Neuro Note #4

For my fourth neuro note, I watched a video on Youtube entitled "Living with Huntington's Disease". I chose this video because this is the next condition that we are studying in our course and I don't know much about it and I think watching videos of people in their everyday lives with these conditions really can open your eyes to what they have to go through. The video was from the perspective of a caregiver. Tammy Stewart takes care of her brother, Mike, who is in the late stages of Huntington's disease. He is almost fully dependent on Tammy and his mother, who also helped some, for making his food, helping him walk and transfer, and helping with his ADLs. He could still feed himself with adapted utensils, walk with a walker and assistance for safety, and communicate in barely understandable one word responses. Huntington's is a genetic disease and it is very apparent with this family. Tammy and Mike's father and sister had passed away from the disease, Mike is in the late stages, and Tammy, unfortunately, had got the diagnosis as well and is in the early stages. It gave the statistic on the video that a child has a 50% chance of having the disease if one of their parents suffered from it. 

It was very humbling to me that Tammy said that she would take care of Mike for as long as she could even with her own diagnosis. She was just having symptoms of tremors and mild depression at the time, but said that she was trying to have a positive outlook on life to keep her brain as healthy as possible. She was part of an experimental drug trial that would hopefully slow the onset of her symptoms and give her a better quality of life for more years to come than without the drug. She described Huntington's on the video as the "monster disease", which I can understand after seeing so many of your loved ones struggle because of it and then to get the diagnosis yourself as well. It was described as a disease that has some symptoms of Alzheimers, Parkinson's disease, and ALS all in one. There is no cure for this disease currently, but maybe one day with more advancements, something more can be done for people with this dilapidating disease. 

Resource:

STAT. (2019, December 4). Living with Huntington's disease. [Video]. Youtube. https://www.youtube.com/watch?v=7fNrzYEl9G0

Neuro Note #3

For my third neuro note, I decided to compile a list of some websites that gives some general information, insight, and support about some of the neurological conditions that we are studying in our course. It is a quick little guide to information about commonly heard of diseases and conditions. Something that I found very encouraging while making this list was the support that seems to be out there for those that suffer from these diseases and the support for their family and caregivers. I hope that it helps them to know that they are not alone in their disease and situations. I am definitely planning on looking more into how to get involved with some of these organizations and foundations.

1. Dementia - https://www.dementia.com/index.html

This website contains a lot of information to help people understand dementia better with its                         diagnosis, prognosis, progression, symptoms, and many more topics.

2. Traumatic brain injury - https://www.biausa.org

This resource contains information about brain injuries, helpful tips for caregivers and professionals, ways to give if you want to help, and testimonials of others and information for those with a brain injury.

3. Cerebrovascular accident (CVA or stroke) - https://www.stroke.org/en

This website offers lots of good resources for things stroke related. There is information about what a stroke is, life after a stroke, and help and support for people that have suffered from a stroke. It also offers healthy living tips and ways to get involved with stroke prevention and in the community.

4. Spinal cord injury - https://facingdisability.com

This website is full of resources that offer general information about SCI and bedsores, videos of experts and people with SCIs, and numerous resources for adaptive equipment, support, advocacy and many other topics.

5. Multiple sclerosis - https://mymsaa.org

This website has information about MS and many supportive resources for those that have MS. It offers a whole section of things for living with MS and there are also ways to donate and get involved.

6. Huntington's disease - https://hdsa.org

This source offers information about Huntington's disease and its symptoms and stages. It also has help to find places to receive clinical care and other support, tips for healthy living, and information about research being done for the disease.

7. Parkinson's disease - https://www.apdaparkinson.org

This website has information on Parkinson's disease, resources for those living with the disease, and updated research and webinars about it. There are also ways to get involved with local events for the disease.

8. Amyotrophic lateral sclerosis (ALS) - https://www.als.org

This is the official ALS website and it has all things that relate to the disease on it. Some of the main sections are entitled "understanding ALS" and "navigating ALS" and are full of good information and useful resources.

9. Myasthenia gravis - https://myasthenia.org

This website offers general information about the disease so a person could understand it better, along with treatment options and tips on management of the disease. It also has lots of information that will hopefully help a person live a full life with myasthenia gravis.

10. Guillain-Barrè syndrome - https://www.gbs-cidp.org/gbs/

This website has great information on Guillain-Barrè with a very easy to follow video on the disease. It is a foundation that offers support to those that suffer from this condition and has ways that you can advocate and volunteer to get involved with the community of people.

