Thursday, 14 January 2016

Occupational Therapy related to Work - with video

In Israel, many times when I have mentioned that I enjoy the area of work from an OT perspective, I often get a response "but what does OT have to do with work?" or "OTs don't deal with work" or "OT is only related to child development." These are just a few of the various responses all along the same theme of total disbelief that OTs have anything to do with the area of daily life known as work.

I can prepare an article on the role of OT in assisting people to be independent in the area of work, and perhaps I will do so. In the meantime, in the video below you can learn some wonderful pearls of wisdom from colleagues of mine who share excellent

I hope that you have gained insight into the holistic role of occupational therapy in general and related to work in particular. If you have any questions, please post them below.

I like the ending of the video "Remember, OTs know stuff" 

Shoshanah Shear
Occupational therapist

Monday, 11 January 2016

PACE your Goals for 2016

We are well into January of 2016 and behind the times to plan your new year effectively. However, there is no time like the present and in truth it is never too late to set goals, revise goals and plan towards an effective year.

Have you set goals for this year? What area of your daily life is the most important for you to succeed in this year? It can be a goal related to your health, it can be a goal related to your career, your relationships, an interest you would like to pursue. Whatever your goals, have you made time to identify them? Have you written your goals so that they are clear, positive, energetic and active? You can reshuffle those words and then you will have the method used in Educational Kinesiology known as PACEing a goal. Which means making sure that your goals are

Why is this important? To begin with, spending the time to PACE your goals correctly forces you to concentrate on what is absolutely important for you and to refine the goal as far as possible.

Let us take a few examples.  How about you have a goal to lose weight during 2016. You can write something like:
"I will do my best to keep to my diet and to lose the weight I want to"

How does that goal sound to you? How specific is it? Is it measurable? Is it positive? Is it clear?

Now let us alter the goal to read "I loose 10 kg of weight by March 2016"

Do you notice any difference? Which goal do you prefer and why?
Can you think of any details that might be required?
If you are happy with your weight, do you have something else that you need to work on in order to develop a healthy balanced lifestyle?

Have you set goals for yourself for 2016? If your answer is yes, are they tangible goals or do they need some revising? If you live in Israel and have not yet set goals and begun to draw up a plan of action to help you meet these goals, you are welcome to be in touch to schedule an appointment work on setting realistic goals for yourself, refining your goals and developing an action plan. 

If you have set your goals and are happy with them, you are welcome to share what your goals are below.

Wishing you a successful, productive and fulfilling 2016

Shoshanah Shear
Occupational Therapist and Healing Facilitator

Wednesday, 6 January 2016

Occupational Therapy and Alpha Stim

Interview with Linda Horncastle, UK trained occupational therapist who is

 also trained in the use of Alpha Stimulation.

Welcome to the first in a series of interview with fellow occupational therapists. Linda Horncastle was the first to respond to an offer to OT's to be featured on my blog and it has been wonderful to get to know her.

We immediately had more than OT in common with a common interest in the condition M.E. / CFS. It's been a pleasure getting to know Linda. So without any further ado, here is our interview. I do hope that you enjoy the fascinating work that Linda is involved with and kindly shares with you the reader in her answers below.

Shoshanah: Hi Linda, it's so good to get to know you. Can you tell us a little about yourself and your background in both OT and alpha stim.

Linda: I qualified as an OT at Dorset House in Oxford, UK in 1981. I first worked in Manchester as a Basic grade in a 6 month rotation post at Withington Hospital which gave me loads of experience in Surgical/Orthopaedics, Geriatrics, Burns and a Young disabled unit. I then specialised in Surgical/Orthopaedics and became very proficient in splint making and treating those with hip and knee replacement and amputees. I think if hadn’t moved because of my husband’s job I would have then specialised in myoelectric limbs for upper limb amputees. After we moved I worked as a Senior 1 in Surgical /Orthopaedics at Ipswich Hospital I then left on maternity leave at the end of 1988 with the intention to return part time.

