purposeful activity.

CBIS

2011-09-10T11:13:00.003-04:00

The Academy of Certified Brain Injury Specialists offer a certification for entry-level and experienced brain injury professionals. This is not limited to a specific discipline but for any "anyone who delivers services specific to brain injury."

Most of my colleagues working in brain injury have this credential although it is not a requirement in the field.

Cognitive Rehabilitation

2011-09-05T18:07:00.006-04:00

While in OT graduate school, I did not appreciate the impact cognitive rehabilitation had on people with brain injury. It seemed as if the focus was on physical disabilities, with a much smaller focus and introduction to the specialized niche of cognitive rehab. As such, I spent less time thinking about cognition and more of my medical-model-mind focused on kinesiology, range of motion, strengthening, stretching, physical agent modalities, and protocols.

My year in cognitive rehabilitation has taught me that my OT approach has been too two-dimensional and less holistic than I thought, that cog rehab is a transdisciplinary form of rehabilitation that has introduced me to thinking outside the box and to reducing self-limiting discipline specific walls that curtail rather than progress client treatment programs.

I highly recommend the book Cognitive Rehabilitation by Sohlberg and Mateer as a comprehensive introduction to this extraordinary specialty.

"a new hope" in Parkinson's research

2010-06-26T21:43:00.003-04:00

Sergey Brin’s Search for a Parkinson’s Cure

A fabulous and informative article about a hopeful direction in Parkinson's research. I'm especially interested in this as my father suffers from it. It's funny how Parkinson's is characterized by the tremors, or as father calls it, the shakes. But when you cross the border into the land of dementia, living with someone with Parkinson's is almost like living with a part-time schizophrenic. Is it the Sinemet? Is it the Mirapex? Is it worth it? My father routinely yells at "the people" in our house, jumps out of his scooter to chase them away. I wonder if the medications give him the ability to move and the curse of seeing and hearing things that are not there. It's so hard not to respond to his hallucinations. No, they're not there. No one is here. No one is tapping the phone lines. No one cut down that tree and put it back together with metal strips. People are not jumping over the fence to get into our backyard. There is no little girl in the corner. I don't see construction workers working on our house. No one is standing by the window.

I often look for old movies to distract him. Right now, he's watching The Magnificent Seven. A great distracter.

Church tomorrow. Chocolate pudding and a good book tonight.

Exam preparation

2010-03-29T14:52:00.015-04:00

After graduating, I was faced with the difficult task of organizing all school materials for a thorough review prior to taking the NBCOT exam. Therapists suggested taking a prep course, so I googled just that and found TherapyEd NBCOT Exam Prep. I was taken aback by the price but heard really good reviews from fellow students. I enrolled, received my very thick study guide book, and began studying.

I must also say that I purchased the NBCOT Official OTR Study Guide for $60 from www.nbcot.org and the Occupational Therapy Examination Review Guide by Caryn R. Johnson. After taking Rita P. Fleming-Castaldy's 2 full-day classes, I hardly cracked open either one.

Here is a side-by-side view of the 3 review guides I purchased.
From left to right:
(1) TherapyEd OT Certification Exam Review & Study Guide
(2) NBCOT OTR Official Study Guide
(3) OT Exam Review Guide by Johnson.

Note that when you purchase the TherapyEd Exam Review & Study Guide separately, the cost is $85-it's included in the price of the course-, $25 more than NBCOT's review guide, yet containing MUCH more material plus a CD-ROM with 3 practice exams.

Another view.

The TherapyEd OT Review and Study Guide is extremely thorough. This book is not required at the classes, though, as the purpose of the course is not to review material but to become oriented with the NBCOT exam format and learn invaluable test-taking strategies designed to help you maximize your time during this time-limited test. The remaining time is spent answering practice questions presented in the question formats you will encounter on the test. This is designed to help discover your strengths and weaknesses in test-taking strategies and to practice what you learned.

I'm going to pick on the "official" NBCOT exam review guide for a moment. It is an extremely expensive book that does not in any way compare to the TherapyEd guide. As a matter of fact, scattered within its pages are corrections to material presented. NBCOT glued correction cards onto the pages of its official guide after being informed by third parties of the errors contained within.

A glued card in the official NBCOT review guide due to errors.

Finally, when you arrive at the TherapyEd course, you will receive an additional manual with excellent test-taking and study strategies that helped me pass the exam. It's pretty much a more in-depth recap of the entire course.

A final side-by-side of all 4 books: from left to right
(1) TherapyEd OT Certification Exam Review & Study Guide
(2) TherapyEd OT Course Manual
(3)
NBCOT OT Official Study Guide
(4) OT Exam Review Guide by Johnson.

I'm back.

2010-03-28T14:18:00.002-04:00

It has been a while since posting to this blog. A quick recap--I graduated and passed the NBCOT exam. I'm suffering through the long wait of licensure until I can practice at a renowned rehab center.

I intend to document my time as an entry-level therapist...when time permits!

Par Fore in the news

2009-06-23T20:46:00.000-04:00

USGA talks about golf and OT.

Update to my life

2009-06-10T18:05:00.002-04:00

So a funny thing happened on my way to the in-patient ortho gym...I was assigned to the in-patient neuro/stroke team. Today is Day 3, and I'm learning a lot of stuff that can't be taught in textbooks. I've been exposed to hackers (hacking up a lung), vomit, accidental discharge of bodily fluids, and a few evil eyes.

No complaints here.

I just have a strong interest in hands, and the ortho unit which is so close (one floor above) is yet so far. lol I'm still waiting to find out if I get to rotate. If not, no biggie. Every experience is a learning opportunity.

Par Fore

2009-05-05T10:24:00.002-04:00

Alexander Lopez, JD, OTR/L, from Stony Brook University's occupational therapy program developed a golf mentoring program called Par Fore.

Perseverance

Accountability

Resiliency

Fellowship

Opportunity

Respect

Empowerment

This program was designed for at-risk adolescents living in environments that foster destructive behavior. It is designed to help them develop self-esteem, self-empowerment, productive social skills, and constructive behaviors.

Mr. Lopez was a guest speaker in my Community Practice class. His program speaks to endless possibilities OTs have when working with clients.

Adaptive Design, New York

2009-04-11T10:52:00.043-04:00

Class trip! We went to Adaptive Design for the day to explore the wonderful world of cardboard and other cheap and sturdy materials. They are used to make much needed equipment such as stools, high chairs, benches, and many adaptive things for kids and adults. Here are some pictures I took during our tour. We also had the opportunity to make a booster seat out of cardboard. I haven't taken a picture of it, yet. Hopefully, it's still in the OT lab.

It's pretty amazing what can be made out of cardboard. I expected to see flimsy and ugly, brown things that wouldn't last long. After our powerpoint lecture at Adaptive Design and a quick demonstration of how they were built, my biases about cardboard ended. The strength and sturdiness is incredible. Depending on the layers and ply of cardboard, these mini pieces of furniture can hold up to 850 lbs. Everything is specially designed to meet the needs of the client. The product is primed, painted, and decorated. And it will last about 3 years.

The following photos show just a few of what can be found at Adaptive Design. I highly recommend this as a source for all professionals. They collaborate with OTs, PTs, family members, and just about anyone. They thrive on donations to keep the program afloat. If you're in the area, they're located on 313 West 36th Street, New York, NY 10018. They, also, have volunteer nights. For more information call: (212) 904-1700.

Abilities Expo

2009-04-11T10:41:00.003-04:00

There's a big event in New Jersey on April 17-19 called the Abilities Expo. It's something I hope my entire class can attend. I'm going with a few classmates and hopefully some family members. This will be my first time attending, so I'll be sure to take plenty of pictures. In the meantime, check out the site to see when the expo will be in your area.

NYC's Underground

2009-03-07T09:21:00.002-05:00

New York City's Underground Community of Mole People

This article brings to light some of the struggles people with mental illness go through just to survive.

a room with a view

2009-03-01T16:36:00.006-05:00

On a non-OT note, I thought I'd share three photos taken from my Community Practice classroom. Washington Square Park under snow and in all its glory. Sometimes it's best to stop thinking for a moment and enjoy the view.

