Category: Blog

In the past six months, how often have you experienced pain? As many as 40% of Americans have pain most days or every day, experiencing what medical professionals call chronic pain. We define chronic pain as pain lasting for greater than 6 months, but it’s much more impactful than its definition might lead you to believe. Let’s be honest – numbers and definitions don’t matter much to those experiencing pain. When you’re the one who can’t get out of bed or pick up your grandchild, the numbers aren’t going to be on your mind.

Chronic pain begins the same as most pain – we may strain a muscle, break a bone, tear a ligament or otherwise damage a part of our bodies. We feel pain when we move that part of our bodies, so we avoid moving in ways that cause pain. This may lead us to move differently to avoid pain or it may cause us to avoid moving altogether. Over time, the tissues we originally damaged heal. Despite this healing, our brains are still telling us to avoid movement because it hurts. When we do move in ways that were previously causing stress to those damaged tissues, it still hurts. The pain is real – even if the injury is no longer there. So, what’s happening?

There are many different types of receptors in your body that sense things like pressure, temperature, light touch, and pain. Pain is a protective stimulus that our nervous system sends to alert us to damage to the body. By design, the sensation of pain is something we try to avoid. The trouble is, when we avoid movements that cause pain for an extended period of time, our nervous system starts to loosen its definition of pain & our alarm bells are ringing if we even get close to stressing the tissues that were damaged initially. Eventually, these alarm bells are going off constantly, convincing us that any movement is painful – so we just stop moving. This can start what we call the “Chronic Pain Cycle.”

1) It hurts when we move
2) We stop moving
3) Our muscles, hearts, and lungs become deconditioned
4) Moving becomes harder
5) Moving causes more pain each time we try & the cycle repeats itself

If your doctor determines that there is no physical damage to your body that is causing your pain, it may be necessary to interrupt this chronic pain cycle therapeutically. Physical therapy can help your nervous system re-organize sensations to reduce the frequency & severity of its pain reactions. It can also help desensitize your body to movement & help you build strength and endurance to support reintegration into activities you once enjoyed. Massage therapy may be recommended for relaxation of muscles that have tensed up to protect the body from pain. It can also be helpful to perform mindfulness activities, practice meditation, or participate in cognitive-behavioral therapy to modify negative thoughts associated with movement or pain. Regardless of the approach, interrupting the Chronic Pain Cycle is critical. If you’re experiencing chronic pain, please don’t hesitate to contact your physician & inquire about your treatment options. You deserve to get your life back.

~Sarah Bassett, PTA, CBIS, CKTP

SEEING (CLEARLY) IS

…believing that you can confidently and safely navigate your environment (i.e., your home and your community), including avoiding obstacles that may cause injury.
…believing that you can read the instructions on a package and read the name on a street sign.
…believing that you can see objects throughout your visual field, including on the far left, far right, upper, and lower portions.
…believing that you can use a computer or watch television without experiencing headaches, watery eyes, or other signs of visual fatigue or visual overload.
…believing that your current eyeglasses are working for you and that they fit well and are comfortable on your face.

Common Vision Issues Following a Neurological Injury or Illness:

• Blurry vision – the inability to clearly see an object up close and/or in the distance
• Double vision – overlapping images
• Decreased or loss of peripheral vision -loss of the normal, wide-angle field of vision
• Visual fatigue – eye irritation and strain; can result in blurred vision and headaches
• Visual overload – hypersensitivity to light or other visual input

Where to Find Help:

• Call your vision specialist, usually an optometrist or an ophthalmologist, who will complete a comprehensive vision examination and determine the sources of your vision difficulties. Be sure to let them know about your medical history, including a neurological injury or illness.
• If you don’t have a vision specialist, contact your primary care provider and ask for a recommendation or referral.

*If you are having problems with your vision, don’t wait.

Vision is your most highly-developed sense:
80% of what we perceive comes through our sense of sight.

 

~Julie Jordan Cook, OTRL, C/NDT, CBIS

As a speech-language pathologist, I am a member of the American Speech-Language-Hearing Association of America (ASHA). May is deemed Better Hearing and Speech Month. The goal is to raise awareness about communication disorders. This could include a multitude of disorders affecting speech, language, voice, and hearing, but today I would just like to address communication not classified as “disordered,” but perhaps broken just the same.

