NN #5 - Sarah Alley "Out of my body, and into my mind"

Today I want to talk about one of my former middle school teachers, Mrs. Sarah Alley. I remember her being so vibrant and enthusiastic and WAY taller than me (something silly to remember huh?). On the first day of school I remember her giving her "get to know me" speech and showing us all these pictures about her life way back when and currently. She took me individually up to the board to show me an old softball photo of when she was a kid, then she pointed at one girl and told me that it was my mom. Throughout the week she would share stories about how her and my mom were very good friends and extremely competitive on the field. And then I would go home and ask my mom for more stories. Right then I thought "oh if she's best friends with my mom then I need to be best friends with her". She might not have known it, but I loved that woman. Her class period was the only one I looked forward to during the day and she made learning (even boring subjects like history) so much fun. Those two years of having her back to back were probably some of my fondest memories.

Sometime when I was finishing up high school Mrs. Alley was diagnosed with ALS/PMA. Long story short - our little town was heartbroken. Everyone knew her personally, or of her and we all shed many many tears. But through it all and still today, she's still the same vibrant and enthusiastic person I knew several years ago. She retired from her job as a teacher in 2015 and is now blogging about her personal experiences, feelings, living with ALS/PMS, and just general thoughts. She started blogging in 2016 (which I didn't know about until about a month ago) and has around 60+ posts. I unfortunately have only read 10-15 of them but I have a goal to finish them all because they are wonderful! One thing I love about her blogs is that despite her exhaustion and daily struggles, they aren't all she talks about. She moves past them. But I currently have two favorites, one really recent - "Birthday Trappings" and one from May 2016 - "Lasts". And they aren't my favorite because they have a dollop of daisy on top of them, but because they are raw. Both of these posts include emotional and physical details about her life and living with ALS. The one titled "Lasts" talks about just what you think it would. She talks about how having a disorder like ALS can make your lasts pretty vivid. She mentions the last time she walked without a cane, the last time she went to work, and the last time she drove. The one titled "Birthday Trappings" was about her 48th birthday, which just happened on June 3rd. In this one she includes a picture of what her view is from her bed, including her nightstand with her machine on it. She mentions that even though it is her birthday they keep their daily routine (they meaning her husband and son who live with her and take care of her). She enjoys oatmeal and coffee with her husband but then the crackling and wheezing begins. Her son has to hook her up to a coughing and suctioning machine to help her breath because her lungs are giving out on her. She then talks about how after all that is all over that is when she does her reading and writing and on that day, she typed through the tears so she could celebrate her birthday accordingly.

Some of the blogs have made me happy and put a smile on my face knowing that she is still enjoying her life but others have just absolutely broke my heart. Just as these two did, and I think that is because I have a personal connection with her and because I am more knowledgable about the disease now than I was when she first got diagnosed. Because I didn't know about how public she was with her life, I didn't want to bombard her with a million questions and emails. I am kind of upset that I didn't know about these personal entry's because I would have definitely done my case study over her to get on a personal level with someone. Anyways, I am going to keep up with her blog to the best of my abilities and continue my learning of ALS through her writings. I hope you check them out from the link below!

http://www.stategazette.com/blogs/2051

Media Project Virtual Display

Client: Susan

Diagnosis: Amyotrophic Lateral Sclerosis (ALS)

About: 55 year old women that was diagnosed with ALS two years ago. She was recently admitted to acute care hospital with pneumonia and worsening mobility. She recently worked as a teachers aide in a public elementary school until last year. She was independent in ADL's but has been experiencing muscle weakness and fatigue and needs help opening food packages.

Interests: She enjoys watching tv/movies and playing cards with her family. She also enjoys scrapbooking and is currently working on a scrapbook that she will give to her daughter for her graduation present in a couple of months. She would also like to create a series of videos or cards to leave behind for her family.

Item: Index cards

Intervention: To address her interest of scrapbooking while working on fine motor skills and muscle strengthening I decided to have my client make "mini scrapbooks" or "personalized cards" out of index cards. Because she scrapbooks I knew she would have the materials at home to complete this intervention. My goals for her were to be able to trace a template from online (fine motor skills), draw and cut this template on multiple index cards with scissors (fine motor skills), hole punch them (muscle strengthening), and tie a ribbon through the hole (fine motor skills). In the end I would also like her to embrace her creativity through her scrapbooking and writing.

