Left Neglected by Lisa Genova (Neuro Note #4)

Left Neglected by Lisa Genova is the story of a busy, successful, and over-worked mom to three kids. She is trying to "do it all" when she is involved in a terrible car crash on her way to work. This resulted in a traumatic brain injury that made Sarah, the main character, lose all awareness of the left side of her body. Although I am only halfway through this gripping story, it has already increased my learning about traumatic brain injury and the effects that it has on the client. Specifically, this book (although fictional) has increased my empathy for survivors of traumatic brain injury by showing a first hand account of what it's like to find yourself after such a traumatic accident. I also believe it has helped increase my empathy. It is particularly interesting to read about the family relationships and the ways that they can change after such a tragic event. I chose this book as my neuro note because I had been wanting to read a book on a topic I will face one day as an occupational therapist. I think it is important to read people's stories to get a better understanding of the clients' needs. I would definitely recommend this book to other occupational therapy students, and I look forward to reading other books by Lisa Genova in the future.

(Lady recommends it too!)

Genova, L. (2011). Left neglected. New York, NY: Gallery Books.

Dementia- Pat Summit

Pat Summit was the women's basketball head coach for the University of Tennessee for 38 years. She began coaching at the age of 22 and eventually even coached the women's olympic basketball team. Pat Summit was diagnosed with early-onset dementia at the age of 59. She also had rheumatoid arthritis. She began to get confused and people close to her began to notice a shift in her personality. She would frequently lose her car keys, call out the wrong plays during a basketball game, or leave her car running outside. Eventually, Pat Summit went to the Mayo Clinic to get some answers. When she was diagnosed with dementia, she was forced to retire and move to the Sherrill Hill Senior Living Facility. Katherine shared with our group that usually occupational therapy would not be utilized for late stage dementia. OTs could be used to help with home modifications and caregiver education, but not much more can be done to help the client. Pat Summit created the Pat Summit Foundation in order to raise funds for Alzheimer's research.

Bradley Walker- MD

Bradley Walker is a 39 year old male that was born with congenital myopathy, a form of muscular dystrophy. He is a country music singer that performs at different venues, and even performed at Joey Feek's funeral. He needs occupational therapy services to drive a modified van and work on independent living. He lives by himself, works full time as a material inventory coordinator, and is able to drive himself around with a modified van. Muscular Dystrophy has caused muscle weakness in his legs and hands. His type of muscular dystrophy has plateaued, so he does not have any shorter life span than normal people. Bradley received OT services when before starting kindergarten and was able to attend a mainstream school.

www.bradleywalker.com

Heather Alimossy- Huntington's Disease

Heather Alimossy is from the documentary "Alive and Well". She made the decision to get herself tested because both her mom and brother have the disease. Heather's main occupations include taking care of her mom and riding dirt bikes. She is seeking occupational therapy for some cognitive delays and help staying organized and working with her memory. Although she is not experiencing any current symptoms of Huntington's, she knows what she will need to work on for the future. Eventually, she will work on postural stability and balance. It is important for OT to focus on organizational skills. Alive and Well is a documentary about Huntington's Disease and chronicles Huntington's in different phases of the disease.
I thought this case study was very interesting and informative! It was unique to hear about a young woman who decided to be tested for the gene linked to Huntington's Disease before the symptoms set in.

Transfatty Lives- Neuro Note #3

This movie documents Patrick O'Brien's onset of ALS from diagnosis to not being able to speak, breathe, or eat on his own. He was a young, wild, artistic filmmaker when his legs began to shake. He was quickly becoming an internet celebrity and DJ named "Transfatty". Shortly after, he was diagnosed with ALS. In much of the movie he is using a speech synthesizer to speak because his ability to talk was gone. During the documentary, Patrick has a son born. He spends much of the movie speaking to him so that his son can know what he was like. It was so interesting to see how ALS not only affects the person that is diagnosed, but also the whole community of family and friends surrounding that person. Patrick films the disease from start to finish, so you see him gradually lose control of his legs, then arms, then swallowing mechanisms, and eventually the ability to breathe. One funny picture Patrick had taken was of a friend pouring a beer into his G-Tube. Patrick was able to finish telling his story through the use of eye movements.
I chose this documentary as a neuro note because I love documentaries, and I have never spent much time around a person diagnosed with ALS. I figured it would be good experience for me to see the effect ALS has on the body. I learned a lot about how to better treat a person who has been diagnosed with ALS. Even in the more severe stages of his disease, Patrick was able to ask complex questions about life and death. He was just as smart as ever. I would definitely recommend that others watch this movie! It is very "up close and personal" with ALS. It was a fascinating film, and I have enjoyed reading more about Patrick's story after watching the documentary.