And when class is over, you get to see Beauty up close and personal.

one of my professors

2009-03-01T16:24:00.004-05:00

My Pediatric Perspective professor Kristie Koenig, pronounced "KAY nig". One of my favorite classes, even though I don't see myself going into pediatrics. This class (plus my little niece and nephew) are giving me the peds bug.

Kristie Koenig to receive the AOTA Roster of Fellows

VESID

2009-03-01T10:35:00.003-05:00

Vocational and Educational Services for Individuals With Disabilities (VESID)

From website:

VESID offers access to a full range of services that may be needed by persons with disabilities through their lives. Through its administration of both the special education and vocational rehabilitation programs, VESID coordinates policy and services relating to:

transition services for infants and toddlers with disabilities (ages birth to two years);
special education services for students with disabilities (3-21);
transition services for students with disabilities from school to adult services;
vocational rehabilitation services for individuals with disabilities, ages 16 and older; and
independent living services for adults with disabilities.

The Transporters

2009-03-01T10:24:00.002-05:00

The Transporters is a DVD collection that plays off of Thomas the Train to "help your child recognize emotions".

Spring Semester 2009

2009-02-10T21:45:00.002-05:00

My list of classes:

Pediatric Evaluation & Intervention
Rehabilitation Evaluation & Intervention
Cognitive Evaluation & Intervention
Community Practice
Health Advocacy & Administration
Professional Issues II
Fieldwork I

Types of Apraxia

2009-02-07T21:12:00.005-05:00

From the National Institute of Neurological Disorders and Stroke (NINDS)

buccofacial or orofacial apraxia - the inability to carry out facial movements on command such as licking lips, whistling, coughing, or winking
limb-kinetic apraxia - the inability to make fine, precise movements with an arm or leg
ideomotor apraxia - the inability to make the proper movement in response to a verbal command
ideational apraxia - the inability to coordinate activities with multiple, sequential movements, such as dressing, eating, and bathing
verbal apraxia - difficulty coordinating mouth and speech movements
constructional apraxia - the inability to copy, draw, or construct simple figures
oculomotor apraxia - difficulty moving the eyes on command

Once again, while reading the OT Exam Review Guide, I came across a question with answers I am not well-versed in. Based on these definitions, I'm still a bit confused. The question involves a man who can put dentures in his mouth but has difficulty applying denture cream to the right places and replacing the top to the denture cream by applying it either backwards or on the wrong end. He has constructional apraxia. The other 3 choices are (1) ideomotor apraxia, (2) dressing apraxia, and (3) unilateral neglect.

Constructional apraxia seems like the best answer, but I probably would have chosen ideational apraxia if it were a choice. The problem I'm having with many diagnoses, including apraxia, is that I need to SEE it. So far, YouTube does not have a video devoted to "constructional apraxia".

baby with hydrocephalus

2009-02-07T20:50:00.004-05:00

It's time to return to blogging. And as I read the Occupational Therapy Examination Review Guide, I'm struck by how much of my learning is not sticking. I first YouTubed "hydrocephalus" because a line drawing is not worth a thousand words, but the video about Kadyn David is.

I wanted to see what a shunt looks like. A malfunctioning shunt causes irritability, nausea, pallor, visual perceptual difficulties, and headaches. A good OT would know this, right? Kadyn also has ASD (atrial septal defect) and VSD (ventricular septal defect). It's so much easier to remember things when those things you have to remember have a face...it also makes it sadder.

research photos

2008-12-09T18:52:00.006-05:00

It's been a burn-out of a semester. So much to tell, so little time. When finals are over, I might be inclined to summarize the whirlwind of information blown at us from all angles. In the meantime, here are photos used for my research project on the Hareau Thumb Opposition Goniometer (HTOG).

The Hareau Thumb Opposition Goniometer

My hand in the HTOG

Me measuring my classmate's thumb opposition using the American Society for Hand Therapists (ASHT) ruler method

Me measuring my classmate's thumb opposition using the American Academy of Orthopedic Surgeons ruler method

memory activities

2008-10-12T21:24:00.004-04:00

I'll be running a memory group in two weeks at a cognitive rehab program. I sat in 3 memory groups already; the topic for all 3 was "Memory for Names". Each session included work or activity sheets related to the topic. From what I've seen, they typically involve one sheet with faces and names and a second sheet with only faces. The patients are asked to memorize the first sheet, then they are collected and the second sheets are administered. They are asked to write as many names they can remember underneath the faces.

I'm wondering where I can get these activity sheets, are they in books or are they online? I have a feeling Barnes and Noble will have something to do with my leading this group.

Documentation Manual for Writing SOAP Notes in Occupational Therapy

2008-09-25T14:05:00.003-04:00

The entire class is trudging through this book, probably putting more effort to comprehend it than is needed. The concept is easy.

S - subjective
O - objective
A - assessment
P - plan

I found I can write an entire paragraph in abbreviations, thanks to this book. The difficulty of SOAP notes, goals, and problem lists is knowing what to document. I frustrate myself with a level of redundancy in everything I write. Tack on the environment in which this documentation is written (mental health, peds, phys dys) and the style changes dramatically. Mental health documentation takes on paragraphs. Phys dys should be concise and to-the-point, lots of abbreviations, and do try to eliminate dregs like "a", "an", and "the". Who knows what peds is like; I won't have a fieldwork in that specialization.

I accidently (through every fault of my own) bought 2 copies of this book. Each page is perforated to make it easier for you to lose, so I'm thankful for my 2 copies--I lose things, rip things, drop things, forget things, and break things easily.

Sensory Integration

2008-09-21T10:39:00.003-04:00

Jean Ayres was the pioneer of sensory integration. For future clinicians interested in SI treatment, there is SIGN.

summer's over and Fieldwork I begins

2008-09-09T19:14:00.002-04:00

School started September 2nd and, for a week, I forgot I had this blog. lol
Here's a run-down of my classes:

Orthopedic Evaluation & Intervention
Neurological Evaluation & Intervention
Research Interpretation of Occupational Therapy
Mental Health Evaluation & Intervention
Fieldwork I - Psychosocial Development

Fieldwork was great. I go every Monday for 8 consecutive Mondays to a cognitive rehab program (CRP) in a rehab institute. My supervisor and all staff are friendly and very welcoming. It's the perfect environment to throw me in for my first fieldwork experience. My doubts and anxiety quickly melted away.

fieldwork I

2008-08-01T22:39:00.002-04:00

Fieldwork I is coming quickly. I'm doing mental health first then hand therapy and finally phys dys. NYU requires mental health and phys dys for fieldwork. It seemed to be a topic to debate when students discovered this. Most want to work in peds. The NYC Dept. of Education, according to students receiving the DOE scholarship, mandate students to have a fieldwork in peds before working in schools. I don't know, nor do I care because I'm not working for the Dept. of Education anymore. Years ago, I considered taking their scholarship when the contract was something like this: DOE pays for one school year, I work for them for 1.5 years. They, recently, bumped it up to 2 years. I can't give the DOE 4 years of my life just because they paid for 2 years of my education. I want to work with other experienced OTs. I want to be in an interdisciplinary setting that promotes growth and development. I want to be properly supervised!

Beautiful Son

2008-07-22T00:59:00.005-04:00

a documentary about healing autism

ReWalk Exoskeleton

2008-07-22T00:18:00.006-04:00

I found this video on Gizmodo. It shows a paralyzed man walking with the help of an exoskeleton. Some extra details on Medgadget.

I'm seeing incredible gadgets of the future that will improve the lives of many. I'm also seeing money and insurance problems. What to do. What to do.

summer

2008-07-20T17:12:00.003-04:00

I'm tempted to spend my vacation brushing up on the fundamentals of anatomy and neuroscience and reminding myself of frames of reference, theories, and research strategies. I don't want to forget anything I've learned when Fieldword I is so close. I'm going back to the basics and will find the time to read the books I've purchased about hand therapy. I'm also wondering if it's hands that's a passion and not peds.

1st half of the master's project

2008-07-15T10:26:00.004-04:00

Today or noon tomorrow, my partner and I will electronically submit the 1st half of our Master's project about measuring thumb opposition, normal ROM, and the reliability of the Hareau Thumb Opposition Goniometer (HTOG). Our mentor managed to contact Hareau for permission to let us copy her dissertation. I'm sitting on my bed with the manual lying open at my feet, yellow Post-Its sticking from the edges and notes in black ink at the margins. Makes me want to develop a tool myself and write all about it.

