Yay! Yay! Yay!

Tonight has gone overall well!

I'm almost done with my treatment project step 1, which forced me to use my OTPF and Occupational therapy for children (Case-Smith) textbook exhaustively. It was hard and I'm not quite finished, but I feel like I managed to fit all the pieces together. My hypothetical child had developmental dyspraxia and it turns out problems with praxis and problems with sensory processing run hand in hand, so I was able to use the sensory integration frame of reference and discuss how some of her problems with dressing, limited play on the playground etc could be due to tactile processing problems since again, dyspraxia/SI go together. I also talked about how she may have somatodyspraxia and/or ideational dyspraxia and I was so proud of myself. AHAHAHA

Also, I had a few friends edit a little thing I wrote for an OT website and neither of them thought it needed much work, so I was thrilled.

ALSO, I heard back from the OT Vice Chairperson of the ASD Committee and her position sounds like it caters to my strengths! I am really excited!

And I am eating a 100 calorie chocolate mousse! Could this day get any better?

Yes it can, because since I'm almost done with my treatment project and it's not even midnight, there is a chance I'll actually be able to sleep soon! Yay! I wasn't going to post again today but I am HAPPY so I had to!

The story of my occupationally not so therapeutic weekend

The more you know, the more you know you don't know.

I've read a ton of articles over the years on how having so much information at our fingertips can be damaging in some respects. We have access to so many things, and so much of it is contradictory, that it is possible to get frustrated and confused on a regular basis. I'm always surprised at people who speak with conviction on things, because I know just enough to know that there is very little in this world that is 100% for sure. I sometimes take that to an extreme and tend to have a questioning attitude on everything. I know a tiny bit about a lot of things, but rarely do I know enough to be positive about something.

I'm working on a case study for our pediatric occupational therapy class. I've been looking up toys that are appropriate for children with cerebral palsy, and I was amazed by the number of websites I found with good ideas. It's hard to pick and choose, and it's also hard to find the time to look through the websites as carefully as I'd like. As I was going through them I was thinking “Oh gosh, this one I should print out for the class, “this one I should print out for a resource binder”, “this one I should show my professor” etc. And then I don't take those extra steps because more and more great resources pop up and I just can't seem to choose!

I've spent the last 3 hours or so working on projects and now I'm taking yet another mini break. I think I'm going to go walking in a minute for some fresh air and sunshine and cardiovascular activity, then get back to work a few hours before calling a few friends and then visiting some other friends. And then back to work again. I don't normally work this much in a weekend, but we are pretty overloaded with work right now. The class is pretty much as overwhelmed as it is possible to get. It doesn't help that I am working on scholarship applications, leadership applications, and writing student articles! That is my own choice though, so I can't complain. With any luck, all my work this weekend will mean that I can mostly just relax next weekend!

Scroll down to read about all the great labs we've had in occupational therapy school this past week, my blog for Monday night will be on the Biometrics Lab and Augmentative Communication/Adapted Technology.

Enjoy your Sunday!

Hoyer Lift Help?

Hi all,

I regularly read a blog Dream Mom, who posts about her child with severe special needs. Dream Mom recently had back surgery and is struggling more so than normal. She is having trouble with her Hoyer lift and could really use some advice on a mechanical issue. If you occupational therapists or engineering minds have any tips you'd like to post here or over on her blog based on the problem she describes, please do so, I'm sure she would really appreciate it. I'm copy/pasting her post in full just to make it more likely it gets read. She can be found at http://dreammom.blogspot.com/

Problem #2: I can't seem to get this legs of the Hoyer Lift to remain spread while I move/transport him. I can lock the legs in the full spread position however then the lift won't go through the three foot wide doorway. If I unlock the legs, then the legs move toward the center (you have to have the legs spread to support the weight of the patient). Does anyone have any ideas on how I can lock the legs when they spread less the full open position? I need to be able to transport him with the legs spread about 70% to fit through the doorway and I need it to lock in place. Here's a picture of the base. In the lift I used at the Respite House, it five slots in the bottom that you could hook the metal post in to lock it in place.

