Preventing Alzheimer's

Today I listened to a Ted Talk by Lisa Genova, the author of the novel Still Alice.  In her talk entitled "What you can do to prevent Alzheimer's", Lisa describes the pathology behind the most common neurodegenerative disease and possible ways to protect your brain from it.  She explains that Alzheimer's Disease (AD) is caused by plaques of amyloid beta accumulating within the synapses in a brain.  This phenomenon occurs naturally in the brain as it ages, but it becomes a problem once the number reaches a tipping point and becomes Alzheimer's disease.  Although there is no cure for this disease, Lisa suggests that certain measures can be taken to help prevent these plaques from reaching their tipping point.  Cardiovascular disease and lack of sleep are two examples of health problems that lead to an overgrowth of amyloid plaques in the body. If we make an effort to decrease these stresses on our bodies, then it can significantly reduce the risk of developing AD.  Preventative measures are more effective than trying to treat AD once you have it; however, she goes on to say that the effects that AD have on the body can be reduced through neuroplasticity and creating more connections in what she calls a "cognitive reserve".  For example, learning a new language like Italian will stimulate the brain and therefore create new connections.

I chose this for my neuro note because I have been interested in Lisa Genova's work ever since we discussed her book Still Alice during class.  I think it is remarkable that she is a neuroscientist and a talented author who has the creativity to implement her knowledge through a work of fiction.  After seeing this Ted Talk, I am going to continue my knowledge through reading Still Alice.  She briefly discussed how the main character, Alice, has a rare genetic component that put her at a great risk to develop AD. I also wanted to learn a little more about Lisa's background, so I explored her "About Me" page on her website: http://lisagenova.com/about-lisa/

She appears to be a truly intelligent person.

My main take away from this video was that Alzheimer's Disease is not necessarily inevitable. It seems that if someone lives long enough, he/she will more than likely get this disease.  However, science is making some serious headway with finding preventative measures and hopefully someday, a cure. As an occupational therapist, it might be a good idea to show this Ted Talk to someone recently diagnosed with AD so he/she can begin to facilitate ways to promote neuroplasticity.  This video could bring hope to many people.

Genova, L. (2017, April). What you can do to prevent Alzheimer's [Video File]. Retrieved from https://www.ted.com/talks/lisa_genova_what_you_can_do_to_prevent_alzheimer_s#t-820240

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"Hi there! My name is Jane. I am a single 33-year-old nurse. Not long ago, I was diagnosed with Guillain-Barre Syndrome (GBS). Along with the funny name the disease also comes with some obstacles. I was unable to perform fine motor tasks due to distal weakness in my upper extremities. My occupational therapist suggested we use the Hook N' Hold as adaptive equipment to improve my grip. She explained to me that this could help me hold my whisk when cooking, my shovel when gardening, and my toothbrush when performing self care activities (see my picture above). Instead of continually grasping an object, I can simply engage the hooks and relieve any stress on my hands. The device is so simple to use and it makes my life easier. I hope to be able to get to a point where I will no longer need the Hook N' Hold; with enough work I will reach my goals! Even though I have GBS, the Hook N' Hold can be used by anyone who has fine motor problems. I love my Hook N' Hold!"

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This Is: A Glimpse into Brain Cancer

I have formed a habit of searching through the provided list of resources for what I will write in my neuro notes.  I skimmed through the various titles and came upon something unusual...a photo documentary.  After I clicked on the link, I came to a page filled only with photos. The pictures themselves were the story. The only explanation of the documentary was provided in the left hand corner of the page: this was Josh and Jenna's story.  "This is..." is the name of the documentary filled with emotional moments captured by a photographer named Jennifer Keenan Giliberto.  She explains that Josh and Jenna were generous enough to allow her to capture some of the most intimate times during Josh's battle with Grade IV, Glioblastoma Multiform.  Just two days into their honeymoon, Josh and Jenna discovered that Josh had a brain tumor.  These pictures are the brief glimpses into the roller coaster of a journey they had.