There isn't much we can report on the HTOG because our research study begins in the fall. We'll set up a little spot in the lobby of an NYU building where people will generously volunteer a bit of their time to have their thumb opposition measured. In the meantime, all I have on this goniometer is information provided by Hareau herself. It appears hopeful that a new tool may finally replace the error-prone ruler method.

pondering and wondering

2008-07-07T16:22:00.005-04:00

I love finding my professors in bylines of journals and textbooks. It makes me want to aspire to such greatness. One of my very first classes in this program was taught by Jim Hinojosa who is well-known in OT circles--and well-written.

As I languidly pore over papers, articles, books, and websites for "a clue" as to where I'm going with my literaure review, I found another professor in my textbook Occupational Therapy for Physical Dysfunction. Jane Bear-Lehman, my professor and the principal investigator of my master's project, occasionally pops up hither and yon in the forestry of academic publications. It distracts me, and I soon find my head in the clouds instead of published materials describing the measurement of thumb opposition.

searching CINAHL and other how-to's

2008-07-06T11:52:00.006-04:00

I stumbled unto this link while searching for information that had nothing to do with what I found. It's a little how-to about searching on CINAHL, which you will do a lot if you're an OT or OT student. It gives you a heads-up if you missed that mandatory library class in which a librarian walks you through the science of database-searching. I'm a little jealous; I couldn't find such a neat link on the NYU Libraries site, only video tutorials and exclusive internal how-to's for NYU students that would be of little use to people with no access.

Rummage around through this site. There are helpful links on EndNote, RefWorks, ProCite, or other cheat sheet tools to make the lives of grads easier. These should be provided by your wonderful school.

Occupational Therapy Song

2008-07-05T23:32:00.002-04:00

I nominate this for a Grammy.

the road to the commencement of a comprehensive literature review

2008-07-05T12:08:00.004-04:00

I've been stalling for a couple weeks. The deadline is July 16 (I want it done the day before), and I'm online blogging instead of reading journal articles. To help me get through the drudgeries of research, I thought it would be useful to write about my accomplishments:

I skimmed through 2 books purported to help me with this project (a) Critical Evaluation of Research in Physical Rehabilitation by Helewa and (b) Health Sciences Literature Review Made Easy: The Matrix Method by Garrard
I compiled a list of 15 journal articles that may or may not be helpful
I'm taking advantage of current technology by using computer programs instead of writing out everything by hand. I particularly like Microsoft Office OneNote
I'm taking frequent breaks to avoid overheating the ole thinking machine
Lots and lots of coffee

You already know my topic, now for my articles:

Bunnell, S. (1938). Opposition of the Thumb
Close, R., & Kidd, C. (1969). The Functions of the Muscles of the Thumb, the Index, and Long Fingers
Cooney, W., & Chao, E. (1977). Biomechanical analysis of static forces in the thumb during hand function
Cooney, W., Lucca, M., Chao, E., & Linscheid, R. (1981). The kinesiology of the thumb trapeziometacarpal joint
Coonrad, R., & Goldner, L. (1968). A study of the pathological findings and treatment in soft-tissue injury of the thumb metacarpophalangeal joint
Edgerton, M., Snyder, G. & Webb, W. (1965). Surgical treatment of congenital thumb deformities
Ellis, B., & Bruton, A. (2002). A study to compare the reliability of composite finger flexion with goniometry for measurement of range of motion in the hand
Haara, M., Heliovaara, M., Kroeger, H., et al. (2004). Osteoarthritis of the carpometacarpal joint of the thumb
House, J., Gwathmey, F., & Fidler, M. (1981). A dynamic approach to the thumb-in palm deformity in cerebral palsy
Jacobs, B., & Thompson, T. (1960). Opposition of the thumb and its restoration
Jonsson, P., Johnsson, P., Hagberg, M., et al. (2007). Accuracy and feasibility of using an electrogoniometer for measuring simple thumb movements
Kuo, L., Su, F., Chiu, H., & Yu, C. (2002). Feasibility of using a video-based motion analysis system for measuring thumb kinematics
Li, Z., & Tang, J. (2007). Coordination of thumb joints during opposition
Littler, J., & Cooley, S. (1963). Opposition of the thumb and its restoration by abductor digiti minimi quinti transfer
McFarlane, R. (1962). Observations on the functional anatomy of the intrinsic muscles of the thumb

I feel I'm giving myself more work than I need to do. I can't tell you if any of these articles will help me. I must substantiate the existence of measuring thumb opposition and determining normal range. Literature is lacking. My mentor is trying to make headway into the subject for her Doctoral of Professional Studies at NYU. In the meantime, I'm kind of stuck.

Hareau Thumb Opposition Goniometer

2008-06-25T21:48:00.004-04:00

I met with my mentor (a CHT) for a discussion on a paper due July 16. It involves Janine Hareau's goniometer for measuring thumb opposition. There is no published work on the tool. Sadly, Janine herself did not publish her thesis (Bonomi, Janine Hareau. The Reliability of the Hareau Thumb Opposition Goniometer. WB 555.1 B719r 2001.).

Considering the unreliability of the measurment tools for thumb opposition currently in use and a lack of gold standard, I'm surprised there are no data or known studies of the Hareau Goniometer.

The Truth About Autism

2008-06-22T00:47:00.007-04:00

The voice of people with Autism are breaking through the barriers.
Wired Magazine: 16.03

Disaboom

2008-06-18T22:15:00.005-04:00

It's been called the MySpace for people with disabilities. This is an online community for those impacted by disabilities. It's better than MySpace; it's DISABOOM!

Thera-Paw

2008-06-05T21:57:00.004-04:00

This is not OT-related because under our domain OTs work exclusively with humans, however one OT who graduated from NYU thought outside the box and applied principals I'm currently learning to do something she loves. She helps animals. Check out her company THERA-PAW.

RESNA

2008-05-27T22:02:00.004-04:00

Rehabilitation Engineering & Assistive Technology Society of North America is an excellent resource for students and professionals alike who often wonder "I have a great idea for an innovative piece of adaptive equipment. Now what?" OT students often think of themselves as future super-therapists with interests in anything and everything, including thinking up new and improved not-yet-realized blueprints for uber-perfect technology that will make the lives of people with disabilities uber-better. RESNA is one of the many ways to make it happen.

Other methods...talk to people...lots of people.

O*NET resource

2008-05-26T20:26:00.004-04:00

Writing a job analysis can be tedious, especially when you are not familiar with the tasks involved. O*NET Online is a great resource for occupational therapists working with patients/clients aspiring to enter the workplace.

summer time

2008-05-21T16:54:00.002-04:00

Spring semester is over. The one-month summer semester will be rather intense. We have 5 credits and three classes: Summer Fieldwork, Activity of Human Analysis II, and OT Research: Project Design.

I have so much to read that I can't write more. But I will update soon!

Rolling

2008-04-28T19:28:00.003-04:00

Here's an educational independent film entitled Rolling which is primarily about 3 people with disabilities.

research projects

2008-04-23T17:01:00.004-04:00

We submitted our choices for research projects yesterday. There were 24 options. We were asked to pick 5. Groups are being assembled based on class choices. These were our choices.

To what extent do individuals who have had total knee or total hip replacements use the adaptive equipment provided to them during their rehabilitation at ---- ---- Hospital?
The role of the extensor digitorium communis muscle in hand function.
How stress reactions from traumatic hand injuries influence the patient’s response to and participation in hand care occupational therapy?
Ongoing program evaluation and development- NYU Entry-Level OT Program-Perceptions of Older Adults.
Ongoing program evaluation and development-NYU Entry-Level OT Program-Perception of the occupational therapy curriculum effectiveness.
How much edema does it take to affect function?
To what extent are hand strength outcome scores influenced by knowing what the score is while engaged in voluntary isometric contraction against the instrument?
What is an effective way to measure thumb opposition?
A look at the current methods used in hand therapy clinics for the measurement of and the management of scarring in the palm.
The influence of homework and home treatment programs on family life.
An Efficacy Study of Handwriting Interventions for School-Aged Children, Grades 1-2.
Ongoing program evaluation and development-NYU Entry-Level OT Program-Multi-Cultural Awareness as part of the new curriculum.
What are the inter-rater and intra-rater reliabilities of the "Posture and Fine Motor Assessment of Infants"?
Feeding problems in preterm infants.
Exploratory study on infants who have feeding problems.
Study of the face validity of the social skills measurement checklist.
Designing and implementing a focus group to examine curricula match for fieldwork experience.
Survey of Preferred Interests in Adults with Autism Spectrum Disorders.
Comparison of Children's Participation and Enjoyment of Activities between children with ASD and typically developing children.
Clinician’s View of Accessibility.
An Investigation of Environmental Accessibility
Underlying Mechanisms of the Handwriting Ability in Primary School Children.
The Relationship between Performance on the Sensori-Motor Test and handwriting ability of Primary School Children.
Comparison of the Sensori-Motor Function in Primary children with good or poor handwriting skills.