Below are pictures of the items I used in the intervention and what the final product could look like:

Items needed

Product before design/purpose


Finished product in multiple forms


Overall media project 

NN #4 - The Notebook

The Notebook - movie 

The Notebook is a movie about a present day elderly couple, in which the wife, Allie, lives in a nursing home with dementia. Noah, her husband, reads her stories written from her personal journal in hopes to get her memory back. The movie is mainly focused on their previous stories that are written in the journal. But in the end the movie focuses on the fact that Allie suffers from dementia and cannot recall who her husband is, how they met, or what they have been through. At the end of the movie, Allie regains her memory for a brief moment and reconciles with her husband. She quickly forgets and panics sending the medical personnel in to sedate her. Because of the panic attack that Allie experienced, it gives Noah a heart attack landing him in the hospital as well. In the middle of the night Noah sneaks into Allie's room and crawls into bed with her. Allie regains her memory once again long enough to tell Noah that she may forget him again at any moment. They both fall asleep in the same hospital bed and pass away together through the night. (What a tear jerker!!) The reason I chose to write over this movie was because a) it is one of my favorite movies (I'm a sucker for sappy love stories) and b) now that I have learned about dementia it is easier to understand the background and reason for the story. From watching it the first 100 times I thought that there were some semi-unrealistic assumptions around dementia portrayed in the movie. For example, Allie regains her memory twice within one day. It is very rare for this to occur especially with people in late stage dementia. It is more likely for them to remember childhood memories and be stuck in that time rather than mid-life memories. And now knowing more about dementia, I realized that there are also some realistic symptoms of dementia shown in the movie. For example, Noah mentions his and Allie's name over and over again, and Allie seems to not know who Noah is or that he is her husband and doesn't even realize that her own name is Allie. Another example would be when she loses her memory as fast as she regained it and finds herself in Noah's arm while he's calling her sweetheart. She becomes very confused, angry, and defensive. It is very common for people with dementia to show aggressiveness towards the ones they love without even knowing it. Because this is such popular movie and is known for its love story I think it is important for people, especially us in the health profession, to pay attention to the underlying plot and what common people assume about a neurological disorder. Next time you watch this movie, or if you haven't ever I suggest that you take the time to, pay attention to the assumptions and realistic features of a movie. Especially one that is centered on a disease or disorder. 

Caroline's case study - Dementia

This is the first case study presentation group that I have been apart of that included a personal story. Caroline's client, Ruby, was her biological grandmother who experienced dementia that was caused by Alzheimer's Disease. One thing I found interesting was that her grandmother was not actually diagnosed with Alzheimer's until 6 years AFTER her symptoms began. Her family, friends, and some doctors just assumed her forgetfulness was happening because of her age. Once she started forgetting who people were and started showing abnormal behavior towards them the doctors issued multiple tests to finally diagnose her. And at this point she was in the late stages of Alzheimer's. She eventually became very lethargic and stopped doing things she loved such as gardening and sewing. Because Caroline's grandmother passed away a few years ago, Caroline's intervention plan and goals for Ruby weren't personally given to her. But, with a little research from her mom she did find out that Ruby actually saw an occupational therapist when she was alive and one of her goals then was to work on self feeding. Caroline took this information and applied it to a intervention plan that would be fit for her today as if she was alive. I enjoyed hearing about Ruby and think Caroline would have met her grandmother's goals if she were her occupational therapist.

Audrey's Case Study: MD

Audrey took her case study topic and put a different prospective on it. Instead of having muscular dystrophy, Brandon Walker has congenital myopathy. Congenital myopathy has similar symptoms as muscular dystrophy (such as weakness in hands and feet and fatigue) except that in Brandon's case it is not progressive or leads to death. He was born with it and has lived with it his whole life. He is currently 39 years old but Audrey did her interventions as if he is 20 years old for OT purposes. His goals are to live by himself and learn how to drive. He wants to be fully independent by living by himself and since he is a country artist and performs different places all the time he wants to be able to drive himself around. Because he has been in a wheelchair his entire life as well, walking is something he doesn't know and does not want improved. He saw an OT when he was way younger but no further information was accessible about any other therapy. On that note, I think Audrey did an excellent job creating a fictional intervention out of a real life situation.