Communication is more than just talking. It’s about connecting with people. In the busy, fast-paced, high-tech world in which we live, people can become invisible. With our time-bound agendas driving us ever forward, we may find ourselves moving from one task to another without connecting to anyone in the process. This can result in many people feeling unseen and unheard, including ourselves. Some can feel socially isolated even in the midst of a crowd.

This leads me to reflect on an encounter I had several years ago. As a college student studying in London, England I met an elderly man in Regent’s Park. I noticed he was feeding birds directly from his hand, not just the ducks gathered at his feet, but songbirds as well. Finches and pipits would fly right into his hand, take some seed and fly off again. As the gentleman and I engaged in conversation, he quickly identified me as an American. He informed me that American’s were “mad hatters, always running from one place to another.” Then lowering his voice and shaking his head, he added, “Sad state, those mad hatters.”

Recent events have slowed many of us down, giving us an opportunity to re-evaluate our priorities – what and, perhaps more importantly, who really matters. Stay-at-home orders and social distancing have caused us to be more intentional about connecting with others. As we gradually move toward resuming our day-to-day routines, let’s choose not to return to our previous “mad hatter” state of mind. Instead, let’s make a point of seeing and listening to those around us. Let good quality communication skills help us connect with one another and truly put an end social isolation.

~April Bluck, MA, CCC-SLP, CBIS

When Sherry was first diagnosed with ALS (Amyotrophic Lateral Sclerosis), she initially felt worried about what life would be like in the future. Sherry, an avid bird watcher, walker, travel guru, and dog-lover, wanted to make sure that she had the ability, time, and energy to keep up with her most valued hobbies. It has not been an easy road to getting where she is today, but she has made a point to “live in the moment” and prioritize her activities to make the most out of life.

When Sherry started to have difficulty with her right-hand function, she wanted to make sure that she was still able to take pictures on her walks. Losing function in her dominant hand would prove to be difficult. But, with a little creativity and some help from Norman Camera, a local store, she was able to fashion a strap that allows her to hold her camera, press the shutter, and focus all with her left hand. She stated that she also has started wearing a lower leg brace to help stabilize and keep up her strength, while on her long walks. She states, “It helps me taking pictures, actually. It all ties together.”

When asked about how she manages to make time for the activities she’s passionate about, she says it’s all about learning to prioritize. “I had to learn to let someone help me clean my house so that I have time and energy to do what I want to do.” She also states that, “With all of my appointments, I make an effort to limit how many I go to in one week. It’s important, but I want to make sure it doesn’t take over.”

Lastly, Sherry’s advice to anyone going through a tough time or a new diagnosis is to “Live in the moment and do not let the possibility of the future ruin the present. Enjoy what you have, because it is so easy to worry about what might be coming. Enjoy every moment as it comes.”

~ Nicole Olson, PT, DPT, NCS

Springtime weather is just around the corner! While you are staying home and social distancing yourself, why not start a home flower garden to bring some joy to your life? Making a raised flower bed allows those that have trouble getting down on the ground tend to a garden and still participate in this fulfilling activity! A simple way to get involved in gardening would be to use a card table outdoors and put some cute decorative pots with flowers on the tabletop. Better yet would be to get a few Terra Cotta pots and paint your own unique designs on them.

If you have trouble grasping onto your gardening tools, using some Coban wrap around the handles allows a larger gripping surface and makes it stickier. Coban is commercially available at your pharmacies and larger stores in the first aid section. You could also put your gardening tools into a palmar band to maintain your grasp on the tools. If you don’t have either of these, place a washcloth or hand towel with duct tape to secure around handle. Don’t forget to water your plants! A watering can is a great way to water plants and there are plenty of light weight options; use your Coban to help hold onto the handles too!

Succulents are a great option for the new gardener, and so pretty to look at! They are much easier to care for, only needing to be watered a couple times a month. They also do not require much pruning, unlike some of their pickier floral counterparts.

