Hello Ilene: I appreciate your message!
In this case, the pain was caused by probably joint misalignment resulting from paralysis of the shoulder girdle. I believe I did assist this patient by providing him my opinion on his shoulder pain, and referred him to an ortho MD. I am pretty confident that this patient understood occupation and OT. Well, at least it was explained to him. In fact, he was discharged because his only stated goal was, "walking like a man". Thanks again! Ron ----- Original Message ----- From: ocil...@comcast.net <ocil...@comcast.net> Sent: Wednesday, April 22, 2009 To: otlist@otnow.com <otlist@otnow.com> Subj: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it even ocn> Ron, IMO there were many things an OT could have done to assist ocn> that patient even without directly treating his arm. Pain disrupts ocn> occupational function in all areas. We can work with chronic pain ocn> patients to learn relaxation techniques. We can educate them and ocn> their caregivers on how to prevent further pain and deformity (many ocn> times CVA patients do make things worse because of dysfunctional ocn> strageties they develop to perfom self-care, poor arm placement ocn> during transfer, etc) We can help them learn how to find a chronic ocn> pain support group or how to find assistive devices on the ocn> internet. I think patients really have no idea all that OT offers, ocn> nor often what "occupation" really is. The best way to get OT's out ocn> of the "UE" box, is to show them what we CAN do for them, rather ocn> than say "there is nothing we can do, refer to PT" for a patient like that. ocn> ~Ilene Rosenthal, OTR/L ocn> From: Ron Carson < rdcar...@otnow.com > ocn> Subject: [OTlist] Breaking the Bonds of Upper Extremity OT; Is it even ocn> Possible? ocn> To: OTlist@OTnow.com ocn> Date: Monday, April 20, 2009, 4:06 PM ocn> Hello All: ocn> A couple weeks ago, I worked with a CVA patient who despite having ocn> multiple occupational deficits, he was unwilling to verbalize any ocn> OT-related goals. And after a couple of weeks, the patient was d/c'd. ocn> The patient's UE and LE were compromised by the CVA. He had almost no ocn> active movement in his affected arm. His shoulder was extremely painful ocn> during any AROM. ocn> I initially told the patient that as an OT, I would address his most ocn> important occupations but that I could do nothing about his arm. Over ocn> the? course of? treatment, his wife reported having difficulty bathing ocn> under the patients arm. After doing some gentle PROM, I concluded that ocn> there was a possible impingement. I believed an orthopedic appointment ocn> was necessary. I conferred? with the PT and? she concurred. I ocn> also ocn> confirmed that the treating PTA would address ocn> the shoulder ocn> ROM/Pain. ocn> -- ocn> Options? ocn> www.otnow.com/mailman/options/otlist_otnow.com ocn> Archive? ocn> www.mail-archive.com/otlist@otnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com
