Holistic meds. vs. narcotic pain killers

I often wonder if the crime rate and homeless rate would be lower if instead of being prescribed narcotic pain killers, people were given a referral for holistic medicine or pain management technique. Before this class I never even thought of substance abuse/drug addiction as a mental illness. The reason I'm so curious is because my ex is a drug addict who is pretty much addicted to anything now but it started out as a pain killer addiction. He broke his tail bone in 2007, he was prescribed a narcotic pain killer for his pain. Instead of sitting on the blow up doughnut seat and only taking the pills when his pain was a 7 or above (on a 1-10 pain scale), he took his pills and went on about his business. Long story short he has been in and out of jail since May 2008. He lost his job because he couldn't get out of bed without his pills so then he turned to selling drugs to buy his drugs. Selling drugs is illegal so he got probation, selling drugs (again) breaks probation so then he went to jail and the story pretty much just repeats its self a few times. Once you get a criminal record then it is hard to get a job even if you go to rehab and get sober. No job=no money=homelessness. Homeless shelters are filled with people suffering from mental illnesses, not so much people who have fallen on hard times. According to the Substance Abuse and Mental Health Services Administration, "20 to 25% of the homeless population in the United States suffers from some form of severe mental illness" (National Coalition For The Homeless). According to the Micheal's house website, "It is estimated that more than 5.2 million people use prescription painkillers without a prescription each year," I couldn't find any stats for people who are addicted to pain killers who have a prescription. I have yet to find any statistics to show that people become addicted to acupuncture for their pain or any other holistic pain management technique for that matter.

Here are some links with additional information:
http://abcnews.go.com/Health/PainManagement/story?id=4082759&page=3

http://www.nationalhomeless.org/factsheets/Mental_Illness.pdf

http://www.blogger.com/post-edit.g?blogID=4999162994534049687&postID=5681947126162234256

Double click my title for some holistic pain management techniques.

Mental Illness & Homelessness

I recently had the pleasure of speaking with a woman who helps run the soup kitchen in downtown Raleigh. I admit that I had never been there, so was interested to know the details of how it is run and the population it serves. The woman spoke of how she felt that Raleigh was changing its attitude towards the homeless amidst the "revitalization" downtown, with all the new buildings, renovations and clean up projects. Anyone who goes downtown would notice the changes happening and would likely agree that it is exciting to see the transformation. She pointed out that part of this revitalization is the plan to move things like the Greyhound bus terminal and the Salvation Army out of downtown. This would in turn draw the population that these places serve, out of downtown - mainly the poor and the homeless. She said they are closing shelters and moving the only place that she knows about that serves supper to the homeless, away from the new revitalized downtown. Though her soup kitchen would remain to serve one meal - lunch, it made me wonder about the future fate of the homeless there.

Then I asked the woman about the kind of people she served and not surprisingly she told me that she was sure that many of them were mentally ill. She says that many of them have obvious illnesses, but also felt certain that many others were also ill. My thoughts went to the many mental illnesses that we are studying in class and how they can lead to homelessness. We have learned that having an untreated or unmanaged mental illness often prevents people from living lives that enable a person to have a home. Being unable to interact normally with others and keep a regular job can quickly lead to social isolation and poverty. Without financial and social support, supporting a home becomes impossible. The link to the article below gives the statistic of 20-25% of the homeless population being mentally ill. Somehow I don't find this statistic surprising and would not doubt that the number is actually much higher. Quite often the homeless are often also physically ill from lack of physical care, and are frequently substance abusers.

The solution to the problem therefore is not simply housing these outcasts of society, but to address the mental and physical issues that caused them to be homeless, and possibly the social and financial ones as well. Please read the attached article for many more details and facts about homelessness and poverty.

http://www.nationalhomeless.org/factsheets/Mental_Illness.pdf

First Fieldwork

My group had our 1st session of OTA fieldwork last week, and it was awesome! We had no idea how many clients would participate & what they would be capable of doing. Our 1st activity was making hand weights from empty bottles & filling them with bird seeds or sand, and amazingly, all the clients participated (about 20). Some of the clients are more disabled than others, but they all seemed to enjoy the activity, & they were all well behaved - taking turns & being patient.

One of the clients stood out - she is such a pleasant girl & has a great smile & beautiful blue eyes. She was very friendly & enjoyed helping the others in the group. She also helped me clean up without me even asking her. I'm not sure of her mental level, but physically she has contracture in one of her hands. Her physical disability did not seem to slow her down at all. When we were doing a session of exercises, she was right there with us doing all the exercises with her dominant hand. I know, I know....don't get attached, don't get attached!

