My Beautiful Broken Brain-Neuro Note 5

     My Beautiful Broken Brain was a documentary film about 34 year old Lotje Sodderland's personal journey after having a stroke. I chose to watch this film to learn more about strokes, what our clients experience physically and emotionally when they occur, and the inspiring journey of what life will look like for many following their diagnosis. I watched this film and took notes on her behaviors, experiences, emotions, and stay at the neurology center.  This helped me to note important barriers and challenges that Lotje experienced.

     Lotje was a perfectly normal and healthy individual, when one evening she woke up experiencing flickering of lights, terrible pain in her brain, confusion, euphoria, fear, and as she says during the movie she was "lacking her clever".  Lotje was actually experiencing a inter-cerebral brain hemorrhage at this time and she did not know it.  She traveled to a local nearby hotel and crashed in their bathroom, waking up to find herself very confused and scared in a hospital room recalling nothing that happened before her injury.  They announced at the end of the movie that Lotje had a pre-birth malformation of blood vessels in her brain, and this was the unique cause of her incredibly young age of having a stroke.

     Lotje is such a beautiful young lady inside and out!  From the first second I started watching this  movie, the way she was always smiling, laughing, and positive on how she was going to get her "clever" back was incredibly inspiring for me to watch.  Lotje experienced a severe amount of dysphasia, due to damage to the left side of her brain. For her to output language was the hardest part I noticed, which is referred to as Broca's aphasia.  To be honest, I am not sure how she kept such a positive and happy attitude.  When I was watching this film I was getting frustrated for her because she was clever and smart and to not be able to articulate what we are feeling and thinking has to be one of the most un-empowering and helpless feelings we can feel.

     "Within your own self is a treasury, an ocean of pure bliss, consciousness, intelligence, creativity, love.  We are not defined on limitations but endless possibility."-Mr Lynch.  This is Lotje's motto that she follows through her recovery process.  I love that she sees her new situation as one that is what you make it, one that still has a lot of beauty, intelligence, and love.  I hope as a therapist I can take her advice that she gives us as future therapists in the film which is to " Focus on the things the patients find along the way".  For Lotje, her discoveries along the way were that through typing she could form complete sentences and thoughts which was a huge milestone for her.  She felt like she got back some of her normal and that was such a beautiful moment of communication and her finding some normal that she used to have.

     Overall, I think I realize from watching this movie that first, life and health are so so short.  They can be taken for granted quickly.  We tend to move through our days acting as if they are chores and forgetting to laugh, smile, and celebrate that some people would kill just to be able to articulate and write a paper again.  Many people would be enthused to be able to have a husband to argue with, or a rent to struggle to pay.  I think this is an important concept to grasp especially as we prepare for our rotations as future practice as a therapist.  Our problems often aren't even problems in their opinion.  Their problems are basic, yet life altering.  Focusing on our clients with a self less practice will be necessary.  If we don't, I think they will be able to feel that.  They make have had a stroke, but I often think when one strong sense is taken away from you, other senses may be heightened just like Lotje's.   After her stroke she had very strong sense of feelings, and the feelings of those around her.  As always, I finished this film with a sense of gratitude, and a motivated and excited heart to make a difference in my little corner of the world soon.

Reference

Robinson, S. (Producer),  & Robinson, S & Sodderland, L.  (Director).  (March 18th, 2014).  My   

     Beautiful Broken Brain [Motion picture].  London.

SLUMS Sim Lab Reflection

     This was such a rewarding and beneficial experience for us as future ot's!  I love that we are offered these SIM labs before our fieldwork begins.  I was laughing so hard when I watched this video, especially when I first walked in the door and had to pat my hands dry on my pants.  I would give myself a good on this SIM lab simply because I am not sure if I did something wrong since the majority of the class finished the assessment and in less than 10 minutes and I did not!  I do think that I used good eye contact, tried to listen to her briefly before I tried to bring her back on topic, smiled, and tried to use the best therapeutic use of self I could.  I as well had gone through the assessment instructions several times and practiced on friends before walking into the SIM lab, I felt as well prepared as one could be before the experience.

    

     I was proud of my self for not letting Francis completely distract me, for quickly bringing her back on topic, and I noticed that I actually did ask her what she prefers to be called (I didn't remember doing this), and I did smile!  My biggest struggles were trying to be kind & empathetic and still completing the full assessment in ten minutes, answering if she will or will not go to a nursing home (of course I didn't know), and trying to explain what occupational therapy was to her without her getting sidetracked.  When Francis said "no" to me when I said, " I see here that you have been having some issues with your memory", this threw me for a loop.  She was completely unaware of her cognition issues and I had a hard time telling her what the assessment was after she said she didn't have any memory issues and still make her feel special and not like I was trying to psychoanalyze her.  We agreed that it was a sort of game of questions and answers.  I am not sure if that was an appropriate way to approach this, or how to introduce the assessment after someone says they do not have any memory issues.   

     Many improvements could be made!  I even said in the video, there is your wrist bracelet, but never checked it, and said her name.  I need to always check the wrist bracelet.  I am also not sure if I gave false hope by telling her good job, or saying no to specific things or by saying ok as I filled out the assessment.  I am not quite sure what to do in those situations.  I am a very responsive and nice person, and I never want my clients to feel like I don't care or I am being curt or short by saying ok next, next, next, with the assessment and never showing any positive enforcement.  Maybe you can provide me some feedback for this question.  

     My takeaway was that no matter how many times you read the client's profile they will always surprise you with what interaction they provide you when you walk in the room.  From this experience, I may be able to develop a good way to answer what occupational therapy is for the clients that we assess for dementia, a way that leaves the client little questions to ask to decrease distraction and I may be able to develop a plan on how to move through the assessment more quickly and effectively after watching this video.   

