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106 – Semantics and Platitudes in OT Apr 02, 2021

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So many times over my career I’ve heard cliche’s and platitudes used by therapists and often wondered….do they know what that actually means? Recently I’ve had a number of discussions on this podcast about terms used that are used incorrectly OR used as lip service and I thought it was about time I did an episode and explored some of these. Terms explored in this episode include: HolisticWoo WooFunctionServingand more…. Tune in to hear my reflections from my brain and a dictionary. I’d love to hear from you. Drop me an email or a DM on socials and talk to me about how I can give you even more value. If you know other OTs who would also get value from Occupied or Occupied plus then let them know and send them to occupiedpodcast.com. I can’t wait to see you next episode. Look after yourself, look after others and always keep Occupied Brock@brockcookOTbrock.cook@me.comwww.occupiedpodcast.com If you want even more valuable content join Occupied Plus+ on Patreon for bonus podcast episodes, resources, mentorship and much much more! Transcription Brock Cook 0:00A quick message to let you know that occupied plus has launched over on Patreon. If you are looking for some extra value from occupied extra podcast episodes, downloadable resources, access to me supervision, mentorship, and many, many, many, many more things that I will be continually trying to add more and more to than jump over to patreon.com forward slash occupied plus, and check us out tiers starting from $4 us a month, it is bargain basement for extra value that can add to your clinical practice. Now let’s check out this episode. I’ve been meaning to record an episode like this for some time. And I finally got around to putting it together and bringing this to you. There are quite a few things that ot say on the daily that I see very regularly on social media, in ot related groups, etc. that I don’t feel like OTS fully understand what they’re actually implying when they use certain terms and certain words. So I was actually have a look at the definition of some of the things that we say and see whether or not it actually matches up with what we are intending it to say. Get a My name is Brock Cook and welcome to occupied. In this podcast. We’re aiming to put the occupation in occupational therapy, we explore the people, topics, theories and underpinnings that make this profession so incredible. If you’re new here, you can find all of our previous episodes and resources that occupied podcast.com. But for now, let’s roll the episode. All right, so firstly, I want to lay out there that this is absolutely in no way intended as an attack on anyone or anything like that. This is simply me looking at patents that I see within promotional material things that people put out there with regards to the profession, how we work, what we do with people, etc. That has never fully sat right with me because I just had this sort of gut feeling that some of it didn’t make a lot of sense based on my understanding of the definitions of these words. I know often the the the term semantics is often thrown around for Potato Potato. Why does it matter? But semantics matters, semantics is the use of linguistics, the study of language and what words actually mean. So it’s kind of important, especially from a profession that is continually complaining that the one word that we use to define our our profession is used or known for a different definition by the general public. I don’t think we can have our cake and eat it too in this instance. So I just wanted to have a look at some of these words. If you’ve got other ones, let me know. And I can do a follow up and we can explore other words, but these are a few that. Some of them I’ve spoken about before some of them I have never mentioned. But let’s have a roll, let’s have a look and see what we can find. So the first one is one that I’ve explored many times on the podcast, but I would be remiss if I left it out, and that is function. So actually having a look at definitions of functions, it’s looking at effect is related to or dependent on other factors. Now when I explained my aversion to using the term within our profession, I use the example of mathematics as does this Deaf dictionary definition as well, where it explains that this factor dependent on other factors is for example, the price is a function of supply and demand. That’s some basic mathematical formula that you can use to work that kind of stuff out. But when you input some set of numbers at the end, you’re going to get exactly the same format the exact same function out the other end of it because it’s consistent, and people are not consistent. People do not conform to if I input the same data into one situation in a person, I’m not always going to get exactly the same outcome. So that’s my aversion to function. There are certain professions that use that term quite successfully. For me Apple, if you’re looking at sort of manual muscle testing and that sort of stuff, if you put a certain charge through a muscle, you’re going to get a certain reaction, there are parts of the body that do behave in a functional manner. But the person as a whole, yes, there is some predictability but not completely to the point where you could say, Yeah, they’re they work functionally. In that instance, and we have other words, we have occupation, as a lot of therapists have an aversion to using the term, I’ve explained quite a few times how you can explain it, that just makes sense to people. But we have terms that we can use that one better explain what we actually do. But to also better encapsulate the breadth of service that we actually can provide. The next one that I want to have a look at. And I know that some of these words are going to get some people’s backs up. But what I would encourage you to do is if you do have an aversion when I bring up a word or a term, have a think have a reflect, because why you’re reacting to something is also a very important thing to reflect on. So the next one I want to bring up is holistic. For a long time, I’ve often been of the ilk that we’re not holistic, OTS are not holistic, there are very few professions, if any profession that actually are holistic. When we look at the definition of the term, from a philosophical point of view, it’s the theory that whole entities as fundamental components of reality have an existence other than as the mere sum of their parts. So you know, that you will have heard that in textbooks that people are more than the sum of their parts, that kind of thing. There is more to a person, then just the different systems within the body, you know, we have our limbic system and our gastritis, and all those sorts of things. And we put those all together, and that is a person. No, there’s a lot more to it. And yes, if you’re looking purely at that, you could probably maybe justify ot as holistic. When we look at medicine, like a medical definition. It’s looking at the care of the entire patient in all aspects of wellbeing, including physical, psychological, and social. And I believe that if you take those last three areas out of context of the whole definition, then yeah, OTS, right, we look at those things, as a profession, as an individual therapist, you should be at least see during those things. But we don’t care for the entire patient, based on all three of those things at the same time. Ideal? Well, yeah, it would be amazing if we can. But in reality, as a profession, there are probably enough people working in enough different areas that we could call IoT, as a profession, holistic as a health service, I would hope that a really well designed Health Service has enough different professions, looking at all of the different aspects that make up a person’s health and well being that the health service could be deemed as holistic. Now, I know there’s a lot of issues with different health services. So I’m not going to say that health services are but in the ideal world, you would hope that a well designed well resourced health service could follow fall into that classification. And individual therapists, I think you would really struggle. I know for one, me as a, an OT work who worked in mental health, yeah, psychological social, all over that. All over that the physical stuff, I can make recommendations, there are a lot of physical aspects of ot I have absolutely no idea about and I would not look at, I might get someone else to do it. But again, that’s because the health service I was working within was holistic, not me as a as an occupational therapist. And I believe that the I guess morphing of this term, is where we’re getting slightly stuck with our use of it. So yes, we do look at the person as a whole but we don’t provide care for that person as a whole. We can’t, we can’t we just don’t have have the resources, I don’t know if one any one person has even the brain capacity for the amount of knowledge that would be required to do that. But the term in more recent years has almost been hijacked and sort of modified in this term holistic health. And what Holistic Health tends to look at is those professions that aren’t generally you identified during general health discussions. So you’re gonna have things like counseling, art therapy, being a youth worker, kinesiologist hypnotherapist, a lot of Eastern style, alternative and air quotes, alternative medicine type professions, tend to come under the moniker of holistic health. Now, that’s not to say that those individual professions are holistic in unto themselves. But I believe that the term is trying to, I guess, encapsulate a more holistic health view as an umbrella term by bringing in a wider variety of Health Professions into health discussions. The The, the thing that OTS get caught up in is there are a lot of 80s that are now looking at providing these sort of, for lack of a better term, I’m going to call them alternative health services. There’s a lot of 80s that, especially in the states that often start off studying kinesiology, before they move into it. There’s a lot of 80s that I’ve seen online that you know, now providing meditation, mindfulness yoga, guarantee you that there is oddities out there that also provide art therapy. Sure, we could find an OT that does hypnotherapy out there somewhere. But ot is trying to expand their skill set into other areas is why one, if it’s them, I guess, trying to expand their scope, because the for whatever reason, it could be that they’re not comfortable, or that there are with the the scope of ot itself, or that they feel like they’re personally able to bring more to their clientele with this extended skill set, whatever the reason is, it’s not important for this discussion. But that holistic health is then is then being tied in with OT, because people are expanding their scope of practice into this, quote, unquote, holistic health realm. When described like that, I don’t feel like there’s too much issue in using the term if it’s being used correctly. I it’s a red flag for me, when anyone is describing themselves as a holistic health profession or a holistic anything other than, like, I’m a whole person, but that’s about it. Because straightaway, I’m like, well, there are definitely things that you can’t look at and you can’t service and that you can’t provide care for. I know a lot of therapists that actually have dual degrees in very in different health settings. So I know a couple of people that are also OTS and physios. I know at least one person is OT and a nurse. And having these dual roles provided, you know, the registered and both and all of those sorts of things would allow you to provide definitely a broader range of services to the people that you work with. But even then there’s still gonna be things that you’re not able to do. So, holistic health or whole, being holistic, I feel like yes, it’s definitely a term that gets used in health. I do feel like often it gets used incorrectly. And I do feel it’s kind of often used as a marketing tool because it sounds fancy and it sounds New Age and it sounds work and all of that. But I think having an understanding of how that word actually frames your service. If I was going to our holistic health profession, I would be expecting that person to be able to do everything, because that’s what the term means. Alright, let’s move on to from that onto one that tends to often go hand in hand from from my observation. Woowoo. And I won’t spend a lot of time on this because I don’t think it needs a lot of time. I see a lot of OTS describing themselves as woowoo. And one, it never made sense because the term itself just doesn’t click with me. But also when you actually look up the definition, the very first word, in the definition is derogatory. And then it goes on to explain that it’s slang based on or involving irrational superstition. So if someone is woowoo, then they’re basing their ideas, their concepts, their thoughts on irrational superstition. Now, if I was going to any health profession, with the knowledge, that Oh, and I found out that they’re basing their treatment and their care on irrational superstition, there’s a fairly good chance I’d be canceling that appointment and finding someone better. I understand that if there’s a cultural thing around woowoo. With it, again, being art, you know, often used in the context of Oh, you know, I’m just fine and a bit quirky. But when you actually look at what that means, it’s pretty much the complete opposite of what the profession is. I don’t want an OT or any health profession that is irrational, and basing their their treatment options on superstition. So I’ll put that one aside for now, because I just feel like it has no place in the profession. And again, my opinion, another one slightly off topic to the slightly off of brand to the ones that we’ve looked at so far. But the the concept of serving, and I know this one’s gonna be slightly controversial. I know people are gonna have different opinions about this. But I have the microphone. So here’s my opinion. When we’re looking at definitions of serving, I know a lot of OTS do talk about I’m serving my clients, or I’m serving this population, etc. And it’s never sat well, and I never really understood whether it never sat well, because I don’t like being told what to do, or whether there was a more sort of genuine reason for me not seeing a correlation with ot. So I’ve sat down and actually put a lot of reflection into this one specifically. And I think I’ve kind of worked out why I don’t like it. So when we’re looking at definitions, the definitions is either acting in service or distributing something that’s kind of the two different trends of the the various definitions of serving. So we’re acting in service. So we’re serving someone, or we’re distributing something. So we’re like, you know, we’re we’re serving dinner or something, we’re serving our service of some sort. Either way, either one of those two, I think, and this is the big thing that that irks me and sort of my intuition never really clicked with the term is either way, neither of those are collaborative. Collaboration is one of the biggest things I see in a contemporary occupational therapy profession. And I feel like that’s where the profession is moving more and more is collaboration with our clients. If I’m serving them, then it’s almost like the complete opposite end of the spectrum to me being prescriptive and giving them a service and fixing their issues. It’s me almost taking that very passive role. And whatever you want, I’ll do that, that’s fine. We can off we’ll we’ll get an idea in our heads of what serving just as a general term, not in a healthcare setting sort of means. But it’s a very passive, it’s a very standoffish, it’s a very submissive role. Generally, in any serving profession. There’s not a lot of collaboration, if any inner serving profession. The other t…

