I saw cancer and, yes, it was ugly

Did I ever tell you I saw cancer?

This is not a joke. Over the summer I decided to pay the incoming occupational therapy class a visit to their anatomy class. As they were poking through their cadavers someone asked me if I wanted to see what cancer looked like. Me being me, of course I said yes!

I saw pancreatic cancer. I wasn't prepared for my emotional reactions--sadness and anger. I don't know what I was expecting cancer to look like but it didn't look like what I expected. His pancreas was covered in these white blobs. The cancer had spread to to parts of his liver and colon. The gentleman who died from it was 45 years old, so young! I felt angry that he died so young and sad that he died so young.

All I could think was, "Wow, cancer is a BEAST." I can't imagine the pain that man must have been in...that cancer was everywhere. I wondered about his family and what kind of life he lived before he died.

My classmate told me that she drives by a billboard of a young girl, in her early twenties, with a caption that reads, 'CANCER, YOU'LL QUIT BEFORE I DO.'

Well stated.

Treating a patient with Breast Cancer

(this daring photo came from this blog -- Musing of a Home Engineer. I know it's racy but I think it's important for people to see images like this so they can not only know the impact of breast cancer but FEEL it. I encourage you to read the post on the blog.

I also encourage you to view my favorite, most inspiring mastectomy photo by clicking here. All I can say is "Wow.")

In Human Dev class we had a case of a woman just referred to occupational therapy from her doctor due to a radical mastectomy (complete breast removal and some muscle, skin and other tissue) as a result of breast cancer. To illustrate how we project our ideas on our clients we had to name her based on our interpretation of the situation. I named her ADORING MOTHER because in the profile she stated that she just wanted to be able to take care of her children and her home. I thought that was interesting because here she is, with breast cancer, recently from surgery, and one of her most pressing concerns is an IADL--taking care of those around her. Wow.

The conversation then went on to describe the things we'd like to know to start our first treatment session, such as

• how is she dealing with her illness
• which occupations are most important to her and why
  
• how does she see her future
• does she have hope or does she feel hopeless
• does she understand lymphedema and other possible effects of breast cancer and mastectomy
• how is her social support
• does she understand her current limitations (no lifting her children, heavy things, etc. for awhile)
• what theoretical approach and assessment tools will we as occupational therapists use to treat her and why
  
• what questions do we, as occupational therapists, have about breast cancer, mastectomies, the psychosocial effects, normal cognitive and developmental changes in a woman of her age (40s)
• where will we find the answers to our questions--what books and other resources
  
• many other things I'm too tired to write right now.

The class was really interesting and I thoroughly enjoyed the discussion.

Different perspectives contribute to the whole picture

(A few of the many sculptures on campus and one of the lakes. I recently discovered that our campus has the largest sculpture park the U.S. Interesting, isn't it? I thought so, as well, which is why I am going to take a tour of the park in October.)

So, remember the quantum physics book I told you about a few posts ago? Well, I have a class that uses that book as a textbook; we meet once per week. This past week the instructors divided us into groups and sent each group to a different area of the campus (we got to go outside, I was soooo excited!!! It was like recess!).

Each member had to write down what they could see, hear, smell and feel. Then, each member had to focus on a different sensation or emotion: some focused on only the sounds they heard, some focused on what was in their immediate vision and then what was in the distance, some focused on things that were only as small as an ant, and others focused on one particular object and how it made them feel.

When we returned to the classroom each group had to collaborate on their particular focus area. I thought each person, saw, heard, smelled and felt things that other people did not even notice. For example, two people in one particular group both noticed the same statue in their area but only noticed a lamppost in front of it and the other only noticed a description post.

The purpose of the project, of course, was to illustrate that in groups people have different perspectives. Each person's perspective is important and each contributes to the whole picture. Also, it's very important to listen. The people who were instructed to only write down what they heard, heard things that the rest of us did not even notice. So, listening is an integral part of stellar teams.

What is occupational therapy?

Occupational Therapy--Skills for the Job of Living:

You'd like to brush your hair if you could only raise your arm if you could just move the muscles so you could get out of bed so you could walk to the mirror like you used to everyday without even thinking about it before you had the stroke.

