Most women wait…

Most women wait over six years before they tell their doctor if they struggle with bladder or
bowel incontinence. Men wait even longer. Embarrassment leads to this delay in reaching out for help.
Other times, people leave this issue unaddressed because they believe incontinence accompanies aging.

Pharmaceutical advertisements help shed light on this issue with promises to reduce the strong
urge to urinate and stop dribbling for men and women in order to make life more manageable. In
addition to pharmaceutical interventions, physical and occupational therapists with specialized training
and certifications provide treatments that also resolve, reduce and improve bladder and bowel
incontinence.

All too often, people receive therapy for incontinence and simply go home with a handout on
Kegel exercises only to find the problem doesn’t improve and frustration increases. To most-effectively
treat incontinence the problem needs attention from a specialist. Trained therapists can utilize
biofeedback to discover what is truly causing clients’ incontinence. Biofeedback allows the therapist and
their clients to see how the muscles that provide bladder and bowel control are performing by
measuring their electrical activity and projecting it on a computer screen. This visual feedback assists in
determining what is actually causing the incontinence, even in complex medical cases and chronic
conditions or diseases and then the most appropriate treatment regime is developed.

In addition to assessing the deep internal muscles of the pelvis, therapists provide helpful
education for bladder and bowel health, home exercise programs, how to avoid irritants and most
importantly, enjoy life, family and the community without the stress and difficulty of incontinence.

This entry was posted on July 20, 2012. 1 Comment

Stories Tell….

So much of what we put out into the online universe is based on education. Facts. Stats. We have heard so many. And we often forget. I think one of the best things I can put out there for people to stumble upon are stories of my journey. I am not the only OT in the world. I am not the only person to have experience with death, dying, older adults, success in recovery, happiness or joy. But, for what it is worth I am submerged into a world that most people do try to avoid. I have learned to embrace it.

 

My first story comes from an experience I had last week with a client. I have seen him at his home for OT off and on for about two years. When I met him he was resistant to therapy and help. An ex-marine, retired doctor and specialist, a hunter, a father of five, a respect from his community that won’t quit, a sharp tongue… Yes, I was a little nervous if he would accept me as some 30 something, blond, OT that could help him. To say the least, he has. I have become incredibly attached to him and his busy-bee wife. Over our treatments together, he has learned how to manage with the right-sided weakness from a stroke, deal with pain in his eyes, integrate equipment to keep him safe like a commode and bedrail, accommodate for delays in his speech and deal with a right hand that moves like a mitten due to his stroke. We’ve trialed knee braces, dealt with falls, given education on swallowing strategies and worked like crazy to bring that strength and balance back. For stretches of times, we have been successful. Last week, we took a turn. His body is failing. 

His affected leg from his stroke has a mind of its own. It won’t cooperate with him; it steps when it shouldn’t and it stays stuck like lead when he pleads for it to move. His knee buckles and luckily his arms are as strong as mine. He braces himself on the walker to avoid a fall and I keep a belt on him to hold him up in case he can’t do it. His wife and caregivers do the same. 

Last week I showed up and instead of being in his straight back chair he was in his recliner. I knew he was not feeling well. I asked if he wanted to walk. For the first time in almost 2 years he said no. His caregiver told me it took 30 minutes to get down to his beloved “man cave” today–the basement with his big TV, his impressive displayed fish on the walls, his photos of his travels, his bear rug, his peace and quiet. She was afraid she would drop him. He told me he couldn’t control his body and for the first time I didn’t see the tough, ultra-strong man I knew. I saw an old, feeble man… scared of the changes he was going through.

We have a jovial relationship. We kid and talk about travel. We talk about politics and sports. Our points of view are very aligned. We aren’t super loving in action. We don’t hug. We take care of business and do therapy. We work hard to make him better and do it together. But, today I touched his leg in empathy, not for exercise. He looked at me. He started to cry.

I learned the power of silence in social work school. We women tend to over-talk. Fill the gaps and voids. We try to give comfort in words and busy-talk. Today I sat and said nothing. I never looked away but I stayed quiet. I never took my hand from his leg. He looked at me and said, “I want to die but I can’t.” When someone says something like that we want to gasp… even pull away. But I think we need to stay there. Deal with our own heart skipping a beat. Quiet our own grief that seeps in. I simply said, “I know you do.” His caregiver jumped in and said, “God’s not ready for you yet!!!” And while I too believe that I knew he didn’t care about God right then. Instead it probably made him want to curse her and God.