Neuro Note #2

For my second neuro note, I chose to watch a Youtube video titled "Multiple Sclerosis-Breea's Story". I chose this because I have known some people personally that have been diagnosed with multiple sclerosis, but I do not have a clear understanding of what happens when MS is diagnosed and what the prognosis is. Breea was an 18 year old high school senior cheerleader when on December 8, 2011 she collapsed and was paralyzed on her left side within 24 hours of the incident after feeling unstable that morning. She was diagnosed at that point with a acute onset of MS and then became blind in her left eye and lost the ability to talk or swallow. She spent 6 weeks in the hospital where she received therapy services to hopefully get her back to herself. With support of her family and friends, she worked on things like feeding herself, writing, and walking. She gradually regained movement on her left side and her speech and swallowing returned. At day 46 after leaving the hospital, Breea started receiving therapy at home and in an outpatient clinic where she worked a lot of walking and grip/hand movement. At the end of the video, they showed her doing an assisted back hand spring 8 months after the initial diagnosis.

In an essay that Breea wrote for college, she talked about how her mom had told her that most people in her position would just be throwing a pity party for themselves and something that really stuck out to me was Breea's attitude and work ethic that she mentioned. She wanted so bad to get better and she responded to her mom that feeling sorry for herself was not going to make the lesions on her brain get better. She was a very hard worker throughout her initial recovery process that was shown and made such amazing gains because of that. She went on the graduate on time and start college at NAU.

In the description of her video, they included some facts about multiple sclerosis that I found very insightful and would like to share. MS is an autoimmune disease that takes its toll on the brain and spinal cord. The fatty, protective myelin sheaths that cover the nerves are attacked causing nerve signals to not fire as quickly or at all between the brain and rest of the body. This disease affects 2.5 million people worldwide with 400,000 of those in the US. Onset is low in young adults and even less in teens, with even fewer of those having an acute or severe onset such as Breea. I am sure that she is an inspiration to many and shows that healing is possible!


Resource:

Breeareneebeatsms. (2012, September 8). Multiple Sclerosis-Breea's Story. [Video]. Youtube. https://www.youtube.com/watch?v=hfD9s1_TN0s

Neuro Note #1

For my first neuro note, I chose to watch the Ted talk entitled "Simple hacks for life with Parkinson's" by Mileha Soneji. There are 60,000 people in the world each year that are diagnosed with Parkinson's disease. This is a condition where the person has degeneration of their nervous system causing tremors or shaking and slowed and rigid muscle movements among other symptoms. During her Ted talk video, Soneji recounts the life of one of her uncles that was always spirited and playful as she had grown up. Then, she noticed after he had been diagnosed with Parkinson's that it was like he was trying to hide from people to avoid their looks of pity because he could not do what he had once been able to because of the disease. She specifically mentioned that he did not want to drink coffee or tea  in public anymore because he could not avoid spilling it. Also, that when he tried to turn while walking with his walker, he had to take the turn one small step at a time and that it took forever and was painful to watch.

Watching her uncle have to go through this disease that strips away a lot of a person's independence and confidence made Soneji want to come up with some way to help her uncle and others. First, she tackled the problem of not being able to not spill drinks. She designed a cup that looked like a cup that anyone would be using, but the top was made where when liquid splashed up because of shaking the liquid could not come out. This gave a sense of normalcy and did not make the cup stand out to draw any unwanted attention. Next, she wanted to evaluate her uncle's walking to hopefully help him with that. She thought that going up and down stairs would be an almost impossible task for him, but to her surprise he went up and down the stairs like a professional. Soneji concluded from this that the continuous motion of stairs made the movement more fluid for her uncle. She took this information and made a staircase illusion on the floor to mimic the continuous motion of the stairs to help aid him on the flat surface. From a video clip that she showed, you could observe that the staircase illusion was successful and that his movement froze at the end of it.

This video was very interesting to me because I got to learn a little bit more about Parkinson's and some aids that can help those that have to deal with the disease and my husband's grandfather suffered from it before he died a few years ago. At the end of the video, Soneji concludes by talking about that we do not have to have the latest technology to make a difference in someone's life. She goes on to talk about how we just need to show empathy and be human-centered when trying to figure out ways to help which I thought went right along with the basis of OT. Sometimes we need to go back to simple things as long as they are simply effective. I wanted to look a little more into adaptive equipment for people with Parkinson's, and simple was definitely the overlying theme for most of the equipment that helps these people live their lives everyday. I'm thankful for people like Soneji that are willing to look at what people need to succeed, take the risk of failing, and keep persevering to help others for many years to come.