After a stroke, major surgery or other illness, it can be a long road back. Occupational therapy can make the journey shorter and help to ease the frustration most people feel when they can't do things for themselves. Occupational therapy not only shortens recovery time, it helps people to become more self-sufficient by teaching them new ways to perform job and life tasks despite their physical disabilities. Things like making breakfast, brushing their hair, driving a car and earning a living. Along the way, they gain the confidence to get on with their lives.

--AOTA

(I wish I could say these are my words but this is an AOTA framed photo in one of the classrooms in my school. I love it so much that I thought I'd share it with you)

OTCAS.ORG

The occupational therapy profession is changing the way students apply to schools. It used to be that you would choose a school and apply on the school's website. Now there is a new online system for students, otcas.org. It's basically a centralized application website for occupational therapy students. You pay a a fee the web service sends your application to your schools of choice. You still have to send in some paper requirements, such as transcripts, but the site is flexible enough where even your letters of recommendation can be submitted online.

This makes me a little sad, it's like losing something...it just seems like some of the personality of the application process is lost in this. But I think I feel this way partly because I applied through a paper system and it's familiar to me. Everything is going electronic now, right? So, I guess occupational therapy has to get on the bandwagon. I also feel a little sad about all the changes because I just found out that my school no longer has a part-time option for occupational therapy students. I think this limits a lot of people who are second career like me. Thankfully, I am able to live on my scholarships and student loans so I didn't have to go part-time but many others don't have this option. So, with every change is a benefit and a loss.

I In a few years I'll probably be happy about this...

Quantum theory, chaos and occupational therapy

I have an Interdisciplinary Team Process class that basically focuses on how to effectively work in teams. We do a lot of creative things in this class.

One of the subjects we are covering is 'chaos.' We're reading a book by Margaret Wheatley that discusses how chaos can be effective in organizations. This is also known as systems theory or chaos theory. The premise is that flow of information and the formation of relationships beyond hierarchical lines opens the door for organizations to self-organize and become productive, creative, adaptive and effective. She basically says that leaders control an organization when instead they should allow organizations to be more chaotic to accomplish their goals. Interestingly, she uses quantum physics (yes, that is not a typo) to explain this.

So, last week our instructors gave us a blank sheet of paper, representing chaos, and told us to do something with it. Some groups crumpled the paper and threw it in the trash, some groups made a bowtie, some made an airplane, a few of us made those fortune telling thingies and others left the paper blank. We then had to describe why we did what we did and if we all agreed to do it (and if not, why not) and how we came to the conclusion to do what we did.

It was interesting.

Problem Based Learning

We are now in the applied section of our occupational therapy education at my school. So, over the last week we have been experiencing 'problem-based learning' (PBL) activities. Problem based learning is basically where students collaborate to solve real world occupation therapy problems. Every class period we get a bit more information about the case, in the form of doctor's notes, social worker's notes, or psychiatrists notes, just as if we were real occupational therapists. One of the most interesting things is that students do EVERYTHING. The instructors are only facilitators. So, they don't really say much. We, the students, sit in our groups, review the 'problem,' and direct our own learning process. The instructors jump in every now and again to guide our learning but that has generally been the extent of it.

I actually like this process, although it is a little frustrating because I am still new at this and need a bit more guidance. Our case has been a gentlemen named Tom, a 28 y.o. Caucasian male who has AIDS. Tom has been admitted due to complications of pneumonia and lymphadenopathy. He also shows signs of depression, isolation and loneliness.

What's interesting is that this PBL scenario is part of our Human Development course. So, one of the challenges is to determine how this disease, and his reaction to it, is affecting normal early adulthood development. This includes normal physical, cognitive, and psychosocial development. It's very interesting.

Cultural experience - Mexican Museum of Art

An ofrenda displaying the elements of earth, fire, wind and water.

These next few pics are pieces of art depicting life or events in Mexico at various times in history. The skeletons are made of paper mache!! Impressive!

The gentleman who made this ofrenda dedicated it to both his Mexican and Chinese heritage. This is only a portion of it, as it was too large to fit in the picture, but it was beautiful.

