Peds SIM Encounter

I believe the SIM encounter went well and was a great learning opportunity. I felt competent in what I was saying and that I was empathetic. I thought it flowed well and that I hit all the components I needed to. If I were to do it again, something I would change is slowing down just a little bit when explaining certain aspects throughout the encounter, as well using more layman's terms. Some examples that show caring through communication is being able to clarify and paraphrase what the client/caregiver expresses and says. This shows that you are actively listening and being receptive, which relays compassion and empathy. Another example is letting the client/caregiver know you are there for their support by taking into account their needs and concerns and being an advocate and encouragement to them. Also, just nonverbal communication with body language, facial expressions, being engaged, and eye contact is really important to show an attitude of caring. From what I have learned from this SIM encounter that can be incorporated in future experiences, is the empathy that needs to be shown when interacting with a client/caregiver. Also, being able to interpret and explain results, diagnoses, and recommendations in a way that is understanding is important. 

Media Project

Media Project Sign:

Innovation:

Materials to the game:

Reflection "Innovator's Statement":
    For this media project, the ah-ha moment for me was when I was able to finally tie in the client's challenges from the diagnosis to what I was going to work on in the intervention to not only motivate the client, but also to make sure we were reaching their goals. I really enjoyed having to think outside the box and come up with something creative to be used as an intervention. That is what is so awesome about this profession. Occupational therapists are able to be creative and adapt to situations in order to optimize the engagement and performance of someone who is having difficulty with everyday tasks and bringing purpose back to their life.
    Having the background knowledge before this assignment really helped to brainstorm ideas about interventions, as well as knowing what types of barriers and symptoms a person could have with a particular diagnosis. This assignment was very beneficial in bringing in a clinical reasoning aspect in order to come up with an intervention and innovation that was the "just-right" challenge. As for the future, this project helped to get experience with how it is going to be in the workplace and having to think about ways to motivate a client, meeting their wants and needs, and having a treatment plan as a means and as an end. This was definitely one of my favorite projects or assignments I have done so far. It allowed me to really be in an "OT think" mindset and type perspective in order to come up with the best plan to help a client become more independent. This was a really fun project and helped me grow further as student!

Neuro Note #4 CVA

For the last neuro note, I watched a TED Talk about a lady who is a brain scientist, advocate for National Alliance on Mental Illness (NAMI) and researcher. She started her career because of her brother having schizophrenia and became interested in researching severe mental illnesses. With that being said, what are the odds that something happens to her own brain? Well in this TED talk titled "My Stoke of Insight," Dr. Jill Bolte Taylor shares her story about her own experience recovering from a stroke and the journey throughout having the stroke. She was able to watch her own brain and do the research and studying on herself. She experienced a hemorrhagic stroke in 1996 and it took away her ability to speak, walk, think, and memory. The stroke brought damage to the left side of her brain, with early signs being pain behind her left eye, her gait slowed down and became rigid, being able to receive and express language became difficult and her right arm became paralyzed. She discussed in the video the differences that each hemisphere has in regards to how we function physically, emotionally and mentally, as well as our motor and sensory skills. It has taken her 8 years to fully recover from her symptoms that occurred from the stroke. The way she told her story was so engaging and the perspective from a very own neuroanatomist was very neat. She was lucky to live because these types of strokes can be fatal. What was told in this video correlated well with what we learned in class about strokes. It is a form of an acquired brain injury and further classified as a non-traumatic brain injury. Also the symptoms that Jill described coincide with symptoms of a stroke. I really enjoyed how she described the sides of the brain in her own terms and feelings. It brought a different meaning to how the brain regulates and works. I am glad I chose this particular TED talk. She was a joy to listen to and it was cool to hear her story and "insight" on a stroke. Lastly,, she has written a book about this experience and a picture of it is provided below.






