Neuro Note 5: Alison Piepmeier's Story

          "My Story" is a collection of blog posts that discuss Alison Piepmeier's personal experience before and after her surgery at Duke to remove a cancerous brain tumor. Alison's tumor is in the language area of her brain. She is a writer and professor, and she uses her ability of language not only to connect with others, but as an integral part of her career, so the placement of her tumor is inopportune to say the least. Alison gives a vivid account of the days leading up to her surgery and speaks in depth about her main concerns of surviving in order to be with her daughter and retaining her ability of language. Her story is real and honest in a way that makes the reader feel as though they are part of her experience. Not only does she speak about how she is feeling leading up to her surgery, but she also writes post-surgery, which provides an extremely interesting insight into how exactly her surgery impacted her language and ability to communicate through written words.
          I chose to write about Alison's experience for my final neuro note because I had not previously written about a personal account with a neurological condition. I truly did gain a lot from reading Alison's story. For me personally, I get so much out of hearing the stories of the real life people that have experience with the diagnoses that we learn about in school. Connecting a diagnosis to a name and face makes its impacts seem much more real and dynamic than just hearing the general implications that a particular condition or disease has on a person. One of my favorite parts of Alison's blog posts is that she writes during the time immediately after her surgery. From these posts, the reader is able to see exactly how her brain is working to process language and put the words she is able to find down on paper. I think that as occupational therapists, this is a great example of being able to see how exactly a tumor in a certain area of the brain can impact a person's abilities that are controlled by that particular part of the brain. Alison's story really relates to our course by giving an account of how brain tumors can change a person's abilities that are controlled by a specific area of the brain, but because of the brain's plasticity and ability to change, a person can still learn and heal their brain in a seemingly short amount of time. I would certainly recommend Alison's story to all people, especially healthcare professionals that work with people who undergo brain surgery because of the powerful way she uses words to convey her experience.

Link to Alison's Story: https://m.charlestoncitypaper.com/charleston/my-story/Content?oid=4985574

Piepmeier, A. (2014, September 3). My story. Retrieved June 13, 2017, from https://m.charlestoncitypaper.com/charleston/my-story/Content?oid=4985574

Case Study Ronald Reagan

Ronald Reagan was diagnosed with early onset Alzheimer's after he was president, though he did start experiencing symptoms such as forgetfulness in the later part of his term. He relied a lot on his wife, Nancy, when he was in the throes of his illness in order to help him get through his days. One thing I found to be interesting about Reagan's case is that he was thrown off of a horse in 1989, which led to the development of a blood clot in his brain. Nancy said that his symptoms began shortly after this allowing her to think that this might have brought on his diagnosis, though this was never proved with concrete evidence. His main challenges included his sleep schedule and his memory lapses that caused communication troubles. One way that an OT could assist him when it comes to his challenges is by teaching him to reduce the number of naps he takes by filling his days with activities. This will allow him to keep to a more normalized sleep pattern. To assist with the communication issues, he and Nancy will use a reminder board so that they are both on the same page and can communicate more efficiently. The story of Ronald and Nancy is a very heartwarming one in which Nancy is able to provide the support that Ronald needed to live his life as best as he could despite what challenges he encountered along the way.

Neuro Note 4: Rollin' Grizzlies

Photo retrieved from http://www.rollingrizzlies.org/

Last month, I attended a practice for the Memphis Rollin' Grizzlies, Memphis' nationally ranked wheelchair basketball team. During this experience, we had the opportunity to watch a team of men, some who always use wheelchairs and others who do not use a wheelchair other than when they play on the team, practice different basketball drills and scrimmage each other during their off season.  I really loved getting to sit in on one of these practices because I have never experienced anything like this before. The amount of athleticism, strength, endurance, and strategy necessary to play on this team was so impressive and awe-inspiring. I chose to write about this experience because it impacted me in a way that changed how I viewed those who use a wheelchair and how their use of a wheelchair impacts their leisure occupations. These men put their all into playing and didn't hold back in the least bit, which was so fun to watch. This experience tied really well into our neuro course. For example, we were able to see how the level of their spinal cord injury played into their ability on the court. All of these men used wheelchairs with lower backs so that they could be more mobile with their upper bodies. I think this experience was a wonderful example of how traces of occupational therapy can be seen outside of OT services. These men were using their occupation of playing basketball to enhance many areas of their lives including their physicality, social connections, and mental health. I would absolutely recommend this experience to anyone because it is truly an inspiring game to watch, and will certainly make anyone recognize that a person in a wheelchair is just as capable at living life to the fullest as someone who happens to not be in a wheelchair.


