The Honor Code

 UTHSC has an honor code in place to help keep our school accountable and trustworthy. I read the honor code in detail from our school's website. I am so honored to go to a school where they take pride in enforcing the honor code for each department. I think our department has three honor code counselors (students) that report any suspicious activity to the honor code representative (faculty member) for our department. I think it is so important now more than ever that the school tries to reinforce the honor codes. It can be so easy for students to cheat since we are distance learning for the time being. If test are not proctored, then it is very easy for a student to cheat. I think it is important that every professor emphasize the importance of following the honor code daily and especially before a test or quiz. It is also the responsibility of each student to have the respect to uphold the honor code since we each had to sign it before starting school. If they do not uphold it, the person they hurt the most is themselves. I believe our department does a fantastic job of emphasizing the honor code and reminding us of how important it is. I pray that as we continue to earn our degree's from home that each student will remember the code that they signed and that it is important to uphold it. We should want to do our part in making our school and department honest and trustworthy to others. 

Reaching Out to Potential OTs

 I have a passion for the field of occupational therapy and I believe it is so important to share what OT is and how you can become one. I have had so many doctors and nurses say to me that they need more OTs now that we are in a pandemic. They tell me how vital a role they play in the recovery process for patients. I personally believe that the job demand will be great in 2021 for occupational therapist. I love telling anyone I can about OT and how I love being a student in this field. I post things on my facebook monthly about occupational therapy. I even tried to recruit a friend of mine to apply to UTHSC OT program based on the post she saw me sharing on facebook. It is amazing the world we live in with technology. There are so many ways to reach people now. If I didn't share multiple post about our program and what OT is, I don't think my friend would have been interested in the field of occupational therapy. She used to want to be a physical therapist and had no clue what an OT did until she asked me. She was amazed at the things we could do because she felt those were the things she was missing when looking into PT. It is so good to see how Facebook can help tell people about the field of occupational therapy. 

Here are some examples of the thing I post on Facebook about OT and our school!

Media Project Assignment: "Dressing Pan"

 For this project, I was assigned to use a cookie sheet as my household item. My client's name was Paula and she was diagnosed with Parkinson's disease. She is a 76 year old woman who used to teach history at a college. She is stated to be a strong willed and independent woman. She wants to be able to do things like bathing, dressing, and communicating with her college peers and husband again independently. She currently lives in a skilled nursing facility, but would like to be back home with her husband. It is important to her that she becomes more independent again so she can move back home. She is not too fond of occupational therapy services and really doesn't understand what it is or what she is doing. She does not like group therapy sessions either. When trying to come up with an innovative idea for Paula to use, I thought about the things most important to her. She wants to be home with her husband and be able to take better care of herself. I knew then that I wanted to come up with something that would help with dressing herself. I know not being able to do that can feel demeaning to her. She stated that it take forever for her to button up her blouse or shirt. I wanted her to be able to do that, but in a way that would be interesting for her to practice. When I observed an OT before getting into the program, I had seen a device used to help children develop fine motor skills like buttoning up a shirt. I knew that the same device would not work for Paula since she had tremors and the device I had seen before was flimsy and that would only make things worse. 

I decided that I could use the cookie sheet as a stabilizer for button device. It would provide support and stability a person with tremors would need. I decided to get a variety of button sizes so it would give a range of difficulty. Shirts are made with all different button sizes so I thought it was important to practice with the easiest ones and the most difficult ones. I knew fine motor skills start to deteriorate when a person is diagnosed with Parkinson's disease, but I never really thought about the specific skills that would be hard for them to do. Practicing buttoning a shirt seems like a child task, but it is important for day to day life. Most jeans and pants have some sort of button that you have to work with. I see now that it could be so frustrating for a person who develops PD. They would struggle every time they got dress, every time they had to undress, or even every time they had to go use the bathroom. It would take up so much time struggling to button or unbutton something. Practicing with a support allows them to focus on just the button and not about if they will drop the fabric or not. 

Doing this assignment gave me a great appreciation to all the OTs before me who have came up with such creative interventions for their clients. It took me a few days to thing what I could do that would be the most helpful for my individual client and also thinking how other clients with the same diagnosis could use it. It also taught me how to look at the personal details in a case. Yes there are things that are somewhat routine for diagnosis like Parkinson's disease, but it is important to look at what the client wants to accomplish at the end of treatment versus what you may want as a standard care. Diseases that are degenerative are the worst to be. I cannot even imagine what it must feel like to know how to do something one day and not be able to do it the next. This assignment has given me an insight to how a client may feel. I feel like I will be a better occupational therapist because I know that they want to get better just as much as I want them to. It has also taught me to be creative and try new skills for the sake of an intervention. I did not know how to sew a button to fabric, but I asked my mother to teach me and now I have a new skill that I can put to future use! I really enjoyed doing this assignment because it made me think and try to create something fun!

Here is a link to watch me explain just what a "Dressing Pan" is!! :) 

https://www.youtube.com/watch?v=BzGXBJv2e8o

Neuro Note #5: CVA (Stroke)

