Jul 23, 2018Weather the Storm
For those living and working in coastal regions, handling hurricanes is becoming a formidable prospect of late summer. In this multi-part article, athletic trainers share how they made it through Harvey and Irma last year.
Athletic trainers are typically ready for anything when it comes to weather-be it the coldest winters, soggiest springs, or hottest summers. But no matter what steps are taken beforehand, some weather events just can’t be fully prepared for.
A year ago, Hurricane Harvey decimated Houston and its surrounding areas, while Hurricane Irma followed a few weeks later and wreaked havoc in South Florida. Though there was advanced warning of both storms, their impacts were still catastrophic. Among the millions of people affected were countless athletic trainers who supported their athletes through flooding, power outages, and evacuations, while dealing with their own well-being.
In this article, two athletic trainers describe what it was like to experience these devastating hurricanes. They explain how they were impacted personally and professionally, how they kept tabs on athletes during the storm, and how their skills and knowledge as athletic trainers helped them-and their communities-survive and recover.
HIT BY HARVEY
By Dr. Erin Hassler
As an athletic trainer, I have been taught to always be flexible and adapt, no matter the situation. Life is unpredictable, but the show-or the game-must go on. This lesson was especially relevant when Hurricane Harvey hit in late August 2017.
The storm path for Harvey was widespread. However, most of the Houston metropolitan area was not evacuated, including Texas Southern University, which is in south central Houston. The fall semester hadn’t started yet, so the only students on campus were the new freshmen and our football, women’s volleyball, and women’s soccer players. Still, TSU closed campus in preparation for the storm.
Fortunately, I didn’t have any athletes in the middle of a long-term rehab when Harvey hit, but I did have two injured soccer players. Both were scheduled to see the team physician first thing on Friday, Aug. 25-the day Harvey was expected to make landfall. After practice on Thursday, I gave the athletes instructions for their appointments. But when the weather reports worsened on Friday morning, I cancelled the appointments. I knew there was a chance the athletes would leave town, and I didn’t want them to no-show with the doctor.
Before I left work on Friday, I made sure the main athletic training room was clean and securely locked. All the athletes had my number and knew to call or text me if they needed anything.
For me personally, I have lived in Houston for 18 years, and I have experienced several tropical storms and two hurricanes. So, I thought I had a pretty good idea of what to expect.
I had just moved into a new home in May 2017, and, like most, was not evacuated for Harvey. But I knew that preparation was necessary, so I moved important documents and mementos to a higher level in my house to keep them safe should flooding occur. I purchased enough water for drinking and sanitation in case sewage systems backed-up.
By Friday at 1 p.m., I had gone to the store for food, rain suits, and boots and hit the bank for cash. Then, I went into athletic trainer mode at my house and made emergency coolers of water and Gatorade, as well as large ice packs to keep food cold in the event of a power outage. I also charged up every communication device I could find. As long as the water did not rise, I knew my family and I would be safe.
Every hurricane presents itself differently. Some carry heavy winds, while others bring never-ending rains. Harvey hit us with both. Friday night into Saturday, so many tornadoes touched down that I didn’t sleep for more than 10 minutes at a time. By 7 a.m. Saturday, I noticed that the roaring outside had stopped and the weather alerts on my cell phone had slowed down.
When I checked around my house for damage, I found water pouring out of the light fixtures in my bathroom ceiling and out of the air conditioning ventilation system. Although the power was out, we were able to stay in the house.
While waiting for the storm to pass over the next few days, I texted and called around, checking on my family members, athletic training students, and athletes. The two injured soccer players were doing fine and benefiting from the physical rest. In addition, I updated friends and family members of our status.
The rain did not slow up until Tuesday. At this point, I left the house to assess the damage around me. My neighborhood was surrounded by high water, but I tried to venture out a little further each day, looking for someone to help.
Three weeks after the storm, an examiner came to survey the damage at my house and found mold-the place that I had just settled into was uninhabitable. For the next three weeks, my family and I bounced from hotel to hotel until we could find a more permanent living arrangement.
