Thanks Mary Alice, I'll try your suggestion the next time I meet with the patient.
Ron ----- Original Message ----- From: Mary Alice Cafiero <[EMAIL PROTECTED]> Sent: Saturday, May 26, 2007 To: [email protected] <[email protected]> Subj: [OTlist] OTnow Colloboration With Spinal Cord Injury MAC> Ron, MAC> Most people I have worked with actually move their upper body first MAC> and then physically lift their legs and move them over. In other MAC> words, they press down and lift their bottom up and scoot over toward MAC> wher they are transferring. Depending on how far a distance it is, MAC> they may have to bring their legs over after each scoot or they may MAC> be able to complete the scooting and then move their legs at the end. MAC> If they move their legs first, it usually will make balance too MAC> "off". At least that has been my experience! MAC> Mary Alice MAC> On May 26, 2007, at 3:54 PM, Ron Carson wrote: >> Thanks Rob. >> >> Yes, she definately needs to address dynamic sitting balance. But >> this >> will improve quickly. She's been wearing her TLSO for many, many >> months >> and we just started weaning her off. >> >> Will you further explain the "press transfer". The patient has >> NO LE >> movement. I envision that she will need to physically place her >> LE in >> the direction of transfer and then push up her bottom and >> swing her >> torso over her legs. Is this technique the same as the "press >> transfer". >> >> She has no bowel/bladder control so toilet transfers are not an issue. >> >> I already talked with her about hand controls. >> >> Keep the ideas coming. Also, I'm sure more questions will develop >> with >> time. >> >> Ron >> >> ----- Original Message ----- >> From: Rob Koch <[EMAIL PROTECTED]> >> Sent: Saturday, May 26, 2007 >> To: [email protected] <[email protected]> >> Subj: [OTlist] OTnow Colloboration With Spinal Cord Injury >> >> RK> Ron, >> RK> I always start by considering what the person needs to >> RK> do in daily life. >> RK> At this level of injury the person should become >> RK> completely independently from the wc. So the goal is >> RK> to try to get the patient to buy into the idea that >> RK> the goal is to be independent - not walk again! >> RK> Unless of course she has an incomplete injury with leg >> RK> movement. >> >> RK> So on to a purely occupational therapy session! >> RK> Start with LE dressing in bed or first transfer >> RK> intothe wc and then get dressed. >> RK> She may be able to get dressed better in the chair. >> RK> The goal should be to press transfer (without board) >> RK> at her level. >> RK> Next she can practice transfer to toilet and do >> RK> toileting. >> RK> Transfer to the tub transfer bench and do bathing >> RK> Obviously all these functional tasks require sitting >> RK> balance work. >> RK> After self care is done time to make breakfast. >> RK> Propelling chair into and around kitchen opening >> RK> refrigerator, drawers, cabinets and using the stove, >> RK> microwave. >> RK> A big part is making sure everything is accessible >> RK> from wc. >> RK> Since she doesn't have to do lifting and self care >> RK> activities with the child she can work on making >> RK> breakfast for the family. >> RK> If she is a homemaker it is on to homemaking >> RK> activities from the chair >> RK> Laundry, dishes, etc emphasizing accessiblity all the >> RK> time and work simplification >> RK> If she if off to work car transfers will be mandatory. >> RK> She should be able to drive with hand controls. >> RK> She should also experience life in the community - >> RK> shopping, movie, buying gasoline, etc - how accessible >> RK> is the world around her? >> RK> Find out in OT! >> RK> Many, many opportunities for good "occupation-based" >> RK> therapy. >> RK> Rob Koch >> >> >> RK> I assume the woman has a complete injury - otherwise >> RK> squat/stand pivot transfers >> RK> --- Ron Carson <[EMAIL PROTECTED]> wrote: >> >>>> Here are some specifics: >>>> >>>> 1. There is no insurance >>>> >>>> 2. The patient is young, late 20's, mid 30's >>>> >>>> 3. She lives with her husband, sister and her >>>> husband >>>> >>>> 4. She has a 4 y/o daughter >>>> >>>> 5. There is no primary care doctor; She typically >>>> uses the ER >>>> >>>> 6. We have just starting weaning her off her TLSO >>>> >>>> 7. She has a donated power w/c (reclining captain's >>>> back) >>>> >>>> 8. She has no pressure ulcers >>>> >>>> 9. She is able to sit without assistance and >>>> without her TLSO. But she >>>> has LOB with UE movement. But this will shortly >>>> correct with practice >>>> >>>> 10. She is undergoing a sacral nerve stimulator >>>> trial to hopefully d/c >>>> cathing and suppository/digital stimulation. It >>>> seems to be working OK >>>> >>>> 11. She has good UE strength >>>> >>>> 12. Initial goal is indpendent with transfers. >>>> Currently uses a sliding >>>> board with min - max assist depending on incline. >>>> I envision that she >>>> will be able to d/c sliding board and do her >>>> transfers w/o assistance. >>>> >>>> 13. I also think a long term goal is for her to get >>>> a ultralight-weight >>>> w/c. >>>> >>>> 14. She has a weight issue but she is struggling to >>>> find enough activity >>>> to off-set her caloric intake. >>>> >>>> 15. They have no computer so on-line resources are >>>> not possible at this >>>> time. >>>> >>>> OK, hit me with some transfer ideas!!! And any other >>>> suggestions. >>>> >>>> ----- Original Message ----- >>>> From: Ron Carson <[EMAIL PROTECTED]> >>>> Sent: Friday, May 25, 2007 >>>> To: [email protected] <[email protected]> >>>> Subj: [OTlist] OTnow Colloboration With Spinal Cord >>>> Injury >>>> >>>> RC> Hello All: >>>> >>>> RC> I recently agreed to treat a patient who >>>> suffered a T9-T10 SC injury >>>> RC> late last year. She has just been d/c to her >>>> home after several months >>>> RC> of rehab. While I have worked with SC injury >>>> patients, I do not consider >>>> RC> it a speciality. There are SO many issues to >>>> manage and address that it >>>> RC> can be a bit overwhelming. Given that I >>>> work alone, I don't have a >>>> RC> 'team' to bounce off ideas, so I'm hoping that >>>> OTnow members will be my >>>> RC> surrogate team? <smile> >>>> >>>> RC> I would like to give and receive advice on >>>> topics relating to this case. >>>> RC> Do you think this will work? Will people >>>> participate?? >>>> >>>> RC> Thanks, >>>> >>>> RC> Ron >>>> >>>> >>>> >>>> >>>> -- >>>> Options? >>>> www.otnow.com/mailman/options/otlist_otnow.com >>>> >>>> Archive? >>>> www.mail-archive.com/[email protected] >>>> >>>> >> RK> >> ********************************************************************** >> **************** >>>> Enroll in Boston University's post-professional >>>> Master of Science for OTs Online. Gain the skills >>>> and credentials to propel your career. >>>> www.otdegree.com/otn >>>> >> RK> >> ********************************************************************** >> **************** >>>> >> >> >> RK> Need Functional Therapy Activities? >> RK> http://hometown.aol.com/MrFunction >> >> >> >> >> >> >> RK> >> ______________________________________________________________________ >> ______________Got a little couch potato? >> RK> Check out fun summer activities for kids. >> RK> http://search.yahoo.com/search?fr=oni_on_mail&p=summer >> +activities+for+kids&cs=bz >> >> >> >> -- >> Options? >> www.otnow.com/mailman/options/otlist_otnow.com >> >> Archive? >> www.mail-archive.com/[email protected] >> >> ********************************************************************** >> **************** >> Enroll in Boston University's post-professional Master of Science >> for OTs Online. Gain the skills and credentials to propel your career. >> www.otdegree.com/otn >> ********************************************************************** >> **************** -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] ************************************************************************************** Enroll in Boston University's post-professional Master of Science for OTs Online. Gain the skills and credentials to propel your career. www.otdegree.com/otn **************************************************************************************