I almost closed the window once I realized what this documentary was.  When I saw that there was no text to go off of, I was hesitant to write my neuro note on it.  However, when I looked at a couple of the pictures in the documentary, I could not stop.  The raw emotion that is depicted is unbelievably intriguing.  No matter how many times I have heard how terrible brain cancer is, there is nothing quite like seeing it.

The documentary begins by showing pictures of Josh and Jenna in a hospital room before his invasive brain surgery.  Josh looks relatively healthy...this is the calm before the storm.  We are then taken on a journey through his surgery, therapy, and adjustment to life.  We see the hard times, but we also see the good times.  Despite all of the sorrow that goes along with this disease, Josh and Jenna experience unbelievable joy with the birth of their child.
The documentary is concluded with images that suggest that Josh is dying: he looses an extreme amount of weight and is lying lifeless in his bed with Jenna.  The last pictures show Josh being hoisted off of his bed and Jenna in uncontrollable tears.  I am not completely certain that Josh died that day, but that is what the pictures suggest.

Through this experience, albeit a short one, I have put together a bigger picture of what a fatal disease looks like. In our courses, we learn a great amount about the science of neurological dysfunction, but we must understand how these diseases affect the family unit. It's not just a MRI or a PET scan.  It's not just malignant cells that eventually kill their host.  It's unbelievable pain that NOBODY can understand unless you have been through it yourself. Families are part of our client demographic, and as such it is paramount that we use our therapeutic use of self in our practice. I cannot understand what their pain is like, and God willing I never will. This documentary is unique because it puts you in a first person perspective into this utterly gruesome experience.  I can say without a doubt that this neuro note experience hit me the hardest. There is something to be said about the impact that pictures have on the human soul.

After this experience, I did some brief research on what this particular type of brain cancer is.  I came across this website: http://www.abta.org/brain-tumor-information/types-of-tumors/glioblastoma.html?referrer=https://www.google.com/
The research says that this type of cancer has a "median survival rate".  To me, that does not seem like a very positive prognosis. Looking at this website helped me put Josh and Jenna's story into perspective. I would recommend this site to those who are interested in learning about this type of cancer. 


Retrieved from https://www.facebook.com/jkeenanphotography/photos/a.512697155472990.1073741838.441149622627744/1089317347810965/?type=3&theater


References 
JKeenan Photography. (n.d.) This is... Retrieved from http://www.thisisdocumentary.com/

Dementia: Ruby Jewel Bowen

Today I presented on the story of my grandmother, Ruby.  It was a really positive experience altogether: my peers seemed interested in her story and asked great questions as well.  Dementia is such an interesting topic to discuss because there isn't just one diagnosis that is attached to it.  Ruby had Alzheimer's disease, which is the most common form of dementia there is.  What I got out of doing this report was that I used my "OT think" to solve problems that a loved one faced.  It helped me practice putting myself into my client's shoes because I was close to her personally.  As occupational therapists, we need to empathize and understand what our clients are going through.  If we think about the challenging parts in our lives and relate that feeling when we are working as OTs, we will better understand their struggles and pains.

Jack Osbourne and Multiple Sclerosis

Jack Osbourne, the son of Ozzy and Sharon Osbourne, was diagnosed with Multiple Sclerosis in 2012.  Before his diagnosis, Ozzy was an extremely active individual with his own TV show "Jack Osborne: Adrenaline Junkie".  Unfortunately, MS is a disease that causes someone to fatigue easily and often, so Jack had to slow down his high-speed lifestyle.  Even despite this setback, Jack participated in the hit reality TV show, "Dancing with the Stars".  This show demanded a great deal of energy output for Jack, so there was a learning curve that he had to get a handle on in order to manage his disease properly.  Jack has Relapsing Remitting Multiple Sclerosis which means that he can experience symptoms at one point in time and they will fade away at another time.  This kind of MS is interesting to me because Jack experienced blindness in one eye for a time, and then his vision would suddenly come back.  I believe this characteristic of MS makes it unique and also more manageable for someone.  Even though MS is a disease that alters someone's life in a negative way, at least the symptoms can be alleviated for some people.  Also, it is very fortunate that this disease is not fatal and allows people to have a normal life expectancy.