I chose to review a video/article about a lady named Katherine Wolf. It was called "Having a Stroke as a New Mom Changed Everything, but I'm Treating it like a Gift". There was a video interview done of Katherine's life now and how she goes about being a mom after her stroke. She was 26 years old when she had a stroke. The type of stroke she had was a massive brainstem stroke. It was caused by the rupturing of a brain arteriovenous malformation (AVM). She had a 16 hour surgery where more than half her cerebellum and many inter-cranial nerves were removed. The doctors had told her husband that the odds of her surviving the stroke were not good. She was in a coma for two months. Six months prior to her having the stroke she had a baby boy. When she finally woke up from the coma, she had to relearn how to do everything over again. She stated that she was learning all the developmental milestones as her child was at about the same time. She was paralyzed on the left side of her face. She could not walk at all, but now she uses a wheelchair at times and a cane. About 7 years after her stroke she got pregnant with another baby boy. She talked about how hard it was at the beginning to come with terms that she was no longer able to take care of her baby and that she needed to be taken care of herself. Her whole life changed at the age of 26, but now she has come such a long way. Katherine and her husband decided to start a non-profit organization to help families like theirs to come to terms with being a family with disabilities. I decided to do this topic because I have a story similar to Katherine's story. My uncle had a stroke in his mid 40s. The doctors even told our family that he had a 3% chance of surviving. He was also in a coma for a month. Thankfully he survived and is still with us today. Unlike Katherine, he didn't have such good luck with his recovery process. He is in a wheelchair, has no control of the lower extremities, cannot feed or bathe or change himself, he has double vision now, and has slurred speech. The thing that impacted his recovery process was that he started to develop tremors about a month after he woke up from the coma. He still has them but not as bad as when they first developed. It changed his and our families lives. He was the mechanic of the family and it kills him not to be able to do the things he loves anymore. But just like Katherine, my uncle has found a stronger root in his faith. He believes that everything happens for a reason and he is so thankful to still be here today. I really enjoyed listening and reading about Katherine Wolf. It is inspiring to know that she didn't let the stroke define her. It is also encouraging as a future occupational therapist to see success stories of how important therapy is for stroke patients. I can see how similar her story and my uncles story was. It is so important to know the types of CVAs to know how bad effects can be on a person. I would recommend people to watch the video and read the article because it shows how someone can adjust their life and overcome a big obstacle. The brain is so complex and has so much control over all of the body. We need to appreciate it and be thankful that we are able to be independent in our daily life. 

Video & article source: 

Bryant, K. (2019, July 25). Having a stroke as a new mom changed everything, but i'm treating it like a gift. Retrieved from https://www.parents.com/parenting/dynamics/having-a-stroke-as-a-new-mom-changed-everything-but-im-treating-it-like-a-gift/?utm_source=facebook.com&utm_medium=social&utm_campaign=health_health&utm_content=video_internalcrosspromotion9

Neuro Note #4: ALS

 Amyotrophic lateral sclerosis (ALS) is one of those terrible diseases that we still do not have a cure for. ALS is a condition that affects the nervous system in the brain that causes loss of muscle control. I read a blog post called "One Year" by a man named Ray. He gave a personal perspective of how ALS affects ones life. He had a whole blog about his journey of living with ALS, but his blog post tells about his first year living with ALS. He talks about the process of telling everyone close to him that he had ALS. He said it was the hardest thing he had to do and that it was draining. He felt that way because he didn't know what to say and the people he told didn't know what to say either. I can only imagine being diagnosed with an incurable disease and having to tell everyone I know that I was dying and there is nothing that can be done about it. It is hard to process the thought of dying yourself, but knowing that you are telling people awful news cannot be easy at all. With this disease, there is no specific time line of how fast the muscles will start loosing their function. Ray thought that in a year he would still be pretty much the same as he was when he was diagnosed. He found that it wouldn't be true. He was getting tired very easily. He had trouble eating independently, and it took him a long time to finish each meal. I feel as he felt that he was a bother to those around him because he stated that people usually were cleaning dishes around him and he felt bad that he couldn't help. He also stated that it took him a while to get dressed with help and it was even harder to do it by himself. He had to have a whole new wardrobe since being diagnosed with ALS so that it would be easier for him to get dressed by himself. Reading through his experience should make anyone feel blessed that they can do simple things as dressing themselves independently and to not take anything for granted because it can be gone so soon. I wanted to read this blog post to see what life was like at the initial start for someone who has been diagnosed with ALS. This is the perfect blog to read for someone to get the perspective on the person diagnosed. We can read all about the diagnoses and symptoms of ALS, but knowing how a person diagnosed with it lives helps me understand the disease better. I learned that the best thing you can do for a person diagnosed with this disease is to be there for them and help them learn how to adapt to the new living situation. It is important that they know all the effect of the disease and how to properly prepare their current living environment. It is important for them to know that there is no specific time line for when the muscles will lose function. It is also important for them to have a support system. They will need someone to help them function independently in their daily life. I strongly recommend reading the whole blog by Ray. It give a great perspective on how he found joy through this trial in his life and what to expect of someone who is diagnosed with ALS. 

Photo & Blog from: 

Rays Little Ride. (2016, May 24). One Year. Retrieved from https://rayslittleride.com/2015/12/16/one-year/  

Neuro Note #3: Traumatic Brain Injury

Concussions are classified as a serious type of traumatic brain injury. Concussions happen all the time, but most of the time to children. A concussion happens when a person has a serious blow or impact to the head. It takes a lot of force to hit the head for a person to sustain a concussion. I decided to watch the TEDtalk "Protecting the Brain Against Concussion" by Kim Gorgens. I think she did an outstanding job presenting information on this subject. I decided to watch this TEDtalk because I have always been curious about the effects concussions have on children who play sports. Both my brothers and my fiancé have played football and sustained a concussion from the sport. It is a very serious and scary situation to be in. Depending on the level of severity of the concussion, the person can be a little light headed and have a headache or they can be completely disoriented and nauseous. My younger brother didn't get completely disoriented, but he got nauseous and had a headache for a week. Thankfully, the coaching staff contacted my parents right away and they were able to take him to the hospital to get an MRI to see if there was any permeant damage. We were relieved when the scans came back and there was no damage. We were worried because this was his second concussion. He had one before when he was little at his daycare. They were riding kids around on four-wheelers and they ran over a bump and he fell off and hit his head on the ground. Kim Gorgens stated in her talk that once you first sustain a head injury, the chances of getting a second injury is higher and it keeps getting higher the more times you injure your head. She also said that high school athletes are three times more likely to have serious injuries to the head and it usually takes them longer to be symptom free. The second time my brother had a concussion, he was a senior in high school and it happened during practice after school one day. Since his headache lasted for a full week, they required him to sit out that week plus a full week after the last day his head hurt. I am thankful that there are rules and guidelines in place like that to protect these children. I feel like there should be some rule put in place that makes the schools record how many times a child sustains a concussion and that after three times they shouldn't be allowed to play the sport anymore.  Having multiple traumatic brain injuries can have a negative affect to the brain in the long run. Kim Gorgens talked about a research study that was conducted on retired NFL players. It was actually the wives of the players who wanted the study done. They were all concerned because their husbands were young and seemed very forgetful all the time. This research study showed that NFL players who have had three or more traumatic brain injuries to the head or concussions had a higher chance of getting demented diseases at a young age. Kim stated that there are three things people must to do to try and prevent concussions. They need to study and be educated on the subject, they need to do something about it, and they need to make sure there is protection in place. I loved those three steps that she talked about. There needs to be more guideline put into action to protect these children and athletes from sustaining so many brain injuries. It should be a top priority to protect the minds of our youth. If everyone cared a little more about the affects concussions had, I strongly believe would could come up with a solution to lower the statistic of people who sustain brain injuries. I strongly recommend parents, teachers, coaches, athletic departments, and even athletes to watch this TEDtalk and educate themselves on how to protect the brain. Kim Gorgens did a fantastic job of explaining how you can start to protect the brain from injury.



