Occupational Therapy: Where Science and Spirituality Collide

In her emotionally inspiring testimony about her fight with epilepsy, Sitawa Wafula shares her encounter with the stigma associated with her condition.  Unable to finish college and fired from her job, Sitawa learned to adapt.  She now advocates for those who share her battle in order to raise awareness and reduce the prejudice against those with unpredictable seizures.  Sitawa admits to her doubts about continuing to live and how debilitating her epilepsy can be even days after a seizure.  Increased stress and anxiety are triggers for a seizure and she admits that she would experience two to three seizures daily.  In its most severe form, epilepsy prevents independent living and requires constant supervision.  Nonetheless, Sitawa fights against the debilitating effects of her epilepsy and strives to increase the understanding of those who struggle with this disease. Something that I have learned is how often we as a population prejudge what is a disabili...

Allie Calhoun, a character from the beloved movie, "The Notebook," winds up developing Alzheimers disease.  Not only does she forget her loved ones (especially her grandkids), but she also experiences Sundowner's Syndrome where she changes to anger and frustration when the sun goes down.  OT services will aim at helping create a schedule and routine for her to engage fully in activities which she loves, such as painting and playing the piano.  Focusing on maintaining a schedule will hopefully reduce her confusion and panic.  Also, the schedule will be sure to incorporate time where she can spend doing the activities she has always loved to do.  OT should also focus on caregiver education as Allie's husband, Noah, is intimately involved in her care.  Integrating family involvement and investing in their health is key in this situation in order to help Allie be involved in activities that bring meaning to her life.

If you have not read Kathy Ritchie's blog on her experience coping with her mother's declining health after her diagnosis in 2010 with frontotemporal dementia, you should!  It is a riveting example of the difficulties encountered when a relative forgets those closest to their heart.  Kathy talks about the shock of learning about her mother's diagnosis and the decline in her memory and outbursts in church.  For Kathy, her mother's death in 2014 felt swift and yet drawn out.  All she wanted for her mother was peace, but yet it was a hard realization to let go.  In a sense, death was the right answer, because her mother was not the same person Kathy had known, yet Kathy talks about how she misses her previous mother.  The mother that bore her.  The mother that raised her.  The mother that loved her.  However, the loss of the mother she spent those four years feeding, bathing, and dressing was not difficult. After reading about the frustrations...

Today, we talked about a twenty-three year old friend of one of my classmates who was diagnosed with Multiple Sclerosis (MS) in July of 2015.  Not only did this diagnosis come a week before her twenty-second birthday, but her MS joined a number of other medical diagnosis already present.  Thankfully, the MS she contracted is the mildest form of MS with intermittent bouts of the symptoms occurring.  Currently, she is living alone and in law school.  She also volunteers weekly doing equine therapy.  Her goals throughout OT are to keep pursuing her interests in horseback riding and continuing law school.  Helping the client to find adaptive ways to write, horseback ride, and conserve energy are all ways OT can help the client to pursue her goals.

Dr. Remy Hadley was diagnosed with Huntington's Disease (HD) in 2007.  Even though her mother died from HD, Dr. Hadley did not want to be tested, but suspected that she had inherited the gene.  In 2008 she noticed tremors and now is in the beginning stages of HD.  Her symptoms include issues such as increased upper extremity tremors, minimal memory problems, and impaired coordination.  Challenges and barriers that she is currently dealing with include issues eating, drinking, balancing, tripping, and coordinating fine motor skills.  Dr. Hadley is determined to continue her current life of working in the hospital, exercising, and maintaining her independence as long as possible.  OT intervention wants to focus on decreasing energy expenditure, such as giving her a recording device for documentation purposes, and finding other adaptive strategies that will aid her in her independent living.