The non-profit facility where we're doing our OTA fieldwork operates 4 small businesses that employ about 41 adults with mental disabilities. It began in 1978 when a set of parents could not find a place in the Cary area to send their disabled child who was finishing school. Their 1st business was a bakery, employing 4 adults with disabilities. The bakery is still operating, along with a laundry department, a silverware contract department (preparing silverware/napkin rolls for major airlines at RDU), and janitorial & subcontract services.

All the employees are mentally challenged in one way or another - from mild to moderate. They are chosen to work at this facility based on their abilities to do at least 1 of the jobs available. A majority will not advance enough to go out into the "real" world of employment. Some may think this is a type of segregation, but as the director explained to me, these employees would have a hard time adjusting to the stresses and demands of working in a regular company. They are very comfortable with their current schedule & with the other employees. I just wish there were more employment opportunities like this for all mentally disabled adults.

Running My First Group

I ran my first "real" group yesterday, and it was scary. I had lots of help though, and as a result, we finished our craft sooner than expected, but that was okay. My team members and I decided to focus on the IADL health management from the chart on page 443 with the focus on making healthier decisions to promote overall well-being. We made stress-relief rice bags, and since we had extra time, the guys were able to make one for their store and one for themselves. They enjoyed their stretching routine that took place before the activity. They seemed to like the idea that football players are now doing yoga. I didn't want them to think that yoga and stretching was just a girl thing. Overall, I think it went well, but now I really understand how hard it is to have clients with different issues in the same group. As I talked to some of the employees at this facility, I thought what great people and how nice of an environment it is there. I think to myself how these guys would be if the environment wasn't so warm and inviting and that's also scary!
Check out this link. It's just a short testimony from a football player who enjoys yoga.
http://www.youtube.com/watch?v=m5lRM-d9IwE
Here's a link just for fun:
http://www.youtube.com/watch?v=uDP1-gcDcAI

DECI

I had a really great experience when we vistited the Durham Exchange Club Industries yesterday with class. Coming from a background of working with children who have physical and mental disabilities it was nice to see a place that would help these folks vocationally and help them pusue a job. With the young lady that I work with now, who is 22 and has down syndrome, we have looked for her a job and have found it very hard to actually find an employer who will see her as an employee and not just a volunteer with no pay. She is capable of doing the same things that the people who are getting paid are doing but she is only ever seen as a volunteer there. It is hard to see that when you know that just becuase of her title she can't get paid to do that job as others do. Steming from this, it was great to see these folks out there yesterday being treated like regular adults who are working, and I saw a few folks with Down Syndrome and it made me think why there wan't more places like this out there who would treat these people like real adults and not categorize them because of their "disability". Is it because of the stigmas placed on the diagnoses? Do they not trust them to do the job correctly? Or do they even give them a chance to prove themselves? It may take a little longer to learn the correct way of doing something but at least give them a chance to be put on the same line as someone who is "normal".

There is one place in Greensboro, NC that offers full and part time positions to people who are blind. They are pretty similar to DECI in what they do for work, but just thought it interesting to see a different site based on a limited diagnosis (blindness).
www.industriesoftheblind.com

Answers to Military Deployments

During one class, some classmates asked about if military members had living wills before going to the Middle East. I asked my son if he had to have a living will before he deploys to the Middle East. He said he had a briefing regarding paperwork he needed to complete before leaving. This briefing included traditional wills, living wills, power of attorney for his spouse, guardianship for children, financial info and training requirements for deployment. His spouse needed to attend a counseling session to prepare for his deployment. The spouse is strongly encouraged to make a traditional will, living will and guardianship for the children in case the spouse is unable to care for the children and the military member is not able to get home from the Middle East.

Before the service members heads overseas, they receive 30 days of weapons/combat training specific to the Middle East environment. It is similar to basic training except the members only get to eat MREs (meals ready to eat) during the 30 days.

The service members are prepared as possible for the deployments and any possible outcomes. However, all this planning does not make the deployment any easier for anyone. Remember these service members in your thoughts and prayers.