Home. (n.d.). Retrieved May 24, 2017, from http://www.rollingrizzlies.org/

Case Study: Muscular Dystrophy

Trevor Conklin was diagnosed with Duchenne muscular dystrophy when he was 3 years old. He is completely dependent on his caregiver, Ben, to help him do all of his ADLs. Trevor's goals with OT were to increase independence in his ADLs with the use of adaptive equipment and to increase social participation in the community. I think that both of these goals are great for someone like Trevor who really seems to want to break out of his shell more, and these goals will certainly help him to be more independent and confident in his interactions with other people. One thing that surprised me about muscular dystrophy is that there are 9 different types and men are more impacted than women.

Case Study Huntington's Disease

Charles Sabine found out that he had the gene for Huntington's when he was in his late 30s and is now in the early stages where he is experiencing symptoms such as difficulty with speech and swallowing, motivation to begin and complete basic tasks, and depressive symptoms. His father passed away from Huntington's and his brother also has it, but his brother was further along with the disease than where he is currently. One thing that I found interesting about his case is the extreme toll that the disease took on his ability to make decisions and stay motivated when doing tasks. He was a former journalist and reporter, which is a great occupation to tie into his treatments in OT. Currently, Charles is a huge advocate for the disease and spends much of his time spreading awareness.

Main Takeaway from Foundations Course

There were a lot of things about the Foundations course that really supplemented my learning. The more and more I learned about all of the ins and outs of what OT is, what OTs do, and how they go about doing it, I realized that my initial thoughts about occupational therapy as a field were so narrow compared to what I now know. I truly feel like learning about what OT is and what it stands for as a profession really helped me further solidify my feelings about occupational therapy truly being more of a calling than just a job. Aside from learning so much about the more intangible aspects that go into the philosophy and purpose of occupational therapy, I also got a lot out of learning about the more concrete components that will be integral parts of our days once we are full time practitioners. Doing things such as the occupational profile, activity analysis, and working through the OTPF, really helped to give me a better idea of what it is OTs do day in and out. In the end, this class really got me pumped about starting a career in one of the greatest professions out there!

Case Study: Andy Griffith

Andy Griffith was 57 years old when he was diagnosed with Guillain-Barre Syndrome. Being a very busy actor, he took this hard at first. He suffered from debilitating pain, muscular weakness, and bouts of paralysis in his feet and legs. He also experienced secondary problems such as depression due to his being diagnosed and the change in lifestyle that occurred because of the great deal of pain that he was in. It is thought that his diagnosis was triggered by an intense case of the flu that he had in his late 50s. This shocked me when I read this, because I was not aware that this is thought to be a main cause of Guillain-Barre syndrome. After many painful months, Griffith was able to mostly recover from GBS and return back to his fulfilling and thriving acting career.

Neuro Note 3: The Fundamentals of Caring

          The Fundamentals of Caring is a comedic film that tells the story of Ben and Trevor. Ben is a writer who takes a job as the caregiver of Trevor, an 18 year old with muscular dystrophy. Because of his sedentary and not particularly riveting lifestyle, Trevor has become rather anxious and cynical, yet he has a fascination for road trips, and believes that he will never be able to go on one because of his medical condition. Ben makes it his mission not only as Trevor's caregiver, but also his friend, to take him on this trip to see roadside attractions across the country. After initially refusing, Trevor gives into the trip of a lifetime. Ben does everything he can to help Trevor overcome the anxieties he has about the trip and allow him to experience things he felt he couldn't because of his being in a wheelchair. The two of them experience both life changing and challenging times, meet new people, reacquaint with old people, and ultimately learn to lean on one another during this great adventure. 

         I chose to write on this film after re-watching it on Netflix recently. I loved this film the first time because it turns a tough situation into a beautiful one that is filled with humor, new experiences, deep connections with another person, and hope for what is to come. I loved how Ben didn't ever plan on a job like this, but he ultimately ended up giving Trevor an experience that provided his life with greater meaning and purpose. It does a great job of showing that just because a person might be completely wheelchair dependent, this doesn't mean that they can't experience life to the same extent that someone else does. This film gives a great description of what it is like to not only experience a neurological condition such as muscular dystrophy, but also how having a condition such as this one can have a huge impact on how someone views the world, their own abilities, and what they can and cannot do based on what others have said. Like we have spoken about in class, this film really hits on the psychosocial implications that can spring from having any type of illness or injury. I would certainly recommend this film to anyone who is looking for a heart-warming and genuine comedy. 

          

Burnett, R. (Director). (2016). The Fundamentals of Caring [Video file]. United States: Netflix. Retrieved October, 2016.