Putting Ice in the Bucket

Putting Ice in the Bucket

Nancy Frates was just your typical mother of a baseball loving son, Pete.  She had a happy, typical life until the unthinkable happened: her 27 year old son was diagnosed with Amyotrophic Lateral Sclerosis.  It began with a hand injury from baseball that just didn't seem to heal; when he went to the neurologist, he was told that it wasn't an injury... it was a degenerative, fatal disease that would turn his world upside-down. Nancy Frates describes this journey in her Ted Talk: "Meet the Mom who started the Ice Bucket Challenge."  Instead of feeling sorry for himself, Pete made a powerful statement to his family: they were going to team up and create awareness about this "rare" disease.  His goal was to get this disease in front of big wig philanthropists such as Bill Gates.  Their entire family jumped on board: aunts, uncles, cousins, and other loved ones were given various responsibilities to make this possible.  The pivotal part in this story was when "the ice started to fall" and Pete's roommate made a call to action.  He poured a bucket of ice over himself and challenged others to do the same...all of this in an effort to raise money for ALS research. This simple gesture started a cascade of events that had worldwide impact.  Nancy describes the most groundbreaking moment was when Bill Gates himself did the challenge; it was so monumental because that was the goal that started all of this!

I chose this Ted Talk because I had seen the ice bucket challenge on social media and wanted to relate a face to the movement.  It's easy to look at a craze like the ice bucket challenge and forget that there is probably a story behind all of the hype.  Watching this video gave me insight into the internal battle that occurs when you or someone you love is diagnosed with a fatal disease.  Nancy said that many times she just wanted to curl up in a ball and not get out of bed.  However, she knew she had to get up and live life for her son.  If he could be this positive about his situation, she had to be brave as well.

After watching this Ted Talk, I looked for the ALS Association's webpage about the ice bucket challenge.  On this page, they have a video of Nancy & Pete's story which was great to supplement with the Ted Talk.  Here is a link to the site: http://www.alsa.org/fight-als/ice-bucket-challenge.html?referrer=https://www.google.com/

Frates, N. (2014, October). Meet the mom who started the ice bucket challenge [Video File]. Retrieved from https://www.ted.com/talks/nancy_frates_why_my_family_started_the_als_ice_bucket_challenge_the_rest_is_history#t-564856

Pictured above is Bill Gates doing the ice bucket challenge. Retrieved from http://www.huffingtonpost.com/2014/08/15/bill-gates-als-ice-bucket-challenge_n_5682914.html

Huntington's Disease: Woody Guthrie

Woody Guthrie

Woody Guthrie was a musician who was diagnosed with Huntington's disease which affects both cognitive and motor abilities.  Woody struggled with erratic behavior and impulse control more and more as the disease progressed.  Some of his inappropriate/dangerous behaviors included shoving sawdust into his son's mouth and writing erotic letters to many women.  His motor skills also greatly affected his beloved occupation of singing and playing the guitar. It would be important to address this occupation early because that is what he loves to do the most.  What was interesting to me was that his mother likely had Huntington's as well, but she was never diagnosed with it.  Instead, she was institutionalized because medicine had not progressed that far during that time. Now there is a test to see if you have the gene that often leads to Huntington's.   

Main Take-Away from Foundations

Main Take-Away from Foundations

As obvious as it may seem, the most important thing I have gained from this course is understanding the OT Domain & Process in the OTPF.  Even though the document itself is long and kind of dry, it is an integral part in our profession.  Before this course, I did not know occupations were split up into categories of ADLs, iADLS, work, education, etc.  I thought occupations was just a blanket term to cover everything we do in life.  I also did not know that we place emphasis on client factors, performance patterns, context & environment, etc.  The domain of OT is definitely the most strange thing that become familiar to me in this course.  I knew there was an OT process before taking this course (and I had a rough idea of the components in it), but I learned that it is not as cut and dry as I had once thought.  In this case, the familiar became strange to me.  I thought evaluation, intervention, and outcomes were more simple than they actually are.  I did not know about occupational profiles, client interviews, adjustment of intervention, and so on. I'm glad I understand the OTPF now because it seemed very overwhelming to me when we were talking about it in our Evidence-Based Practice course.  Thank you for making it a lot less intimidating!