Occupational therapy is all about doing meaningful activities to promote health and wellness. Not only does gardening allow you to care for something else which increases your quality of life, it also is a great way to work on fine motor, gross motor and cognitive skills! Get outside and make the world prettier! ~ Amanda Brennan, OTR/L

Don’t be fooled! With the 2020 Census, the recent passing of the stimulus package, and the extension of tax returns, the scammers have unleashed and are phishing for your information! Here are some pointers on how to protect yourself.

1. Don’t accept email or attachments from anyone that you do not know. Do not be fooled by the emails that are disguising as the 2020 Census Bureau, the government, law enforcement, or IRS.
2. Never give out or confirm your personal information to anyone over the phone, email, text, etc. This includes your social security number, your bank account, birth date, or credit card number.
3. Don’t answer the phone if number is blocked or is not familiar. Only answer if you are expecting a call and recognize the number. Scammers are good at what they do. Once they have you on the phone it is easy for them to feed you bait. Hang up and don’t take the bait. Scammers impersonate the IRS representative, family member, law enforcement, legal, collections agency, etc. They may have some personal information dear to you, that can be used to help confirm other identifying information.
4. Check for identification. Is someone at your door? What is their purpose? Ask for identification. Census Bureau representatives may stop at your door if you have not completed your census. Identification will include a valid ID badge, with photo, a U.S. Department of Commerce watermark, and an expiration date. To avoid a visit, complete your census.
5. Report any suspected fraud activity. Here are some resources to learn more about what to expect from 2020 census and IRS, as well as how to report any suspected fraudulent activity.
   http://2020census.gov/en/avoiding-fraud.html
   https://www.irs.gov/newsroom/avoid-scams-know-the-facts-on-how-the-irs-contacts-taxpayers

What are you doing to keep your mind well during this time of social distancing? Social distancing does not have to equate to social isolation. It is important to stay connected with people during this time and to nurture your mental wellbeing. There are many ways to avoid social isolation in a time of physical isolation. Here are some ideas:

1. Schedule meetings with friends and/or family virtually. There are many ways you can do this: Facetime, Skype, and Zoom.
2. Schedule a game night. There are many free online games and apps that you can use to invite multiple people to join in.
3. Start a social group on Facebook/Meetup.com and ask your friends to join. This might start with a common interest or hobby, such as a book club, favorite sport, comedy, bible study, bird watching, knitting, cooking, gardening, baking, crafting, or wellness to name several.
4. Get outside every day. Having your senses stimulated does wonders. It can be refreshing to be outside in nature, renewing your mind and letting go of any negative thoughts.
5. Keep a routine that is consistent. Be sure to include healthy eating habits and exercise.
6. Take the time to do things that you haven’t made time for. For example: read a book/audiobook, clean/reorganize a messy cupboard, try a new recipe. Create a checklist. It is rewarding when you check off tasks on your “to-do” list and helps you stay structured.

You want to go to college, but you don’t know where to start. It’s one thing to be thinking of where to apply, and to know if you’ll qualify and be admitted. But, then there’s your disability. How does that fit into the whole picture? Whether you use a wheelchair, have visual impairments, ADHD or any other number of cognitive or communicative challenges, the approach is going to be relatively the same.

So what do you do? You start early! The earlier, the better. Don’t be afraid of starting the search. The web is full of information that you can use to help locate the universities/colleges that look good, and are helpful for weaning down your choices – finding the best fit for you. Once you’ve narrowed down your search, then it’s time for a visit to the campus and to connect with the campus disability resource provider or a disability counselor.

Make an appointment and bring your disability documents with you. Once the counselor has had an opportunity to review your documentation and meet you, they will be able to tell you what accommondations and services are available. All universities must be ADA compliant, but that being said, some universities are better at complying than others. The range in accomodations from school to school varies as well. Sometimes the accomodations might not be the accomodations you prefer so, make sure to ask specifically what you will recieve. For example, if you are hearing impaired you may prefer to have a C print captionist. However, the school might not be able to provide that, but they could provide you with an interpreter.

