It began with a dream, and a well-timed opportunity.
I have this opportunity… do you want in?“Our contracts were all coming to an end where we worked at the same outpatient clinic, and at the same time my brother was about to rent a facility in El Socorro and only needed the upstairs,” Lorraine explains. “I said to Nicole: I have this opportunity… do you want in?” “From there, we went to others, saying — we are going to open a place for ourselves, embark on a new adventure… who wants to join?” reminisces Nicole. “And I was wondering if to stay in Trinidad or leave,” Carla chimes in. “It all just fell into place.” These women were in their mid-twenties at the time that Total Rehabilitation Centre was established in 2007 by founders Nicole De Freitas, Doctor of Physical Therapy, and Lorraine Hadeed, Clinical Exercise Physiologist/Cardiac Rehabilitation Specialist. Carla Rauseo, Doctor of Physical Therapy, joined them in 2010 as a Partner, but had played a key role from the Clinic’s inception. Rounding off their team from its inception was physiotherapist Taryn Gobin, massage therapist Melissa Ali, and reflexologist Shivana Inalsingh. Front office receptionist Heather Monroe was also with them from the start. They were later joined by physiotherapists Chanol Ottley and Tiffany Clerk, occupational therapist Stefanie Llanos, massage therapist Tina Greenidge, exercise scientist Rachelle Burns and nutritionist Nicola de Pass. “We had two basic rooms when we first opened,” Nicole laughs. “And only three beds, and boxes everywhere… there was a transitional period where we were just pushing ourselves like crazy!” The dream of these three young women — who have known each other since their secondary school days at St. Joseph Convent, Port of Spain — has now blossomed into one of the premiere clinics in Trinidad and Tobago for rehabilitative care. It is staffed by a robust team of highly qualified specialists in their field (almost all women, to boot!) and well respected throughout the health and wellness industry in the country.
Birth of a DreamFor Nicole, her career path actually was a dream — a dream of her aunt’s, to be precise.
she dreamt I was a physical therapist…“I had always wanted to be in the medical field,” Nicole explains. “Where I was living, a young man had cerebral palsy, and physical therapy had really helped him. Then, my aunt called me one day, and said she dreamt I was a physical therapist… she saw me in the hallways of a hospital in a white coat with a badge…” The dream became more of a reality when her mother helped her to get some volunteer hours at a local clinic during her July-August vacation at home in Trinidad. “I would always exceed the required volunteer hours,” says Nicole. “I loved it so much.” She went on to attain a Bachelor’s of Science in Biology at Florida International University, which she followed with a Clinical Doctorate in Physical Therapy with a focus on manual therapy at the University of St. Augustine for Health Sciences in Florida. She later became an ergonomic assessment specialist at The Back School of Atlanta, and is also a certified kinesio taping specialist — and has in fact made Total Rehab the exclusive local distributor of the kinesiotape brand (elastic therapeutic tape).
A Degree, not a Course!Lorraine’s own aunt also played a role in her career path.
I don’t want you to be a physical trainer!“I was intent on being a lawyer, actually!” she says. “But I was always involved in exercise, and in the gym a few men had had heart attacks. I was talking to my aunt about doing something with exercise and cardiac healthcare… she said, ‘Go and research it properly and find out if you can get a degree — NOT a course. A Degree! I don’t want you to be a physical trainer!‘ ” Coincidentally, it turned out that the school her brother was attending at the time, The University of Texas, was world-renowned for Exercise Physiology. Lorraine graduated from that university with a Bachelor’s of Science in Kinesiology, and continued on to do her Master’s of Education in Kinesiology with a specialisation in Clinical Exercise Physiology. She later became the first Clinical Exercise Physiologist in Trinidad to establish a cardiac rehabilitation and medical fitness care for heart patients, and she has been linked to top cardiac surgeons in the country, working for a few years alongside Dr. Ronald Henry. “So yes, Aunty… now I can say, ‘I’m not a PT, I’m an Exercise Physiologist!’ ” she laughs.
From Environmental to Exercise ScienceCarla was studying Environmental Science during her freshman year at university, when she got injured playing collegiate volleyball.
Hey, this is something I can see myself doing“I spent a lot of time with the athletic therapist, and I realised — ‘Hey, this is something I can see myself doing‘,” she says. “Not to mention… when I went to my first Environmental Science class, I totally hated it!” Athletic therapy at the time did not seem like a feasible option in Trinidad, so she decided to venture into physical therapy instead, and changed her undergraduate degree. She is now a licensed physiotherapist and a Certified Strength and Conditioning Specialist, with an undergraduate degree in Sport Science at Mount Holyoke College in Massachusetts, which she followed with a Masters’ in Physical Therapy at Springfield College and her Doctor of Physical Therapy through Temple University in Philadelphia. She has worked with the Trinidad and Tobago Golf Association, Carib’s Rugby Football Club, Marlin’s Swim Club and Water Polo Club, and the Trinidad and Tobago Karate Federation. She also teaches at the University of the West Indies, and is a columnist in the sports section of The Trinidad Guardian, which affords her the opportunity to impart her knowledge on health, fitness and rehabilitation.
