Pediatric day/SI day for OT!

I was looking at how to make homemade weighted blankets and they were a lot of work. Really only worth it if you love to sew/have lots of patience, and also don't have a lot of money. Weighted blankets provide firm deep pressure that is very calming to most hyperactive children and really most people in general. Think about the lead apron they have you wear at the dentist office and how nice that feels – its for the shield and not the pressure, but when I am having dental procedures done I request they leave the lead apron on the entire time.

I was researching weighted vests today as someone inquired at the clinic about them and they are all so expensive from catalogs. I was looking at Abilitations, Southpaw, Fun and Function, Sammons and Preston, etc. It occurred to me that maybe a walking vest would work just as well – you know, the 10 pound or more vests that people wear while walking to enhance their workout. Anybody tried a walking vest for SI purposes?

Today I prepared a trampoline, tunnel, peanut ball, and host of other items in preparation for a child with ADHD and other similar problems (new phrase I learned today: severe axial hypotonicity, often associated with mitochondrial disorders). Of course the child didn't come – that's what happens when you prepare a lot. Oh well, I'll be ready next week. 🙂

I also pondered how to reduce severe pain after burn (meaning beyond the stage it should be hurting that badly anymore) – I am going to try a TENS unit on the forearm in the acupuncture points of Li3 and Li10 I think it is?? to see if that helps during the actual session. I wrote a burn therapist with some questions regarding severe pain, webspace contractures, etc. I also worked a lot on understanding the Peabody and think I'm pretty close to ready! I understand the basal and ceiling levels and how to calculate ages etc, entry points, now just need to study the instructions on what to say, etc.

I'm trying to think of what else I learned today. I did stare longingly at some “fish sticks” or long chopstick like devices that are great for kids to use like tweezers to pick up items. Speaking of which, my PT partner told me of something her son had to do as a pre-writing skill, which is to use large push pins and use them to trace outlines of objects on a buletin board….ie a simply shaped animal is outlined with many pushpins so the kid has to grab the pushpin and push it in, many times over. Great prewriting muscle work up.

Tme to go shower! Time flies!

OT trying to eat healthy, lol

I haven't written on here much this past week. Seems like I stay busy whether I have lots of patients or not. There is just SO MUCH LEARNING and RESEARCH! There will never be enough hours in the day to tackle all the things I want to learn about. And more importantly, retain what I learn….

Lately my week-day life revolves around work, working out, and eating fresh and healthy as much as possible, so a lot of time researching food stuff. Hardcore. Spent like an hour looking at the raw food movement today. Depending on the day also some OT research as well in prep for next day. Weekends I stay out of town usually, getting away from work seeing as how I live on my work campus, haha.

So today…
I started outpatient on campus and had a 9am, 10am, 11am, treatments, all of which lasted full hour with total one on one attention as I still can't seem to let go of my patients, haha, and noon eval….then I was supposed to be inpatient by 1pm but was 15 minutes late for that….oopsies. Luckily inpatient didn't need me to treat much, just one patient, then supervise a student temporarily, then I went back to OP to write up the IP note as well as all the other OP notes…still need to finish the eval. It's orthopedic so it is a challenge for me, I'm more used to neuro!

After work I came home to chill out with my cat and play online and read about raw food (reading blogs is relaxing to me, nothing intense)….worked out at the gym then took a walk…talked to a friend…watched Glee with interns…home to shower/prep for next day. Dinner/dessert was something I'm proud of, are you ready? I never used to eat this kind of stuff….all of this stuff was natural ingredients, minimally processed, that I put together myself.

1. Spinach salad with Belle Chevre goat cheese, avocado, a dollop of hummus, with a combination of roasted zucchini, mushrooms, orange bell pepper, onion and weird curlique peppers…(last night's also had kumquat but I ran out, I love those things!!)
2. Sweet potato fries with nut butter coating
3. Frozen banana with cocoa/agave nectar/cashew butter on it.

So normally I don't randomly talk on my OT blog too much about random topics but I wanted to share today as the healthy food crap is becoming a big part of my life/attention these days, still got a ways to go. I try to NOT spend too much time on OT outside of work or it would drive me insane/burn me out quickly.

Today I saw a PT working on standing tolerance I guess, while having pt work on Mod-Podgeing something, I am sure she got the stuff from rec therapy…I was jealous at the idea! I really get stuck sometimes on inpatient ideas (ie how to be occupation based) when it comes to people who need basic strengthening….I guess I could try to avoid dumbell and machines and stick to laundry, making bed, etc, but that's not always feasible from a time frame, cognition, language barrier, kind of perspective.