Another ofrenda displaying the elements of earth, fire, wind and water.

This is art made of sand. Isn't it beautiful???

These days one of my goals is to really focus on occupation and culture. I'm always trying something new anyways, but now I want to take it up a notch. I'd like to put myself out of my element and get a little uncomfortable at least once a month. And being out of my element does not mean I have to be uncomfortable but it does mean that I have to learn or experience something new and different.

So, on the 11th I went to the Museum of Mexican Art with one of the organizations for which I volunteer at school. I LOVED it. The art was BEAUTIFUL. We took a tour as a group and I learned quite a bit. One of the main things I learned was all about an 'ofrenda.' The closest English equivalent to an ofrenda is what we would call an 'altar,' except ofrendas are not for worshiping. Instead, ofrendas are an offering to a deceased relative as they make their way back to Earth to visit.

Living relatives decorate (is the word decorate appropriate??) the ofrenda with the favorite food and items of the deceased person as a way to honor and please them on their visit back. Of course, the deceased does not eat the food or play with the items on the ofrenda, instead they enjoy the aroma of the food and the sight of the items they used enjoy while they were alive. I learned that an ofrenda is supposed to display elements of the earth, water, fire and wind. And finally, I learned that there a lot of Chinese in Mexico, due to the Chinese participating in the building of the railroads.

Afterward, we all sat around and ate Brazilian pizza, which was delicious! I've been to Brazil and I loved the food but I never had Brazilian pizza. Overall, I really enjoyed myself!

I AM NOT MY HAIR

If you had to choose a song to describe you and/or your culture, which would you choose?

This was an assignment for our human development class today. We had to choose a song (and write the lyrics) to describe us, our culture, or are cohort. During class we used youtube or a CD to play the song while the class read along. Then we described how/why the song described us. It was so interesting. I learned so much about my classmates. We shed tears, we laughed and we were mesmerized.

Below are my song and my "Who Am I" statement. It's super looong....but all my posts are long so you should be used to it by now! I've included the video I played in class as well. I really hope you enjoy the video, the lyrics and what it means to me.
************************
India.Arie featuring Akon - "I Am Not My Hair"



Lyrics:

[Akon] See I can kinda recall Little ways back small tryin' to bawl Always been black and my hair I tried it all I even went flat, had a gumdee curly top and all the crap, now Tryin' to be appreciated Nappy headed brothers never had no ladies Then I hit by the barber shop real quick Had em give me little twist and it drove them crazy And then I couldn't get no job No corporate wouldn't hire no dreadlocks Then I thought about my dogs on the block Kinda understand why they chose a stealin' rock Was it the hair that got me this far? (uh-huh) All these girls these cribs these cars (uh-huh) Hate to say it but it seem so flawed Cause success didn't come 'till i cut it all off (uh-huh) [India Arie] Little girl with the press and curl Age eight I got a Jheri curl Thirteen then I got a relaxer I was a source of so much laughter Fifteen when it all broke off Eighteen and then I went all natural February two thousand and two I Went and did what I had to do Cause it was time to change my life To become the women that I am inside Ninety-seven dreadlocks all gone Looked in the mirror for the first time and saw that Hey... [Chorus] I am not my hair I am not this skin I am not your ex-pec-tations no no I am not my hair I am not this skin I am a soul that lives within [India Arie] Good hair means curls and waves Bad hair means you look like a slave At the turn of the century It's time for us to redefine who we be You can shave it off like a South African beauty Or get in on lock like Bob Marley You can rock it straight like Oprah Winfrey If its not what's on your head It's what's underneath and say Hey.... [Chorus] [India Arie] Does the way I wear my hair make me a better person? Does the way I wear my hair make me a better friend? nooo... (Whoa, whoa, whoa) Does the way I wear my hair determine my integrity? (Whoa, whoa, whoa) I am expressing my creativity... [India Arie] Breast cancer and chemotherapy Took away her crown and glory She promised God if she was to survive She would enjoy everyday of her life ooh... On national television Her diamond eyes are sparkling Bald headed like a full moon shining Singing out to the whole wide world like Hey... [Chorus]