I am so looking forward to our LS visit on Wed. We are going to plan to see if our group would be interested in making dog treats and then visiting local shelter to deliver the treats that they have made. I hope this works!! I have printed several recipes--all of which seem easy enough--that I can even look forward to a successful experience in the kitchen. (Not one of my strong points!!!) I am encouraged by the possibility of a group outing--how cool will that be to actually go and deliver the treats to the lucky, four-legged animals!! The pumpin treats sound incredibly yummy--more on how they taste after we actually make them!!!!

Professional Behavior?

I have gone over what I want to write on this post so many times that I wonder if it is even worth the effort to explain how I feel. When we had visitors from a local hosptial last week, a joke about the mentally retarded really p....d me off. I did not even hear what the joke was, but the "punch line" was what made me mad. How do you stand in front of a classroom of OTA students and tell a joke that makes fun of the MR? Even though the guy said it was politically incorrect, it was wrong. Having a son that is mentally handicapped makes me more sensitive to the issue, and I understand that. I don't believe anyone would think a joke about cancer or TBI's would be funny, so why would anyone think this joke was amusing? By the way, I don't like the term mentally retarded, I would prefer the term mentally handicapped to be used. I'm off my soap box now. I need to go take some deep breaths!

Poverty Through Children's Eyes

I began my fieldwork last week at a homeless shelter for families. I originally didn't think it would be too big of a deal. After all, I've dealt with children all my life. I come from a family of 12, have close to 30 nieces and nephews, raised my own children and now even have a grandson. Somehow I did not really grasp how different these children could be from all the other children I've seen.

On the surface I saw ordinary children, doing ordinary things the typical way that kids do. They were distractible, talkative, full of questions and ideas. The differences came out in subtle ways. When they talked about the things they liked to do for example, they spoke of very simple things like playing outside, growing seeds, and making crafts (lucky for us!) Occasionally they mentioned the limitations of their lives but never outwardly seemed to feel self-pity.

Afterward I realized that most of the effects of being poor and homeless are not obvious things. Beyond clothes, toys and other possessions, the deeper more profound life-changing effects of poverty are unseen and likely will never get completely addressed. How do you measure the feelings of a child when they have lost their sense of security, of safety and normalcy? How can you fix the fear and uncertainty that they must carry with them every day? Often we see the resulting affects and have to deal with these things without considering the source. We treat ADD or anger, all sorts of misbehavior from talking back right to theft. What if we could prevent most of this by giving all children a happy, safe, secure, loving childhood?

I realize that the limited time we will have with these children will only have a small effect on them. I hope that our determination to teach them games and crafts that they can recreate with little or no resources will add some happiness to their lives. But most of all, I sincerely hope that they will find a way to thrive dispute this difficult situation they are in now.

The following article talks specifically about the statistics and research on the effects of poverty on children. http://social.jrank.org/pages/500/Poverty-Consequences-Poverty.html

My First Experience With a Psychiatric Hosptial

Like my title says, I had my first encounter with a psychiatric hospital this week. I was surprised to know that it is operating with approximately 700 more employees than were ever intended to be there. The OT my group was with said that usually patients have to wait for beds, sadly most of the time in emergency rooms. It was a bit, ok a lot, daunting to walk down a hall with an enormous amount of patients and realize how outnumbered you are. I was surprised that even though occupational therapy was founded by the Arts and Crafts Movement for the "mentally insane" this particular facility that I went to rarely uses arts and crafts. I understand it's because of safety precautions, but it's still sad. As I was looking for potential triggers for possible patients, I came across an interesting website that links aspartame to mood disorders and some other hazards to our health. It may make you think twice next time you have that soda. Check it out!
http://www.newmediaexplorer.org/sepp/2007/09/26/aspartame_triggers_psychiatric_disorders.htm

My sixteen year old has started working on her senior paper--a whole year in advance! She had thrown around some really impressive topics--defibrillators in schools, socks for the homeless, baseball for Autism...Today she asked me if I wanted to read what she had written. I was quite surprised when the title of her paper read"No Child Left Behind". I didn't know what she was thinking, so, of course, I asked. In doing the research for this paper, she found some of the statistics amazing and surprising!!! As I read through this, I could actually feel my pressure go up a bit, as I have never been a fan of "the no child left behind" slogan. I have never understood the fact that certain students get pulled out of the classroom to go for additional instruction, while the struggling child has to remain in class because he/she did not meet the numbers on a standardized test. What are we saying to the child who just doesn't "get it", and because the numbers fell short, he/she will have to remain in the class and keep trying, struggling. What kind of message does that child recieve--I see it as setting that student up for failure, and allowing it to continue. One sentence from her paper just jumped out at me--we are now having to "Dummy down" our education in order to get the scores up to where they need to be, by 2014. When did the bar get lowered for our young people? Doesn't everyone deserve a really good education--at the hands of teachers who are striving for better and want that for their students. We see on the news often, one county that is struggling with zoning problems, year round vs. traditional, ... I am hopeful that someone will consider the fact that these young people are the future, and all are deserving of a bright future. The "no child left behind" policy has already left a huge population behind--that is the struggling child. I hope that by 2014 our policies in the public school system will have changed in order to accomodate those that are left behind!!

