Lauren LaBorde OT425 + OT 537

When looking through what I could write my last neuro note on, I wanted to pick something different that I haven't explored yet. As I was scrolling, an article caught my eye titled "Fu**tionality." I had to do a double take and immediately got sucked into the article. This article is very beneficial for every OT/future OT to read. It sheds light on a subject not addressed enough in the rehab world.. sexual function for the disabled. This article is a quick easy read written by Andrew Gurza, a young adult with cerebral palsy. He humorously points out how OTs can teach anything from holding a spoon to proper wheelchair technique but yet freeze up when a client brings up sex. From this course, we know that sex is an occupation which makes it completely in our field of practice to touch on. This occupation was very meaningful to Andrew in order to fulfill his role as boyfriend and also for his self-esteem. In this article he points out that his inability to perform sexually...

After learning more about ALS in class, I found this disease more and more interesting. It fascinates me so much because while this disease destroys all control of your muscles, your brain is perfectly intact, meaning you are perfectly aware of everything going on. I could not help but imagine what this must be like. In order to gain further insight, I decided to watch the documentary Transfatty Lives. Transfatty Lives is a documentary by Patrick O'Brien, a 30 year old male who was just recently diagnosed with ALS. He shares his journey with us and give us a true look at how ALS affected his life. In this film, you are able to see him go to doctor visits, where they confirmed the diagnosis and follow him along the way to see how this disease progressed. Throughout this journey, Patrick remains his humorous self, and shares his story in a positive way to help raise awareness to this disease. At times, it seemed like Patrick was in better spirits than his family. He cracked jokes...

Allie Calhoun occupied her time by fulfilling the roles of being a wife, daughter, mother and homemaker. She enjoyed painting, playing piano, cooking, and music. Allie was diagnosed with dementia at age 76. This was a tough thing to swallow for Allie and even harder for her husband to adapt. Her husband took awhile to accept the diagnosis which is common for people's loved ones to go through. When Allie found out she had dementia, she prepared by writing her own love story. As the disease progressed, she got her husband to read this story to her, which she loved. For dementia, an OT is concerned with providing comfort, education, and routine to the client and/or their family. The main things to work on with Allie was to decrease panic and create a calm environment. Music can help people with dementia by helping bring memories back. It can also have a therapeutic effect. Another common thing for people with dementia to go through is sundowner's syndrome which is confusion and p...

Montel Williams is a popular busy man, who had several occupations such as TV show host, actor, father, and wrtier. He was diagnosed with MS at age 42. His initial symptoms were vision loss, fatigue, impaired coordination, and pain. He lost 80% of his vision in his left eye. Coping with the diagnosis was tough for Montel. He started to feel depressed and even tried to kill himself two times due to the pain. Before the diagnosis, Montel was a healthy and active man. His family was his motivation because he wanted to be able to be there for them 100% and not let this diagnosis control his life. He also wanted to continue his TV show, still act, and still write. MS presents many barriers for people, but it is not fatal like ALS is. Interventions for MS include increasing strength, ROM, endurance as well as decreasing pain and fatigue. Overall, this disease is manageable, but it presents many challenges that can interfere with one's activities of daily living.

Woody Guthrie was a singer, artist, and social activist who was diagnosed with Huntington's around his 40's. Before his diagnosis, he had some symptoms like violent outbursts and volatile behavior. In Huntington's disease, there are motor, cognitive and psychiatric symptoms. I found this disease very interesting because of how much it impacts daily life. In Woody's case, his biggest concern was still being able to travel and being able to write music. Something an OT can help work on with HD is keeping a routine schedule because if following a planned schedule, there are less likely chances of outburst or behavior getting too out of control. Woody's case however was very challenging because being a singer, musician and traveler, you can imagine that his life didn't really follow a schedule. From this case study, my biggest take away was realizing how much this disease affects one's life.

