You know you're tired when…

your bedroom light is on as you lie/lay/whatever in bed trying to get up the energy to get up, and you keep thinking – why do the lights keep going out? What's wrong with the electricity? And then realize it's just your eyelids slowly opening and closing.

Gonna be a long (but hopefully pretty fun) day! Yay OT school 🙂 Time to get ready for the online management meeting in 20 minutes! Have a great day everyone!

PS: I'm as always a little behind yet again on e-mail/Facebook/any other method of communication – I promise to respond soon – maybe tomorrow! Woot woot!

Monkey vs robot will have to wait another day…OT school beckons :(

So…I had an intention of doing another blog blitzard, because I have a lot of small random things to share…but I just got home since being gone for 14 hours and I have to work on my management class strategic planning stuff and my leadership paper + deal with about a bazillion new school-related emails that need immediate attention. Seeing as how it's 11pm and I'm tired, I guess I have to prioritize for once! Boo!

Tomorrow or soon you can look forward to the age old OT question: “Monkey or Robot?”, Caregiver Burden, a picture of the MOT class of 2010 that just started at my school, our superhero tech guy's glowing review of OT students, some e-mail copy/pastes from some fun readers, etc etc. Plus, of course, a crazy story with a picture, all about how you should vote for Brooke & me.

My tomorrow list:

830am: online management meeting
10am: class
noon: total body conditioning class w/ at least 5 other OT girls at the gym
2pm: learn to input our research data into research database
5pm: go to a fancy dinner with some very nce people who are treating lol
7pmish: Possibly hang out with OTS Virginia 🙂

Rest of the time: work on assignments! Stuff is starting to creep up!

PS: I thought it would be a good idea to do campaign songs American Idol-style and post them on YouTube, but my friends nixed the idea and said it would be annoying! :O

Mother of child with autism talks about her experience with occupational therapy…

The aliens want OT

I'm writing this from outer space. A few weeks ago, aliens came down and said that the only way they would leave peacefully without pulling “Independence Day” stunts was if occupational therapy students would go back to their home planet with them. You see, they observed our entire planet, and got jealous because these aliens have a lot of anatomical deformities that could helped with adaptive devices and home modifications. Of course, they wanted occupational therapy students that were enthusiastic and motivated – (cough the exact kind of OT students that would be great in the Assembly of Student Delegates Steering Commitee cough). So they flew here in their ultrared infrared maaxlox V30202 space cruiser and picked us up. They were nice enough to snap a Polaroid shot of our terrified faces because they had learned we liked photo documentation through their observations. Now we're used to this alien lifestyle, and we've made a ton of changes for them, and they say we can come home around February 20th, the last day AOTA student members can vote.

Ha, in your face, other professions…occupational therapy rules.

Breaking News Update, courtesy of my new friend Keith!

OT was #21 of the 31 best careers in 2008 by US News and World Report magazine!!!!!!!!!!!!

The OT world loves Brooke & Karen. So does Andy Warhol.

It was 1963. Karen and Brooke were but negative 20 year old twinkles in their parents eyeballs. Yet they already knew, way before they were ever born, that they were destined to become famous OTs. When finally born in in the late 1970s (Brooke) and early 1980s (Karen), they set on their path to OT famedom. They helped save the world many times over. Especially with their hard work for the Assembly of Student Delegates Steering Committee in the 2009-ish times. They were so inspiring that Andy Warhol used time travel to do his amazing artwork using their faces. Because Andy Warhol loved OTs. Just like everyone else should.  We should note that due to how the time-space continuum works, if Brooke and Karen are in fact not elected to ASD, the world may crumple in on itself and turn into a massive black hole. So. Perhaps people (and by people, we mean AOTA student members) should go vote for us within the next month.

http://www.aota.org/News/AOTANews/VoteHere.aspx

Rebuilding Together…OT students + home modification

A fellow OT student and blogger, Mama Chill, left the comment below on my Aging in Place Post. I want to share it. I had never heard of this organization, but it does sound like a great way for an OT student to gain some awareness and learning, while also helping others – a win-win! 🙂

Glad to see the posts again 🙂 Hope classes are going well; mine starts tomorrow (just when I started getting relaxed too, I guess break is never long enough). Anyway, you may already be aware of this organization Rebuilding Together. Their focus is low-income, elderly, disabled and to help them stay in their homes by making home modifications and also ensuring homes are safe. Their website does a much better job explaining it; go check it out!

