Neuro Note on Preventative Actions that Can be Taken to Avoid Alzheimer's

The name of the Ted Talk I watched for my fourth Neuro Note was titled “What You Can do to Prevent Alzheimer's” by Lisa Genova. I chose this video because I have heard accolades about the speaker. The title also caught my attention because I was unaware of any strategies that might help prevent Alzheimer’s. While I was watching I took detailed notes and tried to relate the information being discussed to what I have learned in Neuro Aspects and to what I know about occupational therapy.

In the beginning of the video, the speaker discussed how the risk of Alzheimer’s increases with age and that there is no disease modifying medication or cure currently. She then simplified how Alzheimer’s is caused in the brain by saying that amyloid beta accumulates due to microglia not “cleaning up” like the typically do, which then results in plaques that block synapses and prevent neurotransmitter communication. Once the amyloid beta reaches a certain threshold, the microglia get turned back on and sent into overdrive in efforts to try and clean up the plaques. Despite their efforts, the microglia can actually then damage then synapses themselves, which leads to further complications. One interesting thing that she mentioned was that people can have evidence of plaques as early as 10 to 15 years before they become symptomatic and get diagnosed. She then discussed that most medications that have been or are being developed are preventative – meaning that they aim to prevent amyloid beta plaques reaching that threshold. She then proceeded to discuss alternative ways in which the plaques created with Alzheimer’s can be worked around by increasing one’s cognitive reserve. A cognitive reserve is about someone having more than one pathway to a given topic, this increases the odds of that topic not being forgotten, or blocked by plaque, because there are multiple routes to get to the given topic, rather than just one. In addition to this, Lisa discussed criteria that places people at a higher risk for Alzheimer’s like not getting enough sleep, obesity, cardiovascular problems and smoking.

By watching this video and writing this Neuro Note, I gained a deeper understanding of what Alzheimer’s is and how it is caused. In the future, it would be helpful to use the information I learned in order to help explain things to potential client’s and caregivers for people who have Alzheimer’s. In addition to this, my knowledge can help me inform my potential clients about the preventative actions, they can take to decrease their risk of getting the disease – like working on creating a cognitive reserve, prioritizing sleep and improving cardiovascular health. I would recommend this video because it is informative, interesting and the speaker did a great job presenting!  

A hyperlink to the video is provided here: https://www.youtube.com/watch?v=twG4mr6Jov0

Reference

Genova, L. (2017, May). What you can do to prevent Alzheimer's [Video file].

Retrieved from https://www.youtube.com/watch?v=twG4mr6Jov0

Media Project Reflection

My Media Project Poster

The most significant thing I learned during this project a successful, creativity strategy that I developed through trial and error. At first, I had no idea what I would be able to create for someone with a completes, C5 spinal cord injury with a cereal box as a material. I also had apprehensions that even if I did come up with something, it wouldn’t be client centered, or functional. With this perspective, had a very difficult time brain storming any ideas. I decided to take a break and come back with a new strategy. This time I analyzed the provided client profile carefully and tried to pick the most important and meaningful goal for the client. After this, I began thinking about what could be developed to facilitate this goal and how my assigned object could help facilitate this goal. I then began to imagine how I could make this client centered by relating to my client’s values and interests. By breaking things down into smaller steps, I was better able to use my creativity and not get as overwhelmed. I hope to use this concept in the future if I am ever feeling “stuck” while working on a project, or even while coming up with an intervention for a client as a future occupational therapist.

My Matching Music Sliding Board from Above

My Matching Music Sliding Board from the Side 

This project taught me that it can be challenging to come up with meaningful, therapeutic interventions for people with higher level spinal cord injuries. Because of this, I hope to seek more information about spinal cord injuries and successful interventions, so I can be a more equipped occupational therapist. I also learned that a splint can be used to keep the wrist in extension, which then allows for a universal cuff to used by people with completes, C5 spinal cord injuries in order to hold and use various utensils.

            Going forward, I believe I will be more aware of client’s interest and values, so that I can then incorporate them into the therapeutic process. I also think that I will better remember what deficits occur with what spinal cord lesion. Finally, I plan on utilizing the creative process I used for this assignment for

future projects and in future practice!

Neuro Note on a Personal Account of Huntington's Disease

For my third Neuro Note, I watched the Ted Talk titled “Facing Death Full of Life” (2015). I chose to watch this because I know someone personally with Huntington’s Disease and because the topic is interesting to me. Another reason I chose to learn more about Huntington’s disease is because many health professionals are unfamiliar with what it entails, let alone how to treat it; I do not want to be one of these people. Instead, I want to be equipped to provide the best care in regard to occupational therapy when serving these clients and their families. During the video, I took notes and tried to think of ways it tied into the Neuro Aspects class and occupational therapy to enhance my learning and stay engaged. 