My Case Study - Trey Gray

Today I presented my case study over Huntington's Disease on Trey Gray, the drummer for country band Brooks and Dunn. I addressed the basics about Trey to my group members such as: he was diagnosed in 2003 at age 34, his mom and uncle both were diagnosed and died from HD, and his main priority was to drum as long as he can until the disease took over. I explained that little information was given about him on the internet past the year of 2008, for my assumption that he is in middle / late stages of HD and no longer wants his life centered around publicity. None of his interviews mentioned OT or PT, so based on what he said was important to him in some of his interviews is what I centered in on for intervention. And because it is a progressive disease, I focused on maintaining and managing skills rather than improvement. My group members seemed very interested in the topic because they asked a lot of questions pertaining to my client and to the disease in general.

LAST FOCP BLOG POST!!!

I had already wrote a blog post reflecting my learning from FOCP so read that one first :) So for this one I'll hit on our debriefing session today. I'm going to be completely honest, sometimes when I hear the word debrief I get a little anxious and irritated because I think in my head "oh he/she doesn't care for what I have to say" or "I have nothing to say at all". Today was different though. I appreciate that you take what we have to say to heart and actually use our suggestions to profess your course. I guess this is something I'm not used to from undergrad. I'm proud of my class for not tearing each other a part for the suggestions we made, instead we either backed each other up or we made other suggestions to improve the initial suggestion. Doing this before taking the FOCP eval will help me a lot because I've gathered my thoughts already! I've enjoyed our time together, even though its not over, and I hope to take with me everything that was learned in this course. Thank you!

Elvis has left the building
- Must touch on my era presentation that helped me loosen up around my classmates :)

NN #3 - How It Feels To Have A Stroke

Ted Talk - How It Feels To Have A Stroke 

Jill Taylor decided to study the brain after her brother suffered from a brain disorder, schizophrenia. She became a neuroanatomist and one morning she realized she was having a massive stroke. And like any brain scientist would, she studied what her body was doing and remembered every bit of it and lived to tell her story on a Ted Talk. She said it was a normal morning but instead woke up with a pounding headache behind her left eye. She ignored the headache and got on her cardioglider  (workout machine) to start her normal daily routine. While on the machine she began noticing something weird about her body. She said as if her state of consciousness has shifted away from her perception of reality. Instead of looking out away from her body, she was watching herself from an outside perspective. As her headache worsened, she got off the machine and began to walk to her bathroom where she says that she could no longer define the boundaries of her body because the atoms and molecules of her arm, blended with the atoms and molecules of the wall. She describes her left hemisphere of her brain being shut off by a tv remote, it became totally silent. As it turned off she says she entered "lala land" where she just felt one with energy and kept expanded. Then like another switch, the left hemisphere started working again reminding her that there was a problem. Another switch, another entrance to the external world. Another switch, another time, it switched back on and she quickly realized that she needed to seek help. Suddenly her right arm went limp, paralyzed to her side and she knew then she was having a stroke. Throughout the video she describes how cool it felt and was wondering how many times do brain scientists get to study their own brain from the inside out.

Jill goes on to tell how she sought help and brings humor into every bit of it. At one point in the ambulance she describes her spirit leaving her body, almost surrendering to what was happening in her brain. And she thought "this is it". The doctors were either going to save her or she was going to die. When she woke later that afternoon, she was shocked to still be alive. She describes that the noises were so loud that she couldn't depict a voice out in the room, and that the light was so bright that it burned her eyes. She was still enormous and out of her body but realized again that she was alive and that she needed to take advantage of it. The hemorrhage was the size of a golf-ball in the left hemisphere of her brain that was pushing on her language center.

She took her tragic incident and turned it into a "gift". She thought what if people could use this and take a step to the right of their left hemisphere? This motivated her to recover, which took 8 years. She now believes that we have the choice of being the one individual portrayed from our left hemisphere or the "me's inside of me" portrayed from our right hemisphere. And if we all chose the right hemisphere, we would live in a more peaceful world. She ultimately connected her stroke to how our brain defines us and connects us to different worlds. This was honestly one of the most interesting Ted Talks I have watched. It made me put a new prospective on encountering a neurological disorder and the potential research that could be continued because of remembrance. I highly recommend watching it and possibly showing it to future classes when stroke is the center of topic.

