01: MET Levels

All right. Welcome to the OTExamperer podcast. You made it. This is going to hopefully make your life studying for this stupid exam so much easier. The point of this podcast is to make take some of these simple but really annoying topics that show up on the exam that we're supposed to magically just memorize, just completely Xerox into our brains and then regurgitate on the exam even though we could just Google them anytime in real life, just to make that easier, right? So some of these really annoying things, Alan cognitive levels, Met levels, whatever. We're going to nail those down here. So I was one of my like secret superpowers in school was always that I hated memorizing stuff, just straight up so bad. I would always make some sort of like clever way to remember it. So I'd use an amonic or some sort of like weird chart. I would just pull out of my head, something like that. So we're going to be using some tip, some of the little tricks and stuff to make these complex annoying topics much, much simpler and just easy to memorize. So stick with me and here we go. Okay, Met Levels is the perfect topic to begin this podcast. When you open up your textbook, to be like, oh yeah, I got to learn my Met Levels. You realize there's like a hundred things on this list that I'm just supposed to know exactly where they slot in. And if you open up multiple textbooks to the same topic, you're like, wait, they're not even like ranking, they're not even like organizing this the same way. Like this one, they're grouping on Met Levels one through three and this one, it's like one is separate from two is separate from three. Like what the heck is going on? You could spend hours trying to nail this on your own and like have be completely lost and frustrated and annoyed which I'm sure you've come across with lots of other topics on the exam. But we're going to make this one easy for you. So first of all, what is a Met Level? M-E-T, Met Level. M-E-T stands for Metabolic Equivalent of Task. It's a scale that tells you exactly how much energy, how much effort any task will take. This is helpful for like a patient who's recovering from a heart attack or some sort of heart surgery where the MD wants them to take it easy in quotes for a while. Instead of just saying that, which would mean totally different things to different people, we actually have a scale that tells us you can do up to this point and no more. So we can get actually definitive and specific about what a client is allowed to and not allowed to do. And obviously they take it easy up to a certain point for a while and then it progresses and it progresses again and so on. Right, so we need this scale to kind of get specific about how much effort, how much energy is okay for a client at a certain period of time after their event or surgery. So what this looks like, if you have another textbook, is there'll be like Met Level 1, Met Level 2, Met Level 3. Or you know, again, weird ones, group them in different ways. We're just going to stick with like Met Level 1, Met Level 2, 3, 4 and so on. So how do we memorize this? If you pull up your book, it's like a long list of things you could try to just memorize these long list of bullet points or different activities or whatever, but we need something simpler, better, more efficient. So what we're going to use is we're going to think of and remember specific characters, like specific people who are doing these sets of activities, which will make instead of a list, this will be so much easier to just remember this as like a little bit of a story or kind of a picture or something like that. So that's what we're going to go with. That leaves to the next question of which characters are we going to use. So I'll just say, if you aren't familiar with the ones that I chose, you really, really should be. I was going to do this whole thing about, you know, a small band of rebellious ot's preparing to stand up to the evil empire of the NVCOT. It writes itself, we're going to save the time and just skip that. So off we go. All right, so we're going to use Star Wars characters to remember these different Met Levels. So the lower ones are the most important. Remember, these levels go up to like as high as you want to go like 10 and above. But the lower ones are the more important ones, because again, we're dealing with clients shortly after some sort of cardiac event. The lower numbers are more important, but how detailed we get is sort of up in the air. Again, all of the resources sort of group these in different ways, but it's clear that there are, there is sort of a very, a gradation from like a 1.0 kind of activity to like a 1.9 kind of activity, right, getting close to two, right? So like 1.0 is going to be basically bedrest, 1.9, you're going to be up and moving around slowly, but something, something like that. So that it's not really useful to like identify activities that are exactly 1.2 or 1.5 or whatever, because the textbooks don't even do that. So we're just going to remember them in terms of the ranges of like 1 is basically 1.0 to 1.9, 2 is 2.0 to 2.9 and so on. So we're going to cover the first four, and here we go. So four Star Wars