One of our professors is on the board for the local chapter and last semester we helped two families clean up/modify their homes. It was a great experience and gives great perspective that every OTS would benefit from. I know I learned quite a bit.

Finally…an update…gerontology continues.

Caption: I just got a drastic new haircut and I’m struggling with the swoopy bangs!

I’m sorry I haven’t updated much lately. I normally go overboard and post TOO much and now I’m going underboard. Which probably means I’m drowning. Hmm.

Anyway…here are a few tidbits of things I’ve learned or thought about lately.

When you see someone sign their name Bob Smith, OTR/L….the R is referring to the fact they are certified through the national body, NBCOT….while the L stands for your state licensure, which not all states require.

——
I was recently at a Mexican restaurant w/ a bunch of OT girls and when I went into the bathroom, I noticed it was not very ADA-complaint… somewhat unaccessible. The handicap sign was on a normal stall instead of the handicap stall, and the angles were so sharp that it would be very difficult to get in to the stalls. That’s the kind of thing I never would have thought about before OT school. It’s all about universal access!
————————

This is our geriatric semester, so we’ve had several lectures pertaining to the topic. One of our lecturers explained that in old age, we continue to be who we always were, only more so…” I took that to mean our personality characteristics become a little more exaggerated. We also did a chart of stereotypes of older people, looking at both positive and negative stereotypes. Typically, OTs are going to see the elderly person at their worst, since it is usually at a time of crisis/stress. We need to remember that we are just seeing one side of their personality at that time! I’ve talked about this before, but it’s so important to do some decorating of an elderly patient’s hospital room. Flowers, cards, PICTURES – things that remind the staff this person is loved and a real person, regardless of how low level he/she currently is.

We also learned about the difference between dementia and delirium – to condense a lecture into a sentence, dementia is more chronic and delirium is more acute.

We learned that white males over the age of 65 are most likely to commit suicide after a loss, and it is usually via violent means. As OTs we have to be aware of this statistic and look for warning signs! This is kinda scary to me.

Finally, we learned a little bit about Medicare/Medicaid. Honestly, this is still very confusing to me!!!!!!!!!!!!!

Part A – Medicare covers 80% of approved charges
Part B – out patient services
Part C – private Advantage programs like fitness?
Part D – prescriptions

*Typical student disclaimer: This is all my own understanding and I could be totally wrong. Don’t trust me as a source!

UPDATE: My friend Suzanne sent me an e-mail with her more in-depth understanding of Medicare, which I am copy/pasting here.

Part A – This is the coverage for INPATIENT expenses only — it pays 100% of approved amounts after a deductible, and is good for the first 60 days of hospitalization that are NOT broken up by a period of 60 days out of the hospital. If the patient is re-admitted within 60 days of their last hospitalization, they don’t pay another deductible. However, if they then are hospitalized for days that add up to over 60 without a break ( i.e. days 61-90), the patient is in what’s called their “Co-pay” days. For each of these days, the patient is assessed a “co-pay”, I don’t know the amount any more, but I think it’s about 20-25% of the deductible. If the patient remains hospitalized beyond 90 days, they go into what are called “Lifetime Reserve” days, which are finite. If you use Lifetime Reserve days, you never get those back, and you are charged 1/2 of the inpatient deductible for every day in the hospital. You could use some of your Lifetime Reserve days, stay out of the hospital for more than 60 days, then your “normal” days would start again (deductible at the beginning of the stay, good for 60 days, etc.). I could be wrong about some of this
Part B – Out patient and PROFESSIONAL (doctors, etc.) services covered at 80% of approved amounts after the yearly deductible.
Part C – This used to be for children whose parent’s status qualified them for Medicare. For example, a retired person who has a retarded, dependent but adult child — the adult child would be the one who qualified for Medicare Part C, with the ID # being the parent’s SSN + the letter C after.
Part D – prescriptions

Medicare numbers with an A after have full inpatient and outpatient coverage; with a B means they ONLY have Part B (no hospitalization); C used to mean child, and is the equivalent of having full coverage; I’m not familiar with Part D now, though I do know that’s the prescription drug part of it.