This past weekend as I was flipping through the TV channels, I saw that the movie Me Before You was on. I had heard other classmates talking about this movie recently and knew it was an option to write a neuro note on. I saw it as a great opportunity and it didn't take me long to catch my attention. This movie is about a boy named Will who has a SCI and his caregiver, Louisa. Louisa takes on the role of Will's caregiver after losing her job at a cafe. She has no prior experience with this condition and has a tough time at first trying to care for him. Will is not exactly an easy person to care for. He has a negative attitude and makes it difficult for Louisa to connect with him. He is constantly in a bad mood and has a negative outlook on life. Will's outlook on life after his injury is that he is useless and cannot accept the fact of not being able to live his usual active life. Louisa has a very upbeat personality, which Will's family hopes will help lift his spirit...

From this course, I have learned so much about OT. I learned all the different models of practice and frame of references. I have learned the true meaning of occupation and what it means to be client-centered. Overall, I have gained insight into how OTs think and started to develop some clinical reasoning. From this course, I will apply my knowledge to practice and keep developing as a lifelong learner. I truly appreciate the field of OT so much more after this course. I thought I knew a lot about OT before, but now I feel much more knowledgable. I look forward to what is left to learn as I continue on my journey to becoming an OT.

Today Valerie presented her case study to us on Myathenia Gravis. I did not know really anything about MG before today. I had only heard of this. I learned that MG causes sudden rapid fatigue of voluntary muscles. Symptoms for Kristen now come about when she is really stressed. Due to this, she tries to balance her life very well and avoid a flare up. When she does run into an outbreak, her usual symptoms include muscle weakness, fatigue, double vision and facial drooping. The facial drooping can sometimes look like Bell's palsy. Since she is able to recognize what makes her symptoms flare up, she is very good at avoiding such occurrences. An OT can help a client with MG by helping them with life management skills to plan out their routine, and also by teaching them relaxation techniques. Kristen really finds that relaxation techniques work great and help her still be able to engage in her occupations.

I figured for my last blog post challenge, I would reflect on my first semester in OT school. I have honestly learned so much, too much to even put into words. Coming into program, I felt I had a pretty good grasp of OT but from what I know now it doesn't even compare. From OT425, I learned all about the OTPF, a document I didn't even know existed. For how gray of a field it is, this document really does a good job encompassing the field. I feel like our first semester took off so fast and I honestly cannot believe it is almost June! I thought I loved OT before, but my passion for the field has grown so much more. I had learned a lot coming into the program from being a therapy tech, but now I cannot wait to take what I have learned from the classroom and go back to work as a tech this summer. Now when I go back, I will be trying to guess what frame of reference is being used, what theory, even observe evals and think of what goals would be appropriate. There is so much left to...

Today I presented my case study on Lou Gehrig who had Amyotrophic Lateral Sclerosis. The status of my client was early stage, recently diagnosed. He had noticed he had been dropping things lately and his batting average fell to a .143 (used to be .343). His living situation was to remain living at home. One thing in particular my group discussed was what the adaptive equipment might have been like back in 1939 when he was diagnosed. What is available today is probably much more developed and technologically advanced compared to 70 years ago. Lou died 2 years after being diagnosed. It is interesting to note that the intervention for ALS is somewhat similar to Parkinson's in that it is degenerative so you want to maintain function and independence in ADL through use of adaptive equipment. Other interventions an OT would use with a client with ALS include: optimize strength and ROM, educate client and caregiver, and manage pain and energy.

Yesterday in class, we discussed a lot about therapeutic relationship and how this relationship differs from others. A therapeutic relationship is the relationship between a therapist and his/her client. This relationship is different from others because the goal of therapeutic relationship is for one person (the client) to benefit. This means that the therapist is always keeping the clients well-being a top priority by helping them achieve his/her goals. It is important to develop trust in therapeutic relationships. You can develop trust by following though with plans, being punctual, honest, always involving client in decisions, and by using clear language they can understand. Therapeutic relationship is an umbrella term and going along with that under the umbrella is therapeutic use of self. Therapeutic use of self is planned use of therapists' personality, insight, and interpersonal skills to connect with the client in a way that becomes an effective tool in the intervention pr...