O'Brien, P. (2015) Transfatty Lives. [Streaming video]. Retrieved from: https://netflix.com

Main Take-aways from Foundations

Never has a class or experience made me so excited about pursuing the career of occupational therapy! Every single class session I was excited and thinking about the many ways I can apply concepts learned in lecture to my future practice one day. It was so helpful to even break down something as basic as what an occupation can be. Through observation and learning about the profession of OT I had always heard occupation and ADL thrown around but it was so helpful to understand and categorize what these terms could really mean in therapy. I also loved doing the activity analysis, mainly because it gave me so many fun ideas I hope to implement into therapy one day! It was very helpful to learn the models of practice and frames of reference because it gave me a better understanding of the diversity of thought in the field of OT. Doing the era presentation and timeline project gave me a deeper respect for the field of OT when I learned about all the different populations occupational therapy has touched in the last 100 years. I too, am a podcast junkie and the podcasts posted in this class helped me get out of the bubble of "popular" podcasts I had been listening to and explore podcasts that told stories of people I could one day be serving. I also loved the use of Youtube videos in this class! I never realized how valuable of a resource Youtube can be when learning about various symptoms and listening to peoples' stories. the lecture on AT was also so unique and really taught me about a whole world of tech that I was pretty clueless on. I thoroughly enjoyed this class, and I know I'll save so much of what I learned when I am a practicing occupational therapy practitioner.

Andy Griffith & GBS

Andy Griffith was diagnosed with Guillan-Barre Syndrome (GBS) at the age of 57. GBS is when the immune system attacks the body's peripheral nerves. It usually starts with the legs and can spread to the arms and face. Andy Griffith's main occupation was acting at his age of diagnosis. His main problem impeding his occupations was pain due to Guillan-Barre Syndrome. He also experienced some depression as a result of his diagnosis. An occupational therapist could help him with pain management, joint mobility, and various activities of daily living. The OT could also help treat his secondary symptoms such as depression and anxiety.
GBS is thought to be caused by an allergic reaction to a viral infection. Andy Griffith's case is thought to have been contracted after he had a bad case of the flu. Prior to his diagnosis, he was very healthy, independent, and active. After his diagnosis, he was very dependent for all of his activities of daily living. Some of his goals are to return to acting, manage his pain, learn how to cope with his pain, and maintain his career for atleast 10 more years.
Alexa offered some great information about Andy Griffith's life and his diagnosis of Guillan-Barre Syndrome!

Reflections on Reflecting

I have never been a huge blogger or writer. Somewhere out in the "inter-webs" there are several blogs I started with high hopes that only got one measly post, or maybe just a cute theme. I have started many empty journals with aspirations to write my thoughts and feelings nightly, only to not make it past the first page. When I learned that my foundations class would require me to start a blog, I was genuinely excited! Finally, I will be held accountable for maintaining a blog and writing regular posts! I was so excited to begin the journaling process during this crazy phase of graduate school. Then I realized that I would need actual content for this blog. I was very nervous about putting my experiences as an occupational therapy student on the web. What if I seem incompetent? What if I write something that's wrong which means I'll be a bad OT one day? Once I realized that this was delusional thinking, I fell into the comfortable rhythm of writing as I became inspired in class and by my OT experiences. Through the past few months of OT school, I have learned that OT is as diverse as the interventions that OTs use. Although there are concrete truths that OTs should uphold such as being client centered, occupation centered, evidence based, and culturally relevant, there is no one right way to be an occupational therapist. This concept freed me in my writing and I really began to enjoy it. I hope that when I become a practitioner, I will record inspiring stories and interventions that really worked for me so that younger practitioners can learn from my experience. This assignment has been a valuable experience to my learning.

Life as an OT Student

This past week was stressful. There were lots of tests, lots of assignments, lots of high expectations, and lots of obligations outside of school. OT school can be hard, but it is not impossible. In reality, the classes I am in now are not as challenging as gross anatomy, but with the promise of summer peeking around the corner my brain, body, and spirit just feels tired. My motivation needs to be filled back up again. However, when I read a story about an occupational therapist touching the lives of others or hear my peers outside of OT school tell me the important work I have set out to do, I am inspired again. School is so necessary to my becoming a competent OT practitioner, but it is not forever. I have so much learning left to do and I will continue to learn and grow in my practice for the rest of my life. When the days are long and hours of sleep are short it is helpful to envision the future where I am finally helping give back life to the clients I will have the privilege to serve. I can't wait until the day I get to put OT/R behind my name! It will be here before I know it!!

