Post-Interview Reflection

• How do you feel the interview went overall?
  • I felt that the interview went well overall, but there are definitely some areas that I need to strengthen before the real interview process begins.  It was a great learning experience to see what areas were strong and what areas needed improvement.
• How did you prepare for the interview?
  • I studied every website that was on blackboard plus some! I wrote down a handful of questions that I thought might be asked or would be relevant to know, then wrote out my thoughts on how I could answer each one.  This definitely prepared me because some of those questions were asked, but I think I over prepared by studying a script too much and thinking too much about the whole process.
• What went differently than you expected?
  • I shouldn't expect an interview to be super intimidating, but my mind always thinks that way.  After I answered her first question, it was more of a formal conversation vs an interview which helped me to relax. 
• What's something you would change if you could go through this process again (or something you'll do differently when you're in a real-life interview situation)?
  • I would not worry or freak out about the process too much.  I studied what I could say for so many questions that helped me, but also hurt me.  I had so many thoughts running through my head when the question was asked that I sometimes had trouble putting those into words.  This made a few of my answers a bit too wordy when only a simple answer was needed.  For example, I was asked what I was most  passionate about.  Therefore, I went into a huge spill on OT and the geriatric population and what made me passionate about each, but she was really interested in knowing things that I was passionate about outside of my profession.
• What's something you learned during this process that may be helpful to you as you prepare to enter the workforce as an OT practitioner?
  • My interviewer gave me some great advice after my interview was over that I will continue to take with to future interviews.  As I mentioned above, some of my answers became too wordy because I was having trouble getting my thoughts into words.  She assured me that this happens to everyone and it's okay to be nervous.  Instead of scrambling for words when you are flustered, pause and take a breath and think.  This was very reassuring to hear because my fear is not knowing an answer right off that bat and it's okay to sit and think for a short period of time before answering.   I also learned if you think of an interview as a conversation the process seems more lax and smooth.

Aging & Sexual Health

The opportunity to develop and maintain intimacy in later life can be challenging.  Factors that can affect this can be due to declining health, increased incidence in of diseases that affect physical and psychological function, and habits such as smoking and alcohol.  While there is a decline in activity as individuals age, the majority of healthy people with partners wish to remain sexual into later years in life.  It is important that we as OTs should recognize this as a valued activity for older adults and provide interventions to support sexual activity as appropriate.

Interventions such as activity pacing, energy conservation, joint protection, range of motion, and pain management were mentioned in the sexual health lecture.  Group sessions can be held for clients with chronic diseases on activity pacing and energy conservation.  Educating individuals on planning sexual activities for a time of day or day of the week when energy levels are at their highest can be very important and helpful for those with fatigue and weakness. Individual sessions on positioning can also be held for a client who has undergone a total hip replacement or any other major surgery that limits or restricts range of motion.  

Insider Scoop: OT with At-risk Youth

I had the opportunity to communicate with Hannah Phillips prior to her inservice presentation to gain more knowledge on the role of OT with at-risk youth. I chose to write a reflection on this topic because it is relevant to my first level II rotation, which is in pediatrics, but also because adverse experiences in childhood can impact an individuals across the lifespan. I was able to gain a clear definition of "at-risk" youth, why it matters, what OTs can do, and a hand full of assessments and resources.

Youth at-risk is a child or adolescent who faces extreme threats to successful transition into adulthood. A few examples include, involved in drugs/alcohol, neglect, mental illness, & sexually abused. Hannah mentions that in children, exposure to ACEs or childhood trauma can affect brain development and hormonal and immune systems, which can cause behavioral problems, learning difficulties, and physical health issues. In adults, exposure to ACEs dramatically increases the likelihood of 7 out of 10 leading adult causes of death.

As OT practitioners, screening for ACEs in children as early as possible and providing children and their families with the support services they need is a critical step to prevent and undo the existing and future harm to children’s brains and bodies caused by toxic stress. There are some existing programs in Memphis as well as around the United States for those who have had these experiences.  For example, Youth Villages is a program that provides help for children and young people across the United States who face a wide range of emotional, mental and behavioral problems.  Their goals is to improve these individuals' long-term success.