Yes, technically, I know you aren't supposed to transport him however I don't have much space in his bedroom so I am transporting him from his bed to the wheelchair in the dining room, which is about ten feet away. I have been assured this is o.k. from one of the nurses who came to my apartment. She checked the base and wasn't sure how this particular one worked and she uses Hoyer Lifts every day.

Thanks.”

Lab Paradise! Biometrics and AAC left to describe.

Me about to play a space-ship shooting game with only my cheek muscles. Using a $21,000 Biometrics program.
Brooke and Stephanie working on soldering, as we worked on making simple on/off switches to use in toy adaptation.

It’s 2:45am and I’ve spent the last hour writing up lab experiences since I eventually gave up on trying to sleep, so please scroll down since there are about five new posts! This was on my to-do list for the weekend so I’m glad I did it although I wish it hadn’t occurred so late. Oh well, you can’t win them all. I have two labs left to talk about – Biometrics (involving a $21,000 program shown above), and today’s Augmentative Communication/Adaptive Technology Lab, which involved soldering (above)!! So enjoy the posts below, and comment your heart out to provide me with positive reinforcement. I’ll get back to y’all soon with the final two lab descriptions.

I need to do a lot of work this weekend and I’m also visiting with some friends and participating in a Heart Walk tomorrow, so I’ll probably be scarce for a few days. I’m going to attempt to sleep again since I need to be up in 4 hours. Have a great weekend! Hope the two pictures above have deliciously tantalized you so that you come back for more information.

Feeding Lab, based on SOS protocol + other feeding programs

Brooke feeding me yogurt using jaw support.
Allison blowing bubbles in preparation for starting the feeding session. You can go around and blow bubbles first, and then introduce foam soap to wash hands at the table, then start with the feeding.

Food art, probably by Virginia if I had to guess (my camera was hijacked).

The orange/brown foods we ate!
Marla’s trying hard, but Patchez doesn’t look too happy with how things are going! She hates pudding!

This morning we had a three-hour feeding lab, with two visiting therapists in Memphis as well as one in Chattanooga (distance learning). We were following the SOS feeding protocol, which recognizes there are 32 steps to feeding and that children with feeding problems should be treated with understanding and compassion using the rules of the program. It is important to realize that for children with severe eating problems (not just being picky), the children won’t just eat when they get hungry enough – they can literally starve themselves to death. It’s also not true that eating is our number one priority! Different pediatric diagnoses will have different problems. It can range from swallowing problems in babies who had G-tubes to tongue thrust reflexes in children with cerebral palsy. The first hour was lecture on the different textures of foods, food crises and how to solve them (like if the child is gagging or coughing), and how to solve common food problems. (Food too dry? Add butter. Etc).
The second hour we focused on handling techniques that help with chin support, lip support, jaw support, or a combination. Some children may have such low tone they can’t keep their mouth closed while eating, for example, so you may help them support their face in a way that allows them to eat their food without it spurting out. The therapists also pointed out that Stage 3 Baby foods (combination foods of puree/chunks), are dangerous and should not be eaten. The reasoning is that little babies who learn to eat puree do so with a sucking motion. To introduce a combination food before introducing the small chunks previously can cause choking or gagging since the baby doesn’t have the oral motor skills necessary to deal with these chunks. Therefore, babies should be introduced to purees, then little chunks, BEFORE combining the two. Also, Cheerios are dangerous for younger children because they don’t melt in the mouth. There is a new line of Gerber graduates that have cereals that are meltables, and that is essentially because one of the SOS creators is a consultant for Gerber now.
The coolest thing we learned in this hour is how to deal with a bite reflex of a child with hypertonicity. Let’s say you stick a spoon in a child’s mouth with a bite reflex and they clamp down and won’t let go. You might be tempted to go OH NO and start trying to tug open the child’s mouth. This will make it even worse. Instead, there is a technique to rub your fingers down the nasolabial folds (smile lines) of the child in such a way that it helps remove the spoon. It’s pretty cool.
Another thing I learned through previous experience, but I have no verification this is okay as this was NOT in the feeding lab, is that if you have a child who puts something inappropriate in their mouth (like say, a mound of silly putty), you can immediately tilt their head forward with the chin tucked in because that makes it very hard to swallow. Try it right now – tuck your chin in as far as it will go and try to swallow. Difficult, right? I was once working with Celia in one of my first sessions with her, and her mother was sitting with us. We were playing with some neat silly putty and she quickly put a big chunk of it in her mouth. Before I could even blink, her mother (ICU nurse to the rescue) grabbed her head and pushed the chin forward so she couldn’t swallow as easily, and then fished it out from that position. I asked the therapist about that and she said she had never heard of that but she would ask her SLP about it. So I’m not recommending that since I don’t know for sure this couldn’t cause a problem. Still, a good thing to ponder.
During the third hour we did a typical feeding session. We were in circles of groups of six in Memphis, and went through the feeding protocol. Basically each person acts as a social modeler and the key is to play actively with the food and explore it, and there is no bribing or forcing of anything. It is a safe, playful environment. You do a progression of food that typically always has either color or shape in common. For example, we started with a line of chocolate pudding, then moved to a hard pretzel rod, then a cheese stick, then a carrot stick, then a Cheeto stick, and so on. You are definitely encouraged to mess around with your food – OH THIS ORANGE STICK FEELS SQUISHY ON MY FINGERS AND IT WIGGLES. CLOMP CLOMP IT IS JUMPING AROUND MY PLATE! Etc