Total Rehab: what you need to know
1. A network to achieve one common goalThe clinic functions mainly on doctor referrals, so it would be wise to see your own doctor to ascertain the extent of damage and see whether you need therapy in the first place. “We need to have a proper medical history,” Lorraine explains. “Patients are not the best to give their own histories… I’ve had patients that come to me after being to four other specialists, and then he is the one relaying information between all of them. By the time the message comes to me, it’s disjointed and often inaccurate.” The specialists at Total Rehab have built up a robust network of healthcare providers throughout the country including physicians, surgeons, educators, counselors and other allied health professionals. They often connect directly with someone’s doctor, and even prepare progress reports to send to their patients’ doctors to ensure the entire healthcare loop is intact and supporting the one common goal: the patient’s health.
2. Diversity is the name of the gameIn the few years of its existence, Total Rehab has expanded their service area, and gained another physical therapist, an athletic trainer, another massage therapist, a nutritionist, and other professionals in the fields of Thai massage and occupational therapy. They’ve established an aquatic therapy program, and are working diligently on enhancing their wellness programme. Beyond varying fields of expertise, the staff also consists of a very diverse range of cultures and backgrounds.The team’s members have studied all over the world and maintained their relationships to the outside world — so rest assured, despite it being a “local clinic”, there’s a world of expertise within.
3. Education is the root of allBeyond constantly building upon their multidisciplinary approach to health and wellness, Total Rehab has also become very involved in physical therapy and community education. They have done presentations to employees at their offices on the intricacies of ergonomics, and taken part in various medical conferences, seminars and health expositions. They have also established relationships with local and foreign schools and universities, providing clinical internships in physical therapy, and assisting students involved in the health and fitness industry. “We truly believe in education and awareness — even among doctors or other health providers themselves,” says Lorraine. “There’s always something new to learn or benefit.” However, one of the things their field suffers from is the lack of recognition from insurance companies, which frequently only provide coverage for therapeutic care ‘after the fact’, as Nicole points out. “A lot of our patients may have been hypertensive or diabetic or had other issues long before they came to us, because it’s expensive,” she says. “And in reality, if we’d had a few months or years to help the person to have a lifestyle change… it could have made all the difference.” This is the basis of the wellness programme they recently launched, which encourages lifestyle changes and preventative medical care. “We’re trying to prevent you from needing us!” jokes Nicole.
4. The vision is ‘Patient Value’Located in El Socorro, Total Rehab is much more accessible to patients who find it difficult to access quality health care without having to face the traffic congestion of Port of Spain, in which many of the nation’s healthcare providers are located. Building on that notion of accessibility, they have always tried their best to give their patients valuable advice and referrals which will not cause them to be unnecessarily inconvenienced. “We’ve built a network throughout the country, so that if we get a patient from San Fernando, we won’t send them to a doctor in Arima,” explains Lorraine. “We’re realistic. People don’t follow up if they have various obstacles in the way.” They also make it their business to be as helpful as possible. After being mistaken several times as a drug rehabilitation centre, they have taken it upon themselves to learn the names of such centres in order to be able to correctly redirect a future inquiry. “Instead of just saying ‘No, that’s not us’ and hanging up, at least we can offer you where to go next,” says Nicole.
5. Connect! They are here for you!Last but not least, the Total Rehab team emphasize that they are willing to build relationships across the board — with wellness professionals, with patients, with employees needing guidance, and with students eager to learn. Their website, www.totalrehabtt.com, is a great resource for information and a way to get in touch. Much of the time, the query may be irrelevant, but at least they are able to guide the patient to where he/she can receive help — even if it means turning away business.
It’s about what we can do, how we can help“Each of us believes that if you do your work and you love what you do, it speaks for itself — your patients will spread the word for you,” Nicole says. “It’s not about us, as a business. It’s about what we can do, how we can help. We ourselves have a well rounded team approach to rehabilitation, and without them all, it’s just not happening.” “We’re not just coworkers, but friends,” Lorraine adds. “And we were friends long before. We all have the same vision of healthcare, of what we want to do, what we hope to bring to the country — holistic wellness, from prevention to cure.”