Learning and looking deeper into this topic has better prepared me for my upcoming fieldwork rotation at Kenny Rogers Children Center in Sikeston, MO.  I will definitely take what I have learned from Hannah about at-risk youth and ACEs with me and now feel more prepared if I were to find myself in a situation similar to this!
 

Driving & Community Mobility

Accessing a patient is very important especially when it has to do with the most complicated IADL, driving.  Majority of the patients that are sent to a driving training program are told that they cannot drive anymore.  As occupational therapists, our job is to help individuals gain their quality of life back as best we can.  Therefore, we must think outside of the box and think of what they need when it comes to driving.  The three purposes of a driving program are assess individuals for safety and potential to drive, assess for equipment, and train individuals in the use of AE and/or compensation techniques for driving.  Having a basic knowledge on common diagnoses is also very important.  Common diagnoses that are seen in driving programs are stroke, TBI, SCI, amputations, alzheimers, MS, CP, and visual impairments.  Driving is a multi-task, multi-stimulus IADL.  An individual must be able to shift attention from one task to another and be able to come back to the correct point of sequence in the task.  There are so many things that you are doing while your driving and one needs many skills intact to do it safely.  Occupational therapist identify interventions to driving and community mobility and safety.  Interventions can range from driving education held in a group course all the way to behind the wheel assessment with an individual.  Behind the wheel training be used to vehicle control skills and/or train patients how to use adaptive equipment.

Nutrition & Aging

There are multiple things that can lead to malnutrition in older adults and it has become a serious issue in healthcare.  When discharged from the hospital, the importance is often put on medication or therapy and the nutrition aspect is forgotten. Many older adults have little knowledge about proper nutrition, poor oral health, and weakness during kitchen mobility/meal preparation.  As we age, we lose muscle mass and function which can lead to a condition called sarcopenia.  This condition often leads to disability and sometimes mortality.  Along with exercise, nutrition interventions are very beneficial for older adults who have malnourishment issues and sarcopenia.  There is limited research on occupational therapy's role in nutrition, however, malnutrition can be related to occupational performance, including eating and meal preparation. 

There are many occupational therapy interventions that can be involved around nutrition.  Educating a client who has poor oral health and difficulty chewing or swallowing on selecting or preparing soft foods.  As far as a group intervention, leading a support group for those who spouses have passed on different techniques for healthy meal preparation.  Advocating for OT's role in nutrition is very important because many healthcare professionals are not aware!

Glyph Drawing

We were given this leadership assignment over a year ago and had the opportunity to complete it once again just a few days ago.  After we completed our second drawing, we were able to compare it to our first.  I was absolutely amazed at the difference.  According to the drawings, my understandings and beliefs of being a leader have changed significantly.  I believe that this drawing represents how much this program has allowed me to grow in an area that I never imagined.  This program has given me many leadership opportunities and has pushed me out of my comfort zone, which showed me what I was capable of when I never knew it.  When we completed this drawing for the first time, I believed that people were born leaders and if you did not see yourself as a leader then you more than likely would never become one.  A year later, and my thoughts were the complete opposite because I became the "leader" that I never thought I would be.  I have always been very shy and afraid to speak up or take the lead.  One example is that I had the opportunity to serve as the Professional Development chair on our SOTA board allowing me to make many connections with professionals in the community.  Public speaking is most definitely not a strength, but introducing different guests to our class and professors gave me the chance to open up and face my fear.  I enjoyed being able to re-do this assignment to see how much my perspective of leadership has changed.  Take a look at my drawings below to see for yourself! :)

OT 640 Debriefing

https://youtu.be/90A5CupjRx8

Disability Justice & Adaptive Sports

"We are pathfinders.  We enable occupations that heal.  We cocreate daily lives.  We reach for hearts as well as hands. We are artists and scientists at once.  If we discern this in ourselves, if we act on this understanding every day, we will advance into the future embracing our ethos of engagement.  And we will have reclaimed a magnificent."

