28 May 2007

I'm turning into an OT superhero! In my dreams at least


So, I dreamed last night that I was in some foreign country and there was this little OT hut in grave danger. Floodwaters were raging and getting higher by the second. Me and another OT grimly tried to grab as many of the items as we could, walking through waist-high water to safe ground. And again and again, as the water started to get to our necks and we carried OT materials on our head. We had to prioritze the items we thought would be most needed. It was hard work and scary too! We finally stopped (or ok, I woke up) when we started to get scared we’d get swept away in the waters.

WEIRD!!!!!!!!!!!!

Category: Occupational Therapy | Comments: 1

20 May 2007

Fieldwork: Scary, scary times

Well, I had a lot of plans for today, but since I have developed a bad sore throat, I think I’ll mostly just be staying in and studying.

We just got information about potential fieldwork placements for our Level II’s. It’s kind of intimidating to think about 9 months of clinical rotations. Our program does three, three-month rotations. There is just so much unknown and it is scary. Some of it is financial worry and logistical location worry, and some of it is worry about supervisors, competency, etc. Plus I really want to find more about fieldwork placements in places like CA, but there doesn’t appear to be any kind of fieldwork evaluation database where I could find out what other people have said about placements there. Too bad all schools couldn’t figure out a way to at least submit names/places/e-mail addresses to some central database at AOTA, so you could e-mail previous students there. Oh well. Luckily we have a great fieldwork coordinator so I am sure it will all work out!

Do any of you seasoned therapists have advice to give on fieldwork placements or fieldwork in general?

Update, a few days later: I’m still sick, now with a bad cold, so I may be bad about updating for a few days!! Guess I better get into some HEALING occupations…(cackling).

Category: Occupational Therapy | Comments: 3

19 May 2007

Celia: The reason I am in OT school


Celia and I spin in circles, shrieking with glee. I eventually let go, overcome with dizziness. I have my arms out for balance as I hesitantly back up against a wall, the room
spinning. She studies me carefully, then grins and imitates me. She puts her arms out andwalks backwards to the wall so she is positioned like me. But she really isn’t dizzy. Her
vestibular system is immature and she could spin all day. Once my dizziness subsides, I turn on her CD player and we begin to dance to one of her favorite singers, Garth Brooks.
We clap our hands and wiggle around and sing loudly. “Callin Baton Rouge….”

I was a volunteer play therapist that worked with Celia, from when she was five-eight
years old. Her father worked at my college, and he had sent an e-mail out to the psych
department asking for people willing to work long-term with Celia. They were hoping to
follow a child-centered play program based on the model “Son-Rise”. I was intrigued as I
really wasn’t sure what I wanted to do yet, but I love children and this sounded really
interesting. Her parents explained to me that Celia had been born with a life-threatening
heart defect, and spent her first days of life in the neonatal ICU. Her heart defect was
corrected, but there were other issues. She also had hip dysplasia and other problems due
to an unidentified genetic syndrome. Physically she was very small for her age, and
several of her fingers were slightly deformed. She also had hypotonia, dyspraxia, sensory
processing disorder, and cognitive, fine motor, and gross motor delays. They were hoping
to have several play therapists who would come weekly and “play” with her, with the intent
and focus on helping her develop more skills.

I read the binder on the Son-Rise program, and then also read the Out-of-Sync Child and
Greenspan’s “The Child with Special Needs”, which has a concept called Floor-Time that was
very helpful. These books helped give me a grasp on what I should be doing with Celia. And
we were off!

Celia was rather underresponsive to the environment and needed a lot of stimulation and
proprioceptive input. She needed a lot of spinning and jumping and dancing and large
moments to help calm her. Anything involving joint compression or firm pressure was also
good. With fine-motor skills, she just got bored or frustrated easily. Her combination of
finger deformities and hypotonia made it extra hard on her. Eventually, I found a magnetic
tin paper doll set that she loved, and she finally started being willing to work with
that.

