A day in the life of an Occupational Therapist and Certified Hand Specialist

Mar 30, 2019, 12:59 PM by Jessica Wyble

Image of Diane Ugartechea UTMB Occupational Therapist and hand specialist

Diane Ugartechea is a believer in occupational therapy—and not just because it’s her chosen profession. She’s actually living proof that it works.

 After enduring extensive brain surgery to remove a benign tumor, the UTMB occupational therapist was left partially blind and with paralysis in her face. Simple tasks like eating and flossing her teeth were challenging and doctors predicted that she would never fully regain her eyesight.

But determined to return to the life she knew and the work she loved, Ugartechea focused on her recovery and diligently practiced the rehabilitation techniques she usually teaches her patients. Miraculously, 10 weeks after surgery she was back at work on the Galveston Campus, with 20/20 vision and her strong commitment to her patients.

Fast forward seven years and Ugartechea is still doing what she loves—now at the League City Campus, where she serves as both an inpatient and outpatient occupational therapist. Seeing patients in both the hospital and rehabilitation gym setting requires coordination and careful scheduling, so at the start of each day, Ugartechea thoroughly reviews her patient list and plans her schedule—as much as she can, anyway. 

Before her work day begins, her phone is ringing. It’s the first of many calls Ugartechea will receive from a local, non-UTMB hand surgeon.

“She sends us lots of patients,” says Ugartechea, who is one of 19 occupational therapists who help rehabilitate patients at UTMB’s various campuses and clinics. “It’s nice because she has options. She could choose many other options in the region, many of which are actually closer to her practice, but she trusts us with her patients’ care. It’s nice to have that relationship.”

As UTMB’s only certied hand specialist, Ugartechea primarily treats patients with extensive hand injuries, although she’s not exclusively limited to them. Among her patients on a recent day at the office were two individuals recovering from deep cuts on and around their hands caused by broken glass.

While the injuries may sound similar, Ugartechea knows that every case is different. So she starts her time with each patient by first assessing the wound to determine how it’s healing. This process helps her develop a plan of action for the appointment.

For one patient, the injury is fresh and just a week or so post-surgery. During the patient’s appointment, Ugartechea removes the dressing and fashions a thermoplastic cast before sharing care instructions and a home exercise program. 

For the other patient, full recovery is right around the corner. Ugartechea spends their session together focusing on finer detail movements—working with beads, resistance devices and other fine motor tools from Ugartechea’s trusty cart. The injury is on the inside of the middle finger, right around the knuckle, so the bulk of the activities focus on bending the fingers and grasping items. e patient moves through the activities as instructed, but not without sharing a few complaints first. Ugartechea is no stranger to the mumbles and grumbles that sometimes come with rehabilitation work. She’s not fazed a bit.

“I had one patient from the BP explosion a few years back who had some pretty severe burns on his hands,” she recalls. “He actually came back to find me recently—maybe 12 years later—and he thanked me for everything he could do now, from brushing his teeth to putting on his shoes. But he also talked about remembering how much it hurt those first few sessions when I kept challenging him to put his shoes on and tie them. I told him he has to just keep moving.”

Knowing that consistency and movement can make all the difference, Ugartechea maintains a tough-love approach with all of her patients, but makes a point to do so with empathy.

“I always keep in mind what if that was me, my mom or my grandmother,” she said. “I approach each session with that thought.”

A natural in her field, it’s hard to believe Ugartechea was once on a totally different career path, working as an administrative assistant in the oil and gas industry. It wasn’t until an unexpected layoff that Ugartechea found her way back to school to study occupational therapy, a field she had learned about through the safety committee at her previous employer.

 “I volunteered to help the safety group with one of their events and in the process met the occupational therapist we had on site,” she says. “I learned all about what she did specifically in ergonomics, but she informed me there was so much more to the field. I remember being fascinated.”

Nearly two decades later, Ugartechea knows she made the right decision.

“I really enjoyed my time there and appreciate the experience I  gained, but I’m definitely where I’m supposed to be now,” she says.

Ugartechea shares the enthusiasm she has for her work not only with her patients, but also her colleagues, including Lexi Godleski. Godleski works as an occupational therapist at the League City Campus alongside Ugartechea, whom she credits with motivating her to become a certified hand therapist as well.

“Diane is a great hand therapist,” says Godleski, who will sit for the Hand Therapy Certification Examination later this year. “She was my mentor when I started with UTMB five years ago. She’s personable, empathetic and truly cares about her patients.”

While Ugartechea spends the majority of her Monday- through- Friday, 8 a.m.-until-5 p.m. schedule on the League City Campus with patients, she does travel to the Galveston Campus occasionally to teach students and residents. 

“I teach a class at the OT school, and also meet with the plastic surgery residents each year,” says Ugartechea. “At the school, I meet with second-year OT students to teach hand therapy techniques and discuss the certification opportunity. With the residents, we provide an in-service to familiarize them with our role, the services we provide, the referral process and various treatment techniques.”

The partnership between plastic surgery and occupational therapy doesn’t stop there. UTMB faculty members even solicit Ugartechea’s feedback when selecting new members of their team.

“The plastic surgery group frequently asks us to sit in on interviews for potential new faculty members, because we work so closely with them in our daily routines,” says Ugartechea. “That gesture shows how much they respect and value our opinion, which means a lot.”

From the OT students and plastic surgery residents to her everyday patients, Ugartechea says that more than anything, her job is to educate.

“People see the ‘occupational’ part of my title and assume I’m somehow going to help them find a job, especially if their current condition has put them out of work,” she says. “Instead, I help them understand that I support the job of living.”

When patients’ roles as spouses, parents, and caregivers become disrupted in the wake of unexpected injuries and ailments, Ugartechea helps them return to these roles through the use of functional activities.

“These roles are just like a standard daily job except most individuals do not consider it as such. It’s amazing to see previous patients come back and show off all they can do, all the progress they’ve made since being discharged from our services," she says. "It makes me proud to know that I helped plant that seed. I had a role in that."