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105 – OT Needs to be Doing Being and Becoming MORE ft Khalilah Johnson Mar 19, 2021

Show notes

Crowd favourite Dr Khalilah Johnson is BACK! and this time we are delving deep into the realities of inclusive practice. We started out discussing her research around including within a disability context but soon exploded to inclusion in many other contexts. There are many parts of OT that need improvement and we explore the lip service that is often payed to topics around inclusion with different populations. This is an important topic, especially in todays overly connected society where information and access to news is faster than ever before. Where social capital is now derived from what one says and not what one does. How does this impact the work that so many therapists have lived and/or dedicated their lives to? Tune in to hear our thoughts on all of this. Brock@brockcookOTbrock.cook@me.comwww.occupiedpodcast.com Automatic Transcription 105 OT Needs to be Doing Being and Becoming MORE ft Khalilah Johnson 00:00:00 – 00:05:03 We want to look at your your journey Into how you got where you are now and into the causes and the the research that you’re you’re currently looking into and how far back does that does that. Does that janney start before you started. Iot over. Half are baxter. We delve to start with. I don’t know that we want to start all the way back. Ot sixteen years now and we did. We did have a little bit of like hey going to the profession and stuff in the lawsuit that you’re on that’s right. Well i guess i could start is sort of the clinical experiences that I think really changed the trajectory of my work. After i moved to north carolina to pursue my hd at university of north carolina I was Subcontracting through a company that was providing services to the state in developmental centers or intermediate care facilities for adults with intellectual and developmental disabilities and was just really finding it very difficult to do my job Basically being told not only by the facility but really dictated by the state sort of what the range of an occupational therapy evaluation like And the expectation for me not Write a treatment plan or do any additional consultation with staff pertaining to addressing any sort of Occupational needs of the residents there. And so i’m sort of looking at this will want what. What’s the point of occupational therapy. Then if it is not for me to draw on it by professional expertise to say here here are some things. That are problematic weather. It’s just about being able to participate Or if they’re real real safety considerations in these facilities and here’s how we can address them or develop a treatment plant. Always you know in collaboration with staff. They wanted no parts bet. And so the more i pushed more. They pushed and Just went to buy adviser. Nancy bagatelle and said i don’t i don’t care what my dissertation is about but it has the center these sorts of issues So it’s like. What are the really the the policy that mediate not only what i was able to do as a therapist. That really how the people were the issue in these facilities are just able to live regular. Is you know Even what’s wrong with that kind of stuff because we have similar kinds of issues in australia as well. Do you think that the issue is like outdated policies or policies that have just been made in uninformed way a little bit of both right. you know. There’s definitely some historical towards people with disabilities that informed the policies when they were ready some time ago but they earn supposedly revives with you know thinking well ardal supporters in person centeredness and all of these things. 00:05:04 – 00:10:13 But you still have all these antiquated ideas of what that supposed to look like. He can’t be person centered without actually considering the person you know. How do you have a conference about what somebody can do. They’re there for you know. The even their caregivers are included in the decision. Making it makes sense. Yeah yeah it’s like you know. The the literature ari tells us that with appropriate support. People can participate you. But because they’re in this congregate situation there. It’s the thought or up the various a culture of the entire enterprise right that The folks who live in these facilities can’t make decisions can’t do themselves don’t know what’s best for themselves all of these ridiculous things that we hear all the time even each facilities. I mean happens in group homes to. Oh they’re out in the community. It’s like now. These have institutional qualities is experiencing the same thing in various mental health settings impassioned community same thing and one of the real simple things that we push full before i moved in academia was getting the person involved in their own case. Conference like sean. We’re can have a group of people sitting around talking about them but then people were worried about bringing them in because of all they’re going to hear what we say. I’m like yeah. They can hear what you say. You’re talking about them. What are you saying about them. They can’t hear oh that they shouldn’t here in. Does that one does that thing. Need to be said if there is something or a you just making out of a molehill and a lot of the the pushback that we had was more seemed anyway more just because all. We’ve never done that way. It’s always been done this way. I’m going well. It doesn’t mean you can’t change it but this kinda stuck in their ways. There’s no there wasn’t a policy saying that it couldn’t happen it was more just This is how we’ve always done it all. Is that all quicker if we just went through it among is thanks. Here it’s for the state specifically They’re op. There are policies in place to include people would As well as people with mental health as they fall under the same set of standards and guidelines But in practice. It doesn’t happen which is bizarre to me and just like you’re not even income. I at when you worry about compliance. All right i’m going to be in compliance when the state servier shows up. Yeah so where did you. Where did you so that was for your what did you. What did you find that. Basically we legislate ourselves into these holes right and it’s in. It’s all said by attitudes that you know again. People with intellectual and developmental disabilities Are not a musician to Contribute to their own care In ways that people believe are are safe or that make makes sense And that ease facilitation centers or developmental centers On paper say that they’re there to sort of support Bit availability skills and all these things to help. People return to the community. When in fact they. All they do is perpetuates custodial care. They’re really sort of built like skilled nursing facilities. You know with the exception of some adolescent programs respite programs and that sort of thing And that be happy. Let the state and national level. Who i think truly understand that the things we’re talking about about human rights. This isn’t about you know just simple healthcare sorts of things this is you know people have a right to choose what they want to eat and when they eat it you know people have a right to be out in the community like people have the right to the very basic things that we take for granted. And they’re not there. These ask are not exceptional. They’re not exceptional. No it’s not. Stop treating it as such The the people who were charged with their care twenty four hours a day. You know these frontline workers Their their work is grossly undervalued. They’re not treated as experts in the care people with id because they don’t have a particularly isis right so even how The the programming happens is very lowest in a way. 00:10:13 – 00:15:09 it’s like. Oh well if. They’re not the psychologists that are not this. They’re not that than one you have to take. You know their opinions of what you know mr. Tom can do with a grain of salt. Because you know what. They really understand about x. Y. and z. I can’t tell you how much that showed up in my in my data you know so. We have so much more work to do. Not just with how these facilities operate. Although i am in favour in abolishing all of them But in doing so we have to make sure. There’s a cultural shift Just about people with disabilities in general. But really you know understanding that we’re talking about basic human rights you know meeting the threshold people to be able to live the lives. They want to lead and then saw interesting. Because i’ve always found a number of conversations with clinicians about essentially the people with the highest paychecks usually know the least about the people that treating and like and another thing. I used to have her into whatever had students get to know the cleaners because i can guarantee on zone. It was on the key in it. They know everything about everyone. And everything that happens on that ward and if you need help doesn’t even matter what it is if you need help they know who can give it to bob la la. They were more helpful resource than any other clinical highly educated multiple degrees high paycheck stuff that could ever walked through that front door. Because that just around the people hold on bassa they get to them absolutely absolutely. I was a clinical instructor early. before going. back to school. I would do the same. The interdisciplinary team is not just the licensed folk talk about has during the entire environment. Is everybody in it. You know like you said like you said in. Its in its wild. We preach that an ot right but it’s really not practice. I used to get so like The rehab managers and things that some of these facilities sometimes. We get bent out of shape. If i would include a note that you know of the plan in collaboration with staff. It’s like first of all. I’m a i’m a. I’m a contractor. I’m not here every day you know. I’m not in the buildings all day every day. you know. Sometimes the evaluation was my first time meeting. Somebody said the only thing i know about them. It’s what’s an chart and whatsapp is telling me right. So how do how do what do i look like. You know saying like oh this is all these are all the things that you know miss. Betty’s going to need site. No let’s sit down and talk about you know what’s their history you know. What’s a typical daylight. What is it that you’re actually able to do. What source supports. Do you need to be able to do that. You know and if miss miss betty doesn’t use conventional language you know spending some time in the building observing how it is does communicate communicate her interest in likes in speaking to the staff about how to incorporate that so. They don’t have these arbitrary behavioral plans. I hate that term so much. Because they’re like oh she doesn’t want to sit down and you know eat home peas like we or to site world because she likes her deserters but we don’t want a two year dessert i. This is ridiculous like endure at your home. You decided you wanted cheesecake before your salad allen. Just chase guy. yeah. I mean a lot personally love salad. Yeah but you know. There are those sorts of arguments. That i’m like. Are we really spending time right on this really spending time on this. Yeah i often to you tell before about who’s included in the tame and. I wondered why i’ve never seen any literature or anything that has included. Say like one the person or the family or their caregivers or the support work or anything in the md t like as a definition and. I don’t know why. I wonder whether or not just even including them in the sort of the term of the trading team would actually create more. 00:15:09 – 00:20:06 I guess inclusive opportunities will make you normalize it normalized having them involved more were because like what’s what’s written changes everything right if it’s not in black and white then it’s it’s good. They’re excluded. So yeah the stuff that i’ve read to even around and this interpretation of a lot of the stuff but a lot of the stuff that you read. Iran client centered care. What of the models that you look at client centered care. It’s still discuss it as a discusses them as an other. Its yes we’re doing this. What putting them in the middle and we’re doing this but they’re still them and westville us and we’re still yes okay. We’re listening to them while they might be driving. The the the treatment is the usual sort of inclusive language. That gets used in those kinds of papers but this is still a separation this still. There’s no we talk about teamwork and we talk about united cohesion. And we talk about all that sort of things but none of the models. None of the frameworks that we use even for clients care. Do it is found because obviously you looked at a lot more of that than Nope the exact same you know there is. It’s almost like a passive mention right. If i have to make sure we include this one phrase about include the occupy dry. What actually happens in treatment and Sorry mexicana internet unstable message And you know. I think it creates this false narrative if you will that you know this is something that we ascribe to u. n. therapy and then it should happen in ways that that’s representative. Some of these articles are in textbooks. meghan blaskowitz wanda mahoney. I did a massive Scoping review of all all the literature. So not just what’s Represented in american journals but journals across the world that publish anything about people with intellectual and developmental disabilities and you know literature about sort of like inclusive treatment planning or Mid inclusion of people with intellectual disabilities in therapeutic Decision making process was menopausal minimal. And i’m like how. How even in our twenty twenty one with so much talk about self determination About you know person. Senator clients center planning and all these things are we are. We still saying this blinding gap and what we’re actually publishing about it. So it’s like people actually doing it. How are they doing it if they’re doing it at all so the minimal stuff the did find because i’m trying to find the silver lining in this was in. Was it more recent like we actually moving towards that or is it just sort of scattered throughout the last decade. And it’s just kind of a non something that people just ought even considering it’s definitely more sent Just because we that was the the range of the dates that we use all morrison literature. But i i mean it’s concerning that it was not as much as we. We thought we might find angry. And this is not all occupational therapy literature literature that can relate to occupational therapy practice and the ot specific kind of literature is still you know specific to of course i d is still growing So we’re drawing from special education and no seeing at psychology psychiatry Which you know. It’s no secret to anyone that sort of over the history of those organizations to the way People with id disabilities in general have been talked about has not been favorable. So do you think you know. Overall at least There is somewhat in. its incheon. An occupational therapy to make sure that we are addressing. The interest in needs of The communities we serve. 00:20:06 – 00:25:01 Because you know we we ask about it in additional profile right so by it would. It would be my hope that we take it a step further and and sort of treat like we do in participant action. Research right at people are actually included from the beginning that everything about them. That’s what drives are decisions making process. Right they are driving the evaluation and treatment development intervention development. Planning and discharge. Cloudy on top of that. ’cause i probably cooling it in but Do i want a really good. How far back do i want to She’s a really good at patting each other on the back and saying how amazing. But i maybe in pessimist. I don’t see all of the amazing things that people think we do. I don’t think we are doing as well as we could be or should be doing. This is one o…

