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What is Occupational Therapy?

What is Occupational Therapy?

In this day and age, you’ve probably heard the term Occupational Therapy, but you may not be familiar with what it means. Is it the same as physical therapy? Not quite, but it does fall under the physical rehabilitation umbrella. Does it have to do with one’s job? Possibly, but not always.

Occupational therapists (OTs) and occupational therapy assistants (OTAs) are dedicated healthcare professionals who help people of all ages participate in activities and daily tasks that are meaningful and important to them.

Occupational therapy is a science-driven healthcare profession that examines the person, the environment, and the tasks the person desires to perform. The goal is to restore the person’s function or adapt the task or environment for optimal performance.


Who can benefit from Occupational Therapy (OT) services?


OT can help anyone experiencing difficulty with activities of daily living (ADLs). These difficulties might be due to an injury such as a broken wrist or a recent illness or hospitalization that resulted in general weakness and fatigue.

Occupational Therapy - Steering Some activities that might benefit from OT are:

  • Dressing
  • Bathing
  • Toileting
  • Cooking
  • Leisure Activities
  • Work Tasks
  • Other tasks that are meaningful and important to the person

Occupational therapist can also help with chronic health conditions such as, arthritis, COPD, multiple sclerosis or Parkinson’s disease that have impacted a person’s physical or cognitive ability to complete daily tasks.


What will an occupational therapist do?


The OT will start with an evaluation to collect information on your health history, current limitations, and goals for therapy. From there they will develop an individualized plan of care to help you achieve these goals.

Occupational Therapy with Shirley Faw, OTR/L Interventions could include:

  • Exercises or stretches to help you gain strength or range of motion
  • Splinting
  • Adaptive equipment education and training
  • Safety training and education
  • Pain management
  • Suggestions for home modifications or activity modifications to help you better perform specific activities. 

Our OT’s at The Rehabilitation Center also have specialized training in lymphedema treatment and management, pelvic health issues or concerns, ergonomics assessments and interventions, and aquatic therapy interventions.


Having difficulty with something you want to do or need to do?


We have a team of OTs and OTAs at The Rehabilitation Center who are here to help you achieve your goals. If you have questions or want to know if you could benefit from Occupational Therapy Services, call our office at (828) 268-9043.

The Rehabilitation Center Boone

232 Boone Heights Drive, Suite A
Boone, NC 28607
Phone (828) 268-9043
Fax (828) 268-9045
Rehabilitation Center website

The Rehabilitation Center Linville

434 Hospital Drive
Linville, NC 28646
Phone (828) 737-7520
Fax (828) 737-7509
Rehabilitation Center website

4 steps to a pain-free home office

4 steps to a pain-free home office

Setting up your home office for optimal performance and decreased musculoskeletal strain

Image: Home Office Pain The COVID-19 pandemic has disrupted almost every aspect of our lives since early 2020, and work life is a significant part of that. Many who had previously commuted to an office location every day found themselves suddenly working from home in varying conditions.

Although sitting on the comfy couch in your pajamas might sound like a more comfortable way to work, you are at risk for musculoskeletal strain or pain from awkward sitting postures. Here are some tips for setting up a home office and preventing pain and injuries.

There are three main elements of office and workplace ergonomics:

  • Chair
  • Workstation/desk for keyboard and mouse
  • Monitor or computer screen


1. Choose the right chair

Photo: Adjustable Office Chair

Your body will thank you for investing in a proper desk chair. Although a chair from the kitchen table can work for short term (1-2 weeks), it’s worth investing in an adjustable office chair if you will be working remotely for a longer time.

An optimal office chair will:

  • have some adjustable features for height, seat pan depth, tilt, arm rests, and head rests.
  • provide support at your lumbar (low back).
  • allow for your feet to rest flat on the floor.

If your feet do not touch the floor, a small stool or box can be used to allow for foot support. Additionally, there should not be any pressure from the edge of the chair on the backs of your knees.

