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OT140 Clinical Lab
Zack
www.zackinspires.com
Zack Pollack of Passaic is a wheelchair-confined young man of 24 whose life has been spent fending off the ravages of cerebral palsy since birth. His CP has left him a quadriplegic, without most of the function in his arms and legs. Zack was born three months premature on December 1, 1993, at Mt. Sinai Hospital in New York. He weighed in at 1 ½ pounds and remained in the hospital for three months. As a young child he underwent several surgeries and then again, as a teenager in 2008, he underwent a risky 10-hour surgery which left him with life-threatening aftereffects. Miraculously, he survived, but more than that, he survived with a life-changing realization. “Life isn’t just about living; it’s about living with a purpose. If you believe in your strengths, your weaknesses will disappear and your strengths will prevail.”
Zack was born prematurely at 24 weeks and was diagnosed with CP. In his early 20’s, Zack is now a full-time wheelchair user and needs help with all self-care. He graduated high school at the age of 21. Zack attends Yeshiva University part time in a rabbinical program, as well as computer school in NJ. Zack is active, sociable, and speaks publicly about his condition in an effort to inspire others. Hyperspastic quadriplegia. Periventricular leukomalacia: white matter in the brain is damaged during birth so the electrical impulses from the grey matter don’t go through the white matter properly. It is caused by 3 things: not enough blood to child inutero, not enough oxygen inutero, mothers body rejecting the baby.
Film festival at yeshiva university.
Definition of hero: I care for you and you care for me.
Born due to pre-eclampsia.
8 months old MRI confirmed CP
He uses his CP as something to persevere.
He is aware of his CP but overcomes it.
He is special not because of CP, but in spite of CP.
CURRENTLY 24, BORN W/ A LOT OF CHALLENGES, SPINAL SURGERY: INSERTED 2 RODS: MEANINGFUL BECAUSE IT WAS SUCCESSFUL.
SPEAKING MEANS A LOT TO HIM BECAUSEE HE FEELS IT MAKES A DIFFERENCE TO US WITH HOW WE TREAT OUR CLIENTS. WE DON’T JUST CHANGE THE CLIENTS LIFE, BUT THE LIFE OF THE FAMILIES TOO. HE NEEDS US TO WORK HARD BECAUSE OUR CLIENTS DEPEND ON US. WHEN WE ARE THERAPISTS THE CLIENTS EXPECT US TO BE A SOURCE OF STRENGTH FOR THEM. THERAPY IS SUPPOSED TO GIVE THE PERSON MEANING. WE GIVE THE CLIENT LOVE AND COMPASSION. HAVE TO HAVE GREAT BEDSIDE MANNER. LET YOUR CLIENTS CHALLENGES INSPIRE YOU. YOURE GIVING YOUR CLIENT HOPE AND STRENGTH. WE TEACH OUR CLIENTS THAT THEY ARE MORE THAN THEIR DISABILITY.
His OT does a lot of stretching AND GETS THERAPY 2X A WEEK PHYS THERAPY out of pocket and no longer gets OT unless it’s from a family friend for free. LIKES TO DRAW PICTURES. YOU HAVE TO UNDERSTAND WHAT THE PERSON IS GOING THROUGH. HAVING CP IS NOT AN EASY THING, BUT I CAN OVERCOME MY CP BECAUSE OF MY THERAPIST. HAD A MOMENT OF INSPIRATION WITH HIS THERAPIST. Baclofen for pain, it’s a muscle relaxer. Pain in the hips, back, hands, but Dr.Hader helped with relaxation and pain. Uses standers and gait trainers. Personal preference program for new jersey pays a care taker from the home to take care of the person. Prayer and religion are very important to him. Uses Alexa a lot. In a program called kids of courage, its like a camp but more because they’re like a family and teach each other how to find strength in their disabilities. Yachad is a Jewish based group that has retreats. “differently abled not disabled”. HASC summer camp. As an activist: disability activist, make the MTA wheelchair accessible.
Medicaid makes it hard for a CP person to obtain services because it is not curative. Medicaid wants to provide a cure instead of an ongoing maintenance therapy.
· Growing up, which therapy was most helpful to you, and why?
· As a college student, what’s been the biggest challenge for you?
· Why did you decide to become a rabbi?
· What are your favorite hobbies, and were they always easy to perform? I’m a regular guy, watches sports like football (giants), public speaking, loves Chicago Fire, his exercises like arm lifting and leg lifting in the bed, likes to go to plays and fave was Aladdin, likes concerts like Elton john.
· What’s the most important advice you’d give to someone with your diagnosis?
