OT Month with Adrienne Loukopoulos

Welcome back everyone to another another episode of the Freedom Talks podcast. This is your host, Joe Ogden. This week, we've got definitely a pretty fun podcast this week. We have our OT and recently certified certified hand therapist, Adrian, joining us today celebrating OT month. And she's gonna go through a little bit about her certification, and I'm gonna push her a little bit to talk about herself because I know she won't.

What's up, Joe?

I kinda sprung this on Adrian. When I put together a podcast schedule in 2025, Adrian's still on maternity leave, and I really just put this on her schedule without telling her. Now she's sitting down.

It's fine.

And I'm keeping you here so you can't go get your kids too. So you're staying for a podcast.

Yes.

Molly will be so happy.

That's okay.

Mike will be so happy once we post this.

Yeah. All for marketing.

OT celebration month.

Yes. April.

Let's first, I know it's kinda different here at Freedom and Mike. And actually, we have the celebrity owner, Mike Herajenis, actually in the background here as we do this. So pressure's on to say some positive things here. Mike works us like dogs here. Little kidding. Kidding. Kidding, of course. Kidding, of course. OT here at Freedom's a little different probably than some places, would you say, Adrian?

Yeah. Well, if you look at OT in general, right, not a lot of OTs go in the orthopedic world. You'll see them in like acute care working on dressing or at like a skilled nursing facility working on dressing, getting up, all that stuff. So orthopedics is just kind of different in general because we see more of the shoulder replacements, tendon repairs, that type of stuff.

Remind me again. Know we did a podcast last year kind of

Did we?

Yeah. Okay. It's just like an intro to you. Has Freedom been your only professional job out of OT school?

Yes. Yep.

How many clinical rotations did you have in OT school?

Two, like, two twelve week and then two, like, basically, there was shadowing.

Would you say freedom, no pun intended, gives OT and you, like, the most freedom to kinda treat how you want and treat different presentations that people come in with?

Yes. I would say so I was at Froedtert for one of them. And that was tough because it felt like you were being watched all the time and the therapists were really competitive with each other. So you

That's my experience as well.

Yeah. You couldn't, like, share patients if you felt that a different therapist was more suited for them. It was very much like, I keep my patients. You don't see them. And they would get mad with each other if they tried to share patients.

They let you know. Right. Where I feel like here and I was actually just talking about this during the intro too before you got here. I feel like here, especially now, therapist wise and I can speak for Fox Point. I mean, feel like we have a really good group of people working together that whoever and then we share back and forth a lot now Yeah. Which I feel like is more than ever

Yes. Yeah.

Where I feel like everyone's very capable. Oh, Adrian, what do you think of this person? I just saw x y and z. Like, are you

Yeah.

And you're like, oh, you know, try this or this sounds good or I can see them too. I think that's really cool here.

Yeah. Well, and it's nice because there are so many times that a patient will come in and I'm treating them for their shoulder, right? Because I I do upper extremity and they'd be like, oh, my knee's been killing me the last couple days. I'm like, oh, yep. Okay. Let's get you on with Joe or Aaron

or How many times have done that where I'm just walking by or you're walking by like, hey, can you look at this quick?

Yeah. Probably more probably more than the PTs want me to. But it's nice that they're right there. Normally, somebody has a little break or something that they can just take a quick peek. And it's nice for the patient that they get to have something, a stretch or something when they come

in. I think it's nice too, just our setups with the semi private curtains where we can just pop in quick. Like, hey, you're gonna see Joe. You haven't met him before, he's right here.

Yeah.

Pop in and Yeah. Nice to meet you. Yada yada yada. So that it's an easy kind of transition. But since you just brought up your hand the hand surgeons, I'm gonna blast you about your new certification that we're very proud that you got.

Yes. My CHT, certified hand therapist. Finally.

You're gonna underplay it a little bit, but

Yes.

You had a baby in the fall I had baby in studying.

After studying.

For this test that there's no Curriculum, I guess. Curriculum, right? It's just OTs that have passed it that have put it together?

Yeah. So the like, HTCC, the people that make the exam, they technically have kind of, like, a study guide. Yeah. But they don't give you, like, you need to know all of these things. So there are a lot of therapists out there that have taken it, passed it, that have developed their own study programs to help people study for this exam.