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104 – My Hospital Stay Reflection Mar 10, 2021

Show notes

So it took 35 years but in early December 2020 I had my first experience being admitted to hospital. It was eye opening to say the least and my experience highlighted for me certain things that I NEVER considered when working for the same hospital system. These are my reflections on my hospital experience. Look after yourself, look after others and always keep Occupied Brock@brockcookOTbrock.cook@me.comwww.occupiedpodcast.com Automatic Transcription 104 My Hospital Stay Reflection 00:00:01 – 00:05:02 So early december. I had my first ever stay in hospital and during that time. And since all of the follow-up excetera i have really been trying to focus on using it as a learning opportunity to see what it’s like on the other side of the health service. I would like to have a conversation today about my experience. And hopefully there’s some tidbits in there that you can learn from and reflect on your own service delivery or your own experience on the other side of the fence So here’s my reflections on my hospital. Stay get a named brock. Cook and welcome to occupied in this podcast. Where aiming to put the occupation in occupational therapy we explore the people topics theories and underpinnings the make this profession sewing credible. If you knew here you can find all that. Previous episodes and resources at occupied podcasts dot com. But for now let’s roll the episode in early october. Twenty twenty is started getting a sore throat. I had assumed that shoe to the weather becoming extremely hot and the fact that we started using air conditioning. More i was coming down with a cold. I tend to get sick very often. But when i do tends to be around those times where during my day i change from hot to call hot to cold environments sort of more regularly. That sort of shift in temperature is really often during the day. Tend to mess me up a bit. So i just assumed i was getting a cold. It started out. Felt like a bit of a nice strip thrive. That kind of thing took some throat. Lozenges etc fell my glands role a little bit swollen etc. Didn’t think too much of it. The next day that would have been like a wednesday the next day so thursday it was slightly was nothing to be concerned about. I’ve definitely had worse. Flus and sort of gradually very very slowly got worse throughout that thursday so went to bed about ten o’clock on thursday. Not not thinking anything open. I think had a throat lozenges or something just before oh into bed just to try and ease it enough that i could get to sleep. I woke up at three o’clock in the morning. Friday morning and my throat was so swollen. I could feel it impeding on my airway. I could still breathe fine. I was struggling to talk. It fell on. My tongue was swollen. And i thought this isn’t really good. This no longer feels like it might be a cold. I should probably go and get checked out now for a bit of context. I had the day before. Already made an appointment with my gp for that friday afternoon to go and get my throat checked anyway. Just in case at three in the morning it was at a stage. Where i was like. I can’t really white another just over twelve hours for my gp appointment. I’m gonna go into a med and see and get checked out. So i took myself into emergency department at the local hospital here. Which is where my story begins side. I’m rocking up. And i will preface this that i am not out to slag off any particular service any staf any department anything like that. I am simply conveying my experience with going through this system i system that have never been on this side of before of never had a hospital. Stay that our member. Apparently i had a short one went ahead. Add noise that. When i was a kid. I have no recollection of that But this is my first time that i’ve ever had access emergency services. First time i’ve ever stayed any extended time in a hospital or dealt with a lot of the professions that i dealt with during this i. I’ll preface it with that just in case it comes across because as positives and there’s definitely negatives To my experience the very first i would say probably negative was trying to actually sort of check in emergency. I rocked up the Obviously my iron ambulatory wanted myself in and trying to speak when i could. I was having some trouble breathing to a lady on the other side of a perspex screen. Who is asking me all kinds of details. 00:05:03 – 00:10:00 And i can’t speak. She’s struggling to understand me but rather than come up with some other way for me to be able to get her the information that she needed. We just continued this for a rather long on what felt like often al until she got enough details that she could actually admit me to or me on the computer. Anyway to the emergency department. I then waited at the front or in the waiting area at the front of the emergency department for not too long before nurse came out and took me and another lady who had been waiting there monitoring are how long she was there when i arrive. Says she’d been that long than me through the serve stores out into the actual emergency ward where she essentially showed us to a bed bed in an emergency. If you’re not sure is pretty much. Just a little curtained-off area. They’re very taught very small. They’re not very comfortable and it wasn’t too long. I i came pretty much all the same questions. The lady beforehand had asked me through the perspex gave her all of that information. It was stuff about what i’d been doing. You know what. I’d noticed how long the simpsons have been there all the usual questions you would think of a background as to the presenting issue. That was all fun straight. After that i had a junior doctor come and see me again all the same questions that the nurse had literally asked me probably ten minutes beforehand. This junior doctors However did a physical examination of my throat and my tongue and surrounding areas etc tribeca. What was going on which is fine. There was a slight bit a pain. She was quite gentle so it wasn’t too bad when that was sort of parking around my mouth in my my tongue etc. She had no idea what was going was a very unique presentation. I’ve found out since that even the when she went and got sort of her boss which i believe was the registrar on that shift. He came to the very similar examination. He wasn’t quite as gentle. Buddy was still. He was still really good. Those doctors in the emergency department. Wh- excellent keeping me in the loop about what they were thinking. What thou doing. What was going on. What was the next step. Excellent the emergency department at that hospital. It was as good an experience. As i could have hoped on the circumstances i guess they originally thought that it was some rare condition. Based on the fact that one side of my tongue was swollen and raised and my tongue. Wiscon- to slow ping and apparently that was some super rare condition that this Doctor had only ever seen before in his studies years ago. But that kind of made me somewhat of an anomaly for a short period. And i got more attention than i think i needed during that time. He did ask if students could come and have a look and examine because it was at the time he thought was going to be the super rare condition. Truck honey remember what. It was called some big medical name. The educator in me went. Yeah sure that’s fine mcafee lifelock. I got nowhere to be him sitting here waiting for you guys to work out what it is and how to fix it so i was more than happy for them to come and have a look. I eventually hurricane. I probably saw twenty doctors In that first couple hours Would come poss and purely ask if they could have a look do a little examination. Some of them were there for a minute I was poked and prodded more than i was expecting to. When i said that i was happy for that to happen. But in the end again the the educator in me or the want to assist in people’s landing Didn’t blink an eye when i that’s one. I got to a point where people were coming up to me and going. Oh your that such and such or you’re the person it wasn’t even my name. It was your the person with such and such condition by that stage. I was starting to think. Wow this is gonna make an interesting reflection at the end of it because that being labeled as a condition was definitely a new experience for me. It wasn’t some something that i was super pleasant or soup Comfortable with Up i never said anything at the time that we’re doing their job and again i was there