"WHO AM I"

I love my hair. I can wear it short, long, straight, wavy, in bantu-knots, curly, as an afro, in a ponytail, in cornrows, in braids, in a braided ponytail, in afro puffs, in a ponytail afro puff, under a wig, fingercoils, in extensions, in plaits, in extension plaits, twist-outs, braid-outs, flat twist-outs, bantu-knot twist out, bantu-knot braid-out, teeny weeny afro, chunky afro, chunky twist-out, curly afro…and that’s not even the end of the list! I love all the creative styles in which I can wear it. I love using my hair as an expression of my feelings. I love washing my hair, styling my hair and learning my hair’s (sometimes fickle) personality. My hair is an extension of me, but it is not me. I recently cut off my long tresses in an attempt to rid my hair, and my body, of the chemical relaxers used to straighten my hair for most of my life. I want to wear my natural, afro-textured hair. I enjoy the flexibility of it, but mostly, I love creative, funky hair. I love this song, I Am Not My Hair, by India.Arie. I’m very attuned to hair and the power it has over us, especially as I watch my aunt battle breast cancer. In a way, the lyrics to this song represent my ‘coming of age’ story about my hair. It describes perfectly the decades-long internal and external battle I went through before deciding to eliminate relaxers from my life. This song describes the judgments and perceptions attached to natural black hair. It reveals the positive and negative reactions of others, the personal experiences that accompany wearing various natural hairstyles, and the overall importance prescribed to hair, particularly for women. But ultimately, with straight hair, curly-afro hair or no hair, I am always me. I am not my hair. I am not this skin. I am always the soul that lives within.

My Dad was in the hospital!!!

Ok, so I need a SPANKING!!!! or as my Granny would say -- a WHIPPING!!!!

Today my Dad had to go to the emergency room because his blood pressure was over 220! Yes, 220!!! Earlier today, he was at my sister's house and complained of dizziness. My sis is a nurse so she took his blood pressure. When it popped in at over 220 they called the ambulance and rushed him to the hospital.

Turns out he had not taken his blood pressure medication in 3 days and his body was not reacting too kindly to that. He said he hadn't had time to go to Walgreen's to get it.

Not good enough, dad. You can do better.

So, first, I chewed him out for not calling one of us to help him get his medication. Then I chewed him out because he didn't tell me he was in the hospital, I just so happened to call him and heard all the beeping noises! "Well, I didn't want to worry you guys.." DAD!!!!!!

Then I had to slap myself on the wrist because Dad said, "Well, I get it now. The nurse explained to me the consequences of high blood pressure."

I'm sorry, back up. WHAT? I'm an OCCUPATIONAL THERAPY student! My sister is a nurse. My other sister is in school studying nursing. How the heck does this happen??!!! Shame on us for not educating Dad more on the dangers of high pressure. Dad's bp is high because of his weight. Period. The docs always say he's in good health, he just need to drop some weight.

It's shameful that his own children have not taken the time to explain what blood pressure is and its terrible effects on the body. I'm so ashamed of myself! Really! And I'm ashamed to be admitting this on the Internet.

Remember when I wrote the post on health literacy last year??? This is a perfect example of why health literacy is so important. One of us should have explained to Dad that he needs to take his medication EVERY DAY, no excuses, and, better yet, lose weight and lose the necessity to take medication.

The other side of the coin is that family often will not listen to you because you're "little such-and-such." They still see you in diapers and goofy glasses saying 'ga ga goo goo" instead of as the knowledgeable health professional you truly are. We've talked with our Dad about his health and he always says he's gonna be better but he never follows our instructions. We have to stay on him and make sure he loses weight and takes his meds. My dad is barely 60!!!! He's active, he's lucid, he's awesome. I would be heartbroken if he passed on suddenly. HEARTBROKEN.

So, please learn a lesson from this. Talk to your family about their health and make sure they understand why it's important to follow the doctor's directions and/or take preventative measures.

Going to the emergency room is NOT fun. And I'd hate to one day get the OTHER phone call...particularly for something that is avoidable.

Dad's wallet was stolen

So, dad is one of those men that has a big, bulky wallet with receipts and papers hanging out of it. This is a conversation we had earlier today as I was reaching for his wallet to get his medical card.