When did you take it? November?

November ninth.

When was Delfina born?

October 1.

Were you studying in the hospital?

I was studying in the hospital. I got a lot of questions about it. Yes. Yes. Yes.

Tell us a little bit more obviously, certified hand therapist. The name speaks for itself. But let's back up a little bit. Tell us why you wanted to do this, what it opens you up to. Because there's not a lot of OTs that have this. Right?

No. So there are currently worldwide, there are just under 7,000 CHTs worldwide. So there's not many CHTs. The exam, to take it, you have to have four thousand hours of practice and be practicing for a minimum of three years. They tell you to take at least a year to study for the exam because the pass rate can be anywhere from, like, forty some percent to fifty percent. So it's a pretty low pass rate. And they tell you the more times you take it, the lower the pass rate is.

Just like any test, probably.

Yeah. Yeah. So when I decided to go the orthopedic route in OT, then I decided I'm gonna become a certified hand therapist at some point. But it was always at some point. I never had a set time.

You guys decided to have baby number three while you were studying?

Yes. Yes.

I guess my math is kinda off on how all that Yes. Transpired. Yes. You guys are nuts.

Yeah. Brady reminded me, like, I'm having the baby and then I'm sitting for that board exam five weeks later. So we did it. But I've always wanted to be a CHT. The hand surgeons in this area really only refer their patients to a certified hand therapist.

Because they just probably want just added expertise to make sure that things their surgery recovery goes well.

Correct.

Yeah. I the hand is Understandably so.

Yeah. The hand is really complicated, so I get it. And studying was great. It was a really good refresher, and I learned a lot, like, on a deeper level than you learn in just OT school. Now looking back, while I could rehab those patients, I feel like I'm would rehab them even better now having that deeper knowledge of the anatomy and why things work this way and not that way.

Is it set up actually, before I ask this question, I would like to point out that Adrian is there's one hundred and fifty thousand as of 2025 OTs in The United States.

Yes.

So if you're in the 7,000 number, you are Worldwide. That's that's crazy.

Yes.

And you'll never you will never hear it come out of Adrian's mouth. She will never give herself enough credit for taking that. So I just think it's really cool. But is the certification set up more from a rehab standpoint? Or is it also a diagnostic?

It's most of it is set up as, like, here's your patient, This is how many weeks out they are. This is their range of motion measurements. Now what do you do?

Okay.

They have technically different categories of questions. And the questions are all weighted differently. Right? So you have to get a certain score, but that doesn't mean that's how many questions you have to get right because the questions are weighted differently. So if you get all of the really hard questions wrong, you're gonna fail because those are How many questions

is it?

200. Those are weighted higher.

What's a passing? 80%?

There's not it's not a pat there's no percentage. Just have

to get it or you don't?

Yeah. So you have to get it's a it's a number that you have to get. But they don't tell you how anything is weighted. So you have no idea, is this question weighted more or not? And that is the hard thing I think studying, everybody asks in all the online groups, how many can I get wrong?

Is it a standardized test like a board exam? Like, you're taking it at a testing center?

Yeah.

Who's the governing body? Like, who

It's h t c c is the

Is that like the APTA?

Yeah. Yeah.

Like, okay.

Yeah. Like, hand the hand therapy commission.

Okay.

And I I'm trying to remember how long it's been around. It's been around for quite a while that they developed this test. Yeah. But you go to a testing center, you get four hours, two hundred questions to

I saw I I know we've talked about this off off the podcast. But I to me, I think it's crazy that you have this you have this standardized certification that I mean, that this is everywhere. Right? But there's no, like, standard on what we're saying is like, if you know all these concepts, this is what the certification makes up. It's just people making this.

Yeah. I just Yeah. It's a weird concept. Yeah. I don't know who, how, why this really was developed. I mean, they say it's developed to basically show that you have, like, this you're really distinguished in treating

hand Right.

Quote unquote hand therapy. Now, also, being a CHT, the test is not just on the hands. It's on the whole upper extremity. So I had to know neck. I had to know shoulder.

Everyone went through some elbow stuff too, didn't we?

Yeah. So it's not just the hand.

What is so do they go through to like, I know some certifications will be, okay, now you have these letters. This is also now how you market it. Yeah. Because we've we've talked about this, I think I think therapist, Mike and I have talked about, Scott and I have talked about it. The reality is patients who don't know what letters mean.