In class last week, we talked about cultural competence and how it is important for the field of occupational therapy. Cultural competence is the ability to interact with people from different walks of life and work toward a common goal. In other words, it is how we can connect with others who are be different or hold different values and beliefs. The culture of occupational therapy is centered around being holistic, client-centered and stresses the important of engaging in occupation. As a profession, we value these principles and aim to look at our clients as a whole person. By being culturally competent, we can connect with our clients on a better level to fully understand what occupation is purposeful and meaningful to them. As a student, there are many ways to further develop my cultural competence. Some ways include: exposing myself to other people who are different from me, recognizing my own biases, through community service, and through interaction with people of different pro...

Last week, some classmates and I got to go watch the Memphis Rollin' Grizzlies practice basketball. This is an adaptive basketball team and most of the team members have endured a SCI. During this practice, we got to watch them perform drills, practice shooting, and even play a practice game. While observing them play, it was fascinating to see how they maneuvered around so fast with such great control. At times some even flipped their chair, but got up with ease. This sport does not let disability limit their ability. When they played, they gave it their all. The reason I chose this to write my neuro note on is because of how much it inspired me and really opened my eyes to the enjoyment of adaptive sport. I learned so much regarding the sport and after talking to some of the players, I learned how meaningful this sport is to them. This experience allowed me to see first hand how engaging in purposeful, meaningful activities increases one's quality of life, which is the ma...

The emerging area of practice I chose was Aging in Place. I am very interested in geriatrics so this is why it initially caught my eye. This area of practice is emerging today due to the baby boomer generation. The baby boomer generation is wanting to live in their own home as long as they can instead of having to be moved to assistive living. Because of this, home modifications are also a must and is included in the aging in place emerging area. I totally understand how people don't want to be moved out of the house they planned to live in when they retired and for the rest of their life too. This is what adds meaning to their life and increases their quality of life. Vision 2025 states that it aims to maximize health and well-being. In order to better suit the elderly, we must assist them to their needs and help them live their life to the fullest performing the occupations they normally do. Vision 2025 also states that we must use effective solutions to achieve maximal health ...

Today in Neuro OCP, Haleigh presented her case study to us on a man with Parkinson's disease. Robert Smith is an 88 year old male who enjoys fishing, hunting and eating with his wife. After he was diagnosed with Parkinson's, his movements were affected and he couldn't move fast and was sort of rigid. For him to perform sit to stands, he had to really focus on balance and moved very slow. He was referred to OT for participation in the LSVT BIG program, a program centered on big movements to help combat the tremor symptoms in Parkinson's. It is a 4 week program that is also a home program. After 4 weeks of the program, Robert was able to perform sit to stands at ease without trouble. One of his main complaints was how much trouble it was for him to get up from the couch or sit down to watch TV. After the program, Robert had no trouble with this. The main thing I take away from this case study was how much progress was achieved in the LSVT program. I had heard of this prog...

The other day in Neuro OCP, we had the pleasure of having guest speaker Fletcher Cleaves come in and share his story about his injury. In 2008, Fletcher was in a car accident and as a result, left him with a C5 complete SCI. He talked about the accident but more so focused on his life since and how it has impacted him. I was amazed at how positive and motivated Fletcher was coping with his new way of life. He left us with a message of "the sky is NOT the limit." When in the hospital after his injury, doctors told him he wouldn't be able to live on his or achieve half of the things he has already done. He made a point to prove them wrong and used it as motivation. Fletcher inspired me in many ways. One thing that really stuck out to me was when he told us how long it takes him to get ready in the morning. If he had to be somewhere at 9:00, he would have to wake up at 5:30 in order to be on time. Of course I understand it would take him longer, but never did I imagine tha...