-Suzanne M. Peloquin

I was very disappointed that I was unable to attend the Memphis Rolling Grizzlies, but I am so thankful that I got the opportunity to listen to the podcast, Disability Justice & Adaptive Sports.  Danielle Watson is an occupational therapist specializing in hand therapy.  She graduated from NYU with a degree in Art History and Philosophy.  In the summer of 2011, she had a horrible accident and fell while rock climbing in Colorado and sustained a T-6 SCI.  She went through several surgeries and lots of rehab and decided to go back to school with hopes of pursing a career in physical therapy.  With rejection after rejection, because of her disability, she thought about different routes which lead her to occupational therapy.  This podcast was interesting to hear someone with a disability working in the same field but also because hand therapy is also the route that I am interested in!  She made a statement that really stood out to me during the podcast, "If you are willing to work with people with disabilities, why not have colleagues with disabilities as well."  Just because someone is in a wheelchair does not make them any different.  She also mentioned how her accident gives her a way to relate with the hardships that her patients are going through which was really interesting to hear.  Danielle was very active before her injury and still continues to participate in wheelchair sports and marathons.  One thing that I took from her podcast was to have or find resources for patients that are dealing with this type of injury to help them get back to their life.  People with spinal cord injuries know their life isn't going to be the same as before and that can often cause depression along with a lot of other things and our job as OTs is to help them to have the best quality of life that they can have.  Miss Wheelchair Tennessee that came and talked to our class also mentioned the same thing about sharing resources, so this is definitely something I will keep in mind for the future.  Danielle's story was worth the listen and I love her passion for advocating for disability justice and am so glad she chose this amazing field!  Be sure and listen to her story and visit her website as well!

Podcast: http://www.ontheair.us/podcast1/episode-16-disability-justice-adaptive-sports

Website: https://daniellelancelotwatson.wordpress.com/

Rubber Bands

For my media project I was given a client named Barbara, who was diagnosed with Multiple Sclerosis in her 30's and is now 64.  She was recently admitted to the hospital for a significant decline in her level of function.  She will be discharged in 4-5 days and would have to continue with an exercise program.  Barbara is married and lives with her husband and son.  In her spare time, she enjoys sewing and crafts.  She has lost a significant amount of upper and lower body strength due to this flare up.  She also mentioned trouble with memory over the last 6 months.  All of these interfere with her ability to complete her ADLs.  How could I help Barbara with something as simple as rubber bands?

The moment I drew "rubber bands" for the media project my mind started wandering every which way with ideas.  As easy as I thought this would be, it really was not.  Of course, I scrolled through Pinterest, Google, and every OT website on the web looking for ideas but nothing stood out as being original.  Making pictures on a pegboard or putting rubber bands around a can was not creative enough for me.  One day I come across a piece of art that was done with rubber bands and it was like a lightbulb went off in my head.  CRAFTS!  My client loved doing crafts, so this was perfect!  You can wrap rubber bands around just about anything and make something out of it.  The most meaningful thing that I got out of this project was how my mind just one day clicked and ideas all of sudden started coming from every where.  I was starting to question my creativity after weeks of not being able to come up with anything, but once it finally hit me, I learned that I have a lot of creativity than I ever gave myself credit for.  I am interested in working in hand therapy in the future and I knew rubber bands would be something that would help with grip strength, so hopefully I can take this creation and use it sometime during my career.

There are so many things that you can do with rubber bands.  You can wrap them around an object and paint in between the lines.  Or you can wrap them around an object and use that to paint.  For example, I wrapped rubber bands around a wood coaster and used the rubber bands to make black and white stripes.  Then, I wrapped the rubber bands around a wooden block and made my own stamp.  You can make your own design with the rubber bands, paint them, and stamp it on to anything.  I also stamped a coaster,  card, gift tag,  and linen towel.  These are just a few ideas that I gave to my client, but the list goes on and on.  I wanted to be sure and give her a variety of crafts she could do because she mentioned that she gets bored with the same exercises everyday.  Wrapping and stretching the rubber bands around an object will help Barbara with her grip strength.  Her goal is to be able to perform all of her ADL's and iADL's safely and independently.  Increasing her grip strength will help her to grip a brush or tooth brush or gripping a spoon/fork while eating.  Barbara has also mentioned that her memory has declined in the last 6 months.  I would suggest that she keep a journal and log in her journal every time she does a new craft which may help her remember certain things.

This process has really made my brain work, but was so much fun to put together!