2. Set up your workstation or desk

Photo: Adjustable Workstation

An ideal workstation should:

  • be adjustable so that you can sit or stand throughout the day.
  • have a “waterfall” or smooth edge – sharp edges put pressure on your wrists. Pipe insulation or other padding can be used to cover sharp edges if necessary.
  • be large enough to accommodate a keyboard, mouse, document holder, and monitor. If you are working from a laptop, an external keyboard and mouse are recommended.

The height of the workstation (keyboard and mouse) should allow for a neutral arm position with elbows at approximately 90 degrees. Measure from your elbow to the floor and subtract 2-3 inches for optimal placement.

There are many options for an external keyboard and mouse; they are not one-size-fits-all. Find a keyboard and mouse that allow your wrists to sit in a neutral position and avoid extreme or awkward positions (bending the wrist too far in any direction). The size of the keyboard and mouse should be a good fit for the size of your hands.

3. Place your monitor or computer screen

Photo: Standing Workstation

Your monitor or computer screen should be placed:

  • at the correct distance from your eyes to reduce eye strain and forced positioning of the head.
  • at the correct height to avoid neck pain.
  • in a position that reduces glare from natural and artificial light.


A monitor should be about arm’s length or 20-36 inches away from your body, depending on font size, number of screens, and your eyesight. If you find yourself constantly leaning forward to see the monitor, it is too far away; or you need to make the font size on the monitor larger.

The height of the monitor should allow for a neutral head position to reduce strain on your neck. You don’t need a fancy solution; a stack of paper, books, or small box is an easy way to adjust the monitor if it is too low.

Reducing glare can help reduce eye strain or engaging in awkward postures to see the monitor more clearly. Monitors should be placed perpendicular to windows if possible, and indirect lighting is recommended to help reduce glare. If overhead light is the cause of glare on the monitor, consider using a task light as needed. To give your eyes a break, every 20 minutes take 20 seconds to look at an object at least 20 feet away.

Considerations for dual monitors: If you use both monitors equally, center them in front of you. You may need to move the monitors further away so that both screens are within your central field of vision. You shouldn’t  have to rotate your neck repeatedly to look between the two monitors. If you use one monitor primarily and the other monitor occasionally, center the monitor you use the most in front of you.

4. Develop healthy work-from-home habits


Once you have your home office set-up, remember to take breaks and change positions throughout the day. Small breaks, changing positions, and standing up for a stretch break can increase blood flow, reduce the risk of injury, and decrease fatigue.

Lauren Hutchins, MS OTR/L

Need help?


Yes, The Rehabilitation Center can help you with your home office. 

If you are experiencing discomfort, overuse injuries or muscle strains from your current work station set-up, the occupational therapists at The Rehabilitation Center can provide an assessment and recommendations specifically for you. Give them a call at 828-238-9043.

Author: Lauren Hutchins, MS OTR/L, The Rehabilitation Center 

The Rehabilitation Center Boone

232 Boone Heights Drive, Suite A
Boone, NC 28607
Phone (828) 268-9043
Fax (828) 268-9045
Rehabilitation Center website

The Rehabilitation Center Linville

434 Hospital Drive
Linville, NC 28646
Phone (828) 737-7520
Fax (828) 737-7509
Rehabilitation Center website

3 ways to warm up the Winter Blues (with infographic)

3 ways to warm up the Winter Blues (with infographic)

Endless grey skies, drizzle to snow mixtures, and wind so gusty you see it coming before it hits you paints a not-so-colorful stretch of winter weather typically found in the High Country. Days of dark, dreary weather have been known to make some folks come down with the winter blues or its more extreme version, Seasonal Affective Disorder (SAD).

Winter Blues Infographic

Click image to enlarge, download or print.

“The winter blues are fairly common in our area with long winter months and very grey days. The challenge is diagnosing whether a client has a mild case of winter blues, Seasonal Affective Disorder, or another form of depression,” says Lisa Shelton, a Licensed Clinical Social Worker and Director of the Employee Assistance program with Appalachian Regional Healthcare System.