Blogging

I have enjoyed reading every one's blogs. I can't always think about what I want to put on mine and reading the other posts will sometimes give me ideas. We went to our fieldwork for our interview. Our leader was busy with a CPR class so we did not have staff around to interview us and us them. The three of us that went sat around the table with three of the residents and talked to them and played a few games. One was visually impaired so it made it a challenge to play games that were just verbal so he could participate.
One of the clients, who most of us met when we visited the first time, made the remark "This place is what you make of it. The Lord put me here for a reason and I have to make the best of it." What a great statement to hear from him. I don't know that I would feel the same if it were me. I like to think I would feel the same way and have a positive attitude, but I don't know. I don't like the thought that something could happen to me that would take away my independence. I love to help others any way I can, but I like to be the giver, not the receiver.

Butner sterotypes

On Wednesday of this week myself and another classmate will be visiting Butner (Central Regional)to observe a group treatment. As I was discussing this with my fiance, it came to me the horrible stereotypes that came along with just the name of the hospital. When I told him where I was going his comment was, "Oh- you better not stay long the crazy might rub off on you." I then went off on a tangent on how politically incorrect that was to say and how the people there are people just like you and me. I think that was a lesson for me this semester on how big a stereotype that a mental illness can give someone and how differently someone can perceive someone with that label. After my discussion with my fiance I went on to name a few of the celebrities that had mental illnesses and he was shocked to find out who they were and what mental illness they had because they seemed so "normal". I think that it is every one's responsibility now that we have some insight on the people that are there and who they really are, to stand up for them and correct people when they are negative. They are people too. I am interested to meet the folks at Butner and learn about them and their lives. I hope that I can post about that experience next and carry on a true blog. . .

I attached an article on how mental illness stigma's can not only affect how people think about you but how it can affect many other aspects of their lives that you may not have thought about:
www.post-gazette.com/forum/20000318gang1.asp

The Importance of Smiling

I had my first FW experience last week. I was surprised at how low-key and quiet the facility was, and then I thought back to Albert Bandura and what he said about modeling behavior. So, I started scanning the people in close proximity and noticed that everyone, with the construction guys being the exception, had a very positive affect. The employees had great tone and most were smiling and appeared as though they were happy and glad to be there. The residents were imitating the employees and were also very happy, pleasant, content individuals, despite their situation. I was amazed at the comradery between the guys that lived there! This lead me to think about how important a friendly smile can be. I found this website that emphasizes how much of an impact a smile can make. http://www.rbcsgroup.com/OT/OT-2008/Mar-2008/Smile.htm

I feel like we could all use a laugh right now so I also wanted to include this website.
http://www.cafepress.com/shirts4fun/1313481

Investment in the Future

Recently the local Raleigh newspaper - The News & Observer, ran an article called "Unruly Kids May Not Change". I found it pleasantly ironic that we had just learned about that very topic in our OTA psychosocial class. It was wonderful to read about research that supports what we do in OT, even indirectly.

The article was about how a group of psychologists from Duke University just ended a study that took several DECADES (talk about delayed gratification!) as it followed the participants from childhood well into adulthood. The purpose of the study was to determine the effects of learning (or not learning) patience and delayed gratification as a child. Honestly my first thought as I started to read was that it just seemed so logical that what you do or don't teach a child, will effect their adult behavior. But I think sometimes the medical community needs to prove that something is exactly true so that it can become fact to the medical world. The study linked a child's poor self-control with their adult behaviors of smoking, abusing drugs or alcohol, unplanned and early pregnancies and mismanagement of finances.