Richard:
Richard is currently in his 60’s. He sustained a traumatic brain injury after being hit by a car while crossing the street on August 4, 2004. Richard was found unconscious on the scene, was later admitted to a Trauma hospital, and was found to have a Glasgow Coma scale of 6. He was placed in a medically induced coma for 2 weeks. Once medically stabilized, he was transferred to inpatient rehab for 1 month. Richard’s current impairments include: difficulty speaking and understanding language, short term memory loss, loss of taste and smell, decreased attention, and difficulty with visual tracking. Prior to the accident, Richard worked full time in a managerial position. Richard does not currently work full time, but he volunteers at a rehabilitation hospital once a week and is very involved in the New Jersey Brain Injury Association. Richard’s wife is very involved as a spouse, caregiver, and advocate. He also 2 daughters in their twenties, who are also very supportive.
Richard is currently in his 60’s. He sustained a traumatic brain injury after being hit by a car while crossing the street on August 4, 2004. Richard was found unconscious on the scene, was later admitted to a Trauma hospital, and was found to have a Glasgow Coma scale of 6. He was placed in a medically induced coma for 2 weeks. Once medically stabilized, he was transferred to inpatient rehab for 1 month. Richard’s current impairments include: difficulty speaking and understanding language, short term memory loss, loss of taste and smell, decreased attention, and difficulty with visual tracking. Prior to the accident, Richard worked full time in a managerial position. Richard does not currently work full time, but he volunteers at a rehabilitation hospital once a week and is very involved in the New Jersey Brain Injury Association. Richard’s wife is very involved as a spouse, caregiver, and advocate. He also 2 daughters in their twenties, who are also very supportive.
On vacation, struck by a drunk driver in point pleasant NJ. Not expected to survive but here he is today. HRA NYC manager. Helps other TBI survivors. Pseudo bulbar affect. His brain will be donated after death for research. The rolling stone you can’t always get what you want but if you try sometimes you just might find you get what you need. 1.7 mil TBI every 20 seconds. It’s a chronic condition because its forever. Leading cause are from car accidents, self-inflicted, assaults, accidental injury. Phasic meaning trouble with speech, reading, writing. Completely lost sense of smell which affects taste massively. Recent grandfather but can’t smell the baby smell. Severely affected libido “sucks”. Takes a lot of ADD drugs that he’s phasing out. Cognition fatigue. Supposed to nap but is very stubborn. Happy his wife puts up with him even though his personality changed after TBI. Sleep apnea. Over 20 operations. Brain was hurt as well as entire body. Short-term memory issues. Testosterone injections. Aggressive since injections. Im a survivor and I help other survivors. “Everyone needs to be helped”. “my life is very black and white”. Went from a trauma center to an acute care facility to outpatient rehab. Participates in a lot of clinical trials. No calming techniques. No antidepressants because he doesn’t think hes depressed. Don’t think of therapy as a weakness. Enjoyed OT a lot because it helped with daily activities. OT made him feel calm and at ease. OT made him cook rice and black beans for them and it was good. Severe balance issues when he came home from the hospital. Putting up xmas lights hit his head on a tree branch and needed to go to the ER asap for an MRI. “therapized” lmao. Neck and spine surgeries had to do with the TBI accident. Had the food tube for 3 weeks after the initial TBI. Injury was in the back left side of the brain where communication is. Needed a pressure release machine drilled into his skull. Uses a lot of lists. Used to carry a tape recorder to help him remember things as well as post-it notes. Empathy wears with time. Sometimes the spouses and caregivers have it worse. Feels he got screwed out of life and wanted to kill the man who hurt him. Case went to trial. Town and light company were sued. Thought of suicide a number of times but doesn’t want to hurt his loved ones. Very old school New Yorker. John Daverin. No adaptive medical equipment. Has to remind himself why he’s going downstairs or he ends up eating instead of shutting the lights. In rusk for 2 years.
Free time: very busy. Does the finances. Can do everything like before but not as fast or good. Wood and electric work. BIA fundraising.
Assignments: Students should use class texts, other course materials, and additional resources to complete assignments. Each student is required to turn in an individual assignment. All assignments should be in APA format. Be sure to include references.
Initial Case Assignment (50%):
For the initial assignment, refer to the case summaries and provide the following:
· A brief description of each diagnosis
· The neurological structures and functions that may be affected with each condition
· Predicted prognosis and functional outcomes with rehabilitation
Papers should be type written in essay format and should be approximately 4 pages.
For references :Lundy-Ekman, L. Neuroscience Fundamentals for Rehabilitation. 5th Ed. St. Louis, MO: Saunders/Elsevier 2017. ISBN-13: 978-0323478410.
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