Neuro Note 3

Lindsey Becker, Ms. Wheelchair Tennessee, came all the way from Nashville to serve as a guest speaker for SOTA yesterday, and I had the opportunity to attend.  I knew before I walked out of there that my next Neuro Note would be about her.  I was so touched by her story and inspired that she uses her diagnosis to help others.  I learned so much on what it was like to be in her shoes and also how to always view a person as a whole.  Lindsey was born with spina bifida and has been a wheelchair user for most of her life and also is a cancer survivor.  She is happily married to her husband, Wes, who is a veteran that is also a wheelchair user due to a terrible motor cycle accident which left him paralyzed from the waste down.  Being that Wes is a veteran, they received a grant from the VA to completely re-model their house to adapt to their needs.  For example, counter tops adjusted to their reach, roll in shower, and a huge ramp that led to their back deck.  Had they not had these changes, life could be much more difficult, which is why adapting is SO important!  She also mentioned challenges that she has faced throughout her life.  She really preached how individuals need to think about that person functionally and not their physical disability.  This made me glad to be going into a holistic profession because that is our biggest job!  She is very independent and in order to be independent she needs the lightest wheelchair possible, and some people do not think about that, which is so unfair.  People in wheelchairs should not have to worry about going in public and worrying whether or not they will be able to have a seat at a restaurant or get into the doors at a concert, but, unfortunately, Lindsay faces challenges like this everyday and that is why she is all over the state of Tennessee advocating for people just like her.

Ms. Wheelchair Tennessee is not a beauty contest; contestants are chosen based on accomplishments, involvement, and advocacy.  Lindsey is very passionate about educating others on the importance of resources within the community of individuals with disabilities.  She uses her story to help others to make a positive difference in the world.  One of my favorite things she said yesterday was "many people think my life if miserable, but my life is great."  She is such a strong person, and does not let the fact of her being in a wheelchair get her down.  Something that is really important to her and her husband is advocating all the many resources out their.  One of the biggest things that has helped Lindsey and Wes was finding programs and groups available to them with individuals going through the same thing that they were.  Lindsey was a part of the ABLE youth, which gave her the opportunity to perform in so many activities with kids that were also disabled.  Wes joined a group in Nashville where he is able to play sports like softball and tennis.  They both mentioned how these programs have changed their lives and they want more people to know about them to help them see the positive in their disability.

Not only was Lindsey Becker crowned Ms. Wheelchair Tennessee, she has since then started a YouTube channel and a blog called "Meant To Be Lindsey B".  She uses these as resources to help encourage others and to write about her personal experiences.  Every blog has a theme that everything in life is "meant to be", which is so creative!  I look up and admire individuals like Lindsey who are so strong and never look at the negative in life.  Lindsey is preparing for another chapter in her life as she prepares for Ms. Wheelchair America 2019 and I wish her the best of luck! Be sure and check out her channel and website!

YouTube: https://www.youtube.com/channel/UCnRCO5qCNeoIUflFCpIf8sw/featured

Blog: http://meanttobelindseyb.com/about-me

Inside the O'Briens

“You are either Now Here or Nowhere.”

― Lisa Genova, Inside the O'Briens

First & foremost, this book is a phenomenal read and I had a hard time putting the book down once I opened it! This story is about Huntington's disease, and was told through the life of the O,Brien family, which made it so much more realistic. It was so interesting to learn about the disease but also see how the family copes with this disease. It was very eye opening to see that the person with the disease is not the only one affected, but also everyone in that person's life. Huntington's disease (HD) is a horrible neurodegenerative disease characterized by a progressive loss of voluntary motor control and an increase in involuntary movements. There is no cure and, in other words, if you test gene positive there is no way out.

The main character Joe O'Brien is a loving father and husband living right outside of Boston in a neighborhood called Charlestown where he works as a police officer. Joe begins having a change in behavior, such as outburst of anger, memory impairment, and weird movements, that were noticeable by his wife and coworkers. These types of behavior are relatable to the non-clinical stage of HD called "prodrome" which may appear fifteen years before motor problems appear. After several doctor visits, he receives terrible news that he carries the gene for HD and his kids have a 50/50 chance of carrying it as well. Joe is married to Rosie and together they have four adult children. Two of the four children decided to get tested as well and turns out that they are also carrying this gene.

