Neuro Note #4: Breea and MS

Breea's Story

    I did my Neuro Note on Multiple Sclerosis-Breea's Story because I was interested in learning more about MS after we learned about it in class.  Breea was diagnosed with severe onset MS and was in the hospital around 6 weeks recovering.  I enjoyed how in the beginning of the video different people said what Breea was to them.  It made me think about how important roles are to shaping an individual's life.  During her hospital stay, her parents took her away one day to visit the ocean.  They called this "Operation Ocean View".  Seeing the ocean was so meaningful to her especially while being cooped up in the hospital for so long.  Long hospital stays take such a toll on a person's sense of freedom and happiness.  
    Breea set goals for herself which were to walk again and graduate from high school.  Because she was extremely tenacious, she met both of those goals!  In fact, she wrote one of her college entrance essays in the hospital room.  I noticed how much strength and encouragement Breea's mother showed throughout the video.  She always pushed Breea to new goals, yet showed patience and kindness throughout the rehab process.  Therapy was difficult for Breea.  The did several leg strengthening exercises and fine motor practice for her affected hand.  After 8 long months, Breea was able to jump, spin, and do a back bend!  When the Youtube video was published she was about to start college and only uses a leg brace for long distances.
    I really enjoy learning about personal stories involving different diseases. This video gave such a good overview of everything Breea went through with MS.  I learned so much about what it is like to regain function from a MS flare up.  I would definitely recommend other OT students watch this if they want to gain a personal perspective of MS. 


There is also a short version of her video here: https://www.youtube.com/watch?v=hfD9s1_TN0s

B. (2012, September 08). Retrieved May 24, 2017, from https://www.youtube.com/watch?v=hfD9s1_TN0s

Dementia Case Study - Ronald Reagan

    Ronald Reagan was diagnosed with early onset Alzheimer's disease a few years after he ended his presidency.  He lived 20 years after being diagnosed.  Interestingly, he was the first president to be divorced.  Ronald was adamant that Nancy not be negatively affected by his diagnoses.  I think an important aspect of Alzheimer's disease is the relationship between the caregiver and the person who was diagnosed.  Lauren did an excellent job of thinking of interventions and goals.  An issue with clients with Alzheimer's disease is not having normal sleep patterns.  After 3 months, Lauren wanted Ronald to have restful sleeps and would do this by taking walks during the day instead of napping.  I really enjoyed hearing about Mr. President and how he and Nancy were affected by Alzheimer's disease.

Rachel White's Case Study: S.C. and MS

S. C. was born with congenital adrenal hyperplasia which lead to precocious puberty.  This means she started her period at the age of 6 months.  She also had GERD.  A week before her 21st birthday she was diagnosed with relapse-remission Multiple Sclerosis.  She enjoys riding horses and volunteers at a local hippo-therapy clinic a few times a week.  Rachel wanted a short-term goal for S.C. to be to tell all of her law school professors about her diagnoses. A long-term goal is to work on energy conservation.  OT can also help with fine motor skills.  I found it so impressive she has continued through law school without telling her professors about her having MS, but I hope she will tell them soon.  I enjoyed learning about S. C. and her life with MS.

Ellen's Case Study: Woody Guthrie

   Ellen presented a case study on Woody Guthrie and his diagnoses with Huntington's Disease. He lost motor, cognitive, and psychiatric symptoms. He began having violent outbursts and involuntary movements. His mother had Huntington's Disease so when he started having symptoms he assumed that it was HD. He had challenges getting into a regular schedule because he was a traveling musician. OT could help him with routine management to help with the mood changes caused by HD.  OT could also help him map out places when he travels. Lastly, OT can help with end of life planning and caregiver education. I was curious if any of his children or grandchildren got genetic testing done to see if they have the defective gene. This case study was really interesting, and Ellen did a great job of presenting. 

Neuro Note: TransFatty Lives

    TransFatty Lives was an interesting twist on the raw depiction of a man diagnosed with ALS.  Patrick O'Brien was a New York City DJ who got diagnosed with ALS at the age of 30.  He created the film and made it very relevant and honest. 

