They call me...Miss OTPF.

Karen would like to thank her adoring OT fans for their support as she ran for the competitive title of Miss OTPF 2007. She promises to take her role seriously and will spread the power of the OTPF throughout the nation, seeing as how she has not only memorized it, but keeps copies of it in her bag at all times.

I made a one-page Word document OTPF summary sheet for my classmates, which I am copy/pasting here. I hope it is helpful to incoming MOT students, as you will live and breathe this OTPF so you might as well get used to it. (I edited this version slightly, so you may need to do some formatting to fit it on the one page.)

The scoop: All your professors will want you to be familiar with the OTPF (an AOTA official document) and have it serve as a guideline for treatment. Other documents that all OT students should be aware of are listed on AOTA's website under the Student Section.

The Occupational Therapy Practice Framework (OTPF)

Basic Summary: The OT field wanted to make sure there was an official, AOTA-driven document that focused on articulating OT’s “unique” focus on occupation and activities of daily life. It also explains an intervention process used by OTs to facilitate patients, using engagement in occupation as the focus.

How it works: Use a top-down (deductive) approach where you look at the person holistically, then break the issues down using the categories below. The first step (evaluation) includes an “occupational profile”, during which you will learn as much as possible about the meaningful activities of the patient. You then use this information to guide your second step of intervention. Ideally, you will be successful, which will be determined in examining the outcome (third and final step).

Performance in Areas of Occupation (life activities people engage in): Seven areas:

• Activities of Daily Living (ADL) – (bathing/showering, bowel and bladder management, dressing, eating, feeding, functional mobility, personal device care, personal hygiene and grooming, sexual activity, sleep/rest, and toilet hygiene.)
• Instrumental Activities of Daily Living (IADL) (care of others, pets, child rearing, communication device use, community mobility, financial management, health management and maintenance, home establishment/management, meal preparation/cleanup, safety procedures and emergency responses, and shopping)
• Education, Work, Play, Leisure, and Social Participation

Performance Skills (focus on what the person does, looking at observable action that has a functional purpose): Three areas:

• Motor Skills (posture, mobility, coordination, strength/effort, energy)
• Process Skills (energy, knowledge, temporal organization, adaptation, organizing space)
• Communication/Interaction Skills (Physicality, Information Exchange, Relations)

Performance patterns (Behaviors related to activities of daily life): Three areas:

• Habits (Useful habits, impoverished habits, dominating habits)
• Routines & Roles

Context (environmental conditions that may affect client’s performance) Seven areas:

• Cultural, physical, social, personal, spiritual, temporal, virtual

Activity Demands (what an activity requires for it to be doable): Seven areas:

• Objects Used and their Properties, Space Demands, Social Demands, Sequencing and Timing, Required Actions, Required Body Functions and Required Body Structures

Client Factors (body/brain issues that can affect client’s occupational performance)

• Body Functions (mental functions, sensory functions and pain, neuromusculoskeletal and movement-related functions, cardiovascular/hematological/immunological/respiratory system function, Voice and Speech functions, Digestive, metabolic, endocrine, genitourinary and reproductive functions, skin and related structure functions.)
• Body Structures (Structures of the nervous system, eye, ear, voice, speech, all body systems noted in body functions above, structures related to movement, skin and related structures.)

Intervention Approaches

• Create, promote – does not assume disability. Provide experiences 2 enhance performance for all.
• Establish, restore – establish skill/ability not yet developed, or restore one that was impaired.
• Maintain – provide supports to allow clients to preserve performance capability
• Modify (compensation, adaptation) – finding ways to revise current context/activity demands to support performance in natural setting
• Prevent – for clients with or without disability who are at risk for occupational performance problems.

Reference: American Occupational Therapy Association. (2002). Occupational therapy practice framework: Domain and process. American Journal of Occupational Therapy, 56, 609-639.

Update: dude who left me a snarky comment - you may be correct from a historical standpoint, but what I put up was paraphrased from the book - so....don't be mean.

A good but tiring day.

Today was fun. It started with a tour of Youth Villages, which is a residential facility for emotionally disturbed children/adolescents. Several of us in the same project (a community initiative proposal) toured because our project will revolve around trying to get OT into such places, so we needed to have an idea of what to expect.

It was pretty neat. We toured the school area and a lock-down facility, and got to see one of the bedrooms, etc. It was kind of like being in the "Girl, Interrupted" movie at times. Our tour guide recommended the movie "Manic" for a very realistic view of a lock-down facility. Speaking of which, I saw part of "Hillary and Jackie" recently in our lecture on Multiple Sclerosis and it looked really cool, I want to rent that as well.

Then I went shopping with a few OT friends and then hung out with some non-OT friends before going out to a fancy dinner with some other non-OT friends. The dad of the non-OT friend gave me a check tonight for $110 because I lost 11 pounds! And my friend (the son) got $160 because he lost 16 pounds! (He had agreed to sponsor a $10 a pound challenge, ending today.) It was soooo great, I am really happy. I need to keep it up though, the last few days have been a struggle with stress and all.

I am headed out of town tomorrow morning until Saturday evening, so don't expect a post unless I get bored somehow. Unlikely. On Saturday morning I am going to meet up with Celia, the little girl I did play therapy with for several years. I haven't seen her in over a year since her family moved away, and I am so excited about it. She calls me by my entire name, including middle initial, and tacks on "my best friend" to the end every time, so it's an awfully long name. I love it and I miss her. Can't wait to see her and her family again.

Now for the notorious OTPF post.

OT thought of the day and promises of future OTPF-CRAZINESS

My mental health OT thought of the day:

If you had twins, and name one Mariah and one Pariah, there are going to be some serious psychosocial issues down the road.

More later on the Occupational Therapy Practice Framework/OTPF! Stop quivering in excitement, it's going to be okay! You can last a few more hours until my next stupendously satisfying (hi Google please read this) occupational therapy blog post!

Patience, grasshopper. Patience.

Group leading and Leatherworking

My beautiful snailie bookmark I stamped today



Leatherworking tools



Julie learns the hard way that leather stain is PERMANENT and if it's on your mallet, it might end up on your shirt.

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Today it was my turn to lead group! It was nerve-wracking but it went fine. I had to lead group for an hour (with 5 classmate members and the professor as a member), and then we spent an hour discussing strengths, weaknesses, emotions during session, etc. Mine was done on unconscious biases the therapist can have that can affect patient care. We had to do a group protocol (out of the Group Dynamics book by Cole) as well as find a journal article to support our choice. I was overall proud of how I did, I didn't make any self-deprecating comments or cry, and those were my two biggest concerns. I did a good job of keeping track of time so we could get in all of Cole's 7 steps in an hour (introduction activity sharing processing generalizing application summary). I didn't have to facilitate much because everybody was happy to share their thoughts on the sometimes controversial topic of bias! The KEY thing I need to work on is exuding confidence. I was unsure of myself and it showed. It didn't help that I ended up getting sick last night and was up almost all night and also had to make an early morning visit to Walgreens as well as knowing I'd be seeing the doctor right after Group finished. You might be saying TOO MUCH INFORMATION but I share because guess what. No therapist is impervious to sickness. It doesn't matter how carefully you prepare for things, everything can change in a second. Luckily I was able to get through the two hours of Group this morning but at around 5am this morning I was wondering what would happen if I had to cancel it.

I am going to copy/paste two parts of my group protocol that I wrote up, and then if you aren't interested in that you should just scroll past it because I am also going to talk about part two of today, leatherworking!

Outcome criteria:
Group members will come out of this exercise with a more self-aware, insightful perspective on their own previously conscious and unconscious biases, and how to continuously monitor their biases to ensure that they do not interfere with patient treatment.

Method:
Group leader will hand out list of “problem patients” to group members. Examples could include “27-year old male patient in a bariatric ward who has chronic diarrhea”, “32-year old female inmate at maximum-security prison with a shoulder injury”, “18-year old male patient who is homosexual and drug-addicted”, “and 67-year old male with paranoid schizophrenia in a mental institution”. Group members will then determine which patients they would most be willing to treat as well as which patient they would least like to treat. They will then be asked to journal for 10-12 minutes on why they made these decisions. Group members will then share excerpts from their journal as well as list their choices, explaining the reasons that caused them to make that particular decision. Discussion will include bias in healthcare, trust in other group members, generalization on how bias affects other aspects of life, and how they can become more aware of their own biases and how it will affect their treatment of others, particularly patients. Session will close with a reading of the poem “The Cold Within”.

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Leather working!
We had a two hour session on leather working this afternoon. Believe it or not, this included a distance education component. We had the psychosocial OT from the VA come in and give us a quick and dirty introduction to leather working. Our distance component participated dubiously across the state, I am sure it was horrible for them to try and see little leather tools on a TV screen. They had materials there as well.

