29 Sep 2010

still searching for OT job in La Jolla CA :)

Well on Thursday night I start my road trip with a friend across the country….with appropriate stops each night, including a stop at the Grand Canyon if all goes as planned, ie no car breakdowns….then a few days each in Las Vegas and Death Valley to celebrate my grandfather's 80th, then to San Diego, then flying overnight to San Francisco area for a day and a half, then back to San Diego…then about 10 days later headed to South America for six weeks! Still need to be working on networking/sending out resumes/searching for an occupational therapist job to start like January 2nd!! Still hoping for peds but I've got a few comments about other places- appreciate it. Sorry so quiet – been busy preparing to move. I always think of things I want to share and then by the time I get to it its all faded away!! Ugh!!! I wish I could get back to rambling!! ahahaha

MISS YOU BLOGGIES!!

Category: Occupational Therapy | Comments: 3

15 Sep 2010

hahaha

So I think most therapists do cheat and use the hot pack machine to make small adjustments on splints, but I made a big boo boo….this was one of my first weeks at this clinic and I was trying to impress…ugh. I sent this to another co-worker after it happened…am deleting work mails since my last day is Friday and when I saw this I laughed. LOL
 
:::::so…….i know now how to clean out a hydrocollator….seeing as how I lost my tiny trigger finger splint in it….I was being careful with the tongs since you had warned me about not losing it,  but it still managed to slip out…I was like NOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO and my life flashed before my eyes….okay not really but I was like AUGH. So…….I took out all the hot packs and was trying to fish for it….and then trying to decide if I could handle the heat if I plunged my hand in….chose not to, LOL. I was really scared it would like dissolve and ruin the expensive collator.  Luckilly it needed to be cleaned anyway….we dumped it out the back door, then rolled it out the front after cleaning it, to use a hose in front area of building, then brought it back in….of course I got splashed…hahaha….now its plugged back in and hopefully going to be okay….my splint material was just floating peacefully and didn't do any damage or melt or anything…I was so scared. From now on I'll use a real splint pan for anything that requires total submersion. learned my lesson. oopsie doopsie:::::::::::::
Category: Occupational Therapy | Comments: 2

10 Sep 2010

Dynasplints, pediatrics, vocational rehab….OT is certainly diverse ;)

I've been doing some coverage in vocational rehabilitation which means a lot of students with varying severities/types of cerebral palsy and spina bifida wanting to learn independent living skills. Working with one student on putting on own socks and shoes with exploration of sock aids, reachers, dressing sticks, foot funnels, loops placed on heels of his shoes, etc etc…. other students needing work on simple meal preparation, laundry, bed-making etc….I'm a little lost on how to help someone with spina bifida drain a pot of pasta for example, need to find out from a more experienced OT!  ALso dealing with a pediatric patient who likes to scratch – ouch. Need to find some good dyspraxia resources, plus info on modified scissors, theraputty, blah blah blah blah 🙂

Hey, one of my more recent discoveries to buy a one dollar turkey baster to have kids work on sucking up/spraying water (in our case, giving SpongeBob a “bath”), helping strengthen their hands! You can also use one of those little nasal sucky things for babies, I forget what they are called….that was a gross description. Anyway. I can't remember if I shared that.

Also, using Bubble Wrap to roll over on the theraball while prone then using their hands to try and stomp on the bubbles….I use large bubble wrap and its surprisingly hard, my kids get frustrated but for stronger kids it might work better.

I also like putting up bizarre sentences that make no sense/no flow, on vertical surfaces, to have my older kids copy down on their horizontal surface….because it makes no sense they can't as easily just keep it in mind so they have to constantly glance up and down….forces them to continuously have to scan and keep track of what they are doing…most of us never think twice about copying something horizontally frmo a vertical surface (ie sitting at our desks copying from the chalkboard) – but for some kids it's tough.

Hmm, been working on exploration of adaptive devices for MS including slip on hand aid, universal cuff, book butler, etc…….trying to get a neurological splint for another patient …a DynaSplint…..my first time working with DynaSplint. I took the Sae-Bo course and really liked it and would have loved to use their Sae-Bo stretch splint, but Sae-Bo makes life really difficult with requiring outside vendors for their stretch splint…..easier to just go with DynaSplint. Sometimes even if one splint is superior, its the customer service and/or ease of accessibility that makes the difference.