As I was browsing my options on what to write my first neuro note on, I remembered I just recently watched the movie Concussion. This movie is a true story about how NFL football players who suffer repeated blows to the head can develop chronic traumatic encephalopathy (CTE). These repeated blows to the head over time proved to cause brain damage, something that the NFL ignored could happen and didn't even warn players of this risk. We know from class that a concussion is a form of a mild traumatic brain injury. Sometimes the symptoms of a TBI can be so mild that they aren't taken seriously. Any time there is a blow to the head, your brain is bumped to the front and then to the back, called coup and countercoup. This movie really shed light on how a concussion can affect your cognition and present with such symptoms that one is simply not themselves. In the movie, we see Mike Webster's (NFL player for the Pittsburgh Steelers) life after playing for the NFL and suffering...

Today I learned about a boy named Tyler who suffered a SCI when being dropped out of a helicopter. Hearing his story was very eye opening to think about his daily struggles and what he encounters on a daily basis. From what I learned about Tyler, he likes to be very independent and doesn't want anyone treating him differently because of his injury. Tyler spent 3 weeks at Shepherd Center and he says the coolest thing about OT was how they treated him. They treated him just like any other client, regardless of his level of injury. They motivated him to succeed and get better. What I found particularly fascinating was how much determination Tyler has. After spending time in Shepherd Center, he came home and enrolled school shortly after. He also is already back to driving with an adaptive truck and his injury happened less than a year ago. What I take away from this story is how important it is to motivate your clients and how much self-determination can help one succeed despite the i...

In today's lecture in Foundations, we talked a lot about professional development. Professional development is  planning for and seeking out a cumulative series of opportunities and experiences to ass to one’s knowledge, motivation, perspectives, skills, and capacity for job performance. It is building our path to our career and beyond. To be an OT, one must commit to life-long learning, which is a part of professional development. From this lecture, it made me ponder about plans I have for to grow with professional development and stay committed to being a life-long learner. Continuing ed is something that really excites me about entering into the practitioner field. As I worked as a tech, I remember hearing about all the continuing ed courses upcoming and hearing the therapists talk about them. They all seemed so interesting and enriching. I have set some goals for myself already for when I finally become a practitioner. To grow in professional ...

Today in class, we spoke a lot about clinical reasoning, what is it and how does one get it? Clinical reasoning is the thought process you use as a practitioner to evaluate clients and make clinical decisions. Clinical reasoning helps one carry out the whole OT process. It is not something that is learned or taught overnight, but rather is formed over time. You cannot just "study" how to become good at clinical reasoning, but our fieldwork experiences and what we learn in OT school can help shape our clinical reasoning. This particularly stuck with me because this is something that is best learned by experience, which I believe is the best kind of learning. From my past clinical experience as a tech in multiple settings, I feel as though I have already gained useful knowledge that has already started to shape my clinical reasoning. Experience is what makes you be more confident in clinical situations which is crucial to shaping our clinical reasoning.

On this day in class, we talked a lot about documentation. The common way to document a clinic note is called a SOAP note. This stand for S- Subjective, O- Objective, A- Assessment, P- Plan. In the subjective part, this is where you put information reported to you by the client. This could be a direct quote coming from the client's mouth, or a statement summarized that the client reported to you, such as "I didn't sleep much last night due to pain in my left arm." In the objective part of the note, this is where you state clinical findings and measurable objective data such as, client participated in Dynavision activities to increase trunk balance and UE functional mobility Client was able to achieve score of 85% with minimal cueing or assistance. In the assessment section, this is where you put your judgment and opinion as the practitioner. This is your interpretation of the S and O such as, client has demonstrated increase in UE functional mobility and trunk balance...