characters that help us remember 1, 2, 3, and 4. Now lucky for us, there's four Star Wars characters that basically have those things in their names. So for 1, it's going to be OB1 Kenobi, OB1 for 1. Our 2d2 is obviously going to be 2, and of course, C3PO is going to be 3. And the last one is a little, a little bit more of a stretch, but Han Solo is played by Harrison Ford, Ford for 4. Okay? So OB1 for 1, R2 for 2, C3PO for 3, and Harrison Ford for 4. All right, so now we're just going to remember it like a little kind of story, like a little scene with that character, where they're doing some of the things that we want to remember are associated with that met level. All right, so our first one is OB1 Kenobi, right? OB1 for met level 1. Now I'm just going to tell you like what we're kind of picturing him doing, the way we're going to remember it, and then I'll go through it again with like the exact things that that relates to. So for OB1, he's an older guy, so we're going to remember him being old and tired. He likes to sit in his favorite chair, and then he gets ready to go see Luke, right? Just like in the movie. So being old and tired, again, this is met level 1, this is like the bottom of the barrel in terms of exertion. So this includes things like just laying in bed, being on bedrest, or using a urinal at bed level, right? Like just the minimal amount of effort you could conceive of, that's included in met level 1. So our picturing OB1 just being old and tired, laying down, doing very, you know, low effort activities. That's included in this one. All right, so next is he likes to sit in his favorite chair. So low effort like seated activities, those are also included in met level 1. So sitting up to eat a meal, or doing like a bed to chair transfer. So getting to, you know, from his bed to a chair, and then back again, that's included in met level 1, too. And then we said he's getting ready to go see Luke. So the getting ready part is some of these basic kind of grooming hygiene type tasks. So washing your face or your hands, that's the kind of stuff we're looking at. And then finally, again, getting ready to go see Luke. So go see Luke like you're getting up and you're going. So this is walking at about one mile per hour. So walking very slowly. And driving an automatic car, those both fit into the upper end of this, you know, met level 1, which is technically if we're getting really specific, like again, 1.0 to 1.9. This would probably be closer to the higher end of that, like walking or driving a car. That's that's a little more exertion than again, just laying passively in bed, obviously, right? Okay, so that's met level 1 again. Obi-Wan Kenobi old and tired, likes to sit in his favorite chair, and he's getting ready to go see Luke. Okay, next one. So R2D2. So this one is we're going to picture R2D2, and in the movies, you know, he's always doing all kinds of stuff. He's helping people out. So we're going to picture R2D2 in the role of like a maid, like cleaning up and doing that type of stuff. So the you can picture R2D2 in like one of those, you know, black shirt with the wipe apron and like the frilly white little hat and collar and stuff, like a French maid uniform on R2D2. Again, the sillier the better when it comes to being able to easily easily remember this stuff. So R2D2 as a maid is how we're going to remember this. So first off, we're going to remember R2D2 showering, kind of getting ready for his day. He's going to be putting on his maid uniform. He's going to be going about his maid duties, kind of cleaning up, and then we're going to picture him walking and then he's got wheels, so walking/rolling. Those are the four things that we're going to kind of think of and I'll explain what those each sort of expand out to to help us remember. So the first thing, R2D2's got to get ready for his day, you know, at doing his maid job. So he's going to take a shower. Okay, so one thing to remember here, when we're talking about these really low-met levels, we have to get really nitpicky about some specifics about certain activities. One of the big ones being showering or bathing. Having more heat actually makes the task more strenuous. Now this is kind of counterintuitive when it comes to showering, which is why I bring it up because most of us enjoy a warm or hot shower even and we don't think of that as like it's more pleasant so we don't think of it as more effortful, but that is the case. A good example like that's slightly more extreme to prove the point is imagine like going for a long run or jog in the middle of like a pleasant fall day or like the hottest summer day. It's clear which one of those takes more effort and it's like tougher, right? The really, really hot situation is just tougher to do any kind of exertion with than the more cool situation, right? So that's the same thing and we really care about like these small differences when we're again at these lower-met levels. So for our R2D2 thing here, R2D2 can take a sponge bath whether he's seated or standing, that's no problem, but then a shower. It can't be a hot shower. It has to be just a warm shower and he should be seated to do that, right? So if we're going to