Rowdy Gaines and Guillain-Barre Syndrome

Rowdy Gains was a 3 time Olympic gold medalist who was diagnosed with GBS at the age of 31.  One of his interventions during this time was pool therapy, which is not an uncommon occupational therapy treatment.  I thought it was interesting that the OT could use an average therapeutic technique that also served as engagement in an integral occupation in his life.  What is truly impressive about Rowdy's case was that he qualified for the 1996 Olympics even after his diagnosis of GBS (and was the oldest person to qualify!)  Even though he did not end up performing in the 1996 Olympics, it goes to show that individuals with these life-altering neurological diseases can sometimes get to a place where they were before their dysfunction.

Foundations: Course Wrap-Up

Course Wrap-Up

I'm sad to say goodbye to our Foundations course.  Even though this was one of our longest courses we've had so far, it was without a doubt one of the most enjoyable.  Before entering this course, I had a basic idea of what occupational therapy really was. Now that we are finishing up this course, I feel so much more confident in my knowledge of the inner workings of this profession.  I do believe that this course would have been more beneficial to start at the very beginning of the year (as opposed to Evidence Based Practice, for example) because it gives us a good orientation as to what OT is all about.  This course has given me so much to look forward to in the future as a practicing occupational therapist. Thank you again for an awesome course.

Foundations: Fear of Explaining

Fear of Explaining

One of the obvious requirements for this program was the capacity to explain what the profession of occupational therapy is.  I remember in my entrance interview, I was asked "In your own words, how would you describe occupational therapy." I knew what I was going to say because I had practiced possible answers before my interview.  I responded with "Occupational therapy is a profession in which the therapist helps someone get to a best life possible.  This profession is truly unique to me because it applies to everyone across the lifespan: all the way from children with developmental disabilities to older adults who have had strokes."  This was an adequate response to the question because I had limited resources in which to obtain a perfect answer to the question.  
Now that I am in OT school, I feel a greater pressure to give a perfect elevator speech.  However, I have also gained better insight into exactly what OT is and all that it entails.  I do admit that I still get nervous when someone asks me what occupational therapy is.  I suppose that I am worried that I am going to mess it up somehow and do an injustice to the profession.  I believe this anxiety will become less of a problem as I progress in the curriculum (hopefully!)

Foundations: Therapeutic Use of Self

Therapeutic Use of Self in OT

Otherwise known as "the art of relating", therapeutic use of self is a concept that I knew about but did not have a term to describe it. I think this idea is at the very core of who we are as occupational therapists.  We can know intervention techniques and theories frontwards and backwards, but all of that really means nothing if we cannot relate to our clients.  A term that goes hand in hand with this idea is empathy.  For our clients to trust us, we must be able to put ourselves in their shoes.  If we cannot relate to our clients on a personal and emotional basis, what makes OT so unique? Wouldn't we be just like any other branch of medicine that simply sees them as a diagnosis?  I believe the very core of our distinct value of OT is the therapeutic use of self. I look forward to learning more and practicing this intervention technique in the future!

Ulla-Carin Lindquist and ALS

Ulla-Carin Lindquist

Ulla-Carin was a Sweedish news anchor and a journalist who was diagnosed with ALS at the age of 49.  Even though some people can live a longer life with this disease, she died within one year of her diagnosis. What was most interesting/surprising to me about Ulla-Carin's case was that she was an extremely active individual who participated in sports such as boating, skiing, horseback riding, and skating.  Even despite such a healthy condition before her diagnosis, she quickly lost her ability to do everyday activities. She had to focus on conserving her energy just to be able to get by in life. Her condition severely impacted her children, especially when Ulla-Carin lost the ability to speak. Ulla-Carin's family started a foundation when she passed away to support research on finding a cure for ALS. Her story and legacy has helped raise awareness about ALS in Sweden. 

