Pelvic Health or Bust: Following Your OT Passion

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Transcript

Lindsey Vestal

My guest today is Alli Donaldson. She is an OT specializing in pelvic health across the lifespan. Less than a year out of grad school, she is the first pelvic health OT at her mobile therapy based company in South Central Alaska and is leading the expansion of services into Southeast Alaska as the regional director. Allie provides function focused care for adults, pregnancy, postpartum clients and children with an emphasis on delivering pelvic health therapy in real life environments through a mobile care approach. Her approach blends evidence-based practice with open, honest conversations about topics that people are often taught to avoid, helping clients feel more connected, capable, and confident in their bodies and daily lives. Allie is passionate about supporting both clients and clinicians and recognizing that growth often happens before you feel fully ready. I can't wait for you to hear today's conversation.

Lindsey Vestal

Alli, thank you so much for being a guest on the OTs for Public Health podcast. I am so thrilled to be having this conversation with you today. And I was wondering if you could just get us started by telling us a little bit about you, where you are in the world and where you're working.

Alli Donaldson 

Yeah, absolutely. So I am basically a new grad OT. I graduated in May and I started working in June and I currently work at Therapeutic Health and Home. It is a mobile based clinic out of our home base is Anchorage, but I am actually now kind of spearheading the expansion into Southeast Alaska. So I'm in Juneau, Alaska and just kind of getting things started out down here. I've been loving it. I work with adults and pediatrics in pelvic floor therapy, and that's been huge you know learning experience, but I've loved it so far.

Lindsey Vestal

So many things you just said in that very brief introduction that I want to hear so much more about. First thing is you graduated in May and you started in June. And I know you are incredibly passionate about starting pelvic health before you quote unquote feel ready.

Where does that come from? Tell me more about that because I cannot tell you the amount of folks that I think could probably agree with what it feels like, to feel like an imposter in these situations. And this is such a refreshing take. So tell me more.

Alli Donaldson 

Yeah, oh my gosh. So I think everybody has that imposter syndrome coming out of you know grad school. And I don't know that it will ever go away. I think you learn to live with it and to learn from it. And it fluctuates day to day to day. will say I've always been a very audacious and determined person. And when I found pelvic floor therapy, I just, I fell in love and I knew that it was pelvic floor therapy or bust. So it’s, you know, finding the specialty, I just dove, you know, head first into taking courses. And then from there, went on to more continuing ed and branched out and met different people in the field. I've taken OT Pioneers, and that's, you know, helped me along my journey. But, you know, it's been a big learning experience, and I'm still learning, I think. The sooner you realize that, you know, we're always going to be students in a way, the better.

And there's always more that you can learn. But we do come out of college, out of grad school with a lot of knowledge. And, you know, you don't have to wait for that special moment to, like, just click and you'll feel ready. Because I don't know that it'll ever come. I think we decide when we're ready.

Lindsey Vestal

Yeah. Yeah, I love that. And that's so empowering to that. Even just that statement, we decide when we're ready. And I agree with you. I very much felt like pelvic health or bust. And I think when you kind of agree inside your own self that this is the direction that you want, we start to take little micro steps and macro steps that get us there.

And I think that's a really important part of ambition and motivation. to be super clear on something and to be all in. And as you already so eloquently said, we continue to learn as we, as we go.

And honestly, what's better than that? I, I, I don't want to be in a career where I feel like I know everything. I think there's probably nothing much more boring than that. So it's awesome.

The other thing that I know about you, Ali, is that you are the first pelvic OT at your company. And I got to say that is huge. Was that a, was that a challenge for you?

Alli Donaldson 

It definitely, it was. You know, we have some great pelvic floor PTs, and I've learned a lot from them. You know, we work right alongside them. Honestly, part of the hard part was just kind of explaining that we do, like, they wanted to know the difference between us I was like, really, there's not a whole lot. You know, we see the same clients, we do the same types of treatments, we take the same courses.

But it's, yeah, it's been a challenge being the only OT in that it was have been a bit of education for others. But really, it's been great. and I am so glad to have started that kind of addition to our company of having those pelvic floor OTs.