Gorgens, K. (May 2010). Protecting the brain against concussion [Video]. TED Conferences. 
https://www.ted.com/talks/kim_gorgens_protecting_the_brain_against_concussion#t-541603

Neuro Note #2: Alzheimer's Disease

To me, Alzheimer's Disease is the worst disease that someone can ever experience. It is awful for the person with the condition, but it's even worse on the family. I wanted to read the article "OT's Role in Helping Kids Understand a Grandparent's Dementia" because I have a grandparent who has Alzheimer's Disease. She has had this for about 15 years now. I am currently 23 so I was about 8 years old when she was diagnosed. This article was a perfect representation to me on how it was to grow up with a grandparent who has to go through this type of disease. As a kid, it is hard to understand how someone you look up to will slowly forget things and eventually forget who you are. I know for my situation, by siblings and I spent so much time with my grandmother doing fun activities because we didn't think we had much time left with her. As we got older, we have changed roles from being her playful grandchildren to her caregiver. My siblings and I love that we are able to help my grandfather take care of her because we know that it can get very hard for him to do by himself. We all learned at young ages how to correctly control a hospital bed, a wheelchair, and any other adaptive devices she needed to use before she was completely bed ridden. The article explains how Kathryn Harrison was able to come up with a book for children to explain what dementia is and how to handle it from a grandchild's perspective. It explains that the grandchildren help put the mom and the grandmother in better spirits because they would play all kinds of games together. It was a happy time and made for happy memories. They didn't let the fact that she had a disease get in the way of them making the most out of their time with their grandmother. When she eventually had to go to a nursing home, the caregivers there took the time to explain to the children what all they did so they could be there and help. They also allowed them to stay there when they would do any type of examination on her and even let them do crafts with the other people in the center. It was an important thing because it helped the grandmother be more comfortable in the center. It just helps the whole process when she starts loosing her memory. I love that she came up with this idea to make a children's book to help parents explain what will happen with this disease. I know it is extremely hard on the spouse and the children of the person who gets the disease. I cannot even begin to count the times that I found my mother crying when we all first found out that my grandmother had Alzheimer's. It has made my mom so happy to see that we all still have such a great relationship with my grandmother. Even though she cannot talk much anymore, she still recognizes us all! We know this because when we enter her room she starts smiling so much and tries to talk to us. I honestly believe that my grandmother is still with us after 15 years because we have been by her side from the beginning and have tried to make everything as comforting to her as possible. I would recommend everyone who has to go through telling small children what dementia is to get the book that Kathryn Harrison wrote. It will make things so much easier for the parents. It's hard to explain it to children when you don't really understand what is happening yourself. I am glad to know there is a book out there in case I ever need it in the future.





Picture and Article came from:
Seniors Flourish. (2019, February 11). OT's role in helping kids understand a grandparent's dementia. Retrieved from https://seniorsflourish.com/kidsanddementia/

Neuro Note #1: Parkinson's Disease

I chose Parkinson's disease as my first note because it is a topic that I don't know much about. I have seen patients with this disease from shadowing experience and working in a therapy clinic. I know what it is but not to the full extent. I know that it is a disease that causes degeneration of the nervous system. The nerve cells in the brain start dying. I did some research and found out that many of the neurons that die are the neurotransmitter dopamine. When the levels of dopamine in your body start to die or decrease, it causes the brain to have abnormal activity. I also know that sometimes it can be a slow progression and other times it can be rapid. 

I decided to watch a TED Talk on Parkinson's disease. They have quite a few talks about this which makes me believe people need to better educated on this disease. The talk was "Simple hacks for Life with Parkinson's" given by Mileha Soneji. She started the talk out by telling a personal story. She used to have this uncle that she was so excited to see every time they had family gatherings. She stated that she was so excited because he was the "fun" uncle of the family. He was always the center of attention, would always play with the kids, and would jump around with them. She then goes to say that he was diagnosed with Parkinson's disease. He started out showing signs of developing tremors in his body. I know this is one of the most common ways to tell that individuals have Parkinson's. This is also why I mostly chose this topic to talk about and why I chose this TED talk specifically. I have an uncle who had a stroke about 8 years ago. He was left disabled as a result of the stroke. One major factor that hindered him from getting better was that he developed bad tremors a week after the stroke. I always knew tremors were signs of Parkinson's disease. When I saw that there was a TED Talk titled simple hacks for life with Parkinson's I knew I wanted to watch to see if there were any hacks that would be useful to help my uncle with his tremors.