Just a phone call away-neuro note 4

     In Max Little’s Ted talk, A Test for Parkinson’s With a Phone Call, Max discusses his background as a mathematician and his vision to provide a cheap and effective objective tool to detect Parkinson’s disease, and a way to then measure Parkinson’s progression. Max states that when we have an objective measure, this is when disease detection and progression can be determined.  I am interested in Parkinson’s disease as a student, and I am excited to hear what Max is doing with a piece of technology that is moving more universal daily. Max is making a strategic play on assistive technology, and this assistive device could benefit all healthcare, including occupational therapy clients. By listening to Max’s talk, recording what he says during his talk on a word document, and then reflecting on his thoughts and how they can positively impact OT have been my active learning experience.

     Max proposes that limbs and vocal chord organs are both effected by Parkinson’s disease.

Vocal chords begin having tremors, rigidity, and weakness at the same rate as the limbs.  A client with Parkinson’s speech becomes more quiet and breathier as the time goes.  Thus, Max and his team

developed a cheap and simple tool that uses precise voice analysis software to detect Parkinson's with

99 percent accuracy.  Max has set up through the www.parkinsonsvoice.org a way for anyone healthy, who is questioning if they have Parkinson’s, or an individual with Parkinson’s, to have a chance to call in and have the test done.

             

     Occupational therapy practitioners could utilize this device to calm the nerves or fear of their

clients that may wonder if they have Parkinson’s.  There is just as much emotional as physical stress that accompanies a neurological condition or expectation of one.  If the therapist’s clients have a family history of Parkinson’s we could provide them with this app/device to keep up with their health and or have a way for early detection/diagnosis.  Another way the voice detector can be used in occupational therapy could be used on clients we are currently working with that have Parkinson’s.  It is a quick and simple way to see their progression as we progress rough our therapy sessions with our client’s.  This would be an economically positive device as well, because although many people that do not have insurance or may lack the money to go to the doctor and have the 300$ neurological test done for Parkinson’s, they do have a phone or could borrow a friend or families phone to do the test for cheap and would be able to detect their Parkinson’s despite their socioeconomic status.   For countries that may have a lower socioeconomic status, the doctors office or clinic could have 1 phone donated.  This same phone could be free to the public for use or could be used as a free diagnosis option for those that come into the clinic with possible symptoms or questions about Parkinson’s disease.  I absolutely love Max’s approach to this, and hope that it effects many in a positive way.

Little, M.  (2012, June).  A test for Parkinson’s with a phone call [Video file].  Retrieved from

https://www.ted.com/talks/max_little_a_test_for_parkinson_s_with_a_phone_call

               

Ronald Reagan's Case Study Review

     I had such a nice and attentive group!  I feel like it went well, they seemed to understand what my interventions were and enjoyed the idea of making a video for a treatment activity (especially since they were both previous actor/actresses)!

     I did mention in my presentation that I should have only directed the goals set towards Reagan.  Although I know that when clients do have dementia they seem helpless at times, I should not put all of the goals or even half of the goals off onto Nancy because Nancy could die at any point of Reagan's diagnosis and he should be able to achieve them by him self.

     Altogether, this was an enjoyable learning process!  Making the goals and interventions proved to be quite challenging, but I know it will get easier and come more naturally along the way.

Session 8A-MS case study Meghan

     Richard Pryor's occupations were comedian, actor, and social critic. His roles were marrying 7 times to 5 different woman and father of 7 children.  He was diagnosed in 1986 ith a MS diagnosis. He lit himself on fire due to depression, yet he is fine.  He had around the clock caregivers and a often sad because most of his friends did not come and visit after his diagnosis.

     I found Meghan's information about memory recollection activities/intervention's very interesting for more than MS!  I would be interested to research what other areas it is used in as well.  Meghan was well prepared and did a wonderful job executing her presentation!  I enjoyed it.

Doctor Remy Hadly-Lauren Murphy's Case Study Review

     Doctor Remy Hadly is a character from the show House.  She was 35 years old when she was diagnosed with Huntington's disease.  Her occupations were mainly all work oriented. Her hobbies were exercising and gardening. Several of her roles were being a physician and a friend. Long term goals for her is to maintain independence at work as long as she can, work on ADL's for eating, documenting, and memory skills.  HD is fatal, and due to secondary causes will eventually result in death anywhere from 15-30 years after diagnosis.

    She had a brief period of drug use in 2009.  She has anxiety which was diagnosed in 2006. Her mother died from Huntington's as well did her brother.  Her brother had a planned suicide death.  She was tested positive, and her symptoms began with shakiness and dropping things.  HD effected her balance. She lives in a one story home by herself and has 2 stairs entering her house.

     Challenges-feeding and drinking coffee without spilling it.  She would like to not spill things and work on her coordination.  Tremors make documentation at work difficult.  Her priority was to continue to be a physician as long as she can.

     Be careful with exercise due to fatigue, although exercise is a wonderful way to deal with HD if not overdone. Some assertive technology devices we may use are: weighted utensils, cups with lids, and a speaking tool for documentation.

     Lauren Murphy did an excellent job planning and explaining the intervention, goals, occupations, roles and HD in general!  She was well prepared and willing to answer any questions we asked her.  I enjoyed her presentation and learning more about Huntington's Disease.

     

TransFatty Lives-Neuro Note 3

     TransFatty Lives is an artistic, well articulated, emotional, and surreal piece of art that Patrick O' Brien humbles himself to give to us.  The name TransFatty comes from Patrick's undying love for donuts and is as well associated with his career as a popular NYC DJ.  Patrick has a passion for filmmaking also, but when his diagnosis took his life for a quicker turn than he was prepared for, he turned the camera and production on himself.  This documentary allows us to follow Patrick's journey from his first symptom mentioned, to his last muscular movement he makes before he makes the choice to live and depend on the Tobi for his main form of communication.  I am incredibly intrigued by ALS, and do not regret the chance to watch Patrick's journey and to note symptoms, emotions, and his change of focus as ALS changed his world.  These recordings will facilitate my empathy and knowledge on ALS and how it quickly will effect our clients.