NEW UPDATE: My friend wrote the following regarding the statistic above of men over age 65 being most likely to commit suicide.

I can’t speak for the Gen Y people – the ones your age and younger and how they will behave when they grow older, but I feel pretty comfortable talking for those who are now in their 30’s and older. Guys are “doers” and when they can’t “do” anymore then life loses the majority of its meaning. Doing can mean anything too. It is something special and unique to that person. It could be carpentry or driving or even something really esoteric like being able to multiply three numbers by three numbers in your head. Life without meaning is not life.

It does not mean much to us just to hang around and watch the grandchildren and great grandchildren if we can’t “do” something with them. Part of it is culture and upbringing and part of it, I swear, is genetic.

Also a “loss” usually means someone has to take care of the individual. Unless the individual is wealthy, that usually means the spouse. No male at 180 pounds wants to inflict looking after them over the long term on their 120 pound spouse. The nuclear family and/or extended family is no longer there. They are spread to the winds, so only rarely are you going to see brothers, sons and nephews participating. No loving husband wants to inflict this on his spouse. Also, suicide is not the “sin” it used to be. You don’t go straight to the really warm place anymore.

As to why it is predominately true for whites, I can only speculate. In the Asian culture, the male is still so predominant that it may not occur to them that the caregiving is such a sacrifice to the spouse. Also families are still more close than in the non-Asian cultures.

In African culture, I believe there is still a greater religious and cultural intolerance to suicide, at least in African Christian culture. Past that I do not know.

As to the violent means, that’s because we know what works. It may be messy but you can control where the mess is, i.e. the backyard or an interstate bridge abutment. You control the where and the when. Pills and alcohol or sticking the head in the gas oven is too easy to screw up where you either fail or screw yourself up worse to where you are still alive but now are totally incapacitated. A round through the back of the throat or aiming the pickup at a bridge abutment and going to warp works every time.

You need to read “Born Fighting – The Scots-Irish in America”; it will give you some good cultural insights.

These are just my thoughts with no scientific basis to back it up. A lot of the conclusions come from the suicide a long time ago of a great-uncle who was a M.D.

Occupational Therapists Kick Some New York Times Bootie :)

This was copy/pasted to the Tennessee Occupational Therapy Association (TOTA) listserv, and I am again copy/pasting it, since it is a great example of OT. This article is from the New York Times and there are links to it are at the bottom, since full articles are accessible online.

In the Trenches the Occupational Therapist
Coaching the Comeback

By JAN HOFFMAN
Published: January 15, 2008

WEST ORANGE, N.J. – In the therapy gym for the minimally functional, Jodi
Levin props a patient between cushions, kneels behind him and then braces
him with her arms. She directs his mother to select photos of his brother
and his father. At the coaxing of Ms. Levin, an occupational therapist on
the brain injury unit of Kessler Institute for Rehabilitation, the mother
holds one photo to the left side of the patient's head, the other to the
right.

“Look at Dad's picture,” Ms. Levin urges. “Dad's on the left. Find Dad. You
can do it!”

The patient, wobbly and glazed, tries mightily to understand her command and
then heed it by compelling his neck to turn. He almost makes it.

Gently letting him go, catching him as he flops, Ms. Levin explains to his
mother, “Now I'm working on trunk control.” The man flinches. “It's the
basis of everything,” she continues. “For getting in and out of bed,
brushing teeth, getting dressed.”