be getting into the actual shower, we would not use hot water and we would have him sitting down. So we can imagine again like R2D2's this little robot. So if we're doing a sponge bath, you know, we could almost conceptualize it as like, you know, a coating of wax or something that we're rubbing on, that's fine and he can be seated or standing. But if we're going to get into, you know, the shower, he has to be sitting down and we don't go too hot because we're playing it safe here. So that's what we need to remember about the shower. So R2D2 showers to kind of get ready for the day. Then he puts on his made uniform. This is just to help us remember that dressing and undressing comes into play at this level. Again, so that includes, you know, standing up, kind of dreading your your extremities, that sort of stuff. Dressing is just covered in Met Level 2. So now R2D2's got his cute little, you know, wrench made uniform on and he's ready to go about his made duties. So he's going to be doing stuff like meal prep, hand washing items, washing dishes, dusting, vacuuming, that kind of stuff. So sort of this general house upkeep kind of thing, that typically falls into Met Level 2. And then finally, the last one is that as he's going about, he's got to get from place, you know, point A to point B. So he's going to be walking and then in parentheses, we can think of rolling because R2D2's on wheels, right? So that's this is kind of helping us remember that he can walk at two to three miles per hour, which is great because this is again Met Level 2, which is like two to technically 2.9. So it's basically two to three matches. Again, Met Level 1 was walking at one mile per hour, walking between two and three miles per hour is at Met Level 2, which is like two to 2.9. So matches up really well there. And then you can also self-propell a wheelchair, right? So if you're in a manual wheelchair and you're using your arms to push the wheels, that's the same level of effort as walking that slightly faster two or three miles per hour. Now this works well with R2D2 because we can think of him just kind of walking. Sometimes he does that little like side to side waddle kind of thing. And most of the time he pulls out his wheels and he kind of rolls around, right? So we can think of either the walking or the going on wheels on the wheelchair, self-propelling, right? So there we are for Met Level 2. Again, R2D2 takes a shower to get ready for the day, made uniform, made duties, walking slash rolling. Cool. So that's it for Met Level 2. On to three. Now for three, we've got C3PO, right? C3PO for Met Level 3. Things we're going to remember here is just that he's independent, right? So you know, R2D2 is kind of like a Swiss Army knife, but he's a bit of a weird, like little robot. C3PO looks like a person, right? He's got arms, he's got, he could basically be independent kind of going about whatever he needs to do. And then he's always on his feet. So fun little trivia thing. If you pay attention to the movies, there are barely any scenes where C3PO is sitting down because the costume that the guy was in was like really uncomfortable and terrible and so apparently sitting down was really hard. I think there's like one or two scenes where they did it anyway, but he is almost always standing up. So our C3PO is almost always on his feet. So what this is going to help us remember is that again, independent is just that the last of the BADLs kind of comes into play here. So bowel movement on the toilet is happens to be the BADL and that comes, that's the last one. So once you're at Met Level 3, then technically all of your BADLs are possible for you, right? And so you could be independent with your your basics. And then always on his feet, we're going to remember that now again, we've progressed a little bit so you could take a warm shower while standing and there's a couple other activities that are just kind of like you need to be standing to do them, kind of busy body type stuff, making your bed, sweeping, mopping, and gardening are listed on here. But especially like that transitioning from sitting to standing in the warm shower, that's just sort of queued up to be like a really common nitpicky question that the test writers might kind of want to get at you for. So independent and always on his feet is going to be C3PO on Met Level 3. All right, so finally we've got our last one here. So Met Level 4, and we're going to remember this with Harrison Ford, Han Solo, right? Okay, so Met Level 4, Han Solo is attractive. We can picture him working outside like with his shirt off or something. Again, he's kind of like the heartthrob of the Star Wars series. And then so attractive working outside. And then we've got one thing that's like not so attractive. So every, you know, attractive person, they might have something they do that makes them less attractive. So let's talk about these. So attractive. All right, so you can take a hot shower. This is the Met Level where sexual intercourse becomes a possibility and changing bed linen. So we can imagine that the three of those things could be related in some way. I don't need to explain this to you or all adults here. So hot