ALS Case Study

Paul Kevin Turner, K.T., was diagnosed with ALS at the age of 41 and passed away when he was 46. He was a well known and loved professional football player who enjoyed spending time with his family. He experienced the typical symptoms of ALS such as loss of arm and leg function, poor postural stability, the ability to walk, and respiratory function. One of the main takeaways I got from his story was the connection between his ALS diagnosis and the amount of brain injuries he sustained during his football career. As ALS is a neurological condition, it makes sense to me that multiple brain traumas might put a person at a higher risk, but I was not aware of the correlation between being diagnosed with ALS and playing professional contact sports. During his football career he could remember 20-25 seperate times in which he heard ringing in his ears or saw spots after getting hit, but he continued to play. Though his being diagnosed with ALS is tragic, great things came from it in that he has greatly help spread awareness of and raise funds for ALS even after he passed away.

Role of OT in Youth Transportation

     One of the many interesting emerging areas of practice in the scope of occupational therapy is youth transportation. OTs are beginning to work with teens with disabilities by creating driving programs that will allow them the same experience as their peers when it comes to participating in this right of passage to adulthood. Being able to drive as a teenager is the ultimate sign of independence at this age, so as practitioners that work to help people become as independent as possible in order to live their most meaningful life, it makes perfect sense that this be incorporated into our scope of practice. There is a great need for OTs in this area of practice and the involvement of OTs in this can look different depending on the client's goals. An occupational therapist working with this population can educate teens on transition programs that pertain to youth transportation, receive a certification as a driver rehabilitation specialist, talk with teens and their families about the occupation of driving, and teach on things such as community mobility, personal safety, use of adaptive equipment with transportation, and the use of public transportation.
     AOTA's Vision 2025 aims to have occupational therapy play a vital role in facilitating participation in everyday life for all people by maximizing their quality of life. Working with teens with disabilities to help them either drive or get around their community more independently is a great way of reaching out to a population that doesn't always have the same resources as their peers when it comes to involvement in this occupation. OTs are applying Vision 2025 to this area of practice because they really are helping this specific population of teens maximize their quality of life by achieving independence in their daily lives.

Muhammad Ali Case Study

One of the most unique things from Muhammad Ali's story comes from the position he had as a public figure with Parkinson's. Because he was a prominent figure in the world or sports and media in general, he was at an advantage to advocate for people with Parkinson's disease and raise money for research. Ali began the Muhammad Ali's Parkinson's Center which helps to fund research projects geared toward finding a cure. Ali was a major advocate for the disease and because of his personal ties to it, there have been major projects funded toward advancing research in this field.

Neuro Note 2: "My Beautiful Broken Brain"

     

 

(Retrieved from Netflix)

     My Beautiful Broken Brain is the story of Lotje Sodderland, a 34 year old year old female that experienced a cerebrovascular accident. This documentary follows Lotje as she attempts to understand her new world post-stroke and how she must essentially relearn how to do things such as reading, writing, and speaking. Her journey is slow and often times difficult, but because she is determined and committed to regain her abilities, she ultimately succeeds after the many ups and downs that she experiences during her recovery process.
     I would recommend this film to all occupational therapy students and healthcare professionals that work with people who have experienced any type of neurological trauma. This documentary does a wonderful job of showing just how frustrating recovering from something of this magnitude can be, while also showing how it is possible to achieve such incredible feats with a lot of hard work and a willing spirit. As healthcare professionals, treating clients with the same diagnoses often makes it easy to look past how the individual you are treating is coping with their new lifestyle, and this documentary is a great reminder of the reality that comes with living after a stroke. Another reason why I chose to write on this film and find it to be especially pertinent to occupational therapists, is because the film was made by Lotje herself during her time recovering, which provides us with a uniquely personal first-hand encounter of what it is like to recover from a stroke. She used her own occupation of film making as a therapeutic tool to help her process and understand what she was going through at the time. Little did she know, but she was essentially using OT think by incorporating her love of making films into her recovery, which was extremely beneficial for her in both cognitive and psychological ways.

Sodderland, L., & Robinson, S. (Directors). (2014). My Beautiful Broken Brain[Video file]. United Kingdom: Netflix.

SCI Case Study on John Stoker

From hearing about John Stoker's experience with his spinal cord injury, there were two main points that really stuck out to me. The first deals with his OT intervention. John received occupational therapy for bowel and bladder work, which helped him to learn how this feels when paralyzed. I found this to be rather interesting because I hadn't before thought about OTs helping with this aspect of spinal cord injuries. Previously, I had only known of an OTs role in teaching clients how to live with a catheter or a colostomy bag. The other aspect of his story that stuck out to me was how he obtained his injury. John's sustained his injury as the result of a surgical mistake, which is not something that is often brought up. Though it is almost unimaginable to put oneself in his position, John seems as though he handled his new and unanticipated injury with incredible grace and positivity.