Mileha talked about how her uncle started to hate to go out in public because he was embarrassed by the tremors and refused to even order coffee or tea when he went out because he would spill it. She wanted to help him to adapt to the environment so she developed this cup that would prevent spills. She made it to where the top of the cup was rounded so when he would shake, the liquid inside the cup would not spill out. I think that was a great invention to use for people who have tremors. My uncle has the hardest time taking a drink by himself because he shakes and spills it on him. 

She also noticed that her uncle had a hard time walking on flat surfaces. She stated that it would take him forever to get anywhere and even longer when he had to turn. He would only turn one foot at a time at a slow steady pace. He ended up having to use a walker everywhere he went. She was curious to how he went up and down stairs without his walker. She showed a video of him walking the stairs and it looked as normal as could be. She then did some research and found that others with Parkinson's do fine on stairs as well. It is because stairs are a continuous motion for them. She found a way to make walking on a flat surface look like a continuous motion for her uncle. She made a paper staircase illusion and taped it on the floor and he did so much better. It was amazing to see how if you trick your brain it does something completely different. 

I found this talk very inspirational. Mileha stated that we all need empathy and that to me is core characteristic that an occupational therapist must posses. She stated that there are about 60,000 new people diagnosed every year. There is no cure for Parkinson's disease, but there are things that we can do to make their day to day life easier and simpler. As future occupational therapist, I feel like we need to be innovative with treatment plans and make sure they fit the needs of each client. We need to make sure we know why they are having the side effects that they do. It takes time to figure things out but it will be worth the failures in the end. This talk gave me a new perspective of the life of an individual with Parkinson's. They do not have it easy at all. It is a hard thing to go from being completely healthy to very sick just because your nervous system is failing you. I will take the lessons I have learned from this video and apply them when I come in contact with people who have Parkinson's and show them empathy and understanding. 

Mayo Clinic. (2018, June 30). Parkinson's Disease. Retrieved from https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055

Soneji, M. (February 2015). Simple hacks for life with parkinson's [Video]. TED Conferences. https://www.ted.com/talks/mileha_soneji_simple_hacks_for_life_with_parkinson_s 

  

Social Determinants of Health

I really enjoyed this TED talk. I think he made great points that describe how the field of occupational therapy is. I would define social determinants of health as the things in a person’s life such as where they live, where they work, where they socialize, and where they participate in daily activities, that affect their health in a negative way or positive way. As occupational therapist students, we have learned that it is always person first and not the medical problem. To fully help someone get better, you must know what happens in their daily routine to figure out how to help them. I loved that in the TED talk, the speaker said, “zip code matters more than our gene code”. He couldn’t have said it any better than that! As we have learned in class, the limbic system controls our emotions. SDoH can cause our limbic system to produce emotions like happiness for when someone enjoys walking through the park every day on their way home from work. They relate the park or environment that they see every day as something happy. That shows how the SDoH can have a positive effect to our nervous system. SDoH can also have plenty of negative affects to our health. As we heard in the TED talk, there was a lady that had awful headaches because of the place she was living it. It wasn’t her genes that caused the pain, it was her own apartment that caused it. I feel like the lady could have also been stressed because there was mold and roaches in her apartment. We know that the neurotransmitter norepinephrine is a stress hormone in the body. SDoH can cause a person to produce a lot of norepinephrine because of their environment.

I think that the program's requirements for service and professional development hours facilitate preparedness in us by having us informed in all aspects of occupational therapy. It is good to know the concrete facts, but it is also just as important to know how to work with clients. It shows us how to be personable and not medical. 

Locomotion and Adaptive Devices

As occupational therapist, it is so important for us to know why we need to appropriately fit each client for an assistive device. It is important to make sure each device is fitted for each individual because you want to make sure the device doesn't do more harm than good to the person. Sometimes if they are not fitted correctly it can cause poor or improper body mechanics and cause injury to the client. Assistive devices are prescribed to help client improve their base of support and stability so it is important that you don't do further damage to the client. We also need to make sure each device is comfortable to the client. The clients will be using the assistive device a lot so we need to make sure it fits comfortably so the client does not receive pain from the device.  It is so important to fit each need for the client so that they can be as comfortable as possible in their condition. 

To fit for a cane, you need to make sure that the hand gip is at the level of the ulnar styloid, wrist crease, or greater trochanter for the best support. When testing, the clients elbow should be relaxed and flexed at about 20-30 degrees. Their shoulders should be relaxed and not elevated. A cane does not proved great stability for clients so you need to make sure the client has is stable enough to use it before the fitting process takes place. 

To fit for an axillary crutch, you need to make sure the client is stable enough for the crutches just like the cane. Axillary crutches provide a little more support for the client than a cane, but you need to make sure the client has enough upper body strength to use them. To fit them for a client, you would use the same method as you did for the cane. The handgrip should be level with the ulnar styloid, wrist crease, or greater trochanter. The elbow should be relaxed and flexed 20-30 degrees and shoulders should be relaxed instead of elevated. The difference with the axillary crutches is that the axillary rest should be about 5cm below the floor of the axilla with the shoulders relaxed. It is also important to make sure the hight of the crutches matches the hight of the client. 

To fit for a Loftstrand crutch, you would use the same method as the axillary and cane, but this type has an armcuff that wraps around the proximal forearm. It is important to make sure that the armcuff is about 2/3 of the way up the forearm. This is used with clients that have long term disabilities. It provides more support than a regular cane but less support than the axillary crutches. 

To fit for a platform walker, the client is typically someone who cannot bear weight through their wrists or hands. The platform surface should be positioned to allow weight bearing through the forearm when the elbow is bent to 90 degrees. Make sure that the client is standing tall with the scapula relaxed. The proximal ulna should be positioned 1 to 2 inches off of the platform surface. This helps to prevent nerve compression. Make sure the forearms and hands are in a neutral and supported position. The handle fo the platform should be positioned slightly medially to allow for a comfortable grip for the client. 