Reference: 

Psych: Documentary Films. (August 19, 2012). Ted Talks: How It Feels To Have A Stroke. Retrieved from: https://psychdocumentaryfilms.wordpress.com/2012/08/19/ted-talks-how-it-feels-to-have-a-stroke/

Lauren McGee's Case Study - MG

Lauren did a wonderful job digging down deep to find a personal story over Myasthenia Gravis. She found a testimonial on the MG website, found a story she admired, and pursued the girl on Facebook to get on a more personal level. Lauren says the girl (Amanda Jones) was very humble but glad someone was reaching out to her to talk about MG since it isn't widely known about. Amanda hasn't tried occupational therapy but Lauren gave good examples of adaptive technology that could be used for her situation. She has a passion for photography but her MG happens sporadically so she has to cancel on people a lot. Lauren suggested taking pictures of landscapes and nature so she can continue her passion without having to cancel. She also suggested for the use of a tripod or a photography assistant to help her when she is easily fatigued. I thought the tripod was an interesting idea because I had never thought of it as "adaptive equipment", but in the case of Amanda it most definitely could. Overall Lauren did an tremendous job.

FOCP Reflection

Foundations of Occupation Centered Practice has introduced me to the concepts and skills needed to further my career as an occupational therapist. It has helped me learn the background of the profession and who is responsible for the popularity and greatness of what we know as occupational therapy. Compared to other courses, I feel as if this one was greatly beneficial to my knowledge on the profession as a whole and what I need to do as a practitioner to keep my knowledge at its peak. Because both historical and present perspectives were directed toward us, we now know how far the profession has come over the last 100 years and how quickly things can change over time. This lets us know as future practitioners that we are responsible for the future of OT, we are the caretakers, and we can make huge differences over the next 100 years. One of my biggest goals coming into graduate school was to work on my communication skills and behaviors with clients. They have never been bad but I wanted to "perfect" them and make them more efficient especially in a clinical situation. FOCP has helped established a base and some foundation to my so-called "communication house". Because of this course I know how to effectively deliver an elevator-speech about the profession along with knowing how to advocate for and demonstrate what occupational therapy is and its values. I now know the importance of this class and what its relationship to our other curriculum is. FOCP was a well administered and a beneficial class to start my first term off with as a occupational therapy student.

Professional Development

Learning about professional development throughout school and our later careers is a key factor in learning about how an occupational therapist should act. As an OT practitioner we are committed to being life-long learners. We do this so we can never stop growing, so we can keep an open-mind about things, and so we can keep up with the latest trends in technology and research. Along with being a life-long learner we also should continue competence. Continuing competence is our ability to do something successfully and efficiently while ensuring the quality of service to our clients, this also protects our clients. Not only is professional development required to keep our license but neglecting this part of our job can potentially harm a client and ourself as the practitioner. Planning for and seeking out further opportunities and experiences to add to our knowledge and skills is the greatest accomplishment we can do throughout our career.

Therapeutic Use of Self

Since starting school, we have heard about "therapeutic use of self" and "therapeutic relationship" and have used the terms interchangeably but haven't gotten the full meaning behind them. Now that are first term is coming to an end we have finally found the meanings and now know that we cannot use these terms interchangeably ;). Therapeutic relationship is ideally the interaction between an occupational therapist practitioner and the client. Therapeutic use of self is when the OT practitioner themselves identifies the goals and objectives of the client, develops an intervention plan, and uses their interactions with the client to achieve the client's desired goals. Essentially, therapeutic use of self is a key component of a therapeutic relationship, along with other qualities such as active listening, empathy, humor, verbal and non-verbal communication, and empowerment.

Lauren Laborde's Case Study - ALS

Lauren's case study ironically was focused on Lou Gehrig. This was the person that ALS was informally named after ("Lou Gehrig's disease"). In addition to her research over Lou and his disease, she also put in extra effort to find out why it was named after him. The only conclusion she could up with is that he was the first "famous person / athlete" to be diagnosed with this condition in the United States. Outside of the U.S. ALS is not known as Lou Gehrig's disease. Because of the time of his death, Lauren did an excellent job on portraying the differences in occupational therapy then (1940) and now (2017). She mentioned that occupational therapy was still relatively new when he was diagnosed and might be a part of the reason he only lived for three years after diagnoses. Adaptive equipment was limited and couldn't put much affect of quality of life. Lauren expressed intervention planning around optimizing strength and ROM, maintaining function in ADL and iADL, decreasing fatigue, and managing pain and energy. Overall, I think this was an excellent choice considering Lou's condition made him degenerate.