Foundations: Burnout

Burnout

I have realized that burnout is not just something that happens with practicing occupational therapists; it occurs just as often (if not more) for occupational therapy students.  During gross anatomy, I did not experience burnout because that was basically the only course I was taking at the time and I had plenty of room to do things that I wanted to.  In one of the psychology courses I took in undergrad, I learned about the importance of self-care.  Practicing proper self-care means taking time out of a hectic schedule to do something for yourself: whether that be hanging out with friends, reading for pleasure, shopping, etc.  As my courses have loaded up in OT school, I have not had the opportunity to practice proper self-care and as a result, I am experiencing burnout. Also, I have noticed that I must make an effort to look beyond this material as something to study for an exam and see it for what it really is: my passion.  When I was studying for my neuro OCP test, I was looking at the different levels of lesion and functions associated (whilst being extremely stressed out).  I had to stop myself while I was studying and really think: I'm learning about levels of lesion...this kind of information changes people's entire lives.  I realized I needed to look at my coursework through a new lens and not allow my stress to interfere with my passion for occupational therapy.

Foundations: Cultural Competence

Cultural Competence

Cultural competence is a key concept that occupational therapists must have a grasp on to be the best practitioners we can be.  I see cultural competence as going hand in hand with a holistic mindset: if we cannot look beyond differences in culture, how are we supposed to see others as whole human beings?  In class, we discussed some key terms such as racism, discrimination, bias, etc.  It is hard to come to terms with the fact that these kinds of negative feelings come across our minds from time to time, but it is important that we are faced with the reality that everyone has those thoughts.  What's important is to stop them in their tracks.  Taking racism for example: if an OT looks at someone evenly slightly different due to the color of someone's skin, that therapist is not looking at the client holistically.  How can you look at the "whole person" if you cannot accept them as having equal person-hood as yourself?  Even though these topics can be controversial and uncomfortable, it is necessary to have this kind of dialogue to accept others and provide the best treatment possible.

Sexuality and Occupational Therapy: Breaking the Barrier

Ever since my OT class was told that we would be discussing sexual function in our neuro class, I have been eagerly waiting for that day to come.  What intrigues me so much about neurological disorders and sexuality is that it is so taboo! I'm very excited that our class will be discussing this topic.  When I came across the article with the title "Fucktionality: Why Sexual Function Should be Part of Occupational and Physical Therapies for Disabled People", I was immediately hooked.  I mean come on, that is a rather intriguing title.  I started reading the article solely based on the title, but I ended up getting so much more from reading the article itself.

Andrew Gurza is a gay man who has cerebral palsy who has a simple call to action: occupational and physical therapists need to emphasize sexual function in intervention.  He retells a personal story of his frustration with his inability to thrust when engaging in intimacy.  When confronting his OT about his issue, she became very uncomfortable and was unable to help him engage in this occupation.  He goes on to explain that therapists are not being properly educated about the importance of sexual function in therapy and how to help clients engage in this very important activity.

It truly made me angry when I saw how the occupational therapist reacted to the client's request to get help in his sexual performance.  Instead of understanding his frustrations, she made him feel uncomfortable about his desires.  People have a tendency to de-sexualize those with disabilities and have trouble understanding that they are sexual creatures just like the rest of us.  This article was extremely eye-opening for me because it gave a personal account of this kind of problem that many wheelchair-bound individuals face.

I would strongly urge our program at UTHSC to educate the MOT classes on this matter and provide us with the information needed to provide intervention and counsel for these individuals.  The following is a link to AOTA's page on occupational therapy interventions regarding sexuality: http://www.aota.org/About-Occupational-Therapy/Professionals/RDP/Sexuality.aspx
Since I was uneducated in the various ways sexuality can be used in intervention, this site gave me a broad idea of what it might look like.