     Patrick's diagnosis is Amyotrophic Lateral Sclerosis, ALS, and he was 30 when he was diagnosed with  it. During the documentary, it shows Patrick and how very quickly  he loses control of his lower body limbs. They become to weak to even allow him to walk, climb stairs or shower.  One of the moments in this documentary when I realized how difficult it would be to lose those daily functions, such as bathing, is when Patrick's dad was trying to help him lift each leg up into the tub, and Patrick could barely lift one leg up and into the tub without fatiguing.  After that scene, everything happened so quickly to Patrick it was hard to keep up with.

     Patrick met a lady along his ALS journey, whom he fell in love with after he had began using his electronic wheelchair.  She loved him for his personality and his unique view on life.  They dated for a while, and a fun fact is that although many of Patrick's muscles did not work during their time dating, his reproductive one did!  His girlfriend ended up getting pregnant with his baby, and this became the reason of this documentary he says. Patrick says that he wants his child to know who he is before and after ALS.  Patrick and his girlfriend ended up ending their relationship because it was impossible for her to take care of the baby (Sean, now 8 years old) and Patrick.  Patrick chose to go to a home in Massachusetts for individuals with ALS to take the stress off of his family.  Patrick was such a selfless guy, making that decision for his girlfriend and family, yet keeping himself alive solely in hopes to keep in contact with his son while building awareness and funding for ALS.

     Due to this being a real life documentary, many symptoms of ALS were shown.  It began with a skipping or shaking of his leg that would not stop.  Next came constant tripping or falling with Patrick's walking.  This caused balance issues as well.  Not long after Patrick went and visited his doctor, did he begin having more and more issues climbing the stairs and bathing.  Eventually, Patrick lost use of his lower limbs.  He still had decent function in his upper body limbs, and that is how he began documenting and helping produce the movie.  One of my favorite OT moments in this movie, is when Patrick knew that his loss of his hands was almost coming to an end.  He decided to try and have a "funeral for his hands" which upset me, but I can see from an OT point of view how important it was for Patrick to constantly except the change and challenges ALS were appointing him.  I do not think I would ever have the strength, courage, or humor that he exuded as he knew the fate of ALS.  I do not think Patrick wants us to feel bad for him, I think he wants to start a riot and show others what it is in hopes for future funding and a cure.

     In closing, I feel as if this documentary was a beneficial learning experience.  This prompted me to take notes as the documentary progressed, and at the end I had the opportunity to compare his symptoms with the ones I had from class.  They were accurate, but brought a sense of pain to watch them come along. Sometimes it seems so black and white when we learn of the neurological diagnoses in class, but the truth is, it is hard.  People's lives are effected.  Emotions are involved, "hand funeral" moments do happen, and the question we should ask ourselves at the end of this film is, how will I best enhance my client's with ALS's lives and what can I do to increase their quality of life for as long as that may be. 2 years or 10 years.  I would recommend this movie either in class or outside of class!

References

Brien, P (Producer), & Brien, P (Director).  (2015).  TransFatty Lives [Medium].  USA: Handsome

     Cargo.


    

Take it away-foundations

     Foundations was so much fun!  I feel like after this course I understand and am able to clearly define what OT is, what OT's do, which settings they work in, the history of OT, how to do an activity analysis, occupational profile, and how the OT process works.  I as well have a better understanding on what the OTPF does, the domain and process of it, and how each section applies to the application in the field.  Of course I have learned much more from this course, but these are my main OT take-a-ways I can think of currently!:)

     I look forward to learning about more theories in future courses, and having hands on or simulated experience on doing the OT process, especially doing the occupational profile on someone other than myself!  You did a wonderful job prompting us with learning experiences and assignments/tests to facilitate this!  

     I love that you always try and develop our OT think, and credit us when you see us using our OT hearts.  During the first semester of school, with all of our classes and assignments and struggles to have a life balance, it is nice when you receive a compliment or are told you are thinking like an OT.  Some of us may not be straight A students, or may freeze on tests, but you, as well as I, know that this does not make you a "good" OT.  We have learned that much of being a good OT is developing our therapeutic use of self and using the variety of characteristics to best suite our clients.   I look forward to continuing our journey together in this OT world, and appreciate all of the time and concern you show your students.

Until tomorrow...

This quote reminds me a lot of you, and is fitting for OT I feel!

Andy Griffith-Alexa Tooker Case Study

     Guillain Barre Syndrome moves from the legs and move towards the upper body.  Andy had severe debilitating pain and of course suffered through some depression.  OT will help Andy with pain management, helping him with his ADL's, acting,  and managing his guilt from not being able to participate in occupations and  he will be depressed.  He had limited use of feet and legs, they think this GBS was caused from an allergic reaction to the viral infection of the flu.  Andy needs constant supervision, and is fully dependent on his wife for daily ADL's.  He is hopeful to return to full health and to be able to live without assistance and to get back to acting.  Returning to acting, and sustaining his career for 10 or more years was a goal of Andy's!  Their main  goal for Andy is pain management techniques. Their secondary goals were to manage his feelings and figuring out how to cope with his pain, depression, and guilt and to work on leg muscle strength.

     Alexa did a wonderful job explaining GBS and focusing on Andy's initial goals, and thus tying those into his primary and secondary goals of the intervention.  The goals were both fitting and realistic!  You can tell Alexa was well prepared and had previously done her research to best inform us. I enjoyed it!

Autonomy and Confidentiality-foundations blog

     Autonomy and confidentiality are one of the seven principles of the AOTA Code of Ethics.  I find all of the ethics important, but I find this one the most commonly broken.  Although many people probably do not know that they are breaking it, they are.  Talking at the restaurant to your friends that evening about your clients and maybe not using a name but telling them the whole entire dialogue and session is still breaking the autonomy and confidentiality ethic.