Me: Wow, dad you got a new wallet?

Dad: Yeah, someone stole my other one. They stole it from my car right in front of the house!

Me: Why did you leave it in your car?

Dad: I always leave it in my car because I take it out my pocket so that I'm not sitting lopsided. And you wanna know what the crazy part is??

(dramatic pause)

They stole it from my car again a week later.

Me: But, isn't it crazier that you left your wallet in your car a second time after someone stole it the FIRST time?

Dad cracks me up sometimes. He's so trusting. But don't worry, he never leaves any cash in his wallet and the cards never work anyway. He's silly!

I WON A PRESTIGIOUS SCHOLARSHIP!

I won a very prestigious award last week! It's called the E.K. Wise Scholarship and it's supported by AOTA. I applied for it a few months ago and I actually got it!!!! I am soooo excited. Only three occupational therapy students nationwide were selected.

The director of my department sent me a congratulatory note and cc'd all of the occupational therapy faculty. I'll be interviewed by the College of Health and Human Services here at my school and have my photo and the interview published in the newsletter. As my director pointed out, this is a very prestigious (I feel like I keep saying 'prestigious') award for both myself AND the school.

So, wow, I just put the school on the map. ;-)

I feel pretty darn good about this!

GARY KIELHOFNER DIED!

(This is a random picture I pulled from Google because I didn't want to take a picture from UIC or AOTA. So, AOTA or UIC if you're reading this, I did not infringe upon your sites. Please don't punish me :-)

Dr. Gary Kielhofner died last week.

I forgot to mention this, I apologize. Dr. Kielhofner is an integral part of occupational therapy because he created a well-known, widely used model--The Model of Human Occupation, otherwise known as MOHO. This model actually was the result of Dr. Kielhofner's thesis. How amazing is that?! In a nutshell, the model explains how patterns in occupation are formed, hwo the environment influences occupation and how people are motivated to perform occupations. Anyone can use this model (not just those with disabilities) and it can be used throughout the lifespan. (for a direct link to Kielhofner's MOHO site, click here.) I personally find the model very interesting and have an upcoming project to study it further for my human development course.

Interestingly, one of our textbooks was authored by Kielhofner. We had an occupational therapist and student of his who worked closely with him come to our class to give a lecture on MOHO. He was also the head of the Dept of Occupational Therapy at the University of Illinois-Chicago campus, which is about a 10 minute drive from my house! One of my instructors informed us of his illness last week; she bought a card and we all signed it. Unfortunately, we signed it on a Tuesday and I believe he died the next day.

It's very unfortunate.

Keep quiet, listen, and just let them talk.

I'm always looking for ways to improve certain behaviors. One thing I'm really working on these days is truly listening to what people say...and what they don't say. I want to notice their body language, facial expressions, and intonations and interpret what they are truly saying. Instead of reacting to something I find disagreeable I want to listen and ask questions as to why a person believes what they believe.

So, the story--I am 31 years old. As my mechanic was fixing my car he commented on how surprised he was to find out I am 31 as he thought I was in my 20s. He then went on to comment that I should be working on having kids now because if I don't I'll be a 40 year old mother (I'll be a 40-year old mother whether I have kids now or not because you're ALWAYS a mother, but that's another conversation). Time is running out, he argued, and I'd better hop to it.

I was annoyed.

I started to argue with a him a bit about how waiting has afforded me opportunities and experiences that younger mothers can't experience. And then it hit me--'why am I arguing with him?' Everyone always wants to give you unsolicited advice on how to live YOUR life. So, I decided to just listen to what he was saying and let him think he was teaching me something.

And so I listened.

He didn't ask why am unmarried or if I am going to marry soon. He didn't ask if I am dating or what my plans are for a family. He didn't ask if I was even interested in having a family, he assumed that's something I would want. He didn't ask about my experiences or where I've been or what I've seen in the world. He didn't try to find out about ME, which I found alarming; he only made assumptions about who he thinks I am. Clearly something was going on in his life where he felt the need to give me advice based on his LIMITED perspective. His current situation is not favorable. I won't tell you everything that is going on with him but I will say that he is 38 years old and lives with his mother. He's always giving me advice on something of which I am more of the expert. And yesterday I just decided to let him talk.