To fit for a rolling walker, the client is someone who cannot lift a regular walker due to UE weakness. This assistive device allows for a large base of support for the client. It is important to adjust the walker to the hight of the client to provide the best support and comfort. Again, you would use the same method as the cane when fitting. Make sure the hand grip is level with the ulnar styloid, wrist crease, or greater trochanter when the arms are at the sides. The elbow needs to be relaxed and flexed at 20-30 degrees. Shoulders need to be relaxed and not elevated. 

It is so important that each occupational therapist follows each of these steps for each assistive device so that they can provide the best support for each client. 

Transfers

The order of hierarchy of mobility skills is as follows: bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADL, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. I think that this hierarchy is in this specific order because you start out with simple task of transfer and then work your way up to more complex tasks. I agree with the order because I believe it is easier to complete the simple task before trying to master harder tasks. I have seen this work in my experience as a physical therapist technician. I have seen clients start out trying to get off the mat by themselves to being able to get into a wheelchair by themselves after surgery. I think every client is different though. Sometimes I would see clients be able to transfer from the wheelchair to the mat with no problem, then struggle to get from the mat to the chair. I believe that as occupational therapist, we can adapt to any different situations that may arise. Even though a client may not follow the exact steps in the hierarchy of mobility, we need to be flexible to each specific client. I have also had the experience of seeing someone fall down the hierarchy of mobility. My grandmother was diagnosed with Alzheimer's Disease about 13 years ago. I have seen here be functional enough to drive to know she cannot get out of the bed by herself anymore. Even though she went backwards down the hierarchy, she did progress through each level of mobility skill. Overall, I think this approach to the hierarchy is well because it allows you to start from an easy level or level that if comfortable to the individual and build up from that point.

Posture and Body Mechanics

It is so important to teach proper posture and body mechanics. I'm sure we have all been told to "stand up straight" at some point in our life. It is so easy to get into bad habits of slouching or poor posture. To have good posture, we must have good body mechanics. Poor body mechanics can cause problems with the lower part of the back. It is important to teach a person with poor posture/body mechanics to "stand up straight" so that we can prevent further damage to the lower back. It is important to teach clients with poor body mechanics how to lift things properly. By doing so, it will help reduce back pain and injuries. It is important to show them how to lift and bend properly so they can fix the bad habits they already have. I have seen first hand how fixing poor posture and body mechanics can help reduce pain in the lower back. I used to have a lot of back pain when I was in high school as a cheerleader. We were taught incorrectly how to lift other girls in the air. It wasn't until we got a new coach who had health care experience that we learned how to lift properly. This reduced a lot of pain my teammates and I were experiencing. It is important to learn proper body mechanics early so that you wont do more damage. With my own clients that experience back pain from poor posture and body mechanics, I would show them the right way to lift things and bend. I believe that visually showing someone what to do helps out a lot. I would start by showing them how they do it (which is the wrong way) and then show them how it is supposed to be done. I would explain that when bending to lift something, the proper technique would be to start bending with your knees, widening your base of support, and use your legs to lift the object. I would tell them that when you have your torso bent forward, it would cause strain in the back muscles. The next intervention I would do to help a client with poor posture and body mechanics is practice sitting straight and not slouched over. I would demonstrate again what they did wrong and how to do it right. I know it may be hard for a person who has slouched their whole life to start sitting up straight. A suggestion that I would give the person to help them remember to not slouch would be to buy a tennis ball or softball. Whenever they go to sit for a period of time, find a chair that has a back support. I would tell them to put the ball between their shoulder blades and sit back. The object of this is to not let the ball fall down and this helps with keeping a straight posture. It is so important that we educate clients on proper posture and body mechanics because it can help reduce pain and injury.

Advertisement and the Impact of the Human Nervous System

An ad that sticks out to me a lot is the Haribo Gold Gummy Bears commercial. They are promoting gummy bears. I am not even a fan of gummy bears but every time I see this commercial, I want to go buy some! The reason it sticks out to me the most is because you see a group of adults who look like they are in a serious business meeting sitting around a table. When they start to talk you hear little kids’ voices. Each adult has a voiceover of a little kid and they are trying to sell the gummy bears. It makes me laugh all the time because they even use grammar like little children would use. One guy is saying the red gummy bear is “more gooder” than the others!! To me, it makes me want to buy it to feel like a kid again! Emotions are controlled by the frontal lobe of the brain. Some of the important functions that the frontal lobe does when I watch the ad is emotional expression, memory, and judgement. It is considered our “control panel” of our personality. When watching this commercial, it brings back happy memories from my childhood of going to candy stores with my grandparents. This memory is caused by the amygdala. The emotional significance attached to this memory and experience is mediated by the amygdala in my brain. It integrates my emotions, my emotional behavior, and my motivation for wanting to buy these specific types of gummy bears. This commercial is brilliant because it hits towards emotions of the potential buyers. Most of us would love to go back to our childhood and eat all the candy we can without have to worry about all the calories  I always love this ad because it makes me laugh and smile every time!!

The link to enjoy this wonderful commercial!!