     My brother (used to) and mamma still does, work at a pharmacy in my home town as a tech.  They see just about everyone I know in the town, and I have always respected both my brother and mom because never once did they talk about to me the medicine that they handled or who came through the doors of the pharmacy.  They took the ethic of autonomy very seriously!  As comforting as that is, my fiance currently works at a hospital, and shares an office with the PT's and OT's.  He tells me often about how much they say in the office, using the clients names, and situations in front of him, and how bizarre he finds this (he works in Cardiac Rehab).  So with that being said, I want to take all of my ethics seriously, with a strong focus on not breaking the autonomy code of ethics.  If I was in the hospital for any reason whatsoever, I would not want people talking about me to other health care professionals or others in general if it is to just laugh at the situation or gossip.  If there was a benefit to it of course I would accept it, but I would expect it to be handled in a professional and HIPPA respected manner.

Never stop learning-foundations blog

     I find it very interesting and almost challenging when I look towards my future as an occupational therapist.  We currently have our road mapped out for us for 2.5 years, and then it is our turn to grab the map and choose our destination.  Although I know this will be difficult and maybe a struggle at times, I look forward to seeing where my road takes me and what interests will be sparked as I move through my time in OT school and begin my fieldwork.

     I know being a life long learner will be a fun journey!  I love that occupational therapy is a field that never quits evolving, growing, and there are no limitations on where we may venture to next.  I know during class we discussed that being a lifelong learner can stem from our professional development.  We can be intentional and strategic with our professional development, guiding us to our next destination or area of specialty!

     It is important to highlight that without the OT student program, being a lifelong learner in OT would not be possible.  This is a journey, and although it seems to be a short one, it is the next step to becoming the therapists that others are investing in us to become.  I am excited for the future, and will always keep in mind to be intentional with the way I choose my professional development and CEU's to best serve those around me as my client's.

The OT Process-foundations post

     We learned about the OT process and how it is considered dynamic and interactive!  Before the OT process ever gets started, typically there is a screen to see if there is a further need for evaluation.  Then comes the referral, and this will kick off the official first step of the OT process, the evaluation.  During the evaluation the OT profile is developed, and the analysis of the OT performance occurs. This is the initial stage that the client voices what their interest and goals are due to the Occupational Profile.  This is why the Occupational Profile is the most important part of the OT process, it builds trust and rapport and provides the therapist with hearty details.

     Next comes the intervention.  During intervention, there is the intervention planning and the intervention implementation.  There are five intervention approaches: create/promote, establish restore, maintain, modify, or prevent.

     Re-evaluation is next. During this stage the re-analysis of occupational performance and measurement of outcomes is completed.  The review of target outcomes will help guide the therapist in deciding whether they will discharge the client or continue the OT with them and possibly rethink their intervention plan or grade the activities to provide the client with their "just right challenge"!

     Although this isn't the most emotional or heartfelt post, I know it is important to have a blog and documentation for when I begin my rotations and time as a therapist on my own begins.  This will act as a quick guide on how I will use a top down approach and how the OT process generally works!

Use your self-foundations blog post

     I love the therapeutic use of self and all of the fun elements that play a part within it.  Small things that we often do not think about, such as our non verbal communication is huge!  I think my favorite of all the components of the therapeutic use of self is humor!  When I shadowed a therapist for 6 months for an undergraduate internship, that was her go to.  No matter if the situation was getting awkward, intense, or sad, she would always use this technique of humor and it was a game changer.  Not only did it lighten the mood for all of us, but relaxed the client to a state of participation in the activities or goals they had set for the day.  I will strive to involve humor in my future practice, firstly because I am goofy so I would find that as a strength, but even on my bad and non goofy days I want to make my clients laugh and smile.  That's what it is all about at the end of the day for me, their happiness when they walk out of our doors.

Love is culture. Foundations blog post.

     I love OT culture.  The more I learn about my field of occupational therapy, the more I fall in love and look for ways to bloom within it.  OT is rooted in a holistic, mind, body, and spirit sort of feel as a whole.  We love to look at people for who they are and the story they have.

     During our culture lecture, I never really understood how most all OT's posses this empathetic and people first culture, I felt as if a specific sort of individual is drawn to this lifestyle choice.  Although this is somewhat true, I have learned that through professional development hours, the OT school program, practicing as a therapist, or shadowing before hand, field work, journal clubs, SOTA, and the variety of our professors is a big part of developing our already great culture into an extraordinary one.

     I love that we have moved from using the terms cultural sensitivity, tolerance, to saying cultural competence.  I love the "SCRUB" of the way we initially view things.  I know that every OT or future OT has had a bias, racist, prejudice, stereotype, and discriminatory thought of another before.  Although it is not correct, it is the culture WE have been raised in.  It is our generational duty to break that curse not only in our healthcare profession, but as well in our personal lives to make sure we are always using the thought of "We don't know others situations" and loving and respecting all human kind.  I look forward to continue fighting to demonstrate this in my own life and future health care practicing.  I love this quote and thought I would share..



Retrieved from Pinterest.

So how do we know who does what? OT/OTA/OT aide-foundations blog

     The Scope of Practice is the "model" for how the state views our field and it guides them in their laws and legislation's.  It has no legal control, it is just a guide for the states to follow.  When each state is forming their specific laws and legislation's they will consult the Standards of Practice for Occupational Therapy, which will describe the minimal standards of practice for professional responsibility, screening, reevaluation, intervention and outcomes.  States can as well use The Guidelines for Supervision, Roles, and Responsibilities During the Delivery of Occupational Therapy, this will outline the supervision for OT personnel.  It is important to keep in mind that each state uses these as a guide only, and will develop from these the roles and supervision of the OTA's and aides and  are delineated by state regulations.  The state as well regulates how the OT is  legally responsible for the services provided by the OTA and Aide underneath them. So I look at it as an umbrella.  The Scope of Practice is the top of the umbrella, then falls the Standards of Practice, then The Guidelines, and these have no legal ramifications.  From the above umbrella, each state will develop their expectations for the OT, OTA, and OT aide!  These will be legal documents, and can and will be reinforced!