My thoughts turned to our recent class discussion about Life Stages, where Early Childhood (age birth -4yrs) involves teaching control of impulses, and then Middle Childhood, ( 5-12 yrs old) involves teaching children the importance of considering other's needs, and about delayed gratification. Here is a link to Erickson's life stages which explains his theory. http://www.learning-theories.com/eriksons-stages-of-development.html

I loved how the article went on to say that interventions in childhood that boosted a child's self-control, improved the participants adult life in the areas of health, wealth and crime. A child psychologist, Linda Silber, who was also interviewed for the article, recommended teaching even toddlers self-control, beginning their foundation as young a 2 years old(temper tantrums come to mind).

As OTAs we learn to focus on the behavior that needs to be changed, rather than on the person or just the diagnosis. We will be faced with the behavioral challenges of children who have not mastered these tasks and will be able to respond to that challenge with treatment interventions that utilize the psychoanalytic, behavioral and environmental approach. Our goal will be to give these children the foundation they may be lacking as we teach them trust, appropriate behaviors and appropriate social roles. What an empowering thought, that we as OTAs can have a positive effect on these future members of society. Here is the link to the original article for anyone who wants to read it in its entirety:

http://www.newsobserver.com/2011/01/30/955533/unruly-kids-may-not-change.html#storylink=misearch

Today was the day I got to tour a psych. unit. Quite an impressive facility. It is huge. Every where you look, there are employees--abundant, to say the least. We were told that the employees check on pt.s every 15 minutes. The OT that met with us provided us with a wealth of info. regarding the facility, as well as what goes on within each floor/wing. The OT dep't was rather quiet, as a few of the COTA's were out. We were able to look through some of the assessment books, and also caught a glimpse of some soap notes on the computer. Sometimes being brief is best!!
We did observe a "Fun Group"--the Ot lead a game of 20 questions. It seemed to be a good activity when nothing else was planned. It was interesting to see the dynamics of the group. Those that did participate really seemed to enjoy the game. It was wonderful to see the pride shown by one of the pt's. as he got to pick the "person" to be guessed--he chose himself and was smiling from ear to ear when someone asked if it was him!!!! In the beginning when he was waiting for some clues to be thrown his way, he said "this one will drive y'all crazy!!!!"
Our OT did state that COTA's are very much needed at this facility, as they run different groups every day, most days 3 to 4 groups. Hopefully, she will push for that, and maybe even employ a few more!!! This facility did not escape the budget cuts. The full-time dentist has been replaced with one who is contracted out, as well as an OT also there today.
We were able to observe certain behaviors of some of the pt's. One pt. hummed and sang very softly too herself, not disruptive to the group at all. She had a beautiful voice! We also observed two pt.s who were rather withdrawn from the group. One pretended to be asleep, as noted by the OT, and the other snored throughout the game. We heard of the person who has quadraplegia, and doesn't seem to know it! Very interesting and fascinating all at the same time. OT can provide many opportunities to each of these "unique individuals" through an array of groups--cooking, community life skills, cognitive, and also sensibility training. Hopefully, through therapeutic use of self, we can provide a sense of normalcy and a quality of life to which we are all deserving.

Psych setting

Today I visited a nearby psych hospital. I was really nervous before I got there, not knowing what to expect. The OT at the hospital took a lot of time with us, showing us around, answering questions, and telling us what the COTA's responsibilities were. She said she is always trying to get more COTA positions and how valuable they are to the hospital. This is a new facility that has been open for about three years. With budget cuts, the economy, and regulations changing all the time, they have had to make due with less money than they need. The OT had us sit in on a group session. She was combining two groups because several of the COTA's were out due to sickness and vacation. For the activity she had the group play "20 questions" because there were not any plans in place. Several of the pt's were very involved, a couple fell asleep, and some were not verbal at all. Seeing the different responses to the game was interesting. The saddest part of the time I spent there was when the OT showed us the seclusion rooms. She said they were very rarely used and only when a pt. was totally out of control and was a danger to themselves. I still don't know if the psych setting is a place I would want to work. I guess I would have to spend a lot more time there before I could make a definite decision. From the outside of the beautiful building it looks like mental health is a top priority in our society. Hearing some of the stories about how budget cuts are made, it makes me wonder where the priorities really are.
Click on the title for a list of psychiactric hospitals in NC.