The Collision of Science, Creativity, and Compassion

During my 4 months of OT school, I have learned so much about what it occupational therapy is, what is isn't, and what it means to be a practitioner in the field. Our professors have said so many incredible and enlightening things about what occupational therapy means to them and how they choose to describe what it is that we as OTs are attempting to achieve as service providers. To be honest, I have days where I wonder if I fully understood what OT really was before I began this program. Out of all the wonderful statements that have been made about our profession thus far, there is one quote in particular that has stuck out to me when I think about describing what occupational therapy is to someone that might not know otherwise. The quote spoken by Jessica Kensky reads, "occupational therapy is where science, creativity, and compassion collide." I think that this is a wonderful summary of some of the main pillars that make up our profession. Occupational therapy is in a unique position to achieve incredible results in our world because there are few other health professions out there that aim to involve each of these concepts. If done correctly, I truly feel that occupational therapy practitioners have the opportunity to change the lives of our clients and the world around us in a way that was never expected.

Changing Interests

As fresh, bright eyed occupational therapy students, many begin their journey with a destination in mind. Some are set on working in pediatrics while others set their sights on specific hospitals or organizations that they aspire to work for. Before I began school, I thought I might want to work as a traveling OT and have the opportunity to experience several settings before settling into my niche, or I thought I might enjoy the acute care or mental health settings. My answer would change depending on the day, which I find to still be true almost 5 months into my journey in OT school. I think that this is one of the great advantages of our field. Being able to work in a variety of settings and having the chance to change settings depending on your interests is such a unique and wonderful thing about occupational therapy. I have certainly found that the more I learn, the more interested I become in things I had not considered before now. I look forward to watching my own and my classmates' interests evolve as we continue to open ourselves to learning about the many wonderful qualities of our future profession.

Emerging Practice in Mental Health

As society and its needs change, so does the role of occupational therapy practitioners in the lives of our clients. To cater to this, there are many different emerging niches within the field of occupational therapy. As time goes on and society continues to evolve, this list will expand even beyond what it encompasses currently. Justas well, some of the niches that are currently emerging, will no longer be emerging in the future because they will be mainstream areas of practice for OT professionals. For example, a few of the emerging niches in mental health include the work of occupational therapists with depression, recovery and peer support programs, sensory approaches to mental health, and veterans’ and wounded warriors’ mental health. Occupational therapists are slowly but surely finding their place when working with these specific populations and they will continue to develop the role that they play in the lives of those that fall into these more specific mental health categories.  

Being Present with our Clients

As occupational therapists, we are in a valuable position to treat our clients in more ways than just addressing their physical needs. Sure we can test range of motion and implement activities that address certain client goals, but we can also address our clients' humanity and need for social connection through the often overlooked concept of the therapeutic relationship. One can go about establishing a therapeutic relationship in a number of ways, but one way this can be achieved is just by being wholly present with our clients as psychologist Debbie Hall says in her podcast on the power of presence. Being completely present is a state of being and not doing, which in American society, this concept is not necessarily valued because of the emphasis that we place on the need to do all things quickly and efficiently. By forming an intimate connection with our clients, we have the wonderful opportunity to prove the healing power that connecting with another in the quite of just being with them can have. One of the many wonderful impacts that being present can have is its ability to change all parties involved. Being present and just being there or listening to what our clients have to say is a very important role that we play as occupational therapists.

Vision 2025

As professionals in healthcare, it is important to have goals that guide us in our career so that we continually have a purpose and meaning behind what we are doing. Since this is an important thing to have as individuals, it makes since that a specific field within healthcare would have goals for the professionals working within it. AOTA has done just this, first with its Centennial Vision and now, with Vision 2025. Vision 2025 builds on the Centennial Vision, but goes beyond it by calling for, “occupational therapy to maximize health, well-being, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living” (AOTA 2016). This vision calls for holistic and client-centered care for all persons in various populations and communities. It places emphasis on culturally responsive services, services that are collaborative in nature, therapy that is evidence-base and cost-efficient, and leaders that are influential in changing policy. These goals are crucial in proving the distinct value of occupational therapy as a profession and if achieved, have the potential to make a huge difference in the positive impact that occupational therapy can have on the world.

AOTA unveils vision 2025. (2016, June). Retrieved April 22, 2017, from https://www.aota.org/AboutAOTA/vision-2025.aspx