Correct.

Some patients will come in and be like, well, I just want someone who has most letters after their name. Others, it's like, it doesn't matter to me. Do they also go through in the certification like, okay, Adrienne, now you have your CHT.

Yeah.

Now do this because this expands your practice. Because it's not like people are just knocking on Freedom's door and like, oh, Adrian got this yesterday. Can I come see her?

Yeah. They do provide some, like, marketing information for us. It wasn't a ton, but they provide some handouts and, like, how to explain it and, you know, diagrams to show really how specialized or how few therapists there are that have their this certification. But I would say the hard thing is because there's not, like, a a person or a teacher or professor from them that you can talk to, it's hard to ask questions. So, like, my teacher that I had, she has her own practice, and so she would talk about things that she's done with her practice, but that's not necessarily, like, worldwide or

how That's why I think it's so tricky about our market, whether it's OT or PT. It's Yeah. State to state, it's different how things It's

different. Yeah.

It's different how even we work with doctors. Mean, it's a

Yeah.

It's real it's you're comparing apples and oranges sometimes, which is helpful, but at the same time, it's like, oh, that was relatively useless Yeah. For what we need.

Well, and in our area, a lot of the hand surgeons have their OTs and CHTs right across the hall from them. So for me, to get them to send patients to me is gonna be more of like a battle for me, I would

How does this compared to what you do now, how does the CHT kind of change either the I know, obviously, it's a lot of hand surgeries, right? That's how it changes the demographic. But how does it change kind of your caseloader? How do you want it to evolve?

Yeah. Eventually, ideally, the hand surgeons would refer. I think for our clinic as a whole, we would have to be more suited to treat hands in terms of splinting, different materials, wound care, which would be great. I just wanna see that those patients increase before I really start changing the clinic and taking on some of that stuff because it's not cheap to do all of that either. So ideally, starting to market, meet with some of those hand surgeons, and also to the patients.

I think that's a really good educational piece. And I think before we kind of go into this, we're not knocking how it works. It's it's just the reality of it. Yeah. I think you're familiar with in Appleton, the what is it? The hand and hand shoulder center?

Yeah. Yep. I had

thumb surgery there. I remember going

Yeah.

Into the surgeon. Mhmm. And he's like, oh, just hang out. I'll I'll do this today. I'm like, oh, okay. Whatever. Yeah. They do the surgery, and then they walk you down the hall Correct. To their PT, OT

Yeah.

Room, which is massive. And they're like, all right. You can start. We'll we'll splint you first.

Yeah.

And then you can start OT. And I remember my parents had to speak up. We're like, we live forty five minutes away. I'm not going come here for

Yeah. Yep.

Whatever, half hour, forty five minutes just to go through

Yeah.

Some exercises, which is tough.

Mhmm. Yep.

But patients have to advocate for themselves. Yeah. You don't have to go anywhere, really.

No. You can go wherever you want.

And of course, they're gonna try and keep it because that's just

Yeah. It's part of the business. Right? And I get it. And I get it, right? Especially if you do have a patient that just had surgery and you're taking their post op dressings off and they need a splint right then and there. Yeah. It's really convenient for the patient to walk across the hallway.

And they did it all right there, which is pretty and that building's really nice too, Yeah. And that was ten years ago. I'm sure it's gotten nicer now.

Well, and Ann Perretto is the big OTCHD up there, who's kind of like this world renowned CHT in our world who does all the classes and education.

Oh, that's where she works?

Yeah. Oh, cool. Windsor Clinic. Yep. So I get the ease, but also, like you said, some patients don't live where that Yeah. Surgeon is. And so for them to drive then, it's more convenient, right? And like our location here, we're right in the neighborhood. We have so many patients that in the summer can walk here, can bike here because they live right around here. Not going to then drive to go see their hand surgeons, OTs, when it's way more convenient to come here.

Do you looking back, and I think this is the tough for me personally, is the tough part about continuing education. Are you after you finish this, did you look back at a ton of patients and be like, oh, dang, I wish I would have known what I know now because I Yeah.

