Hey Chris: Base on my limited time with the patient and his mother, I think they are very knowledgeable about strengthening. The mother was very matter of fact in stating that her son was beginning to dwindle down. In fact, the the patient's form of muscular dystrophy is genetic and his father died from the disease and his sister also has it. All and all, I think they have a good handle on his disease but not on OT. At least I wasn't able to convince him to focus on occupation. Interestingly, the patient/caregiver stated how much progress PT was making by teaching the patient better bed mobility.
I don't know, the entire situation is confusing to me!! Ron ----- Original Message ----- From: cmnahrw...@aol.com <cmnahrw...@aol.com> Sent: Saturday, February 21, 2009 To: OTlist@OTnow.com <OTlist@OTnow.com> Subj: [OTlist] The Timing of OT... cac> It is ironic though that the man has muscular dystrophy though and cac> wants to focus only on PT. I wonder if the man realizes the cac> progression of his disease and how aggressive strength training can cac> cause problems. It seems as though the man is in denial about his cac> disease and wants to fight it by building up his body, but in reality cac> the nature of his disease will most likely force him to compensate cac> during his daily occupations. This would be the perfect oppurtunity cac> for early OT to pave the way for this man's unfortunate future to help cac> in his quality of life. I have a feeling that this man will encounter cac> OT again in the future ,but this time he will have a new appreciation cac> for our role. A strong educational program including the neurologist, cac> PT, psycologist, and nursing would alleviate this problem in educating cac> this man on the common progression of the disease and how an OT can cac> help with the occupational issues for the future. cac> -----Original Message----- cac> From: Ron Carson <rdcar...@otnow.com> cac> To: Mary Alice Cafiero <OTlist@OTnow.com> cac> Sent: Sat, 21 Feb 2009 8:03 am cac> Subject: Re: [OTlist] The Timing of OT... cac> Hello Mary Alice: cac> Let me be the 1st to say "Thanks" for writing. I understand what you cac> mean about taking time to write and then not getting any responses. But, cac> such is the nature of listserves!<smile>. cac> I think you've touched on at least ONE area that can frustrate the OT cac> process. IF an OT is focused on improving occupation but the patient is cac> focused on improving strength/ROM there is inconsistency. Notice that I cac> say FOCUS because as you correctly identified, improving occupation cac> usually results in improving the underlying impairments. But in this cac> case, the patient stated he was doing all he could. cac> OT is a "bizzaro" world! <smile> cac> Ron cac> ----- Original Message ----- cac> From: Mary Alice Cafiero <m...@mac.com> cac> Sent: Saturday, February 21, 2009 cac> To: OTlist@OTnow.com <OTlist@OTnow.com> cac> Subj: [OTlist] The Timing of OT... MAC>> I think that patients often equate PT not only with walking, but cac> 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 cac> 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 cac> neuromuscular MAC>> disease. MAC>> We, as OTs, can clearly see that learning to do the things you cac> 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" cac> theory MAC>> and feel that they have to do multiple reps of an exercise in cac> order to MAC>> address weak muscles. MAC>> My two cents. I'll be curious to see if anyone responds. The cac> 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 cac> reluctant MAC>> to post because it doesn't seem to add to or lead to further cac> 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 cac> this MAC>> communication by anyone other than the intended recipient(s) is MAC>> strictly prohibited and may be unlawful. If you are not the cac> recipient MAC>> of this message, please notify the sender and permanently delete cac> 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 >>> >>> >>> >>> >>> -- >>> Options? >>> www.otnow.com/mailman/options/otlist_otnow.com >>> >>> Archive? >>> www.mail-archive.com/otlist@otnow.com MAC>> -- MAC>> Options? MAC>> www.otnow.com/mailman/options/otlist_otnow.com MAC>> Archive? MAC>> www.mail-archive.com/otlist@otnow.com cac> -- cac> Options? cac> www.otnow.com/mailman/options/otlist_otnow.com cac> Archive? cac> www.mail-archive.com/otlist@otnow.com cac> -- cac> Options? cac> www.otnow.com/mailman/options/otlist_otnow.com cac> Archive? cac> www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