for assistance. I had no idea what was going on. 00:10:00 – 00:15:00 I wouldn’t say. I was stress too worried because i like. I said i was still able to breathe. I started getting a lot of pain paint swallowing pain drinking pain anytime. I can talk anytime. I move my tongue. It would hurt so even though i could breathe. It hurt to do pretty much anything else i. I was trying to limit that which sending thirty five million doctors around to talk to me. Probably wasn’t assisting in it. I was sent for a c t where they discovered that it wasn’t actually this super a condition that they originally thought it might be all in reflection. I think they were kind of hoping that it would just to liven up their day or something. But in fact it was a massive soap starring in my saliva gland on the left hand side onto my tongue that had then become so infected and saw a swollen that it was actually pushing up on my tongue and then when it had nowhere else to go there was pushing in towards my airway side. The odd thing was often. I had that answer. I don’t think are sore now. The doctor until i got moved to award It was very it was an interesting experience. Where one it was on my slack. I i can understand why people play the victim. Because i had more attention than i wanted. When it was essentially sounding what could be super super severe and rare. And i was in there trying to google. What was what the treatment plan was for that particular condition etc and it didn’t sound very good But as soon as they found out it was something that sort of mundane that was it now was interested in talking after that the other issue was i was in the originally. They kept me onto by mouth. Because up until i found out what the actual issue was. They weren’t shortfalls. Gonna need surgery or anything like that. So i was kept nobody mouth. I got in there at three thirty. Am and by the time. I’d got back from the c. T. i had the answer. They realize that there was gonna be nice surgery i. It was probably about three o’clock in the afternoon. Saw lordy been there for twelve hours and eighty bed just sitting on it. He’s not the most comfortable thing. I was starving. I hadn’t had any water Either and it was difficult to get a plan What was going to happen with regards to the next step by that stage once once i had that sort of an saw so i i ended up having to go up to the n. T. and i had a skype. They checked out my throat to make sure my throat wasn’t being impeded from the inside or anything like that And there was purely this Swollen tissue around this this stein. Why before i left n. T. oft the skype that was oh that oh came back on before i left because i was admitted under the anti tame. I asked them if it was okay to eat. Now that they knew that the plan was gonna be that. I was going to have to stay in hospital and going some. Iv antibiotics for a few days. There was going to be no surgery. Okay sweet. that’s awesome to have some food have some more. Yep sweet niwa race. I had to go back down to d because that would chaka’s and almost waiting for a bed on the surgical ward. So i’m back down to ed just as the nursing shift handover was happening I heard during the hand iva that i was apparently still nil by mouth by which a doth protest because i obviously the anti hadn’t put that into the notes from my appointment in the department so the nursing staff in a d was still under the impression that was nobody math by that stage. I was getting hungry but that will really good once. I pointed out. Mike dude i just got back from ent. They said this is the plan which was written in the knights but the nobody mouth ending actually wasn’t conveyed cy. Shanna bringing in t- it took about forty five minutes but they found out she got permission to yes you can have some food etc and i got like hafa sandwich and a bottle of water which was by that stage. Because i hadn’t eaten the day before. I think it was about twenty eight hours. Since had anything fluid food or fluid. That was the best tasting. 00:15:00 – 00:20:03 Sam tell you what was on it now. But that was the best tasting sandwich i’d have had at the on because i was fading away to a baby elephant. Apparently eventually i got moved to the war now. This is in my experience where i think most people would guy your health. Professional health professionals make terrible patients. And i can agree with that for the most part because one of the things that annoyed me and i know it was hospital policy but it was really really frustrating. Was the fact that no one would allow me to walk anywhere. And that’s annoying. I feel like an easy situation where i can’t go any way. I can’t do anything being able to go to the appointment or move to the war etc on my own. Steam was one of the only things that i actually had control over in that situation. And that was being taken away de. I was in there for a starring in my mouth. I wasn’t on any medication at that point. In time i walked in a drove. The hospital. And i walked in on my pal. There was nothing impeding me from mobilizing. I’d been often wandering and garner the toilet etc in the in the idi ward the whole thirteen fourteen hours that i was in there and multiple nests. Had seen me do this but for some reason. Walking to the next ward was pooh-poohed. Anyway i got stubbing at some points and at one point i gave often just sat in the chair and push me around which was to me. I felt at the time really demoralizing. I found it really embarrassing. And i know there’s no reason for it but to me if i’ve got the power to do something myself and you’re taking that away that’s really disenfranchising and the everything else that have been going on. It has been a really emotional die. I was so tired up. Since three o’clock i was hungry house thirsty. I was not knowing what was going to happen. I’d be on the final tried to be on the phone to work to say. I’m not coming in which was an interesting phone. Call when you can barely speak but it was just sort of this one and it seems like such a little thing when you take it out of context but within the context of everything that had happened up until that point it was almost like. This is too much like i caught. I don’t want to deal with this. Just let me walk. It was the walking was the especially being confined to this tiny little bed so long. I’ve wanted to wanted to stretch my legs. I couldn’t go out of the the ward because the is locked. And i guess it’s locked for a reason like if you generally most people if you’re any there’s a reason you’re in there. I was in for the long period just purely writing for bed. Psi it was a very draining experience and it really got to me that the whole like you know. You can’t walk anyway to me and it got to a point where i think halfway to the wall. Actually the nurse. That was pushing me to this other ward. She was getting directions off another nurse. As to which room it wasn’t it was like back the other way like we’d we’d overshot the hallway and she was gonna turn the wheel and i just went and just stood up and walked because by that stage i was like i don’t care what you policy says. There’s no and this is the bad health bad patient. Because i’m a healthcare professional in me coming out but i was I feel like that choice was made for my own. Mental health was just getting a bit too much. So that assad once. I sort of settled into the surgical ward. Which is where i would stay for the next five days. I was on an…

Full show notes at the publisher

103 – Lived Experience Inside Graffiti Culture ft Mr Toy Division Feb 28, 2021

Show notes

Waaaaay back in episode 090, the lovely Clarissa Sorlie came on the show and discussed her exploration of graffiti culture. After this episode aired I was contacted by an anonymous therapist, Mr Toy Division. Mr TD was an occupational therapist who has been a part of this relatively unexplored culture for many many years. We arranged for him to come on the show and give a “lived experience” of being a part of graffiti writing culture.

Now Mr TD has done an episode previously on OT & Chill which I do encourage you to check out as well.

https://open.spotify.com/episode/05tP992ph7NTgwIA1PxbSo?si=nWXRRCRxQ5WWGMHjNRMPeg

So Sit back, relax and see how deep exploring a subculture can get!

Check out his podcast which “includes stories about being a clueless graffiti writer and other related subjects”. If you are an OT in the Sydney area, Mr TD is now offering graffiti workshops for clients. If you’re interested contact him through the Toy Division Podcast instagram account.