There are a few of them. I think for me, the one diagnosis that drives me nuts is tennis elbow. I don't know why. I that diagnosis, I feel like patients just don't get better, or they don't get better quick. Yeah. And they're frustrated, and I get it and it's frustrating that they're frustrated. So there are different things that I learned throughout the class, things to work on that I wish I would have known Yeah. Years ago to better treat those patients.

Where does it go from here? Like is there do you have to do certain continuing ed just for the CHT itself? Or you've got this? You've got it forever?

No. You have to recertify every five years. And you so, like, the first time you recertify, you have to have, I think, it's two thousand hours of direct patient care. And then you have to have eighty hours of continuing ed. And you have to submit it all and get it all approved. So, like, I could start submitting now, like, my hours of practicing and get that approved. But you have to do that every five years.

And that's true, like, the APTA of OT. Like, they're saying, hey, this stuff counts for continuing ed if you take it.

Yeah.

Does your review group like that where's the private practice? Is there in Florida? Where is that first lady?

Oh, yeah. It was in Florida. Yeah.

Does she also do continuing ed to say like She does. Okay.

Yeah. Yeah. So she does, like, in person manual workshops and and things like that.

Okay. Does it go from here? I mean, I know you just got it, but, like, Well,

great question. I feel like the last couple years, right, I did my dry needling certification, then I took this on and did this. So I am just, like, living life, enjoying my kids, taking a little bit of a break because I can't even begin to consider another certification. So I'll do, like, my continuing ed. I would like to do more splinting, so I'm hoping to do more splinting classes.

If you start doing the splinting

Yes.

I'm just thinking off the top of my head. How would that work? Would patients see the surgeon? Mhmm. And they say, okay. We're gonna go see OT. We're gonna splint. Would patients then have to say, I already know I want to see Adrian. They come in without anything and then you do it?

Could. Otherwise, more than likely what will happen is they'll see the surgeon, right? They'll have the surgery, Okay, follow-up with surgeon, surgeon says, okay, you need this type of splint. The surgeon's CHTs will put the first splint on and then I would take over. And I can, right, modify modify the splint, right, if they have a tendon repair, we can adjust it.

I'm gonna give you a hypothetical

Go for

it. Age. Because you and I are not I feel like we get along very well.

Oh, god.

And I am not very competitive at all

Yeah.

As far as with patients. Yeah. You just took this CHT. And we talked a little bit during a review on some Tommy John stuff just because it came Yeah,

yeah, yeah.

From your standpoint, a patient comes in and says, you know, just had Tommy John. Now you have your CHT. What do you from that or even like a rotator cuff repair, like a thrower. Right? Yeah. What advantage do you think you have over me?

Well

Now, obviously, this is different if we're super competitive, and I'm trying to keep that patient.

Yeah. I mean, so things like that, right? Baseball. I've never played baseball. I don't really care about baseball. So if I think you are gonna be a better fit because you're gonna know what exercises they do in practice, what I am happy to refer them out. Yeah. Right? Now if you're seeing a baseball player, but they have, you know, a flexor tendon repair, I'm gonna say, okay, Joe, like, let's Yeah. Let's figure this out.

And the only reason I bring that up like that, I I really think here and not that it was bad before, but I think we're I just notice it more that we're more now and it's probably because we're working together longer. I think professionally, as a whole, OT and PT, I'll speak for them as a whole. I think we do a really bad job of being like, okay, This probably isn't the best for me, but I do know someone that

Yeah.

That can take it here. Yeah. Yeah. Because we all have our strong suits.

I mean, and even some of my shoulder people. Right? Like, I evaluate them, like, I don't love treating the neck. I mean, I had to know for the exam and I can do it. I just don't love it because I don't have as much experience with that.

We flipped a couple patients back and forth like, hey. This is what's going on. Okay. Cool.

Yeah. I will tell them, especially if I think it's related to their jaw, I don't wanna do TMJ. Nope. Don't put that on me. Give that to one of the PDs that specializes in that. I am more than happy to refer that out if I think it's coming from neck or jaw stuff.

Should have said that twenty minutes ago when the boss was still here.

Yeah, I know. He'll be thrilled.

Is he still is there still pressure to take him?

I will take his TMJ class at some point purely to diagnose patients and refer them out to a TMJ specialist. I do not want to treat TMJ.

Well, now it's a CHT. You don't have to.

