Case Study: K.T.

Today in class, one of my classmates told about a guy named K.T. that was diagnosed with ALS.  He was a NFL football player.  His symptoms presented first through weakness in his hands and he was diagnosed with ALS in 2010.  His ALS was likely related to the head trauma he acquired while playing football.  This was startling to me that a healthy, professional football player acquired this disease that completely crippled him.  He had cognition but his muscles deteriorated to the point of his death in 2016.  Not only was K.T. a football player but he was a father, husband, and coach and ALS majorly affected each of these roles.  ALS is a progressive disease that weakens the person's muscles overtime.  There is no treatment for this disease.  It was so sad to see the pictures of K.T. from fully healthy to near death, to watch a person of full health deteriorate so much and so rapidly.

Ethical Principles

There are seven ethical principles laid out in the Occupational Therapy Practice Framework (OTPF).  In this post, I will be briefly defining each of these principles.

Beneficence - Looking at the client as a whole and being thoughtful about a client's well-being

Non-maleficence - "Do no harm"; refraining from actions that cause harm to the client

Autonomy & Confidentiality - Freedom to choose and a right to privacy

Social Justice - Right, equable, appropriate treatment of the client

Procedural Justice - Compliance with institutional rules, federal, and state regulations

Veracity - Honest, accurate truth, information, proper credentials, not plagiarizing

Fidelity - Respect and faithfulness to the client

By adhering these ethical principles, an OT practitioner can better avoid or solve sticky ethical situations that arise.  I think having these principles laid out helps practitioners know the correct and appropriate response and it gives a baseline for same practice among all OT practitioners.

Professional Development

I believe the key to being a successful practitioner is to strive for professional development. When I think of professional development, I think of the term lifetime learner.  Lifetime learning enhances knowledge and provides continual growth.  It can be motivated by professional organization demands or just personal curiosity.  The continual pursuit of knowledge produces competence in an area of interest.  Currently, I am in school where material is laid out and I am required to learn.  In some ways, it is easy for me to be professionally developing because I am enrolled in a curriculum that focuses directly on learning about OT practices.  In the professional world, learning is not mapped out in this way and it requires self-discipline to make time to continue learning.  Professional organizations often motivate this learning though with continuing education requirements for retaining a license.  The motivation behind this is to improve quality service and protect the public.  Professional development helps practitioners keep up to date on the newest research and treatment and give the best care to the clients served.  Our profession is only strengthened by a pursuit of continual learning.

Neuro note 2 - Sheryl and Myasthenia Gravis: How I cope!

For my second neuro note, I focused my search on looking for a video or blog telling about a person's life, the disease they face, and part of their story.  I ended up finding this YouTube video about a girl named Sheryl that tells about how she copes with her condition, myasthenia gravis. 

Sheryl is a 17 year old girl that was diagnosed with myasthenia gravis at age 16.  In this video, she talks about the onset of the disease, the description of the disease, and how she deals with it.  Myasthenia gravis is a condition that inhibits the communication between neurons and muscles causing extreme muscle fatigue in voluntary muscles.  Common symptoms are muscle weakness, drooping face, drooping eyelids, and trouble talking, breathing, eating, and swallowing.  Sheryl talks about how she began to experience some of these symptoms one day at school and then the process of being diagnosed with myasthenia gravis.  She receives a treatment called plasmapheresis that keeps her symptoms at bay for a time.  Because of her disease, she can no longer participate in activities to the same degree that she used to.  She talks about how she has made modifications to activities in order to continue participating in some way.  For example, she enjoyed playing softball before her diagnosis and now she cannot play in a game but she continues to participate by going to games and cheering on her teammates and by going to the batting cages to do what she can. 

Listening to her story was inspiring.  I cannot imagine the difficulty of a disability like this while also trying to be a teenager.  I felt sorry for her and yet, she did not feel sorry for herself.  She looked for what she could do, what made her happy, and did it.  She is striving to live as normal of a life as possible.  She even spoke about returning to school after some time spent in and out of the hospital.  However, my favorite part of the video was probably the end when she was showing random pictures she took on her iPad.  This part showed just showed how human she is and how she has many interests that she continues to pursue.  I am reminded that I should encourage the interests of my future clients, especially those with a chronic disease.  I can see the importance of retaining as much normality as possible.  Please go watch this video for yourself to gain insight into this disease and the coping strategies of those dealing with it.