I think we add a lot in this field in that, you know, we already come out of school with some different specialties in like sensory integration and interoception skills that PT may not necessarily have had exposure to.

And so I think that was a great addition to our pelvic floor team at Therapeutic Health and Home. And they've embraced me full force. They've been amazing. Part of this going so smoothly, I think, is having such a great company behind me.

But as OTs, as I think we all know, it's all about advocating for ourselves and showing, you know, are worth in different fields because pelvic floor therapy was definitely not an OT specialty or a well-known one for a long time and I think that's changing, but still a lot of growth there.

Lindsey Vestal

Absolutely. I mean, I think that the fact that we now have an OT specific certification, you know, the functional pelvic health practitioner exam, I mean, I think that there's so many steps that we're taking towards validation and certainty that our approach is to be celebrated. i think that we're going to be having a very different conversation in even a matter of the next three years. 

And it has been so inspiring to see people like yourself, like in the trenches, so to speak, making sure that happens. Because that brings me to the next thing, which is so huge. You said this in your intro just a few minutes ago, that you're opening a new branch as regional director. You've been with the company seven months and you are already opening a new branch as in such a prominent position. Tell me a little bit more about how this came about and what it's going to look like.

Alli Donaldson 

Yeah. So yeah, we are very excited to be expanding into Southeast Alaska. Alaska in general doesn't have enough pelvic floor therapists, let alone Southeast. And if anybody knows anything about Juneau, it's almost like it's an island. We're surrounded by water, except for on one side, we are connected to the mainland, but it's all ice fields. So we're very secluded. And we have a ton of different islands around here that have people who need help. So we will be branching out slowly but surely providing pelvic floor therapy as well as pediatric OT and PT.

And the way this came about was kind of a whirlwind. My husband and I knew we wanted to go back to Southeast Alaska. We have lived here from 2018 to 2021, January 2021, you know, I have hopes of having a family not too long from now. So we knew we wanted to come back. And when he found a position, I knew that I wanted to stay in pelvic floor therapy, but there really wasn't any positions open for that, for pelvic floor. So I knew I was going to have to make my own.

So I originally started by kind of taking the steps to create my own business. And when I let my employers know that, you know, I was going to be moving and potentially doing my own thing, they wanted to keep me. They were like, why don't we move with you?

And I was so excited when I heard them offer that because Therapeutic Health at Home has really helped me grow into the therapist I am today. And I love their focus on having accessible care in these communities. We're a mobile based model, kind of mobile clinic hybrid.

So we can meet people in their homes, at a park, in the library, anywhere, and really see people in their natural environment, which as OTs, we know how important that is.

That plus having a clinic space in case, you know, there's those people who want that more private environment. And it's just been great. And so with their support, they decided to create this role of Southeast Regional Director because they've had their eye on Juneau as well and knowing the need for, you know, the populations here. So that's kind of how it came to be. wasn't expecting it, but it's been amazing. And I'm so looking forward to it.

Lindsey Vestal

When do you think it will actualize?

Alli Donaldson 

So it's actualizing right now. I am seeing clients this week. It's just me at the moment, but we are actively hiring. So any OTs who want to move up to Alaska, whether that be Anchorage or down here in Juneau, we would love to have you and then, yeah we're doing interviews. So hopefully we'll be expanding very quickly.

Lindsey Vestal

Did you raise your hand for that position? like how, how did you get that?

Alli Donaldson 

It was really created for me, I think, because they saw something in me early on, which I'm forever grateful for. They knew that I was going to be somebody who, you know, kind of sought more.

I reached out to them in college to originally get the position as a pelvic floor OT. So I wasn't quite out of grad school when I reached out to them wanting to move up here and work for them once I graduated.

They took me on and I think they saw from then on that, you know, I was a go-getter. And so when basically when I said that this means I might have to leave because I need to move down to Juneau with my husband, we're hoping to start, you know, a family the not too far future.

they we said, well, we're going to come with and we're we, we'll make it happen. And it just kind of worked out that, you know, they were wanting to expand and I was wanting a new opportunity and, you know, we just kind of came together and made this happen.