I was diagnosed with fibromyalgia syndrome in 1999 even though my symptoms started in 1989. My symptoms worsened in 2000. I was so disabled then I thought I would never work as an OT again and that I was probably facing the rest of my life using an electric wheelchair. I gained some improvement through dietary changes, pacing and relaxation but not enough to consider working again. I couldn’t tolerate the medication or the TENS device. I started my private clinic in 2010, six months after starting to use the Alpha-Stim.
Shoshanah: Thank you Linda. Having started in physical rehabilitation, can you tell us a little more about your experience with fibromyalgia, M.E. and the Alpha-stim

Linda: It is tough trying to keep going with fatigue. The Alpha-Stim has certainly reduced my relapses. Dr Myhill (a doctor in the UK who specialises in ME/CFS) thinks when describing ME/CFS and FM it is continuum with ‘Fatigue’ one end and ‘Pain’ the other, and we’re somewhere along the line. I would have been 1/2 way along the line.

I find the ear-clip only device can help people with ME/CFS by increasing the time in deep sleep, increasing ATP production and reducing the effects of the over active ‘fight and flight’ response. It can also reduce sensitivities, e.g. I found it almost impossible to fill up my car with petrol because of the smell, now it’s less of a problem. Also it’s not so painful trying to hold the pump.

Occasionally CES sadly hasn’t worked with some people with ME and my theory is that in these cases the possible viral cause is still in an active state.

Shoshanah: That is fascinating. How did you learn about micro-current therapy and what training is required to become a practitioner?

Linda: I came across the Alpha-Stim by chance. I swim at a warm swimming pool and in the same group I met a very active retired doctor (Dr Bob Lister). At this stage I had founded the Chiltern Fibromyalgia (FM) and Chronic Fatigue Group, (previously known as S. Bucks Fibromyalgia and CFS/ME Support Group). After I discovered Bob had done research into FM I asked him to became an advisor to our group and he is now the mentor of my clinic. Because of his research Bob was approached by the new UK supplier of the Alpha-Stim wanting to trial the device on people with FM. So in 2009 I was offered the chance to trial a device. It had only been in the UK for a year, (I was annoyed later to find out it had already been available in the US for 26 years). I knew after 2 weeks the ear-clips were helping. I had a very stressful day in London, which would normally have triggered a relapse but this time it didn’t. There was no training available in the UK so I taught myself how to use the device. Then I found lectures online about the Alpha-Stim and took part in webinars with the inventor Dr Kirsch and had further training online with Dr Marksberry. From this knowledge and personal experience treating pain all over my body, I started an informal trial with 18 members of our support group. After the amazing results of this three-week trial where 15 out of the 18 people found the Alpha-Stim also helped them, I decided to become registered again and to set up a clinic to help others get the best from the devices. I now train other Alpha-Stim practitioners in the UK.

I use 2 devices in my clinic:
  • The Alpha-Stim AID which is an ear-clip only treatment of gentle microcurrent waves called cranial electrical stimulation (CES). The Alpha-waves promote a feeling of calm and alertness. These can help with mild all-over body pain by improving the inhibitory messages from the brain.
  • The Alpha-Stim M, is what I call the 3 in 1 device, with ear-clips (CES) as above and for more specific pain relief the probes and sticky AS-trodes (Microcurrent Electrical Therapy, MET)
The Alpha-Stim uses micro-currents close to the type and amount of electricity that naturally occurs in the body. These micro-currents produce residual and cumulative results that encourage the body’s system to work better.  It is a well researched class lla device and is approved by the FDA for the relief of anxiety, insomnia, depression and pain management. It has been used in the USA, in the clinical setting for the past 31 years. There have been 28 randomised studies done independently of the manufacturer, four of these show impressive results with Fibromyalgia.

Shoshanah: It sounds like you are doing wonderful work. I am interested in your combination of OT with Alpha Stim. Do you have any confusion in promoting your work since you use OT combined with another modality?

