at the dorm room and the accessibility and advised on how they could accommodate his needs as he was in a wheelchair, and just do everything possible to make it the most accessible option for him and make his transition there go more smoothly

Host: . And at your alma mater as well, you said.

Sally Moeggenberg: Yes. Go Pilots!

Host: I was just going to say, "Go Pilots!" You beat me to it. And I actually know the Portland athletic nickname. How about that? And is there any truth to the rumor, Sally, that Scott wound up at Portland, because that's where you matriculated, as they say.

Sally Moeggenberg: I don't think so.

Host: Well, folks, we trust you are now more familiar with physical and occupational therapy for children. April, Sally, such important work that the two of you do. Keep up all your great efforts and thanks so much again.

Sally Moeggenberg: Thank you.

April Trenaman: Thank you.

Host: Now, if you found this podcast helpful, please do share it on your social media. I'm Joey Wahler. Thanks so much again for being part of Healing Heroes PDX with Shriners Children's Portland.