Sarah Berry/Caldwell's Case Study

     Sarah Caldwell did a phenomenal job on informing us on Stephen Hawking's and his diagnosis of ALS.  She explained how he used a cheek muscle switch, with use of a infrared light.  Through this switch he  had access to his computer, wheelchair, and speaking.  Intervention of Stephen Hawking's:  Inform the caregiver's on how to maintain the equipment and teach Stephen how to work it.  He wanted to play games with his grandchildren!  He accomplished this through the cheek switch! His  ADL's are dependent. Long term goals were to keep cheek movement maintained.  She also told us he had no risk factors or school stress growing up.  The movie the Theory of Everything was made several years back highlighting his life!  I really enjoyed Mrs. Sarah's presentation!

Neuro note 2

The Rolling Grizzlies

“Believe in your infinite potential. Your only limitations are those you set upon yourself.”
― Roy T. Bennett, The Light in the Heart

             

I had the privilege recently to attend a Rolling Grizzlies basketball practice.  The Rolling Grizzlies are an extraordinary group of men in the local Memphis area that can play some ball!  They play competitive basketball, and do it all in a wheelchair.  Not all of the players have an injury, some players join the team to play for fun.  The Rolling Grizzlies travel often for games, and are incredibly talented. 

While watching the Rolling Grizzlies, I was in awe of their coordination.  Not only did they dribble the ball with one hand, they would watch the movements of the other players with their eyes, all while rolling their chairs up and down the court.  The amount of endurance necessary for these gentlemen to achieve a two-hour practice is amazing to me.  They also were not shy with falling out of their chairs or smashing their hands to be as competitive as necessary. 

             

              I observed while watching the players move up and down the court what upper extremity movement that they had.  One of the players had both of his legs amputated, and many of the players seemed to be players with a full upper body movement, meaning they more than likely had a T10-L1 SCI or L1-S5 SCI.  One gentleman stood up at the end of practice  and was capable of ambulating with a walking assistive device, his injury either being a T10-L1 SCI or possibly a L1-S5 SCI.  I as well observed several of the players that had atrophy of their lower limbs (visibly), but they made up for what they did not have in lower limb strength with their amazing upper body strength!

           

               I had the opportunity to chat with one of the players after the practice.  He was 29, and said he had been in a wheelchair since middle school.  He then persisted to ask me if I was a physical therapy student and I politely told him no I was occupational therapy (which he said he knew what it was) but said I still looked like a physical therapist.  He then continued to tell me, as a future therapist, to please keep in mind the availability of sports that are available for children and adults that are in a wheelchair.  He said that when his parents found out about wheelchair basketball when he was in middle school, his whole entire world changed.  He told me that it brought so much “normal” back to his life, and for me to always make recommendations and maybe even try and take a client to see them practice sometime to give them some hope.  He was a kind soul, with great advice. 

             

               I left the practice that evening with a grateful and inspired heart.  They found meaning and purpose in their new lives, and I hope to bring that to my clients one day as well. 

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

Rolling Grizzlies website: http://www.nba.com/grizzlies/community/rollin_grizzlies.html

References

Bennett, R.T.  Quotes about limitations.  Retrieved from

http://www.goodreads.com/quotes/tag/limitations

The Rolling Grizzlies.  2017.  Retrieved from

http://www.nba.com/grizzlies/community/rollin_grizzlies.html

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Emerging Area of Practice Foundations

    

      An emerging area of practice I am intrigued by is aging in place and home modifications!  I do want to highlight that although home modifications are wonderful for the geriatric population, I love how Professor Lancaster mentioned in class that home modifications are great for children, adults with special needs, neurological client's, and so many more.  This emerging area of practice is limitless with the populations and clients we may have the opportunity to impact and help.

      "There will be 73 million residents, aged 65 and older, by the year 2030 -US Census Bureau."  Where this information came from is included below, but wow!  This is an extraordinary number of adults aging.  Although I know nursing homes are wonderful, I am passionate for the aging population (and probably influenced by the fact I know my own parents would like to age in place), and am hopeful to look more deeply into this certification and practice upon graduation, maybe beginning with a CAPS certification (thanks for mentioning during class). I am not really Geriatrics focused, or really any practice focused at this point, but this can be used for the benefit of many clients!

      Maximizing health, well being, and quality of life for all populations, communities, through effective solutions to participate in everyday living. This is what Vision 2025 strives to do.  
Aging in place, and home health modifications will help maximize client's health, well being, and quality of life.  Their health mentally and physically can be positively impacted. Their well being, for some, will be enjoying aging in their homes and continuing to perform their daily routines. Their quality of life will be enhanced through many different venues using home modifications, all of which I do not have the answer now but can positively think of how they will be effected.  As mentioned in my opening paragraph, home modifications can touch the lives of many client's, not just geriatrics.  This is a perfect match for Vision 2025, and I look forward to seeing where it goes by 2025!

Vision 2025 retrieved from https://www.aota.org/AboutAOTA/vision-2025.aspx

Quote retrieved from https://www.businessreport.com/realestate/interest-aging-place-home-design-features-rise-baby-boomers-plan-golden-years

session 5A Whitney's Case study!

     Muhammad Ali was a father, a boxer, and a philanthropist.  His wife Lonnie, did an interview on care-giving and gave a neat perspective on care-giving!  Whitney did a really good job at informing us on what his goals were that they "made together" and how they achieved them!  His main goal was to carry a torch, and she said through working specific areas with him they accomplished this goal!

Neuro blog post about Sara Caitlin's case study

     From Sara Caitlin's case study, I learned what the role of an occupational therapist would look like if we have a client with a quadriplegic injury.  Viewing the client's emotional state, setting short and long term goals, and helping Joni enjoy leisure activities (such as painting), were a focus of the occupational therapists for Joni's new found injury.  Joni can now sing, paint with her mouth, has full control with her mouth/shoulder/head to move her wheelchair, is married, has written books, and travels the world giving conferences to other individual's that have experienced a disability.  Joni's motivation and perspective, along with the help of family, caretakers, and some wonderful OT's have helped Joni find purpose and meaning in her life.  

