Neuro Note: Brain on Fire

     The book Brain on Fire: My Month of Madness by Susannah Cahalan is a memoir about and by Calahan, a journalist for the New York Post in her mid-twenties. Typically an intelligent, outgoing, and friendly woman, she starts experiencing strange symptoms that first seem like the flu but then become more psychiatric in nature and much more concerning, such as hallucinations, seizures, and behavioral outbursts that were very unlike her normal self. After visiting several different doctors and a month-long stay at the hospital, Susannah is finally diagnosed with anti-NMDA-receptor encephalitis, a rare and likely under-diagnosed autoimmune disease. The disease has a roughly 75% chance of normal recovery or mild side-effects, and a 25% chance of severe side-effects or death, even if it is caught early and treated. Luckily, Susannah makes a full recovery and is later able to return to her life as a journalist and continue in her relationships, both with her boyfriend and other friends and family.

     I chose Brain on Fire because it was a book I had read my freshman year of college for an introduction to psychology class. (Funnily enough, it was for extra credit in that class, as is this neuro note that I'm writing. I've always been a sucker for extra credit points.) I enjoyed the book back then, and when I saw it on the list of resources, I thought it would be interesting to reread it now- five years later, with a bachelor's degree and a semester of occupation therapy school under my belt. I now have a much deeper understanding of many of the neurological terms used in the book and I have a greater appreciation for the book and the doctors mentioned in it.

     While Susannah did not see an occupational therapist, there were a few places I could see her benefitting from occupational therapy. As she is recovering from the disease, a months- and years-long process, Susannah is very nervous to return to living by herself after living with her parents during this time, but she is also desperate for the freedom that it will allow her. I think seeing an OT would have helped her re-learn her usual occupations and also increase her confidence about living by herself.

     Something that I took away from this book is that it can be incredibly helpful to get a second opinion as practitioners when we are working with a client who is outside our area of expertise. Susannah saw several different doctors and got several incorrect diagnoses until her neurologist at the hospital sought the help of someone who had experience in cases like Susannah's. This doctor was finally able to correctly diagnose Susannah and get her the treatment needed to start on the road to recovery. While we as OTs will not be diagnosing people, we can learn from this and refer clients to other therapists or get ideas from them to best help our clients when we may not know exactly what to do. I am so glad that I chose to reread this book, and I highly recommend others to read it as well.

Cahalan, S. (2012). Brain on fire: My month of madness. New York, NY: Simon & Schuster
     Paperbacks

Memphis Rollin' Grizzlies

     Last week, some of our class went to watch a practice of the Memphis Rollin' Grizzlies, a local wheelchair basketball team. The team is made up of men with varying levels of disability and a wide variety of ages. The coach- who used to play on the team- talked to us quite a bit to tell us more about wheelchair basketball and answer our questions. We learned that there are different levels that wheelchair basketball teams can play on competitively, and the Rollin' Grizzlies are on a fairly high level and do well in this level. Watching the team practice was very interesting, but also not much different from a non-wheelchair basketball practice. Just like any other basketball team, the players were not afraid to play hard and run into each other, and we saw quite a few players fall over in their wheelchairs. While this made a lot of us students pretty nervous, the players did not seem too phased and just got back up, often with the help of other players (again, not unlike what you see in a "typical" basketball team).
     We also got the chance to try out the sport at the end of the practice. This was a lot of fun and showed us how hard it is to play basketball in a wheelchair. While I am definitely not good at basketball anyways, I found out that it was even harder to shoot while sitting in a wheelchair. You are not able to get momentum from bending your knees and pushing off the ground like you would while standing up. It was also very difficult to maneuver the wheelchair while also controlling the ball, and I can imagine it may take awhile to get the hang of that. The players were all so friendly and encouraging while we tried our hand at this sport that they are all fantastic at.
      The biggest takeaway I got from watching this practice and then participating is that these guys are really no different than regular basketball players. I think that I sometimes start to feel sorry for people with disabilities and forget that they are people outside of their wheelchairs or other assistive devices, with different hobbies, talents, and interests. While we need to keep in mind any specific precautions for people in wheelchairs, we also need to remember that they are not glass dolls and they may be comfortable being rough and occasionally falling over. It is so important to recognize clients as their own individual and not just see them as a disability, condition, or illness.

Media Project

     Doing the media project (where we were each assigned a random household object and then a "client" to make something out of the object for) has been an eye-opening experience. It has made me use my creative skills, something I am not very confident in, to come up with a way to use my item, which was cotton balls, for my client Paula, a 76-year-old woman with Parkinson's disease. I decided to use the cotton balls as either pretend "buttons" to practice buttoning with or to cover actual buttons with a piece of the cotton ball to give Paula something larger and more textured to hold on to, as well as to serve as a visual cue since she also has cataracts. I think that realizing there was a practical way to use the cotton balls (covering the buttons as opposed to just practicing doing buttons with the cotton balls) was the most meaningful realization I had. When I first read about Paula, I was frustrated because all of the uses I could think of for cotton balls were crafts or games, and in the information given about Paula, it states that she thinks the games and activities done in the skilled nursing facility where she lives are boring and she seemed to think she was above those types of things. I didn't really think she would like to practice buttoning with the cotton balls either, but when I finally thought of how to incorporate them into the actual act of dressing, I realized I could explain that to Paula so she could work up to using the cotton balls practically.
     From completing this project, I have learned there are hundreds of ways to use everyday objects to help our clients, which can be especially important if we do not have access to resources that cost more money. This has encouraged me to change my thinking to be more outside of the box. The project also reminded me that we have to always be client-centered. While I may think it would be a lot of fun to use cotton balls for arts and crafts or to play games with, I will have clients who might not think it is so fun and I will need to come up with other ways to help them. The project has definitely had an impact on how I will work in the future, both while in school and once I graduate. It will remind me to think of different ways to help clients that may not be typical. I will also remember that assistive devices do not have to be high tech, and low tech can sometimes be the best way to work around a problem. The media project has helped me see things more creatively as well as practically, and I can't wait to put these skills to use in the future!