Origami Boxes – Media Lab

My finished origami box. Brooke let me borrow her wrapping paper, thanks!

Anna’s duck box, quack quack

Julie working diligently.

My partially unfolded origami box showing my half-hearted snails.
===========================

This lab was interesting, although as a general rule I hate origami.

Basically you fold three sheets of paper in the exact same way. Then you tape them together. Then you take two pieces of foamboard that are the same size as the folded-papers, puff up some cotton and glue it to one side of each piece of foamboard. Then you wrap each piece of foamboard with wrapping paper or tissue paper. You glue the foamboard to the paper so that it looks like a gift, although on the bottom piece you also glue/tape on some ribbon. That way you can wrap it up like a gift and it is very compact, although if you open it it is almost like an accordion. You can decorate the insides with pictures, stickers, drawings, whatever. It can be really cute! Also therapeutic, if you don’t hate origami. I guess you can work on frustration tolerance if so.

Reiki & Chakra Bear- Intro for Occupational Therapy Students

I’d now like to introduce you to my very own invention, CHAKRA BEAR!!!!!!!!
This bear is named “Choku Rei” as her belly’s power denotes the first Reiki symbol and represents energy with a purpose. (Note to self: Next time I complain about not having enough time, remind self about Photoshopping Carebears at 2am.)

Meg healing my headaches using CHAKRA POWER!

(Emily healing something in her back!)

According to www.reiki.org, “Reiki is a Japanese technique for stress reduction and relaxation that also promotes healing. It is administered by “laying on hands” and is based on the idea that an unseen “life force energy” flows through us and is what causes us to be alive. If one’s “life force energy” is low, then we are more likely to get sick or feel stress, and if it is high, we are more capable of being happy and healthy.”

We recently had an hour lecture on Reiki by a fellow OT student, Cheryl. Our professor is having us give presentations on various techniques and he is interested in making sure we have exposure to many different techniques, even ones that most Americans greet with skepticism. I personally think it’s pretty cool!

We learned about “ki”, which is an unlimited spiritual energy flowing through pathways called chakras. There are seven major ones. The women’s power center is above/between the eyes (the glabella area?), and the men’s power center is in the solar plexus.