     Sara Caitlin did an excellent job quickly(the time she was given) presenting her material on Joni.  It was evident that she did a lot of research pertaining to Joni's case, even doing extra reading on blog posts and read a book written by Joni to understand her perspective on the case she presented.  I enjoyed her case study, and it was very well presented!

     I feel as if this case study helped me to think deeply on what the focus of occupational therapy would look like if we were to walk into a client's room and they had a new spinal cord injury, especially the shoulder or neck down.  Some things we often do not think about, Sara Caitlin helped us think of/brainstorm on in a different light!

   

Neuro Note 1: The Fundamental's of Caring Movie Review

          The Fundamentals of Caring, is a movie about a young man in his early twenties named Trevor, who has Duchenne Muscular Dystrophy (DMD). Trevor gains a new caretaker named Ben, who takes Trevor on a road trip across country!  Several months ago, my fiancé and I watched this movie on a plane ride to California.  I decided to watch it again because I never caught what Trevor’s condition was and became interested to learn more about how his daily occupations, routines, and social interactions were effected by muscular dystrophy.  The second time I watched the movie I decided to document everything I saw or heard on a word document from the movie about Trevor’s condition. During my documentation, I kept in mind what an occupational therapists job would be, and recorded any observations I made about Trevor’s physical, social, and accessibility struggles he experienced.   

Trevor’s mother mentioned during the movie that statistically Trevor has 7-10 years left to live and was diagnosed at age 3, and Trevor’s age was mentioned to be 21 years of age at the end of the movie.  He had a medication notebook that his mother provided Ben with to keep track of what he needs to take and when (it was a LOT of medicine).  Ben was taught how to put the CPAP machine on Trevor, did daily stretching on Trevor’s hamstrings, IT bands, hip flexors, heel cords, and forearms on the bed.  Ben also helped Trevor with toileting, transporting him in and out of the car and bed, preparing his meals, and with keeping him company.  Ben had lost his son 3 years ago to a tragic accident prior to him being Trevor’s care taker.  Ben, through taking care of Trevor, found himself being more fulfilled and healing through the process of care taking.

 I researched and found that Duchenne Muscular Dystrophy is caused by a gene X-linked recessive disease. There are no current cures for the condition, but there are medications that can be used for DMD to help prolong the condition’s symptoms.  DMD usually effects all voluntary muscle control, eventually.  The condition usually confines the client to a wheelchair by early teens, and is discovered around 3 to 4 years of age (Cleveland Clinic, 2005). 

Trevor’s favorite occupations during the movie were watching TV and recording the world’s most lame roadside attractions on a map.  He had a dry and unique sense of humor and loved to look at beautiful woman, highlighting that Trevor is a normal guy with thoughts, feelings, and goals.  My favorite occupational therapy part of this movie was when Ben asked Trevor, “If you woke up and you were fine, what is the thing you would want to do the most?”  Trevor’s response to Ben was, “Pee standing up”.  Although the caretaker had no idea, in occupational therapy language, this would be considered what is purposeful and meaningful to Trevor.  He wanted to achieve the occupation of peeing standing up.  Thus, Ben convinces Trevor’s mother to let him take Trevor on a cross country road trip.  On this road trip, Ben wanted to complete Trevor’s bucket list, which was to visit the world’s most lame roadside attractions.  This trip targeted another one of Trevor’s occupational goals, traveling.  During their road trip, Trevor experienced his first date and kiss, a slim jim, a few failed attempts to pee standing up, and had a blast interacting socially with the 2 people they picked up along the way!     

Near the end of the movie, Ben finally had an idea on how to help Trevor achieve his main goal, to pee standing up.  Ben borrows a flat board from an ambulance nearby and straps Trevor into it.  He then stands the board up in front of the world’s largest pit (the main place Trevor wanted to visit) and Trevor was stabilized without Ben touching him, allowing him to pee standing up.  That moment made me cry, because something so small that we take for granted everyday was Trevor’s main desire in life.  They screamed and rejoiced during Trevor peeing standing up!

This movie helped me gain knowledge on what an individual with muscular dystrophy would experience or lack experiencing, and what some of the main physical actions/movements that client’s with DMD do not have.  I gained an insightful perspective on how much effort goes into traveling when a client has muscular dystrophy.  A client’s medication, sleep machines, and a medical transport vehicle have to be accessible.  The places they stop to go to the bathroom, sleep, and eat have to be handicap accessible.  I enjoyed watching Trevor and Ben’s relationship as the movie progressed, and so much of what Ben did for Trevor is what an occupational therapist would do for their client.  Ben established rapport with Trevor, asked him what his main occupational goal was, provided him with goal oriented activities along the way, used the road trip as a sort of intervention, and through all of their experiences or (sessions), they achieved Trevor’s final goal to pee standing up.  Once the goal (outcome) was met, the movie states that Ben resigned from his position (discharged the client), yet remained friends with Trevor.  Ben helped Trevor achieve his occupations and goals, and through this process, Ben’s heart was healed from the loss of his son and divorce from his wife. 

     

           I would highly recommend anybody over the age of 18, occupational therapists or students to watch this movie.  It is encouraging, informative, raw, and unique.  Disclaimer: There is a large amount of suggestive language used during the film.  I accessed the movie off of Netflix as a Netflix original movie for free (I am a current monthly member).  Following the movie, I looked up Duchenne Muscular Dystrophy to learn more about the condition.  Hopefully this movie will encourage others to do the same!  Below is the citation for the movie and a photo of what the movie looks like.  Also, the site of where I found my further information of DMD is below in my citations.  Please take the time to watch Trevor and Ben’s journey in The Fundamental’s of Caring!