Eight weeks earlier, the patient, 18, wearing a helmet and protective
leather gear, had been riding his motorcycle to community college. As he
came over a hill, the car in front slowed abruptly; to avoid hitting it, the
teenager swerved and was hit by an oncoming car.

Remarkably, his body survived relatively unscathed. But he suffered a severe
traumatic brain injury. He cannot yet swallow food, control his bowels or
regulate his body temperature. His brain cannot yet send messages to his
limbs. He cannot speak.

When he arrived here, his eyes were open but unseeing. He has already come a
long way.

His care is overseen by neurologists and physical medicine doctors. But it
is the job of Ms. Levin, his occupational therapist, to plan exercises that
will help him develop or adapt skills to live as safely and independently as
possible. She also educates and supports family members as they adjust to
their loved one's new normal.

Now Ms. Levin puts her grimacing patient, who wears nerve stimulators 12
hours a day, onto a therapeutic exercise bike. The machine moves the pedals,
but as he initiates more movement, it will calibrate. She straps him in,
jesting, “I can't wait for you to yell at me and tell me this stinks.”

The boy's mother watches Ms. Levin tearfully. “Some people talk around my
son as if he's not there,” the mother says. “But Jodi talks right to him.”

Ms. Levin, 28, has worked on the brain injury unit here for six years.
Daily, she confronts the fallout from behavior that has been reckless or
cruel, with injuries caused by drug overdoses, drunken drivers and drive-by
shootings. Many of her patients have had strokes or brain tumors. She has
also treated Iraq war veterans, who are now trickling into nonmilitary
facilities like Kessler largely because of the persistence of their
relatives.

Her treatment plans adjust to the serendipity or horror of a split second: a
hit during a football game, a slip on an icy patch, a veering car. Annually
in America, there are 1.5 million traumatic brain injuries, a category that
includes external blows to the head but excludes damage caused by illness.

The extent of destruction to a brain, the possibility of recovery for each
patient, hinges on so much – and so little. Ms. Levin's definition of
optimism for one patient may be regaining the ability to drive. For another,
it may be the ability to blink in assent.

When patients sustain frontal lobe injuries, their personalities can be
affected. They may unexpectedly become agitated or angry and have difficulty
filtering inappropriate language. On occasion Ms. Levin's hair has been
pulled. She has been kicked, groped and bitten. “The families are so
embarrassed,” she says. “I keep explaining that it's the brain injury, not
the patient.”

Yet even in her brief career, there have been advances in occupational
therapy, which can address many mental and physical disabilities. Ms. Levin,
who has a master's degree in the field, has been adding computer-generated
programming to her capacious toolbox, which includes blocks, flash cards and
cutlery adapted for stroke victims. The prognosis for many patients is
improving.

At the same time, though, insurance companies are demanding more frequent
updates, with proof of functional rather than cognitive progress. Otherwise,
requests for further therapy may be rejected.

In reality, Ms. Levin says, cognitive ability often precedes functional
progress. “A young brain won't plateau at month two or three,” she says in
frustration, during lunch break. “Recovery from a brain injury is not like
the flu. It takes a long, long time.”

On this early day in the new year, Ms. Levin has seven patients. Three are
18-year-old men. The winter holidays often bring a surge of adolescent
patients and their victims to acute rehabilitation centers. Elsewhere in the
unit's two gyms, therapists work with patients who were passengers in car
accidents. Another influx of this kind of patient tends to arrive shortly
after spring break.

Her second teenage patient, a bright high school athlete, went to a party at
which prescription and illegal drugs were swapped. He was the only youth
there whose body reacted starkly. He went into cardiac arrest and his brain
lost oxygen, before doctors were able to revive him.

During his session this day, Ms. Levin places her face close to his, and
makes simple, cheery conversation, trying to hold his gaze. “Hi!” she says.
He stares back, eyes widening, eyebrows raised in concentration and effort.
His jaw lowers. “Hi,” he mouths silently.

“That's a breakthrough!” she says joyfully.

Ms. Levin sets weekly achievable goals for her patients. “I invite families
to watch my sessions,” she says, “so when they visit, they don't say, 'Is
that all he can do?' I want them to see how hard the patient is working to
achieve holding up his head.”