A Life Worth Living

Last week we had a chance to visit a post-acute care facility that is home for individuals that have suffered from a Traumatic Brain Injury (TBI). The visit was filled with great interactional experiences with the residents. We took a tour of the facility lead by one of the residents, asked a lot of questions for the staff, did some activities with a few residents and really just experienced a glimpse into the daily life of individuals that have experienced TBI’s. During the tour we were encouraged to step inside one of the residents rooms while he was sleeping calmly. Hesitant, I stepped just inside the door. The first thing I saw were military posters and a young man laying underneath with a trach extended from his neck. I immediately thought…oh man this young guy is a veteran. Our instructor encouraged me to step in closer and look at his personal pictures on the walls of the life he lead before the accident. The first picture I saw was a gorgeous man on his wedding day staring into the eyes of his bride. My heart immediately sank, my stomach jumped up to my throat and my eyes welled up with tears. My heart broke for him…for his wife…for his family …for all the people who know and love him. I wasn’t able to compose myself to look at more of his beautiful wall of pictures and had to leave the room. The rest of the visit I my head was stirring with questions, doubts, and a whole lot of emotions. Even to this day it is very hard to articulate some of the feelings without feeling overwhelmed with emotion and anxiety. I’ve always been in touch with my emotions and am usually the first in a group of people to get moist around the eyes when I feel moved by something, but I don’t think I’ve felt this prolonged intense and troubling sadness for an individual that I have never met before.

Our professor said something powerful in class right before we went on the site visit and it has stuck with me ever since. “Physicians save lives, we make the life worth living.” Wow. Just powerful! Simplifying our responsibility as OTA’s…we make life worth it for our patients. What a great way to look at a devastating tragedy. If we can somehow make a life that has been turned upside down and broken to pieces…into a life that is filled with hope and a life worth living, that is one of the greatest gifts to a person.

For the next 10 weeks, I will be working with similar patients that have suffered a TBI at different levels of functioning for my Fieldwork. I anticipate to be drained emotionally, but also to be filled with knowledge and great experience I can take with me on this journey. I pray that I am able to play even a small part in making someone’s life there worth living.

I leave you with a few TBI success stories....just click on the title "A Life Worth Living"

Health Insurance

After talking about health insurance today in class, it got me thinking about a situation that I would share with the blog. Last year, after having went from full time work to part time work I had to come off of my employee health insurance. I had been a long time customer with Blue Cross Blue Shield of NC for many years, from a child on my parents insurance until college on my own policy - for a hefty $250 a month consistently.
For people with a "pre-existing"condition such as diabetes, insurance is a nightmare. There are several stipulations that you must abide by in order to be able to have health insurance. You must have had insurance since you had the pre-existing condition and you could not have had a lapse in coverage, not even 1 day or they can deny you coverage or make it impossible to find a company that will.
During my venture out into the wild land of health insurance premiums I decided to go back with BCBS of NC because I had been with them for a while and thought that they had good coverage. After applying, I was dumbfounded to find out that in the mist of 6 months my premium had skyrocketed from $250 a month to $450 a month. Nothing had changed in my condition, no new bills or doctors. All the same, just $200 more a month. I have come to find out that this increase is due to the new "health reform". Witch all sounds good but in real life for people with pre-existing conditions makes health insurance even more of a nightmare. Let me explain:
The new health care bill made it possible for "everyone to be covered" meaning that the insurance companies can't deny you anymore (even if you have a lapse in coverage or have a pre-existing condition). This sounds good right? But if you are like me with a pre-exiting condition there is one thing the government did not take into consideration: Now that the insurance companies can't deny you coverage, they are raising the premiums to astronomical amounts to compensate for this. There is no cap on what they can charge you now if you have a pre-existing condition or lapse in coverage. What I can't figure out is if they are going to penalize someone for not having health coverage - what if you can't afford the premium each month that was inflated due to the new bill. It all sounded good but if they are going to reform then there needs to be a reform in the billing and premiums department. They have a good start but they have a while to go.
Health insurance companies are highway robbery. There was no reason to raise my premium. I still have the same meds, same doctors, nothing to explain a $200 a month jump. What I found online while searching on BCBS of NC was ridiculous. I have attached an article on the profits of BCBS of NC from 2009. They made so much money they don't know what to do with it. Their CEO made $2,000 and hour. That is ridiculous. And to be so hard up for money that they need to raise their premiums $200 a month and not allow for the care that people need that have paid their premiums their whole life, just to be denied coverage. What a joke. Like I said - there needs to be a reform just in the way of a whole new health system.

http://wral.com/news/local/wral_investigates/story/4668082

TBI and Gulf War Veterans

On Friday I toured the Durham VA OT Department as part of my fieldwork preparation. I learned that TBI is the "signature injury" for the military serving in the Perisan Gulf and Afghanistan. According to the Brain Trauma Foundation, between 150,000 and 300,00 military personnel have experienced some form of a TBI. Many of these service members do not take the injury seriously and do not seek treatment right away after an explosion. It is part of the service member's nature to be strong and get back to work as soon as possible.