We were introduced to wetting the leather and stamping the leather today, with a brief overview of staining and other techniques. We practiced and then got to make bookmarks. We discussed the client populations you would use it with, which client populations you would avoid using it with, and how it could be beneficial. It uses some sharp and potentially dangerous tools but also can promote strength, fine motor skill, creativity, etc. For example. Good client populations: mental health, teens, physical dysfunction. Bad client populations: Arthritic patients, violent patients.

It was a lot of fun. I wasn't feeling so hot during the activity but I still took some pictures and it was enjoyable. After the day was all over I came home and spent several hours writing up SOAP notes on every group member which I just sent to the professor. I unfortunately can't share due to confidentiality but I am excited to get feedback on them.

Tomorrow I discuss the OTPF and whatever else floats my boat. By the way, I have decided I am addicted to M&Ms because the other day about 3 of them fell out of my 100 cal packet and onto the concrete and I truly thought it was the most devastating event of my life. And also by the way, I have a new reader named Paula who said she LIKES my randomness and that made me happy.

Quick update on leading group in OT

Leading Group went well. Not exhilaratingly on top of the world well, but good enough that I'm not upset/depressed. More details later, just wanted to share!!!!! I know the suspense is suspending....;)

"You could kill your patient..."

I'm tired of hearing all the different ways I could screw up and permanently hurt or kill someone.

While normally we learn about different diagnoses, and it's all lollipop and sunshines, there are days where it seems the moral of the lecture is "If you mess up, your patient could die."

We had a visiting lecturer on traumatic brain injuries the other day, from a physical therapist who works in the ICU. She gave us a brief overview of all the different leads and machines that might be hooked up, and included at least two stories of how a therapist either almost or did kill a patient due to doing something wrong, like moving a patient's head in relationship to a machine after a ventriculostomy? Or something like that. The point is, we're students, and when you tell us about a bunch of stuff we've never seen and warn us we could kill someone, it mostly just serves to overwhelm us and scare us. I know we need to be aware of the dangers and that we could potentially make fatal mistakes, but seriously now, we probably don't need to hear it a year before our rotations ever start. Tell us what we need to know about NOT killing our patients right before we are put in applicable situations as students. Because I'm not going to remember the specific way we could kill the patient - I'm just going to vaguely remember that therapists have killed patients when working in an ICU, and be frightened to work there.

We have another professor who has ten thousand years of amazing experience who likes to do similar things - not with death, but just lots and lots of reminders of how we could hurt our patients. If we stretch them too much we'll hurt their joints. If we don't stretch them enough we'll give them contractures. If we bend them this way and they have a certain injury they'll never be able to use their hands again. If we are too aggressive with ROM we'll cause heterotrophic ossification. If we do NDT/Neuro-IFRAH/other big treatments, we'll do this/that/something else/nothing/because everything has flaws/everything has evidence proving it/not proving it. I know, again, we need to know there is a specific way of doing things. I just wish there was more focus on doing the right thing, not NOT doing the right thing.

It's confusing. It's overwhelming. I realize we can hurt patients if we aren't careful. I realize this is especially true in acute settings. But for the love of all that is good in this world, stop bringing it up so much when we are still almost a year away from our rotations. It just scares us.

That's my two cents - some therapists/professors/students may have a different view of it, and if so, please share your thoughts.

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Moving on to other news. Today we had a hideous test. I studied hard and still didn't recognize a lot of the questions. I didn't feel like I could have studied the material anymore and known the answers - they were weird things I just don't recall even being in the notes. And if a professor says something only once and it isn't backed up again in the books, the notes, or a verbal repeat, chances are, it's not going to stick. So the test was very frustrating. Especially the day after I posted Study Tips and bragged about how I'm a great test-taker!! In my possibly arrogant opinion however, if the typically highest scoring people in the class all agree the test did not match the study material, then something is wrong....  At least the test on Monday wasn't bad.

TOMORROW I LEAD GROUP!!!!!!!! AUGH AUGH AUGH OMG OMG OMG OMG SCARY!!!!!!!!!!!!! Tomorrow's post will probably be about Group (I hope exhilarated and not depressed), and then Thursday's post is going to be about the OTPF (Occupational Therapy Practice Framework) ...know it, love it, you'll never get away from it.

Basic Study Tips for Incoming/Current OT Students

Above: Studying for a big test!

Lately these posts just write themselves, I pretty much always have a topic lined up for the next day. Like tomorrow, I want to discuss how overwhelmed I get when we have lecture after lecture basically telling us if we screw up, we could kill a patient. But I promised study tips today, so here I am....big test tomorrow though augh! Allison, Brooke, and Virginia came over and it was fun studying together. They just left a few minutes ago and I am going to write this post then study a little bit more before going to bed!

Update: Recent male graduate from OT school did a post on studying for the NBCOT exams that I somehow missed even though I thought I was all caught up on blog reading! I think it's a good match - mine are kind of for basic skills and geared at incoming students, while his is geared at GRADUATION! http://www.aishel.net/

Preface: I have a really strong academic background so I think these are basic study tips that technically everyone should know by middle school. However, what I have learned by studying in groups this past year is that ALOT of people, even at a Master's level, don't have these basic study tips down. (I've also discovered that a lot of people know the material better than I do, but do worse on the test because they have poor test-taking skills. But that's a whole other post.)

Preface2: This is geared at studying Powerpoints, which is how most classes are taught these days - you download Powerpoints before class, take notes during the class on the Powerpoints, then study them for the test. (And before I get a bunch of whining from old people who say this makes it easy - it actually doesn't. You can fit a lot more information into Powerpoints and say a lot more if the students don't have to write everything down, so the downside of Powerpoints is that they are usually DENSE.)

Okay moving on.

Study Tip 1: QUICKLY GO THROUGH THE ENTIRE POWERPOINT to get a feel for the divisions, the amount of information, and keywords...the layout in general. Then start again and go through it much slower.

Study Tip 2: PAY ATTENTION TO THE OUTLINE SLIDE OFTEN INCLUDED AT THE BEGINNING OF LECTURE! It will help guide you to the important divisions of the Powerpoint and therefore the main points.

Study Tip 3: PAY ATTENTION TO THE HEADERS AT THE TOP OF EACH SLIDE. Don't just learn the three items on the slide like "apples, oranges, bananas". Look at the heading and realize that this means all these things are under the category "Fruit". Ask yourself a question using the header -like "How does these items reflect the intellectual rigor of Fruit?"

Study Tip 4: REWORD WHAT YOU JUST READ OFF THE SLIDE IN YOUR OWN WORDS.
I cannot tell you how often my friends will read the Powerpoint information to me, and then when I ask them to explain it to me in their own words, they can't. If you can't rephrase it, you don't understand it. Read it again or get clarification from the book/others until it actually makes sense.

Study Tip 5: LOOK UP WORDS YOU DON'T KNOW. I've been surprised lately at the common words people don't seem to know. If you don't know the word, you probably don't know the concept. A recent example is "Ego Adaptive Milieu". If you don't know what a milieu is, that phrase will never make any sense.

Study Tip 6: USE YOUR RESOURCES. Use the book and any other resources (articles, friends, therapists, professors) at your disposal, to clarify the Powerpoints. Often times these resources will fill in the gaps you either didn't know existed or just didn't understand.

Study Tip 7: START EARLY- give yourself as many days as possible to start going through the Powerpoints. Plan on doing no more than a few Powerpoint presentations a night, depending on the density/complexity of the material.

Study Tip 8: HAVE FUN - that's always important when studying for a brutal test. Chocolate makes everything more palatable too.

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By the way, I've gotten several requests for my e-mail address lately. It's on the top of my blog in that paragraph explaining about my blog, but I'll also post it elsewhere in a more prominent location. It's karen.dobyns AT gmail.com

Thanks all for the great comments lately!

Day 2: I'm a ghost again

My twisted logic for including a dream on this OT blog is that typically I only dream when under a lot of stress and it is also typically a themed dream, so maybe we can interpret what is going on - and I guarantee you the stress or issue is related to OT school!  I am doing a post on OT Study Tips this evening, so skip this if you want.

So, background. Growing up as an anxious kid, I dreamed of tsunamis swallowing me up and I could not breathe. Then I started having dreams where airplanes either crashed on me or near me, and always had the sense of the dread as I watched it. I occasionally had dreams where for example, there would be a bunch of orange cats, and I'd know only one of them had been my pet along, and it would be devastating to try and figure out which one is mine and making sure I got the right one. (I once told that dream to a friend's psychoanalyst mother and she got a horrified look on her face and said I had serious identity issues). Moving on. I have never dreamed of death, and especially not me being a ghost. But yesterday I had a dream I was wandering around as a ghost, and then last night I had another one, even more disturbing and similarly-themed.

Note to self though: Stop reading "American Gods" by Neil Gaiman right before bed.