Lindsey Vestal

A match made in heaven for sure.

Alli Donaldson 

Yeah.

Lindsey Vestal

That's incredible.

Lindsey Vestal

I love, I love that. You know, one of the things I also have to, I feel compelled to share that you had reached out to me, to be on this podcast, which, you know, doesn't happen a lot. And so that told me a lot about your internal fortitude and sort of your drive, you know, And one of the things that you had said to me in the course of us talking about you coming on as a guest was, you said, waiting would have slowed both my growth and access to care.

Tell me a little bit more about that, because I think that's something that will really resonate with the audience.

Alli Donaldson 

Yeah, I think with waiting comes a lot of second guessing yourself. and you know, I don't know, like I said earlier, I don't know that there will ever be a time where you just feel ready.

And with pelvic especially, it's so important that you're just, you get your hands on people, you know, you're working with the clients, you're learning what a tight muscle feels like versus, you know, a weak muscle. you're you're actually in it. You know, you're getting your reps in, I guess, as you could say.

And if I had waited to feel ready, I don't know that I would ever have saw anyone because I was so nervous, especially my first like real client doing like an internal exam. It's nerve wracking for them. It's nerve wracking for you. You're always going to feel like there's more classes I could have taken more things I could have done. There's all this knowledge that I wish I had, but I don't quite yet.

But the real learning comes by doing. And I think by you know, just getting out in the field and working and starting before I was ready and getting comfortable feeling uncomfortable.

I've grown so much. You know, it's only been like eight or so months since I graduated. But the girl I was then and the girl I am now are two different people. And I attribute that a lot to just going after it.

You know, the worst that can happen is you learn from a mistake and you, you know, it's a growth experience, all of it. So I think, you know, that's kind of where that came from of just do it and then you can learn from it and correct as you go.

Lindsey Vestal

That phrase that you said, learning by doing, you know, as occupational therapists, we know that that's such a core part of our graduate school experience, you know, and I love that you're bringing that back to us and kind of challenging us to remember that in our own career trajectory, in our own pursuits, in where we see our own growth happening, because yes, it's beautiful that we share that with our clients and it's such a true sentiment, but I think you're really reminding us to bring it back home and to to remind ourselves that in the doing we become.

Alli Donaldson 

Yeah, exactly. And I think, you know, we, I’m really passionate about trying to get more OTs to, you know, push themselves into doing this kind of thing, whether it's in pelvic health or just general OT.

Yeah. I just, I want people to just, you know, test their limits, you know, go do the, do the thing, you know, you're more skilled than you'll, you give yourself credit for.

You know, we wouldn't have made it through grad school if we weren't super passionate about what we're doing and very knowledgeable in our work. And I think if we just take the risk, take the leap, we can really surprise ourselves with what we can accomplish.

And there's so many people who need our help. And if we're waiting forever to feel that spark of like, oh, I know everything, there's going to be people who, you know, miss out on the care that we can provide.

Lindsey Vestal

And I innately believe, Alli, that there is never a point that we know everything. Our field is evolving so much, you know, The Pelvic floor therapy specialty is still so new and we're so behind in terms of evidence-based research that one of, to me, the most beautiful things about being involved in it is the fact that there's always something to learn. And I think that newbies can feel really daunted by that. But the truth is, if you future cast yourself four years into the future, two years into the future, you're actually thinking yourself, how many folks have you met in a wide variety of professions who are burnt out, disgruntled, unimaginative, you know, they've lost their spark. And I think one of the things about pelvic health in particular is that as long as you stay current and are always growing, that is the last thing that's ever going to happen. And thankfully we're in a field where new revelations and new, new research is coming out all the time.

And so I think it's one of the most exciting things when we can, you know, recognize that it's hard, but that our future self can thank us.

Alli Donaldson 

Absolutely. Yeah. i I think this field really attracts people who are lifelong learners and like desire that new knowledge. And, you know, we want to know the best exercise, the best manual technique, all the things to help that one client. Like it every, like we go above and beyond to learn and to just be as up to date on the research as possible. And I applaud pelvic floor therapists and OTs in general for that.