Resource:

Mileha Soneji. (2015, February). Simple hacks for life with Parkinson's. Ted. https://www.ted.com/talks/mileha_soneji_simple_hacks_for_life_with_parkinson_s

Neurobiology Blog 2 - Social Determinants of Health

Everybody has different things that they have to deal with in life such as living conditions, socioeconomic status, employment, access to healthcare and the list could go on and on. As we evaluate clients and try to figure out the best treatment options for them we need to keep these factors in mind that are referred to as social determinants of health. Social determinants of health are anything in our social environment that could affect our health in some way which could be good or bad. It's things that are going on outside of our bodies that are affecting our body functions, organ functions, or occupational performance. As occupational therapist's, this goes right along with the concept of client-centered, holistic practice of looking at the person as a whole and not just at the problem they are having. A client profile is so important when considering their social determinants of health because we will be able to ask questions to help us get to know the client better personally and any special circumstances that they might be dealing/living with that is causing an observable effect. These social determinants of health could affect our nervous system by adding on excessive stress or altering our sleep wake cycles to where we're not getting the rest that we need to function. Also, the excessive stress could also cause sleep problems, headaches, anxiety disorders, etc.

I believe that the OT program at UTHSC really does a great job at allowing and encouraging us to see  and interact with people that are different than us that might have things under the surface that are affecting their health. Through the hours that we have to acquire of service/professional development we get to interact with people that may have very different social determinants of health compared to our own. Whether they are homeless, live in unsafe conditions, deal with abuse, are health illiterate, have a very physically demanding job, are unemployed, have a disability/take care of someone with a disability, etc., we get to talk with people that come from all walks of life and might have to deal with things that I would never dream of that will consequently affect their health. I'm thankful to be pursuing this career that encourages me to get out of my comfort zone and interact with people that are different than me that I can hopefully help and maybe learn something from in the end.

Biomechanics Blog 7 - Locomotion and Adaptive Devices

There are many situations where a person might need adaptive equipment to help with their ambulation and mobility. When picking what kind of AE the person needs, many factors need to be taken into account to make sure the most efficient and safe option is chosen for the client. Things such as disability, weight bearing status, strength, ROM, balance, and coordination will need to be assessed to make sure the correct assistive device is being chosen and if they need any added on equipment to the device. Other factors should also be looked at like age, endurance, and psychological condition. As an OT, we need to make sure that the device is comfortable for the client and doesn't cause any pain or breakdown of the skin, puts the client in a position to use correct body mechanics, and is practical and usable for the client in their day to day life.

Some devices that can be used to help with ambulation and mobility include canes, crutches (axillary and Lofstrand), and walkers (platform and rolling). A cane would be used when the least amount of stability needs to be added to the client. To fit a cane to the person, we need to make sure that the hand grip is at the level of the client's wrist crease and that their elbow is slightly flexed to hold on to the cane. There are also different types of canes that can be chosen from, for example, a standard or straight cane with one leg or a quad cane that has a wider base and 4 prongs to increase stability (base can be wide or narrow).

Crutches can give more added stability than canes. To fit crutches to a client, we would need to take the same measures as for a cane and add that the crutches, if axillary, should be around 5 cm below the floor of the axilla with the shoulder relaxed. This is for comfort and correct alignment of the shoulders while using the crutches. For Lofstrand crutches, these have an arm cuff that goes around the proximal forearm of the client. We would still need to make sure they are the right height and that the arm cuffs were a correct fit for the client. They provide less stability than axillary crutches, but are for long-term disabilities.

Finally, walkers are more stable than either canes of crutches. The same measures should be taken when fitting a walker to a client as with a cane. A platform or rolling walker will have 4 points of contact to the ground, but the rolling will be less stable than the platform. A platform or standard walker should be given to someone with fair balance that needs a large amount of added stability. A rolling walker is more efficient for a person that cannot lift a walker up to move.

Biomechanics Blog 6 - Transfers and Mobility

Mobility is a very important part of people's lives. We like to be able to get where we want to go without much resistance or problems. When a person loses that ability of moving themselves around, it in most cases becomes a goal of restoring that mobility as quickly and efficiently as possible. There is a hierarchy of mobility skills that can be followed in this kind of situation. The steps include bed mobility, mat transfer, wheelchair transfer, bed transfer, functional ambulation for ADLs, toilet and tub transfer, car transfer, functional ambulation for community mobility, and community mobility and driving. These steps set up a system that can be used to gradually restore the person's mobility in the most safe and efficient way possible and helps to also gradually restore the person's confidence in their mobility skills.

During high school I received my CNA license and during the time I spent in different facilities, I saw some of these steps, but not all and sometimes not in the same order. I think that the hierarchy was put in this order because it is the most functional and safe process to use for the patient, but sometimes people will progress differently causing the hierarchy to maybe be changed for some. This hierarchy of mobility skills I believe is effective in treatment of others because it goes from the basic needs of mobility and self care and proceeds to more difficult tasks that should be implemented at a later time when some/most mobility has been restored. As an OT, it will be my job to make sure that whenever someone of trying to restore their mobility that we are doing it in the safest, most efficient, and personally accepted way for the patient or client. This hierarchy seems to be a good guide to go by.