Today we learned about the OT Process from referral to discharge. The OT process includes the evaluation, intervention, and outcomes of treatment of a client. In the evaluation process, there is the referral, screening, and as an OT you try to form an occupational profile. The main purpose of an occupational profile is to provide the OT with background information on the client's goals, habits, occupations and history. It helps the OT look at what their functional performance is. During the intervention process, the OT does planning, implementation and is also reviewing as treatment continues. During the outcomes process or re-evaluation, the OT must measure the outcomes, review goals, and decide if they client is ready for discharge or if there is more to work on. Throughout this process, it is important to document because if it is not documented, it technically did not happen.

In this lecture, we had Professor Flick come talk to us about health promotion, literacy, and prevention. It was interesting to have pointed out that many people think of health as just a physical thing. Health is not the absence of disease, but rather having a good mental, physical, and social state of mind. This was the first time I heard about the IHI triple aim. The Institute for Healthcare Improvement put together 3 major recommendations on how we can deliver good healthcare. They are improving the patient's experience, improving the health of populations, and reducing the per capita cost of healthcare. I enjoyed hearing about how our nations spends tons of money on healthcare a year but yet we don't get that much quality out of it. This really stands out to me and shows a need that we really need to come together to achieve overall health.

In this lecture, we learned a lot about universal design. Universal design is a way of setting things up so the maximum amount of people are able to access or use it. I was really interested in universal design and then started thinking about things in the community I see that are built with universal design in mind. Examples of some are automatic doors, reachers, and ramps. This lecture really made me think about things in the community and how things are built without keeping in mind accessibility to all. I now notice little things in the community that either stand out as having great access to all or things that were built without universal design in mind at all. For example, I was thinking about New Orleans, where I am from, and thinking about the city's design and how hard the streets, and sidewalks are to access for wheelchairs and such. Furthermore, all the houses in the city are raised with many steps to enter because of frequent flooding in the city. For a city that I kno...

I am very interested in the brain injuries and it is a diagnosis I hope to one day specialize in. I have worked a lot previous at both inpatient and outpatient setting treating various patients with brain injuries. One thing that stuck out to me that was common with all the brain injury patients I saw was that impulsivity was a common trend. In the past, I have had a lot of fun interacting with the brain injury patients because you never know what is coming next, but it really amazed me with how capable the brain was of changing. We had this one patient who when she was inpatient had vulgar outbursts in the gym but by the time she made it to our outpatient clinic, she was a much calmer and changed person. Her viewpoint had completely shifted and her attitude completely changed. I felt it was very rewarding to work with these patients because it was challenging given that each case presents with different symptoms and needs. I love how much brain injuries vary and keeps you on your toes...

The TED talk was very motivating. I felt that Aimee was such strong person and very inspirational. I agreed with everything she was saying and found it shocking the way disabled is defined in dictionaries. Society should define who and how one is disabled, rather that is something that is more internal and how that person chooses to view or accept their current status. In Aimee's case, she was a bilateral amputee, but did not allow that to set her back in life. Instead she used that motivate herself and prove to society she is capable of achieving what others are, if not more. We need more people like Aimee in our society, to send a message that disabilities are not limitations necessary in life but rather how we choose to move on and accept these changes is what defines us.

I really liked the KAWA Model particularly because it was easy to understand. I loved how it was a metaphor to a river and felt this analogy was so fitting to the practice of OT.  It was easy to visualize it and see how the flow of a river is similar to the flow of life. I also like this model because it would be easy to explain to a client when providing OT services. It may be hard to explain the term of occupational performance to a client, but by relating this to a river and pointing out the many features, it is easy to explain to them that all those contents reflect how their occupational performance. Overall, I feel like this model is very relatable to one's life which is key to providing client-centered intervention.

How does OTPF influence/guide OT practice? OTPF guides OT practice by providing OTs with the domains and processes that encompass the field. It provides OT with a common framework and unified language on what domains we can work on with our clients to better serve their daily life. OTPF guides the practice of OT to use a top-down approach by that focuses on occupation first.