Question

Case study

Rolando Garza is 28 years old, Hispanic, and had partial complex seizure. He is the only child in

a strongly traditional Mexican-American family. The family response to his epilepsy tended

toward overprotective. Since his late teens, Mr. Garza’s family physician has been treating him

with Phenobarbital; yet adequate seizure control has never been achieved.

Mr. Garza seeks vocational rehabilitation services while still suffering from third degree, or deep

partial thickness burns he sustained while working as a chef in a neighborhood restaurant. This is

the second burn he has experienced while at work. Mr. Garza explains that his seizure condition

is disconcerting, but he has more or less become accustomed to it. Seizures occur once every two

to three months.

Mr. Garza is a high school graduate with one year of college. Results of aptitude testing suggest

he has high intelligence. He professes an interest in engineering and completed several years of

architectural drafting coursework while in high school and college. Due to lack of funding, Mr.

Garza states that he was unable to continue his college education.

Presently, Mr. Garza is unsure what to do. He is financially compromised and must leave the

rental home he shares with roommates to move back with his parents. An avid user or his home

computer and the Internet, Mr. Garza believes has developed expertise in this area.

1. What are the issues related to Mr. Garza’s current medical care? What should the referral

sequence be in order to optimize his care?

2. Is Mr. Garza a possible candidate for epilepsy surgery? Explain.

3. Should Mr. Garza attempt to return to his job at the restaurant? Support your response.

4. What are the potential vocational rehabilitation counseling issues related to Mr. Garza’s

situation?

5. Describe cultural considerations relevant to this case and implications of the family’s

overprotective?

Answer 1

1. Mr. Garza's current medical issues are seizures, third-degree burn, and emotional imbalance due to lack of financial support. The first preference of care is given to partial thickness of third-degree burn. Vocational Rehabilitation training assists him in doing daily activities and to return back to the job. It also supports the physical, and psychological well-being of the Mr. Garza. Secondly, the care is focused on seizure control by proper interventions through epileptologist and through medications. If both the burn and the seizure has been treated Mr. Garza has been emotionally balanced and to take a decision on his education and career.

2. To undergo epilepsy surgery one must meet the criteria of failed with the first-line treatment of antiepileptic drugs, and eligible to undergo the process. As Mr. Garza is on phenobarbital for a long time, still his seizure was not controlled. So he can refer to epilepsy surgery center where he has to undergo further investigations and assessment for the evaluation of surgery.

3. Sure, Mr.Garza return back to the restaurant job, with the help of vocational rehabilitation training and counseling.the only thing he must be careful in his work to prevent further injuries and burns and also on proper control and treatment for epilepsy. He has to inform the colleagues about his seizure conditions so that they will take care effectively if an emergency arises.

4. Some of the issues are rehabilitation therapy requires for a long time. Requires a specialized training to fit his job. Difficulty in maintaining the emotional balance of Mr. Garza and to meet the self-esteem. Problems in meeting emotional balance of the patient.

5. Normally, Hispanians do not understand the American culture and struggling with the overprotectiveness to overcome the culture. They believe that overprotectiveness should protect from psychological risks. Social discrimination, language barriers, financial difficult makes Mr.Garza's parents be overprotective in his health.