Gurza, A. (2016, June). Fucktionality: Why sexual function should be part of occupational and physical therapies for disabled people. Retrieved from https://www.kinkly.com/2/13660/sexual-health/health-professional/fucktionality-why-sexual-function-should-be-part-of-occupational-and-physical-therapies-for-disabled-people

Foundations: Activity Analysis

Last week, we participated in an activity analysis lab for our class in Foundations.  Even though the expectations for the project were not extremely difficult, the assignment itself is important.  We as people may not understand the importance of learning the ins and out of daily activities, but as occupational therapists we must know them!  People do not necessarily think of all the steps it takes to make a cup of coffee; however, if someone needs to re-learn how to do this activity due to a disability, these steps are critical.  I think it was very helpful to practice explaining and teaching activities to others because that is something we will have to do with our clients.  My biggest take-away from the lab was discussing the different ways to grade an activity to make the "just right challenge" for our clients.  This kind of brainstorming helps us getting into an OT mindset when thinking about daily life activities.  All in all, the activity analysis lab was both fun and useful.

Emerging Areas: Bullying

Bullying is without a doubt one of the many problems a child/adolescent could face in his/her lifetime.  This kind of strain on a child could cause many issues that could hinder occupational performance (depression, lack of motivation, problems with playtime, etc.)  It is important for an OT to address this in order to provide clients with a satisfying quality of life.  One way that this could be achieved is by creating after-school programs for children and discussing this problem with them. Susan Bazyk is an OT who has implemented this kind of program and has seen positive results from it.

This emerging area correlated with AOTA's Vision 2025 by embracing the guidepost of making occupational therapy leadership-based through being "influential in changing policies, environments, and complex systems".  By making strides to end bullying, occupational therapists are being leaders and role models to children.  In turn, it helps them become leaders themselves.

Michael J. Fox and PD

Michael J. Fox is probably best known for his role as Marty McFly in the hit movie, Back to the Future.  However, people also commonly associate Michael with his illness, Parkinson's Disease (PD).  What is so unique about Michael's situation is that he was diagnosed at an extremely young age.  At age 29, Michael was among the 4% of people with PD who are diagnosed before the age of 60.  This really stood out to me because most people in their late 20's could not even fathom the idea of having an illness that is geriatric in nature.  At that age, people tend to think they are invincible! Michael is private when it comes to the nature of his own illness, but has made great strides in creating a foundation for those with Parkinson's.  I think it is admirable for someone who is already in the spotlight to emphasize the need for a cure rather than his personal challenges with the illness.

Foundations: Becoming Aware

Instead of writing a blog post about what I learned in class on a certain day, I'm going to discuss a trend that I have noticed since starting OT school...there are SO MANY WAYS the human body can go haywire.  Like any other educated adult, I was aware of various diseases or disabilities that happen in the human body; however I was not faced with the gravity of it all until coming to UT.  It is so remarkable to me that any of us have gotten this far without some sort of catastrophic disease/disability.  It is a miracle that most of us were born without a congenital disease; but even so, there are many other diseases out there that can plague the human body during the lifespan.  We take our health for granted every single day.  How lucky are we to be able to come to school and learn about OT!  We need to be thankful for the health of ourselves and our loved ones every single day.  As a future practitioner, I think this realization will help me because it has caused me to become aware of the fragility of human health and how it affects our clients.  I can look at their situation and not pity them...instead I will understand that this could truly happen to anyone, including myself.

Tyler's TBI

Tyler sustained a TBI in the T7/T8 area of his spine when he was on a helicopter for a drill with the Air Force and Army.  I found this story to be especially upsetting because he was a young man who had his entire life ahead of him.  He was all set to be a pilot when he graduated and even had job opportunities from companies like FedEx lined up for him.  However, those plans came to a screeching halt when someone made a mistake and forgot to strap him into the helicopter.  It is not difficult to understand why Tyler is so extremely frustrated with his current situation because his life was drastically changed at the hands of someone else.

What stuck out to me the most was when Macy explained that in the interview, Tyler seemed very optimistic and surprisingly happy despite his current state.  However, when she talked to her best friend who is closer to that family, Macy learned that Tyler is especially irritable and depressed because of the accident.  It goes to show that even though we hear these various stories of brave people overcoming neurological challenges, we should not forget that they are real people who experience real emotions.  We cannot expect these people to keep a facade that everything is OK and understand that it is normal to be depressed and angry during these troublesome times.