Here is the link to access Taylor's TED talk:
https://www.ted.com/talks/jill_bolte_taylor_s_powerful_stroke_of_insight

Reference:

Taylor, J. B. (2008, February). Retrieved August 13, 2019, from https://www.ted.com/talks/jill_bolte_taylor_s_powerful_stroke_of_insight

Neuro Note #3 ABI

For this neuro note, I watched a movie called "Brain on Fire" that was based on a true story about a young woman who experienced a rare autoimmune disease and had encephalitis. When Susannah was 21 she was working at the New York Post and she started experiencing weird symptoms. The doctors could not figure out what was going on. She was seeming to have episodes of schizophrenia (catatonic, hallucinations), bipolar disorder, seizures, fatigue, memory loss, coughing, numbness on the left side of her body, headaches and dizziness. After spending lots of time trying to diagnose Susannah, a doctor by the name of Dr. Najjar finally asked her to draw a clock and everything that Susannah wrote down was on the right side. This signaled a red flag that the right side of her brain was affected so the left side of her body was not functioning correctly. Come to find out her brain was inflamed and was causing all these symptoms. I found this story to be intriguing because it shows how much the brain can be affected by a non-TBI. It also showed what type of tests can be done like a MRI, EEG, neurological exam, and a simple cognitive test like drawing a clock to help diagnose someone with a neurological disorder. Also, having to go through all those tests, and spending a month in the hospital can take a toll on someone. This story shows how complex the brain is and how something like an inflammation can cause such odd and crazy symptoms. It also gave a depiction of how ADLs were affected, especially her job, hygiene, bathing and grooming . I also learned that this rare disease is called anti-NMDA receptor encephalitis and was only discovered 3 years before Susannah became ill. Lastly, since this disease has been discovered and diagnosed, there is a better understanding of the symptoms and how to properly diagnose and treat this specific neurological disease. I think it is great that people are willing to tell their stories and help educate on diseases that are rare. It gives opportunities for cures, support, treatment, and a hope for advancing medicine.

Here is the book that Susannah published about her story that this film was based off of:

Reference: 

Cahalan, S., & Theron, C. (2018, June 22). Brain on Fire. Retrieved August 11, 2019, from https://www.netflix.com/watch/80128245?trackId=13752289&tctx=0,0,03e7cdfd85f8229941edae282b1e623836d7fbbb:c4ec2d0b385d11b968e419843174d79c581560a9

Neuro Note #2 ALS

For this neuro note, I decided to look into a blog about someone who has been fighting ALS since they were diagnosed in 2015, at the age of 28. Her blog is titled "How I Live Now: Life with ALS" and she has been willing to be open and transparent about her journey living with a progressive disease. It took her almost a year until she started a blog in late May of 2016. She talks about the struggles having ALS (Amyotrophic Lateral Sclerosis aka Lou Gehrig's disease), like not being able to teach, the symptoms that occur, relying on others to help take care of her, not having the same chances to travel and not being able to start a family. However, she also mentions how this disease has changed her outlook on life and is grateful and humble for what she has and having the opportunity to share such a story that is unique and special to her. Being able to read about a personal story of someone with this neurological disease was so eye-opening and allowed me to encounter such an inspiring story. From reading her blogs, she discusses her symptoms and the challenges she has dealt with, but she always seems to stay positive and have the best outlook and mindset on life. She definitely has her days when it is hard, but she also finds joy knowing she has a great support system, especially her husband, Evan and her medical team. I learned that ALS affects upper and lower motor neurons, which Rachel mentioned she has the disease that affected the upper motor neurons, so her prognosis is better than those who have the lower motor neuron type. Also, she is having to use a catheter to help with bowel and bladder function, she has lost her ability to speak, as well as move her limbs, she gets fatigue easily, and has spasms. She also talks about the different surgeries, treatments, adaptive equipment, and medications she is on and has been through and using. Her lungs are starting to dysfunction, and she may only have up to 3 years to live, but she still presses on and lives life to the fullest and most potential that she can. I am glad I chose to do this specific type of note for this assignment because it gave me an insight on how ALS can affect someone, but even more how reading and learning about someone's experience with a disease like this helps advocate and raise awareness about it. In addition, her letting us get a glimpse into her life, allows us to be in her shoes and have empathy for her, as well as support her. I would highly recommend reading her blog and experience what I did!