Retrieved from 

          https://images.search.yahoo.com/search/images;_ylt=AwrSbneO8_xYs48AAWJXNyoA;_ylu=X3oDMTB

yNWU4cGh1BGNvbG8DZ3ExBHBvcwMxBHZ0aWQDBHNlYwNzYw--?

p=The%20Fundamentals%20of%20Caring&fr=tightropetb#id=3&iurl=http%3A%2F%2Ftopdezfilmes.o

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References

Burnett, R. (Producer), & Burnett, R. (Director). (2016).  The fundamentals

of caring [Motion Picture].  United States: Levantine Films.

Cleveland Clinic. (2005).  Duchenne muscular dystrophy.  Retrieved from  

http://www.clevelandclinic.org/health/health-

info/docs/2100/2108.asp?src=news&ref=2100/2108.asp

Session 9B

     I really enjoyed this lecture over documentation!  I have yet to work in a clinical setting, so the only experience I have with documenting is watching the therapists I shadowed document, and my internship supervisor spent many of her lunch breaks documenting.  If I could make a suggestion, I would love to see a documentation workshop before we start our level 2 fieldwork.  I am not sure if I am the only one that would be interested, but I think more than I would enjoy this!

     I like how you clarified that when an OT documents, that is our time to shine and really show that occupational therapy services are different than other services, and effective!  I am excited to learn more about interventions and how to document those to show the effectiveness of occupational therapy.  I am passionate for all clients in all settings to receive therapy services, and I agree through effectively documenting we will hopefully continue to show the difference between physical therapy and occupational therapy, and thus begin being referred appropriately by doctors!

       I am interested at collaborating with the medical students at UTHSC with orientations, volunteer service, and other opportunities! Ultimately, I think that knowledge of what occupational therapy is should start in our universities.  If we can start showing doctors in training what OT is, the benefits from it, and that we ARE different from PT, we could begin to build those relationships.  This will help, because when those medical students graduate they will always remember and have knowledge of the OT's, and be more willing to refer their patients to us, ultimately growing the field of OT!  I hope to use my position as Public Relations to get this started.



   

The Mighty blog post session 9A

      "I do not know what it’s like to be able to interact naturally and un-self-consciously, but others do not know what it’s like to experience music the way I do, to hear the sounds of instruments dividing and subdividing into unique universes of soundlets, all separate yet simultaneously coalescing together into a larger whole, and then seeing those sounds turn to images in one’s mind."- Max Chis 

     I pulled this quote from the blog post, What Does 'Disability' Really Mean?  Written by Max Chis, from the site The Mighty.  I LOVE this blog/story Chris wrote.  I admire how he is raw, but purposeful with his words.  He is vulnerable, but for the benefit for others to grow and gain insight of the word 'disabled'. Chris might be a person which happens to have a disability, but look at all of the beauty Chris experiences.  The above quote is one of the many I found to be inspiring, and would love to hear and see what Chris sees one day.  

     Are any of us really 'normal'?  I know that some days I just want to lay in the bed all day watching Netflix and eating donuts without seeing a soul.  Some days I feel as if I can conquer the world.  I find it incredibly important for developing occupational therapy students and therapists to find a way to connect with those that do happen to have a disability.  How?  It is quite simple ---> I think none of us are normal, we just do not have it displayed outwardly.  If all of our worries, insecurities, stress, secrets, fears, and down right ugly actions/thoughts we can have were outwardly displayed, I surely think that we would see that we are all the same; but oh so unique.  That is the beauty of Chris's message to all that care to read his words.  They breath, crave milkshakes, love someone to tell them how nice their hair looks, and might just want to drink a beer with their buddies just like the rest of us messed up 'normal' folks.  Just because a person has a disability does not classify them as aliens or even different.  I do hope to teach others and remind myself beyond the clinic that we are all strange, and that we really can all connect on some level. We all have our mess.  If our ears for one day could experience what Chris's do, we might be able to understand and hit the brink of joy he has.  The world is a different place when your not what society says you should be.  This is why Chris inspires me as a person and a future therapist.  I will never hear the same music Chris does, but I can surely provide Chris with the stage to lead the rest of us in singing the same song he hears with us. 

Foundations Session 8B Blog Post

     What a neat take on occupational therapy!  Health literacy is something I have never even considered.  This is why I love our classes. All of them!  As a future therapist I might think of something such as helping the client find different ways of transporting to the doctor to get a prescription prescribed. However I love how occupational therapy goes even deeper than that.  Our job might start there, but directly after that it is our duty to make sure they understand why they are taking it, what they are taking, how many they are taking, and what time of the day to take it.  T

     The question then crossed my mind in class as we watched the videos on health literacy, "Do people graduate elementary, middle and high school without being taught to read?"  Then it hit me.  Not only are there individuals that might be my age that can not read for many different reasons, but we also will meet other client's that may not have been born here, having a language barrier or maybe a focus on education and reading in their country still is not as important as our culture.  Some of our clients may have been from my grandparent's generation.  It is not uncommon in their day and age to never graduate school or develop their reading skills fully.  Many might also ask how is this possible?  Times were different 50 years ago.  Farm hands had children often to help them work the field, including during school hours.  Just because school was in session did not mean that the garden would still not be growing!  Grocery store's were smaller and often family run.  Having such a strong focus on academia or even basic education was not terribly important when my grandparent's were in grade school, resulting in an aging population that does not have the ability to read medicine, food labels, etc.

     So as always I left class today thinking, "Man Lauren, you must start thinking big, creative, and generationally as a I move forward as a therapist to provide the highest quality of care I can possibly do".

Foundations session 8A Blog Post

     I enjoyed the article from this lecture's material, Health Education Programming for Older Adults Based on Social Cognitive Theory.  I enjoyed this article because firstly, I love all gerontology knowledge I can get my hands on. Secondly,  I like how it explained the social cognitive model in action/application for a specific population and focused strongly on the "hows" of behavior change.