Symptoms for the winter blues and Seasonal Affective Disorder (SAD) appear to be similar on the onset and may include:

  • Sleep issues (either too much or not enough)
  • Fatigued to the point where it is difficult to carry out daily routines
  • Overeating and/or strong cravings for “comfort foods,” especially carbohydrates
  • Lack of interest in normal activities
  • Social withdrawal

Treatment techniques will determine whether or not the winter blues really are SAD or another form of depression. Shelton recommends a three-step process to clients describing some form of the winter blues.


Step one: Exercise

Wellness Center Yes, it’s a verb buzzed about all the time, but all this talk must lead to positive results because doctors, counselors, and other healthcare professionals are always recommending it. And, our area offers the Paul H. Broyhill Wellness Center, the Greenway, several parks, and sidewalks round about Boone to help you enjoy slivers of daylight during the winter months. A long walk outside helps refresh your senses, and if it is too yucky to go out, a creative solution may be to brighten up your home and do some jumping jacks, run-in-place, or stretches. Any form of exercise will help you warm up the winter blues.


Step two: Strive to sleep and rest well

Sleep StudyIf you exercise, you’re more likely to tire yourself out and sleep better. Other considerations include reducing caffeine intake, make an effort to turn off your thoughts (counting sheep is always a popular game), or just simply lying there and resting. If you continue to have trouble sleeping, seek your doctor’s advice and ask if a sleep study is right for you. If you are sleeping too much, make an effort to avoid snoozing past eight hours.


Step three: Engage in an activity that gives you pleasure

Art-Therapy-2 This suggestion seems simple enough, but people often struggle with time and money to make it happen. However, if you make it a priority, you’re likely to come up with an affordable solution that fits your budget. Popular winter activities may include reading, completing craft projects, sledding, ice skating, or other ideas discovered by talking with friends.



Be self-aware

“Being aware of your symptoms is so important to getting past the winter blues. We’re most vulnerable when we’re unaware of what’s going on with us. Sometimes sitting down and talking with a trusted friend, family member, or professional, qualified healthcare worker can be very successful in dealing with the winter months,” continues Shelton.

If the above three steps do not seem to help your mood, seek the advice of your doctor or a licensed behavioral healthcare worker. Appalachian Regional Behavioral Health Services offers crisis care, therapy, and psychiatric services if you should need professional help.



Treatments for Seasonal Affective Disorder (SAD) may include light therapy, which involves exposure to daylight or a specially-made fluorescent bright light for 30 minutes to two hours a day. SAD can often be confused with other forms of depression, and patients with SAD aren’t usually diagnosed with it until their symptoms can be observed over a period of one or more fall/winter seasons.

Shelton concludes, “The most important consideration is to take the time to make your mental health a priority. People affected by the winter blues or other more serious forms of depression must strive to adjust their routines in order to have success, and the rewards of a happy, healthy mind are well worth the effort.”


Wherever you are, we’ll meet you there.

By using our Telehealth option, you may visit with your provider from the comfort and convenience of your home. No referral needed.

  • Contact Appalachian Regional Behavioral Health at (828) 737-7888 or visit the website
  • Contact the Employee Assistance Program (EAP) at (828) 268-9049. 



For High Country employers: 

Lisa Shelton and staff of the Employee Assistance Program (EAP) are available to provide short-term professional help and guidance to all employees and their family members of the Appalachian Regional Healthcare System as a part of the system’s benefits program. The EAP is highly confidential and accepts voluntary self-referrals. Additionally, the EAP contracts to provide services for the Town of Boone, Town of Beech Mountain, Grandfather Mountain, Boone Drug, several doctors’ offices, and other organizations throughout the High Country. For more information about EAP, call (828) 263-0121.

Could you be at risk for vascular disease?

Could you be at risk for vascular disease?