Below is a link to access Rachel's blog:
https://howilivewithals.com/

Doboga, Rachel. “How I Live Now: Life with ALS.” How I Live with ALS, 21 May 2016, howilivewithals.com.

Neuro Note #1: OT Interventions used in Multiple Sclerosis

For this neuro note, I decided to read and review a systematic review about occupational therapy interventions used for multiple sclerosis. This article particularly looked at activity and participation as the intervention that was given by a multidisciplinary team. Multiple Sclerosis affects the central nervous system and impairs people's abilities to functionally engage in occupations. The three main categories or types of interventions given were rehabilitation programs, including inpatient and outpatient, fatigue management programs, which were either long-distance or face-to-face, and health promotion programs, that really align with occupational therapy philosophy. Having the multidisciplinary effort, it was beneficial in improving functional status, motor function, and self-perceived quality of life. Occupational therapists being a part of this team, they were able to help with ADL functioning, as well as stress and fatigue management. Being able to see the different aspects brought to the table with the multidisciplinary approach was beneficial for my learning, because it really is a team effort to help someone get back to their meaningful and purposeful everyday life. I chose this article and this neurological condition because we have not yet fully discussed MS in class, so I wanted to dive deeper into it. Also throughout my experience doing observations and an internship, I was not able to see a lot of cases of multiple sclerosis, so being able to learn in detail about what occupational therapists do for this condition was helpful. Occupational therapists play such a vital role in helping people recover and to be able to research and find articles like this are so beneficial to know on how to become a client-centered, evidence-based practitioner.

Below you will find the link to the article for access.

https://www.researchgate.net/profile/Virgil_Mathiowetz/publication/259461986_Systematic_Review_of_Occupational_Therapy_Related_Interventions_for_People_With_Multiple_Sclerosis_Part_1_Activity_and_Participation/links/55ff2a8508aeba1d9f840470/Systematic-Review-of-Occupational-Therapy-Related-Interventions-for-People-With-Multiple-Sclerosis-Part-1-Activity-and-Participation.pdf

Yu, C., & Mathiowetz, V. (2014, January 01). Systematic Review of Occupational Therapy–Related Interventions for People With Multiple Sclerosis: Part 1. Activity and Participation. Retrieved July 16, 2019, from https://ajot.aota.org/article.aspx?articleid=1863111

Hierarchy of Mobility Skills

In order to increase someone's confidence when it comes to mobility, it is important that the client is educated on the steps it takes to carry out the action, as well as it pertaining to the client's goals, needs, values and that it is relevant. In addition, we want the client to be able to move and function in a safe and correct way, so risks can be minimized. For the body to be mobile, there are some ways to make it easier, which includes making sure the center of gravity is moving, the line of gravity is near the outer edge of the base of support, outside joint motion is controlled, and the base of support is small. As for the order of the hierarchy of mobility skills the first mobility that is done is bed mobility, then mat transfer to wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and last community mobility and driving. It makes sense that it is done in this sequence so it is expected, and I believe it is in this order because the level of cognition needed starts out less complex and easier to understand. As you go up the pyramid, there are more steps and movements to follow and carry out to remember. Also, the base of support is wider and more stable starting with bed mobility, but as you go up the BoS gets smaller, which makes it more difficult. I have observed in the past that it is done in this order, but not with every client depending on their level of independency (level of assistance) along with comprehension and functional body control. I think it depends on the status of the client and what they can do that determines which mobility skill needs to be worked on or started off with. I do agree with this approach because there is not only room for improvement and progress, but it is also putting the client in a safe environment and builds their self-efficacy.