In this one, I somehow died - I forget how - and ended up under autopsy, still very much awake from a soul perspective. They would be like "Karen, how much do you weigh?" and I would tell them, so they could figure out the right amount of autopsy stuff to use. So I was dead, but alive. I was also devastated and scared and upset that I was dead. When the autopsy people started to leave, I got even more upset and felt abandoned and began to cry. One of the autopsy ladies came back out and said "Come home with me, honey". And I remember the (incredibly stupid) words in my head at that second (I've always had a tendency to have bad novel phrases in my head to explain what is going on in dreams): "Brainless and spinecordless, it was hard for Karen to figure out how to move. But after a while, she figured out how to leave the shell, and followed the lady".

Eventually I managed to get to my CA home and visit my family. They could see me, but I wasn't fully there, I was hovering. I told them I had a day or two at most - my external self was going to age rapidly, like the people with that old-age syndrome, because there was no antioxidants or anything flowing through me anymore.

I went on all sorts of weird trips that I don't remember now, but one of them involved first class on a Southwest flight and an Asian man offering to sell me $500 for my ticket. And I was thrilled to buy Butterfinger balls and realize I could probably eat whatever I felt like for the next few days while I waited for the shell to wear out. Unfortunately the food I would have loved to eaten, no longer tasted good.

The other thing is that my house in California was having serious water issues. My neighbor came over and turned on the water and all of a sudden water started coming in all over the house - through every possible crack and cranny. At first I started to make fun of Mom for waiting so long, but she burst into tears and cried hysterically, so I felt bad and patted her back. I was thinking - first she has to deal with me dying, and then she has to build her house from scratch, this sucks.

In another part, I started to walk up to my Memphis door, and there was a giant spider blocking the way. I turned around and motioned to my adopted fencing family , who happened in this dream to be living in my landlord's house, and they came out and took the spider down for me. My fake sister was chiding her fake mom for using 30 pots to water the plants. When we got inside, they discussed who the place would go to once I finally died in a few days. I began to sob because I could see my cat Nikki hanging out in a car outside and I begged them to take good care of her. It was only until after  I woke up that I remembered Nikki was dead. Overall it was an upsetting dream. It bothers me that this is the second night I've had a room where I've dead, then hung around as a ghost, unable to leave.

So dudes, if I die really soon for some reason, and then you start seeing ghostly apparitions, maybe it really is me! ;)

So I have a few theories on this new theme.
1) This week has been the one-year anniversary of having my cat put down and my grandfather dying, so I've been thinking about it a lot.
2) I should stop reading freaky books before bedtime.
3) I feel like I have unfinished business somewhere?
4) I'm finally really happy with how things are going in my life, and I am scared something will stop my happiness?
5) Your interpretation?

Ok it's 810am, I need to go get ready! First I'm meeting Allison at 9 to help her search for an article, we have a new class 10am to noon in Pediatrics, my friend Doug is coming to the campus for lunch for the first time, then we have a lecture on traumatic brain injuries from 1 to 3, then we have our research project design test, then I'm going to work out, and then study the rest of the day with probably at least 1-2 others. Tonight, STUDY TIPS! Sorry for the tangent, had to get it off my pectoralis majors (chest area, get it, haha, I crack me up)...

Karen

SENSORY ISSUES UNPLUGGED

I recently sent out an e-mail to a bunch of people asking them to tell me about any sensory issues they seem to have. I wanted to know what people can't stand, because we all constantly hear about occupational therapists can help with sensory integration. It is my opinion that EVERYONE has some sensory issues, and that song lyric "Sounds like...you need some OT" is correct. ;)  If any of you guys have weird sensory issues, comment them for me!! I want to know!

I've read the book "The Out of Sync Child" by Carol Kranowitz(sp) and also have her activity book, and I've worked with a child who had sensory integration issues, so this has always been an interesting topic to me. One new thought I ended up having based on the e-mail responses I got, was wondering when you draw the line between actual sensory issues versus psychological issues. Many people shared things that disturb them, but are really not so much an insult to the senses as to the brain. The most common one seemed to be the stereotypical "fingernails on a chalkboard". You have to wonder if kids today would never have that answer, since chalkboards basically don't exist anymore.

So first I'll share a few of my own sensory issues and then share some of the ones I got via e-mail.

My main sensory issue: I cannot STAND to have my neck grabbed. I will shriek and hiss and even fall to the floor, depending on how unexpected it is or how tense I am. Also, I am really freaked out by loud noises, and busy visual patterns make me feel sick. Probably the time I feel most sensory-pounded is when I am forced to shower really early in the morning when I am tired. The sound of the water hitting the tub floor, the bright lights, and the overly hot or cold temperature, is like torture to me. Also, again if I am really tired or stressed, I cannot STAND the sound of people chewing if I am not eating too. I truly want to hit people in the face because it sounds so hideous to me.
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And now, voila, the sensory issues of others:

"I cannot stand heat and humidity.  I am taking tamoxifen for the next 5 years and it makes it even worse.  It is horrible horrible awful  no good terrible to get hot.  About once every hour I have about 2 seconds of dizzy/nausea and then the heat comes.  Sweat just pours off of me.  OMG!  It is horrible.  It is hot hot hot and comfortable I am not not not! - Christine

"I can't stand for my hands to be wet after I have washed them.  I hate it when the restroom is out of paper towels.  Also, I absolutely hate to have my nails filed.  Manicures and pedicures will never be relaxing for me."-  Brooke

"You know how I am about the back of my neck, too. I guess one thing for me would be I can't stand the texture of cantaloupe or mushrooms -- it just feels too weird in my mouth. plus, I get really agitated when there is more than one source of sound in a place, like a tv and radio on at the same time.- Suzanne

The only thing that comes to mind is fingernails on chalk boards. Sometimes I think my nose is broken—Ray-ray is always complaining about how Georgie smells, but don't think he smells bad (unless he's wet) – he just smells like a dog. - Dad (John)

"I can't stand to look at or to deal with liver .. gives me a gag reflex
fingernails scratching on a blackboard..makes me cringe.. moot point now
that they use dry erase boards." - Carol

"Bright lights in the morning along with, overly
cheerful people...[edited]...
------
In general, I don't like eating any food(s) that still
has bones and/or skin still attached. ...[edited]....
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Listening to someone in the office over the cubicle
wall eating anything.  Making those yummy,
lip-smacking noises along with
nose-snarfeling-on-mustasch

-munching noises absolutely
drives me nuts! Makes me want to rip my ears out of my
head and chew them to bits! - Bill

"I don't know that I have any issues.

But I read an interesting article in the LA Times Health section indicating

the people born with anosmia often have sensory integration issues. The

woman described in detail how icky most food feels and what extreme lengths she has

to go to to accommodate her issues."- Mom (Kathy) (Hey Mom, needing about fifty pounds of blankets on you at night is a sensory issue...;))

"Bodily scratching sounds make me want to barf...

Abnormally large fruit freak me out!" - OT friend

"I am extremely sensitive to TV or radio commercials.  Almost everyone I know can simply ignore them and carry on a conversation or think about something else, but not me..[edited]...It's a visceral experience for me.  On a cognitive level, I deeply resent and reject any attempts to manipulate me or force me into buying some product.  I think this is hard-wired in me.  I would change it if I could."-Arnie

"I am extremely sensitive to music.  In the early years of my telephone company career, they used to play Muzak through speakers in the office ceilings, which absolutely drove me crazy, since it was crappy music - usually pop tunes played by Montevonti Strings or some crap like that.  I had to plug my ears with both hands when composing correspondence.  I would think of a line to write, then write it down before forgetting it, then cover my ears again to think of the next line.  I'm sure that is not what the "efficiency experts" who designed Muzak had in mind." - Arnie

"If I am on a ladder and look up, I feel like I am falling backwards.  I have to hold on to something other than the ladder, like the gutter, when cleaning them." -Burt

"When I was a kid, I could not eat cherry tomatoes because the thought of them exploding into my mouth was too much to bear." - random friend I won't name ;)

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Hope you enjoyed this episode of SENSORY ISSUES PART 1!!

This weekend has not been as productive as planned. I just finished my dessert of a 100cal pack of oreos, fresh strawberries, and fat-free CoolWhip mixed together...now I am going to go shower and then do a little bit more studying before bed.

Boo, this Sunday is no fun

Wooie, you know you are sleep-deprived when you can take a 3 hour nap, then go to bed at 10pm, sleep 10 hours, and you are still tired. But I got up because I HAVE to study Frames of References for a few hours before I meet up with a friend to study it. (Kinda like cleaning the house before the maid comes? AHAHHAA)

I also just had this bad nightmare of watching a plane crash in the canyon of my CA house, I climbed through the canyon to help and then couldn't find my way back to MY house...I kept wandering around and was lost (after all the victims had been carted so there was no one there anymore). Then the thought occurred to me that maybe I was dead, hurt when trying to help or something, and I was going to wander around forever, trying to find my home and my family.