Once back at work on Aug. 30, my focus turned to helping TSU faculty members, students, and athletes find a sense of normalcy. Despite the news about my house, I was fortunate to still have most of my belongings, so I wanted to play a part in our community’s recovery. My family and I donated clothes, furniture, and money to organizations that were helping people get back to a new normal.
In addition, my athletic training colleagues and I banded together to support one of our athletic training students who lost everything. We helped her replace some of the items that were destroyed and find temporary housing. Despite the rocky start to the school year, she made the Dean’s List in the spring and had the highest grade point average in the program.
Within athletics, we had to move or cancel a lot of events. For instance, the fall preparticipation exams (PPEs) for incoming freshmen, transfers, and offseason sports were rescheduled and split up over a period of two weeks. This better accommodated our team physicians and the student-athletes’ classes. Coaches were notified of the available time slots for their teams, and they relayed this information to the players.
To decrease the amount of traffic in the athletic training room during the PPEs, we had athletes complete necessary forms ahead of time and had them stop in on different days to get their vitals checked. Along with our department’s other certified athletic trainer, I coordinated the flow of the exams, ensured that documentation was completed, and scheduled any follow-up care or screenings.
Although things started to get back to normal in the weeks after the storm, returning to a routine was hard. Many grocery stores and restaurants were out of commission, and several roadways remained under water, which caused re-routing and extended drive times.
The issues with my house compounded things further. I was driving around with half of my belongings in my car, constantly going back and forth between the old house, the hotel, and two different storage units. It seemed as if someone was always looking for me. If I was at work, the insurance person was looking for me at my house. If I was at the house, someone at work needed my attention.
Outside of work, the stresses piled up. Since 2015, I have been pursuing a doctorate in athletic training from A.T. Still University. Working full time as a certified athletic trainer and being a full-time student was already challenging. When Harvey hit, I almost reached my breaking point. I would come home from an already long day of practice, treatment, and teaching and try to do my homework, but I had a hard time completing the simplest assignments.
Fortunately, my supervisors understood the responsibility my job entails, as well as the pressures I was under. They knew it would be nearly impossible for me to keep a 40-hour workweek as a dual-appointed athletic trainer, and they allowed me to get some things done outside of the office. With their support, I was able to complete my doctorate in June 2018, as scheduled.
The entire Harvey ordeal reinforced many of the skills I use regularly as an athletic trainer, such as the importance of preparation and communication. However, I also picked up a few new traits-most significantly, humility and grace. I found more compassion for others, especially homeless and displaced people, and learned the importance of patience. Sometimes systems put in place to provide aid take longer than anticipated to deliver, but patience can result in a favorable outcome.
In addition, I recognized how crucial it is to stay hopeful and keep a positive outlook during a crisis. As athletic trainers, people are always watching us to see how we handle adversity, and they may be able to draw strength from our response.
When you walk in humility and extend grace toward others, it will always come back to you. In the year since the storm, my life has grown richer personally and professionally. More than before, I realize I have been blessed beyond measure, and I’m aware of my responsibility to give back to others. I think that is truly what being an athletic trainer is all about.
Erin Hassler, DAT, MS, LAT, ATC, PES, is the Director of Sports Medicine and Director of the Athletic Training Program at Texas Southern University. She also owns the Sportz Factory, which provides sports medicine and sports performance services. Hassler can be reached at: [email protected]
IN IRMA’S WAKE
By Erin Cernuda
In South Florida, the fall sports season brings more than preparticipation physicals, football practices, and conditioning sessions. It’s also the heart of hurricane season, which athletic trainers in the region do their best to handle.
During the first two weeks of September 2017, we saw an especially brutal storm in Hurricane Irma. It was a Category 4 hurricane that covered the entire state of Florida at one point.
We had about a week’s notice to get ready for Irma. On Thursday, Sept. 7, government officials started to open shelters and mandate evacuations for coastal areas and flood zones. The full force of the hurricane was expected to hit on Sunday, Sept. 10.
At Miami Sunset Senior High School, we enacted our hurricane closure procedures, which include securing outdoor equipment, unplugging electronics, and covering materials that should not get wet. All of our sports medicine supplies that are kept in an outside shed were brought into the main school building. Our school closed on Thursday and Friday, and we didn’t know when we would reopen.