     This theory is a perfect match for supporting the idea that we as therapists should encourage our client's to accept adversity and to grow with their adversity all the while celebrating how it has strengthened them.  If a model is always looking at the "why's" instead of the "how's"..then where is the encouragement for clients to be motivated once they hit a wall?  By the social cognitive model having a heavy emphasis on self efficacy, the client's confidence in achieving daily activities by themselves will be noticeably boosted, even if a wall is hit.  When we empower client's and positively guide them through their adversities, we ultimately give them the gift of confidence and do not enable them to quit, give up, or view themselves as less, because they are not. 

     Client's often probably wonder if we pity them or feel badly for them and their current state.  The real truth is, WE should feel badly for ourselves, because we will never have the same view, appreciation, or love for life the way those that have experienced life changing adversity ever will.  Let's keep promoting self efficacy of all of our client's, I think this article is on to something!

OT 537 session 1B Response

     I want to begin with highlighting the strength Professor Lancaster displayed during not only discussing in class the blog about her father's journey and celebration of life, but also for sharing with us her raw emotions and experiences during this time.  It was an eye opening experience for myself, and I am sure my peers. 

      My father is much like yours, strong & kind & determined, so immediately when reading this blog post I made your story incredibly personal.  Not only did this story increase the gratuity in my own life, but sadly gave me to many examples of poor health care.  It helped me understand why you are so passionate for us to always put the client first, including their family.  I do believe the things you read, experiences you have, and emotions you feel can and will guide our practice as therapists in the future.  I tried to refrain from judging the health care workers while reading the post, but could not seem to refrain as I said above, this story was made very personal quickly for me.  I know I will let clients and their families down, all health care workers have, however I do promise to strive to apply my knowledge from your personal experience moving forward when providing care to all clients.  I have so much sadness in my heart when I think of how stressful the situation already was, and then the health care provided increased the stress of you and your families day. I am not sure how I would have handled those 10 weeks, or honestly how you did. My daddy is my whole world. 

     My fiance is currently applying to nursing school at UTHSC and is a kind and gentle man.  I have emailed him your blog post, and told him to read it and pay attention to the lack of empathy provided by the nurses, including the lack of emotional support they were able to offer.  I am excited for him to see an inside perspective on what and why nursing is so important to all individuals.  So thank you for inspiring him, my self and so many more with your selflessness of sharing this story. 

OT 537 Daily Challenge 1

     Aimee Mullin's Ted Talk was a unique lens to view the word disabled.  When we are "diagnosed" with a new cold, cancer, or illness we often want to research the information supporting the diagnosis. We want to know what it is, means, and how it will effect us. People that do have a disability have looked into their diagnosis as well.  They have already been disheartened by what the web defines them as due to their diagnosis and listed their limitations with a lack of encouragement to follow.  We do not often think of how hurtful, un-empowering, or what the word disabled can mean until possibly we are the individual with a disability.
     This video is important for teaching us as future therapists that we may never 100 percent understand how they feel, but we can use our words wisely to uplift, support, and strengthen our clients instead of spurting out words causing a disheartened client.  If our words are used with empathy, we (just like Aimee's childhood doctor) can offer a strength and support for our clients to accept and grow with adversity instead of telling them to always go around it or overcome it without acknowledging how obstacles have helped them grow.  By helping the client celebrate and acknowledge their obstacles, we as therapists will be providing our clients with not only current support but a life long attitude of I can do anything.

Flow until you grow

Today I teared up a bit when I read of the authors experience with her mother.  All I could think of is my sweet momma or daddy and how I always have said I want to treat every client just like they are my own parent.  At first I was angry/disappointed with the therapist's decision to focus on home improvements or sponge bathing.  However then I realized, the therapist failed because of either a lack of knowledge that our profession is client centered, or that they forgot to look at this sweet momma as a person holistically and instead used a reductionist approach.

Once her daughter (also an occupational therapist) spoke with her mother (Ann) about which occupations she was wanting to work on, the intervention went from being frustrating and disappointing to empowering and confidence boosting.  The therapist used an acquisitional frame of reference.  This frame of reference uses encouragement of the client from the therapist, shows no judgement and full acceptance,  uses the belief that if the client believes they can then they will improve, FoR utilizes a skill is a skill and eventually through "practice makes perfect" the client will achieve their skills again.  This was a neat FoR because I feel like it uses client centered therapy, and ultimately I feel as if it's rooted in encouragement.  I hope that I am never someone's occupational therapist that treats them like just another "case" but instead take the time to ask them what is important to them and how I can put a big smile back on there face.  I have always loved making others smile, and I have known every day since I have started school here that I found the way I can give someone a smile straight from their soul every day of my life, until I need an ot as well.

My favorite model that we have covered in the last few days is the KAWA model.  I enjoy that it looks at a person's spirituality and balance.  Above, Ann's spirit was broken and her balance that she used to be able to do everything was as well effected.  Ann's water in her river had been disturbed, her house was a bit of a wall and floor.  Her daughters helped knock down those walls and doors by moving her stuff from upstairs to downstairs.  Anne was experiencing many rocks, including having a hard time toileting, dressing her self, and even bathing.  Ann's driftwood was being an independent woman.  She seemed from the article a positive, kind, and willing client which helped her to pick up her driftwood and move it out of the way.   Once Ann's daughter came in and helped change Ann's outlook, the therapist was capable of tapping into the spaces of the obstructions.  Ann's occupational performance was effective because they focused on her as a the river (whole person) which resulted in a calm flow of water once the therapy ended.  Such a fun model, speaks right to my soul!

How does the OTPF influence OT practice?

The OTPF looks firstly at the OT process and then classifies the occupations. The OTPF helps guide the practitioner to classify their client’s occupations into a specific "domain". These domains will assist the therapist to include appropriate and meaningful activities related to their client's occupational interest. 

OT 425 Era Presentations

The era presentations were not only informative but incredibly creative and presented in a
 fun and lighthearted manner.  All groups, in my opinion, included: Major historical events,
legislation,occupations, and populations when presenting their findings.  By taking detailed notes,the era presentations guided the students in constructing our timeline projects.  This was a fun way to learn the history of occupational therapy.  Great job on your presentations everybody, your hard work showed!