https://open.spotify.com/show/5HiztPTWAS72nsBYeszkVw?si=0ebvudpjSgKzLbUWbgisIA

Look after yourself, look after others and always keep Occupied

Brock
@brockcookOT
brock.cook@me.com
www.occupiedpodcast.com

102 – Difficult Conversations & BPD ft Keir Harding Feb 23, 2021

Show notes

DURING THIS PODCAST TOPICS SUCH AS SUICIDE, SELF HARM AND MENTAL ILLNESS ARE DISCUSSED. IF THIS IS A TRIGGER OR MAKES YOU UNCOMFORTABLE, LOOK AFTER YOURSELF AND DON’T FEEL LIKE YOU HAVE TO LISTEN. A while ago I asked the audience what topics they would like episodes on and there was a big swell of support for an episode on how to have conversations with people about difficult topics. On top of that, there was a lot of people recommending that I get this gentleman in to have that conversation with. Keir is a bloke that has been on my radar for a VERY long time. I’ve followed his work and his projects for years through Twitter so meeting and connecting was well overdue for us. We discussed the complexities of the healthcare system and how that often fall short when working with people who are diagnosed with Borderline Personality Disorder. We also have an important discussion about suicidal ideation and self harm and where Occupational Therapy might actually fit when working with people experiencing these. It’s super important that OT’s learn to become comfortable with these kind of conversations no matter what field they are working in. Keirs links:https://twitter.com/Keirwaleshttps://www.instagram.com/keirhardingot/https://www.beamconsultancy.co.uk Look after yourself, look after others and always keep Occupied Brock@brockcookOTbrock.cook@me.comwww.occupiedpodcast.com Automatic Transcription 102 Difficult Conversations & BPD ft Keir Harding 00:00:01 – 00:05:02 So very accidentally so I my parents got divorced when I was doing my a-levels which is what you do before you go to UNI. Okay, so I didn’t have a brilliant time doing those exams before you leave. So I finished my levels without any offers for University. So I had to go through our clearing system of trying to find a place to do something so awful and I had it in my head but I was going to be a physiotherapist and I had this idea about traveling the world with Rugby teams and doing lots of massage and that kind of thing and you know started going through clearing couldn’t get these courses. And so someone said, well, what do you think about doing occupational therapy? And I went yeah, let’s do that and they’re right. Well think about you for this course, then we’ll think about you for the occupational therapy course will give you a call back and then because this was like a million years ago. I had to walk down the library to look up what occupational therapy was dead. Click through a couple of Brooks for yeah. Yeah, that’ll that’ll do about that might be okay might be able to switch to physiotherapy while I’m doing it and I am in London on an occupational therapy course, I think I was a terrible student for a big long time. And then I did my mental health placement on the second year. And yeah, I think the song is about being part of a touring rugby team went out the window then and I just thought I want to work in Psychiatry. This is where I want to be. What was what was the the placement was impatient or Yes, it was an inpatient. Psychiatric hospital I tell you one of the things that really struck me but and and it just kind of like really showed me that this place was very different to buy it experienced Soldier. So I was walking through the reception and there was this really bad smell and we looked around and if there was that and we looked over and there was this woman squatting on the floor defecating off. I was like look look what that woman’s doing and they said yeah, she’s visiting a guy on ward nine so the visitors coming in and doing this and I’m not going to get these expect other places in my life. I see that on a regular time. You never see anything like that interesting me write a couple of years ago. I was at this celebration of old T’s patients on Princess. Anne said to me. Oh, what was what was some of your memorable experiences and working in mental health and I felt oh do I tell that story or not and I did Serenading the royalty. So that’s that that’s clearly about the royal family want to hear stories about public expression. That’s what they want. I’m sure it’ll stand out as a highlight from a trip post. You’ll remember it hopefully cuz I can see she loves till I hit the punch line which might have been politeness a lot but they were a couple of people from the Royal College of Occupational Therapy looking at me as violence. 00:05:05 – 00:10:11 Yeah, if I just dropped my trousers in the room it was what is this man doing? He got a good story out of it. Yes. Yes, but it’s like I’m surprised impatient didn’t scare you away from mental health month, but I quite like the idea of getting people off the boards and it was my first experience of kind of doing things with people who were I kind of thought I probably couldn’t articulate it very well at the time but they were just kind of like outside of my reality and I felt that was quite fascinating that something had happened that they they were not connecting to the emails in the same way that I was so yeah talking to people who would repeat back everything you said talking to people who had ways of understanding things that sounded like some kind of spy novel and just I don’t know cuz she got to ask them about their lives in so much detail. You became a part of town. Narrative which seemed so much better than the see somebody and fix them up that kind of fell in the physical settings, but that really touched on the wage and the the stories was something I always cuz I work in a couple of different inpatient units over my career and the the stories you were here always fascinated me and home for me. The interest was more around sort of how that story developed cuz for a lot of them I could sort of work out like where the store or you had like, there’s some basis in reality to some of it and it was sometimes like a misinterpretation of an event or something that someone had said to them and then it’s sort of that got skewed and she could kind of almost tracked back to what actually happened to how they got from that to you know, whatever the the big tail that you were being told was and Thursday. Out of an OS just fascinated me and I think it really kind of cemented. I felt like a lot of people and it’s well-documented in history mental health treatment history that for a long time people in mental health were sort of treated almost as long as people they were you know to unroll with lock them away or we essentially treat them like farm animals and some cases and even just making that simple and a lot of home maybe still look at that, but that’s another story but I think that making for me making that link between like okay like these stories that are sometimes super her labret and out there and like you said something like a spy novel can sort of be interpreted into reality as I see it in a lot of cases is if you’re willing to spend the time and get to know the person and sort of explore it with them and that to me sort of went. I feel like these did that dip people know not not dead. Like in death of that, but it’s like they’re not it almost I guess gave me hope that the work that I was doing was actually going to offer help these people cuz there’s a lot of I’ve heard all you hear all sorts of things from other professions on boards and stuff like that where you know, you are such and such as hopeless has been here for months and months and he’s never going to get better or that kind of thing. And I think in the I always found working in a ward it was very much. I was kind of difficult for me in the first world that I worked that cuz I was a new grad because you kind of in this little bubble where you only ever see what happens on the war and I never cuz I was in new grad. I hadn’t committed any other places. You never see like the progress from the war you only ever see people at their very worst kind of thing. So I found in that role initially thought some of those sort of I guess perpetuating stigmas that other people were sort of taught other staff were saying on the ward. I almost started to I guess believe some of them like, you know, such-and-such is a hopeless case or back on it. So and I think yeah making that link between some of those sort of stories Andrea and my reality with my version of reality really so I think it was so high opening thing for me. Yeah a couple of weird things. I used to find working on an inpatient unit was dead. My Style Network people tended to be on inpatient units a lot longer, whereas now I think people kind of go in short admission and names again and I always remember some of my old colleagues say in do they get them off the board so quickly they they never leave them long enough so that they’re able to access OT and I always used to think. 00:10:11 – 00:15:30 Just getting there. What are you talking about? You know, freshener you where people have got to be a certain level of Wellness for you to get involved and I always thought quite annoyed that people didn’t see that that Acuity off when somebody came in but that was a reason to walk away as opposed to a reason to get in there when they’re functioning was absolutely through the floor. So yeah, I got off of frustration with my colleagues when they’re going to I had the same thing and in the one of the impatient years that I worked at because there was multiple OTS but on the second one, I was the only one so I just did Ed. Myself, but yeah, I had the same thing in that it was like, you know such as just come in. We’ll wait a few days until he starts getting a bit better before, you know OT goes in season. I’m like just yeah just need to talk to the dude like yes. Building Rapport, like start the process. It’s not going to hurt and if anything it’s going to make your life easier and his life easier. You probably get him out of here quicker. It felt like a quest to make our input a relevant to the board if we would only start to work with people when they were on the cusp of leaving it kind of sent this big message that we weren’t required wage. But the population there and people have the attitude. We just got the wrong patience. If you have any patients would be doing some good work and like oh such a nonsense off. Yeah. That’s that’s that even just that is interesting. I never thought of it like that, but I think that’s that correlates well with my experience as well on terms of like people were often, uh, almost like picking and choosing who who they would see based on diagnosis based on level of organization. Sometimes like if there were in a depending on how far they were from the the clinicians reality. I guess you could say, yeah. Yeah people We’re often put it in and it’s not uncommon for award to be like to for a too hard basket to be discussed on award unfortunately, but yeah, I always found that some of the some of the clients. I had the most success and the most personal enjoyment with were the ones that were passed by other people as too hard, you know to acute. Mm. Yeah actually work with and there’s some of the ones that I had the the biggest breakthroughs with and like the most personal where you call warm and fuzzies cuz I actually feel like I made a difference to this person. Yeah, but even like I used to say when I used to have students I’m like, even if you on the day they get here you just go and introduce yourself and not a chat. If you do nothing. Other than that then like that’s more than they probably going to get there in a strange Place. Some of them have never been there before. It’s not the most I can probably speak for all wage. Units they’re not the most stimulating of environments and they usually not very nice or comfortable. They usually freezing cold. For some reason. I don’t know why it doesn’t matter what off our country country a little Tropical Greenery over here. I don’t know why because it’s hot outside. So they just dump the air-con and it just that everyone I’ve ever been down here is freezing. So I don’t know how people sleep at night so cold. Yeah, they’re just not very inviting environments. But if you can be a happy face be a friendly ER, you know, introduce yourself actually show genuine interest in a person if you do nothing. Other than that when they first arrived you’ve already made more steps in any other profession on that Ward, I think and I think you know if we were going to put it in our own terminology, I think that is you’re addressing the social environment around him a little bit you are being a friendly place. So that will be perfect person but you didn’t have to be you know, in a sense that is a bit of an intervention and you know, we can write that off as just chatting to 70 but it’s not it’s it’s it’s worth the effort. That’s another one of the biggest Revelations I’ve ever had in my career is I am part of the environment for that person. It’s like a lot of questions. I found even talking with a lot of a team specifically like see themselves as having an impact on that person’s environment or like almost like an external force on that person on their environment on their occupations God, but without ever really looking at like they’ll talk about Therapeutic use of self but I don’t know how many people actually consider that in doing that you are the person’s environment and by changing like if you go in there, it’s just nothing else different other than you’re in a shity mood that’s going to have an impact on that person’s social environment and it’s going to have an impact on that person and I do Wonder off in a queue coming back to I guess have it working with the difficult people. 00:15:30 – 00:20:34 I wonder how often that I guess labeling of someone as a difficult person is mainly just them reacting to you, you know, cuz I’ve seen it a lot in other caring professions where if they’re in a shity mood then the whole Ward tends to sort of carry that mood whether they mean to or not. It’s sort of transference and Thursday. We use always used to say on the on the last board that I worked on that your mood is kind of contagious within that little cuz it’s such a little enclosed bubble on the ward. Yeah, whatever you bring into the ward is contagious and that metaphorically speaking but probably nowadays. I guess I can’t really say that nowadays Lobby carries a very different meaning but speaking around food when I’m saying that rather than bacteria and viruses but thinking about how those influences in the social environment do kind of reverberate off each other off. Remember, I think it was like the first acute inpatient unit that I was employed on I’m a rag I got admitted and the leader of this kind of pointy came out and he said, oh he’s got personality disorder and I didn’t know what that meant at the time and I was like, oh, what’s that just means that you can’t do anything to help them and because I didn’t know any different I kind of like, oh, right. Okay, that’s a shame and you know the idea about we can’t help those people. They’re just walk and seek and they just manipulative because I think we’re not trained particularly well in our undergraduate training to understand why people might act a certain way then we pick up there was kind of really stigmatising attitudes from people who also went trains to understand things in a different way and that just carries on you know, and we get this toxic idea of people Who you know don’t deserve to be on the boards people who are the source of their own Misfortune. And unless we do something to combat that that just carries on and off and I think that’s a big part in those people who you know, we end up thinking are we can’t help them because there’s often cuz people have told us that and it’s often because people have gone into trying to help them with the idea that they can be helped which generally doesn’t help sounds like I had a very similar experience the very first time I again, I never heard of a personality disorder. I was in a case management team…