A big part of my hurricane prep was making sure my students and athletes were ready. Before they left school on Wednesday, I spoke with my injured athletes and gave them specific instructions for continuing rehabilitation protocols at home. I printed handouts that explained rehab exercises and loaned them any necessary equipment, like bands and ankle weights.
Even though school was closed on Thursday and Friday, I stayed in touch with my students and athletes. Miami Sunset has an online communication app called “Remind 101,” and students used it to ask me questions about the hurricane.
For instance, one student asked how he could help his mom, who was worrying about the storm. We discussed some things he could do to assist her, such as helping with the emergency supply shopping, doing laundry (as water and electricity could go out during the storm), and babysitting his younger sister. I also reminded him, and all of my students, to be smart and safe and check in with me after the storm so I would know they were okay.
While I was preparing my students and athletes for Irma, I got ready myself. With every update to the storm’s path, my family and I discussed and re-discussed our plan. We boarded up our house; shopped for food, water, and basic essentials; and waited in long lines to fill our cars with gas.
Irma lasted for several days, with the worst of it hitting on Sunday. During the storm, the sounds of uprooted trees crashing into cars and buildings and transformers blowing shook my neighborhood. However, what scared me the most were the numerous tornadoes tearing through the county. We just hunkered down and hoped everything would be okay.
Once Irma passed, we met with neighbors, checked on everyone in our immediate area, and surveyed the damages. We had a leak in the roof that was exposed by the heavy rain, our landscaping was destroyed, and there were a lot of downed trees all around our neighborhood.
The first week after the storm was dedicated to my family. I spent that time taking care of my twin toddlers, clearing debris out of our backyard, and camping out in the living room, where we had a fan to keep cool.
As soon as I had a way to charge my phone, I used Remind 101 to check in with my students and make sure they were safe. After a week, we got power back, and my focus switched more to school.
By this time, almost all of the schools in Miami-Dade County Public Schools (MDCPS) had regained power, so the district reopened. Miami Sunset’s athletic directors and coaches got to work assessing our sport facilities for any issues that would impact student safety. Most of our athletic equipment had been properly stored, but the baseball team’s portable backstop had been twisted beyond repair, fencing was destroyed, and debris covered the playing fields.
A few years ago, I started a garden at Miami Sunset for students and athletes, and, unfortunately, it did not hold up well in the storm. Our garden shed was destroyed by the high winds, and plants were uprooted and broken.
Once school reopened, we began making plans to resume athletics. The Florida High School Athletic Association and MDCPS did a wonderful job ensuring the safety of student-athletes during this transition. For instance, MDCPS implemented a shortened heat acclimatization procedure to allow athletes to readjust to activity and re-acclimatize to the heat. Football players practiced in helmets only and progressed to full gear over the course of a week. No games were allowed for any sport until the athletes had four consecutive days of practices.
Missed games were made up during the season, which meant a lot of teams had a condensed schedule. Because of this, we focused more on recovery, and I educated athletes about stretching and hydration techniques. Football did less contact at practices surrounding the make-up games, and all other teams had restrictions on when they could return to competitions.
As an athletic trainer, I helped athletes during their return to activity by providing a sense of regularity. Most of our injured athletes did well while school was closed because it gave them time to rest and rehab. Upon their return to school, most of their small sprains and strains were completely resolved.
But for those that hadn’t, I made sure the athletes continued their rehabilitation. They were expected to attend practices, conditioning sessions, and physical therapy just as they had before the storm.
With families still recovering from Irma and many without power, MDCPS gave students free breakfast and lunch to ensure they were eating enough. I checked in with my student-athletes to make sure they were taking advantage of these meals and fueling appropriately for their practices and competitions.
Now almost a year later, Irma has had a lasting effect on our school. Students, athletes, and staff are able to face daily challenges with a new sense of connectedness, and we’ve come together to rebuild what we’ve lost. For instance, three months after the storm, Miami Sunset secured a grant that allowed us to replace the destroyed plants in our garden. This spring, we had limes, peppers, okra, broccoli, and other vegetables and fruits growing.