When I'm an occupational therapist I don't want to talk AT people like this gentlemen did without getting all the information first. He knows nothing about me. He put me into his little box and I could only be what his box dictates. I never want to treat my clients like this. Ever. It doesn't individualize people or take their perspective and life experiences into account.

And so I think I'm going to work on listening more. It's interesting what people tell you when you just shut your mouth and really listen to what they are saying. I'd better get used to it because there will be a lot of clients that feel the need to 'teach' me or think they know more than me.

I'm learning to keep quiet, listen, and just let them talk.

School started on Monday!

Btw, school started on Monday! We're FINALLY getting to the meat and potatoes of the curriculum. I'm learning more hands-on occupational therapy! It's amazing. I love it!

Tomorrow we meet with children and 'document' them. This is exciting because this term fieldwork is in....drum roll please...PEDS (peds is short for pediatrics). Yeah! So, I'll be learning a lot about human development and kids.

One thing that I REALLY appreciate about my university is that we have FIVE fieldwork experiences. We have three Level I experiences--mental health, behavioral health and physical dysfunction--and two Level II's. Only ONE Level I is required by AOTA and, because it's currently midnight, I can't remember how many Level II's are required. lol. I'm tired.

Anyway, we receive a very rich fieldwork experience.

It's wonderful and fabulous, isn't it?

Good night!

Icebreaker game

Here are some pics of a game we played with the girls at the Girl's Home while on fieldwork. This is a game we made up to keep the girls occupied and give them something to laugh about, despite their circumstances.

In this game, everyone sits around a table with a blank piece of paper and a marker or crayon. The leader yells 'Go!' and everyone starts drawing a picture. It can be any picture of their choosing--a house, a flower, a cross, food, a face, etc. After 10 seconds, the leader yells 'Switch' and everyone gives their paper to the person to their right (or left) who then adds to the drawing. After another 10 seconds you switch again and the third person adds to the drawing. This continues until the owner receives their drawing.

This is a fun game because when you receive your drawing it's interesting to see what the others in the group have added to it. Sometimes the pictures are drawn very well, sometimes they are silly and other times they are nonsensical. But it's great to talk and laugh about what others have added to the drawings.

Although we played this game with teens, I think this would be a great game to play with kids.The excitement doesn't last very long (one of the girls said 'ok, this is getting boring' after about 3 rounds), but it's a lot of fun while you're playing and it's a great icebreaker.

Grieving

When my grandmother died last October my grandfather went through a serious depression. Emphasis on the word SERIOUS. My mother feared that he would not make it. His mental state was so weak that she had to commit him for fear he would commit suicide. He lamented that he was unable to go on without my grandmother. Some days I would call him and say, "Hey Grandad, how ya doing?" and he would answer in a voice that would break my heart, "I'm not doing so well today."

Have you ever heard someone speak to you in a tone that was totally unlike them, and as a result completely unfamiliar (and a little scary) to you? For months, this is how my grandfather sounded. He couldn't bear to be alone (remember he and my grandmother were married for over 50 years). It took a lot for me to talk to him and keep engaged.

I share this with you because as occupational therapists we have the opportunity to work with the families of our patients. Depending on the situation, the family may know that the patient will die soon. Or, perhaps the patient has suffered a recent injury and the injury resulted in a loss. The loss can be that the person is no longer able to participate in meaningful activities. The person, and perhaps their family, may experience the grieving process. They will grieve, and as the health care professional, you have to counsel them while providing health services. Sometimes this means listening, sometimes allowing them to cry, sometimes allowing them to feel angry or hurt. This encompasses many things. This is the human service side of occupational therapy and it's very important.

If you've ever suffered a loss think about all the wonderful things people said to you to help you feel better or get through that difficult time. Also, think of all the terrible things people said to you. If you know someone who suffered a loss think of all the wonderful and terrible things you may have said to them. It's important to channel those memories when dealing with clients during these times. I believe it makes us better health care professionals.