    Being a musician by nature, the film was very deep and poetic.  He said once that before he was diagnosed, he never thought life could get any more complicated.  O'Brien said he realized how unimportant most things were before he was diagnosed.  The fact that the disease was only going to worsen adds an intense mental and emotional struggle to ALS. 
    At the end of his life, Patrick fought relentlessly to stay alive.  He narrated the film to his son Shawn using his AAC.  When they took him to the hospital, he repeatedly said he did not want a tracheotomy.  Although, he made the difficult decision to get a trach and live in a nursing home just to be alive for Shawn.  Because Patrick's cognitive function was still intact living at the nursing home became monotonous.  Patrick had an idea to have a fashion show using the nursing clothes and equipment.  It was inspiring that in the midst of the end stage of ALS, Patrick's humor and creativity never diminished. 
    I chose to watch this film because I heard good reviews from my classmates, and we recently learned about ALS.  Learning what happens to individuals behind closed doors is so important for future OTs.  This film showed the struggle, fear, and vulnerability that can accompany ALS.  Patrick directed this film all while typing directions using the movement of his eyes!  How amazing!  I think this would be a great resource for other students to watch on their own time.  I really enjoyed watching it, but I'm not sure everyone would as a class. 


O'Brien, P. (Director). (2015). TransFatty lives [Motion Picture]. United States: Netflix.

Virginia's Case Study - Joseph Heller

     Joseph Heller was an author of No Laughing Matter, a book recalling his experience with Guillian-Barr'e Syndrome. He was diagnosed when he was 58 and it wasn't until he was 60 when he fully recovered. At the time of diagnoses he was in the process of writing his 4th book. It was interesting that his symptoms started at the middle of his body rather than the limbs. Doctors considered this an anomaly. His best friend and co-author Speed Vogel was also his caregiver during his time with GBS. Heller had issues with grasping door handles and lifting his legs to take steps. He was always pretty dependent on others because he rarely had the opportunity to do anything on his own. Sounds to me like he was pretty spoiled before his diagnosis with GBS. Therefore, OT could help him with his ADLs and learning how to be independent. According to Heller, GBS does not discriminate and it comes out of nowhere. I enjoyed learning about Joseph Heller and how it affected Joseph. Virginia did a great job!

Foundations Wrap-up

    I am in awe that we have already been in OT school for almost 5 months.  Foundations has been such a rewarding and fun learning experience. It was so beneficial that we touched on a little bit of everything regarding the profession.  My class and I now have a solid "foundation" of OT!  I think my favorite project was the Activity Analysis.  I loved breaking down activities and really examining what factors when into each one.  This course has enabled me to begin thinking and acting like an OT. While the tests in this class sure do make us think critically, I believe it will allow us to be well prepared for the NBCOT when that time comes.  Overall, I appreciate all the hard work Professor Lancaster put into this class and our learning experience. 

Humor Me

Another aspect of a therapeutic relationship in OT that I thought was important is humor.  Humor and laughter are an important source of communication between most people and even more so when in a therapeutic relationship.  It is a way for people to relate to one another.  Being able to laugh and joke with our clients makes both parties so much more comfortable. It also makes the session so much more fun!  I remember my dad liking the clinicians who joked with him so much better than the ones who didn't.  I also think it is important to know when to joke and when not to.  Being self-aware about humor is vital for it to be effective.  In conclusion, when creating a therapeutic relationship, humor can benefit both the client and the clinician.

L. O'Brien's Case Study: K. T. and ALS

    K.T. was diagnosed with ALS in May of 2010.  He began seeing signs in his left hand when he was 41.  Lauren said numerous football players have been diagnosed with ALS due to the trauma from playing.  When K.T. was diagnosed he and his wife got a divorce and he moved in with his parents.  The case study revolved around what K.T. was experiencing when he was in stage 3 of ALS. He had lost upper extremity function and his breathing worsened at this point.  He utilized an AAC device and several home modifications.  K.T. lived 5 years with ALS.
    I enjoyed learning about ALS from this case study because we were able to hear about it from a personal perspective. K.T. was a friend of Lauren's family, so she knew more details.  His diagnoses enabled him to create a foundation for ALS and TBI awareness. I visited the website and it is hopefully igniting an awareness of severe injury in the football community.