Her speech was poor and most people could not understand it unless they knew her well. She
didn’t fully close her mouth when speaking due to her low tone and she drooled frequently.
She could not do things like stick her tongue out on command, due to her apraxia.

The thing I loved most about Celia was her infinite joy. She would shriek with glee and run around in circles when she saw me, and she would laugh hysterically at even the silliest joke. That’s not to say she didn’t have her moments, but in general, she was energetic and happy and sweet. I truly loved her (I still do, it’s too bad her family moved away last year).

We worked on things like identifying emotions, the concept of pretend, answering “Why” questions, grading our movements and voices, and more. Every week the sessions were a combination of untrained PT, OT, and speech in one! It was wonderful getting to do whatever we felt like, not having to worry about insurance justifications or IEP goals. Of course, I wished I had more training though.

I had never heard of OT until I started working with her, since she had an OT and I was reading a lot of books that mentioned OT. I had previously wanted to be either a psychologist or efficiency expert. I knew I needed to work with people, that I enjoyed helping people, and it had to be one-on-one, but there were flaws in both psychology and efficiency that made me hesitate to choose it as a career. Through Celia, I discovered OT was a combination of all my strengths.

From there, I did an internship through my college at a pediatric cancer hospital in their rehab department, where I was exposed to OT, PT, and speech. It was a great experience.

Since I choose this path rather late in my college career, I ended up taking a year of prerequisites after I graduated, in order to fulfill the requirements to get into OT school.

So I had 5 years of undergrad instead of the 3 needed to get in, and I’m a little bit older than most of the students in my class, but I feel that’s an advantage in some respects, since it means I have more experience.

I love OT school! And I am passionate about the work OT does. The End.

PS: Thanks Patti, for your pre-emptive OT story!
PS2: Celia’s name/picture was used with permission by her mother

Category: Occupational Therapy | Comments: 1

19 May 2007

I can has OT?

If you don’t know what a lolcat is, you live in the dark ages. Here is my first OT lolcat. 🙂

Category: Occupational Therapy | Comments: none

18 May 2007

Anything can happen, anything can be.

This weekend, I'll try to update with a post on how I ended up in OT school (hint: I'd love to know how all y'all ended up on the OT path as well). For now, I need to go read a few articles for Evidence-Based Practice and look at some Biomechanics!

So I leave you with a quick quote.

“Listen to the Musn't's child, Listen to the Don't's. Listen to the Shouldn't's, the Impossibles, the Won't's. Listen to the Never Haves, then Listen close to me. ANYthing can happen, child, ANYthing can Be.” -Shel Silverstein

Category: Occupational Therapy | Comments: 3

17 May 2007

I will be changed.


Things are happening. Daily.
I come across new disturbances
in my routine. I am curiously
unsettled. I dress myself
and the clothes fall to the floor.
I scratch my head. Dust
in my hand. All morning
arranging flowers, and for what?
Petals fallen, litter
on the pretty cloth. I march
straightway to the mirror
and shake my fist. My hand
is a blue maraca scattering petals.
I shout my rage
and hear my words praising
the vast goodness of the world.
This is beyond control.

Even so, I am slowly learning one thing:
of one thing I am slowly becoming
aware: whether or not I would
have it so, whether I sleep
or no, I will be changed.
I am changing as I speak. Bless you all.
Suffer the children. Finished. Keep.
–Scott Cairns

Category: Occupational Therapy | Comments: none

17 May 2007

I'm gonna be a weird OT

I am sitting here procrastinating as I have a final tomorrow and can’t bring myself to study anymore. It’s in Conceptual Foundations on things like ethics, licensure, documentation…SOAP NOTES!