In a sense, I have always known that I had a knack for therapy, but it wasn't until I learned about the intricate details of OT that I realized I'm going to be a part of the perfect profession for myself!  Growing up, I have always been one of those people who has a higher standard for myself than for others (perfectionism runs deep), and something about OT that I respect is the fact that it requires its practitioners to continuously strive to better themselves through continuing eduction, evidence-based practice, and even learning from ethical dilemmas.  OT always strives to provide the best services possible, and I believe that is crucial in a field where health care personnel are called to serve others and enable them to live healthy lives.  While there are a lot of expectations placed on practitioners, I also feel there is an overwhelming amount of community and grace within the profession.  OT practice is a team focus with accountability and wisdom readily avail...

My takeaway from this presentation on Myasthenia Gravis (MG) really showed me how important it is to ask questions.  I had the great opportunity while doing this project to contact Amanda Jones, the woman who I based my case study on.  She loved the fact that someone was showing interest in her condition and was ready and willing to answer any questions I might have had.  Her condition at this point is incurable, but she still finds ways to keep her hope up and enjoy each day even if her energy doesn't stay.  She told me that she is undergoing Chemotherapy and is trying to stay positive about her prognosis.  Each day is a struggle but she admits she couldn't continue without the support of her family.  I felt it vital to focus on ensuring that she participated in social events and was not impeded by the sudden and unexpected bouts of fatigue, so schedule planning was at the top of my list.  Planned rest intervals and family participation is household c...

You can listen and research about the way someone with a disease might live, but you never truly understand what their life is like until you witness it firsthand.  This is exactly what happened to me after watching "TransFatty Lives," a documentary about Patrick O'Brien's life after being diagnosed with Amyotrophic Lateral Sclerosis (ALS).  Being a movie producer, O'Brien felt it necessary to capture every moment of his life from then on -- not leaving anything out.  It was like I was able to personally witness the progression of his fight with ALS through the film.  I watched as his functioning slowly but surely left his body.  I watched as the telltale signs of his condition progressed throughout his body.  I watched him, and three other grown men, struggle to get him in the shower.  It was real.  It was heartbreaking.  It was him.  The incredible part to witness was his continual effort to be himself.  Even though he admittedly ...

Today we talked about Stephen Hawking, renown scientist and lecturer, and his fight with Amyotrophic Lateral Sclerosis (ALS).  The incredible thing about him is that while he now is completely dependent on the help of others, he is still pursuing his passion of writing, science and speaking.  While he is dependent on a tracheotomy for breathing functions and cannot actually speak, he has found ways to communicate and live life to the fullest.  In fact, Assistive Technology (AT) has helped him to communicate by use of cheek movements in selecting words and phrases on a computer.  Even though his AT has helped, Hawking's therapy should focus on continued effort to find the most advanced AT and adaptive equipment so that his continued loss of function will not impede his ability to pursue his desires and interests.  Goals for OT involve training caregivers on how to us AT, discovering new techniques and methods to incorporate in his daily life, and helping him to f...

Before owning my dog, Buck, I would have told you I was a cat person.  Granted, the only exposure to pets I had before Buck was a cat named Cacey.  In many ways, Cacey was like a dog.  She was always by my side and would even come when I called her name!  The day she went missing was one of the saddest days of my life, and I still sometimes wish I knew what happened to my furry friend.  Thankfully, you can always get a new pet, and that is where Buck came in (and now we have a new addition to our family named Levi).  Honestly my two dogs, that I consider my fur-babies, have added such a wonderful dynamic to my life!  They have done ridiculous things, like pooping in the shower, and they have also done sweet things, like sitting with me while I am upset and crying.  At the end of the day, they are always there ready to cuddle.  In many ways, they probably understand me more than others would, and that is why I truly believe the old adage that ...

Recently, I have been astounded at how much awareness of a disease has to do with the amount of research aimed at treating the disease.  I mentioned before how the awareness about Parkinson's Disease came through the work of famous faces like Muhammad Ali and Michael J. Fox.  If it weren't for individuals like them, Parkinson's treatment may not be as developed as it is today.  This idea is true for other diseases as well.  One such illness that I believe will receive a lot of attention now is Tetralogy of Fallot, a disease that Jimmy Kimmel's newborn son, William John, was diagnosed with just hours after his birth.  The fact that Kimmel opened up about a personal family situation in such an emotional way really resonated with me and, judging by its popularity on social media, many others.  Not only were well-wishes sent to the family, but donations towards the operation flooded in as well.  Here was a man, add to that a comedian, crying on live TV! ...

