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This is thepresentation that I gave as part of the #OT24vx- the24 hour Virtual Exchange for OT in celebration of World OT day, which in 2011 was themed "Pay it Forward". It was hosted by the excellent OT4OT group, leaders in the use of Online Technology in the profession of Occupational Therapy. My biography: http://ot4ot.files.wordpress.com/2011/05/abstract-ot24vx-jones.pdf The link to the presentations with audio and video is here, please see presentation 18 http://ot4ot.com/world-ot-day-2011/ All content is copyright, please get my permission to use this for teaching purposes and group work.
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Claire Jones
• “Lateral scissoring” can irritate a misaligned pubic symphasis.• Many activities create lateral scissoring motion, e.g. walking,
running, climbing hills and stairs, carrying shopping or children unevenly.
• Photo credit:
The Pubic
Symphasis
“Volition, habituation and performance capacity are maintained and changed through what one does and what one thinks and feels about doing” p.27
“A shift in volition, habituation, performance capacity or the environment can alter the overall dynamics, leading to the emergence of something new” p.28
Keilhofner, G. (2008) Model of Human Occupation, 4th
ed.
Volition• Driven personality
• High pain threshold
• Pride in Joint breadwinner role
Habituation• Very busy lifestyle
• Long hours on feet
• Used to running/ lifting/
carrying
Environment:• Housing-
Steep hill with no vehicle access
Carrying shopping up the hill
Often carrying toddler up the hill
Steep stairs in back-to-back housing
House on three floors
• Work- Very busy M H Inpatient
Ward
Poor advice from GP and Midwife• outdated with reference to published research about PGP,
• services under re-organisation led to use of locums without specialist expertise,
• administrative and communication problems,
• my pride- perhaps I didn’t state my case forcefully enough?
Good advice from Doctor at work • recognised the problems with my gait and insisted I pursue the physio.
referral, despite several unsuccessful attempts
Finally, advice from Physio• Physio couldn’t believe I was still working with the level of injury
Started OT on Wheels blog http://otonwheels.wordpress.com/2010/06/26/so-what-happened-to-you-anyway-why-you-in-that-chair/
“Occupational deprivation is...a state in which a person ...(is) unable to do what is necessary and meaningful in their lives due to external restrictions.
It is a state in which the opportunity to perform those occupations that have social, cultural and personal relevance is rendered difficult if not impossible.”
(Whiteford, 2000)
•Side lying with knees
gripping pillow is most
comfortable position
•It is surprisingly difficult
to do things in this
position!
•Started to use
painkillers and
mindfulness to deal with
pain
Using services gave me valuable insight into the service user experience- things don’t always go the way we think they should!
Took delivery of a bed-stick, two urinal bottles from OT- at last I can get out of bed independently!
Blogged about attitudes of the staff and services I encountered, including Patient Transport
If I can’t work the system, what hope has anybody?
http://otonwheels.wordpress.com/2010/06/30/disabled-people-arent-allowed-to-be-parents-btw/
http://otonwheels.wordpress.com/2010/06/27/a-few-examples-of-how-disabled-people-are-treated/
http://otonwheels.wordpress.com/2011/04/29/patient-transport-again/
DLA- Disability Living Allowance• Benefit in the UK for people to address the increased
cost of living with disability• Very difficult process to claim, but necessary as a
gatekeeper to other disability serviceshttp://otonwheels.wordpress.com/2011/02/14/valentines-day-my-dla-story-ombh/http://otonwheels.wordpress.com/2011/04/22/still-waiting-to-be-awarded-dla/http://otonwheels.wordpress.com/2011/04/22/i-finally-won-my-dla-tribunal/http://otonwheels.wordpress.com/2011/04/23/higher-rate-mobility-dla-it-means-freedom-i-hope/
Motability• Scheme in UK where part of DLA is sacrificed to
provide independent transporthttp://otonwheels.wordpress.com/2011/05/16/all-aboard-the-motability-scheme-renault-review/http://otonwheels.wordpress.com/2011/05/22/motability-scheme-citroen-c4-grand-picasso-review/
Cried each night before going back up the stairs- it hurt so much
Despairing about the future
Hoping that after the birth I would recover quickly
Blogged about problems in the home http://otonwheels.wordpress.com/2010/06/26/whats-the-access-to-my-house-like-rubbish-and-heres-too-much-information-about-how-it-is-in-
the-house-too/
Successful elective c-section
Celebration shared through Social Media-#clairesbaby is born!
Baby develops anaemia within first few hours of birth- soon becomes critically ill
What is it?• Haemolysis leads to elevated bilirubin levels. After
delivery, bilirubin is no longer cleared (via the placenta) from the neonate's blood
Symptoms• Jaundice increase within 24 hours after birth.
Treatment is• Phototherapy• Exchange blood transfusion
http://en.wikipedia.org/wiki/Hemolytic_disease_of_the_newborn
#clairesbaby Tweets became huge source of support
Agreed treatment:
• Triple phototherapy
• Fed baby expressed milk under phototherapy lamps
So happy she was going
to make it!!
Allowed to resume
breastfeeding
And to pick her up for
cuddles
Looking after baby from my
bed- all dressing, nappy
changing and feeding done
in the same way.
Bathing baby in hospital
breastfeeding room-
partner needed to carry
filled bath to table in order
for me to participate in
bathing
PROBLEM SOLUTION
Couldn’t open
heavy fire doors
from wheelchair-
need access for
• Meals
• Toilet
• Shower
Make friends with the
housekeepers, who
brought me meals and
tea!
