First Success with a Consumer

One month into the Occupational Therapy program and I've had my first success with a real life person! Ok, so I admit the person was myself, but who else is going to let me unleash my minuscule amount of skill on them at the moment? Learning about one of the principle OT process models, I have managed to apply it to one of my own Occupational Performance Issues (or OPI's as we say in the biz). My OPI is that I can't participate in my chosen sport (field hockey) due to a knee injury. Now my injury is not that serious in the grand scheme of things, but imagine the effect on someone's life if they were unable to doing something that is so central to them - something that practically defines them. The implications and ramifications of this are huge, spanning way beyond the immediate medical problem.

Having waited 4 months to see the knee specialist, I felt like I had to take matters into my own hands in order to get my story across. With an average consultation duration of 15 mins, even doctors with the best intentions would find it difficult to get up to speed with not only what is troubling the patient but also how it is affecting the rest of their life. I decided to make a 'Resume of Tom'. The resume included basic demographic details, a summary of my sporting involvement since I was a child (embarrassingly, the highlight of which still being an accomplishment at the age of 11), my current physical activities including those involved in my work duties, a detailed breakdown of my knee troubles (patterns of pain, signs and symptoms) and my goal for the future. My goal was to be able to participate in all my chosen physical activities, many of which involve a high degree of knee twisting. I had heard the word on the street that specialists are reluctant to operate unless the ligament is completely torn - my dubious MRI had concluded a grade II tear, so I thought I was fighting an uphill battle.

As the doctor scanned my scant notes trying to ascertain the reason I was in his office, I thrust this resume in his hands. My hope was that in the minute he took to scan it, he got a much broader picture what my complaint was, what I wanted done, but most of all, who I was. I was trying to make him realise how central physical activity is to my sense of self. I suppose I would define myself as being 'a sporty person' and therefore it is part of my sense of spirituality. He told me to jump on the examination bed (it was more of a hop) and tested the strength of the anterior cruciate ligament. My good leg had an 'end point' when he pulled, like a rubber band that wants to resist being stretched. My dodgy leg did not have an end point which led him to the quick diagnosis that the ligament was completely torn, apart from maybe a few fibres ahnging on for dear life. He immediately offered the choice of having the ligament repaired or leaving it the way it is, each with their associated risks and benefits. I chose the first option, final answer, with no need to phone a friend (admittedly, I had been polling my knee injury-ridden field hockey teammates in the few weeks prior so I had probably exhausted this lifeline already). I couldn't believe I was being given this opportunity. Utterly surprised at how easily he had agreed to go ahead with the surgery, I forgot to ask exactly what procedure he was going to do - I heard the word 'arthroscopy', but that didn't mean anything to me. The secretary told me I could be operated on in one month and again I was shocked with the immediacy of it all.

All in all, the visit to the specialist had been very successful. Let's be honest, being offered the surgery probably had nothing to do with the Resume of Tom. However, it made me feel like I had done everything I could have done to get my story across in the brief time available. I felt like an accurate picture of me had been presented rather than just first impression cues. In my mind at least, the hierarchical gap between the 'all-knowledgeable' doctor and the 'clueless/dependent' patient had been reduced; for this alone, I felt that it had been worth the effort. At the very least, my little primer had showed I was motivated to engage in this invasive procedure and the months of rehab that would follow. This motivation would definitely be capitalized upon in the OT realm.

So now to find out a little bit more about knee arthroscopies...hmmm...Google?

Salsa As Medicine: Mind, Body and Soul

El que canta y baila su mal espanta
(He who sings and dances scares off any misfortune)

This piece of writing really embodies many of the ideas we have discussed during the first few weeks of the OT program. It's written in a very honest manner and the message comes through loud and clear. For me, it was very inspirational to read - it confirms why I am entering this profession. It is also one of those pieces of writing that all health care professionals should take the time to read once in a while to maintain focus in our increasingly pressured world.

Please click on the following link to read this featured article:

http://www.salsavancouver.net/articles/salsaasmedicine.html

Initial thoughts (one week into the program)

“So do you feel a little overwhelmed with all these women?”, I was asked after the first class into the Introductory week of the Master of Occupational Therapy program. Having made the transition into OT from Elementary teaching, I replied that I was used to it, yet the ratio imbalance she was referring to was hard to ignore. In a class of 40 students, I would be one of two men. As I often did when I was an elementary teacher, I’ve been reflecting on what it is that makes the OT profession particularly attractive to women or conversely unattractive to men. I’ve posed this question to OT’s over the last few months and generally no one really seems to know why. Some speculated that men prefer to be in managerial positions which can be more easily attained in other professions such as related to finance or business. Some proposed that the lay perception of Occupational Therapy (if a lay perception exists at all) is that the nature of the work is similar to nursing which has traditionally been a female dominated profession. Others thought it was a money issue (or lack of it). Whatever the reason, and I continue to speculate, I began to question whether male OT’s can have an important impact in providing services and treatment particularly in areas such as spinal cord injury in which clients tend to be over-represented by the young male demographic group.

The first week of the MOT has been a good balance of orientation details and introduction to course content. The inclusion of an ‘Introduction to Anatomy’ was a nice touch. It represented a caring outstretched hand to new students who had not studied Human Kinetics in the past. As noted by one of the teachers, there seems to have been a shift in trend towards students entering the program from psychology and social science backgrounds and this is certainly true of our ‘Class of 2009’.

Among the special items we have been given to place in our tool kits as we embark on this learning journey, has been a formula to answer the question, “So what exactly is an OT?” that predictably gets asked after the question “So what do you do for work?” As an aside, is it my imagination or does the word ‘So’ appear before any question that is asked more out of the need for conversation rather than genuine interest? Going back to the original question, it seems that the answer can change depending on who is asking, but the formula stays the same. The little gem given to us was: always base your answer in the context of that person’s experience. For example, if I was asked by an old school friend what an OT does, armed with this advice, I would reply, “well you know Frank…” (and those that did, knew Frank was quadriplegic), “…an OT would have worked with him after his accident to ensure he could participate in all his daily activities and pursue his interests in the best way possible". I have tried this formula a few times already and usually it elicits the switched on light-bulb response followed by the person giving me examples of what an OT does; therefore, ultimate proof that it works.

Returning to university again, and this time to study a discipline that seems like a perfect fit for me, has been extremely exciting; one instructor even commented that my mood had been ‘euphoric’ on the second day. I’m hoping that the large doses of interesting, yet intense anatomy classes will reduce the euphoria to realistic and possibly more sustainable levels. As I embark on this 24 month journey, I would like to share with you my experiences and reflections upon entering this wonderful profession and in my mission to become a fully-fledged Occupational Therapist.