Something I have learned about myself since starting OT school is how I tend to center my beliefs on what should be done for a client based on what I would prefer to be done for myself.  Therefore, the idea of integrating more technology into one's life does not seem appealing to me, so I won't do that to someone else.  But what if that technology could allow someone to access rooms that were once unreachable or even get to a place of living independently because of technological advances?  Who am I to say that people shouldn't have more technological assistance just because that does not sound appealing in my life?  Ironically enough, my husband is an electrical engineer who, of course, specializes in home automation.  Most of his customers are very wealthy people who want an Apple system installed in their homes, but recently I've begun thinking about how much he could help me promote participation in meaningful activities for my future clients.  That sou...

Muhammad Ali was a famous boxer diagnosed with Parkinson's Disease (PD) at the age of 41.  Up until his diagnosis, not much was known about PD.  But thanks to his previous fame and philanthropy involvement in raising awareness and money for PD, this disease has received a lot of attention and research in treatment options.  As an OT, the focus should primarily be on promoting occupational performance in areas of interest such as public speaking and traveling.  Education on managing a schedule and medication should be taught not only to Ali but also to his caregiver.  Big and Loud treatment for Parkinson's Disease is a therapeutic measure that integrates the profession of OT, PT and SLP in an attempt to promote health throughout the body.  Thanks to the tireless work of Ali, awareness of PD is growing in the public.

Learning about a spinal cord injury (SCI) in class is important, but hearing personal testimonies helps facilitate an understanding of these situations.  Jordan Bone, a popular Vlogger and YouTube figure, talks about her struggles after her complete SCI at the C6 level.  First, Bone states how important knowing the associated issues that can arise from a SCI can be.  For instance, she struggles with autonomic dysreflexia which can quickly turn into a deadly situation.  Autonomic dysreflexia is characterized by hypertension, slowed heart rate, flushed skin and headache.  If symptoms like this occur in someone with a SCI, it is important to elevate their head because the results could be deadly. Thankfully, Bone knows when she is experiencing these symptoms and can educate others on how to proceed, but she talks about how many people, even in the health profession, don't know about this serious condition.  Another issue that Bone must pay attention to is her ...

Everyone has their own story.  Each person has a history that depends significantly on family, friends and who that person is on an individual basis.  Even though my classmates all share the same goal, we all have various reasons why we want to become occupational therapists.  For me, first and foremost, my parents and siblings motivated me to continue working hard in school.  Each of my siblings has worked hard throughout school and given their best effort no matter the situation.  My mom homeschooled all five of us and, I think we all agree, that was motivation enough to get out of the house!  From my mom, I saw that I did have a certain enjoyment in teaching.  That was actually my first "dream" job.  I liked the idea of facilitating the success of others which is something very important in education.  However, I found myself just a few short years later wanting to become a dentist (I know, kinda random!)  Growing up, I was always the...

The other day in class we had a guest speaker, Fletcher Cleaves, come and share his testimony about his life after a serious car wreck.  Due to the distraction of another driver, Cleaves swerved to avoid the oncoming car and wound up crashing into a ravine.  After emergency transportation to a nearby hospital, medical personnel informed Cleaves he suffered a spinal cord injury and would never be able to walk again.  Let me interject here and say Cleaves was a freshman college football starter and in the best shape of his life.  I don't know all the details about how he initially dealt with this realization, but I have witnessed his accomplishments just eight years later.  Not only has he regained functions doctors told him he would never be able to such as living independently, he also has turned this seemingly hopeless situation into bright opportunities for others.  I was astounded at his entire outlook on life.  Here was a guy who before was looking...