BLAH. it's almost midnight and I should not still be online. Lester is snorkeling next to me, what a little dork face. 🙂  It's time for people to start taking boards and I'm getting more questions on that so I guess one of my next posts better be about boards!!

Okay Lester just got into my arms making it hard to type, I think it's the sign I needed that it's bedtime seeing as how the temporal cue was clearly not strong enough. I needed a feline tactile cue as well. :0

If any of you OT related peeps out there – no matter how far removed – have some thoughts they want to share on OT, let me know so I can post it!

Loooooooooooooooove, in a like kinda way, so really just Liiiiike, Karen

Lester's back, wheelchair basketball done, OT coming up for the week, etc

Strokes, paraplegia, peripheral neuropathy, accidents leading to brain injuries, and pediatric clients with sensory issues, CP, ADHD, etc are the bulk of my caseload right now.

I just learned about Cisplatin-induced peripheral neuropathy and how it can start causing symptoms months after treatment stops, and how severe sensory ataxia and pseudoathetosis are frequently seen with this diagnosis. Pseudoathetosis meaning you may see movements of the fingers resembling athetosis and it’s because of damage to the proprioceptive pathway. People with this issue will have a positive Romberg’s sign, meaning that if they put their feet directly together while standing and close their eyes, they lose their balance instantly. Very interesting to me.

Also learning about brain injury and how it can “jog” the cranial nerves and cause vision, hearing, olfactory senses, etc, to go awry.

Also continuously learning more about sensory issues – sensory modulation, sensory registration, etc. Was re-reading Greenspan’s famous book about encouraging growth in kids with special needs and the need for closing “circles of communication” this weekend, ie not just giving your kid what they want right away but rather playing gently dumb to draw out communication. They bang on the fridge and you know they want juice? Play dumber than usual, gently. Ask if they want milk. Ask if they want something else. Draw it out a few times, not to the point of INSANE temper tantrum but enough to frustrate them enough that they communicate more than they would have you just gotten it for them. Then reinforce it. Lots of great idea in Greenspan’s book. I read that he just died, that made me sad. I consider his book one of my OT bibles.

This weekend: Germany just barely beat USA In an exciting world championship game of women’s wheelchair basketball. Saturday evening was a party at my friend’s house and she and her husband are AMAZING cooks – he smoked pork and turkey and chicken and corn on the cob, she made an amazing four layer Paula Deen chocolate mousse cake + pasta salad etc. It was my first gluten challenge in over a month and it went surprisingly well. I think maybe I’m more sensitive to carbs and processed foods and sugars than I am necessarily to just gluten, but I’m still going to try and stay predominantly gluten free + processed food free. with occasional splurges. Today my friend and I went on a hike in the forest trails surrounding the Institute here – I knew VAGUELY how to get to a waterfall but wasn’t positive. A few turns and mistakes and ponderances here and there and we finally ended up at the waterfall, it was nice and beautiful and I took pics to come later maybe. We got semi lost coming back too – never off a marked trail but lost in the sense of which trail to get back home. We eventually figured it out and so the roughly 1 hour trip took us more like 3ish….when we were on the final part back to my house which is PAVED, after several hours of carefully navigating, I guess I stopped being careful since it was familar ground again, and I slipped off the paved part with my ankle into the dirt part and kind of sprained it. I had to sit down on the path, I couldn’t walk on it, it was hurting. My friend is a girl scout and so she cracked me up with pouring out the ice in the water bottle and putting it into the plastic bag we had the bottles in, to put on my ankle and elevate for a few mins. When I could walk again we finished getting home, I felt so sheepish!! It was fine a while but now it’s a little swollen and I’m hobbling. Following the RICE principles + drugs. When I got my drugs, I had to give my cat some treats because when he hears the bottles rattling he is like a little junkie and his ears perk up. He thinks bottles rattling = treats. Yep I have my adorable special needs kitty back for about a month. I love me some Lester. 🙂 He snores like a truck driver. Okay that was way off topic.

I’m just procrastinating. I really need to shower and go to bed.

Oh, this Friday I’m taking an OT shoulder course through Summit continuing ed I think! Yay! Well boo since I’m not a fan of shlders, but yay because I need the training.

OT filled life

My blog reader/friend Ananannanifhaihadiaiaiaiai ( looong name) just got into OT school!!!!!!! YAY!!!!!!!!!!!!!!!!!