One of the biggest lessons that I learned from this experience is the importance of having a disaster plan for my sports medicine program. From securing my athletic training room to checking in with athletes, this plan is crucial for ensuring that student-athletes are ready in the face of a disaster and know what to do to stay safe.
Erin Cernuda, ATC/L, is Head Athletic Trainer at Miami (Fla.) Sunset Senior High School, where she also teaches science. She was a 2016 recipient of the Gatorade Secondary School Athletic Trainer Award and can be reached at: [email protected]
To read about Cernuda’s garden at Miami Sunset, search for “Planting the Seed” at Training-Conditioning.com.
This article appeared in the July/August 2018 issue of Training & Conditioning.
By Erin Cernuda
When faced with a weather-related emergency like a hurricane, it’s important to make preparations well ahead of time. Here are some disaster preparedness suggestions:
• Establish a personal disaster plan for you and your family. If you are worried about yourself or your family, it will be impossible to serve the needs of your athletes.
• Have a communication plan and a backup. Remember that cell phones may not be reliable in the case of an emergency. Ensure that you have another way to communicate during and after the event.
• Pack disaster kits at home, in the car, and even at work. Include basics like food, water, clothing, and hygiene materials.
• If mandated to evacuate, do so immediately. Do not wait.
• Remind your athletes to fill any medications prior to the event.
• Instruct injured athletes in an appropriate home exercise plan that fits their rehabilitation needs.
• Remind athletes to follow all government proclamations and to use proper precautions when participating in clean-up activities.
CALLED TO SERVE
By Jeremy Howard
As a member of the Florida Army National Guard, I have an obligation to support my state in times of need. So when Florida Governor Rick Scott called all National Guard members to active duty when Hurricane Irma hit, I answered the call.
At the time, I was an Athletic Trainer at Ave Maria University, and it was the start of football season. Because of this, the assignment raised some challenges for the rest of my sports medicine department. Fortunately, my Director of Sports Medicine was very understanding. He and the rest of the staff covered my sports in my absence to ensure everything ran smoothly. This support made the call to active status far less stressful for me.
I was gone for about two weeks. During that time, I had numerous roles, including:
• Assistant Officer in Charge (OIC) of convoys and hurricane shelter teams
• OIC of multiple shelter sites
• Multi-mission roles with inter-agency partners
• Mission OIC for an assignment in which soldiers handed out thousands of units of water, food, and ice to the local population.
Each of my shelter sites housed 500 to 750 civilians. Our teams aided the shelter support staff in operations and offered assistance in our specialty areas. For instance, because of my health care background, I worked with the assigned unit medics to monitor and manage the civilians.
The shelter I was stationed at had five pregnant women, two of whom were later in term. Further, we had a child with a high-grade fever and another who experienced a serious allergic reaction.
I am truly thankful for the general medical knowledge we have as athletic trainers, as treating these individuals would have been quite challenging without it. This just goes to show that the athletic trainer’s skill set is an asset even when working in other capacities.
While fulfilling my various missions, I worried about my Ave Maria athletes and how my peers were doing in my absence. So I sent check-up text messages to my colleagues, my athletic training students, and my patients to make sure all was going well.
My experience during Irma made me a better athletic trainer. I learned a great deal about managing large groups and working in an interprofessional environment. This is relevant because athletic training education is moving toward a model that enables health care professionals to better understand each other’s specialty areas and collaborate to treat our patients.
In addition, it was rewarding to treat the sick and injured in the shelter. The majority of the cases we see in the athletic training room are orthopedic, so having the opportunity to work with general medical patients helped me develop new skills.
After the storm, I was awarded both the Humanitarian Service Medal and the Florida State Active Duty Ribbon, and my superiors nominated me for a Florida Commendation Medal. I am extremely thankful for these honors and even more thankful for the experiences and lessons learned.
Jeremy Howard, MS, LAT, ATC, CSCS, CES, SFMA-L1, was named the Health Promotion Officer for the Florida Army National Guard (FLARNG) in June. Prior to that, he was an Athletic Trainer at Ave Maria University and a Warrant Officer 1 in the FLARNG. Howard can be reached at: [email protected]