Full show notes at the publisher

101 – Comprehensive Kawa ft Dr Michael Iwama Feb 14, 2021

Show notes

Kawa Model has to be the topic that I’ve been asked to do an episode on the most. As well versed as I am in the model and its application I’ve held out for 2 1/2 years until this very moment when I could bring the one and only Dr Michael Iwama on to talk about it himself. This has been on my list since before I even started Occupied so I’m soooo happy that we finally made it happen! I’ve known Michael for quite a number of years through various online networking and he has always been an incredible support to me and my career. Clinically the Kawa changed how I worked with and viewed peoples situations and the role of OT. The aim of this episode was to create a grassroots resource about how the Kawa came to fruition as I strongly believe that in order to get the most out of the model, understanding its roots is imperative. For those already familiar with the Kawa, you’ll know how ironic that statement is. Please do enjoy this episode and I’d absolutely love to hear how you’ve used the Kawa model in your life/practice. Referenced during the podcast:Iwama, M. (2003) Toward Culturally Relevant Epistemologies in Occupational Therapy, American Journal of Occupational Therapy, (57), 582-588. https://doi.org/10.5014/ajot.57.5.582 Dr Iwama’s details: https://twitter.com/michael_iwamahttp://www.kawamodel.com/v1/https://www.facebook.com/KawaModel Keep Occupied Brock@brockcookOTbrock.cook@me.comwww.occupiedpodcast.com Automatic Transcription 101 Comprehensive Kawa ft Dr Michael Iwama 00:00:00 – 00:05:18 All right, I suppose it took a while but I you know, my family emigrated to Canada in the early 1970s and I attended High School in Vancouver, British Columbia Canada. And so for my first studies when I went to college and it’s typical for I think it’s stereotypical for Asian families that have immigrated to other places that it’s just imperative that everybody goes to college or university. There’s this unspoken expectation that somehow your supposed to be supposed to be better than the past generation. Yeah, and so I went and studied. I think what people these days call Kinesiology or Sports Sciences. Yep, exercise physiology job. So I went and and studied for my first bachelor’s degree in a program called Human Performance. So I got a Bachelor of Science and Human Performance. And by the time I graduated I was working with Elite athletes and you know for the I’ve had stents working with the Canadian national men’s and women’s basketball teams, the men’s and women’s volleyball teams. I’ve even you know Fitness tested the professional hockey team and in fact that side of Canada called the Vancouver Canucks and so, you know Varsity athletes, I you know worked as a trainer for many of the Varsity Sports that the universities that have been at so that that was where I was but however, I I started to realize that Elite athletes are probably some of the most egocentric people on Earth birth You know, it’s all about me me me and how can I get the best performance out of me? And how can I win and and that and and so I began to bring it on my career Outlook and I guess I I sought to really want to work instead of working with people at normal levels of performance trying to reach normal levels. I wanted to work with people at sub normal levels of performance trying to reach some semblance of normalcy. I wanted to work with Ordinary People. Yep from all walks of life wage. And so the natural progression was to go into physical therapy or physiotherapy as we call it in Canada and probably in Australia and what it is. Yeah, okay. And so I applied to go to physiotherapy school. I got accepted and I was well on my way to becoming a physical physiotherapist until home in one of my clinical experiences. I was posted at a small Hospital on Vancouver Island and was called a Gorge Road hospital and I remember as I was working with client counting repetitions of hip extensions bored out of my mind wondering whether I was going to spend the rest of my life counting repetitions of people doing exercises, of course physiotherapy is far more than that, but you know, that’s what I thought, you know, this student was was too but I noticed across the gymnasium floor stump OTS working with a person who age For two stroke and what was remarkable was that as I watched these these OTS at work. 00:05:18 – 00:10:08 They were the same two people they happen to be husband and wife and they were not even Canadians were from the United States. They moved up from California and they were working in this little Hospital in Canada. And so I noticed that every day they were doing something different with the client. So while I was counting repetitions with the same client on a daily basis here, you know, they were doing things with objects and cones and balls and you know from one day to the next they’ve been doing something different and I became really intrigued with that and I got to know I’d befriended this couple and I didn’t know it at the time but well they were talking about occupational therapy. Like they were a couple of Crusaders, you know, they were so excited and passionate about what they were doing and log So I became really intrigued with with the whole professional occupational therapy at that point. We used to laugh at them from the physiotherapy side saying that oh, they’re just a bunch of basket Weavers home, you know people not addressed, you know, all of these things that anybody can do and so I found out I didn’t even know very much about o t at the time but I found out that they had studied at a place called the University of Southern California and they were there teachers were people like Bob Barry Riley and rude and Jean airs and others now, I know what those names mean they were just well, so what? Yeah, and then one day I guess that was so enthralled by by this relationship that I was developing with this couple that they invited me to move into their basement. So I was living with them and eating dinner with them and one day at dinner. I looked up and I saw this carving over the lintel of the door way to the to the kitchen and I guess that’s a really nice carving which one of you did that and they said oh we didn’t do that that was done by one of our classmates in school in California, and they said the person who carved that was a guy named Gary kielhofner. Yeah, of course. So so talk about finding me, you know, I couldn’t have asked for a more a better introduction to the profession. Yeah. That’s I was so enthralled by the by the end of that month so clinical experience that that I went back and I quit my plans to become a physiotherapist and I did the most audacious thing. I moved from physiotherapy to occupational therapy. All of my physiotherapy friends thought that it was crazy. You know, why was I leaving this sophisticated world of tienes and ultrasound and you know this and that. Um to a world where I’d be leaving baskets and teaching people how to dress and put on their shirts and things like that. But but I knew Brock at that time that way just the ability to manipulate a button, you know was the fine line between whether a person saw themselves as being able or disabled wage and and that really spoke to me and and so anyway, I enrolled in the program in occupational therapy at the University of British Columbia and the ice, you know graduated as with a bachelor’s degree in occupational therapy, and then I was invited to come back and teach vocation. Yep. Rehabilitation because that’s the field that I entered back into okay that I started in and I should say. Yep and I was doing some Innovative things at the time in that area and the then director of The Rehabilitation medicine program that British Columbia was an American fellow whose name was Charles Christensen and he gave me my first job teaching occupational therapy at the post-secondary level. And so, you know, I’ve had really good mentorship thumb good role models. And and so that’s so that’s my long-winded story about how I became an OT and I it was the best decision I ever ever made and if I could go back and do things over again, I do it exactly the same way, or maybe I wish that I would have found occupational therapy sooner. 00:10:09 – 00:15:16 So it’s been it’s been a wonderful Journey so far and that’s that’s there’s so many names in there that most people here would have probably found in textbooks and that sort of stuff we’ve had child child has been on the podcast before so people would would hopefully have heard his story. But yeah, that’s that’s an incredible like palm tree into the profession. I mean, yeah, so when I so when I look back I realize okay and and you know, I another thing that I kind of took leave and in terms of my own values is that you know, the more that you’ve been given the more the greater is a responsibility to do good with it. Yep. And and so that has certainly been the impetus to go forward and to try to squeeze as much as I can out of whatever abilities inoperative. It is and privileges have been given to me and in in that way. I think probably my work in the field of Occupational Therapy has been in in some people have called it all listed in that, you know, I’ve never wanted to profit from this. I wanted to give back and constantly get back and maybe that’s been the secret to whatever successes I’ve experienced wage is that you know, you just go forward with the sense of gratitude and do as much good as you can and the rest is sort of takes care of itself. So yeah, that was how we got to where we are today. So you did you work in Voc Rehab sort of the whole time until you went into Academia or had you tried a few other areas or was that your thought was your passion? Well that you know, it was what happened. Was that small hospital where I was doing my clinical placements that knew that I had a background in, New Jersey. Size physiology and they were developing a new approach to Vocational Rehabilitation sort of a kind of a a separate entity from the hospital self sort of a free-standing vocational rehabilitation service and work hardening ergonomics Consulting and and evaluations of people work capacity to help lawyers make decisions about whether somebody was able to return back to their former jobs or not following an injury or an illness. Yep. And and so when they started that program a fresh read like me, they invited me to come and be the coordinator of that new and took yeah, you know, you grab, you know experience but they I guess they they saw that I had a background in exercise physiology and that that you know, I’d probably be a good person to be able Go ahead and do it. So I was flying by the seat of my pants. And before I knew it I was being asked to be an expert witness and the Supreme Court and and then I started working privately as a consultant and it was just really really unbelievable times for a new grad who was like pumped full of testosterone. And you know, I had my red Triumph TR6 sports car. I was living in a in a penthouse suite in a high-rise apartment building with sweeping views Victoria Harbor and I would take a helicopter from Victoria to Vancouver to the to the Supreme Court in order to give testimony off and then later on when Chuck Christensen invited me to come and teach Vocational Rehabilitation. You know, I I was yeah, I was traveling across the streets and wage. Going. Yeah, I mean it was just crazy crazy times that you’re a rockstar back then as well. Yeah, but you know, there’s a story. Well, I should say a rockstar. But but what I say though is that I turned away from it. I threw it all the way and it’s where I had an experience and I’ve shared this story with some people wage war, but it’s one that really changed my whole life and changed my whole outlook toward occupational therapy and its future and that is that I had a client that I was just doing a legal evaluation for and the lawyers then took that report and used it to basically get this person cut off from all of their wages ability to benefit payments and you know young father of three small children and this person suicided And it was it it talked about rocking ones world. 00:15:16 – 00:20:03 Yeah through me right on onto my back home. That’s when I did some soul-searching and I thought what the heck am I doing? And so going from the red sports car and the penthouse apartment. So on I disappeared I went I went to Japan and the excuse that I used at that time was that I was going to Thursday how Japanese companies handle their employee health programs and so on. So I went and studied how Nissan and Toyota and Hitachi and all of these companies, you know managed all of that and taught English on the side in Japan. And so that was my first experience of going back to Japan as an adult and then later on I would go back. You helped establish. One of the first bachelor’s programs in occupational therapy there. So so that was a so when people ask me what is my clinical specialty area? It’s it’s Vocational Rehabilitation. But embedded in there are some real lessons that have really shaped who I am today and wearing the other thing that I’ll say about that to Brock is that other than that that one in stock that really really affected me vocational rehabilitation in the work that I was doing was a perfect merger between physical medicine and um and social and environmental aspects of of well being so it was really truly biopsychosocial in nature because when you’re helping somebody to return back to work again, you’re not just getting them physically able to meet the capacity that’s required for their for the job that they’re going to but they also have to make the transition. Socially and emotionally spiritually from being a chronic patient to see themselves as an able employee and worker and off after having lost their regular routines of daily life of a well person of not engaging in the song So activities not engaging in work losing having losing confidence in one’s own abilities not even knowing what what’s cheaper bilities are anyone, you know, the OT that I was practicing at the time was seemed to be Innovative because I was I recognized those those those challenges. Yeah, and I’m working with them more on a physical and environmental level than I was physically like I found out that you can get a person physically. Well, you can get ten people with the same soft tissue back injury dead. Then you’ll see ten different levels of function and you’ll see 10 different levels of recovery and return to work potential. So that’s what I thought. Well occupational therapy. It’s just like it’s incredible. It’s just so Broad in its scope in it and Incredibly useful. It’s it’s essential, you know, we spend with our lives gaining competencies and abilities, but we don’t quite know what to do when catastrophe interrupts that yeah and turns it all apart. Right? We’re not so good at putting all the pieces of the puzzle back together again for ourselves and we need professionals who understand a whole landscape to come in and help us. That’s what I’m original there appears to me. Yeah. I see i t is kind of when people aren’t able to still sort of see that big picture like we’re able to stand back and see you know how their soldiers weixin and how their experiences and all of that sort of stuff fits into the big picture so that we can kind of help them Stitch things back together and get back on on onto that that track Yeah, yeah, absolutely. So so yeah, I mean Talk about serendipity or Karma, you know, it was really important that I I went and studied Sports Sciences or exercise physiology first, you know that I I happen to meet some incredibly influential people that then I would go and practice in the field of Vocational Rehabilitation and had the kind of experiences that I have. Yep. And that’s really what clued me into the incredible potential of occupational therapy. 00:20:04 – 00:25:07 And so that’s always been my vision.…