Walk a Mile in Another Man's Shoes

Today in Foundations class we discussed how to effectively utilize therapeutic relationship and therapeutic use of self.  Experiences and perceptions play a vital role in creating this relationship with clients.  Empathy is also so important to create this relationship.  I have recently been actively trying to improve my empathy skills.  Events in my life such as when my dad was sick gave me a new perspective on so many things especially in the health field.  In class while going over the do's and don't's I was fortunate enough to have experienced some of these things first hand.  It's funny to say I was "fortunate to" because at the time of my father's illness I did not realize these experiences could benefit me one day.  That thought made me realize how important life experiences are in order to create therapeutic relationships with clients.

Using My "OT Think"

    I am so grateful for all the knowledge I've gained while being in OT school thus far.  This weekend I noticed myself starting to observe my environment and begin "OT thinking".  I went to a 10k in Corinth, MS.  I struck up a conversation with a friend who is facilitating a research study involving exercise physiology and individuals with SCI.  It feels so rewarding to be able to discuss such a topic and be able to understand and articulate. I asked him if his participants utilized universal cuffs or tenodesis to perform the activities in the research study.  He had never heard of tenodesis therefore I did my best to explain this phenomena with him.
    My next situation was during the start of the race, the wheelchair runners began first.  I was analyzing all of the wheelchairs trying to point out any adaptive equipment I recognized and if they were tilted back or straight up.  I was so happy that these people were able to be a part of such a fun and meaningful event.
   Lastly, after the race I was sitting on a bench and witnessed a man have a bike wreck due to his chain coming off his bicycle.  As I called 911, my friend ran over to assist him.  The rider was what I believe in shock and lying on the ground.  Luckily he had a helmet on.  While I was talking to the dispatch, all I could think about was all that I have learned about TBIs and what I should be doing to help the man.  Finally, he was helped up and they realized the severity of the accident was not to the extent we assumed.  What a tough guy!  After the rider regained energy, he walked his bike past us and I noticed that he appeared to have Down's Syndrome.  I have not learned a lot about Down's Syndrome, but I am very excited to.  Knowing that he is able to participate in activities that are meaningful to him made me so happy.  What an awful experience for the rider, but the toughness he showed was inspiring!

Cultural Competence

    In class today, we discussed cultural competence.  I am so glad this topic was brought up in our curriculum. It is so important as OTs to have our cultural competence skills fine tuned.  This will benefit us in the workplace, with clients, and even when using interventions with clients. 
    Learning about different professions' culture is important to be able to co-treat and work together.  There are so many professions that we as OTs will work with especially in an acute setting.  When a client knows that you are aware they have different values and you respect them, I feel like they will be much more trusting.  Empathy plays a huge role in this as well. I love the phrase, "walk a mile in another man's shoes", because it gives a good depiction of what it's like to try to understand another person. Lastly, being culturally competent is essential for intervention planning.  An example I thought of was how people eat. Some people eat with their hands, some people eat with chop sticks, and some eat with a fork.  Not all of these individuals would benefit with doing activities with a fork. While this is a minuscule example, it shows how culture can affect our daily lives.  Conclusively, I enjoyed our class on culture and I hope to continue to learn and grow from my classmates so that we can all be more culturally competent. 

Neuro Note: "Attitude is Everything"

"Muhammad Ali's Eldest Daughter Shares Memories of Her Dad and Hope for Those with Parkinson's: 'Attitude is Everything'"

    I was very intrigued when learning about Parkinson's Disease (PD), therefore I chose an article about Muhammad Ali to reflect on for my Neuro Note. The title of this article is: "Muhammad Ali's Eldest Daughter Shares Memories of Her Dad and Hope for Those with Parkinson's: 'Attitude is Everything'". This People article is centered around an interview with Maryum Ali, Muhammad Ali's oldest daughter.  Maryum gave advice for family members of individuals with PD.  She told the interviewer that a very important aspect to living with PD is to do what makes you happy. When I read this, I immediately thought about how this aligned with OT practice. Maryum noted that ensuring the whole family is aware of the details and symptoms of the disease is imperative to live happier lives.  As a future OT, I hope that when I effectively educate caregivers and family members of their loved one's disease or disorder, it will bring happiness to the family just like Muhammad Ali's.