Such an exciting journey to begin! Hard work but if you're passionate, usually pretty fun.

I have a blog reader/FB friend named Wendy who is constantly posting OT school statuses and I love reading them. I get the impression she is busy and at times overwhelmed, but overall still loving it. 🙂

I was talking to a dude in the gym today about OT and he was saying how he wished he had found a profession he loved.

I need to go prep for peripheral neuropathy, 2 strokes, and paraplegia tomorrow! Yep I still do a lot of prep work and research. I wish I could remember all the stuff I learn.

And I found a few more pieces of the Peabody today. Man, it's all over the place.

I just got back from a work-out/going in and out of the Germany vs Great Britain women's world wheelchair basketball tournament. Germany slammed Great Britain. In the last 5 minutes of games I swear girls fell out of their chairs like 10x. It was intense. Two more days!!

This post could use a dose of Ritalin.

Women's World Wheelchair Basketball Championships!!

The women's WORLD wheelchair basketball tournament is here this week in Warm Springs, GA! Tonight at 6pm I watched Germany vs Netherlands and it was strangely reminiscent of the movie Murderball (quadriplegics etc playing rugby!). There was a lot of crashing. I stumbled across one of the players in the weight room tonight, ODDLY ENOUGH AN OCCUPATIONAL THERAPIST FROM CANADA!!!!! What are the odds. She was on the Stairmaster and was able to do 15 minutes (If I do 5 minutes I am elated) and I was like um, you play wheelchair basketball? She explained the point system to me and how she can, for example, do the stair climber and elliptical but can't do impact sports because of so many ACL tears she has had. She is considered high level and is assigned a high point ranking while others with less function are at a lower point ranking and somehow the combination of players on the court has to equal a certain number of points….by the way I've never seen so many young females with prosthetic legs in one place! Lots of chicks rambling around with double prostheses and stuff, and not the fake cosmetic ones but the sticks! One thing i love about this campus is how open and accepting it is to people with disabilities…

The teams here are Great Britain, Canada, Mexico, the Netherlands, USA, Germany…..tomorrow night at 6pm is Mexico vs USA I think. CINCO DE MAYOOOOOO. There are games at 9am, 11am, 2pm, 4pm, and 6pm, between these six world teams, every day meaning today, Weds, Thurs, Fri….

SATURDAY MORNING is the CHAMPIONSHIP game of world women wheelchair basketball 🙂 I am going to try and take my camera tomorrow and take some pics and maybe a little video for you all to see. VERY cool. Inspiring. Man those women had BUFF arms too. In June, we have the men world wheelchair basketball tournaments!!

They all stay at Camp Dream on Lake Dream which is part of our campus here at the Roosevelt Institute. It's a beautiful camp and extremely accessible, as it dates back to when President Franklin Roosevelt had this as a polio haven. For example, in the apartment I live in on campus, my toilet is so high I have to be on tiptoe and I have an arm rail and back rail and the bathroom is wide.

I GOT A CONFIDENTIAL comment on FB regarding my blog post on energy conservation and how it was helpful (confidential in that I won't explain details!) – glad to know it helped even one person.

I really really need to focus on pediatrics this week! More later, I'm sweaty (I just went down to the entrance of campus and back which is hilly and about a mile total) – I've been gluten free and very healthy more or less since Easter now, and my energy level has definitely done a lot better.

After my shower i may go peruse Jan Davis's Facebook page for more treatment tricks for my patients with strokes, and also look at a few books I brought home to look at about development of hand skills etc. I'm a dork….I love OT.

Hey, one of the PTs today took a patient – newly wheelchaired – down to the wheelchair basketball games going on today as part of her treatment session, I thought that was a great inspirational idea. 🙂

OKAY IM STOPPING NOW I SWEAR I JUST WANT TO KEEP TALKING BUT ILL STOP AUGH

Great basic stroke videos made by Jan Davis :)

it's midnight but I'm up watching videos made by Jan Davis,
http://icelearningcenter.com/
http://icelearningcenter.com/resources/video-tutorials/video-tutorials
She has some GREAT basic videos up regarding stroke care! Also great ideas about cheap ways to incorporate ADLs and intrumental ADLs into treatment, such as washing/shining a car, shining shoes, squeezing orange juice, making chocolate milk or powdered tea, etc. Really enjoyed what I saw, now to convince her she needs me to have ALL her videos for free so I can review them for you all and tell you guys how much you need to buy them. From what I saw, very impressive. 🙂 Great for a new practitioner like me, I am excited to try some of her ideas.