Wasn't that cheery? I used to dream of tsunamis and plane crashes all the time, but this is the first dream like that I've had in a long time.

Ok, gonna go study for a few hours, then meet Virginia to study more, then meeting a non-OT friend, then possibly studying with Brooke if she heads this way after she gets off work at 8pm, it's up in the air. I've already done most of my Group protocol and studied for Research Project Design - Qualitative Studies - so it's all Frames of Reference now. And dishes. And cleaning. ::cries:: This is a stupid stupid Sunday.

Now I have to go study since I finished my cereal. Bye everyone, pray for me...keep reading below and tell me what you suggest for geriatric medicine management, Patti and Mamachill have already added in great comments.

Medication Management for Geriatric Patients

A lot of older people take a TON of medication, and these meds might have to be on various schedules. In particular, I currently have a friend whose geriatric mother will be undergoing oral procedures soon and she will be on a very confusing assortment of drugs with different dosing times. Do any of you all have good ideas on how to allow the geriatric mother to take these pills independently without getting confused?

My original contributing idea was to take a short, wide piece of posterboard and do a timeline from left to right, taping the pill (in a tiny bag) beneath the date/time...so she'd just go to the chart and see the date/time and take the pill that was taped there. But the friend pointed out, rightfully, that this would probably be insulting to her mother, insinuating she cannot keep up with her medications. I think the current plan is to get several different pill boxes so that each medication has its own pill box, and then segment them by time. Or something. I don't know if I understood the plan correctly. The point is, it's very obvious my friend is not the first one to have to wonder about this - do any of you all have ideas, based on personal experience or OT knowledge,  to help manage lots of pills at different times without making it too confusing OR insulting intelligence?

Please comment if you do!

Thanks!

Karen
PS: Tomorrow is (at least for my blogging purposes), SENSORY INTEGRATION DAY! GET EXCITED!

Shout-outs to my new readers and to my newly arrogant self

Shout-outs to new readers who have de-lurked and made some comments or sent e-mails (THANK YOU!!! I love delurkers!!)

Bernard - a precious rare male looking into starting OT school. We've exchanged several e-mails and I think he'll be great. I very much hope he starts that journey soon!

Mama Chill - she just started OT school and has young children, wish her luck. She said in a recent comment she managed to snag "The Healing Heart" by Ora Ruggles based one of my previous blog posts, and that she loved it. I was so happy to hear it, and also jealous she owns it. Her blog is linked on my sidebar. MamaChill - I will warn you that orientation can be overwhelming and that the first month or so may seem a little boring at times when the professors pound the definition and conceptual background of "occupation" into your head a thousand times. But keep your chin up, it gets way better once you get past that basic information. Also, don't let gross anatomy get you down - use mnemonics, keep up, study hard, you'll be fine.

Lady of Musotopia - she is in OT school in another country and sounds really fascinating. She mentioned she makes more "qualitative" observations now, which I thought was pretty neat. She also agrees your priorities shift a lot once you start OT school.

Ryn Tales - this is a blog linked on my sidebar and it is by a mom who has a daughter with CP. She is a wonderful writer and she gives GREAT insight into the world of CP, I highly recommend her blog to see the parental standpoint of therapy. She has written me some sweet and helpful e-mails recently about her thoughts on some of my posts, and I really appreciate it.

Burt - thanks for refreshing my stock of toilet paper. It truly was, as he pointed out, a story of "The Princess and TP"

Merrolee - also linked on sidebar- not a new reader but I consider her my OT blogging mentor and we've recently had some chats via Gmail that have been inspiring.

Everyone else who comments (Sarah, Suzy, Arnie, Scott, and many others): Thank you so much for your support and kindness! I really love it.

=================
My own shout-outs! I'm trying to become arrogant instead of self-deprecating...

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I submitted a Top 10 list to the Disability Blog Carnival hosted by David at http://www.growingupwithadisability.blogspot.com/. For my submission he posted: "Karen, an occupational therapy student and new blogger is stepping into a new world. She shares her love of her new career and learning through reading disability bloggers, "I realize, again via these blogs, that non-compliance has less to do with the client being stubborn and more to do with me not fully understanding their true needs." Yes!! You are on your way." (See, Anita, I did retain our lectures on the OPPM)

---------------
Joshua, a recruiter over at CollegeCare, posted my tips for Newbie OT students (also linked on sidebar at way bottom) - that was so cool! See it at http://college.rehabcare.com/

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My stats are going up - this is really exciting to me. I'm also getting more comments and more e-mails. I'm happy because while I blog to get out my thoughts, I also very much want it to benefit others who are exploring the field of occupational therapy. E-mail or comment anytime, I promise I'll love you forever.

Volunteer to hold babies :)

I know I said today is a shout-out post day, and it will be. I want to post about my day so far first and then I'll do my shout-out post! Because I'm allowed to post twice in a day! So there!

First thing I want to share is that as of today I have lost 12 pounds! I am really excited - with the exception of an occasional splurge, I have been working VERY VERY hard to lose weight so I am thrilled. Now of course this is just the loss of the weight I gained since starting OT school. AHAHAHAA - last semester involved a lot of milkshakes due to stress.

I'm trying to work out 5 hours a week (treadmill, elliptical, bike, swimming, yoga, pilates, Spinning, Weights, Core exercises, etc) - and stay between 1200-1500 calories a day. 1200 is actually pretty low though so I've gone up and I'm still losing weight just as quick, I think after a few weeks at 1200 your body gets angry and starts refusing to give up fat.
It's fun going to the gym at the university because it's filled with med students, physical therapy students, etc - lots of fit young people to motivate you.

Also, last week at Baskin-Robbins (getting a scoop of nonfat ice cream, thanks), I ran into a therapist from the local peds hospital. I couldn't remember if sh was speech, PT, or OT, since I was only there two weeks in March, but I knew her from the office. She was like Oh, are you a physician there? And I was like ummmmmm no, but thanks! She said Oh sorry, your glasses make you look so intelligent.
The funny thing is, I don't think she was being facetious? Or maybe she is just smart enough to always "guess up"....

Speaking of which, I'd like to go on a mini-rant here. When people say GUESS WHAT! and ask you to guess, always guess really low or really high depending on what they are excited to share. Like if they say guess what i got on a test and you say 100 and they actually got a 92, they feel bad. But if they say guess what I got on a test and you say 90? then they can excitedly tell you they got a 100. Work on that, people.

I also did my two hour volunteer session at the local peds hospital mentioned earlier. When I first walked in I went past their pictorial timeline of the last 40 years of hospital history. I normally ignore it, but today it got my attention. They had black and white photos from way back when, and the cribs looked so austere. The medical technology was so big and bulky and threatening, and even the wheelchairs were giant and wooden. The kids stared at you in these photos with a haunted face. I know it was meant to be inspiring, but it made me feel sick to my stomach. Thinking about the mortality rate of these children back, and how sterile and cold those environments used to be, made me so sad.

After that though, the volunteering was pretty good. I walked in and asked if they had anybody special they wanted me to go to. A nurse pointed me to a 5 month old baby who had been crying all day. I held him and he calmed down and fell asleep within about 5 minutes. He just desperately needed some human contact. I continued to hold him for about an hour as he slept because a lot of these babies need the stimulation so bad that it doesn't matter if they are asleep - they can still benefit from that touch. His IV went out though (not my fault) and he started to be in pain so I put him down so they could try to redo his IV. They tried multiple times and couldn't and had to get someone else in. Very traumatic for the poor baby. While they were doing that there was a little newborn squalling so all I did was stick his pacifier back in his mouth and press my hands against him a while, he immediately fell asleep too after staring at me a while. (I guess I'm THAT BORING! AHAHAHA) I stuck one of his beanie babies (he had the SNAIL beanie baby!) on his chest against the pacifier so he'd be less likely to have it drop out of his mouth. Then I went to the little girl I had held for 1.5 hours last time I was there. Unfortunately, I didn't realize one of her bigger tubes was actually pinned to the bed this time (normally you can at least lift them a little way and then start maneuvering the tubes), so I hurt her by trying to pull her up - it pulled on her stomach and she cried. I felt really bad. But the nurse came by and unpinned her and encouraged me to hold her because apparently she is just sensitive to the tube being moved by anyone period, and would calm down in a second. So I held her and sang to her for about 30 minutes until I needed to go and it was time for her bath. From now on I'll be more careful to make sure nothing is pinned down. Overall, with the exception of the tube issue, it was a good day. I wish they had more comfortable chairs though - it is really hard to hold babies for 2 hours in crappy chairs with nothing to put your feet on and IV poles and tubes to be navigating. One thing they have there that I really like is pacifiers sewn into the mouths of beanie babies - you can lay the beanie baby on their chest and stick the pacifier in their mouth and it gives them both firm pressure to the chest for calming as well as makes it less likely for them to lose their pacifiers, since most of them have a dysfunctional or poor sucking pattern.