Carter, B. [Bryan Carter]. (2014, October 23). Sheryl and Myasthenia Gravis: How I cope! [Video file]. Retrieved from https://www.youtube.com/watch?v=UZU2nTf6_cc

Mayo Clinic Staff (2016, April 23). Myasthenia gravis. Mayo Clinic. Retrieved from http://www.mayoclinic.org/diseases-conditions/myasthenia-gravis/home/ovc-20200259

The Basics of Clinical Reasoning

Clinical reasoning is a skill that is refined through time and practice by OT practitioners.  The practitioner uses what he or she has learned and seen to clinically reason in order to answer questions and solve clinical dilemmas.  Clinical reason also takes into account the feelings of clients.  This involves keeping the well being of the client as a priority.

There are three elements of clinical reasoning: scientific, ethical, and artistic.  The scientific element asks, "What are the possible things that could be done?"  The ethical element asks, "What should be done?"  Last, the artistic element uses creativity to help with the specific needs of the client.

Some types of clinical reasoning are scientific reasoning, diagnostic reasoning, procedural reasoning, narrative & interactive reasoning, pragmatic reasoning, ethical reasoning, and conditional reasoning.  Scientific reasoning focuses on the facts.  Diagnostic reasoning is the merging of the effects of the diagnosis to the clinical picture.  Procedural reasoning helps with the order or pattern procedures should follow.  Narrative and interactive reasoning is a reliance on storytelling and interaction to solve the problem.  Pragmatic reasoning has to do with logistics like time, resources, insurance, and equipment.  Ethical reasoning looks at what is right and wrong.  Conditional reasoning examines the condition of the client and their situation in a holistic manner.

Various situations will call for various uses of these different reasoning styles.   It is a crucial, learned skill that practitioners use to know what to do in "gray" situations.

Specialty Areas of Practice: Driving and Community Mobility

In occupational therapy, there are several specialty certification that one can pursue.  I believe certifications are important because they allow clinicians to obtain in-depth knowledge about a particular area that can enhance the care of the client.  Today, I am going to focus in on one of the many certifications and talk about it's merits in occupational therapy and how it relates to AOTA's Vision 2025.

Specialty Certification in Driving and Community Mobility (SCDCM) is a certification that appeals to me because I value the difference that mobility makes to a client's well-being and happiness.  SCDCM focuses on mobility in the community through not only driving but walking, taking public transportation, etc.  Practitioners that hold this certification are advocates and facilitators of driving and community mobility.  They prioritize community mobility for their clients.  SCDCM can be helpful to the occupational therapist because it allows the therapist to do more for their clients.  It is a client-centered area of practice and it adapts the equipment and environment to suit the client's needs.

Vision 2025 statement:
"Occupational therapy maximizes health, well-being, and quality of life for all people, populations, and communities through effective solutions that facilitate participation in everyday living."

I believe that SCDCM fully embodies the AOTA's Vision 2025.  By giving clients the ability to be mobile, you give them better well-being and a higher quality of life.  Using this certification will provide effective solutions to a incapacitating problem.  By having mobility, client's are able to fully participate in daily living.

I hope to pursue this certification in the future because of great ways it can help my future clients!

Retrieved from http://www.aota.org/Education-Careers/Advance-Career/Board-Specialty-Certifications/Driving-Community-Mobility.aspx

Michael J. Fox

Michael J. Fox was diagnosed with Parkinson's in 1991 and since has created a large foundation for Parkinson's.  He is very vocal about promoting Parkinson's research but he is very private about his own health and treatment. I find it fascinating that he is a star and yet so little is known about the disease he struggling with. In class, we hypothesized that he would require home modifications and treatment could be focused around his love for dogs.  We guessed he was wealthy enough to afford whatever treatment he needed.