The average human heart pumps roughly 2,000 gallons of blood per day through an intricate network of arteries, veins and capillaries that help make up the cardiovascular system. Through these blood vessels this organ system transports nutrients, oxygen and hormones as well as waste to and from cells throughout the body.

In fact, a human body has nearly 100,000 miles of blood vessels. By definition, vascular disease is an abnormal condition of blood vessels. Because blood vessels travel the entire body, vascular disease can present itself anywhere and cause serious problems that may even be fatal.


What is Vascular Disease?


John Fry, MD

Dr. John Fry of the Heart and Vascular Center at Watauga Medical Center.

There are dozens of vascular diseases, but some of the most common are Peripheral Arterial Disease (PAD), Abdominal Aortic Aneurysm (AAA) and stroke, which account for 140,000 deaths each year.

According to Dr. John Fry, of the Heart and Vascular Center at Watauga Medical Center, “Vascular disease affects approximately 10% of Americans with almost half of those being asymptomatic.”

Fry says the most common symptoms are:

  • Pain in the legs or feet
  • Cool shiny skin
  • Lack of hair growth
  • Sores or ulcers that are slow to heal
  • Redness or discoloration
  • Swelling
  • Hip pain
  • Neuropathy
  • Impotence or ED (men)

Risk Factors


Although vascular diseases may strike without warning, according to Dr. Fry, “the same risk factors associated with heart disease are also important with vascular disease and include poor diet, lack of exercise, diabetes, high blood pressure, high cholesterol, and most importantly tobacco smoking.”

There are also risk factors for vascular diseases that cannot be changed like age and genetics. For patients experiencing symptoms or who are concerned they may be at risk for a vascular disease, Dr. Fry advises talking to their provider or calling the Heart and Vascular Center for more information and consultation.

Fry says, “the diagnosis can be confirmed most often using simple non-invasive tests. We have those available at Watauga Medical Center. Treatment can be as easy as lifestyle changes and medication. For others, simple outpatient, minimally-invasive techniques are available.”

Vascular Services in the High Country


Appalachian Regional Healthcare System offers several options for Vascular Services in the High Country.  Vascular Services are available through the Heart and Vascular Center; Vein Services and Wound Care Services at Watauga Surgical Group; and The Rehabilitation Center. Some of these treatments include:

  • Peripheral Artery Disease (PAD) Treatment
  • Peripheral Vascular Stenting
  • Peripheral Vascular Angioplasty
  • Ankle-Brachial Index (ABI)
  • Varicose Veins
  • Vascular Surgery
  • Chronic Disease Wellness
  • Nutritional Counseling
  • Wound Care Services
  • Edema Management
  • Physical and Occupational Therapy

The Heart & Vascular Center

formerly The Cardiology Center
336 Deerfield Road
Boone, NC 28607
Phone: (828) 264-9664
Fax: (828) 264-8144
Heart & Vascular Center Website

Watauga Surgical Group

965 State Farm Road
Boone, NC 28607
Phone: (828) 264-2340
Fax: (828) 262-0731

The Rehabilitation Center Boone

232 Boone Heights Drive, Suite A
Boone, NC 28607
Phone (828) 268-9043
Fax (828) 268-9045
Rehabilitation Center website

The Rehabilitation Center Linville

434 Hospital Drive
Linville, NC 28646
Phone (828) 737-7520
Fax (828) 737-7509
Rehabilitation Center website

For more information about the Vascular Services offered through Appalachian Regional Healthcare System, visit or call:

  • Heart and Vascular Center at 828-264-9664
  • Vein Services at Watauga Surgical Group at 828-264-2340



Know the Facts: Top Winter Health & Safety Hazards (infographic)

Know the Facts: Top Winter Health & Safety Hazards (infographic)

Know the Facts: Top Winter Health & Safety Hazards


We asked our emergency medicine, same-day care, and walk-in clinic experts about the top health and safety issues they typically see each winter. Armed with the facts, you can take steps to stay healthy and safe this winter.