Each project is headed by one or two mentors. Obviously, I chose all the hand projects.

meet Gabe

2008-04-22T19:54:00.001-04:00

Measuring Blood Pressure

2008-04-20T14:18:00.010-04:00

Fieldwork students were asked by supervisors to measure patients' blood pressure. This is a skill that develops over time, and becoming comfortable with it requires lots of practice. Never measure BP more that twice on one arm, and wait at least 30 seconds before measuring a second time on the same arm. The best way to know which arm to measure is to ask the patient which arm is routinely measured or ask the doctor. Never take it on the involved side (i.e., breast cancer, CVA, traumatic injury).

The class spent about 30 minutes taking each other's BP as an introduction to the skill after a short lecture and video. We'll have more of an opportunity next semester. Here is what I learned by making all the common mistakes:

Don't go above 200mm HG (millimeters of mercury) if you can't hear a beat. That's the point! I kept thinking I was supposed to hear something as I pumped up the rubber cuff and cut circulation off my "patient" (fellow student). When I looked up in frustration, his red face told me I should release the air. Usually, 30mm HG above normal Systolic pressure (i.e., 120mm HG) is enough, generally, 150mm HG.
Remember that your patient's blood flow has been cut off, which is either very uncomfortable or--in the case of my patient--painful. Once the cuff is full of air, don't take your sweet time looking for all the instruments you should have arranged beforehand. Be quick about it before the patient knocks you out with the arm that still has blood flow.
Make sure the room is quiet or else all your efforts are for naught. If you can't hear, you can't measure BP.
Know where the brachial artery is, and demonstrate this by feeling the pulse. Don't try to hear the pulse with the stethoscope because it won't happen. Press firmly enough to leave a mild press mark so you know where the artery is and where to place your cuff after lifting your finger. The cuff has an arrow that's to be placed right above the brachial artery.

As a YouTube addict, I felt compelled to search for a video on measuring BP. This one is adequate enough for an overview.

And here's a link to a website that gives the basics.

Face of MS

2008-04-20T12:07:00.002-04:00

Last week for Medical and Psychiatric Conditions, Anita Perr introduced us to a fabulous site about people who have Multiple Sclerosis called FaceofMS.org. It's a thought-provoking medium that propells us to view first the person then the disease. I'd love to see a similar site on Parkinson's Disease. Anyone interested?!

AOTA Certification Blog

2008-04-20T11:47:00.003-04:00

For an entire year, I've expressed to all that would hear that I was going to be a Certified Hand Therapist. In this month's issue of OT Practice, voluntary professional development is addressed. As I'm moving toward completing my education, I and many fellow students wonder if we should plow forward to add letters at the end of our names. Most of the class want to work in pediatrics. What better way to make money that plopping on the floor and playing with kids? This seems to be the number one reason to go into pediatrics. On the other side of the spectrum, some refuse to go into pediatrics because at this rate, the field will be so saturated that the demand will peter out. What if you were board certified in pediatrics? Will you as an OT be worth more?

AOTA has a blog about board certification and specialty that attracted my attention. I pulled it from the certification section of the AOTA website, and I'm hoping it will help me make an important decision about my own professional development, even before I've completed my education. CHT? Or BC is some other area?

Adaptive Design

2008-04-13T16:27:00.004-04:00

We OT students receive many volunteer opportunities through an NYU listserv. The most recent was for Adaptive Design Association. The pictures on the website says it all. For all of the future Adaptive Technology Practitioners, thanks!

vaccine limbo

2008-04-10T12:00:00.006-04:00

I'm sitting in Kimmel Center, waiting for a 1:30pm vaccination appointment at the Health Center. The OT Department strongly advises taking the 3 dose Hepatitis B vaccine before Fieldwork. You can waive, but--as I just said--it's strongly advised. I've been out of class since 10:45am. The Health Center is packed with walk-ins for MMR and have no room for little ole me before my appointment time. I bought bags at the book store, a sandwich at Space Market, ate the sandwich, and have 1 1/2 hours left before I get shot and can go home.

I'm kind of bored. The books I need to study for next week's exam and Activity Analysis paper are sitting on my dresser. Too heavy to carry those monster manuals for a 1 hour 45 minute public transportation commute. I will admit that I'm happy Mayor Bloomberg's congestion pricing proposal didn't go through. I do want to help the environment, but I would like to be able to travel about my own city. Bloomberg, if you want us to stop driving cars, improve public transportation EVERYWHERE IN NEW YORK CITY (all boroughs). I'm proud to say I use public transportation when entering the city (aka Manhattan). Everywhere else, I drive. I refuse to go to Staten Island anymore because the Verrazano Bridge toll is outrageously $10. I love this city, but I have this city.

the joy of hands

2008-04-09T09:56:00.002-04:00

Sally Poole is the kinesiology instructor this semester. It's a fun, hands-on class that puts anatomy into action. Because I'm very much interested in hands, I'll go through a run-down as to what we've done so far. We started off with the wrist, it's bones, ligaments, and significance. The ligaments look complicated, but if you have a good atlas and common sense, following the patterns isn't difficult.

There are 5 extrinsic ligaments:

Dorsal radio-carpal ligament
Volar radio-carpal ligament (the strongest) - radiocapitate, radiotriquetral, and radioscaphoid
Volar ulnar-carpal ligament - ulnolunate, ulnotriquetral, and capitotriquetral
Radio collateral ligament
Ulnar collateral ligament

The intrinsic (intercarpal) ligaments have not been named, however I found a hand kinesiology site that really helps with the visuals. Hand Kinesiology

Muscles that act on the wrist: FCU, FCR, PL, ECRL, ECRB, and ECU.

Professor Poole challenged the entire class to search for the Triangular Fibrocartilage Complex (TFCC) in anatomy. I was amazed at the amount of lubrication at the joints, especially between the carpal joints. Then I cracked the wrist open, scraped away tissue and located the TFCC just distal to the ulna.

We briefly touched on the arthokinematics at the distal radius, radio-carpal joint and mid-carpal joint. And ended with wrist positions:

Position of rest:

10-15 degrees extension
5-10 degrees ulnar deviation

Position of function:

40-45 degrees extension
15 dgrees ulnar deviation

NEXT TIME: THE HAND!

brain class

2008-04-04T13:49:00.002-04:00

Professor Anita Perr suggested a New York Times reviewed book entitled Head Cases by Michael Paul Mason. She usually provides us with lists of suggested reading material and movies that address brain injury and other conditions. It's wonderful to have an instructor passionate about what she does. Here is what she compiled for her class.

The following list contains fiction and nonfiction books that were written by people with disabilities or are about people with disabilities.