Anyway, I was scrolling through my old, non-OT and very unprofessional blog just refreshing my memory on some of the weird things I’ve blogged about. I came across a post from this fall when I dried pretty colored leaves and then taped them to my wall just for fun, another post where I talked about velcroing chapsticks all over my house so I never have to hunt for them, and a post from where I tried to make my mom a t-shirt with an iron-picture-transfer of 3.14 platypuses (Platypi, get it?) – but only ended up ruining an iron.

I’m gonna be a weird OT.

Category: Occupational Therapy | Comments: 2

17 May 2007

Ora Ruggles: Queen of Struggles


I’ve heard about Ora Ruggles for several months now, in introductory OT textbooks. I was instantly intrigued by the fascinating stories I read about her. She was one of the first reconstruction aides after WW1, and was a pioneer in OT. Her biography was written by John Carlova and is called The Healing Heart. That’s based on her famous line, about how you must reach for the heart, as well as the hands, for it is the heart that does the healing.

I’ve tried to get my hands on this book, but apparently it is out of print and it costs about $60. I was thrilled to discover my local major library had it. I read the book in a single day because it was so great. In fact, the 2005 Slagle lecturer, Suzanne Peloquin, wrote an article on how Ora Ruggles exemplified the trait of empathy (as mostly evidenced by this biography), which is a trait all OTs should strive for.

It turns out Ora was a tomboy who had a rough life. Her father died of sugar diabetes, her mother had a stroke that left her hemiplegic for a long time. One of her sisters was deaf from whooping cough. Ora ended up becoming an incredible reconstruction aide working in various asylums and institutions in different parts of the US. She basically helped shape OT into what it is today. She even knew Eleanor Clarke Slagle personally, and apparently they butted heads a lot! She had a strong artistic knack as well as ingenuity, imagination, and compassion. And of course, intelligence!

Two stories in the book that made me laugh:

1) She and a bunch of other reconstruction aides, who were all young single females, ended up dating soldiers they were working with. One time, she and several other aides went out with their boyfriends to meet their parents, and one of the moms fainted, because every single one of those soldier boyfriends was missing at least one limb!

2) She talked about teaching men how to “rake knit”, a more masculine form of knitting. The aides gave them bright red yarn for its attention-getting properties. These men would knit and knit and knit to stay occupied, making very long scarves. They’d be proud of them and send them to their wives and girlfriends and mothers, so in 1919, in many cities across America, you’d see women wearing long red scarves that were often dragging on the ground, because these soldiers had made them in OT.

————–
So I totally recommend this book, and wish it would STOP being out of print because I think it should be required reading in every OT school across the nation!

One of my long-term goals is to eventually own this book. 🙂

What books do you all recommend to all future OTs??????

Category: Occupational Therapy | Comments: 5

12 May 2007

Shaken Baby Syndrome

Suburban Turmoil (http://www.suburbanturmoil.blogspot.com/) is a Nashville mom with a newborn. In a post titled “Crybaby” (May 10th), she wrote about her son’s reflux and how hard it has been dealing with it, and then posted a link to a recent article about a woman who killed one of her newborn triplets by putting him down violently in a moment of frustration because he wouldn’t stop crying. You could listen to the 911 call on that article page, and it was chilling. What Suburban Turmoil discussed in her post, and what many commenters said in their responses, is how easily it could have just been any mom making that call. She talked about how those first few months can be very frustrating and exhausting and emotional, especially when you have a baby screaming constantly. Many of the moms who responded did share that there had been times they just wanted to shake or scream at their baby to get him or her to shut up so they could get some sleep. I thought it was very interesting to read mothers sharing such intimate details about their experiences. The article and 911 call can be found here:

http://www.winnipegfreepress.com/local/story/3961774p-4574643c.html

The reason I write about this is because of observation experiences I’ve had as well as blog entries I’ve read elsewhere (like at neonataldoc.blogspot.com). Basically, a lot of teenagers have babies. And these babies are frequently born premature due to the risk factors associated with lower socioeconomic status, maternal age, STDs, you name it. Premature babies are at risk for so many problems and are frequently very fussy and often inconsolable. It can be hard for any mother to not get frustrated and emotional when dealing with a crying baby. Now think of a teenage mother with poor social skills and a typical adolescent low frustration tolerance, and think of her trying to deal with her fussy baby who just won’t stop crying. This poor mom is dealing with resentment and inexperience and frustration and anger. I can just imagine how easy it would be to give that baby a little shake or two.