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100 – A Celebration of OT Podcasting Feb 08, 2021

Show notes

What a journey podcasting has been. Mid-April 2018 I finally pulled my finger out on an idea that I’d been tossing around for years. I got the equipment (what I thought I needed), learn the process, set up the accounts and made some graphics. On May 17th 2018 Episode 001 of Occupied launched to the world and I couldn’t be prouder having put a whole 22min of content out for public consumption. I shared that first episode with, friends all over the world via email, in Facebook groups, and Twitter. In the first couple of weeks, about 350 people had listened and I was absolutely blown away. I’d had people I didn’t know email me about it, tweet to me, DM me and I was in a state of disbelief.

Right from the very start, I’d always lead with the belief that if just 10 people listened it would be worth the effort. If a handful of people learned something or took something away it would be worth the time. And if i was able to have an impact on just 1 person in a positive way then it would be worth the long recording and editing sessions and the lack of sleep.

Now:

Advance forward 33months and it’s safe to say my initial goals have been far surpassed and podcasting has given me so much more than I could have ever predicted. I’ve connected with amazing practitioners, learned massive lessons and made life long friends.

The absolute best part about hitting episode 100 is that I’m doing it at the EXACT same moment as one of those life long friends, Sarah Putt from OT4Lyfe. We’ve been there and supported each-other right from the beginning and i couldn’t think of a more amazing person to celebrate these milestones with. I can’t thank you enough Sarah for everything you are and everything you do.

Lastly, I’d like to thank, you. Without you, podcasting wouldn’t have the meaning or purpose that it does. You are the reason I do it. You are the reason for the hundreds of dollars spent and countless hours invested. You’re the reason for the late nights and super early mornings to align timezones. You are the reason that I love doing this so much. Without you, there is no Occupied. So thank you for listening, engaging, DMing, sharing, reviewing, disagreeing, supporting and continually being there for the podcast. You are Occupied.

Enough soppy talk. Enjoy the episode and lets make the next 100 even bigger and better 😉

Keep Occupied

Brock
@brockcookOT
brock.cook@me.com
www.occupiedpodcast.com

099 – Sexualisation and Identity ft Sakshi Tickoo Jan 27, 2021

Show notes

Dr. Sakshi Tickoo (she/her) is an Occupational Therapist, Personal Counselor, and Student Mentor based in Mumbai, India. She currently works in telehealth, school-based and home healthcare settings serving a diverse population of age 3 years to 65 years. She’s also the brains behind Sex, Love, and OT.

Sex, Love, and OT is a sex-positive space for everyone to embrace their whole being and be respectful of everyone else’s choice(s). It is to build a better ecosystem, a healthier community, and be ready to voice and protect what matters to us, what we love.

This episode we explore the concept of sexualisation how that relates to identity and what this means for Occupational Therapy practitioners.