Making a universal cuff

Today in class we got to get hands-on once again (these are my favorite days) and make a universal cuff. After a little tweeking and do-it-agains, all different types of cuffs were made. Even though we had a sheet full of directions, I like that we were able to be free-spirited with our cuffs. Because they are universal, each one shouldn't and won't be the same when making and providing them to clients in the future. I like this activity particularly because it involved a simple "tools needed" list. We didn't have to get fancy with a sewing machine but instead we used everyday household items such as duct-tape, scissors, velcro, and elastic. This is an easy and cheap way (low tech) to introduce assistive technology into a client's life. Like my activity analysis, I added the directional worksheet to my professional development portfolio for future use.

Activity Analysis - Little steps that go a long way

A couple of weeks ago in class we got to choose a fun activity, create an activity analysis, and present our activity to our group members. These activities were chosen with the objective being purposeful in its application to occupation-based activity and increase our ability to assess client performance, come up with an intervention plan, and modify an activity to fit the "just right challenge" based on a client's needs. It was a fun opportunity for us to practice occupational-based intervention planning and provided a lot of learning situations. It was nice to see a plan being formed and implemented rather than just talking about it in class. I actually kept all of my directional worksheets that were created by my group members and put them in my professional development folder for future use. Knowing how to form an activity analysis, putting it to use, and how to modify it when needed will be extremely helpful in my future. I look forward to more hands-on learning opportunities like this one.

The Sky is NOT the Limit

A couple of weeks ago, my class had the opportunity to experience a spinal cord injury story firsthand. Fletcher Cleaves, a young african american male,  gave us a glimpse into his life and what it is like living with a spinal cord injury. Needless to say, his feelings toward his injury aren't what I expected. Even through all his trials and tribulations he seemed to keep the most uplifted spirit he possibly could. Not only would he joke about things to his doctors / therapists / friends and family during the healing process, he cracked a joke every other sentence during his lecture. The biggest take home message I got from him (besides saying no to texting and driving) was him quoting "if the sky is the limit, then why are there footprints on the moon". He was basically saying that the sky is NOT the limit, we have so much potential and there are further things than the sky that we could reach for. His story and his prospective on his injury was honestly so inspirational. He, along with thousands of others who do not believe in giving up, are the reasons I want to be an OT. He has not, and does not ever let his injury define him. He has reached way past the sky and found a way to live normally and happily, and I hope his occupational therapist had something to do with that.

NN #2 - Rolling Grizzlies

Rolling Grizzlies 

Last week I had the opportunity to sit in on and watch a Rolling Grizzlies practice and scrimmage. The Rolling Grizzlies are a wheelchair basketball team that competes locally and nationally with other wheelchair basketball teams. When thinking of a wheelchair based sport, I automatically think of people with disabilities or injuries. (This is very stereotypical of me and I realize that now). The unique thing about this team, and other teams around the world, is that they don't restrict membership to just people who have a disability or injury. Anyone can participate and I think that is a wonderful learning opportunity for those who want join and get to know the sport from a different perspective. 

Another thing I found interesting is that each member of the team had their own story, very few of them being the same. For example, one member played basketball in college and had the potential to play at a professional level until a tragic shooting happened, leaving him with a spinal cord injury. After hearing his story, I found myself focussing on him for the rest of my time there. I couldn't help but to feel sympathy toward him and think about how sad he must have been the day he found out his basketball career was over. At that moment a little light bulb went off on the top of my head. I quickly realized the connection between my future career and what I was doing there that night. My job as an OT would to be to never let that dream die for that particular player. My goal would be to get him back doing what he loves. Now I don't know his therapy background but I do know whoever he encountered had to be a special person because this player obviously did not let his injury define him. He played his heart out and did it with a smile. Need I remind you that this wasn't even a real game, it was simply a scrimmage against his other teammates. 

I chose to go to this event because I am so intrigued by spinal cord injury and was earlier influenced by one of our guest speakers. There were several lessons learned that night and a many new experiences gained. I am grateful for the opportunity I had and glad I gave it a chance. Not only has my view of wheelchair based sports changed, but it gave me so much respect for those who participate in them. Just from watching I could feel the energy in the room and see how difficult it was and how much concentration goes into the game. If I had to say, I would bet it is way harder than on foot. If anyone has never watched a wheelchair based sport, I highly recommend it because it might just blow your mind.  