https://www.youtube.com/watch?v=EAnwmmPFYgU

Man from the South

This was an interesting story to read about. We know that the story took place in 1948. Things were a lot different in terms of occupation for men and women in 1948. If the man had lost the bet, then he would have trouble doing his daily occupations. He thought it was a fair bet because he felt like he didn't use his pinky in his daily life activities. If the soldier would have lost, I believe he would have had many difficulties in his occupation as a soldier. He would have difficulty in shooting a gun, using a knife if they trained with those, and even his daily physical training that soldiers have to do. He would lose his grip strength when he looses his pinky. It is very important for a soldier to have good grip strength especially if he is a naval soldier. Being a Naval soldier, it is assumed that they have to do a lot of maintenance on the ship. There is a lot of cleaning of the boat, getting sails ready, and also tying ropes for sail. I think the soldier would have trouble in performing those skills because he wouldn't have the hand strength that he used to have. He would have to modify the way he learned how to tie ropes, how to fix the sails, and preparing the boat for sail. I believe the soldier would have a harder time adjusting to the loss of his finger than he expected. I was shocked to see how the story ended. I did not expect the wife to come in the room before the bet was over. I also didn't expect to find out she only had a thumb left on one hand. A woman's role in that time period was to be a wife. Most of her occupations would include cooking, cleaning, gardening, and taking care of her husband. It would take a lot of practice to adapt to cooking or cleaning with basically one hand. She would have to learn how to cook easy recipes that don't require you to do multiple things at one time. Since it stated that the woman was wealthy, she could hire someone to cook for her so it would be easier. Her daily routine of getting ready had to change tremendously. The first time we were introduced to the wife, we see she was coming back from getting her hair washed. I think that shows that she is not able to do it herself anymore or that it is too hard for her so she would rather pay someone to do it for her. Something that I think the wife could invest in since she had a lot of money is a multiple shower head. I think it would be helpful if she had three different shower heads, one up top and two on the sides. I feel like it would help the wife by being able to rinse her hair better. I feel that if the wife could get ready on her own, she would feel better about herself and feel more independent again. We can tell that she may regret betting to lose her fingers since she had to move her husband away from their home and stopped the soldier from losing his finger. I feel as if she thought her fingers weren't important just like the soldier did.

Neurotransmitter Project: Acetylcholine

Implicit Bias

Implicit bias is automatic processing in our brain of negative stereotypes that have become embedded in our brain over time about certain groups of people without us being aware of it. There are associations that we relate with certain groups and our brains automatically make us associate things with that group. You can retrain your brain to think differently about a group but it takes time. The way we have been practicing fairness or equality may be flawed. There are things that we have been taught to think or do in certain ways, but our values can often overrule the things we have been taught. Having a bias does make us human. We are most likely all taught to be color blind when we are little and to not judge based on looks, but so many things in society make it where you can't help but think that way. You have to train your brain to process differently if you want to change or stop implicit bias.
It is so important for OT students and practitioners to learn about implicit bias because we will be treating clients of all types of religion, race, and ethnicity. When treating a client, you do not need to let your own values or beliefs get in the way of giving them the treatment they deserve. Even if we believe one thing and they believe another, then you need to make sure you let the client feel comfortable in therapy no matter what. We also should not label or automatically judge a person on the way they look or appear. Each client already suffers some way or they wouldn't need to be there. It is our job to make the therapy environment a safe and welcoming place for them. Our main goal is to help the client improve to do their daily activities independently. As we read or listened to the podcast, our presence is so powerful. If we have a negative look or attitude about a client then their results could be negative and they may not get better.
There are things we can do to examine and address our own bias. For one thing, is to take a survey and see how biased you are from your answers. I know for me personally, I did not think I was being biased until I saw the results. Another thing is to try and train you brain to process differently. Try to replace the biased association. Lastly, you can think about how you want people to treat you and you should treat them the same way. We all want to be accepted and not judged for the things we like, we wear, our race, or what we believe in. I think it is important to treat people the way you would want everyone to treat you. I think this lesson shows how much implicit bias our brains process over time. Even though we may not tend to have bias towards others, it is still there. We have to be aware of what we say and how we act to our clients to make sure we are providing the best treatment possible. 

Scapulohumeral Rhythm

Scapulohumeral rhythm is the kinematic interaction between the scapula and the humerus. In the scapulohumeral rhythm, the scapula needs to tilt back. For full range of motion, the humeral head must rotate laterally. Scapulohumeral rhythm permits good length tension relationships. It also helps with assessing muscle function and shoulder joint motion in the clinical environment. The primary movements that a practitioner looks for with the scapula is upward rotation, posterior tilt, and lateral rotation. When the practitioner notices that there is a change of the primary positioning between the scapula and the humerus,  they know that the scapulohumeral rhythm has been damaged. When this happens the scapula can become "winged". You would be able to notice this if you had a client put their hands on the wall and lean in like they were doing a push up. You would be able to see the scapula poking out. The shoulder has the greatest range of motion (ROM) in the body. It has a full 180° of motion. The scapulohumeral rhythm is very important to achieve the full 180° of motion. For every 3° of shoulder movement, there is 1° of scapulothoracic joint movement and 2° of glenohumeral joint movement. To reach full range of motion, the scapulothoracic joint must produce 60° of movement and the glenohumeral joint must have 120° of movement. If the scapulohumeral rhythm is damaged, then a client cannot achieve the full 180° of motion.   

Test Positioning

It is important to know to use bony landmarks and proper positioning when doing ROM because you have to know how to set up your goniometer. You need to know where to position the axis, stable arm, and moving arm. Measuring ROM accurately requires precision, and precision is achieved through a lot a practice. You need to make sure you know how to palpate bony landmarks to have complete accuracy when measuring. It is important apply the goniometer in the proper position and read it correctly so that you can measure progress accurately. If another therapist has to measure the client, you want the measurements to be close to the ones you did. Test positioning in manual muscle testing is equally as important if you want to get the correct measurement for your client. The test position allows the muscle to be in a position to achieve the greatest contraction. You want whatever limb that is being tested in the best possible position to achieve a great mechanical advantage. It is important that the lever is in the best position for muscle strength. It is good to test muscle strength in an antigravity position. If the muscles are too weak to function against gravity, then it needs to be tested in the horizontal plane. It is also good to test in a gravity eliminated position when the muscle is weak so the therapist can feel any level of contraction in the muscle. Test positioning is also important for providing good stabilization to all joints to avoid unnecessary compensation. Muscle compensation could cause more damage.