If you are in a wheelchair, how easy is the campus to navigate? How far from building to building are your potential classes going to be? Are the elevators functioning well? For the visually impaired, navigating the busy paths, and buildings is something to be addressed as well. Other things to consider and discuss w/ the counselor include talking about your semester load. Are you capable of meeting the demands of a full time class schedule on top of your disability? Or, would you be more successful and feel less overwhelmed with a reduced course load?

You may be wondering about available assistive technology resources. This too is something to discuss with the disability counselor. You may already use your own assistive technology (screen readers, CCTV, speech to text software to name a few) but given the expense, many folks choose to use of the existing technology provided by the school. If that’s the case, remember that learning any new software taskes time and it may be beneficial to train on the systems during the summer so that when school begins you can put your full energy into school and not into learning how your new technology works.

It’s manageable really. With the right approach, and knowing there are folks in your corner at every campus to help you out is half the battle. A second visit to the campus may need to happen in order for you to feel comfortable with the decision. And, that’s great! That’s how it is for a lot of folks. It’s a big step (or roll) towards the future you want for yourself, and you can do it!

A special thanks to Joy L. Ferwerda, M.ED, CRC for helping us understand how it all works.

~ Michele Dykstra, MA, CCC-SLP

 

Warren Nelson, sustained a spinal cord injury a few years ago in early 2016, but he did not let that stop him from pursuing his dreams. Following his injury, he became very dedicated to recovery. He began therapy at Life Beyond Barriers Rehabilitation Group in Rockford and then transferred to the Traverse City location upon opening of the clinic. He currently attends twice per week, and also trains at Barwis on other days.

Warren met Ci’onna in March of 2017 while she worked for his family at BC Lanes. “She avoided me the first few weeks after I met her”, he chuckles. They began dating shortly after. On August 10, 2019 they tied the knot at Castle Farms. Warren stood for the entire ceremony, a full half hour and walked her down the aisle. “It’s hard to walk in a tux,” he said with a smile, not to mention there was a little bit of uneven turf with the brick terrain. Warren says he doesn’t have much for words, but he is so glad that it worked out. The weather turned out nice, a perfect 70 degrees. He had been working hard on this goal in therapy for a while. He wanted to be able to stand for his wedding ceremony and walk Ci’onna down the aisle. Take a look at his wedding video on our Facebook page. Thank you Warren for sharing your wedding day with us and being an inspiration to many.

LIFE DIVIDED

Through my years of working as a therapist for those who have survived traumatic neurological injury, I have not only witnessed the physical pain my patients have gone through, but also the emotional hardship that results from the healing that must take place after such an injury occurs. As a member of a small portion of society that deeply understands the implications and ramifications of a traumatic injury to the body, I also care deeply about the emotional wounds that are surrounded and imbedded in the physical wounds. Because of the need to restructure their existing lives in a new way, the transition of how each of my patients fits within society and relationships changes drastically.

“They say they don’t care that I am handicapped, but are they saying that to be nice?”

Matt, 34 years old, has been in a wheelchair for half of his life. As a senior in high school, he had no idea how a dive into a lake would impact his friendships, relationship with his parents, and networking abilities. “They say they don’t care (that I am handicapped), but are they saying that to be nice.” Missing out on “the college lifestyle,” moving out of his home, getting married, having children, and witnessing his closest friends move on has been a heart-breaking reality for the last 17 years.

This was a hard lesson to learn as a young man, trying to experience life and develop bonds with people that “say they were his friends,” especially at a time when those relationships were imperative. Since his time being in a wheelchair, Matt has experienced a turn-table of friends and has struggled through the isolation of a significantly altered social life.

Although Matt is very personable, because of his handicap, it is much more difficult for him to further develop friendly interactions.  “I call people 2-3 times and if they don’t return my call, I stop and figure it must not be worth my time.” Matt talks of the difficulty with finding a ride to attend a social gathering, a restaurant, or the movies.

His spinal cord injury has left him with minimal hand control, therefore requiring him to have an additional person to drive him in his wheelchair accessible van. “My parents are the people who drive me most of the time, and they are getting older.” The planning involved to execute something simple, and the necessary reliance on others, sometimes outweighs the effort to make and maintain friendships. Despite Matt’s significant effort to maximize his physical recovery potential, his adaptation to his lacking relationships is a continual battle.