Lindsey Vestal

Yeah, 100%, 100%, Another thing when you had reached out to me, Allie, that you had shared was that patients don't need a perfect therapist. They need a present one. Can you tell me a little bit of more about that philosophy of yours?

Alli Donaldson 

Absolutely. Yeah. You know, none of us are perfect, whether you've been in the field eight months or eight years. or however long. We are constantly learning as we go.

And I fully believe that a lot of our clients really just need somebody to be present and, you know, listen to them and validate these symptoms and emotions that they're feeling. If we're, you know, if we're there, speaking with them and we're listening to their needs, this could be the first time that they've had that from a provider.

And like oftentimes I think it was like seven seconds that they found but between the time a patient starts talking and they get interrupted by a provider.

So I think just being there means the world to a lot of these clients. They're going through some, a lot of them are going through some very hard things in their life that brought them to pelvic floor therapy.

I mean, just the word pelvic floor therapy can be really triggering to some people. It's a, I think, very, can be kind of stigmatized for those who haven't, they don't know much about it.

It's a scary thing to take the leap and go to that first appointment. So, you know, my first thing is just to listen and validate and say, I'm here, going to work together.

You and I, you know, I don't know how long this is going to take, but you and I will work together. We're gonna find a solution.

Lindsey Vestal

That's beautiful. You are someone who really likes to be a bit of a visionary, kind of have a path to follow. Where do you see yourself in the next three to five years?

Alli Donaldson 

I see myself growing this branch, so Therapeutic Health at Home Southeast. I hope to have, you know, a few, at least two, three therapists, if not more, as many as I can have. But as I've mentioned, Juneau is a very secluded place, so we'll see what we can get in the next few years. And not only pelvic floor, but as well as general OT practitioners and pelvic or physical therapists as well.

I see growing my skills and knowledge set on all things pelvic. I'm, I guess you could call myself a little bit of a continuing ed addict, although I try to limit myself. I love taking courses, learning new things.

I, and yeah I just see, I think growing with that my but my company and within this community.

Lindsey Vestal

That's amazing. It was such a pleasure to talk with you today. Thank you again for reaching out to me and for initiating this and sharing this incredibly positive, invigorating approach that you have. I hope that so many of our listeners can feel a sense of, sort of the, the, not only the solace, but the clarity that comes with making a decision like this and sticking with it.

Because one of the things I think is most inspiring about occupational therapy is that we can reinvent ourselves so many ways. And I think that's some of the most fulfilling aspect of what we do. 

And so I really appreciate and and want to acknowledge your approach. And I know going to continue to be so successful. So thank you for for bringing this incredible conversation to our community today.

Alli Donaldson 

Thank you. Yeah, thank you for, you know, letting me on this podcast, getting to share my story. And hopefully this reaches some new grads or just newbies to the pelvic floor world. I know how scary and overwhelming it can be. And You know, I'm still in it. I'm still learning. I'm still growing. And if I could give, you know, any advice to a new pelvic floor therapist, it would be, you know, get comfortable being uncomfortable.

There will never be that perfect moment and, you know, start before you're ready. I would also say slow down. I know that for me, I felt like if I just kept talking, if I just kept moving and doing the things and having them do this exercise, then they couldn't question me. 

And they would think I was more intelligent than I was. But really, if I've found that if we slow down, not only do I feel like I'm better able to trust myself in what I'm doing and think through and make those clinical decisions, but my clients will they feel more confident in me as well.

And then the last thing I would also say is seek community. The biggest thing that has helped me throughout this journey has been reaching out to other pelvic floor providers.

And, you know, I reached out much like I reached out to you. I have gotten to know so many amazing people in this field and people who I you know idolized back when I was still a student, I now can call colleagues and friends because we're all still just figuring it out. and we really lean on each other to learn and grow.

Lindsey Vestal

Amazing. Thank you so much, Allie.

Alli Donaldson 

Thank you.