A really simplified explanation of how this works is that you can hold your hands in various positions over the main chakras for self-healing, although you could do it to others using a very gentle touch. You might do this for about 5 minutes until you start to feel some tingling or other sensation that tells you you are ready to move on. Virginia commented this was probably just a sign your hands had fallen asleep.

While I made some jokes about Reiki, I do think it has potential and that it is important as occupational therapy students to be aware of the many different ways one might approach treatment, and that we shouldn’t automatically discount more Eastern-based treatments! I really do like the idea!

Chakra Bears unite!

Binder Overload – OT Students Bewarned

Patchez & Julie have the biggest binders in the class. The binders seriously look bigger than the girls. I literally go through 2-3 inches of filing a week for classes, but I put a lot of stuff into storage binders so I don’t drag these monsters around!

Kinesiotaping Lab for Occupational Therapy Students

Caption: Virginia showing off her taped shoulder, with three layers of tape covering different muscle bellies.

We recently had a session on kinesiotaping. Here is the introductory quote from the official Kinesotaping website:

“Kinesio Taping has emerged as the rehabilitative taping method within the US and international medical communities. Kinesio Taping, or simply “KT”, is an absolute must-have skill for the committed musculoskeletal practitioner. It’s easy to learn, requires a minimal initial investment, and is reimbursable with many carriers. The elastic, latex-free tape takes very little time to apply, is long-lasting (stays on 3-5 days) yet easy to remove, and is suitable for patients of every age or condition. KT is extremely versatile in its ability to re-educate the neuromuscular system, promote lymphatic flow, reduce pain, enhance performance, prevent injury, and promote injury resolution.”

================

We watched short clips of the Kinesotape demonstration video and then practiced on each other. It can really reduce pain and/or make a surprising difference. You can apply the tape going from origin of muscle to insertion if you want to help the muscle contract (like in weakness) and apply it from insertion to origin if you want to lessen the strain (like in carpal tunnel). I might have this backward, I’ll check my notes soon. It will definitely make your muscles feel weird, like they are tingling. It can also leave you sore. This past summer I had physical therapy for back issues and the PT taped up my scapula one day to alleviate some pressure (I have really mild scoliosis), and it felt so weird! Even having the tape on for about 10 minutes at a time during this session was slightly odd. As an added bonus, you’ll get free hair removal when taking the tape off if you aren’t careful. Eyebrow wax, anyone?

Me demonstrating my beautiful taping job on Meg.

Virginia taping up a foot for plantar fasciitis.

The Arrogance Rollercoaster + Lots of Labs

I’m exhausted, which means I can’t sleep. I have a bunch of labs to write about and I am realizing that for blogging traffic purposes, it is best if I submit about 10 mini posts on different labs then write one really really really long one like I typically do. So that’s what I’m fixin’ to do. Guess I’ve been in the South too long when I start using that term! That’s right, I’m in Tennessee. I’m outing myself as a University of Tennessee Health Science Center (Memphis) MOT student. Those of you who found me through OT Practice already knew that. Those of you that didn’t, well, please don’t stalk me. I have bodyguards.

I said yesterday I’m applying for the TOTA (Tennessee Occupational Therapy Assocation) scholarship and ASD Steering Committee. Yesterday I was arrogant. Today, after looking more closely at the application and thinking about the staggering odds (at least for ASD), I am humble and scared. It’s funny how your confidence levels can rise & plummet so much in just 24 hours. I still plan to do it though, rejection is good for skin-thickening.

I’ve also decided that while I refuse to give up my stream-of-consciousness stressed postings, I’m also going to try and write slightly more concisely/formally the rest of the time. I’ll still be incredibly random though, oh look a ladybug on a camel.

So. Enough blibbly-blabbering. Let us commence with the concise verbal descriptions and stunning pictorial evidence of our most recent labs.

Here is the outline (all of this took place this week!)
1. Kinesiotaping – Technique
2. Reiki – Technique
3. Origami Boxes – Media Lab
4. Feeding Lab
5. Biometrics
6. Augmentative Communication/Adaptive Technology Lab