Conceptual Diagram of the Field of OT

When approaching this assignment, I had no idea how to best complete it in order to create creative, shareable content. I was supposed to answer three big questions: What is occupational therapy? What do occupational therapists do? How do occupational therapists think? I could talk for hours about any one of these topics! However, when I think about popular content frequently shared to Facebook timelines or linked to on Twitter, I figured that my conceptual diagram needed to be fun, short, and "catchy". My goals was to add humor to the assignment, much like we learned to insert humor into a therapeutic relationship. I tried to approach this assignment like an OT would approach a problem in order to explain my answer to these questions in a clear and effective way. I was so upset with myself, because at one point in the video I said patient instead of client! I had worked so long and hard on it I decided that it would be too much work to record my voiceover all over again. Overall, this assignment taught be a lot about "OT think" and how to approach a problem as a future occupational therapist.

Therapeutic Relationships

The therapeutic relationship is essential to the rehabilitation process for the client. Therapeutic relationships differ from friendships in that the overall goal is to benefit the client, not both parties. In order to develop trust in the therapist's therapeutic relationship with their client, they should follow through with plans, be on time to appointments,  be honest with clients, not overpromise, be cautious when disclosing personal information, discuss client's intervention plans in private, involve the client in the decision making process, and remember to put the client first. Empathy is one of the most important traits the therapist needs to understand the client's feelings. Active listening also makes the client feel valued and listened to.
Through observation hours and personal experience, I have been able to witness many different therapeutic relationships. Some have been life-changing for the client, and some have left the clients feeling like second-rate people who were not valued. When the therapists develops trust with their client and is empathetic and a good listener, the client is much more motivated to get better and return to the occupations that give their life meaning. In therapist/client relationships where the therapist rushes through sessions, just puts the client on an arm bike, and doesn't listen to the needs of the client, the client will end up feeling that occupational therapy is pointless and that their therapist does not care about them or whether or not they get better. Learning about the right type of therapeutic relationship has informed the way that I will interact with my clients as a future occupational therapist.

My Presentation on Stephen Hawking

It was so fun and educational to present my case study on Stephen Hawking. My group found the information about information about his cheek muscle sensor particularly interesting. They asked lots of good questions and facilitated good discussion. A lot of the information I learned about Stephen Hawking was very technical or medical and the questions that my classmates asked made me realize how much I need to learn about assisted technology in relation to ALS. Some goals I made for my client were to be able to play 3 games with his grandchildren, teach caregivers how to maintain and use the adapted equipment, and help treat some of his depression after diagnosis. I recognized the need for other professions to step in and take over some areas outside of occupational therapy's scope of practice. Overall, I learned a lot about Stephen Hawking and enjoyed teaching others about the advancement of assisted technology in relation to ALS.

Documentation & Professional Development in OT

Keeping proper documentation of certificates, licensures, immunizations, and professional development hours is an essential part of becoming a competent and professional practitioner. I have always struggled with organization, but thought I had come a long way throughout undergraduate school. I quickly realized when I started the process of applying to OT school just how important it is to keep all important documents on file and easily accessible. One stressful night I realized that I was missing the document proving that I had received my second hepatitis B shot. I looked every where both in my room, in my back pack, in my mom's file cabinet, and all throughout my computer just in case I had scanned it. If I did not find this documentation, it was possible that my school account would be put on hold. I called the Walgreens I had received the shot at and they said they could give me proof that I had received that shot, but I would have to come in. Unfortunately, that Walgreens was located in Clinton, MS, about three and a half hours away. I drove to my local Walgreens around 1:00 in the morning. Thankfully, they were able to print my history at the Walgreens pharmacy from the last month. Although it wasn't the best proof that I had received the shot, it was still documentation. Needless to say, I learned an important lesson that night about keeping up with the materials I will need when I head out on fieldworks and start my career. When I began starting to assemble my professional development portfolio, it was very eye opening to think about all the documentation I will need to have access to throughout my future career as an OT. I am so glad that I was educated on the different types of professional development hours and how to keep track of them in case of a future audit by the state or national licensure board.