One of the other things I thought was neat was that some of the babies had big notes tacked on their crib from OT/PT on them with advice like "Please try to play with this baby from her left side so she will move her neck more." I tried to follow the advice because of my OT-osity, but really I just need to focus on holding the babies - if they are grumpy I am not going to irritate them further by forcing them to do things like turn to the left - my job as a volunteer is to calm babies, not piss them off. They burn more calories when angry due to the screaming etc, and none of them can afford to lose those calories - best to keep them calm. But I definitely would NOT be comfortable or have any idea what I was doing had it not been for my two weeks of occupational therapy observation there!

Okay this got long. Sorry. I'm really tired. I got home from the session and had lunch and decided to write a while. I also need to work out, study, and I am going to a friend's house for dinner, then studying some more. Not to mention dishes and cleaning the house. Etc. But now I am thinking that after I write the shout-out post I may just take a nap first. Don't y'all think that's a lovely idea.

Time for shout-outs.

Random occupational therapy nuggets of joy

Above: My new flower vase with acrylic glass, PVC pipe, and Aquamend

Above: This is random but it is the multi-inch thick stack of papers I had to go through today, all that in a single day.

Above: Make a pencil grip for someone with no finger capability, using only a rubber band.


Stephanie scoring acrylic

Katie putting on zip ties according to people's height.

Hi Everyone!

I'm ready to move on from the drama of the last few days regarding my Lolcats post and the surprising (eye-opening) controversy that ensued!

I wanted to post some random (cough long) tidbits, and then Saturday I'm going to give some shout-outs to new readers as well as some exciting shout-outs to my self (I'm going to go from self-deprecating to arrogant overnight), and then Sunday I have the BEST POST ON SENSORY INTEGRATION EVERRRRRRRRRRRRRRRRRR, so you better come back each day this weekend or I'll cry.

A) I got an e-mail from a local church the other day that had the subject line "13 days after Pentecost" and I read it as "13 days after Percoset". I've been in the medical field too long.

B) The other night I went to a fancy restaurant with some friends (I didn't have to pay! Woot woot). They started discussing colonoscopies almost immediately. They commented "Oh, this probably isn't good dinner material for Karen" and my immediate response was "It's okay, I'm in the healthcare field." And it was another one of those mini-defining moments in my life, like when I first got to put "OTS" (occupational therapy student) after my name or got my first professional AJOT (American Journal of OCcupational Therapy) in the mail. It just struck me that it is TRUE. I am no longer a generic student. For the first time in my life, I have a career label! That may seem obvious to some of y'all, but hey, I'm a little slow. Oh no, that was self-deprecating. Oops...

C) This is a really really really stupid question (Here I go again), but I am confused gramatically about the whole Master's degree thing. A lot of girls in my class have the "MOT" written out in their e-mail headers, and they all do it differently. Should we be saying Master of Occupational Therapy? Master's of Occupational Therapy? Masters of Occupational Therapy? And when we say we are getting this degree, do we say we are getting our Master's in occupational therapy, or what? I'm so confused. Help me out, peeps.

D) I met with my Group professor to go over the Group I'll be leading next Wednesday. I am nervous but also kind of excited. I have decided it is going to be called "The Cold Within", which is the title of a poem that deals with six freezing people - if all six of them had contributed the stick of wood they had, they would have been able to start a fire and been warm. Instead they all clutched their sticks and did not share because they had biases against the others. Google it, it's a great poem. So basically my group is going to be about the unconcious biases that could potentially affect our patient care, and how as therapists we can become more self-aware of these biases and thereby less likely to act on them.

E) WE HAD THE COOLEST LAB IN THE ENTIRE WORLD TODAY AND I WOULD POST A PICTURE IF I WASN'T SO LAZY BUT I WILL LATER SO CHECK BACK BUT ANYWAY OMG IT WAS SO NEAT!!! It was a lab on designing quick-fix, cheap/easy solutions - so it focused on things like duct tape, PVC pipe, Acrylic glass, Rubber bands, you name it. We learned how to make a hand grip with only a rubber band, how to cut/bend acrylic glass for various uses, how to use epoxy putty to make grips, how to use dysum (?) aka frictiony rubber drawer liner paper to help grip, how to use pipe insulation to build up grips or items or pad things, how to put wax paper between heavy things to ease friction, how to cut PVC pipe into different configurations, etc etc. I made myself a little flower vase using a piece of acrylic glass, Aquamend epoxy stuff, and PVC pipe. I also used a torch to bend a piece of acrylic glass to serve as a mini upright clipboard, and then I also used PVC pipe with right-angle crookies (I'm so technical) to make a square, and then made grips for it using pipe insulation. I'm going to give that to my friend Suzanne who needs to build up shoulder strength, since you can wrap ankle weights around the pipe and do overhead lifts, etc. OH and we learned about Quick-Grips (mini clamps) and Zip ties (apparently everyone in the world knew of this but me), and more. It was eye-opening and really, really excited me. I could have spent six hours playing with it. Too bad it was only an hour and a half. We also had a challenge of using a strip of duct tape, 15 pieces of dry spaghetti, and two rubber bands, and making as long a "rope" as possible going from the end of the table but not touching the ground. We followed the law but bended the rules. Or maybe I mean bent. Grammar angers me. We almost won by having the longest strip but it broke right as he was going to measure it. :( It was so cool.

F) The same professor who taught the earlier class sat down with me over an hour today and helped me understand an SPSS statistics lab we had done. It really "clicked" and helped me a LOT. If it weren't for hating statistics so much, I would have strongly considered a PhD program.

G) That's probably enough nuggets of joy (that phrase makes me gag but it also makes me laugh), so I am going to stop for now. It also occurred to me I want to write a post about study tips, so um, yeah, maybe that will be Monday's topic! Oh my goodness, I bet y'all are already on pins and needles waiting for that post. Oh wait, maybe that's your paresthesias...

Update: Obviously, I added in the pictures.

Blog Comment Devastation- I need reader advice

Update: I received several e-mails and comments, which I am very grateful for. It gave me a lot of insight and it was a great learning experience. I've decided to keep the Lolcat post up, but put on a disclaimer. Several different perspectives were pointed out to me and it opened my eyes. The "debate" basically ended up that people who are not disabled didn't find it offensive at all, and my friends especially felt quite strongly I was in the right. Which I did appreciate, since my intentions were good. But I also got some differing viewpoints from mothers with special needs children and a few other people with disabilities, and I understand why. I vow to be more careful from now on, and will repeat one more time that no offense was ever intended. Thank you all again so much for your insightful and helpful and sweet comments.



Yesterday, an anonymous person left a comment sharing their dismay at my post written a few days ago, "Occupational Therapy as Described by Lolcats"

Here is their comment:

"As a healthcare consumer, these feels condescending, arrogant, disrespectful - as thought clients and providers are 2 different species. I am guessing as you are a student that that was not at all your intent, but I tell you honestly that's how it feels to me.
Wishing you success and wisdom in your chosen career. Keep in mind that the people that use your services are people too - people with their own careers, relationships, and lives."

--------------
When I read this comment, I almost cried. It reminded me that while having a blog is mostly fun, it also leaves me open to criticism. I pondered taking down that particular post. I couldn't e-mail the person since there is no contact information. I talked with a friend (who had previously told me she loved the post), and she said I should open it up to the community. Did any of you find this post offensive and disrespectful toward clients? Is it wrong of me? Should I take it down?

My take on the manner is that it meant no harm. If you read my blog regularly, you know that every other entry is how we should be client-based, compassionate, open-minded, etc. But occupational therapy is not all fun and games. As an occupational therapist, I might deal with people who have severe depression, rage, or other serious issues, all day every day. This can lead to a lot of stress and burn-out, just like it does in any healthcare profession. I think it's important to look at things from a humorous standpoint at times to try and prevent that potential burnout. I by no means meant to imply clients are a different species and that therapists are superior, and I hope the majority of people who read this post feel the way I do - that it was not disrespectful.

However, I am just an occupational therapy STUDENT, and I still have a lot to learn. I blog to chart my journey from student to clinician, and to share this journey with others who have or might want to follow this path as well. It is not a straight path to "perfection", and I am bound to make mistakes or put things badly at times. My overall desire is to profess my LOVE for occupational therapy, and my JOY at getting to help clients improve their lives. If some of my posts don't get that across, I apologize.

So please, readers, let me know what you think about the post on Lolcats, linked above. - Disrespectful? Wrong? Acceptable? I really, REALLY want to know what you all think.