Karen

Basic energy conservation for household management

A lot of times OTs see people with disabilities that cause them to fatigue easily. Household management can be very hard! So some tips to help conserve energy or make household cleaning easier. In all cases use your best judgment and safety and get professional assistance as needed.

1) Make your bed while you are still in it. While lying down, pull up all the sheets, then CAREFULLY get out of bed, ie dont let your feet get tangled.

2) Vacuuming: either delegate, have dark carpets that don’t show the dirt as much, or try to find a lightweight propelling vacuum that doesn’t require so much energy on your part. Also try to break it up – maybe vacuum a room a day instead of the entire house.

3) House cleaning in general: Consider getting house cleaned professionally if you can afford it, so that you can save your energy for other things you enjoy more. If not weekly, maybe have them come in once a month for a deep clean so you don’t have to worry so much the rest of the time.

4) Laundry: Front-loading is best, you can have them on blocks or pallets or something to raise their height so you aren’t having to stoop or bend as much (CHECK CODES AND ASK PROFESSIONALS BEFORE YOU DO THIS!! I don’t want to be responsible for anything bad happening!!). This can make a big difference for back pain.

5) Mopping: People like the Swiffer or similar products a lot as it takes away alot of the hardest work. Try to use a grid pattern for more efficient moving around, and to help avoid getting into slippery areas.

6) Dishwasher: Ideally this would be higher, but that’s a hard one to change if it’s not like that to begin with. Consider delegation or unloading/loading over a longer period of time. Hmm, must research this one further for more ideas.

7) Doing dishes manually: Either open the cabinet and prop a foot up on the ledge, or get a small step in front of you, so that one leg is on the step. You can alternate legs and shift weight around to help with back pain.

8) Stovetop cooking: If you’re in a wheelchair, having a tilted mirror over the top of your stove (again, be careful about safety here, have professionals assist) will help you see inside to know whether its boiling, burning, etc.

9) Prioritize, pace, etc…only do what you have to do, and don’t necessarily do it all in one sitting. Think about what you are about to do before you do it to try and decide how to make it easier and less energy consuming for you.

10) Chime in and tell me what you do to conserve energy while managing the household. Besides eating bonbons while watching your children do it all 😉

OT for massage?

i was reading an old ladies home journal – dont laugh, my grandma gets it for me – and there was a blurb on massage in the march 2009 issue and one of the parts was which therapist you should get. It mentioned LMT, OT, PT, and Nurse Massage Therapist. I thought it was kinda bizarre -but cool – she mentioned OT/PT for massage. For OT she mentioned “An OT will occasionally integrate massage into an overall plan for patients they are treating for hand injury or lymphedema”. The writer’s name was Emily Chau.

peds and stickers

I'm starting to get more and more peds. Been an oddly busy week and I am worn out. I'm sticking around this weekend so should have more time than normal to catch up on stuff. I'm back to 120 new mails in my e-mail box and like 500 older ones to go through.

Pediatric idea of the day: to encourage supination and tactile discrimination, place stickers on pt's hands and underneath forearms, so pt has to turn over arm to find stickers and peel off.

You can also put the stickers on the bottom of their feet and have them peel them off a foot while seated on a theraball.

As always, be safe while performing any of these activities, blah blah.

Gearing up for the end of April! Almost end of OT month!!

Tomorrow is vocational rehab and inpatient or outpatient depending on census. Wednesday is all day satellite outpatient, and it's gonna be a challenge as it will be my busiest day in a long time. I think I'm seeing ages 3 to 50 with a huge range of diagnoses. I need to study up on my pediatrics as I am JUST finally after 8 months starting to get younger kids. 🙂 Augh! LOL.. I LOVE peds and I will learn what I need to learn, just intimidating!

I got to hold babies at a church nursery this weekend and it was so nice to hold babies after the looong time I didn't get to, I used to love holding babies in Special Care at LeBonheur. Plus it was nice to hold babies that didn't have tubing and lines and monitors…..it's pretty rare I get to hold healthy babies!

It's 11pm and I am tired so I am headed to bed. This past weekend I got to go to a Need to Breathe Concert in Birmingham AL and do a bunch of other fun things, but I just got home (GA state employees got today off because its Confederate Memorial day, HILARIOUSLY WEIRD to my CA-based mind)….so……good night.