Book List

Arnold, Madelyn. Bird-Eyes (sub-mental institutionalization experience)
Albom, Mitch. Tuesdays with Morrie: An Old Man, a Young Man, and Life's Greatest Lesson (about a man with ALS)
Axline, Virginia Mae. Dibs in Search of Self
Bauby, Jean-Dominique. The Diving Bell and the Butterfly (by and about a man with locked-in syndrome)
Bixler, Susan. The New Professional Image
Bombeck, Erma. I Want to Grow Hair, I Want to Grow Up, I Want to Go to Boise (about children surviving cancer)
Broyard, Anatole. Intoxicated by My Illness
Callahan, John. Don't Worry, He Won't Get Far on Foot (by and about a man living with spinal cord injury)
Craig, Elizabeth. Don't Slurp Your Soup: A Basic Guide to Business Etiquette
Csikszentmihalyi, Mihaly. Flow: The Psychology of Optimal Experience
Cooper Sinykin, S. Alison Walks the Wire (Magic Attic Club)
Crimmins, Cathy. Where is the Mango Princess?
Dorris, Michael. The Broken Cord (about a man who adopts a baby born with fetal alcohol syndrome)
Duncan, Barbara. and Woods, Diane. (eds). Ethical Issues in Disability and Rehabilitation
Eiesland, Nancy L. The Disabled God: Toward a Liberatory Theology of Disability
Featherstone, Helen. A Difference in the Family: Life with a Disabled Child
Fiffer, Steve. Three Quarters, Two Dimes and a Nickel: A Memoir of Becoming Whole (by and about a man with spinal cord injury)
Finger, Anne. Past Due: A Story of Disability, Pregnancy and Birth
Fleming, Linda Frazer. Releasing Arthritis: The Seven Year Plan
Fox, Michael J. Lucky Man: A Memoir (By Michael J. Fox about the 10 years since diagnosis with Parkinson’s.)
Grandin, Temple. Thinking in Pictures: And Other Reports from My Life with Autism (by and about a women with autism)
Greenfield, Josh. A Child Called Noah: A Family Journey
Hockenberry, John. Moving violations (by and about a man with spinal cord injury)
Karp, Gary. Life on Wheels
Kaufman, Miriam. Easy for You to Say: Q & A's for Teens living With Chronic Illness or Disability
Kovic, Ron. Born on the Fourth of July (about a disabled veteran)
Lamb, Wally. I Know This Much is True (about mental illness)
Linton, Simi. Claiming Disability
MacCracken, Mary. Lovey, A Very Special Child (about emotional disturbance)
Malloff, Chalda. & Wood, Susan. Business & Social Etiquette with Disabled People: A Guide to Getting Along with Persons Who have Impairments of Vision, Hearing, or Speech
Milam, Lorenzo Wilson. Crip Zen, A Manual for Survival (disability rights advocacy)
Monette, Paul. Borrowed Time: An AIDS Memoir
Newborn, Barbara. Return to Ithaca: A Woman's Triumph Over the Disabilities of a Severe Stroke
Norden, Martin F. The Cinema of Isolation: A History of Physical Disability in the Movies
Norman, Donald. The Design of Everyday Things (about product design)
North, Carol. Welcome, Silence (about schizophrenia)
Oe, Kenzaburo. A Healing Family
Packer, Ann. The Dive from Clausen’s Pier (about relationships following spinal cord injury)
Papazian, Sandy. Growing Up with Joey: A Mother's Story of Her Son's Disability and Her Family's Triumph
Pitzele, Sefra Kobrin. We are Not Alone (chronic illness)
Rapoport, Judith L. The Boy Who Couldn't Stop Washing (about Obsessive Compulsive Disorder)
Reeve, Christopher. Still Me
Roy, Travis. Eleven Seconds: A Story of Tragedy, Courage, & Triumph (by and about a man with spinal cord injury)
Rubin, Theodore. Lisa and David/Jordi/Little Ralphie and the Creature (about mental illness and kids)
Russell, Marta. Beyond Ramps: Disability at the End of the Social Contract
Sacks, Oliver. Seeing Voices: A Journey Into the World of the Deaf
Sacks, Oliver. The Island of the Colour-blind and Cycad Island
Sacks, Oliver. Awakenings
Sacks, Oliver. The Man who Mistook His Wife for a Hat
Sarton, May. As We Are Now (elderly experience, nursing home)
Seigel, Bernie S. Love, Medicine & Miracles
Shapiro, Joseph P. No Pity (Disability rights movement)
Simons, Robin. After the Tears: Parents Talk about Raising a Child with a Disability
Smith, Jillyn. Senses and Sensibilities
Stone, Ganga. Start the Conversation (about dealing with death)
Stone, Karen. Awakening to Disability (about MS, dealing with disability)
Strohm, Kate. Being the Other One: Growing Up with a Brother or Sister Who has Special Needs
Styron, William. Darkness Visible: A Memoir of Madness (depression)
Tavalaro, Julia. and Tayson, Richard. Look Up for Yes (Stroke)
Thomas, Abigail. A Three Dog Life: A Memoir (head injury, family interactions)
Thomson, Rosemarie Garland. Extraordinary Bodies: Figuring Physical Disability in American Culture and Literature
Werner, David. Disabled Village Children: A Guide for Community Health Workers, Rehabilitation Workers and Families (about rehab in developing nations)
Werner, David. Where There is No Doctor: A Village Health Care Handbook (about rehab in developing nations)
Winchester, Simon. The Professor and the Madman (about mental illness)

The following list contains movies with characters that have disabilities or plotlines that bring into focus the struggles people with disabilities contend with.

Movie List

A Patch of Blue
Above Suspicion
Artificial Intelligence: AI
As Good as it Gets
At First Sight
Blink
Blue Skies are a Lie
The Bone Collector
Born on the 4th of July
Children of a Lesser God
Coming Home
Deconstructing Harry
The Elephant Man
Fuzz
Gaby- A True Story
Genghis Blues
Go Now
Hillary and Jackie
Hunchback of Notre Dame
Jennifer 8
Mask
Monkey Shines
Murderball
My Left Foot
One Flew over the Cuckoo's Nest
Open Hearts
The Other Side of the Mountain
The Other Sister
Passion Fish
Patch Adams
Places in the Heart
The Prince of Tides
Rain Man
Rear Window
Regarding Henry
Scent of a Woman
See No Evil, Hear No Evil
Silver Bullet
Simon Birch
Sybil
Tell Me You Love Me, Junie Moon
The Sea Inside
The Three Faces of Eve
Tommy
Voices
The Waterdance
West of Zanzibar
When a Man Loves a Woman
Whose Life is it Anyway?
Wit

anatomy lab exam

2008-03-31T16:54:00.000-04:00

It wasn't bad at all. About 8 cadavers were used, tagged with numbers. We were given 2 sheets of paper directing us to identify muscles, innervation, bones, and other structures. There were 50 questions, and we were allowed 1 minute per question. I know I made a mistake on 2 of them. All part of test anxiety.

It's funny how I refused to get up close to the cadavers during lab without a mask. But I found myself practically nose-deep in dead flesh while taking the exam. lol

book addiction

2008-03-26T17:11:00.000-04:00

I've been purchasing a lot of academic books on Amazon.com. Books that are not required. But if a professor lists it on a syllabus, even as a suggested reading, I feel compelled to purchase it for my personal OT library.

Canadian Occupational Performance Measure

2008-03-20T23:18:00.000-04:00

I'm working on a COPM assignment due next week. I interviewed, now I have to fill out the COPM, write a 3-page paper which will include a summary of the interview process and my personal response. Then I team up with a partner and compare and contrast our interviewees. I'm not motivated to complete this at the moment.

brachioradialis - "the beer-drinking muscle"

2008-03-20T13:52:00.001-04:00

Typing things out helps me remember.

The MMT and palpating position of the brachioradialis is pretty much the same.

For palpation, the forearm is in neutral (thumb up) and the elbow angle is 90 degrees. Give resistance to flexion and the muscle is easily palpated.

For MMT, the subject is sitting or lying supine. Place your hand under the subject's elbow as a cushion from table pressure. The elbow is flexed and the forearm is in neutral. Ask the subject to hold the position before applying pressure in the distal forearm in the direction of extension.

Get Body Smart: Brachioradialis - This is a cute site for people who need visuals.

spring break

2008-03-19T13:20:00.000-04:00

It's spring break. The week of March 17. While most students are enjoying their time off, I'm in pre-test limbo. Not quite studying the constantly splayed books in front of me. The lab practical is on March 31. The Canadian Occupational Performance Measure (COPM) paper and the kinesiology practical exam is on March 27. Of course, this is not a huge workload, but I cannot relax knowing that it must be completed upon the end of the break.