https://www.instagram.com/p/CGh6V1VBMYo/?utm_source=ig_web_copy_link

https://www.sexloveandot.com/

Keep Occupied

Brock
@brockcookOT
brock.cook@me.com

098 – What Does My Depression Look Like? Jan 21, 2021

Show notes

On December 8th I went public about my journey with depression. Some of you may have seen this on the Occupied Insta and some on my personal FB. If not here is the post: “Story time about a little photo project I did. About 2 months ago I was depressed. My time management disappeared, I isolated, didn’t want to get out of bed, no motivation, tanked mood, drowning in work, barely left the house and all these things combined in a perfect storm of shitness. This has happened in the past a few times even though only a hand full of people know it. Each time you come out of a depressive episode with new knowledge about triggers, coping mechanisms, your reactivity to situations and your levels of tolerance to even little tiny things. This time, or the first time, I was able to remain quite analytical about the situation. This time, I understood that despite my feelings, a lot of the stressors I was experiencing had a time limit. I knew that I had about 4 weeks till the weight would start to lift. So, theoretically, if I could get through the following 4 weeks that I would start to “feel better”. Now, it’s not uncommon for people with depression to try and hide it from others. The way I’ve described it is that it’s like wearing a mask. A mask put on for everyone else so they couldn’t see the real me. That’s what this picture project was about, what’s under my mask. So 2 months ago I decided to see if I look different when depressed as opposed to when I’m feeling great. The first image, most of you will know but may not have known the story behind it, surprise lol. The second pic I took this morning. I tried not to have an expression in either pic, just my resting face. Same edit on both, and tried to get the same lighting, angle etc. I can see a big difference and that’s really heartening and yet a little scary putting this out there. So, why did I post this right now? I don’t want your sympathy or anything like that. I was talking to a friend today who encouraged me to share. Reminded me that sharing my own experience you never know who might benefit from it. You never know who might hear something in your story that might help them along their own journey. I want to normalise the discussion. If you can relate to any of this, don’t be shy or embarrassed by it. Depression can happen to anyone. If you want to talk about it, I’m more than happy to engage with you. Look after yourself, look out for others, stay connected and prioritise your mental health.“ Some people asked for more, asked for an episode. So here it is. I hope someone out there finds it useful Keep Occupied Brock@brockcookOTbrock.cook@me.com Episode Transcription Hi, on The eighth of December 2020, I made a post, both on my personal Facebook page and the occupied Instagram page about my journey with depression. And a lot of people asked if I could turn that into an episode elaborate and share my story a bit. So that’s what I’m going to do today. So in about September, I took a self portrait, it was black and white, it was just my face. The background was blacked out. It was dark, it was moody It was me in a depressive episode. Now I had this thought. While I was sitting with that, and trying to sort through some emotions and feelings that I was curious as to whether or not I actually looked any different, while depressed compared to normal. Depression is something that I am familiar with. I definitely wasn’t the first time this has happened. The first time, I recall very clearly Well, the first time I recognized it as depression, I recall very clearly it may have happened before that and I didn’t pick up on it. But the first time that it really well that it clicked for me was in about 2015 16 I was feeling just so low. And I had constantly put it down to the fact that I wasn’t enjoying my work, I didn’t want to go to work, I was feeling bullied at work, I put all of this negative emotion that I was experiencing down to that simple fact. I can’t precisely remember the what triggered it. But I remember the almost lightning bolt realization when I went, holy shit, this is depression. It was eye opening to me for a number of reasons. Because it was like an instant shift in all of the emotions that were in my body. So it went from all of these emotions of flatness and sadness and low mood and that kind of stuff. And all of that was like instantly evacuated and replaced by guilt and shame. I was at the time working clinically as an occupational therapist in the mental health community rehab team. And I remember thinking, How am I? How am I helping other people if I can’t even recognize at the time what I was expressing to myself as like very basic, very, very simple depressive symptoms that I would recognize in an instant if it was with anyone else. But in myself, I didn’t see it for months. That instant like no I’m talking it would have been 10 second moment was both freeing and terrifying at exactly the same time and unless you You’ve been there, it’s so hard to explain what that’s like. I all of a sudden had an answer to everything that had been going on for me for a number of months. I all of a sudden knew that there were things that I could actually do to assist to manage what had been going on with me. But at that same time, I had, like I said, that intense guilt and shame like how did I not see this coming? Like, this is what I do for a living? How did I have all people? How did I not see this? So in the lead up to that, and I described this in the post, and I’ll share the post in the show notes if you want to have a read and I’ll share the the photos that I’ll talk about in a bit. But I describe the fact that I got to a point where I wasn’t feeling anything i was i was numb. And I was essentially self aware enough to know that okay, say for example, that person said something funny. I need to laugh at that. That’s the social convention is to laugh when someone says something funny, so I would laugh. But I wasn’t actually feeling the the funny, so to speak. I describe it as wearing a mask. I’m essentially putting on a show to hide my own feelings, my own depression from everyone else. I didn’t want people to know that I was having a hard time I didn’t want the the pity the Oh my god, are you okay? I there is. And this may be one of my own shortcomings. But there is very little that drive me up the wall more than that. I know that it always is coming from a good place and that people do it because they care or they don’t realize the stuffs going on, I get that. But for me, and I can’t speak for everyone for me that that’s not what I need. That’s not what I want, when I’m talking about this kind of stuff. So please don’t message me saying oh my god, are you okay? I’m fine. It’s okay, I promise. So I the very first thing I did once I had that 10 second sort of realization lightning bolt was I was speaking to a friend, I was actually due to meet that friend for a coffee. And I spilled to her my realization built up the the guts to get over the guilt and shame to actually tell someone and she opened up that she understood she had been through similar. And she gave me probably some of the best advice to this day that I’ve ever been given. And that advice was that at times, that point in time being one of them, it’s okay to be selfish. And I know that is hard for some people because it goes against a lot of things that we’re taught and what we believe and how we should behave towards other people, etc. But the, what she was meaning was that there are times when you need to prioritize yourself, and you need to say no to other people’s stuff. We’re in a helping profession. That’s one of the main reasons I was in occupational therapy. And in occupational therapy. We’re in a profession that we give so much of ourselves and sometimes it’s hard to switch that off. It tends to be the types of personalities that are attracted to that profession, this profession. So it’s not just at work, that this happens, you know, we generally fail in giving of our time of our resources, etc. But that can have a toll on us, especially when we need our energy. to focus on us and helping ourselves. So the way I interpret that, that advice is, it’s okay to take back some of that energy of your own and use it on yourself, it’s okay to go No, sorry, I can’t help you. Yeah, move house or whatever I need to look after myself for a bit, I need to you don’t even need that’s the that was one of the big freeing things, or you don’t even need to provide an explanation. You are an independent person that needs to look after themselves. So that was some of the best advice. And it’s To this day, I’ve talked to many people from this post, I had a number of people messaged me with their stories of either being currently in the same situation, or having been through it before. And I did have a number of people asked me for advice. And that was the exact advice I gave to them as well, because even though it happened, you know, sort of within half an hour of me working it out, it’s still to this day, some of the best advice that I’ve ever got, with regards to managing this, this, this demon of sorts. One of the other things, I guess I kind of turned it on myself to a degree. Even though that sounds really cheesy and corny, and, and whatnot, I, at the time, sort of had a look at my occupations. And I had the time, there was really only one that was making me feel anything that was a big thing for me, once I realized, like, I’m not like, I’m not actually feeling anything, happy, sad, angry, mad, anything at all, like, there was just nothing. So the only occupation that I was actually feeling anything during which luckily happened to be, you know, happiness, or joy, or whatever you want, it was making me feel good, was my my strength training. So for a period, I put a lot of stuff on hold, I pulled back on a lot of what I call extracurricular ot activities. So things that I would classify like this podcast, I would classify as an extracurricular activity, things that are ot related, but aren’t necessarily your job. I used to run, I still do. Like Facebook groups, I used to be involved in all my conferences, and I used to be involved in our national association and the state association and all that and I pulled out of me everything, everything, I tried to free up as much of my energy and my time that I could then redirect into me. And I ended up training more, I did the thing that was actually making me feel good. That was making me feel something, which I don’t think is uncommon. But I think what you’ll find is that for some people, it’s not always things that make them feel good, that are the things that are making them feel, sometimes people will have maladaptive coping mechanisms where, for example, something like cutting might be the only thing that will make a person actually feel anything. So that’s what they end up doing more of. So luckily, that’s one area where my clinical experience did help guide me and I was very aware of maladaptive coping mechanisms, etc. So that wasn’t something that I was going to do, per se. And I did that for a while. And what you find is if you are spending more time of your so you know, you’ve got a finite number of, say, hours in your week. If you’re spending more of those hours happy, then I guess your average happiness is gonna go up. When that happens, you start to feel better overall, that kind of leaves like a happiness impression on you on you. And what you will find eventually is, after doing that for a while, there are going to be other activities that emerge that will start to make you feel they will make you not necessarily always feel good, but you might all of a sudden, things might start annoying. You, which is what happened to me. And initially I was did the typical thing, and I got annoyed. But then, after a couple times, I’m like, no, wait a minute, this is something I haven’t actually felt in ages like this is as weird as it sounds, this is a good thing. This is progress. This is me moving forward. So then you can, I guess, build on your strengths, to start filling your week, with more and more things that make you feel good. One of the things that I wasn’t able to shift was that work situation. So as we know, as all good it is, we can either change the occupation, we can change the environment, or we can change the person, I tried a number of things to change the person, me to be able to increase the occupational performance of that occupation, did not all work. Unfortunately, I ended up changing the environment, I left that job and moved on. And it was a decision that had to be made, obviously, with my partner, because it was a big decision, because it was a really good job. It was well paying, it was secure. But the decision we came to was that no amount of money is worth being sad. Like if you don’t want to go to work every day, if you if it’s a struggle to drag yourself out of bed. It’s not worth it. You better off being on unemployment and actually being happy than to put yourself through that. And I think that’s a very Western culture thing, to essentially work ourselves to death, which is just dumb when you actually frame it out and look at it from a distance. But most of us are too close to it to actually recognize that. Anyway, so I moved on. And that situation was then remedied as well. So I think I was then you know, doing something that I actually enjoyed, I went into teaching. And again, my week was then even more filled with activities that I actually enjoyed, that made me feel good, that made me feel. And my average happiness, as I seem to have adopted, the term went up. And that’s sort of gradually slowly how I started to bring myself out of that initial depressive episode. Now, since that time, I’ve had a couple. And it’s been the same process to come out of them. But what you learn is with each one, I seem to be getting better and better at actually identifying before hit. You catch it early are, you put things in place earlier, you may already have some preventative things in place. To stop you getting as low as you have been. But it’s still gonna happen. It’s seen for me anyway, I know not for for some people, it seems to be I guess more of a trigger thing for me, it seems more of a cyclic thing. So whether it’s hormones or brain chemicals, or whatever it is, I don’t know. All I know is my experience of it. So the photo that I mentioned at the start, so the last episode that I had was around September ish. I took that photo. Because I had had a couple of these episodes before I caught it much earlier. And almost immediately, I already knew that I was going to come out of it, which was a big, big shift from the last couple like I already knew straightaway. I’m coming out of this. And I took that photo, almost as like a future plan. Because even in my head when I was taking that photo online, I will compare it to another photo that I will take in the future when I’m feeling better. Previously, I don’t even think I would have been able to get my head Have railed that concept of when I’m feeling better in the future. So to me again, that’s growth. That’s progress in how I manage it. The interesting thing, I guess, I when I took the second photo I hadn’t, hadn’t thought about it in a while. But I made the first photo, my facebook profile picture. Because, again, I knew that there’s no end like a definite endpoint where you go, yep, okay, depressions over. It just kind of fades away. And because you’re immersed in your own life, quite often you don’t notice it. And I knew that would happen. So I made the photo, my facebook profile photo. Now granted, I don’t go often, and look at my own Facebook profile photo very often. But it got to about the eighth of December, when I made this post, and I caught glimpse of it went, ah, how to sit back how to reflect went, yeah, I’m actually feeling really good. So I took the seco…

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