A Talk with Tourette

As I was glossing over the list of possible resources to use for the neuro note assignment, I stumbled upon a Ted Talk about Tourette's Syndrome called "Tourette Does the Talking".  I immediately clicked on the link because I have always had an interest in Tourette's Syndrome.  I think this is primarily due to the fact that I have never met someone with Tourette's, so it seems very foreign to me.  I have done some research about it over the years and I would love the chance to be able to sit down with someone who has it and talk about how it has affected his/her life.  I would like this opportunity because I believe it is one of the more challenging neurological disorders in our world.  It affects a persons life 24/7 and tends to start in childhood or adolescence (so they endure the hardships for the entirety of their lives!)

In the Ted Talk, college student Thomas White gives us a look at a day in the life of someone living with Tourette's Syndrome.  He explains that he has the common verbal and motor tics that most people who have Tourette's exhibit, but that he has Coprolalia as well.  Coprolalia is the usage of profane or offensive language that rarely occurs in those who have Tourette's.  Thomas is constantly insulting people he likes and even those he loves.  It is because of these challenges that he deems Tourettes to be an "unrelenting neurological assault."  He continues his discussion by giving us a play-by-play as to what his average day looks like.  He begins his day by stating "I hate you, you f*cking sh*t" to a friend in the bathroom and is answered with "Hey, how's it going Tom?"  He mentions that he is fortunate enough to have friends that understand what he goes through.  When putting his books away for the classes of the day, he hits himself in the head with each book.  Before watching this Ted Talk, I did not realize that Tourette's not only causes bizarre language patterns, but also causes someone to do things they would not normally do.  He continues on to describe the struggles that he faces on a daily basis.  However, he does not end on a pessimistic note.  He actually does not see himself as a victim.  He states that he has problems, just like each and every one of us does and if we as humans are going to overcome these hardships, we must stick together.

In this course, we learn about empathy and being sensitive to others who have these neurological conditions.  To empathize with someone, it literally means to share feelings with someone else. Thomas hit the nail on the head when he said that we are all in this together, no matter what the diagnosis or problem is.  He states that "we can triumph together when we see that we are in the same boat."  If we just look outwardly at what other people are feeling instead of getting caught up in our own hardships, we can work together to overcome.

After watching the video, I did a bit more research on Tourette's, and I came across the website for the Tourette Association of America (https://www.tourette.org/), which has a vast array of information about Tourette's.  It also has testimonials from different people of different age groups of those living with Tourette's, which I found to be very conducive to my learning experience.

White, T. (2014, February). Tourette does the talking [Video File]. Retrieved from http://tedxtalks.ted.com/video/Tourette-Does-the-Talking-Thoma;search%3Aneurological 

Foundations: Thoughts on Clinical Observation

Clinical observation is the most intimidating part of the OT process, in my opinion.  For example, I am considering working in pediatrics when I become a practitioner.  When I imagine myself doing a clinical observation of the child, I am worried that I will be able to accomplish it successfully.  It seems rather difficult trying to juggle interaction with the child while taking note of their performance.  Not to mention, you have to document everything you see! I am worried that I will either forget something the child did or I will be too focused on documenting what the child is doing that it affects the way I interact with that child.  I understand the process is an art that will be refined with practice, but that is just how I feel at this point in my career as an OT student.

Foundations: OT Process

Today we learned about the OT Process, as described by the Occupational Therapy Practice Framework.  Above you will find a graphic that includes a sort of word collage of terms that relate to each aspect of the process.  I found this graphic helpful because it helps me associate what belongs in each part of the process at a glance.  I love learning about the process of occupational therapy because it is the meat of what we do.  Learning about our domain is interesting of course; however, I find the process of OT captures my attention more because I can visualize myself in each of these steps.  I am getting more and more excited just thinking about going through this process with my clients.  Before today’s class, I did not realize how important proper documentation was in the process.  It’s amazing to me that even leaving a single blank empty can be a tragic mistake!  I see how this kind of strictness is important to our profession; mistakes in our documentation can negatively affect our clients.

