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RSL in hospital

amb said:
Is there a thread on the wellbeing of James Randi? How is he going with the chemo.?
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His latest updates on Facebook seemed upbeat. Hopefully someone who knows better will provide more updates.

Hopefully also this will get split to a sticky in its own right - I've asked the mod team. :)
 
Looks like Susan is organizing a decent doctor and HMO, even if she is confused over which forum account to use :).

Also I am happy Robert has stayed out of hospital. I think Susan has done well not to have said 'Now that I have got Robert home I realize that I cannot cope with him.' Robert is home, Susan is getting things organized. Keep up the good work, both of you.

Tip of the day Susan. Make sure that these adventures (or whatever you want to call it) are on your Resume. Being able to demonstrate you can do these things would be a great asset to an employer. If nothing else shows you have people skills and a good brain.
 
Oh man,

I remember all those tests they made me go through before they would release my Social Security money. After they were all done I was mentally spent for the rest of the day/night.

Has Robert gone through his first full neuropsyc testing as well? That one is the one that takes almost an entire day the first time around. After that one, I think I had to sleep for two days non-stop to regain my energy!
 
However, I asked where he thought Robert is as far as cognition. He suggested we ask a nerologist or occupational therapist (I think he meant slp, Borealys), but he did say that Robert scored well above average in many parts of the testing.
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I'm surprised he couldn't say more about general cognition... but no, I think he did mean an OT. It may depend on jurisdiction, but I think that's part of the OT scope of practice in most places (overlapping with psychologists and psychiatrists). The SLP scope of practice regarding cognition is a bit ill-defined. I do screen memory, orientation, visual and auditory perception and reasoning skills, since they all relate to communication, but I'm not allowed to make general diagnostic statements about cognition. Instead, I refer to OT (for adult clients) or psych (for pediatric clients) for a full assessment. I am, however, allowed to treat those sorts of problems, since they directly impact on communication. Fuzzy boundaries! Glad I have good relationships with the OTs where I work.

Are you getting OT services? The ideal situation would be to find a place where you could get speech, OT and PT in the same clinic. Failing that, give them all each other's phone numbers so that they can try and coordinate their goals.
 
borealys said:
I'm surprised he couldn't say more about general cognition... but no, I think he did mean an OT. It may depend on jurisdiction, but I think that's part of the OT scope of practice in most places (overlapping with psychologists and psychiatrists). The SLP scope of practice regarding cognition is a bit ill-defined. I do screen memory, orientation, visual and auditory perception and reasoning skills, since they all relate to communication, but I'm not allowed to make general diagnostic statements about cognition. Instead, I refer to OT (for adult clients) or psych (for pediatric clients) for a full assessment. I am, however, allowed to treat those sorts of problems, since they directly impact on communication. Fuzzy boundaries! Glad I have good relationships with the OTs where I work.

Are you getting OT services? The ideal situation would be to find a place where you could get speech, OT and PT in the same clinic. Failing that, give them all each other's phone numbers so that they can try and coordinate their goals.
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Some good advice, as usual. And good information as well, as I was under the wrong impression. Robert has not had a strong OT.

Right now we are getting NO services. But we see the new doctor on Monday and I am hopeful it won't be long. I will make sure he understands we need it all. Not quite sure how that will work with my co-pays, though ($30 per visit). We shall see.

We're supposed to get "up to 60 consecutive days" of outpatient therapy. However, we were supposed to get "up to 120 days" inpatient care, and Robert definitely exceeded that. The HMO was the judge of how much time we were allowed. Perhaps it will be the same in this case.
 
All the more reason to support Obama's health initiatives. Boy do you need them.
 
There's always going to be a rationing of care. That's simply the nature of the beast, regardless of whether you have socialized medicine, or the vicious morass Ronald Reagan and crew unleashed on us in the '80s. The question is how is it to be rationed, and what criteria are to be used?

I've heard some pretty good discussions on this on NPR, and some of the talk stations, and, no, I don't mean the scaremongers on the whacked-out Right. There are better ways to fix this mess, but there's too much money at stake for there to be serious discussions.

In Robert's case, helping him to become whole again cuts into a corporation's profits. Never mind that he and Susan paid in advance for coverage in the event of something like this. The company made money at the start, and they continue to make money now. Helping a patient is not in the interest of profit.

As I said, there's better ways to fix this, but right now, I'm just hoping to scrape together some green to send Chill's way for some goodies. At least I know the money's going where it belongs when I do that.

Keep on keepin' on, Susan. We're with you.
 