Some contact information:

Facebook page - https://www.facebook.com/Memphis-Rolling-Grizzlies-129140780501102/

National Wheelchair Basketball Association:

(For Memphis) - http://www.nwba.org/page/show/2023830-mem-rollin-grizzlies

(In general) - http://www.nwba.org

Childhood Obesity - An Emerging Area in OT That Shouldn't be Emerging

Childhood obesity as a speciality was identified as an emerging niche in 2011 and since then has become more mainstream - which is mind. blowing. At the time, it was emerging because childhood obesity had tripled over the past thirty years. I could only imagine what those number look like now in 2017... enough to mainstream this speciality. The area came about because children were having trouble meeting physical demands inside and outside of school. These physical demands also put a damper on their cognitive demands, such as stress and depression, due to actions such as bullying. 

Rising obesity rates in children and epidemiology is something I am highly interested in and familiar with. In 2011, my younger sister contributed to those obesity rates. At first it was something that we just looked over and thought she would "grow out of". Then I became more aware. I started taking health classes and became more knowledgable about the long-term effects of childhood obesity. What some people are unaware of is in fact the long-term effects of obesity - in children, adolescents, and even adults. Once diabetes took my grandmother's life at a relatively young age, my viewpoint on healthy lifestyle became even more adamant - especially when diabetes is hereditary and prominent on both sides of my family. I have been wanting to find more ways to promote healthy living for my younger sister and do it in a positive way rather just emphasizing that she is over weight and needs to lose weight. 

An OT's role with childhood obesity is developing activities for children that promote health and fitness while keeping it light and positive. Individualized programs are highly encouraged to consider specific needs of each child, what they child wants to be able to do, and the resources that are available in that child's community (Hey look - it's a holistic approach!!). Not only can the programs promote healthy living to the child but also their families - highlighting healthy food and exercise/play resources that can come cheap and easy! 

This area is highly relatable to AOTA's Vision 2025- it is in fact maximizing health, well-being and quality of life for children. Now, hopefully with all this commotion and promotion about childhood obesity, maybe we can stop this area from emerging anymore! 

Resources:

The American Occupational Therapy Association, Inc. Childhood Obesity. (2011). Retrieved on May 2nd, 2017, from http://www.aota.org/Practice/Children-Youth/Emerging-Niche/Childhood-Obesity.aspx

Camille's Case Study - PD

Camille mentioned to us that she, at first, had a lot difficulty finding a personal story from someone with Parkinson's disease. Instead of making something up, she continued her search because she wanted the case study to be beneficial to our learning, which I found really considerate and admirable of her. I think it is so interesting that the personal story that she did find came from Sherri Woodbridge's blog - which is pretty famous and have been awarded for. Sherri's story never mentions OT intervention but Camille did an excellent job on coming up with ideas for the OT role. Since Sherri does write for her occupation, typing comes difficult with Parkinson's disease. Camille found an assistive keyboard cover that puts all the keys on an even plane so your hands can lay flat and finger movement is lessened. Another emphasis that was put on Parkinson's was the sadness / depression that comes along with it. Sherri writes in one of her blogs that even if you aren't depressed about your situation, when someone mentions it or asks you how you feel you then become depressed. Overall, Camille did an excellent job hitting on all the aspects of Parkinson's disease and gave me a clear idea of what we are about to touch over in class.

P.S. I personally think Camille would be a great OT for someone who is in Sherri's situation 😊

Code of Ethics and Social Media

Yesterday in class we did some retrieval practices on AOTA's Code of Ethics. This was learned once before, at the beginning of the year, but wasn't quite grasped. Learning about it again helps with the retrieval process and helps me get a understanding of why these principles are appropriate and important for my profession. While the purpose of the code of ethics and all the principles is to reflect the nature of our profession and prevent any ethical concerns, there is one principle that I find really important in today's society. The definitions of autonomy and confidentiality basically say we, as practitioners, should respect the rights of the client. What is important to know is that the word "rights" is such a broad term. This can be anything that describes or identifies a client (name, diagnoses, birth marks, physical looks). It can also be anything that a client possesses, says, wears, or practices. The reason I think this principle is the most important is because of the high use of social media. Social media is basically our "one click" link between privacy and total exposure. As young health professionals who are highly active on social media, I think that it's important for us to understand that privacy isn't something that comes easy in such a technology driven world. As the generation that started growing up without technology and slowly made our way into that world, we need to be the main educators and spokespeople for other health professionals that are currently surrounding us and will come after us. Most of us don't like our insecurities and imperfections to be exposed, so why should be expose others? (Even when we're not meaning to).

