It is ironic though that the man has muscular dystrophy though and
wants to focus only on PT. I wonder if the man realizes the
progression of his disease and how aggressive strength training can
cause problems. It seems as though the man is in denial about his
disease and wants to fight it by building up his body, but in reality
the nature of his disease will most likely force him to compensate
during his daily occupations. This would be the perfect oppurtunity
for early OT to pave the way for this man's unfortunate future to help
in his quality of life. I have a feeling that this man will encounter
OT again in the future ,but this time he will have a new appreciation
for our role. A strong educational program including the neurologist,
PT, psycologist, and nursing would alleviate this problem in educating
this man on the common progression of the disease and how an OT can
help with the occupational issues for the future.
-----Original Message-----
From: Ron Carson <rdcar...@otnow.com>
To: Mary Alice Cafiero <OTlist@OTnow.com>
Sent: Sat, 21 Feb 2009 8:03 am
Subject: Re: [OTlist] The Timing of OT...
Hello Mary Alice:
Let me be the 1st to say "Thanks" for writing. I understand what you
mean about taking time to write and then not getting any responses. But,
such is the nature of listserves!<smile>.
I think you've touched on at least ONE area that can frustrate the OT
process. IF an OT is focused on improving occupation but the patient is
focused on improving strength/ROM there is inconsistency. Notice that I
say FOCUS because as you correctly identified, improving occupation
usually results in improving the underlying impairments. But in this
case, the patient stated he was doing all he could.
OT is a "bizzaro" world! <smile>
Ron
----- Original Message -----
From: Mary Alice Cafiero <m...@mac.com>
Sent: Saturday, February 21, 2009
To: OTlist@OTnow.com <OTlist@OTnow.com>
Subj: [OTlist] The Timing of OT...
MAC> I think that patients often equate PT not only with walking, but
also
MAC> with strengthening. It seems they often feel that the majority of
MAC> their problems doing things are because of weakness. If they can
just
MAC> get stronger, all else will fix itself. I can see this especially
MAC> being true with a diagnosis like MS or other progressive
neuromuscular
MAC> disease.
MAC> We, as OTs, can clearly see that learning to do the things you
need to
MAC> do for yourself has inherent value. It also ends up addressing
MAC> strengthening without doing a straight exercise program. I tend to
MAC> think that patients often prescribe to the "no pain, no gain"
theory
MAC> and feel that they have to do multiple reps of an exercise in
order to
MAC> address weak muscles.
MAC> My two cents. I'll be curious to see if anyone responds. The
majority
MAC> of times that I post a response on this board, no one directly
MAC> responds, and my answers just get shuffled over. Not sure of the
MAC> reason for that, but it is certainly frustrating. Makes me
reluctant
MAC> to post because it doesn't seem to add to or lead to further
discussion.
MAC> Mary Alice
MAC> Mary Alice Cafiero, MSOT/L, ATP
MAC> m...@mac.com
MAC> 972-757-3733
MAC> Fax 888-708-8683
MAC> This message, including any attachments, may include confidential,
MAC> privileged and/or inside information. Any distribution or use of
this
MAC> communication by anyone other than the intended recipient(s) is
MAC> strictly prohibited and may be unlawful. If you are not the
recipient
MAC> of this message, please notify the sender and permanently delete
the
MAC> message from your system.
MAC> On Feb 21, 2009, at 1:21 AM, Ron Carson wrote:
I had an interesting experience that I want to share.
Last week, I evaluated a middle-aged man with muscular dystrophy. He
had
recently moved back home with his parent and was started on home
health.
The man essentially told me that there was nothing I could do for
him.
He said that PT was all he needed. I explained that as an OT, my job
was
to teach him to take care of himself as much as possible and
desired.
But, he still felt that PT is what he needed.
I am really perplexed as to why someone might value PT instead of
OT? I
have some ideas, which I'll share, but I hope readers are
willing to
discuss this situation.
Thanks,
Ron
--
Ron Carson MHS, OT
www.OTnow.com
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