Biomechanics Activity Analysis: Drinking Coffee

I absolutely love coffee!! I have to have a cup every morning when I get up to start my day right! During this quarantine, I have found myself drinking a cup every afternoon as well. My starting position for grabbing my coffee, is my arm with elbow at extension by my side. It is currently in the sagittal plane and coronal axis. When I reach my right arm forward to grab my coffee, my elbow is still crossing the sagittal plane and coronal axis. It is currently in extension. Once I grab the cup of coffee, I flex my elbow to bring my coffee cup to my mouth. This movement is still in the sagittal plane and coronal axis.  Depending on how heavy the cup of coffee is, my wrist will flex and extend when I bring the cup to my mouth and when I put it back down. When my wrist flexes and extends it is also crossing the sagittal plane and coronal axis. Once I place my coffee cup back down, my end position will be the same as my starting position. My arm with my elbow at extension by my side will fall into the sagittal plane and coronal axis. The osteokinematic movement is flexion and extension in an open kinematic chain. The arthokinematic movement of elbow flexion occurs at the humeroulnar joint and the humeroradial joint. During open chain elbow flexion, the concave ulna and radial segments roll and glide anteriorly on the convex humerus. The prime movers are the biceps, brachioradialis, and brachialis muscles. They perform a concentric contraction.

Health Literacy

Health literacy is the ability to read, comprehend, obtain and use health care information in order to make appropriate decisions and follow treatment instructions. It is so important to know how to talk to your clients to make them understand everything clearly. I know for me personally, I hate it when doctors talk to me with words or information that I do not understand. As future OT practitioners, our goal should be to provide the best type of treatment for a client to improve their daily living, but it should be done in a way they can understand. We want clients to leave a treatment session feeling confident in what they did and not confused about what you were asking them to do. It is important to know everything you can about the treatment you are giving, but it is equally as important to make sure the client understands as well in a way that makes since to them.
It is so important to promote health to everyone so that people know how to live a healthy life. You can be healthy by eating right, exercising, not smoking, get all your immunization shots, going to the doctor when you feel sick and being active daily. It is important that health care workers not only practice good health habits, but promote ways to be healthy. Everyone deserves the option to be healthy, but it is our responsibility to promote how you can be healthy. When you treat clients, you need to promote health as much as possible. Some may want to know ways to be healthy so they don't injure themselves again. I believe that it is important for OT practitioners to promote health during intervention plans. You should want the client to maintain a healthy lifestyle while they receive treatment. Some ways to promote health is to give a client healthy meal plans, tell them to take a walk each day for at least thirty minutes if they are able to, refer them to doctors that will help them, ensure that they have a stable home environment, and many more things like those examples. Overall, I learned that health literacy is so important because we want understand how to treat clients in the best possible way but to make sure they know what is happening as well. It is also so so so important to promote health. Our society is the unhealthiest it has ever been and as health care providers, we need to do our part to educate our clients so that they can better themselves and have a long healthy life.

Can Occupational Therapy Help with ADHD?

I chose to listen to the podcast "Can Occupational Therapy Help with ADHD?" by Jennie Friedman with guest speaker Dr. Stephanie Lancaster. I chose this podcast because I have someone in my family that deals with ADHD on a daily bases and I had no clue that you can benefit from occupational therapy if you have ADHD. It is important to learn all you can about a condition to be able to mange it better every day.

While listening to the podcast, I learned a lot of important things about the condition of ADHD. Often times, people can mix up ADHD and sensory processing disorder. There is a fine line in distinguishing between the two disorders. Both disorders can make a person restless and unable to concentrate in task they do in their everyday life. Sensory processing disorder happens when ones brain has trouble receiving and responding to information that goes through your senses. ADHD is more about problems with focusing and controlling impulsive behaviors. Both of these disorders can cause people to be anxious and even act out in social setting. Some children with ADHD might get mislabeled as problem children when they don't follow the "sit still and focus" rules in classroom settings. They are not "bad" children, they are just having trouble focusing on one thing. These type of children can fall under the category of sensory seekers. Examples of things that sensory seekers do is twisting or playing with their hair, spinning in circles when sitting on the rug during quiet time, tapping their pencil, chewing on their pencil, and even picking or chewing their nails. There is a sensory profile that OT's in the school settings do to test to see if children have ADHD. The profile is called the Dunn Sensory Profile. The OT will give the teacher and the parents a form to fill out for that child. It helps the OT see what behaviors the child has at school and at home.

When dealing with a child that is a "sensory seeker", there needs to be something put into place to help the child focus their attention in the right place. An example that Dr. Lancaster gave during the podcast was called the Sensory Diet. It is not your typical diet. It has nothing to do with food. She even said another name for it could be the sensory schedule. For the sensory diet, the OT would tell the teacher to have the child take a "move break" for about three minutes every hour and a half to two hours. The teacher can have the whole class participate. It can be something as simple as having the class do jumping jacks in place or doing a stretching exercise for three minutes. This gives the child a break from focusing and allows them to relax their mind. It helps with anxiety they may feel because of their ADHD condition. Doing this everyday can make the child happier and have them actually enjoy school instead of dreading it every day.

Overall, I really enjoyed this podcast. It was helpful to see that there are more ways to help with ADHD than taking medication. I learned from listening to Dr. Lancaster and Jennie Friedman, that minor changes to a person's environment and routine can help people with ADHD fix or manage their problems if they can commit to doing it every day.  ADHD is a daily battle for people and it is important that they know there are was to manage it besides medication. I strongly believe that occupational therapy can help find ways to manage the disorder that fits each individual specifically.

Common Misconception of OT

One of the biggest misconceptions we hear about in the field of occupational therapy, is that it is the same thing as physical therapy.