Neuro Note #2 The Friend Next Door

I moved into my new apartment with my husband immediately following our wedding. It's an old apartment complex in midtown that many of my parents' friends say their parents started out their married lives in way back when. I had seen the man next door a few times, and thought he was a bit unique, possibly just socially awkward. My (future) OT brain started churning and I began to wonder what made the man next door so special? One day as I was flying out the door to head to class, the man next door was leaving also. He was friendly, as usual. I could tell that he was willing to stop and talk for much more time than I could allow him. He had a goofy "happy birthday" hat on and was carrying a bright rainbow umbrella, and he started walking to his bus stop, where I frequently saw him walking back and forth from. My biases and preconceived ideas of him made me wary. Who rides the bus? Was it really his birthday or did he just like to wear goofy hats? And oh how I hoped it was the latter, because I felt a tight knot of guilt all day in my belly for not wishing him happy birthday when it possibly could have been.
The next week, I was taking our puppy out for a walk. His door opened at the same time. He stopped and greeted me in his usual friendly way. I introduced him to our puppy and we stood in the door way and I began to actually get to know the man next door. He saw that my t-shirt said occupational therapy and lit up! He showed me a new orthotic he had very recently received that went from his ankle to his knee and was really helping his ability to walk. I asked if he had been injured somehow, and he began to tell me his story. I found out that a few days after his graduation from my rival high school, he had been involved in a horrible car wreck at an intersection I use almost every week. Some kids were racing home, ran a red light, and the man next door's car went air borne. He described how his car grazed the traffic light as it shot into the sky. Thankfully, a nurse who rode on the helicopter for the upmost trauma center in the area was driving in the car behind him. She called her supervisors, requesting the helicopter to come to the scene of the crash immediately. Later, they told her that she could have been fired for doing that, but that it saved the man's life.
As it turns out, the man next door was a traumatic brain injury survivor. He told me that he bruised his basal ganglia, which can cause other parts of the brain to not function to their full potential. He told me that his memory is not so great, sometimes he can have trouble moving, and he can have a hard time finding the right words. He received extensive PT and OT during his long hospital stay. I waited patiently in the long pauses between his sentences, realizing how wrong I had been about the man next door and realizing my own biases.
The man next door is currently in a master's program at a school within walking distance from our apartment complex. He excitedly told me that he graduates in 9 days and was talking about all the many ways he wants to help people. He is currently volunteering at the trauma hospital that helped him regain his independence over a decade ago. He told me that his parents (who live in the same town I grew up in) pick him up every Friday so he can do laundry ("because it is MUCH cheaper there than at our apartment complex") and bring him back every Saturday so that he can be sure to make it to the church he has been working at on Sunday morning.
The man next door invited me to a small group Bible study, to his church, and asked how he could pray for me. He volunteered to take care of my puppy if me and my husband are ever too busy or are going to be gone for too long. We talked for over an hour! He is a guest speaker every year to a class at the local university that talks about similar brain injuries to his. He said that he would love to come speak to our class someday, if the opportunity allowed! Oh how wrong I was about this independent, friendly, strong, benevolent man next door! I'm so glad that I found a new friend next door.
This experience is hard for me to write about, because I do realize how unfairly I judged him. I think this moment happened at a crucial point in my occupational therapy journey. Before I head out on fieldworks and work with real people who are very different from me, the friend next door was able to teach me an important lesson about how I think of and treat other people.
I was wary to write about this experience, since I can't cite it or simply link to it. But I can recommend that my classmates come over and meet my new friend. I would also recommend our class having him come as a guest speaker! This experience taught me so much about people who have sustained a traumatic brain injury, and just how independent they can be! I will look back on this story for years as I continue on my OT journey.

Emerging Areas of Practice

Emerging areas of practice are important because occupational therapists are able to specialize in one specific area to fit the needs of a smaller population. They may not be able to help a wide variety of people, but for those specific folks they can help expertly, it makes all the difference in the world. One emerging area of practice that I find fascinating is new technology in rehabilitation. Technology is not always used to its full potential, but when used correctly it can open up a whole world for the client. Ninetendo Wiis are a fun tool that can be used with the geriatric population. Technology can provide a voice for those who can not speak for themselves. Ipads and apps can lead to significant changes in cognition when used correctly. I am looking forward to learning about the many ways that technology can be used to transform someone's life in a rehabilitation setting. I also find home modification and environmental changes an interesting emerging area of practice. I love the idea of being able to make the place where someone lives as accessible and client friendly as possible. I would love to get my "CAPS" certification one day in order to be able to help people stay in their home as long as possible.
These emerging areas of practice can be related back to Vision 2025 when you take into consideration the guideposts. Emerging areas are "accessible" because they help to reach specific populations that may or may not have been previously served. Areas can be collaborative because many times, emerging areas require interdisciplinary work with engineers, doctors, psychologists, home builders, and a wide variety of other professionals that would help specific populations. Emerging areas are effective because instead of being a generalist OT, experts in these emerging areas can devote their time and energy to this one specific niche to make treatment in that area as helpful and cost effective as possible. Emerging areas promotes leadership in the field of OT, because practitioners can emerge as experts among these specific groups that can be called upon for advice by generalists.

Bob Roberts

Bob Roberts was diagnosed with Parkinson's Disease in 2003 and passed away in 2014. He loved to fish, gamble, read the paper, smoke, eat, travel, and play games on the computer. Parkinson's began to slowly take these enjoyable past times away from him. Bob would frequently fall because he was shuffling his feet instead of picking them up. He did not get occupational therapy early enough in his diagnosis, but occupational therapy did help his balance.  His granddaughter, Sarah, told us that one time his occupational therapist told him they were not going to do therapy that day. Instead, they played cards. Obviously, playing cards was used as an occupational therapy intervention, even though to Bob, it just seemed like a fun game! I feel as though I have a much better understanding on Parkinson's Disease because of Bob's story!