This book gives perspectives from numerous viewpoints, whether it's being diagnosed with the disease, fear of testing positive for the disease, learning how to cope with this disease, living with someone with the disease, or simply what it is like being a friend of someone who carries the gene. My favorite quote from the book relating to this is, “As they lurch down the hallway and finally make it to the kitchen, it occurs to Joe that this is the best anyone can hope for in life. Someone you love to stagger through the hard times with.” Joe came home to find Rosie hysterical after everything that she has been through, but Joe encourages her that even though things may be different, everything is going to be okay, and they will get through it together. Although this family is experiencing one bad thing after another, they show how to keep living life to the fullest. Although I am still very upset with the ending, this book did an amazing job on showing what Huntington's disease looks like & I highly recommend this book!


Genova, L. (2015). Inside the O'Briens. New York City, NY: Gallery Books.

Joe O'Brien

DOB: unknown

Reason the client is seeking OT services and concerns related to engagement in occupations (may include the client’s general health status)	Huntington’s disease (HD) is an inherited neurodegenerative disease characterized by a progressive loss of voluntary motor control and an increase in involuntary movements. Initial physical symptoms may include a loss of balance, reduced dexterity, falling, chorea, slurred speech, and difficulty swallowing
Occupations in which the client is successful and barriers or potential barriers to his/her success in those occupations (p. S5)	-Husband, dad, grandfather, brother, police officer, community member of Charlestown, dog owner, baseball fan -A few symptoms that Joe showed throughout the book include depression, difficulty focusing/prioritizing, involuntary movements, and impaired balance. These were all symptoms that Joe was experiencing slowly over time. He mood could instantly change, he fell early on in the book hurting his knee, he began to have trouble writing police reports because he was not able to focus or remember, he was unable to hold his grandchild because of his chorea, he had thoughts of killing himself due to depression, and was not able to keep his job because it was not safe for him to drive nor be around a gun
Personal interests and values (p. S7)	-Being a strong and loving father & husband, cheering on the Boston Red Sox, protecting his community, having Sunday dinner with his family, spending time with his best buddies, Tommy and Donny
The client’s occupational history/life experiences	-Client experiences knee problems due to falling, his mother died from HD -Client lives in 3 story home with wife, children, and dog, Yaz -Work duties include driving police car to monitor safety around town, type police reports, and work security at big events going on in the community -Home duties include walking the dog, repair/replace items in home, provide for family
Performance patterns (routines, habits, & rituals) – what are the client’s patterns of engagement in occupations and how have they changed over time? What are the client’s daily life roles? Note patterns that support and hinder occupational performance. (p. S8)	-Roles: husband, father, grandfather, coworker, police officer, friend, community member -Routine: wake up, go to work, drive around to monitor community, respond to calls, type reports, go home, eat supper, spend time with family -Client has temper outbursts towards his children and wife, Rosie. His chorea has caused him trouble with sitting still and he has broken several glasses at the dinner table. He has a hard time writing his police reports due to memory, and many complaints are filed assuming he is on drugs due to chorea. -Habits: walking dog, eating dinner with family, drinking beer and watching tv -Client has balance issues so walking his dog might cause him to fall
Aspects of the client’s environments or contexts, as viewed by the client (p. S28)	Supports to Occupational Engagement:	Barriers to Occupational Engagement:
Physical	-Client lives on first story of home -Walking his dog is good exercise -Katie introduces him to Yoga	-Street can be crowded so client may have to park a good distance from home  -Chorea may cause him to fall walking dog -Driving police car could be dangerous
Social	-Client has loving and supportive family -Friends to watch out for him and protect him	-Dinner table too small for the whole family -He passed down HD to his kids and it is difficult to stay strong for them
Cultural	-Client has always been known as backbone of family -Tough mindset of policeman	-HD caused him to quit his job so he is no longer to provide for his family -Client is embarrassed of involuntary movements and does not want to be considered an alcoholic like his mother
Personal	-Male, 44 y/o, father, husband, police officer	-Client is afraid of dying after watching his mother suffer in the hospital
Temporal	-Client symptoms HD are slowly progressing, but he still has time to spend with his family and friends	-Client’s children have 50/50 chance of getting HD, but symptoms shouldn’t show until around 35 y/o
Virtual	-Client has cell phone to contact wife & children when needed	-n/a
Client’s priorities and desired target outcomes (consider occupational performance – improvement and enhancement, prevention, participation, role competence, health & wellness, quality of life, well-being, and/or occupational justice) (p. S34)	-Learn the best way to cope and help his family cope with this disease -Be strong for his family -Learn how to better manage his symptoms

Neuro Note #2 - Multiple Sclerosis

In a few short weeks my classmates and I will be presenting media projects, which involves our intervention plan with one item and case study that was assigned to us. The client in my case study was diagnosed with Multiple Sclerosis, so I decided to find a story on someone living with this horrible disease and learn more about it.