    Muhammad's first symptoms were slowed movement and softer speech. They suspected he acquired PD from a combination of his boxing and exposure to pesticides. I thought this was interesting because of the misconception that solely boxing caused his PD. I would enjoy digging deeper into the research involving the negative effect of pesticides. According to Maryum, the medications for PD caused abnormal side effects. For Muhammad this was the desire to look at books constantly. The family did their best to accommodate his new hobby. I'm interested in learning more about side effects of the medicine for PD and how that can affect the OT intervention.  From having experience with my own father's chronic illness, I know it can often be challenging to face the negative or abnormal side effects of medication knowing you possibly cannot live without it. 

    Maryum's main takeaway of this interview was that when facing PD, "Attitude is everything". Muhammad Ali was constantly motivated and determined to not allow PD take over his life and live his life to the fullest. What better way to live life than by living it to the fullest! 

Maryum and her Dad 

   

Herbst, D. (2016, August 25). Muhammad Ali's Eldest Daughter Maryum Shares Memories. Retrieved May 03, 2017, from http://people.com/celebrity/muhammad-alis-eldest-daughter-maryum-shares-memories/

photo retrieved from: http://people.com/celebrity/muhammad-alis-eldest-daughter-maryum-shares-memories/

Why are speciality areas important?

   While researching specialty areas, I thought of several reasons why they are vital for OT practice.

1. important to distinguish skills to better serve clients

Speciality areas allows OTs to give clients the best and most relevant OT intervention. 

2. helps us relate to each population

Each population has different needs and those needs should be focused on. Learning about what relates to certain populations positively influences the client and therapist relationship.  

3. A way for OT practitioners to incorporate other fields

 Because Professor Lancaster is specialized in assistive technology, she is able to learn and help other fields. For example, she worked with a home builder to help insurance pay for certain home modifications the client needed. Also, Professor Lancaster explained that an OT in Murfreesboro is working on having an OT on the city council. If this happens, it would be extremely beneficial to the city! 

In conclusion, specialities are a way to better serve our clients, relate to different populations, and connect with other fields. I am excited to see what speciality areas I will be drawn to. 

Emerging Area of Practice: Chronic Disease Management

    Because chronic illness is becoming increasingly common, I find this a very relevant and important area of practice.  Being specialized in this emerging practice could also reduce the cost of healthcare that the client is responsible for.  Reducing health care spending is a shared goal among many Americans.  Chronic disease management allows OTs to work with clients to improve their occupation of managing their lifelong disease.  Daily activities and routines play a vital role in managing a chronic illness, and this fits perfectly in our scope of practice.

    This emerging area of practice facilitates solutions for individuals with chronic illnesses to live their life to the fullest.  Vision 2025 is centered around providing occupational therapy to all people and increasing their health and well-being.  Related to chronic disease management, this could mean managing medications, daily routine, changes in diet and physical activity.  Specializing in the management of chronic illness aligns well with this vision, as it is a way to promote health and help individuals manage or prevent conditions.
 

The Sky is Not the Limit

In class yesterday we had the privilege of meeting Fletcher Cleaves. Fletcher obtained a C5 and C6 spinal cord injury around 7 years ago. Since then he has pushed himself to accomplish tremendous goals and has become an inspiration along the way. Fletcher said so many important things I couldn't help but jot them down. Here are a few things that stuck out:

-  Fletcher pointed out that goals are just dreams if a plan is not created. This mindset started when he was playing high school football. He trained twice a day to reach his goal. This carried on after the accident, thus he successfully met his goals. I found this relevant to so many aspects of my life, especially as an OT student.
-  Fletcher gave us some advice as future OTs. He reminded us to be realistic to our clients, yet do not shoot down their dreams. This balance is so important when helping clients reach their goals.
- Fletcher's presence gave the entire class such joy. I find it extremely inspiring that he can capture a room so quickly.
- Lastly, I was amazed at his adaptive truck. I'm sure for a mid-20s man, driving is such a meaningful occupation and realizing he is able to do this is

Haleigh's Case Study: Robert and PD

    Haleigh's case study was about Robert, a client with Parkinson's Disease. The discussion centered around a program called LSVT BIG Program. Her mother is certified to administer this program and recently completed a research study involving Robert. This plan consisted of outpatient therapy four times a week for one month. He was taught the different activities a part of the program and was asked to do them at home as well. There is also a six month follow-up so that the therapists can see his progress. We were able to watch videos of Robert doing sit to stands and sit to supine. These videos were great to supplement our learning and helped us see how the program positively affected him.