We hope you don’t suffer from any of these conditions, but we are here for you if you do! Our Emergency departments, Same-Day appointments, and Walk-In Clinic providers can treat these conditions and more. If you have a true medical emergency, call 9-1-1 immediately.

Download/Print the infographic PDF >


To keep yourself and others safe, continue practicing COVID-19 precautions by wearing a mask, social distancing & washing your hands.

Cold Exposure

Hypothermia, or abnormally low body temperature, is a dangerous condition that can occur when a person is exposed to extremely cold temperatures. Symptoms in adults include shivering, exhaustion, confusion, slurred speech, and drowsiness. Seek immediate medical attention if a person’s temperature is below 95° F.¹

Frostbite is an injury to the body that is caused by freezing. It most often affects the nose, ears, cheeks, chin, fingers, or toes. Symptoms in adults include reduced blood flow to hands and feet, numbness, tingling or stinging, aching, and bluish skin. If you notice signs of frostbite, seek medical attention.²

Slippery conditions lead to falls & car accidents

Many injuries related to cold weather happen from falls on ice-covered sidewalks, steps, driveways, and porches. Keep your steps and walkways as free of ice as possible by using rock salt, another chemical de-icing compound or sand.³

Each year, there are approximately 1.2 million vehicle crashes due to adverse weather or on slick pavement.⁵ If you must travel, let someone know your destination and when you expect to arrive. Ask them to notify authorities if you are late. Check and restock the winter emergency supplies in your car before you leave. Always carry extra warm clothing and blankets with you.³

Space Heater Mishaps

Approximately 21,800 residential fires are caused by space heaters each year, and 300 people die in these fires. An estimated 6,000 persons receive hospital emergency room care for burn injuries associated with contacting hot surfaces of space heaters, mostly in non-fire situations.⁴ Don’t use a space heater within 3 feet of anything that may catch on fire and never cover your space heater.⁴

Cold, Flu & Sickness

Protect yourself & others from feeling under the weather

  • Wash your hands often with soap and water
  • Avoid touching your eyes, nose and mouth
  • Stay away from people who are sick
  • Stay at home if you are sick
  • Avoid close contact with others
  • Practice good cough and sneeze etiquette
  • Disinfect frequently touched surfaces and objects⁶

Winter Sports Injury

According to the U.S. Consumer Product Safety Commission, almost 200,000 people were treated for injuries related to winter sports in 2018.

  • 76,000 injuries from snow skiing
  • 53,000 injuries from snowboarding
  • 48,000 injuries from ice skating
  • 22,000 injuries from sledding

Common winter sports injuries include sprains, strains, dislocations, and fractures. Most winter sports injuries can easily be prevented by wearing protective gear, maintaining good physical condition, staying alert, drinking plenty of water and resting when tired or in pain.⁷

Overexertion while shoveling snow

Shoveling snow is strenuous exercise. People who have a medical conditions such as high blood pressure or heart disease should talk to their healthcare provider before shoveling snow. The combination of cold temperatures and strenuous exercise can trigger a heart attack.¹

Local cardiologist receives international recognition, explains cardiac resynchronization therapy (CRT)

Local cardiologist receives international recognition, explains cardiac resynchronization therapy (CRT)

Andrew Hordes, MD Cardiologist Dr. Andrew Hordes is the Heart & Vascular Center’s Certified Cardiac Device Specialist. He was one of the first to perform internal defibrillator procedures at Watauga Medical Center, as well as the first Micra procedure, using the world’s smallest leadless pacemaker.

Dr. Hordes recently renewed his certification for the International Board of Heart Rhythm Examiners (IBHRE). He placed in the top five percent of all scores and was offered an ambassadorship for the IBHRE. Worldwide, the IBHRE has about 50 ambassadors who assist in writing the exam, as well as mentoring others as they prepare to take the test.

Cardiac Resynchronization Therapy (CRT) is a treatment that Dr. Hordes says can make a significant impact on quality of life. He has a wealth of experience and knowledge in pacemakers, internal defibrillators, and CRT.