Neuro: Thoughts on Today's Lecture

Today has truly been an emotional day for our class.  During our first pathology class, we discussed with Prof. Sasse some problems we have dealt with and overcame in our life and during this class we saw various ways that brain injuries have dramatically changed the lives of others.  It's so easy to get caught up in our own problems and what is important in our lives that we rarely look at other people and realize that they have problems just like we do.  What is amazing about occupational therapy is our ability to look past our own selfishness and look at the individuals we are caring for.  One of our core standards we hold ourselves to is embracing altruism in practice.  I love how occupational therapy is so unique in this way.  I cannot think of another health profession that is as selfless as occupational therapy.  When people get services from us, they know for certain that we are looking at what matters to them because that is exactly what our job description is!  Seeing these cases of traumatic and non-traumatic brain injury have definitely humbled me and made me realize how often I take my own health and the health of my loved ones for granted.  I know that one day I may have to deal with illness (whether it be my own or one that a loved one has) that is difficult like these are, so I need to understand how gentle the health of humankind really is and appreciate it while I still have it.

Foundations: Universal Design

As far as theories go, my favorite so far has been the Universal Design Theory.  I never realized how much of our everyday experiences are linked to helping people with disabilities.  It did not occur to me that automatic doors and automatic soap dispensers were made to accommodate those who have trouble getting around in the world we live in.  I thought those things were made to make our lives more convenient! It is true that this type of equipment does make everyone’s lives easier, but that is not the point here.  This kind of mindset I had just proves that able-bodied individuals often have issues with relating to those people with disabilities and understanding the everyday obstacles that they must overcome.  Understanding Universal Design Theory has given me a new lens in which to look at my world.  I will now notice if something is disability-friendly or if it is not.  

Reaction to Aimee Mullins Ted Talk

In her Ted Talk, Aimee explains that words can hinder someone from being the best version of himself/herself.  She illustrates this by showing what a thesaurus came up with when she looked up the word "disabled".  I believe this principle can be applied to everyone, not just someone with a physical or mental disability.  No matter who you are, words have the power to change your entire mindset about who you are.  I was inspired that Aimee did not allow negative thoughts and statements about what she was capable off affect the way she saw herself.  This Ted Talk was specifically called Ted Med, so I believe that the audience consisted of medical professionals.  This is important because she emphasized the importance of seeing people for who they are, not just as a diagnosis. As holistic practitioners, occupational therapists are all about this concept.  I think this holistic approach is one that needs to be shared in other fields of medicine, not just occupational therapy.  I am pleased that Aimee gave this call to action and I hope that physicians, nurses, and other medical professionals embrace this mindset as well.

PEO Model

In Lynne Oberle's article, Putting OT Theory Into Action: Knowing and Applying Frames of Reference, she discusses the frustrations her students have with learning theories in occupational therapy.  In our Foundations class, I had a similar experience: I first thought that this information was not really important in performing OT services.  I have gained a little more insight as to why these theories actually matter.  One of the more interesting theories to me is the Person-Environment-Occupation (PEO) Model.  I like this model because it stresses the importance of environment in occupational performance.  I believe that as occupational therapy students, we tend to neglect the impact that environment has because we focus on the disability or illness! In order to be successful practitioners, it is absolutely imperative that we have a holistic approach to practice: that includes looking at a person's environment.  This became even clearer to me when Oberle discussed how someone will need modifications in a home that was built in the 1800s; when someone has trouble getting around, the home must be a safe environment in order for occupational performance to be successful in that person.

How does the OTPF influence (guide) OT practice?

The OTPF has given us a guideline for everything we do as occupational therapists.  It illustrates the "top-down approach" which basically states that we look at a client's occupation first, then look at the challenge or disability they face.  The OTPF lays out what our scope of practice looks like; it describes what we should be looking for when trying to identify occupations and the client's challenges that are associated with these occupations. It also describes the steps we should be taking when providing services to our clients.