The COPM assignnment is for the Analysis of Human Activity class. There are two papers due excluding the filled-out COPM form. It's a hybrid, solo-group project involving interviews. I'm not big on interviews. I must overcome my dread of interviewing people. I must also abandon my hatred for writing papers. I have an English BA and an aversion to writing anymore academic drivel. I learned that a degree in English doesn't guarantee an education in creativity, just what-is-the-professor-looking-for prose.

triangular fibrocartilage complex

2008-03-18T23:29:00.002-04:00

Professor Sally Poole challenged the class to find the triangular fibrocartilage complex in a cadaver during our next anatomy lab. She said it was difficult. I thought it would be easy, until I realized I couldn't even find it online. I have lab on Monday, so I can't tell you anything about my experience in finding the TFCC as it hasn't happened yet. Whoever finds it gets an extra 5 points in class. I'm still trying to differentiate cartilage from all the other white stuff surrounding it that looks like cartilage.

I'm guessing the TFCC is located between the distal ulna and the lunate and/or triquetrum. I cannot locate a definitive photo. I have found some interesting x-rays of Colles fractures!

MMT

2008-03-16T16:02:00.000-04:00

I have a Kinesiology practical exam on the 27th: 3 muscle palpations & 5 manual muscles tests.

We don't know which muscles we'll be asked to palpate or test, but they will be taken from a list we learned in lab.

serratus anterior
upper trapezius
middle trapezius
lower trapezius
rhomboids/levator scapulae
infraspinatus/teres minor (lateral rotators)
subscapularis (medial rotator)
teres major
pectoralis minor
pectoralis major (upper and lower)
latissimus dorsi
anterior deltoid
middle deltoid
posterior deltoid
supraspinatus
triceps brachii
biceps brachii
brachialis
coracobrachialis
brachioradialis
supinator
pronator quadratus (cannot be palpated)
pronator teres

My main concern is with the book Muscles: Testing and Function by Kendall. Our lab instructors made quite a few corrections and changes, including showing us some "old school" testing. It's hard to study from this book while wondering if this is the correct or the corrected test. I don't like the terms "lateral and medial rotation" in reference to external and internal rotation respectively. Not all of the pictures are clear nor do they all show optimal testing postions.

Oh well, what can I do. As far as studying, I'm going to learn 3 off the list each day. Let it sink in, become an inherent action, second-nature. As Greg Roth, my lab instructor said, "Don't study it, learn it." Too many people claimed that this was too much to study, but if you LEARN it, then what's to remember? Like riding a bike.

My plans? I'm going to carefully look at the muscle in the atlas, read palpations in Clinical Kinesiology, then focus on MMT. I'll take it one muscle at a time. I'll have one glass of red wine, let my muscle knowledge marinate, then start again the next day. It's a great plan. I'll tell you how it worked after the practical.

research methods

2008-03-09T12:39:00.000-04:00

I'm in Panera Bread procrastinating and feeling sorry for myself because I have to read 5 chapters in Research Methods in Applied Settings by Jeffrey A. Gliner and George A. Morgan. I love occupational therapy. I hate research. I know it's beneficial for me as a practioner to decipher research results and travel through journal articles supporting evidence-based practice. Blah blah blah. It's boring! Give me kinesiology and psychiatric conditions any day. I've been putting off the readings all weekend.

Chapter 1 - Definitions, Purposes, and Dimensions of Research
Chapter 24 - Evaluating Empirical Research Studies: A Synthesis
Chapter 4 - Research Problems, Variables, and Hypotheses
Chapter 2 - A Tale of Two Paradigms: Quantitative and Qualitative
Chpater 5 - Overview of Research Approaches and Questions

You see? YOU SEE?!

what the torque?!

2008-02-27T09:42:00.000-05:00

Brunnstrom's Clinical Kinesiology Chapter 2 is in alien language. Thankfully, I don't need to understand every mathematical concept (trigonometry, algebra).

At equilibrium when no motion or acceleration of the body is occurring, the torque of the resistance force equals the torque of the holding force: force times the force arm equals resistance times the resistance arm. F x a = W x b for each type of lever.

Brunnstrom, page 37

Torque = force times perpendicular distance
static equilibrium for torque = 0
static equilibrium for force = 0

My question: what the hell?!
Okay, I'm not THAT clueless. But I am having some difficulty knowing when to plug in certain numbers. My professor laid it out in an obvious fashion, but I didn't get it.

The forearm was the example. The elbow joint is the axis. The forearm is at 90 degrees flexion and paralell to the floor. The hand is holding a 10 pound weight. The perpendicular distance of the resistance arm is 12 inches (axis to weight), the perpendicular distance of the force arm (axis to muscle pull) is 2 inches. We do not know the force of the muscle is exerting (X), but we are looking for how much it has to exert to hold up the 10 lbs.

10 lbs x 12 in = 120 lbs in
2X = 120
X=60

I'm getting it, but I'm not.

test update

2008-02-20T19:26:00.000-05:00

Quick Kinesiology Practical Exam update. I got a 95.5! I made a mistake when measuring radial deviation of the wrist. I let the stationary arm move a bit. Be careful with wrist radial and ulnar deviations! Keep the stationary arm stationary!

Kinesiology Lab

2008-02-20T19:18:00.000-05:00

What's more fun that running around in tank tops grabbing fellow classmates and leaving fingerprints on their body? It's a bit weird at first. Do I have enough deodorant on? Am I sweating? T-shirt sweat stains? Enough perfume? Did I remember to shave? lol

We're venturing toward the axillary area tomorrow, palpating muscles in the shoulder region. Thankfully, I was assigned serratus anterior and supraspinatus to teach the class. Unfortunately, I don't know whether I'm palpating the trapezius or the supraspinatus. I'm following the instructions in Brunnstrom's Clinical Kinesiology. Still having some difficulty.

goniometry

2008-02-08T14:18:00.000-05:00

My first practical exam for kinesiology is Wednesday. I will be tested on 3 bony palpations, 3 active ROM goniometry, 1 passive ROM goniometry, and 1 documentation.

This is a list of bony structures we learned to palpate:

clavicle
spine of scapula
medial and lateral border of scapula
superior and inferior angle of scapula
acromion
acromioclavicular joint
corocoid process
greater and lesser tuberosity of humerus
bicipital groove of humerus
sternal notch
manubrium
medial and lateral epicondyle of humerus
olecranon fossa
ulnar ridge
ulnar styloid process
radial head
radial styloid
capitate

Testing shoulder range of motion (ROM) at the glenohumeral joint:

flexion
extension
abduction
abduction with external rotation
external rotation
internal rotation

Testing elbow ROM at elbow joint:

extension to flexion

Testing forearm ROM:

supination
pronation

Testing wrist ROM:

flexion
extension
radial deviation
ulnar deviation

The biggest problem I'm having with using a goniometer is when I'm measuring passive ROM (patient's limb is moved by therapist). Actually, I feel the entire science of goniometry is looking for a ballpark range. I measure the same person twice and can get two different measurements. It doesn't seem to be an exact science, which makes me a bit nervous concerning the test.

crunch time

2008-02-02T13:26:00.000-05:00

Can't type, gotta study! I have a medical conditions exam on Wednesday. Mondays are cadaver days. I schlepp up to the NYU Medical Center to poke around donated bodies, and when I leave, I'm a vegetarian. We have much to read, more books for me to post. It's a lot of work, but very worth it.

push

2008-01-26T11:38:00.000-05:00

Palpating is not as easy as it looks. Clavicles are, though. But when asked to find the coracoid process of the scapula or the lesser tubercle of the humerus, things get a little tricky. To get to the coracoid process, you have to find a hollow below the scapula, dig your finger in the flesh, and move it around until you feel a piece of bone moving. My instructor had no problem hard-pressing the students. I was afraid of hurting my partner. "Is this hurting? Just tell me when I push to hard." Then I realized the length of my nails weren't conducive to satisfactory palpitating.

Note to self: cut nails before palpating. You get to push your fingers harder without leaving nail imprints.

here begins another semester to open my mind further

2008-01-22T21:55:00.000-05:00

normally, i'd lunge myself in self-destructive depression as a biannual ritual before mind-breaking classes hosting term paper orgies and presentation hoopla. today, i do not. i am closer to a personal breakthrough in becoming a "something". i'll have letters trailing my name, credentials framed on my wall, and secretive knowledge only members of the OT community are privy to. in the meantime, i'm taking

(1) human anatomy lab
(2) medical and psychiatric conditions
(3) research methods for occupational therapy
(4) professional issues 1
(5) kinesiology
(6) analysis/human occupational performance 1

and reminding myself that i am here to learn how to help people help themselves. if only i could define "occupational therapy" in less than 10 minutes of jabbering about what it's not.

neuro final

2007-12-17T14:22:00.000-05:00

I'm typing away on my Dell laptop, somewhere on the NYU campus--a secret location thus far for security reasons--awaiting my neuroscience final exam. It's 2:11pm, the final is scheduled for 4:00pm. Instead of reviewing like a good future OT, I'm blogging. But so I don't waste all of my time, I'll let you in on the little particulars swimming in my cerebrum.

