I have been invited to write about the contribution the profession has made to Karen's care (see Karen Wright Case Study). Readers may need to be up-dated about the current definition of the profession and its scope.
Occupational Therapy (O.T.) is: any activity that engages the individual in their recovery to health and future well being.
In Karen's situation the referral of O.T. came from her surgeons who requested Hand Therapy. (As Karen lives in Newmarket she came to the O.T. Services at the local hospital.)
Her "donor site", the left forearm, required therapy to regain her wrist and hand function for normal every day activities. Karen's treatment programme included, initially retrograde massage to manage the swelling in her forearm, scar management for the forearm and neck, tissue massage followed by the introduction of a hand gym - excercises and modelling with resitive putty. Karen was encouraged to use her arm and hand as normally as possible. Eating for example, cutlery with a bigger grip made a normal function possible. Karen was encouraged to use her hand and any other bi-lateral activity. This use then became her therapy and so her arm and hand improved.
In managing her scars, forearm and neck, I considered both the physical and psychological aspects, particularly to the neck. Physical techniques were used to prevent fibrous tissue forming and help promote her skins elasticity and suppleness. Karen used a Rolz tissue massage tool for her forearm and I managed her neck areas with a fine pencil vibrator. Both techniques assisted with the skin's suppleness and normal colour.
Karen's self consciousness and confidence (the physchological aspects) were addressed by discussion and an analysis of "Mr. World" observational skills!
Supporting Karen to take on a part time job in the retail sector was a very positive part of her recovery. Not only did she manage on her bicycle to get to work, but she interacted with customers in their trading transactions. She proved to herself she had regained the confidence to manage herself, her family and all its demands, the world at work and the world at large.
It has been a privelage to be part of the specialised team involved in Karen's care. I hope that this article will have demonstrated the holistic-ness of the profession and the positive contribution it can make to the individual.
Anne Loch
Occupational Therapist
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