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.

May 10, 2010 | Category: Occupational Therapy | Comments: 2