Let's start with cerebellar diseases, these diseases result in motor dysfunction on the ipsilateral (fancy word for "same") side of the body:

1) damage to the flocculonodular lobe of the cerebellum results in overall difficulty of balance and gait, and causes nystagmus (eye drift)

2) damage to the vermis of the cerebellum causes problems with the trunk muscles, presenting postural issues

3) damage to the intermediate region of the cerebellum causes problems with the limbs only

Deficits Involve:
1) COORDINATION
a. dysmetria - errors in force and direction in movement
b. dysdiadochokinesia - difficulty with repeated pronations and supinations of the arms
c. decomposition - movement accomplished in a series discrete steps instead of one fluid motion

2) EQUILIBRIUM
a. balance difficulties
b. tendency to fall forward on affected side
c. speech may be slurred or slowed

3) MUSCLE TONE DISORDERS
a. hypotonia - low tone

Now, let's talk language! When speaking, I often fumble my words, stop myself short before completing a thought, sounding like a speech-language pathological candidate. What ho! Miss Neuroscience brought a little of that into her last lecture. Let's see now:

1) Wernicke's Area (pronounced "VER ni kee") is located within the LEFT temporal-parietal junction (the neurophiles will know what I'm talking about) and involves the comprehension of spoken language. Oh what joy it was to discover the existance of Wernicke's Area; it so explains the annoying tendencies of certain people who truly do not understand what the hell I am saying, even though I speak comprehensible English. So for those of you who cannot understand plain English, I will henceforth assume you have a Wernicke's Area problem resulting in receptive aphasia (you can hear spoken language but you cannot understand it). Wernicke's Area is also associated with the speaker's content selection. In this case, I feel most people have a problem with Wernicke's Area, especially the jackasses on Jackass.

2) Broca's Area is located in the LEFT frontal lobe and involves grammatical refinement. So, what is grammatical refinement. Apparently, it's what I lack, not to this extent though. So, for instance, if you want to say something like: the surface of the table is slippery. You may end up saying something like this: surface table slidey.

Let's put this all together and see how speech production occurs!

First, content is selected in Wernicke's Area
Second, grammar is refined in Broca's Area
Third, movement of the mouth happens through the motor cortex.

That means, when telling people to "shut up" we're really asking them to master various aspects of the brain. I say, wear earphones!

we are...

2007-12-05T18:35:00.000-05:00

I'm taking a short study break to share a quote from my neuroscience professor. She's a genius and the funniest person I know. Not Jim Carey facial skin-stretching supersillyess funny (No, I didn't mean to type "supercilious"). Or Robin Williams boingy wall bouncing curiously bizarre funny. But a dry Frasier and Niles Crane wit that I've been thirsting for on television since the end of that show. Picture a short, full-figured women with glasses and tightly cropped hair, choosing her words meticulously when instructing the class: Professor Cadenas.

"We constantly exist in a state of semi-delusion. You will see me as I was, never as I am."

In reference to the visual system in the occipital lobe at the back of the brain. By the time our visual sensory input arrives at the occipital lobe, it is a part of the past. We never see the actual present as it happens. "Mothers really do have eyes in the back of their heads."

Now, imagine toiling over college-ruled loose-leaf paper, tightly gripped pens, neck extension /flexion from note-taking and overhead projector-watching. Then hearing that we're all semi-delusional. It's so much funnier if you've been in the same classroom for the past 6 hours. Professor Cadenas rocks!

Dressing Lab

2007-11-29T19:27:00.000-05:00

I love lab. I love pretending I have disabilities I don't have; it reminds me to be thankful for little things--like arms. Today, there was an Occupational Performance in Context dressing lab in which we silly students attempted to do what people with hemiplegia, limited hand use, and hip limitations do every day. We tried putting on clothing with limited function in various body parts. I'm thrilled with these labs; they're entertaining, educational, and fun during the process of doing. But when it's over, I get a smidgen of a microscopic trifling idea of how difficult it is to live with limited range of motion, loss of function, or amputation. I exit the lab knowing that I really don't know anything. So what if I tried putting on shirts, sweaters, front-closing garments, pants, socks, shoes, housedresses, outerwear, and closures (buttons, zippers, snaps, etc.) as if I recently received a hip replacement or suffered a stroke. We all cheated. It's hard not to use functioning limbs. Flexion of the hip, bending toward feet, raising arms over the head, trunk rotation. How do you will your body not to function? No matter how hard I tried, I couldn't feign being a hip replacement patient.

Anita, the OT professor gadget expert AKA adaptive equipment professional, had us explore such things as the zipper pull, the zipper ring, the button aid, the sock aid, the long-handled shoe horn, the dressing stick, and the reacher. It was difficult for us all to use these items. I couldn't imagine clients/patients with affected areas using these gadgets. Towards the end, I threw my hands up and shouted, "Why not just use Velcro?!" Or how about the sock aid? You need to wear tube socks for you to be able to use this device. Only one person in class had socks high enough. Ankle length socks are the style. Does that mean people who need to use sock aids have to be out-of-style?

So, in the end, we all excessively flexed our hips to raise ourselves from our seats, rotated our trunks to grab our coats on the chairs, and walked with perfect stability out the door. I believe fieldwork will be a rude awakening.

Resources for adaptive equipment:
Sammons Preston
Ableware
Rehability

Krik Krak Restaurant

2007-11-28T18:40:00.001-05:00

OR (if you can't see the first slideshow)

I finally uploaded some of the photos from my cultural awareness group's excursion to Krik Krak. As you can see, it's a very tiny restaurant, but the Haitian flavor offered is huge.

procrastination & unknowing

2007-11-27T20:39:00.001-05:00

Why am I a procrastinator? I'm reading Herman Hesse's Demian instead of researching Haiti. I'm tiresome of these lessons that don't seem to be occupational therapy related. I'm asking Haitians in Haitian restaurants about Haitians in general. They are so willing to fill me in on the culture, to explain how Haitians react to doctors, to demonstrate expressions. I listen and nod and wonder if someone asked me the same questions would I be able to generalize Americans that way. "Americans are materialistic. We shop til we drop for items we don't need. We rush to the doctor if we have a little sniffle. We have road rage. We enjoy violent movies and video games. We're all Christian."

This project is starting to seem silly to me. It has it's benefits, but to think of all Haitians in one way is ridiculous. How to occupational therapists interact with Haitians? I don't know. Be culturally sensitive. But isn't that what we're supposed to do for all people? Is this not in the occupational therapy practice framework in something called "context"? Who knows, I have yet to read it in its entirety.

Anyway, anatomy class was exciting. We did the lower extremity, the knee joint. Medial meniscus, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), lateral collateral ligament (LCL). It's all an anatomical jumble. I usually know absolutely nothing in class, and then become a scientific genius right before exams. I consider myself a slow learner in that I must read and study the same thing several times before I get it. But at least I get it. My professor, Dr. Aqua, said he wanted to recruit me for the clinical doctorate in occupational therapy or doctorate of professional studies (D.P.S.). Woohoo for me. I figure I'll graduate, get some experience, come back, and get my D.P.S.

I'm buying OT books galore. Whatever I can find, I buy. I'm spending more than I need on books that are not even required. And it's so worth it. I especially love Occupational Therapy Without Borders. It's a great book for people who want to go to other countries and help while not knowing how to help as OTs. Nurses go to give shots. Surgeons operate. OTs...um...help them make sandwiches?

Absolutely not.

Krik Krak

2007-11-17T10:34:00.001-05:00

I and the culture gang went to Krik Krak for a traditional Haitian meal. The cuisine was less rich than we thought it would be. "A Fellow Culture Friend" (named to disguise) told the chef that he expected the food to be more frenchy. The chef said that people are more health-conscious, and she tries to accommodate to their wishes. Fine by me, but not by the goat I ate. Very interesting flavor and texture. Kind of gamy and intense. I had to tone it down with the rice and beans. Replace the goat for chulettas, and I'm home again. I took tons of pictures which I will post soon.

