Vol. 23 Issue 5
Occupation for Endurance
After spending as many years as I have delivering OT services (50 years now), it is an interesting experience being on the other side of the bed. Luckily, I have been in good health all these years except for the occasional flu or the like. But recently, I've encountered two limiting experiences that make me better understand the role of patient, and I must say, it's about time. I probably would have been a better therapist all this time.
A few months back I tore a rotator cuff in my left shoulder, and was eager not to have surgery if it would mend on its own. Along with the problems with buttoning my bra, putting on my coat and fastening the seat belt in my car, I had to endure the many jokes about how my pitching arm needed to heal before spring training began. While that healing was under way, I encountered a case of faulty gall bladder which had to be taken care of.
So now I couldn't reach to the right or the left, couldn't carry anything heavy, and worst of all, had to eat a limited diet when everyone was eating the delicious Super Bowl food my husband had prepared. I was on clear liquids. Ugh!
Needless to say, I was very cranky. Turning over in bed became a logistical nightmare, forcing me to haul a living room chair into the bedroom so I could sleep sitting up. In addition, the weather in the Northeast turned very cold, so that going for a walk was very unappealing. What to do? What to do? Life became infernally boring. Cranky turned to grumpy, and unpleasant was my new middle name.
The solution was to draft a treatment plan for my patientme.
Last month I wrote about my bonsai collection. I didn't realize that one of the solutions would come from that quarter. I found that I could sustain my arm at shoulder flexion for a greater period of time while playing with my little plants than if I was only doing exercises. I raised the plants up so the tops were at shoulder height to encourage reaching. The pruning of the little trees was totally non-resistive with the exception of the weight of my arm alone. Of course I was motivated to do those activities, so I kept it up until the plants were looking like I wanted them to.
Another interest of mine is training and exhibiting dogs. My family has been into that sport for almost as many years as I have been an OT. As it happens, the Westminster Kennel Club Dog Show takes place in the middle of February each year, and I haven't missed a show in more years than I can remember. We have friends that we only get to see once a year when they make their way to New York City for this event, the longest-held sporting event. Some nurturing friends and family saw to it that I got to the show and took my usual seat in the box friends and I have shared for many years.
Keeping up with e-mail kept me busy. That and computer games filled many hours. Being able to correspond with friends when one is not feeling well is wonderful. And if your sleep cycle is irregular, the computer is always available to fill the time. The messages remain to be read at everyone's leisure.
Another long time interest of mine is old movies. I love the black and white films of my youth. They are like old friends.
Not long ago two friends of mine turned me onto Sudoku. This came just in time to keep me focused. I must have gotten sufficiently caught up in this compulsive activity that other friends noticed, because I got several holiday presents on this theme. I had plenty of these puzzles to keep me occupied.
Books, newspapers, needlework and a nightly backgammon tournament with my husband rounded out my activity schedule. I've just gotten the go ahead on driving, so I expect I will be shopping soon to build my walking around stamina in preparation for returning to work. I can't wait. Maybe I will be a more sensitive therapist now that I have had this experience. I sure hope so.
Estelle Breines, PhD, OTR, FAOTA, is nationally known for her study of the creative process in therapy. Her latest book is the 2nd Occupations and Activities from Clay to Computers. She is currently president of the New Jersey Occupational Therapy Association and has a private practice, Geri-Rehab Inc, in Lebanon, NJ. Readers may e-mail Dr. Breines at firstname.lastname@example.org or go to her new Web site at www.grbookpublishers.com.
It's a Mind-Body Thing
Though everyone seems to know that mind and body work together, the fact is still given only lip service in the Western medical community, where mental and physical dysfunction are still treated in two separate medical arenas.
To bring them together requires a little cutting and pasting.
And, in fact, our Web search for "activity and recovery from illness" yielded many pages, very few of them involving activity other than exercise, and none of them involving occupational therapy, unfortunately.
But one small article on The American Cancer Society's Web site actually listed ADL as a great form of exercise (after going through a raft of exercise protocols and contraindications). It suggested things like "taking a walk around your neighborhood after dinner," "riding your bike," "mowing the grass," "playing active games with the kids (especially those you liked to play as a kid), "taking a friend dancing," etc.
All of these things provide distraction from pain and fatigue; and distraction, as any dentist or pediatrician knows, lessens the degree of pain perceived. It's also true that the physical exertion of mowing the lawn, in this particular case, may actually "replace" some of the pain sensation.
All of these activities, of course, are occupational pursuits. They help to make you feel productive rather than defeated, and fill your time with something healthy.
Motivation is highly linked to hope and self image, which is the core of self-esteem. The whole philosophy behind cognitive therapy for depression is that if you actually do what you dread doing, and then objectively evaluate how you felt about it while you were doing it, you'll discover it wasn't as bad as you expected. Gradually, you stop expending energy in resistance, and put it into positive action.
And isn't cutting and pasting mind and body together in healing really what OT is all about?