Breea Renee was diagnosed with an acute onset of Multiple Sclerosis when she was a senior in high school. Her YouTube channel shares her story along with her journey of healing and recovering. Multiple Sclerosis is a disease involving damage to the sheaths of nerve cells in the brain and spinal cord. Symptoms can include numbness, impairment of speech, blurred vision, and severe fatigue. 

I watched several videos on Breea’s channel but the video that shared her story was the most inspiring and tear-jerking. I loved the way the video started out with her family and friends telling who Breea was to them. She is a friend, daughter, cheerleader, etc., not a girl with MS. On December 8th, 2011, Breea woke up feeling off balance and later that night collapsed. Within 24 hours she became paralyzed on her left side. She eventually became blind in her left eye and could not talk or swallow. The video starts out with her hospital journey and pictures of friends and family visiting, celebrating Christmas, and different therapy sessions. My favorite part of the video was Breea sitting in her wheelchair at the hospital and she says, “I now have no time to waste. Life can change so suddenly.” This is so true, yet heart-breaking. She wrote goals everywhere of what she wanted to accomplish to overcome this disease. One of her goals was to walk across the stage at high school graduation and she worked so hard and progressed at every therapy session and was able to meet that goal! It shows a short clip of her mom spotting her doing a back handspring at the very end of the video. Before being diagnosed with MS, she was a high school cheerleader, which really hit home being that cheerleading was one of my hobbies growing up. Breea is still in a leg brace today and is working hard to gain back all of her strength. If you want to watch an inspiring story with a happy ending, Breea’s is the one for you! 

Find Breea’s story here: https://www.youtube.com/watch?v=hfD9s1_TN0s

Learn more about Multiple Sclerosis: https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269

Neuro Note #1 - Spinal Cord Injury

     Learning about spinal cord injuries and all the different types has been so interesting to me and I often catch myself wondering, how would I deal with an injury like this? So much would be taken away and life would be much different, but when I hear other peoples stories, I feel so selfish. It is so inspiring and tear-jerking seeing how they adapt to a different lifestyle and get back to life as best as they can. Also, as a future OT, being able to help others with this injury adapt to life will be so rewarding! Alicia Reagan is a mom, wife, and christian that is living with a spinal cord injury. While she was expecting her 6th child she developed Transverse Myelitis, which is virus that attacks the spinal cord, and left her paralyzed from the ribs down. Her spinal cord was damaged at the C5-C7 vertebrae level.
     Reagan uses her blog and youtube channel This Enabled Life, to inspire others who are living with an SCI, and also those who want to learn or hear about her story. She has multiple YouTube videos of tips on how she deals with certain daily activities (blowing drying hair, shaving legs, cooking, etc.) and also certain obstacles that she faces or deals with on a daily basis. I chose to write about her because she amazes me with her faith and motivation to keep on keeping on. I have learned so much about what it is like to live with a spinal cord injury just by watching her videos. Also, we are learning about the different areas of the vertebrae and what affects each level. Being able to visualize a real life story of a C5-C7 injury has been helpful! 
     One video that stood out to me was her showing what is looked like to have a spasm. As she struggled to get out the bed and transfer to her wheelchair in the mornings, she experiences spasms. She commented that it is very embarrassing when this happens, especially in public, but wanted her followers to see what it looked like. THAT IS HUGE!!!! I didn't know what that looked like so it was very neat to see, but also very heartbreaking. Her story is so heartening and I encourage everyone to check out her blog and YouTube channel which I will link below.

https://aliciareagan.com 

https://www.youtube.com/channel/UCO-DMDPGPWe8_aoklNWDmpA
   

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