Thanks!
Karen
PS: I didn't really have the time to write this right now, but that comment has been floating in my head for two days and so I needed to write this out. Posts on sensory integration (SI) and new readers coming by this weekend!
PS2: Check out http://www.growingupwithadisability.blogspot.com/ for the blog carnival, posted today! My entry is on there! I can't wait to read the entries!

air conditioner fixed

air conditioner fixed. lots to catch up on. No time. several blog posts in the work, especially regarding the comment about being disrespectful. Also want to give shout-outs to some new OT contacts. Check back late tonight!

bad bad day

wow. bad day.

my group professor told me i had off-putting comments, someone emailed me anonymously and said my blog on lolcats was degrading and disrespectful, i almost got hit in the parking garage by someone not paying attention, and then i came home to a house that was 95 degrees because my air conditioner broke. i am spending night at a friend's whose wireless previously worked on my computer and now does not. lovely. not fun. so uh, more tomorrow if my air conditioner is fixed...

Quote of the Day/Thought of the Day

Quote of the day:
Scene: In class, playing a "Price is Right" quiz show over the Person-Environment-Occupation (PEO) model and the Occupational Adaptation (OA) model.

Question asked: Name one thing the Canadian Occupational Performance Measure (COPM) is concerned with.

Answer provided: Canadians!

--------------------------------------

Thought of the Day:
Scene: Shower

While Showering: Hmm, I need to remember to post to the blog about how I have right hemineglect because every time I get out of the shower I always have soap suds on my right shoulder/arm.

Post-shower, toweling off: Holy crap, I did it again!

"Top 10 reasons I love being an occupational therapy student that (gasps for air) also has access to eye-opening fantastic disability blog carnivals!"

10. In no other field can I get a Master's that not only includes classes in ceramics, leather working, woodworking, and craft media, but also involves cutting into cadavers and neurobiology!

9. I get to practice wheelchair wheelies and fall on my professor's knee when I tilt too far back, thus ensuring he will one day need a knee replacement and then I can be his OT and thereby complete the circle of OT life.

8. I get to play/learn how to use button hooks, dressing sticks, splints to hold utensils, plate guards, etc. And then I get to learn that most clients prefer not to use them.

7. I learn a little about a lot of different diagnoses and issues and really get to address the holistic, client-centered practice that makes up OCCUPATIONAL THERAPY!

6. I realize, through experience and by reading disability blog carnivals, that my future clients have a whole other life besides the few hours a week I may see them in occupational therapy.

5. I realize, again via these blogs, that non-compliance has less to do with the client being stubborn and more to do with me not fully understanding their true needs.

4. I realize via these blogs that no matter how stereotypical a client may sound or look on the outside, there is often a hilarious, intelligent, and wonderful personality inside! I just need to look harder!

3. I discover that there is often times a fine line between hope and reality, and my job as an occupational therapist is to nurture this hope while retaining reality.

2. I realize that the best way to help my clients is to help them help themselves - making leaders, not followers.

1. I realize that as a future occupational therapist, I have the potential to help so many lives if only I can stay open-minded and compassionate and AWARE of how others feel, through any means of communication possible!

0. I REALIZE DISABILITY BLOG CARNIVALS ARE AMAZING!!!!!!!!!!

*Note: This was written for a disability blog carnival with the theme of "Top Ten Lists" being hosted by David at http://www.growingupwithadisability.blogspot.com/ and being posted on Thursday, August 23rd

New RehabCare blog linked to me!

You better scroll down and read about my LOLcats, I am really proud of that 1am posting.

 

But I'm also excited to tell you I got an e-mail from a "campus relations manager", Josh, with RehabCare. He told me he liked one of my posts and has posted it on their new blog and linked back to me! I am excited!

http://college.rehabcare.com

 

What is ironic is that I stumbled across this blog a few days ago and had meant to mention it/add it to my sidebar! I'll do that when I get home tonight. That is so cool!

 

We just had neuro on Gross Arm Control, now I am doing some e-mail/printing out stuff in the lab. Then we have a class from a guest lecturer (VA OT) on spinal cord injuries...then lots of studying then working out!

 

 

Occupational Therapy as illustrated by LOLcats

DISCLAIMER: PLEASE SEE COMMENTS SECTION BEFORE READING THIS! Apparently this post is slightly more offensive/controversial than I would have ever guessed, considering my intentions were 100% benign and I only meant to amuse, not offend. I've addressed this in a post linked in the comments section, so please visit that if you do (hopefully not) take issue with this post. I again apologize for any offense I may have caused. I have decided to keep the post up instead of pulling it because dealing with the controversy it caused was a good learning experience for me and hopefully for others as well!

This is how many of our patients come to us, emotionally and physically...


Sometimes our patients are struggling with life-altering changes, like in the case of an amputation...Sometimes our patients just have bad habits we need to work on, or at the very least, need a referral to a 12-step program.


Sometimes our patients have trouble taking turns and need gentle but firm reminders.


Sometimes we can use Wii therapy with our patients, as discussed recently on www.otility.com, to make their therapy more fun and engaging.


Sometimes our patients shock us with their stories of occupational deprivation and it is all we can do to hide our surprise or dismay.

And sometimes, as occupational therapists, if we are unable to compartmentalize our workday and bring our emotions home with us, our patients will lead us to drink. If this happens too often, it starts the "Halp" cycle all over again. And this time we begin it as a patient, not a therapist.

The moral of the story? Don't let yourself run out of happy.


The End.

You love me, you really love me! And I love OT school! And OT blogs!

::cries with joy:::

You love me, you really love me!

I've been having like 30+ readers a day and around 60 page views! I feel so popular. Now I'm going to become mean because that's what all popular girls do, right?

This week my goals for occupational therapy school include studying for two tests and preparing for group (ie not procrastinating until this weekend then stressing out and writing OT blog posts that say AUGH AUGH AUGH), keeping up on the reading, working out 5 hours, and seeing my friend Doug a few times because he leaves for England for a year, in two weeks! And I just found out we have to go to three 12-step meetings BEFORE September 19th, I was totally planning on doing it in like October. So now I'm like :O...

Guess I better get on that! I want to hit an Overeaters Anonymous, Al-Anon, and AA. Problem is, we are kind of saturating a specific church out East, and I think they are going to quickly pick up on the fact we must be students doing a project. That's not good for the whole "emic perspective"! (Hello, qualitative research design test next Monday). But all the other ones I have found seem to be in scary areas of town. Hmmm...

Ok, I'm going to finish gnawing at this delicious watermelon, shower, and look at some OT frame of reference notes before attempting to go to sleep!! Yay! (Do you like how I liberally sprinkled OT and occupational therapy in this post? I'm working on increasing my google rankings...)

Occupational therapy school, OT blog, I love you! And Google, I love you too! Boost me up in your heavenly rankings!

Signed,
Karen, Occupational Therapy Student aka OTS
PS: Aren't I clever to talk so much about occupational therapy and blogs? It sure does make for thrilling reading.
PS2: Hey Will of famed Meta-OT, I have a Google Analytics account but I totally don't get how it works!!!
PS3: OT school is splendiferously vociferously yet not timorously magnificent!
PS4: I'm not as ditzy as I appear on this blog.
PS5: Okay, yeah I am.
PS6: I decided this picture looks like me doing neuro-IFRAH on my San Diego cat.

Stream of conciousness, statcounter, Star dust...salliteration...silliness

I had a bunch of readers today too, according to www.statcounter.com :)

I can't figure out why some days have so many more readers than others! Grrr! Somebody enlighten me! I beg of you!

I wrote THREEEEEEEEE entries yesterday so you should all pretend I wrote one Friday, Saturday, and Sunday, because I don't have much to say this weekend - it's not a bad upcoming week, but the week after that I have a test Monday and Tuesday and then I lead group on Wednesday (AUGH AUGH AUGH), so I need to be good about not procrastinating!

The last few days have been a lot of fun - Wednesday night I spent the night at Brooke's aunt's house along with Allison to study for a test, and Thursday night I got to go to the Memphis Pizza Cafe and then go see the movie Star Dust (really good!) with some friends to celebrate their son's 13th birthday.

Conversation the 13 year-old and I had:
Me: Hey kid, guess what?
Him: What?
Me: The girls in my class think I'm smart.
Him: :::laughs hysterically::::

Today I worked out, went to Easy Way for some fruit, visited my friend's house to feed their chickens/cats/turtles, napped, went to Costco and Wal-mart during a lovely storm and got soaked, then went to a friend's house for dinner. They made salad, beef stew, and then watermelon for dessert and it was wonderful. I had a lot of fun with them. They also provided me with a bunch of food as well as some TOILET PAPER!!!!!!!!!! based on a post a few days ago I wrote that said I was on my last roll of toilet paper and would probably forget to buy more until it was too late because I'm so busy with OT stuff! AHAHAHAA!

Tomorrow I am working out, studying, meeting my wonderful OT friend Virginia, and spending time with a non-OT friend. Yay, fun weekend!