What’s the difference?


Unless they’ve had a personal experience with heart failure or heart attack, people often don’t know the difference between an internal cardiac defibrillator (ICD) and a pacemaker. Both devices are implanted into a patient’s chest, but they have very different functions.

A pacemaker helps control abnormal heart rhythms. It uses electrical pulses to prompt the heart to beat at a normal rate. It can speed up a slow heart rhythm, control a fast heart rhythm, and coordinate the chambers of the heart


An ICD monitors heart rhythm. If it senses dangerous rhythms, it delivers shocks. This treatment is called defibrillation. An ICD can help control life-threatening arrhythmias, especially those that can cause sudden cardiac arrest (SCA).


Most new ICDs can act as both a pacemaker and a defibrillator. Many ICDs also record the heart’s electrical patterns when there is an abnormal heartbeat. This can help the doctor plan future treatment (source).

Until the early 2000s, ICDs were mainly used for people who had already suffered a heart attack or were in the midst of heart failure. Dr. Hordes served as an investigator on a trial addressing the implications of expanding the use of ICD. The study found that anyone with poor ventricular function could benefit from an ICD – saving and extending lives.

But according to Dr. Hordes, it’s important to understand that with a defibrillator alone, the patient may not “feel” any better. The device will, however, save their life in the event of a sudden heart event.


Heart Pacing History

Heart Chambers  

The innovation:

In the 1950s, physicians began treating heart failure patients with pacemakers, although the first pacemakers were external. On October 8th, 1958 the first internal pacemaker implantation was performed in Sweden (source).

The problem:

These early devices only had one wire pacing the ventricle of the heart. Because the pacemaker was only pacing the ventricle, and not the atrium, some patients suffered from “pacemaker syndrome.” Their atrium and ventricle became out of synch, making the patient very sick.

The innovation:

Enter “dual-chamber pacemakers” in the late 1970s. These devices improved the synchronization of the ventricle and atrium, but there was still a problem.

The problem:

Dr. Hordes explains, “When we’re born, our heart naturally paces itself from left to right. But our pacemakers paced from right to left, throwing off the motion of the wall in the center of the heart – the septum. The heart loses efficiency and quality of life for the patient.  The treatment could actually create a condition called “left bundle branch block.”

To correct the problem with traditional pacemakers, cardiologists asked themselves, “What if we could control the timing between the right and left sides of the heart to more closely match the natural rhythm and create a more efficient contraction?”

And thus, Cardiac Resynchronization Therapy (CRT) was born. Not everyone will respond to this therapy, but when successful, CRT increases survival and quality of life, with 50% reduction in heart failure hospitalizations.


Who is a candidate for CRT?


  1. Patients who have experienced heart attack or suffer from heart failure, have scarring, or a problem with the heart’s electrical system (left bundle branch block).
  2. People with merely a weak heart that doesn’t stem from a heart attack (non-ischemic cardiomyopathy).

“In fact,” says Dr. Hordes, “the second group of patients are the ones who typically get the most benefit from CRT, as left bundle branch block is common with non-ischemic cardiomyopathy.” About 95% of Dr. Hordes’ patients receiving CRT show an improvement in heart function.

Some patients, whom Dr. Hordes calls “super-responders,” experience a significant improvement in heart function and quality of life. These patients feel much better and they live longer.

If you experience fatigue and shortness of breath with exertion – even with medication – contact your cardiologist today to see if CRT may be right for you. In addition to general cardiac needs and interventional cardiology (heart catheterization), you can receive CRT right here in Boone at the Heart & Vascular Center of Watauga Medical Center. Most patients report an improvement in energy levels, ability to exercise, and quality of life.

The Heart & Vascular Center

formerly The Cardiology Center
336 Deerfield Road
Boone, NC 28607
Phone: (828) 264-9664
Fax: (828) 264-8144
Heart & Vascular Center Website