Cameron's Case Study - SCI

Cameron did an excellent job taking a fictional character and turning it into a real life situation. Even though there is a lot of controversy around the movie, the injury is very much real and so are the characteristics that Will Traynor portrayed. Even though Will's character saw a physical therapist rather than an OT, Cameron used his imagination and knowledge to change the story line a little if there had been an OT involved. We discussed things such as reasons for referral, short-term and long-term goals, assistive technology, and the role of the OT. One big thing that I took away from Cameron's presentation is that one of the overall roles of the OT, in this particular situation, was to be a friend. While he/she would aid in helping his physical ability, most of Will's problems were coming from his mental state of mind. As an OT, being a friend as a main role is very much realistic and might be the one thing that changes your client's mind about their quality of life.

NN#1 - Me Before You

Me Before You

The movie (and book) Me Before You is about a young man who was involved in a motorcycle accident and suffered from a complete spinal cord injury which paralyzed him from the neck down. Before the accident he was full of life and adventure and afterward he no longer saw the need for living. Because of the accident and his impaired way of living, Will Traynor also suffered from depression which had led him to attempted suicide once before. After many conversations and arguments with his parents, doctors, and therapists, he gave his life a limit of 6 more months before he was to admit himself into an assisted suicide facility in Switzerland. His parents hired a female "caregiver", Louisa Clark, in hopes to lift Will's spirits and change his mind about suicide. 

I had previously read this book and watched this movie before entering OT school, with only a basic understanding of the related topic. For the purpose of this assignment, and with a greater knowledge of the injury, I re-watched the movie over the weekend. The first time watching the movie, I only considered and felt empathy toward Will's role in the movie. But watching it again, and thinking like an OT, I considered Louisa's role in the movie as well. At first she minded her own business and was only doing the job to help her family with financial struggles. As time passed she realized that Will's quality of life was poor and as his "caregiver" she should (and could) make his life better and potentially change his mind about assisted suicide. Though not directly, I noticed that Louisa's way of thinking was the same as an Occupational Therapists would be when treating a client with a spinal cord injury. Because of doctors orders, and his nurse's help, Louisa knew there was little she could do to help him regain function in his limbs so instead she used the resources Will had to get him back doing the things he wanted and used to do. 

Even though the movie didn't have a happy ideal ending, some progress was in made in Will Traynor's life.  Something I gained from re-watching the movie is that as OT's, some of our clients may or may not want us being involved in their injury, and after a certain amount of time, they may not want to be involved with their own injury anymore. Because of the high risk of other mental disorders, such as depression, forming after traumatic injuries I feel as if it is important for meaningful treatment begin right after an injury. Because of the movie's small time frame we don't know the extent of his treatment, but Will Traynor could have been one of those clients who didn't have a meaningful experience with his therapist(s). Because of Louisa's OT way of thinking, if she had been introduced in his life two years before, instead of just 6 months, there is a possibility that Will's quality of life could have done a 360 rather than just a 180. 

As OT's we shouldn't just be involved with our clients because that is what we're getting paid for but because we want our clients to regain a meaningful life and we want them happy. Another lesson learned from this movie is that we may be their only hope. Others may have given up on them already but we shouldn't. 

Book: 

Moyes, J. (2012). Me Before You. (Kindle Edition). New York, N.Y.: Pamela Dorman Books/Viking. 

Movie:

Rosenfelt, K., Owen, A. (Producers), & Sharrock, T (Director). (June 3, 2016). Me before you [Motion picture]. United Kingdom: Warner Bros. Pictures. 

Clinical Observation and Documentation

When I was shadowing a hand therapist in undergrad, she would spend 15-20 minutes documenting notes after seeing each client and then at least an hour at the end of her day everyday documenting more notes. I remember asking her once why she spent so much time documenting and she told me it was beneficial for her in remembering who the client was, what their situation was, and what kind of activities were done on that day. I just thought it was for the purpose of her remembering ROM and client progress, but now learning about documentation first hand I realize it's so much more than that. Not only does clinical documentation provide observations by the OT, it also gives us a chance to justify our services (the why and the how) and its our opportunity to showcase our services and why we are important.

Like I said in the last post, I like having something laid out for me and organized. This is why I think I will enjoy goal writing and the SOAP note when I become a practitioner. Goal writing will help me keep myself organized when intervention planning for each of my clients, both short-term and long-term goals. It will also be a reminder of what my purpose as an OT is, to satisfy the client's goals wants and needs. I think the SOAP note method will also keep me organized in the manner of being able to locate things when I go back and look at my documentation. I'm excited to learn how to implement these things in a clinical setting.