Hey, one last thing - today at Costco there was a mom with her little girl in a tilt-back wheelchair, and I was realizing that I'm slowly being able to recognize more components of wheelchairs based on our lectures/labs! It's cool to think one day I'll see someone zooming across the street in a power wheelchair or wheeling themselves up a curb and know exactly what is going on!!

Ok this ends my stream of conciousness. You know you love it. (See, I'm working on not being self-deprecating as my goal for Group, is it working yet?)

Our session on neuro-IFRAH

We had a two day, four hour workshop on neuro-IFRAH this week. This is basically a branch off NDT. It is intended for patients who are affected by lesions that occur at the level of the brainstem and above. It stands for Neuro-Integrative Functional Rehabilitation and Habilitation. The program was started by Waleed Al-Oboudi, MOT, OTR, who actually now has a clinic in La Jolla, CA (my hometown). One of his mentees (is that a word)? taught us, her name was Mary Lindner, I believe.

The first day, we discussed key components of this treatment. Basically, you look at the person holistically and examine 41 different variables that may affect the patient's recovery from their stroke. The goal is to facilitate movement so they can regain as much movement as possible. We learned about things like "assessment of shoulder girdle mobility and control", "facilitation of scapula and clavicle to achieve scapular adduction", etc. We practiced on each other, using our hands in VERY VERY SPECIFIC ways on very specific parts of the body to help facilitate motion. It was a lot harder than it looked.

The OT teaching us was amazingly energetic and enthusiastic so it was a lot of fun. It definitely seemed like a great tool to add to our box of tricks!

The picture above is a picture I took during a break of all the people in my class (not including the distance component of course), since everybody was so colorful! Click on it to make it big!

The picture below is the OT illustrating a technique on Brooke!

Wheelchair Lab and Wheelies

We had a wheelchair lab on Wednesday night, 3pm to 6pm. A wheelchair rep came out and talked to us about different wheelchairs, and then we had to practice advanced wheelchair skills like wheelies!

I was petrified - I have a huge fear of falling backward. We had partners tilting us back and then were supposed to try and mantain that position. I kept on leaning forward and pushing my legs out because I felt like I was going to tip. I did actually fall back and landed on my professor's knee ahahahaa. I couldn't imagine trying to teach people how to do that! I could do popups or whatever though, like when you move your arms so quickly on the wheels it actually causes the front wheels to come up slightly. The professor put out wooden beams for us to pop over, and I could handle that, but it was too scary to imagine trying to go up curbs that way!

It was certainly an eye-opening experience!

A productive day! OT Diversity, baby

Today I was pretty productive. I had neuro, went to woodworking and finished my toolbox - YAY see above - and then I worked out. And then I came home, showered, did my SPSS labs 4 and 5, wrote in my required journal about the woodworking experience, made a CD of pictures for a few girls in my class, did my part of a cognitive frame of reference study guide, organized a two inch thick stack of newly acquired papers, called my grandma, cleaned off my almost full computer desktop, and now am crossing off my final thing on the to-do list, writing a blog entry. I work from 9 to midnight and my friend Doug is going to come over while I work to hang out and do his own thing, so I have a short amount of time to write this. I was extra productive today because I have a busy weekend coming up as well between seeing friends, pet-sitting, working out, and studying for 2 tests and group leaderships coming up.

I wanted to give an example of OT diversity - that two inch stack of papers? I organized it out so I could put it in the proper place in my binder, and it was a packet on neuro-IFRAH, a "how to write progress notes" SOAP guide, a wheelchair prescription form, some powerpoints on personality disorders, cardio-pulmonary rehabilitation, research statistics/project design, spastic hypertonia/tetraplegia, multiple sclerosis, frames of reference on cognitive-behavioral/allen's cognitive levels/sensorimotor, etc, and finally, a woodworking packet.

I now present to you a little thing I like to call "Priorities Shifting" due to OT school.

OT School And The Priority Shuffle

Before: Pre-OT school

1. I would throw away old vegetables.
2. I would not let stuff stay on the floor.
3. I swept the kitchen at least weekly.
4. I did dishes every few days.
5. I would regularly straighten up my bookcases.
6. I would go through and throw away clutter.
7. I read magazines/books that came in immediately.
8. I would make sure my toilet paper/paper towel supplies didn't run out.
9. I knew where everything was.
10. I would prepare and eat healthy, chemical/artificial free nonprocessed foods.
11. I would regularly clean out my many e-mail boxes.

After: Mid-OT school:

1. I have sweet potato trees a foot high in my fruit basket.
2. Stuff on the floor provides important proprioceptive input to my tarsal joints when I run into said items so why bother picking it up.
3. Crunchiness on the kitchen floor gives much-needed sensory texture to my bare feet.
4. I do dishes once a week. (To be fair, I only use a rinsed-out bowl a day and 3 utensils so it's not that much).
5. My bookcases are a jumble.
6. I have precarious heaps of clothes and clutter near my bed. I will die in an earthquake due to suffocation from those heaps falling on me.
7. I have another precarious heap of books near my bed. Some have been there since January. If I don't die of suffocation I will die of a concussion.
8. I have half a roll of paper towels and no reserve toilet paper left as of today. You will hear cursing in about a week when I realize this matters.
9. I can't even find my black angel wings to wear to Roller Derby. Seriously, who loses that in a one bedroom apartment?
10. I live on Lean Cuisine, WW Smart Ones, Lean Pockets, and Healthy Choice for 2.5/3 meals a day. (hence, no dishes - see the genius plan?)
11. I have 3,400!! new e-mails in my work e-mail (I cleaned it right before I started OT school in January for a final time), 500 old unfiled mails in the Google box I cleaned this summer, a month's worth waiting at the hospital I volunteer at to go through, and at least 100 to file in my university e-mail. Oh, and 170 new ones in my AOL box. And I barely care.


Need I say more? I would if I didn't have OT homework to go do.

Wow I'm like dying from sleepiness

I took a THREE HOUR NAP today and it's 1020pm and I am tired! How crazy is that! I think I'm still sleep-deprived even with the occasional good night of sleep/nap because it's such a huge deficit.

I promise I will post something substantial in the next few days, hopefully tomorrow - it won't be that bad of a Friday - we have a neuro class, then we finish our toolboxes finally!! Then I'll work out. Then I'll finish my SPSS statistic labs and then I'll see friends and then I'll work 9 to midnight. And somewhere in there I'll probably blog!! Or web journal, as I like to call it since everybody correlates the words dork and blog. :(

That's ok, dorkiness is cool in my eyes. My newly black/squarey spectacled eyes.

Good night!

I swear on a stack of bibliotherapy

...that I will post later on today about neuro-IFRAH, group, research project design, projects, etc.

AND, I got new glasses!! Black and squarey! I'm moving up in the world of trendiness slowly but surely!

giant research test tomorrow nooooooooo

Ok, it is 730am and I FAILED last night at posting because work was busier than I would have guessed. Boo. Oh well. Today I have GROUP!!! (:O") from 830 to 1030, then work out quickly, then home to shower/study for a BIG test, then back to class for a 3pm to 6pm wheelchair lab where we learn important stuff and how to do wheelies, I am scared because I'm a scaredycat of breaking open my head :O

Then Allison and I are spending the night at Brooke's aunt's big ol' home to study MORE after that, because the test is in the morning. On research project design. Augh.

And I was going to write more but posting about Group reminded me I need to find some pictures, so uh, yeah. Talk to you guys soon about Neuro-IFRAH and/or Group and/or lies, damn lies and statistics....

PS: Dude who wants to go to OT School, I haven't forgotten you, I just am a little scatter-brained right now. I'll try to email you within the week or you are always free to e-mail me again...

neuro-IFRAH and sleep and swimming and augh sleep deficits did I mention sleep

I'm so tired still! I went to bed by 10pm and got up at 6:40 and I could have slept another six hours!! Soo soo tired trying to catch up from last week's massive sleep deficit! I also had crazy dreams about being in scary claustrophobic situations. :(  It was not cool.

We had a great lecture on neuro-IFRAH yesterday and today we are actually going to have 2 hours of lab time, learning technique. I should be excited but in all honesty I'd right about now rather just sit still all day.

At noon I get to go have my first session as a participant in a lumbar stability program at the University, then from 1-4 we listen to lectures on Frames of References by other students - Allen's Cognitive Levels and Sensorimotor.

THEN, Allison and I are going to go swimming to work out and then I'm going to study as much as I can (hopefully energized from the swimming and not tempted to nap) before I work 9 to midnight!

I would really like to share more about neuro-IFRAH after today. I think there's a realistic chance I'll get to it at some point tonight too, are you all keeling over dead in shock? I hope so. But not really because then my stats would go down. :(

Have a great day, everyone!
Karen

Neuro-IFRAH - yay!

We have Neuro-IFRAH today! Patti, are you excited? I am!

