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

Retrieved from

https://images.search.yahoo.com/search/images;_ylt=A0LEV2D0vwtZ.pgAwbVXNyoA;_yl

u=X3oDMTE0YTA3NTE3BGNvbG8DYmYxBHBvcwMxBHZ0aWQDQjM4MzJfMQRzZWMDcG

l2cw--?p=memphis+rollin+grizzlies&fr2=piv-

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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!