She sees her third 18-year-old in an adjoining gym for more functional
patients. The boy is healing from an operation in which doctors temporarily
removed a section of his skull to accommodate brain swelling. His jaw is
wired shut. He has visual and cognitive impairment.

In early December, he drove after having a couple of drinks, crashed, flew
through his windshield and hit his head.

But last week, after interviewing his family about his activities, Ms. Levin
had him playing tennis with a balloon. A few days ago, he halted his
wheelchair before a vending machine, correctly counted his coins and got a
soda. On this day, holding a trained therapy dog by a leash, he walks
haltingly across the gym. She hands him a word-search exercise: he picks out
three-letter words. By the end of the mont
h, Ms. Levin expects him to go
home and to start outpatient therapy.

“He's a miracle,” she says.

As for her feelings about his own role in his injury, Ms. Levin says,
“Everyone deserves a second chance to redeem themselves.” Nonetheless, she
adds, she would like to show videotapes of her patients to high school
students.

One patient in particular haunts her. He was a 21-year-old drunken driver
who survived a terrible accident. After many months, he left Kessler in good
shape, mentally and physically. Ms. Levin happened to work a rotation in an
outpatient clinic and continued treating him.

“He'd come in and boast, 'Hey Jodi, I was out drinking last night, blah,
blah, blah,' ” she recalls. “He was my biggest failure.”

She glances around the gym, at therapists and doctors working with patients
in various states of alertness. A father tenderly kisses a young woman on
the forehead as she stares vacantly. An elderly woman tries to sort plastic
knives from forks.

“I had a young boy, about 20, who had been in a car accident,” Ms. Levin
says. He had been driving at night, was blinded by headlights and, in the
ensuing crash, was ejected.

He was in a coma. He had brain surgery, plus broken legs and wrists. Ms.
Levin treated him for three months. He left Kessler with a walker. During
her outpatient rotation, she continued working with him.

“He still has memory deficits,” she says. “He repeats himself. But he covers
it well. He can drive now, and he has a job stocking shelves.”

The accident was three years ago. He talks of going back to college, perhaps
to study occupational therapy. “He called recently and said, 'Can you help
me find an O.T. school that will accept me?' “

She smiles tremulously. “When you have one good patient like that,” she
says, “he sticks in your head. He gives me my drive. I think, 'It can
happen.' “

—2008 The New York Times Company

See Audio Slide Show (Flash) — “Retraining the Brain” / “In the Trenches
the Occupational Therapist”

http://tinyurl.com/39nksg or

http://www.nytimes.com/interactive/2008/01/14/health/20080115_TRENCH_FEATURE
.html#section1

Also find photos and a link to email the author with the article online
here: http://tinyurl.com/3cy7dv or

http://www.nytimes.com/2008/01/15/health/15tren.html?_r=2
<http://www.nytimes.com/2008/01/15/health/15tren.html?_r=2&oref=slogin&ref=n

Hola, occupational therapy students… Yo soy Karen…no me gusta Muzzy…

I was in the Special Care Unit of the local pediatric hospital, holding a fussy baby less than a year old. I was standing up with him in my arms, next to his crib since the tubes only go so far. I was kind of gently dancing with him as his TV (which I forgot to turn off) showed Pooh & his friends dancing. He hadn't been very responsive to my coos and singing.

Then my eyes were drawn to some sort of game near the crib – it was in Spanish. Anyway, inspiration struck, and I realized maybe he was more used to Spanish. So I said to him the only thing that popped into my brain at that time…

“Hola, donde esta la biblioteca?” (Hello, where is the library?)

Yeah. It didn't work…

*I've had Spanish most of my life…but when I spent my year in Norway it took over the Spanish part of my brain and now when I try to think in Spanish, Norwegian words come up instead…ugh.
*This was while volunteering – although I get to shadow an occupational therapist next Friday morning there! Yay! I cannot wait to both shadow AND volunteer there!