Linda: Yes, if I had already had a well established clinic or been able to join a local clinic with good referrals from doctors it wouldn’t have been such a struggle. My accountant said he’d never seen anyone set up a business as I did after being unable to work for 20 years.
I know it’s unusual for OT’s to use this type of device but due to the holistic benefits this device can achieve, I feel we are the ideal profession to get the best from it. I personally don’t see it any different from OTs who specialise in splint making, mindfulness practices and some I know do NLP and acupuncture. If we don’t take this device seriously other professions will take over this market such as Acupunctures and Massage therapists. I don’t think many Physiotherapists would be willing to take on the psychological benefits this device can treat which is so important when treating people with chronic conditions. Such as lifting mood, reducing the stress of living with a chronic condition, improved concentration, better sleep patterns and reducing the effects of central sensitisation.

Shoshanah: The area of pain and pain management is a problem and need to a large percentage of the population. I noticed that you have included patients post MVA (motor vehicle accident). Can the micro-current therapy assist those experiencing pain from nerve damage which is often more severe than from e.g. incorrect lifting.

Linda: The Alpha-Stim can be used successfully to treat a variety of pain related conditions. Such as: FM, CFS, arthritis and back pain. It can also be used with certain conditions with nerve damage such as brain injury, Parkinson's disease and MS where it can be used to reduce anxiety and spasm. There are some case histories for these on the US website. I’ve had success with a young man with a brain injury from a skiing accident where it has reduced his agitation, also a man with dystonia where he felt his body was more relaxed. Both of these cases just used the ear-clips, CES.

I treated a practitioner during a training session who had reduced sensation in her arm due to surgery on her elbow, she had increased sensation after a few minutes of treatment with the probes, MET.

More care needs to be taken with conditions like trigeminal neuralgia where the cases I’ve treated responded well to the ear-clips but they found the probes too strong.
If a person has severe electrical type neuralgia then I am very cautious and will first see if they can tolerate the ear-clips. Only after 4 - 6 weeks of daily CES to try to reduce the severity of their symptoms might I consider trying the probe treatment, MET.

Shoshanah: For those not aware of the role of OT with pain management, can you share a few words about this?

Linda: OTs can play a vital part in pain management. There are so many aspects that should be looked at to help a person in chronic pain reduce their symptoms. See my ‘Diamond Approach’ summary.
OTs can help with adaptations, relaxation, sleep management, pacing (done extremely slowly in those with CFS!!), some dietary suggestions and other life style changes. Such as; in the work situation by the use of activity diaries and learning how to protect oneself from the pressures of the work environment. A new area I’m currently looking at is ‘personality types’ and being aware how that can impact lifestyles and the perception of pain. I’m learning how one can protect oneself from, as Dr. Judith Orloff describes, ‘Energy vampires’. The Alpha-Stim can help these techniques.

Shoshanah: Are there any contra-indications for using micro-current therapy e.g. the TENS can not be used with those suffering from epilepsy. Is this the same for micro-current therapy?

Yes, officially it is OK with those with epilepsy and I have used it with a couple of people with mild epilepsy without a problem but I certainly wouldn’t with anyone with active seizures.

It is also not advised for people with pacemakers or who are pregnant. You shouldn’t use the ear-clips CES whilst driving, but you can use the AS-trodes on the shoulders which I do to reduce pain in my shoulders when driving long distances. I also find used near the neck the AS-trodes can produce a calming effect which was good when I’ve had to drive across London.

The Alpha-Stim can make medication more efficacious, therefore it can be used when trying to reduce medication. For example, one client reduced his morphine by half within 2 weeks of using the Alpha-Stim and another was able to stop taking her antidepressants. Dr Kirsch the inventor of the Alpha-Stim suggests: possibly reducing medication typically by one-third to one-half within the first few weeks of starting Alpha-Stim.

Shoshanah: It has been a pleasure to get to know Linda and the work that she is involved in. For more information about the services offered by Linda, her support groups or how to book a session, do visit her
Twitter: MicrOTherapy clinic @LindaTherapy

If you are an occupational therapist and interested in being interviewed for this blog, please do be in touch.

I hope you have enjoyed learning about OT in the UK and OT combined with Alpha Stim. If you have any questions, please do post in the comments below.

Have a wonderful day

Shoshanah Shear
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