For the past few days my classmates and I have been learning about the AOTA Code of Ethics and what each of the six different standards means.  Some of the regulations seem to me to be no-brainers, such as the one saying that health care providers should always refrain from doing harm to a client.  Intentionally hurting another human being seems like the opposite of what you are supposed to do as an OT.  Another of the codes, Autonomy, states that each individual has a right to what information of theirs is disclosed and that clinicians should refrain from posting information about clients on social media -- again, common sense.  Honestly, all of the codes seem to me to be pretty cut and dry, until you come to a situation where a 16-year-old pregnant girl asks you not to tell her mother about her pregnancy.  Uh oh!  When reading the descriptions of each of the rules, certain themes keep emerging: respect, honesty, fairness. On the surface, these seem pretty...

Chucky Mullins was a college football player who suffered a spinal cord injury in the cervical injury resulting in his loss of functioning in all four limbs.  Mullins went from a life of complete independence and success as a college athlete to complete dependence and reliance on caregivers.  After his injury he struggled with speaking and swallowing due to a medical trachea.  He hoped to still be able to attend college and get a degree. Occupational therapy services in this situation should be focused on adaptation in order to facilitate activity in meaningful occupations.  While his arms were unable to move, he still had neck and head control that could be used with adaptive equipment in operating a computer.  His intervention services should be focused on capitalizing on the movement he does have through the use of creative and innovative strategies.  Mullins may not be able to regain the ability to walk, but he definitely can return to the pursuit of a...

An aspect of the health care profession that excites me is the dynamic ways clinical reasoning is applied to the practice of occupational therapy.  Some ways to apply clinical reasoning skills are through the use of scientific, ethical and artistic elements.  The importance of evidence based practice cannot be emphasized enough! Ensuring that your clients are receiving the most scientifically supported evidence is the duty of every health care professional.  Regardless, even with the most scientifically based practice there are some issues that cannot be answered through science.  For instance, ethical reasoning is also a part of the health practice.  Knowing how to address every situation will always be a challenge as everyone is different, but I hope that I will strive to pursue routes that keep ethical standards intact.  Artistic reasoning is something I look forward to developing as I grow in my career.  This is where being able to read people in o...

Yesterday, I had the incredible opportunity to participate in showing possible future OT students around my school.  First of all, I loved being on the other side of things where I already was in the program and not worrying about interviewing and getting accepted!  I also really enjoyed getting to know the possible future students of the program.  It was neat to hear their stories and see their excitement about the profession of occupational therapy.  Hearing others' perspectives on the program has always been fun for me because everyone has a different story of what brought them to the field and what they really want to pursue.  Having been a part of this fueled my excitement for the profession as well as meeting the incoming students!

Last week our school had a "Student Appreciation Day" where there was an abundance of food trucks, music and fun for the students and faculty.  I had a fantastic time eating wings, talking with classmates, and enjoying the day (it was a Monday and those days are typically difficult to enjoy!).  Truly, it was a fun time and a great break from the chaos of school.  While some people might have just looked at this as an opportunity for yummy free food, it reminded me of the great things in life I tend to forget!  So often I get wound up on little assignments or tests and quizzes that I forget to enjoy life and appreciate the opportunities before me.  In all honesty it really is the little things in life that can make a big difference, and how much more so do these things affect someone who cannot go out and experience them for themselves?  This got me to thinking -- how do people who are in a hospital enjoy their time?  I know that some places offer commu...

The reality of the sadness and frustration encountered by individuals after a traumatic brain injury (TBI) is quite evident when hearing testimonies of people who have personally dealt with TBIs.  Something that deeply saddens me about TBIs is the fact that they are unpredictable and debilitating in their results.  To go from fully functioning, to completely dependent on others is something that I cannot fathom the radical lifestyle change.  Not only do TBIs tend to completely change the way life looks for the individual, but they also can produce mood and personality changes in the individual.  Because TBIs vary considerably depending on the severity, where they occur in the brain, and even the functioning of the individual prior to the injury, effective treatment of TBIs can be difficult. An idea emphasized through the work of Kendall & Terry (2008) emphasizes discrepancies among people in coping after a TBI.  This study investigated the Goodness-of-Fit ...