Amos, 32 years old, has experienced similar hardships with his social connections. He talks of severe anxiety and depression that is associated with the loss of his physical function, loss of friendships, and a “whole new life.”

“I may have pushed them away, but they don’t understand what I am going through.”

Amos was injured in an automobile accident that resulted in a spinal cord injury leaving him with limited function of his hands and legs. “I was to be the best man in my best friend’s wedding, and I don’t even know when he got married.” Having had difficulty with his health since his spinal cord injury, has resulted in losing three of his best friends. “They just disappeared,” explains Amos.

Coping with the change in his identity has been his biggest struggle. Amos identified himself as a hard worker and an active weight lifter with many social networks, but his new body does not match his internal self. This has caused anger and sadness that created rifts with the very people he needs the most.  “I may have pushed them away, but they don’t understand what I am going through.” It seems that the only new friends he has made are people he has met in the hospital or in therapy who are going through similar hardships and changes. Not knowing how to feel comfortable in his new reality has made it difficult for Amos to have a life beyond those living a parallel life.

Although both of the previous men have struggled to find their home in a community, the opposite is true for Kathleen. “I have found that people are very kind,” she explains.

“This world can seem very curt, but the love, and generosity that I have experienced since my accident was something I was surprised by.”

Involved in an accident that left her with minimal ability to use her lower extremities for walking or standing, she has found a community that has embraced her new physical function. “This world can seem very curt, but the love, and generosity that I have experienced since my accident was something I was surprised by.” Kathleen depicts her relationships as deeper, more vulnerable and open. “At first, my friends weren’t sure how to act because I was in a wheelchair.” She has found that over time, they no longer see a wheelchair, just her. At the age of 60 she has learned that the superficial things like clothes, jewelry, having her hair perfect are just not important. She used to always be “done up” but has realized her friends “only see her” and that is the most important thing. Kathleen talks of the compassion and commitment that her children have shown. “We are the house that all the kids hang out at,” she explained. She has been surprised because the kids still come around, they laugh, have fun and “it’s like nothing happened.” Kathleen reports the hardest part about being injured is her relationship with her spouse. He has had to take on more of a caregiving role and financially her injury has taken a toll on them. “My husband is 14 years older than me and had dreams of moving to Florida and retiring.” She speaks of feeling bad about how his new caregiving responsibilities and financial expenses have affected their relationship and altered their retirement dreams. Despite this hardship, Kathleen says “We have to move on, that’s just what you do.” Where many of Kathleen’s relationships have grown and withstood the challenge of her injury, others have been precariously stressed.

We should take a moment to extend our time, commitment, and love to those who are in need of a friend or community.

Fortunately, many of us have not been through a life changing injury such as those mentioned above. Many of us have the ability to make and maintain relationships without more than the normal barriers of everyday life. For those of us who are this fortunate, we should take a moment to extend our time, commitment, and love to those who are in need of a friend or community. It is crucial for those of us who deal with people suffering from injuries to know the healing cannot happen through the physical alone. Having a place and an importance in a social stratum is essential to the continued development of social identity and self-worth. We say it takes a village. This village needs to go beyond the medical model. Meeting basic physiological needs are only the beginning. A willingness to be
vulnerable and open within these relationships and to allow them to grow and bloom is the key to strengthening this community of individuals.

How can we change the paradigm?

As a therapist working with people with varying degrees of disability, I have witnessed many of the hardships and similar accounts to what was expressed by Matt, Amos and Kathleen. I have seen individuals struggle through divorces, embrace a new baby, make new friends, find soul mates, lose friends, get married, all while they are finding their new normal in their new life. “It takes a village,” is what most people are raised to believe. Then why does it seem that society has such extremes as to how to cope with people with disability, to run away or overwhelm. How can we change this paradigm? How can we make it easier for these individuals to feel normal in this world? Next time I see someone in a wheelchair maybe I should ask for their phone number, get a coffee, share a book, or simply shake their hand and greet them with sincerity.

-Rachael Billingsley, PT, DPT, C/NDT