We sat. His grief and fear and emotions waved up and down. He’d settle. Then the wail of tears would come. He told me he was so successful but at this time in life what did it serve him? He was prisoner to his body. And he is right. To see this man of so much knowledge, so much skill, so much business sense, so much toughness, so much love for his children and wife, so many experiences all over the world hunting bears and catching sailfish, helping people in other countries go to school, providing for his family, boxing in the military, laughing with others, giving people faith in themselves… in this space… it broke my heart. But, I know I was put there to give him a rod of strength to grab. Like a relay but this one is life. All along his almost 90 years he’d maybe passed that relay baton a handful of times to someone else. Today it was me. So I took it. We cried together. 

I can’t explain the whole transgression of the hour we spent together. All I can tell you is that it was the best place I could be. What I have learned from this is that we all are brought to a place of weakness—some of us more than others—and it is each of our duties to grab that baton for someone else when it happens. Run that race with the person. Don’t let it be a solo experience. When I am in his shoes, and we all will be (another lesson, right?) I hope someone grabs my baton. Validates how much it stinks to lose my body, keeps their hand on my leg, let’s me cry. I hope that they don’t step away. That they don’t let their own uncomfortable feelings take over. I hope they stay even if they don’t know what to do. Sometimes you can’t do anything. You can’t do anything but stay right where you are. Together. 

JUNE is National Safety Month!

DRIVER SAFETY

Staying connected to your community is an important part of your well-being. For most of us, driving our own car is how we stay mobile and on the go. Driving is the most common means for seeing the people we want to see and getting to the places we want to go- at our convenience. But changes in our physical, mental, and sensory abilities can challenge our continued ability to drive safely.

Role of Occupational Therapy
Occupational therapy practitioners  trained in driving rehabilitation understand the critical demands of driving and how our ability to move about our community affects the quality of our lives. These occupational therapy practitioners have the skills to evaluate an individual’s overall ability to operate a vehicle safely.

Occupational therapy practitioners have the science-based knowledge to understand progressive conditions and life changes that can affect driving. Because occupational therapy practitioners take the time to understand the role that driving plays in your life, they are able to help individuals make the transition from driving to using other forms of transportation that offer the services and features they require to maintain safe community mobility. In doing so, they help people maintain their autonomy, independence, and sense of worth.

Getting Around Safe and Sound
For most of us, driving represents freedom, control, and competence. Driving makes it easier to get to the places we want or need to go. For many of us, driving is important economically. We drive as part of our job or volunteer activities. Driving is also important socially. It allows us to stay connected to our communities and to participate in the activities we find meaningful.  If it is the only means of transportation you are familiar with, it may be difficult to imagine using any other means of transportation to get to the places you want to go!

Please visit…www.aota.org for more info!

Chronic Pain

picture of a man's torso

More than 130 million Americans suffer from chronic, or frequently occurring, pain.

Chronic pain creates both physical and psychological problems that affect whether a person can engage in meaningful activities each day. Pain can decrease a person’s strength, coordination, and independence in addition to causing stress that may lead to depression.

With the help of occupational therapy, people with chronic pain can learn to manage the physical and psychological effects and lead active and productive lives. Many people with chronic pain already have received treatment with medication, surgery, heat, cold, nerve stimulation, and massage. What many have not yet learned is how management of daily activities and lifestyle can contribute to successful, long-term coping with pain.

What can an occupational therapist do?

  • Identify specific activities or behaviors that aggravate pain and suggest alternatives.
  • Teach methods for decreasing the frequency and duration of painful episodes.
  • Implement therapy interventions that may decrease dependence on or use of pain medications.
  • Facilitate the development of better function for daily activities at work and home.
  • Collaborate with the client’s team of health care professionals, such as physicians, physical therapists, psychiatrists, and psychologists, to determine the best course of treatment and intervention.
  • Recommend and teach the client how to use adaptive equipment to decrease pain while performing tasks such as reaching, dressing, bathing, and perform household chores.

What can a person with chronic pain do?

  • Develop and practice a lifestyle based on wellness, which includes plenty of rest, exercise, healthy nutrition, and maintaining a positive attitude.
  • Practice techniques to decrease the intensity of pain.
  • Organize a daily routine with personal pain management goals, such as eliminating or modifying activities that use a lot of energy and implementing body mechanics that move the body in ways that are less likely to aggravate pain.
  • Exercise to increase strength and flexibility and reduce pain.
  • Practice relaxation techniques that calm the mind and reduce tensions that aggravate pain.

Need more information?

Chronic pain is a serious problem that should not go untreated. If you would like to consult an occupational therapist about pain management, practitioners are available through most hospitals, community clinics, and medical centers.

Occupational therapists and occupational therapy assistants are trained in helping both adults and children with a broad range of physical, developmental, and psychological conditions. Practitioners also help clients in wellness techniques that may prevent injury and disease. Contact your local health officials for more information.

Visit http://www.aota.org for more information!