The Brain Trauma Foundation is developing new technology to determine if an individual has received a TBI in the combat zone. Medical personnel will be able to determine if a service member has received a TBI and start treatment immediately.

The lead story for the News & Observer on February 6, 2011 was "Hobbled Vets Regain Sense of Self Through Active Living". Staff writer Martha Quillin writes "It's one of the cruel tricks modern combat injuries play on soldiers. Healed from their visible wounds, they look like their strong, confident, active former selves. They just can't figure out how to be those people anymore." The story goes on to say how important it is for the service members to find a purpose and learn to live life to the fullest with a TBI. OT is extremely important for these individuals.

TBIs can be devastating to anyone, but especially to a strong, young person serving his/her country. We need to do a better job supporting our servicemen and servicewomen.

References: newsobserver.com
braintrauma.org

Therapeutic Use of Self

So I opened my book to chapter 10 and thought to myself, “Therapeutic Use of Self…AGAIN!” I mean we’ve covered this topic of discussion several times already. Why is this discussed in such great detail? Shouldn’t we be focusing more on activities, how to run groups, assessments, etc? I can see how some would think so, however, therapeutic use of self is the major component in every aspect of what goes on between the client/therapist relationship. My class and I were exposed to 2 great speakers last week, and one of them reminded us that everything we do and say and how we present ourselves to our clients could potentially “make or break” the treatment process. Even something that may seem minor to us, such as being late to work, could jeopardize developing a rapport with clients.

Needless to say, what a great chapter to read and reiterate right before we go out on fieldwork! I have provided a link to a short message about self-reflection. Just remember, sometimes the best therapeutic use of self is just simply listening…

Device helping amnesia patients

Yesterday's 2 guest speakers in our class were very informative about ABIs & how their rehabilitation centers deal w/ different types of clients & their symptoms. I also had the privilege to visit 1 of the centers on Tuesday & met 3 of the clients that live there. I was amazed at how well they were doing - some even do their own shopping & cooking. 1 of the clients was in a work accident & had not spoken for 10 years, but then 1 day he just started speaking & hasn't stopped since! This is a good example of how our brain's plasticity does remarkable work.

While I was reading a magazine at the dr's office yesterday, I came across an article about a device for amnesia patients called Sensacam (it took me back to our class discussion about amnesia patients, and how some cannot remember the day before). Sensecam is a camera that a patient wears like a necklace, & it takes pictures every 30 secs. The patient can download & review the pictures - it can possibly help stimulate memories. It's not a cure for amnesia, but the pictures can give patients a sense of belonging & that they do have a meaningful life. If you click on the title, you'll be redirected to the article.

It's incredible how far we've come from institutuionalizing anyone who wasn't "normal" to being able to rehabilitate a "not normal" person into an independent person... makes me wonder where we'll be in 20-30 years.

The "What if" Question?

This week OTA 180 took a trip to LS. I had no idea what LS was and really went on the trip having no idea what I was getting into. I had not prepped myself for any emotions or feelings. To be honest, I was tired and really wanted to just go home. To my surprise, I have not been able to stop thinking about the trip or the people we encountered at LS. When I go to sleep at night, I have dreams involving not only the patients at LS, but imaginary, made up family members. The question I can't seem to get out of my head is what if a TBI happened to my husband? Where would I start? Where would he go? How would our relationship change? These are not questions I really want to think about, but somehow in my subconscious they keep coming up. I hope to express some of my thoughts and questions here and hopefully help my subconscious rest tonight.
To begin, I think about my husband having a TBI because most of the patients we met at LS were men. There are so many unanswered questions about the "what if"s. How much will insurance cover? Where will the extra money come from? Who will we trust with his care? How long will his recovery last? Will he recover? How much recovery should we expect? How will I take care of our two boys? What does the "old" David(my husband) want? Where will my emotional support come from? All of these questions I have about my "what if's" remind me that there are real life questions happening as seen at LS. We focused on the patients that day, but I can't seem to stop thinking about the families. Although the TBI person is changed forever, so is the family.