As occupational therapists, if we are working in a neonatal ICU or similar area, I think it’s really important to remember to address problems of frustration with the caregiver. During one of my observations, I remember watching a teenage mother dressing her young baby and getting ready to finally take the baby home. She seemed, at least to my inexperienced eyes, just the slightest bit hostile and agressive in the way she was moving the baby. I saw a huge potential in her to get tired of the baby crying and just try to shut it up in a reckless manner. It scared me a little bit. I was observing a great OT at the time and I was really impressed with how she handled that mother. She explained that babies with a lot of problems might cry a lot, and sometimes it would seem like nothing would make them stop. She advised the mom, in those cases when she was getting really really frustrated, to make sure everything was okay (hunger, diaper change, etc) and that the baby was safe, and then if the baby still wouldn’t stop crying, just walk away for a few minutes and calm down. I thought that was really good advice.

I know I’m only an OT student with VERY limited experience, so I don’t mean to sound like I am preaching. I’m just sharing what was going through my head today about my future role as an OT as it related to Shaken Baby Syndrome, based on that newspaper article I read and Suburban Turmoil’s column!

Have any of you experienced issues with this in your practice?

Have a great weekend! I’m going to try and figure out how to add OT blog links to the sidebar of my blog this weekend, using my very nonexistant html skills. I’ve been thrilled by what I perceive as a recent upsurge in OT-related blogs.

Category: Occupational Therapy | Comments: none

12 May 2007

Ding dong, the week is dead…


This has been the worst week of OT school so far, in terms of academic workload. Or maybe I have anatomy amnesia and don’t remember how stressed I was during that class. This at least SEEMS like the worst it’s been. Anyway, several nights this week have been such that I could only get in 4-5 hours of sleep, but I function best at 8 hours so I’ve been awfully tired! I was working on a bunch of stuff that was due, but neurobiology was hovering over my head. Normally, I’m the type of student that sits in the front row, pays attention, takes copious notes, and studies. For whatever reason, I wasn’t that way in neurobiology, and goofed off alot. I knew as I went to each class that I had no idea what was going on and didn’t understand, but for some reason decided that was okay and that I didn’t need to study. Until this week. Because it was time for our neuro final, worth 50% of our grade. And I started to freak out, because I had so many other things going on. So I studied a little bit Tuesday and Wednesday, when I found time. Thursday, several girls came over around 1pm to study for neuro, and it ended up turning into a 12 hour affair. They left around 1am. While we did go off on tangents and take a dinner break, it was essentially 12 hours of marathon neuro studying. It was actually kinda fun. The material really ended up making more sense. Of course by the end of it as it was getting really late we started getting giddy and everything seemed funny. LATERAL GENICULATE NUCLEUS! HA HA HA!!! Hmm. Anyway, I think we all ended up doing a good job on the final and I am reasonably confident I got an A in the course, so I am thrilled. I wish I had been a better student in his class though. The problem with cramming is that you learn it for the test and then forget it. So on the one hand, it’s unlikely I’ll ever need to know detailed information in the clinic about “the magnocellular neurosecretory system”. On the other hand, if someone comes in with a cut or compressed peripheral nerve, it would be nice to have remembered some of my neuro off the top of my head so I can spend less time looking up symptoms.

Anyway…the week is over. WOO! One more month until summer break!

Update: I did get an A in the course, and the professor was a very nice, knowledgeable man. It was just that our learning styles didn’t mesh.

Any of you have a grad school horror story you want to share?

Category: Occupational Therapy | Comments: 1