No. No. Give me all the hands.

Do you think do you think now too? I mean, is your hope at Freedom to have all hand surgery patients?

Eventually, that would be ideal. Where is Eventually. Eventually. I mean, I would love to bring on another OT at the clinic too, or even here at Grafton or Brookfield and start to build the OT program. I think I think we could do it. I know, right, like, Mary and Anne are here, and then I came on. So I think we could do it. I think we could that OT program.

Where do the I know there's a smaller subsection of OTs, obviously, compared to PTs, right? Yeah. Are all the OTs?

There's a I mean, right?

Like, most clinics either don't like, private practice, I've been in one that has one OT. Yeah. One OT that just works part time or at multiple Yeah. You're not in a hospital Yeah. Like, where

skilled nursing facility.

Okay.

Yeah. I mean, right? And even if you're

I just feel like you don't see as many private practice OTs. Like, where

Well, because if you're a private I mean, if you're an orthopedic OT, you're gonna be a certified hand therapist working for a surgeon.

Okay. Or like in Appleton, how big is that OT department?

I don't even know. I did my dry needling certification with a lot of their therapists, quite a few of them from that clinic. I don't know if they ever said how many therapists they had there. I don't remember if they did.

And I don't even know if we have that many applying here.

OT's applying here?

Yeah. I feel like we're hiring. It'll always say PTOT, but I don't

Yeah. Don't

I'm just for out of curiosity. Like, how many OTs do we actually

Yeah. Especially because not many go into orthopedics. So I'm not really I don't know. And I think nowadays, if you are an OT going into orthopedics, the goal is to become a certified hand therapist.

Okay. Was there a prerequisite for that? Like, the OCS, you have to have x amount of hours, I think.

Yeah. You have to have

Treating beforehand?

Thousand and three years of

So you can't do it right out of school?

You can't do it right out of school. Okay. No. I mean, maybe you should start studying right out of school, but, no, you can't sit for the exam.

Okay.

And you have to get you have to submit all the paperwork and then get, like, approved to sit for the exam.

Okay. Adrian, is there anything else you want to add? Last minute OT month celebration?

No. I would say most patients that come don't even necessarily know that I'm an OT because as soon as you tell them, oh, you should see Adrian, she's an OT, they kind of get, you know, they question it. Right? So just also spreading awareness of what OT is and if you've had OT, explaining to other people what OT is. So that's also a battle that we are fighting all the time.

It's one of the questions that I think, as I get older, it just drives me nuts even more. Like, where'd you go to school?

Oh, yeah. Where'd you go to I

really don't think it matters. No. If if if you took the board exam

Yeah.

For OT or PT Yeah. You're obviously knowledgeable enough to be a PT. Yeah. And I think for those that are listening that are current patients or have been patients in the past, I mean, really believe that Mike, Scott, Mary, Mike for planky, Jeff for Jeff, that we don't just hire anyone off the street. I really think the standard we keep for for how our therapists treat is really high. So whoever you see

Yeah.

You're you're in pretty good shape. I mean, don't you've been here longer than I have and you're an eight too. Mean, you've seen probably more people come and go. I feel like that standard is

Yeah. And I would even I yeah.

And I would say that if I didn't work here, that's why I've applied here.

Yeah. No, I would say that the standard to work here, and I would not even argue, maybe maybe Joe felt this, but coming in as a new therapist, there's a really high standard from the current therapist to be a good therapist, right? And you have to really build the trust of the current therapist, right? Yeah. I mean, which can be hard, but

I think Fox Point is the toughest. And we've talked about And that's not good or bad. It's just the reality of it.

Yeah. Right? I mean, our clients have been coming here for years. And so Which I think

is good too. As a patient, you need to know what Yeah. What you deserve and what's right and wrong. I mean,

I'm Yeah.

Business can have any model they want. I mean, that's it. Whatever you want to do. But I think here, they know what they want. And if they don't get it

Yeah.

They will let you know.

Yes. Yeah.

Or someone. Yeah.

Or somebody. Yes, exactly. So no, I think there's really high standards to come and work at Freedom as a whole.

And you started here as a new grad too, right? Were you in Fox Yeah. I think that is really tough.