I was also stuck by a simple, true comment from our instructor, "If you get injured, you want to be injured on the job". So, from my understanding most of the patients at LS were there because of workers comp. This leads me to think of the person who is injured on personal time. What is available to them and their family? I found some comfort in the link above. Here you will find blogs from family members and resources for TBI persons. I found the blog about new technology for TBI's especially helpful. A telephone that dials the numbers with the push of one number. The automatic pill dispenser and the freedom for family members to have time out knowing their loved ones are safe. As an OTA I will look for continued rehabilitation but also knowing when and how to adapt this new life for clients and family members seems critical. How will you know when to adapt and when to keep pushing? Does experience and long time work with TBI's help an OTA in answering this question. Sometimes, I wish I had more answers than questions.

LS field trip was a reminder to me to ask the "what if's". It was a reminder of how blessed I am, and also another helpful push to finish the OTA program to help others (family or clients) and use my talents for God's purpose!! Be sure to double click on the title to check out a great website.

The Lives They Lived Before

The other day we had a couple program directors come speak to our class. One of the many subjects that they spoke on was that some of these people (people suffering from TBI's) remember who they used to be. On the inside they are exactly who they were before their accident. We also recently went on a field trip to a living facility for people with TBI's. The resident that gave my group a tour took us into a building that looked to be the arts and crafts room. There was a particular man that stood out to me. I felt some sort of connection with him. I guess it was his age that drew me to him. The other men that I met were much older than I am, old enough to be my dad in fact. I also noticed his tattoos. He had tribal tattoos on his arm (I will attach a photo of tribal tattoos for those who are not familiar) Forgive my generalization but every man that I know that has those type of tattoos are tough, manly, physically active men. This man was thin and in a wheelchair. I couldn't help but think about the life that he had before he suffered his TBI. Was he like my friends? Did he enjoy playing sports or going to the gym? I started to wonder if he had a girlfriend before and if she had broken up with him. I wondered if his friends ever came to visit him. It broke my heart to see someone who could have been my friend in a condition like this. Then I realized that I shouldn't feel more empathy/sympathy for him just because we are close in age. Most of the men at this facility had a life before whether they can remember it or not.

I've included a link to an episode of MTV's True Life. This is "True Life: I have a traumatic brain injury." Please watch in it's entirety, it is very moving and informative.

The Mandt System

Today we were fortunate to have two guest speakers (Rob & Sean) from Learning Services in Raleigh & Durham, who came to talk to us about Traumatic Brain Injury clients at their residential facilities. During their presentation, the topic of Autism came up, and we discussed our experiences with different rehabilitative approaches to interacting with this type of patient. Sean mentioned a story about a man he had met named Mandt, who had an autistic child. Mandt was disappointed about the overly physical way the health care staff handled his child, and therefore decided to develop a new method of handling developmentally disabled children.

During my research I discovered the system that Mandt developed, called "The Mandt System" which describes his vision of "working with human service organizations to decrease workplace violence by increasing safety through use of positive behavior support". Mandt's program is designed to be used in multiple fields beyond health care, such as education, juvenile justice and mental health. His universal goal is "building healthy positive relationships" and his philosophy of "putting people first" and "supporting people, not just their behaviors" seems to be a direct reflection of his earliest health care experiences with his autistic son and directly indicates his motivations.

The Mandt System's focus is on staff development and it offers competency training, professional consultations and interactive teaching techniques through a certification program.
More information can be found at: www.mandtsystem.com

Awesome Visit to Learning Services

I really enjoyed visiting Learning Services today. It was great to actually see what we will be doing when we are on field work. The clients were very interesting and engaging. They answered all the questions about their challenges and disabilities and allowed us to practice on them. I learned so much about people with brain injuries and it was nothing like what I thought it would be.

Ms. Marcus and Ms. Gonzalez offered great insight to activities for therapy. Also the clients obviously love Ms. Gonzalez and are willing do whatever they can for her.

Thanks for arrange this opportunity for us!

Jack of all trades

Last week during one of the many classes that a OTA student has to take, I realized that there is so much that we have to know. From mental illness and mental health to physical dysfunction and stroke, add in the assessments and learning the many parts of the body, add activities and a sprinkle of acute care and what do you have.... a "jack of all trades" OR an OTA. There is so much that we have to know and be competent in with so many different clients. The great part of all this knowledge and this OT field is that it make us so diverse we can work in any setting. But isn't that what occupation is? We help people to regain/manage the variety of occupations in their own lives and maintain the roles (wife, mother, father, husband, brother, sister, etc.) in their lives. Jack of all trades or OTA either way that's what makes us really special.