RSL's better half said:
Some good advice, as usual. And good information as well, as I was under the wrong impression. Robert has not had a strong OT.
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A lot of people don't know exactly what it is an OT does ... I sure didn't until I started working with them! Most people assume OT is all about fine motor skills, just like they assume speech pathology is all about lisps and stutters, physio is all about walking, and dietetics is all about weight loss.

It's a shame you guys haven't gotten good OT services. A good OT is incredibly helpful, especially at the point you're at now.

Right now we are getting NO services. But we see the new doctor on Monday and I am hopeful it won't be long. I will make sure he understands we need it all. Not quite sure how that will work with my co-pays, though ($30 per visit). We shall see.

We're supposed to get "up to 60 consecutive days" of outpatient therapy. However, we were supposed to get "up to 120 days" inpatient care, and Robert definitely exceeded that. The HMO was the judge of how much time we were allowed. Perhaps it will be the same in this case.
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Ooh, good luck. I hope that, whatever length of time they give you, they give you the full range of services you want.
 
borealys said:
A lot of people don't know exactly what it is an OT does ... I sure didn't until I started working with them! Most people assume OT is all about fine motor skills, just like they assume speech pathology is all about lisps and stutters, physio is all about walking, and dietetics is all about weight loss.

It's a shame you guys haven't gotten good OT services. A good OT is incredibly helpful, especially at the point you're at now.



Ooh, good luck. I hope that, whatever length of time they give you, they give you the full range of services you want.
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Speech Therapy seemed to have almost NOTHING to do with speech (in my case, any) and was primarily about cognition. OT seemed to have nothing to do with anything occupational, unless there are occupations out there where you get paid for stretching therabands and tossing beanbags into buckets.
 
RSLancastr said:
Speech Therapy seemed to have almost NOTHING to do with speech (in my case, any) and was primarily about cognition. OT seemed to have nothing to do with anything occupational, unless there are occupations out there where you get paid for stretching therabands and tossing beanbags into buckets.
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Yeah, at the higher levels, the problem-solving and social-pragmatic language skills that are most often mucked up by a right hemisphere stroke are almost impossible to separate from attention and memory and reasoning. There's a lot of overlap between speech and OT when it comes to the kind of issues you would have dealt with, and who does what may depend as much on the individual expertise of the people on your team as whose scope of practice is what.

Same goes with the boundary between OT and physio. In a lot of places (apparently like where you were), OT does physio-type work with the upper body, particularly when physio is occupied on regaining walking. You've probably been subjected to all sorts of questions and information about ADLs, or activities of daily living. That's what OT is primarily all about -- just getting out of bed, going to the bathroom, taking a shower and getting dressed falls under their broad definition of "occupation." And you need good upper-body strength and coordination to do those things.

A lot of it is counter-intuitive if you haven't been in the system before. I think the one that surprises people the most is when the speech therapist comes in to test swallowing function. It's up there with audiologists treating vertigo -- makes perfect sense if you know the anatomy, but it isn't what you'd initially expect.
 
Ya,

It took me a bit to figure out what some of my therapy was actually for, until a bit later in the process.

And, also had to realize early on that my OT work was mainly for my own mental health in the long run, and less to do with my physical problems.

When I was in my speech therapy, my wife had to sign paperwork for mine, I was in the last of the trials for using music to regain speech in brain damage patients. So, music, combined with Levadopa, is what really made the huge breakthroughs for my speech. That, and, listening to myself talk through a microphone with the earphones on, you really don't notice just how different/bad you sound when you don't have a direct feedback. What you think you hear when you talk normally during the day is much different that what you really sound like. Your brain is GREAT at filling in gaps in speech in your own head. That is one of the reasons speech aphasia works the way it does.
 
skepticality said:
When I was in my speech therapy, my wife had to sign paperwork for mine, I was in the last of the trials for using music to regain speech in brain damage patients. So, music, combined with Levadopa, is what really made the huge breakthroughs for my speech. That, and, listening to myself talk through a microphone with the earphones on, you really don't notice just how different/bad you sound when you don't have a direct feedback. What you think you hear when you talk normally during the day is much different that what you really sound like. Your brain is GREAT at filling in gaps in speech in your own head. That is one of the reasons speech aphasia works the way it does.
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You wouldn't have a cite for the music study, would you? I'm really interested in melodic intonation therapy.
 
borealys said:
A lot of it is counter-intuitive if you haven't been in the system before. I think the one that surprises people the most is when the speech therapist comes in to test swallowing function. It's up there with audiologists treating vertigo -- makes perfect sense if you know the anatomy, but it isn't what you'd initially expect.
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Yes, it made me wonder why they even bothered to give the varius therapies names at all.
 
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