Cultural Group

2007-11-10T14:50:00.000-05:00

The class has been divided into groups of 6 or 7. Each group has chosen an ethnic population to "study" and report on at the end of the semester. We must research health concerns, culture, family structure, and other elements of life. My group is researching Haiti, and as I delve deeper into their sociopolitical climate, I'm amazed at how little the average American knows about Haiti and the struggles its people face. One member of my group actually asked, "Where is Haiti again?" What an eye-opener to the ignorance of we Americans (me included). U.S. immigration policy for Haitians is of particular interest to me. I wish I could speak to Haitians who could give me firsthand information on the atrocities they or family and friends have faced.

This group project is meant for us to examine our biases towards others, biases we didn't even know we had. It's meant for us to be aware of how to professionally communicate with people of other countries without unknowingly offending them. It's meant to break us from our cozy American molds.

the stuff i do and write

2007-11-02T21:43:00.000-04:00

activity analysis, activity analysis, activity analysis. we spend a lot of time writing down every minute detail of our lives or the lives of our little guinea pigs. this semester is fraught with interviews and concise papers. we're taught interviewing skills--look at my eyeballs when i'm talking to you!--and the finer points of writing short papers stuffed with data. this is a challenge for english majors (shout-out to all the long-winded, flowery language-teurs). I have to brush up on my interpersonal skills.

Anatomy 101

2007-10-30T16:17:00.000-04:00

That's right, my friends! I managed a score of 101 on my second anatomy exam.
I'm thrilled. There were 6 points of extra credit questions. I don't know what I got right, part of me doesn't care. I'm too happy right now. I'll spend the evening typing up anatomy notes to keep my grade up. We're studying the lower extremity (LE). I'm annoyed with the textbook we're using, which apparently medical students are using as well. Clinically Oriented Anatomy Fifth Edition by Moore and Dalley is chock-full-o-mistakes. I made some notations in the book and plan on taking pictures of them. It's rather annoying to find these typographical errors while studying. I even found some in one of the neuroscience books. This is my own way of "giving it" to the publishers. In the meantime, some clinically oriented typos.

As a matter of fact, I'm recording all typos I find in ALL my textbooks. We graduate students must dish out hundreds of dollars for these textbooks, $500 a semester. And most of us complain about errors that, if you're not studious, will lead you to false information.

Neuroscientific Brain Clog

2007-10-29T21:08:00.000-04:00

Neuroscience isn't as bad as it sounded at NYU's information session. I expected mad scientists in lab coats with glass vials speaking in a thick Bavarian accent and sporting out-of-control wiry hair. I got none of the above. What we have is a very enthusiastic professor who's in love with the brain. I listen to the lecture intently because we have no assigned books, and if I miss something, I don't want to rely on someone else's notes. Last week, I bought two Neuroscience books she suggested, Neuroscience: Exploring the Brain by Bear, Connors, and Paradiso; and Neuroscience (4th Ed.) by Purves, et al.

The subject isn't as distasteful as I thought it would be. It's amazing how long we spend on "small" topics. The brain is truly amazing. I chose to buy these books to supplement the course, to see pictures, and to get a better understanding of what Professor Brain is saying. It's funny that we're taking these hard sciences along with courses that involve art projects. The first project of this sort was the self-portrait craft box assignment in which we had to decorate a wooden box to reflect our interests, and overall selves. We also had to submit a paper answering the following questions:

1. Briefly describe your craft box. What materials did you choose to use? Why did you choose them? Think about the process of making the box, was it easy or difficult for you? Explain. What did you observe about your fellow classmates during the process of making the boxes?

2. What aspects of your personal context are represented in this project?

3. What did you learn about yourself during this process?

4. How will knowing more about yourself influence your future work with patients/clients?

We had an anatomy exam around the corner, so I doubt we put too much effort in it. But the resulting boxes were beautiful. I'll have to take a picture of mine and post it once I visit the person I gave it to. lol

Problem Based Learning

2007-10-29T14:52:00.000-04:00

On Friday October 26, Jody Bortone from Sacred Heart University guest-lectured at NYU using a Problem Based Learning approach during Development Across the Life Span. She immediately informed us that the class was not going to be lecture-based in the traditional sense. We watched a video clip twice then tackled a clinical scenerio we future-OTs may be confronted with. We divided into small groups, and using the Clinical Decision-Making Concept Map she provided as a guide, we set off to first find a clinical problem. After 20 minutes of formulating clinical questions, she addressed each question raised then guided us through each of the 6 steps.

(1) Issues/Clinical Problem or Question
(2) Client's Goals
(3) Evaluation of Client's Occupational Performance
(4) Theoretical Rationale
(5) Research Evidence
(6) Therapist's Experience

She bridged the gap between the course work and the clinical reasoning process, incorporating theory and the OT Practice Framework in such a way that I finally understood the purpose of both.

I had a strong desire to transfer from NYU to Sacred Heart after the "lecture" just so I could be exposed to this kind of teaching. I asked my professors if they would implement problem based learning at all throughout the semesters. I was hit hard with an open-ended no. I used the word "open-ended" because it seems as if at least one professor iswilling to adapt although not fully transform her teaching to PBL.

Annoying class

2007-09-20T19:12:00.000-04:00

Occupational Performance in Context was backbreaking today. Because the professor knew only one person (me) out of a class of 60, she used me in all her demonstrations, including a mock massage that was really fists and karate chops on my back. How embarassing.

Anatomy was annoying because most of the class asked annoying questions. "Do we have to know this table? This chart? These pages? For the test?" Are we not all in graduate school? Is it not our purpose to learn as much as we can to be competent therapists??? I couldn't take the high school questions from these people. The older students felt my pain. There's a clash between the right-from-undergrad crowd to those with more worldy experience. I see the rift widening.

Season 1: Year 1

2007-09-11T22:05:00.000-04:00

It's September 11, the second week of class. I've decided to record my experience as a graduate student studying occupational therapy before I forget this wonderfully rich environment of intellectuals full of hope and promise. I've already taken several courses ahead of time, so I'm limited from now on to the ones in progress and the ones that have yet to be.

Human Anatomy is the most time-consuming thus far. The professor is ready and willing to answer all our questions. He enjoys teaching, and it shows. We brushed up on the basics, an introduction to the body: the approaches to studying anatomy, the 11 systems, anatomical planes, terms of relationship and comparison, terms of movement. A brief brush up of each system. We're studying the body regionally. First, the thorax. Every part of the thorax is fair game unless otherwise noted by the professor. The material is not unmanageable, but when you have 5 or 6 other classes, it becomes a load pushing the comfort level. We're using Clinically Oriented Anatomy, 5th Ed. by Keith L. Moore and Arthur F. Dalley which can be found in Barnes and Noble on 5th Ave and 18th Street. This is where the textbooks are sold. It's small, stuffy, and a reminder that we students have limited funds and the extravagances of life are being put on hold until graduation.

Neuroscience is still a mystery. We have no textbook. All information will be provided to us in lectures. I'm a little nervous about this. When I'm rushed to write, my handwriting becomes illegicaly sloppy, my hand tightens and forms a power grasp on the puny pen. My first true lecture is this Thursday. More on that later.

Occupational Performance in Context is self-explanatory. It seems like a fun class with projects and a group presentation that will hopefully lighten spirit of the semester.

Performance and Development Across the Lifespan used to be called Biopsychosocial Maturation. Last year I couldn't remember that name; now it's the only one I do remember. We study human development. It's chock full of years that can seem confusing. If you're really interested, though, it should come easily. Just pretend you're watching a fast forward of a related child (son/daughter, cousin, niece/nephew). You have to be imaginative in this program.

I've already taken the New Student Seminar. You're taught about the campus, how to use online blackboard, library resources, OSHA requirements, and HIPPA. It's informative.

Activity Group Process teaches you how to run activity groups. Most of my classmates questioned this course. "When will we ever do this?" Our professor was an OT specializing in mental health. He pretty much informed us that conducted groups is not uncommon. Be prepared.

Foundations of OT gives us a history of the profession. We have a fun project and paper. It's pretty laid back and casual. Just enjoy.