The OT Process

When first entering into the program, one of the main questions I had in the back of my mind was "how does the process work, and how do the practitioners know what to do when a client comes in for the first time?". Even though that is still a question I have and will always have until I gain experience, learning the OT process really helped to clear up some thoughts. Having clear instructions and a plan laid out for me is the best way I get a job done and I think the OT process (even though it is subject to change) is organized in a way that I can be the best practitioner I can be.

Health Promotion, Literacy, and Prevention

I was excited when I learned that this lecture was going to be a part of the curriculum for this class! I took epidemiology in undergrad and found myself very interested in the topic and now I am even more interested that I can also apply it to my future career. Though this was a refresher lecture for me, in terms of OT application, the section on health literacy stood out the most. I think that being able to obtain, process, understand, deliver, and communicate basic health information is key to being a practitioner. I have encountered plenty doctors / nurses / health care providers that do not practice this way of thinking, and honestly it made me discouraged and wanted to frown upon health care providers.

For example, in the winter of 2015 my grandpa was diagnosed with lung cancer and was back and forth from hospitals, cancer treatment centers, etc. When I came home for Christmas break, I was responsible for taking my grandpa back and forth to his doctor visits while my parents were at work - meaning I was also responsible for interpreting information back and forth from my grandpa and the doctor, and the doctor to the rest of my family. (Keep in mind, I am also one of the few people in my family that has any medical background). There was one point in time that had I not have been there my grandpa would have undergone an extensive and crucial round of chemotherapy AFTER he had already told all the nurses and doctors that he did not want treatment. This ultimately happened for three reasons: 1) lack of information provided to my grandpa, 2) medical terminology was used instead of basic language, 3) lack of communication between health care providers in the same facility.

Because of encounters like this, other health care providers mistakes make me want to be a better practitioner. We, as OT's, need to know and embrace the fact that the majority of our clients are going to have the minimum amount of knowledge about what we do, why they are seeing us, and basic information on health benefits. It's almost pointless to deliver services to these clients without it being purposeful. And for it to be purposeful, they need to have a basic understanding and that is our job description as well.

TBI

Instead of reflecting on today's topic and what was learned, my mind is geared toward my personal experience with the topic and questions I have now that I didn't once have. When I was in second grade my dad had an ATV accident which caused swelling on his brain and required emergency surgery. Because I was so young and my dad has a hard time recalling all of the information the only thing I know for sure is that he now has a metal plate inside of his skull. I don't think he was "diagnosed" with a TBI but now knowing what I know, he often shows signs and symptoms of one. (And he could have easily had one and I just don't know about it because I was so young). From my perspective the symptoms have worsened but I thought this may just be because of stress from recent family misfortunes. These symptoms may have always been present and I am just now noticing them because of my medical experience and knowledge. He is slow to comprehend things, has difficulties expressing his words, and experiences confusion a lot. My question(s) for you would be can this be something that waits 15+ years to set in? And is this something I should address with him to seek a doctor for? Thanks for listening!

Response to ECS lecture

Empathy in the medical/therapeutic field is something that seems essential of the caregiver, right? Something that all people with a medical degree should be aware of and put into practice, especially occupational therapists who have a goal to look at a person holistically rather than just at their disability. With this assumption, it surprised me that the ECS mentioned that only 4% of the surveyed OT's took courses that were related to therapeutic use of self. With this in mind, Beatriz did an excellent job advocating that training in the empathetic process needs to be expanded and more focused on, especially in our career. I like how she addressed six positive interactions that she has experienced beforehand and turned those interactions into questions she or her client might have that relates to empathy of herself or her client. Along with empathy being a critical ingredient in practice, she stresses that learning never ends, exceptions are always happening, and hope should be a precursor to an outcome.

Applying Frames of Reference

The article Putting OT Theory Into Action: Knowing and Applying Frames of Reference helped me get a better understanding of the PEO (person-environment-occupational) model because of the examples of case studies that went along with it, especially the story of Ann. It also made me realize that OT's not implementing their job description or using a client centered mind happens more often than thought of. Overall I learned that it is pretty much impossible for an OT to do their job (make change happen) without correctly and efficiently assessing their clients holistically, and a good way to make this happen is by using the PEO model. 

OTPF Influences

How does OTPF influence OT practice?

- It gives us a guide of how we should approach our clients
- It defines our OT lingo