This Ted Talk was done by a woman named Danielle Valenti whose mother had passed away one year before she presented the talk. She informed the audience that her mother had Huntington’s Disease, which means that she had a 50% chance of getting the disease herself. Danielle explained that she was nervous to get genetic testing at first, but finally decided that she needed the clarity it would provide. Shortly after, she received the news that she tested positive for Huntington’s. This means at some point she will develop Huntington’s herself (people usually get diagnosed between 35-55 years of age). She then discussed her initial feelings of hopelessness and followed with how she has worked to manage them. Making a commitment to and investing in happiness when having a non-curable, neurodegenerative disease is one goal she listed. Danielle mentioned she works to execute this goal by breaking up her life into smaller stages that are more manageable, rather than looking too far ahead into the future and its “what ifs.” In addition to this, she stated that she tries to find small things that make her smile and asks for help when she is in need. All of these goals and strategies remind me of things that an occupational therapist could work on with a client who has Huntington’s.

            Combining this Ted Talk, my previous experience learning about this disease and my completed case study on someone I know with this disease has deepened my understanding of this disease and the potential implications it has regarding occupational therapy. The speaker talked about how this disease is often thought of as a combination between Parkinson’s, Alzheimer’s and ALS. This is similar to what we discussed in class, which was that Huntington’s has a physical, cognitive and psychological impacts. Another way this video overlapped with what I had learned previously is that suicidal ideation is relatively common symptom with Huntington’s. Danielle spoke about her mother ending up in a skilled nursing facility that specialized in Huntington’s disease, and shortly after that she decided to stop eating in efforts to end her life. 67 days after she made this choice, her mother passed away. Not only did we learn about depression and suicidal ideation as one of the associated symptoms in class, for my case study (about a woman I know personally with Huntington’s), she also attempted to stop eating in efforts to end her life. Learning about these two stories emphasizes the psychological changes Huntington’s can have on someone and how devastating the disease can be. 

            I would recommend this video to others who are looking for a more personal perspective on Huntington’s Disease. The speaker did a great job executing the sharing the information she provided!

A hyperlink to the video is provided here:https://www.youtube.com/watch?v=6JRwCdmewl0

Reference:

Valenti, D. (2015, December 04). Facing death full of life. Retrieved August 14, 2019, from https://www.youtube.com/watch?v=6JRwCdmewl0

Neuro Note on a Man's Journey with ALS

For my second Neuro Note, I chose the documentary Gleason, which is about a former NFL player named Steve Gleason and his journey after being diagnosed with ALS (Tweel, 2016). While I was searching for something to watch for this assignment, I came across this documentary. At first glance, it seemed “too long” being nearly two hours. Despite this, I decided to watch a short clip from a random part of the movie to “test it out.” The clip started with Steve walking onto the New Orleans’s Saints football field wearing his retired jersey and jeans with two teammates on either side of him. The emotions I felt in this brief clip led me commit to the near two hours of watch time! To further my learning during this experience I took notes and also tried to think about the ways it relates to what we’ve been learning in Neuro Aspects and what I know about occupational therapy in general.

This documentary covers from when Steven initially gets diagnosed with ALS at 34 years of age to about four years post diagnosis. It did an excellent job detailing the raw, severe, emotional decline in health and independence that Steven experienced during this time. Six weeks after being diagnosed with ALS, Steve and his wife found out that they were expecting a baby. Despite this, they wanted to take advantage of Steve’s independence while it was still available and chose to take a two-month long road trip to Alaska and explore its beautiful scenery. The couple participated in additional exertions with increasing help throughout the rest his journey. 

Watching this documentary helped me gain an insider’s perspective on ALS and also help solidify what I had learned about it already in Neuro Aspects. For instance, Steven reported the initial symptoms he experienced that led him to meet with his doctor including; muscle twitching in his arms, chest, back and even upper legs. These symptoms overlap with what we learned in class. The film also confirmed that ALS is a disease involving one’s motor neuron and that their cognitive abilities are not affected. At nine months post diagnosis, Steven’s speech deficits, or dysarthria like we’ve learned in Neuro, were noticeable, however he was still able to walk. Steve lost his ability to speak at about two years post diagnosis; he chose an assistive speaking device accessed by eye gaze technology that used his own recorded voice when used to audibly communicate, which I thought was pretty cool! I remembered from class that people with ALS typically have to get feeding tubes and have the choice to go on a ventilator when they are no longer able to breathe or swallow on their own; Steve opted in for both these procedures in hopes of extending time with his family. He also tried a stem cell transplant procedure (that turned out to be ineffective); this is a new treatment option that I learned about. Another piece of knowledge that I gained through viewing this film was about the Stephen Gleason Act that president Obama signed into law July 2015. This act helps people with ALS who have lost the ability to speak have access to assistive communication devices that use eye gaze technology (since ocular muscle remain intact for those with ALS). 

Although many aspects of this film were heartbreaking, I still believe this film is 100% worth watching, especially for occupational therapists! It illustrates an insider’s perspective on how this disease manifest itself and brings light to how an occupational therapist might choose to interact with an individual diagnosed with ALS and their family including; client education, appropriate assistive technology and end-of-life care decision making. 

  
A hyperlink to the film is provided here:
https://www.amazon.com/Gleason-Steve/dp/B01I2BH81W

Reference: 
Tweel, C. (Director). (2016). Gleason [Video file]. United States: Dear Rivers Production. Retrieved August 13, 2019, from https://www.amazon.com/Gleason-Steve/dp/B01I2BH81W