It's tough except that I was here as an aide. So I knew a lot of the patients. I knew what the expectations were. I knew the other therapists. I was friends with the other therapists. That is true. They were really willing to take me on and help me and do mentoring.

Because then Scott come up to you as an aide and say, do you want this job or not? Yeah. Isn't that kinda how worked?

Yeah. It was, can I talk to you and pull me in a room? Do you want the job? Yeah. Okay. Send in your application. And that's how it was. So, I mean, yeah. Yeah. I was really thankful that I was able to get the job right out of school, especially because I knew the patients too. Right? Like, one day I'm working at the front desk and then the next day I'm treating their patients. Right. That was that was kind of fun to watch and and see them too.

Were there three OTs when you started here then?

No. Rebecca was here. She left and

I She was here when I was a student with Mary Anne.

Yeah. Yeah. So I basically she left and I came on. It was like within a month of each other that that happened. Yeah. I'm trying yeah, I think that's how that worked. I'm pretty sure.

Well, I guess since we're on the topic too of hiring, we'll kind of finish it with this, guess. If there's anyone listening that knows an OT or is an OT listening that potentially is graduating or looking for a job, what would be one thing or piece of advice or just something you think is important for either being interested at working for Freedom or just in general as a whole looking for an outpatient OT position?

I would say they're not super common, Right? So they're hard to come by. And, like, the hand surgeons, a lot of them typically require that you become a CHT within a year or two of hire. So being a new grad, right, freedom is great because we don't have that requirement where you have to be a CHD within a year or so. It's also nice because Marion and I have the time to do some mentoring if if they wanted that as well.

I think here too where it's nice is it's very tailored towards you. Like, didn't take a bunch of mentoring because I just felt like I was just trying to just build my case load. I didn't wanna take slots away. I had Nicole who was such an awesome PT. We really wish she was back here. I know. But it was like, what what do you need? Yeah. Like, okay. This is what you need. Let's go through it. Yeah. Like, how can we benefit you the most? And there's no pressure on it.

No. And it doesn't matter if you're wrong. Right? It it's that's not the point of it. It's to help you learn. Right? Like, when Erin especially with the neck, that was all I wanted to work on is, like, teach me how to treat the neck. And she never was like, Adrian, how do you not know this? Like, there was no judgment towards any of it. It was just like, okay. These are the tests. Let's practice this. Let's do that. So that was really beneficial.

Can you legally treat the neck?

Yeah. Mhmm. Yep. And

do whatever you want.

Yeah. I mean, I could treat the ankle if I wanted to. I just don't I just

don't want to. You could.

Yeah. Yeah. There are OTs that that have, like, really remote clinics that treat technically the whole body.

Okay.

But they're an OT.

Interesting.

Yeah.

Well, as Mike says, and I've I've never thought about this until he said it. Ed, in private practice, you can do anything you want. Yeah. Or as far as taking continuing ed, like

Yeah.

I mean, he has so many people take his Yeah. TMJ classroom. Yeah. Like, oh, interesting. I would never thought that person would take it. Yep. Which, again, I think is no pun intended, the nice freedom that

Yeah.

We have Mhmm. At Freedom, especially. Yep. Well, Adrianne, again, we're very proud of you. Don't know how many people have told you that finishing your CHT. And I especially think about, for me, personally, you and I both have kids Yes. Roughly the same age and the same kind of category.

Maybe we should start a working parents podcast.

I feel like my life is crazy.

And just talk about

And I'm not studying for anything. I mean, I don't know how you did it.

Yeah. I don't know either, actually. But

It actually kind of scares me because I have no interest in doing any of that right now with young kids. So more power to you. Yeah. Powerful mom.

Thanks.

Thank you, Adrian. Happy OT month. If anybody's in need of seeing an OT or seeing Adrian, come see us here at Freedom. Adrian's in Fox Point, maybe Grafton the future if needed. Anything else, Sage?

Nope. I think that's it.

Thanks, Sage.

Thanks for

having in the next couple weeks, in the next podcast. Looking forward to April. Again, OT months, we're really celebrating Adrian and Marion and Anne. But obviously, this podcast focused on Adrian or CHT. Looking forward, May, we're gonna kinda keep kind of a little theme going, going towards women's pelvic health and we've got Anna and hopefully sitting down with Nina who's another great therapist here at Freedom.