I only have SIX days left of work…tomorrow plus 5 days of next week. September 17th is my last week. Next week will include vocational rehabilitation, inpatient, outpatient at two different clinics, a case manager presentation where I'm presenting on basic adaptive equipment/DME used in Inpatient Rehab, a goodbye lunch with one clinic, a goodbye lunch with the other clinic……

I am goign back and forth on being overwhelmed…some days yes some days no. Tonight was so-so, was slightly overwhelmed and tired but tried to stick with it. Got some stuff done although not as much as maybe I would have liked. I just found out today one of my fav peeps from Warm Springs is throwing me a little party this weekend, and a good friend of mine will be driving in for it tomorrow, so I am excited 🙂

La la la…..more later. 🙂 Or not, who knows…

KD

Category: Occupational Therapy | Comments: 1

4 Sep 2010

Brunnstrom techniques…I tried at least…

I took a bunch of notes out of my OT for Physical Dysfunction book, on the Brunnstrom section for dealing with stroke. Needed new ideas….I ended up trying most of it with minimal success, but I guess I can't expect miracles after a single session! I am copy/pasting my notes just to share the kind of stuff i looked at – do NOT try any of this stuff without reading up on it on your own as a lot of this is out of context and/or abbreviated!!

Brunnstrom Ideas 

Extensor synergy evoked by applying resistance to horizontal adduction of uninvolved UE.  

Resisted grasp of uninvolved hand causes grasp reaction in involved hand. Mirror synkinesis.  

Push pt off balance toward involved side

Then push pt off balance toward uninvolved side. 

Cross arms with uninvolved hand hander involved elbow. Therapist supports patient under elbows, assists in trunk flexion forward.  

Push pt backwards, regain active posture. Then go forward flexion in oblique directions.  

Trunk rotation with head movement in opposite direction of rotation (so tonic neck and lumbar reflexes can elicit shld components).  

Lateral flexion of neck toward involved side, to intiate scapular evelation. With pt’s arm supported on table in shld abd with elbow flexion, therapist gives resistance to head and shld while pt asked to hold head and not let it move  

Try bilat scap elevation, resist uninvolved scap. If involved scap elevates associatedly, add resistance 

Stroke upper trapezius to facil muscle contraction. Hold, don’t let me push your shoulder down. Repeat holding, some resistance, then try to let shld down slowly.  

Extensor  synergy assisted in initation

Hold therapists arms in horizontal abd/add, tell them to bring arms together, apply resistance to uninvolved arm proximal to elbow. Don’t let me pull your arms apart.  

Bilat weight bearing to develop arm extension 

Rowing: Therapist resists pronated uninvolved LUE while guiding involved extremity into extensor synergy. Then guide into reverse motion of flexion and supination. Keep trying and trying until feel some active extension. If so, apply bilat resistance.  

Extend elbow, support at wrist, bring up wrist extensors, over and over again,  

FINGERS: Hold thumb in extension and abduction. While holding thumb, SLOWLY and rhythmically supinate and pronate the forearm.

Apply cutaneous stim over dorsum of hand while forearm is supinated

With forearm supinated, apply rapid, repeated stretch to extensors of fingers by repeatedly rolling toward palm. Continue until flexion releases.

Slowly pronate forearm, elevate above horizontal to evoke finger extensor response

Category: Occupational Therapy | Comments: none

4 Sep 2010

as the OT world turns…

I'm reading “A Therapist Goes Home After a Stroke” by Rebecca Dutton, a book about an OT who has two strokes, and what she personally learned from rehab/her own dealings with the stroke. She goes into insane amounts of detail on how to do things one-handed. I have to admit I'm not very visual so I tend to skim some of the details, BUT the two things I have so far come across that I think are immediately helpful are:

1) Cane management – a lot of times (okay, constantly) people drop their canes – they need to be able to figure out how to pick them up off the ground safely, and/or find ways to ensure they don't slide, to help increase level of independence, so they don't have to constantly ask someone to collect their cane for them.

2) Holding things under the armpit of the affected side. This is so obvious and yet I've never worked on it with clients. If they are using a cane then their good hand is taken up. While there are options such as a light messenger bag, etc etc (again, within realms of safety), another option is to teach the clients to adduct their affected shld if they have that ability, so they can carry towels, etc and go to another area.

——–
Lately I've been working on burns, strokes, wrists, shoulders, multiple sclerosis, developmental delay, pediatric traumatic brain injury, etc etc….I know that's not at all person-first or occupation-based the way I phrased it….but I guess I mean the RESEARCH I have been doing lately focuses on those areas. Like I read up on Brunnstrom neurological techniques to find alternative ways to activate extensors of the affected side after stroke….

Blah blah I am delirious. I am packing my head off getting ready for the move to CA. 🙂 And trying to prepare for getting a job in CA, spending time in South America, etc….way too much on my mind, but for now I need to focus on physically packing, as well as preparing all my work stuff so that I don't leave anyone hanging. I only have NINE days of work left!! 5 days in one outpatient satellite clinic, four afternoons in inpatient, several late afternoons in another outpatient, and 3 mornings in vocational rehab. Gotta make sure I get lots of handouts and stuff for my pediatric clients, finish up all the home exercise programs, organize all the files and assessments….

Category: Occupational Therapy | Comments: 1

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