More later! I have a big test Thursday that will consume a lot of my time studying, but after that is over my time should increase dramatically for fun stuff like blogging!

Jello Cereal: My OT skills are lacking

Scene: Me at friend's house. Paul folding laundry, me watching.

Me: I'd help you fold your laundry, but you know I suck at it.

Me pondering: You know, I'm probably going to be a crappy OT because I'm so dazzingly incompetent at doing all the functional things like laundry and dishes.

Paul: Yeah. You'll be like, you lost your arms in an accident but don't worry, we'll figure out a way for you to put jello on your cereal.

Me: Exactly

(Note: One time I ran out of milk for my brown rice krispies and I decided they just needed something to help wash them down so I threw some red jello on top. It was good, so shut up).

PS2: My other job tonight while at their house was to sit in the vestibule of their laundry room while Paul started laundry, and I just had to push the chickens living in there from trying to get into the rest of the house. These are the days of my lives.

Holy cow! I really AM famous! But not.

I check my stat counter more or less daily, and I typically stay stable at around 13-30 new visits a day. I checked today and double-taked. On Friday I had a 135 new visitors! That's like ten bazillion times higher than normal! I tried to figure out where the traffic came from, but I couldn't. If you are a new reader who found me on Friday, I'll be your new best friend and give you lots of secret knowledge about OT school (cough) if you tell me where the link was!

I also wish I had been a little more SANE this week in my entries, but it's been such a busy week that pretty much my blog entries have consisted of "AUGHHHHHHHHHHHHHH more later". Oh well.

Tonight I was supposed to work on stuff like I said in the previous post. Instead I took a 3 hour nap (because I was on a huge sleep deficit and I'm still tired so I will try not to feel TOO bad), but also spent 2 hours at a party instead of 1, and also spent well over an hour at another friend's house instead of like 45 minutes. So um, it's now almost midnight on Saturday and I have done NOTHING school-related. I'm gonna be freaking out tomorrow. :O

The good news is, the reason I was staying at the housewarming party two hours is that it was filled with nurses and other vaguely OT-related people. One person has a daughter with William's syndrome who was at the Tennessee Rehabilitation Center in Nashville, which has OTs. She got my e-mail and is going to send me more info, so hopefully that can be a contact for my OT department for fieldwork locations. Another one was a NICU nurse at the Med and I asked her about the feasibility of her being allowed to let me come in one day with her and get some basics on what is going on, to help me be a better volunteer with the newborns. Another one is getting her master's in social work at UT and is in a building I am in regularly at UT, and we discussed trying to network, since there is often times overlap between OT/social work, and it would be great if social workers could recommend OT more often. Etc. Plus, yesterday I ran into an old professor from college who also teaches kindergarden and told me she would love to have OT students "practice" on her kids. So it's been a network filled weekend and I LOVE IT!

I eat, sleep, and breathe OT. I think about it constantly. I love it. If you like the medical field, like people, like creativity and efficiency, like psychology, like um, anything, you will love OT school.

OCCUPATIONAL THERAPY SCHOOL IS THE WAY TO GO!!!!!!!!!!!

Holding babies in a hospital, or appealing to a Philanthropist, it never ends

Whew. Been a very busy week with a lot of late nights. It's a good thing most of my OT classmates have Verizon too or I'd be over by about 500% on my minutes. The night before two of the of the big presentations, my call phone log went something like this "Brooke Brooke Allison Brooke Brooke Camiell Anna Camiell Brooke Brooke Allison..." etc.

The class enjoyed the Cognitive Behavioral video we made that I showed a few posts down. It was easy and FUN to make. Overall our presentation was good, the game we prepared was not so great. I also had staff meeting, which is where once a month I meet with the faculty as the student representative (Co-VP of Academic Affairs along with one across the state). I pointed out that I think I'm pretty "with it", organized and efficient, and yet it was near impossible for me to keep up with all the different groups we were in. Especially Thursday and Friday, when I was interacting with ELEVEN other people in FOUR groups for THREE different things. But we're also in a Lab Group, a Group Group, a woodworking Group, and in about 9 other group projects with 2-3 people, and then oftentimes the groups have to interact with other groups, doubling the trauma. One thing about OT school, at least our OT school, is that you RARELY will do ANY project or big paper alone. You are in a group for pretty much everything. Now, I hate group work, but you eventually get used to it and it gets more fun, so don't think OT school isn't for you just based on what I said.

I was thinking today about how much fun I've had in the last few months. EVEN when I'm stressed and exhausted and threatening to drop out of OT school like I was this week, IT WAS STILL FUN because of the material and the people. I feel so lucky to be doing something I find so fascinating. The Visitable and Accessible Environment Project we have been working on is also over, we presented to a philanthropist a 20K budget proposal for a home adaptation using my home, as needed by a woman with ALS who had a power wheelchair and bilateral upper extremity weakness. We had to get estimates on getting a ramp put in, widening doorways, lowering the closet, raising the electrical switches and lowering the light switches, and changing the furniture around. Then we had to pretend the philanthropist rejected us and we had to present a 2K budget to the family, just getting down to the basics - not always pretty but at least functional. I learned a lot from my project as well as watching everyone else's.

One big mistake the people who went on Day 1 made was that they did not really "appeal" to the philanthropist. They didn't cater to his emotional drive or his generosity or explain why he should do it. It was just like "We need this, we need that". The philanthropist, who was actually our normal professor, did a good job of being abrupt and busy, which took us all aback but was a good learning experience. It reminded us we needed to get down to the nitty-gritty. A philanthropist offering up to 20K doesn't care about 10 dollar things, he wants to know why you want 3K for this object, 5K for this object...etc. Those of us that went on Day 2 got to go change our stuff around based on the stuff we saw happen on Day 1. It was fun. I can basically recite to you my part.."...how can you help? Home adaptation allows us to modify her home to make it safer, improve her quality of life, and provide her with more independence. Unfortunately the people who need it the most are often the ones who can least afford it. This is where your generosity comes in...." etc.. and btw, the people on day 1 DID do a good job, they just didn't get the benefit we got of knowing how the professor/philanthropist was going to ask and how he was going to challenge our choices.

I'm really tired today - I had work until midnight and then I am now volunteering every other Saturday from 10am-noon at the local children's hospital. Since I haven't had much sleep anyway, that was extra hard this weekend. The first baby I tried to hold was receptive when I was standing over him, but as soon as I picked him up he was unhappy, so I put him back in and felt kind of incompetent. The next baby I went to was adorable. She had been in that particular ward her entire life. She smiled at me a lot and I interacted with her a long time. I eventually found her nurse to make sure I could hold her and then literally held her for about an hour and a half. I just stroked her feet and arms, held her close to my body, looked her in the eyes, and sang to her. A lot of the babies in those wards who have been there long enough, especially those without parents, tend to develop some bad habits. Like they may develop sensory issues and not be able to handle a lot of touch, and/or may only be able to calm down if left alone. This one seemed fine and just needed the loving. At one point, staring into her eyes, I got tears in my own. It just seemed heartbreaking to me at that moment, thinking of all she has gone through and what her future might be. She seemed perfectly content to be held by a stranger, just soaking in love. She eventually fell asleep in my arms and I continued to hold her, as I figured it was probably a rare luxury for a baby to get to sleep in someone's arms when they are in a hospital without a parent. Unfortunately at that point I needed to go, but I hated to think I might wake her up by accident. I gingerly put her back in bed, and she started to open her eyes. I quickly put my arms in and held her arms and legs against her body, and it worked for a few minutes, but when I then moved again, she woke up for good. I felt bad, but by now I was already like 20 minutes late, so I had to go. I am really glad I got the experience of being at that hospital for my Level 1 rotation, because I had a much better idea of what to do with these babies for calming. The babies are still intimidating with all their tubes and issues, but it gets easier with time I think. Plus weekends are calmer and that helps a lot to volunteer during those times. Plus I am not as scared of the monitors as some volunteers would be - like the baby's respiration monitor would drop to zero and I think the average person would panic, but since I had been there before watching an OT I knew that I should monitor her behavior, and since her heart rate and oxygen were fine and she was breathing the same as she had been, it was probably just that one of her connections to the monitor had gotten lose. That was probably one of the most important things the OT taught me about being in there - yes, watch the monitors and listen to them, but when the baby seems fine and it says their oxygen is at a life-threatening level all of a sudden, it's most likely due to a connection issue - watch the baby, watch the monitor, and look for correlations.

This is long and has no real flow, but I had a lot of random things to get off my chest. I'm about to head out but I hope to be back early because I am REALLY tired and I desperately need to start working on some tests, one needing to be submitted Monday and one in Wednesday in class. Tomorrow I will work a lot on them, but I'm supposed to meet several different people and run to several different stores, so as always, I'm low on time!

I always like to promise a more coherent blog post will come soon, but who are we kidding. More random blog posts to come.