I love what I do.  I cannot describe the amazing feeling of wanting to go to school and learn about my future career.  There is no dread.  There is no procrastination.  There is only excitement to learn. I cannot wait to become an occupational therapist! (BUT I also understand I have a long way to go).  This is truly the first time in my life that I have loved going to school and learning.  I honestly did not realize how much I disliked my undergraduate major until I started my graduate course studying OT at UTHSC.  While I love the idea of being completely fluent in Spanish by then end of my undergraduate career, all that I felt I learned was the history of other countries (ew!) and that I am terrible at speaking another language.  Now I don't want to indicate that I absolutely hate anything related to the Spanish language.  In fact, I think Spanish is a beautiful language spoken by amazing people.  I love the culture and food. ...

When I was younger and watched The Three Stooges with my family, I would always cry at the end of the episodes because I would think about the poor set managers that would have to clean up the mess left by the three mischievous men.  In a culture filled with humor at the cost of another, violent movies and music that follows the breakup bashes of Taylor Swift, the idea that someone would cry over a few broken plates during the filming of a comedy is comical in itself.  While I do not tend to get upset about such matters anymore, I do also wonder where the line is between being overly sensitive and callous.  Empathy, I would hope, is a common personality characteristic found in the health care profession, but something that has struck me the longer I have been exposed to the health profession is how seemingly insensitive practitioners can sometimes appear.  Instead of embracing parents after informing them that their child is suffering from cancer, it seems that healt...

Something I have been accustomed to growing up are the phrases "shake it off" or "suck it up" after falling down or sustaining an injury.  Having grown up in a family where there were many children to support on a tight budget, I understood the fact that a hospital visit was the last resort.  Undoubtedly this has facilitated my understanding that you shrug it off and move on.  To a certain extent, I agree with this ideal.  However, after learning the extreme results of certain injuries and their lifelong effects, I may have my future child's doctor on speed dial!  Something that continued to bother me during the story of nurse, Dawn Pereda, was the fact that her own facility where she worked sent her home after she sustained a severe head injury.  It wasn't until hours after alarming symptoms began to appear that she was screened for an injury.  By this point, it was too late.  Now life relies on a schedule that must be maintained or she will not ...

The older I have grown the more I have seen the crippling effects of societal mindsets.  Simply looking at the various changes in roles of women, men, children, and races has revealed the side effects of societal norms.  From working on plantations without rights to their own bodies to finally becoming integrated and viewed as equal, African Americans have suffered the stigma associated with their race.  Alongside this is the issue of women's rights and their desires to become involved in the workforce.  Over time and gradual mindset changes equality and rights have been achieved, but I believe the real issue behind societal expectations can be found in the definitions of words and how they are used.  Aimee Mullins does an incredible job emphasizing the importance of word definitions and how they are used in her Ted Talks about the demeaning impact of the word "disabled" to refer to an individual with special needs.  By reading the synonyms listed with this...

The beautiful thing about occupational therapy as a profession is its adaptability.  It thrives in an environment that is multi-dimensional where the profession morphs according to the client.  "Client-centered" and "top-down approach" are all key terms when describing OT.  Instead of being a rigid process with little adaptation, the profession molds into the best fit for each specific client. Occupational therapists are more than just practitioners.  In a way, OTs are detectives, teachers, and companions.  One theory that capitalizes on the adaptability of OT is Frame of Reference (FoR).  FoR implements the strengths of OT by allowing the practitioner's roles to adapt to each individual client. Using the client's FoR aids the therapist to develop an intervention that best suites his specific needs.  This is where solving mysteries and applying reasoning to the situation is useful.  Deducing the client's motivations and context are key in the deve...

OTPF Guiding OT Practice When thinking about occupational therapy as a whole, its ideals and values center around helping clients regain their functioning in the world.  Because each individual's idea of functioning looks different, it is vital that an OT first look at the motivations behind a client's life choices and interests.  This is where the OTPF plays a vital role.  Its defining features include focusing on the client's occupations, lifestyles, environment, beliefs, etc.  Basically, the OTPF states that an OT cannot proceed with a treatment until the OT understands the client as a person.  This is integral in the OT profession because it guides the therapist to initiate interventions valued by the client that will not only increase the client's ability to participate in his own lifestyle but also allows him to participate in the world.