shower, sexual intercourse, changing the bed linen. All right, next one, working outside. So we could picture him again, working outside with his shirt off, some sort of, you know, 80s movie heartthrob, not that hard to picture. So gardening, raking, weeding, and then last swimming at, and it specifies oddly, 20 yards per minute, which is one foot per second, right? Because a yard is three feet. It's 20 yards would be 60 feet. So 20 yards a minute would be one foot per second. So if you, if you picture that, like imagine yourself swimming, can you swim at one foot per second? Like, yes, that's not very fast. That's just kind of like doggie paddle even, right? So that's not especially strenuous swimming. It's just basically swimming and moving around. All right, so gardening, raking, weeding, swimming, so we can imagine, you know, him doing this yard work stuff or like at the beach, whatever, all that stuff becomes, is a, meant level four for Harrison Ford. And then the last one, not so attractive, is bowel movement in a bed pan. Now this one's goofy because it feels like, you know, a bowel movement at bed level in a bed pan, ought to be like a lower met level, then the bowel movement on the toilet, which was, again, C3PO at level three, this is level four, turns out that the position your body is in and all that actually makes it a little more effortful. You know, I, I don't know how the nurses swing that whole situation if they've got someone who's on bed rest and they're supposed to be below a certain, like, that's not really our whole thing. Who cares? So just remember that if we get questions about this, it's important to point out some of these counterintuitive ones just to make sure that we have those down in case that's what they choose to ask us about. So again, just like sitting versus standing in the warm shower, now it's, you know, bowel movement on the toilet at three, bowel movement in the bed pan at four. So the way I remember that was not so attractive. So we've got this, you know, attractive guy. He's working outside with his shirt off and then, oops, like he's got this, you know, a bowel movement in a bed pan. That's sort of like, oh, it ruins the whole, you know, mystique of this attractive dude, right? So whatever, that's the, that's the little scenario everyone through our heads, to remember this stuff. So again, now we've got, let's just run through it all, really, really fast. Again, the kind of overall view that you can actually remember and carry with you in the exam. So we have, Met Level 1, Obi-Wan Kenobi. He is old and tired. Again, like bed level stuff. He sits in his favorite chair, simple, like seated activities and bed to chair transfers. And he's getting ready. So like simple, grooming hygiene stuff. And then go, to go see Luke, you can walk at one mile per hour or drive an automatic car. Then Met Level 2, we've got R2-D2. So he's taken a shower. So he can take a seated or standing sponge bath or a seated warm shower. He's putting on his maid uniform. So dressing, maid duties, some of this simple kind of home, home management type stuff, washing dishes, dusting, vacuuming, meal prep, that sort of stuff. And then walking or rolling. So we can walk at two to three miles per hour or self-propeller wheelchair. Met Level 3 for C3PO. He is independent. So he can have a bowel movement on the toilet. And he is always on his feet. So he can take a warm shower and standing and he can do some other stuff that you need to be a little more, a little more on your feet, a little more effortful, but not quite like yard work, right? That's the next one. So like making a bed, sweeping, mopping, gardening, that type of thing. All right. And then finally, we've got Harrison Ford. So Harrison Ford for Level 4, Han Solo, attractive, hot shower, sexual intercourse, changing the bed linen, working outside, gardening, raking, weeding, swimming, and then not so attractive, bowel movement, a bed pan. Cool. All right. And that gets us through, obviously there are more met levels. We could go further with this, but this gets us through the most important ones that are the bottom level ones, because that's where we're getting really nitpicky. This is often where the question's like to focus. We can get ones that are higher, but this tends to be more of where we're looking at. So with these little Star Wars mononic, pneumonic, we will be covered. You'll be set. So I highly recommend that you get the PDF from OTexamprepper.com/studyguides. Get the free study guides. It comes with a visual for this. Kind of get this Xeroxton to your brain. You know, you can practice writing it out a few times. Hopefully the little character things make this easy to remember even without doing that. You can just really get this down and simplify this stuff from memorizing a million things down to having like four simple characters with an easier, remember, a little little set of things they're doing, a little scene that you set in your head that helps you remember all this stuff super easy. So that's it. I'll see you in the next episode and hang in there. Last but not least, music this episode was provided by Kevin McLeod at engopateck.com. Thanks Kevin. [Music]