Blissful Ordinariness is ESSENTIAL

"Blissful ordinariness" is different for every individual. It is finding meaning of the little things in your day to day life, finding joy in the simplicity of a routine, and even finding comfort in being able to do the things you enjoy. Often we tend to overlook the small things in our life until we find ourselves unable to do them. Too often, we take things that we are able to do that others cannot do for granted. Life is too short to not acknowledge being able to do our daily activities independently. Occupational therapist strive to help individuals find their "blissful ordinariness" in daily activities by having a good therapeutic relationship with the client.  Using the holistic approach when working with clients shows people how OTs care more about the person than the illness. Even if clients are not able to fully do complete their daily activities like they used to, then the therapist finds ways to ensure that the client reaches "blissful ordinariness" in their own way. Each client that comes in with the same problem or illness will not be treated in the exact same way. Yes some things will be the same, but each treatment plan should be built around the individual client and not the illness. Cynthia Cooper, MFA, MA, OTR/L CHT  hit the nail on the head when she stated that occupational therapy is a "mystique" that you cannot put into words. That is one of the main reasons I decided to pursue a career in occupational therapy.  By using the holistic approach in a career with individuals, they will feel like there is someone out there that cares about them and wants to see them succeed in daily life activities. No individual should feel less than someone else. I believe it is so important to encourage clients to find their "blissful ordinariness" in their day to day life.

Possible Setting as an OT Practitioner

There are many fields an occupational therapist can go into once they graduate from occupational therapy school. Currently, I am interested in working in a pediatric setting in a hospital. My dream job would be to work for a private not for profit agency such as St. Jude Hospital. I have always loved working with children growing up. Working for a private not for profit agency would inspire me daily as I went to work. It shows how amazing an origination can be to help people who cannot afford insurance get the quality care that they need. At St. Jude, there are private investors who contribute to the funding of the hospital. If patients have insurance, their insurance company will get billed, but if family cannot afford to pay the rest of the bill then the hospital covers it.

In this field, I would love to work with children with disabilities and those with mental health problems. I have a passion that each child should get the chance to have as normal as a childhood as possible. I also would like to working in a school system that focused on the mental health of the students. The school that I went to never had a counselor that students felt comfortable going to about anything other than academic problems. Being able to work at a public agency would provide some challenges with how much funding the government would allow to work with students with mental health struggles. I would work to get a grant to fund the therapy sessions about mental health if I needed to because I feel it is extremely important in our society today. I hope the rules for government funding for occupational therapy practitioners in the school system change so they can met all the needs they see for each child.

Era Presentation

The era presentations were sooo good all around!! Everyone went into great detail on how occupational therapy impacted the era, but also how each era impacted where we are as a society today. There were a couple of points from some presentations that stuck out to me more than others. One point that I found interesting was from 70s group presentation. It was about the Developmental Disabilities Assistance and Bill of Rights Act of 1975. This act started the protection and advocacy system. It was appointed the "Big Responsibility" act. It gave people the authority to pursue legal and administrative action to protect the rights of those with disabilities. It granted people freedom from harm and discrimination. It was also cost free, as supported over 50,000 Tennesseans. I loved this point because I feel like everyone should have the right to protect themselves no matter what. Another point that I found interesting was from the work portion of the 80s group presentation. In this part, they stated how there had been a big growth in the health care services in the 80s. Health services grew so much do to factors like a growing elderly population, technology advances, more government requirements, and some private insurers. In an effort to cut cost there became more outpatient facilities, nursing & personal care facilities, and residential care opportunities. It is important that the health care services grew so much then, because the facilities that resulted from the growth are the bigger areas that occupational therapist practice in today. The last point that I found interesting from the era presentations was about health care in the 2010s era.  The 2010s started part of the affordable health care act. It stated that coverage cannot be canceled unless there is fraud present. It also made it to where dependents could be covered by their parents health insurance up to the age of twenty-six. In 2014 it eliminated annual limits on essential health benefits and restriction on pre-existing conditions. We still use some of those rules today. I really enjoyed learning so many new things about each era throughout the presentations! Everyone made each presentation fun and enjoyable!

The History of Disabilities

After hearing Dr. Kiesling speak, I feel as if I have a better understanding of the history of disabilities. It is so important to review history to understand why things happened in the past to be able to better our future. People used to be viewed as criminals, and now we see that disabilities are become a way of culture. It was hard for me to hear how awful people with disabilities were treated before society realized that it was okay to not be "normal". At the institution in Pennhurst, PA, people were institutionalized for significant developmental disabilities and minor disabilities. The list for minor disabilities included things like diminished sight or hearing, imperfect speech, and imperfect gait. If history did not change for the better, I would be included in the minor disabilities list. I've had glaucoma since I was born and I personally do not feel disabled. I have very little vision in my right eye. I don't feel that way because I have not known anything different since I was born. Most people don't know that I can only see out of one eye unless I tell them. By the rules of the Pennhurst, PA institution, it would have be acceptable for me to be institutionalized. It is important to understand the history of disabilities so we can know how to keep improving society's view on disabilities. 

It is amazing to me to see how far society has come to accept people with disabilities and to provide inclusion. The Individuals with Disabilities Education act is a great example of how far society has come. This act states that children with disabilities are not to be excluded from public schools because of their disability. The school districts are required to provide service to meet their individual needs. As a future occupational therapist, I believe inclusion is a vital role in helping people with disabilities. They want to feel like any other person without a disability feels. They want to be "normal" and function independently in their daily living. I was very impressed with the life of Ed Roberts. Ed Roberts contracted polio as an eleven year old child. Once he had polio he became paralyzed and the school he went to did not want him to go to school anymore. Luckily, he had someone in his corner to fight for him and Ed was able to continue to receive schooling through phone call taught lessons. His mother wanted even more for him so she fought for his right to go back to school and he eventually did. Once Ed graduated from high school, he went to a community college and earned his associates degree. Ed wanted more for his life so he tried to get a job at the vocational rehabilitation center but they turned him down. He wanted to go to Berkley college and eventually made that dream happen. Ed is such an inspiration because he never gave up even when life tried to knock him down. I hope to be able to encourage clients to never give up on their goal no matter how much society tells them that they cannot do it. Dr. Kiesling really opened up my eyes to the history of disabilities and how it continues to change today.