Plan loo visits during
visiting hours when
many people around to
hold doors
Have daily shower
when I have my own
visitors
Handy grab Toilet frameUrinals (downstairs
and bedroom) Bath seat Shower seat Perching stool
(bathroom) Bedstick Trolley Zimmer Frame
I want to go home, but
don’t know how I’ll
manage!
Home Care helped to: Carry baby downstairs PADL
• Showering• Dressing bottom half• Emptying urinals
DADL• Hoovering• Pegging out washing• Making a cup of tea• Ironing• Making bed• Washing up
Blogs http://otonwheels.wordpress.com/2011/0
1/23/the-woman-who-would-not-take-off-her-shoes-in-which-i-discuss-my-disappointment-with-home-carers-lack-of-respect/
http://otonwheels.wordpress.com/2011/01/23/social-care-the-forgotten-public-service-in-which-i-discuss-the-lack-of-education-of-the-role-of-the-helping-professions-in-our-primary-schools-at-key-stage-1/
http://otonwheels.wordpress.com/2011/09/23/a-funny-story-about-psychosis-in-which-i-discuss-occams-razor/
http://otonwheels.wordpress.com/2011/01/23/social-care-the-forgotten-public-service-in-which-i-discuss-the-lack-of-education-of-the-role-of-the-helping-professions-in-our-primary-schools-at-key-stage-1/
Still in pain, but healing from the birth now
Still find side lying to be best relief from pain
Parenting tasks very difficult- Nappy changing Couldn’t carry baby Couldn’t bathe baby Couldn’t use oven
My set-up each
morning- reducing
trips up and down
stairs- keep
everything handy!
Receiving services- not providing services!
• Daily Home Care
• Family aide 3x weekly
• Social Services transport
• Wheelchair Taxi http://otonwheels.wordpress.com/2011/02/28/
going-out-maybe-or-maybe-not-in-which-i-discuss-problems-booking-out-the-wheelchair-taxi-service/
http://otonwheels.wordpress.com/2011/04/22/access-to-my-house-from-car/
• Physiotherapy• Perinatal Mental Health
Support• GP• Pharmacy delivery
Found online support networks to be invaluable
Couldn’t get out to meet friends
Couldn’t get to schoolHousebound, except
when partner / wheelchair taxi took me for medical appts
Kubler-Ross
Cycle of grief
Denial-Anger-Bargaining-Grief-Acceptance
http://otonwheels.wordpress.com/2011/01/23/life-changing-injury-in-which-i-start-using-the-kubler-ross-stages-of-grief-model/
http://otonwheels.wordpress.com/2011/06/02/feeling-rotten-sucks/
Impact on friendships:
http://otonwheels.wordpress.com/2011/09/19/so-good-to-see-you-back-on-your-feet-again-in-which-i-discuss-the-well-meaning-but-misinformed-friend/
http://otonwheels.wordpress.com/2011/02/14/a-little-knowledge-is-a-dangerous-thing-in-which-i-discuss-medical-student-syndrome/
Starting to accept my situation- assessing how I lived my life before and after disability
I didn’t miss my daughter’s
Nativity- first Family outing!
Spiritualityhttp://otonwheels.wordpress.com/2011/09/24/
faith-and-healing-in-which-i-discuss-faith-healing-prayer-and-christianity/
Familyhttp://otonwheels.wordpress.com/2011/03/13/
a-weekend-away/http://otonwheels.wordpress.com/2011/05/15/
childcare/http://otonwheels.wordpress.com/2011/05/17/
childcare-2-time-to-start-letting-go/
Fit for work?
http://otonwheels.wordpress.com/2011/04/29/fit-for-work/ http://otonwheels.wordpress.com/2011/06/09/telecommuting/
Personalisation
http://otonwheels.wordpress.com/2011/04/23/a-tale-of-personalisation-in-adult-social-care-personal-budgets-and-how-i-still-cant-access-them/
Disablism
http://otonwheels.wordpress.com/2011/09/17/disabled-or-just-lazy-scroungers-in-which-i-discuss-the-home-care-ladys-disablism/
Pelvic Instability Network Scotland• http://www.pelvicinstability.org.uk/pregnancy.asp
Pelvic Partnership• http://www.pelvicpartnership.org.uk/
Wikipedia• http://en.wikipedia.org/wiki/Pelvic_girdle_pain
Kielhofner, G. (2008). Model of Human Occupation (4th ed.) Lippincott Williams and Wilkins. Baltimore.
Kübler-Ross, E. (1969) On Death and Dying, Routledge. Cited on Wikipedia. Accessed 17.35 25/10/11
[http://en.wikipedia.org/wiki/K%C3%BCbler-Ross_model]
Whiteford, G. E. (2000). Occupational deprivation: Global challenges in the new millennium. British Journal of Occupational Therapy, 63(5), 200–204.
Haemolytic Disease of the Newborn. Wikipedia. Accessed 15.05 07/09/11
[ http://en.wikipedia.org/wiki/Hemolytic_disease_of_the_newborn]
Nhs local (2011)Women with pelvic girdle pain left in agony unnecessarily. Thursday 31st March. Accessed 15.05 07/09/11
[http://nhslocal.nhs.uk/story/women-pelvic-girdle-pain-left-agony-unnecessarily]
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Blogs:
Claireot.wordpress.com
Otonwheels.wordpress.com
T: @claireot
G: +claireot