More than coincidence...

So, as you probably have figured out, I did not pass the dang strength test... again. This means, once again, I cannot start work. It's super frustrating because it is not my NBCOT scores, nor is it my state license that is preventing me from starting work, but my strength. I have done everything I can think of to pass this test. I've gone to the gym 6 days a week for the past month. I am stronger, just not strong enough. The test is based on BMI. So the more a potential employee weighs, the more they are required to lift. Somehow this method doesn't seem effective to me. Because I weigh more than someone who can pass this test with a lower BMI than I do, doesn't change the fact that we both will have to transfer patients that are the same weight. The people in the HR department don't seem to understand that therapists don't "lift" patients- that we transfer them with a combination of body mechanics, gravity, and momentum. If you are interested in what this test is all about, you can watch a video on it here.

Either way, I'm unemployed and have bills. I'm currently looking for new OT jobs to apply to. I have a few leads, but if nothing develops I am left to apply to jobs at restaurants to pay the bills until something new turns up. Because I've taken the strength test 3 times (yes, three...) the job offer has been retracted, the job has been reposted, and I'm only allowed to take the strength test one more time. I'm not sure that I'm going to.

While I am (extremely) frustrated to have been in Myrtle Beach for 6 weeks and still not have started work, I'm strangely not upset to not be working at THAT hospital. I am okay with the fact that I probably wont work there, and I think that in itself is a reason to apply to new jobs. I think everything happens for a reason, and everything will work out. What will be, will be. And that was the inspiration for this:

On top of that, I feel fate has once again intervened. I was supposed to have a phone interview with a job recruiter today at 10am. The phone rang at 9:58 with a number I didn't recognize, and I assumed it was the recruiter. I answered and quickly realized that it was a different recruiter, one that I had not yet spoken with (and didn't realized I applied to). She has a prospective job opportunity for me, and submitted my resume for that position in a skilled nursing facility. While I was on the phone with her, the original recruiter called, and I missed the appointment. I called back about 2 minutes later and left her a voice mail, and have yet to hear from her (almost 12 hours later).  ((One of my favorite TV shows is How I met your Mother-- and my mom was quick to point out that I should keep track of all these divine interventions to have a documented trail of  "How I met your Father" for my future children)) :)

On another positive note. When I moved to MB I bought new living room furniture and got it financed so that I would make monthly payments for a year. I have yet to receive a bill for it, 6 weeks after having bought it. I called La-Z-Boy for the second time to make sure it didn't get lost in the mail and that I wouldn't have to pay late fees etc for it. She called headquarters and found out that it processing was delayed on their end, and I won't get a bill for at least two more weeks. Another blessing since I don't have a job.

I want to begin canning vegetables, but don't have a pressure cooker. Anyone want donate one to a poor college grad?

That's all for now...

A series....

I'm sitting here on this BEAUTIFUL Sunday afternoon/evening, after Irene has passed, and I am inspired. I just started my laundry. My work out is done. The pool is closed. Julie and Julia is on tv. I love this movie, it always inspires me. It's cliche, I know, to turn to my blog while watching a movie on a woman who blogged for one year while cooking her way through Julia Child's cook book, but, as I said before I am inspired.

There is a quote, maybe I'll try to find it after I'm finished processing my thoughts by blogging, that I've been thinking a lot about lately. It has something to do with living life NOW, not after the next major hurdle, (or even pebble in your shoe-- that one came from my dad). I've been in Myrtle Beach for almost a month now, with nothing significant to report. I haven't met people because "I'll do that when I start work." I haven't picked up any new hobbies because "I don't know anyone." My days consist of going to the gym, cooking food, and watching tv with Lou. And while I enjoy each of those things, my life is mundane. I need to live now, and stop waiting for the next phase in my life. If I do that, I will have gone through life waiting to live.

So, what I want to do, is pick something new to do, or to learn within the next year, and blog about it. I want to pick up a new hobby, learn a new language, start a revolution-- something, anything. I've looked into volunteering and didn't find too many opportunities in the area (there is no Big Brothers Big Sisters in Horry county, which makes me sad). I'm not giving up yet though. I'll come up with something. And if you have any suggestions, feel free to offer them.

That's all for now.

P.S. I found the quote (LOVE IT):

For a long time it had seemed to me that life was about to begin - real life.  But there was always some obstacle in the way.  Something to be got through first, some unfinished business, time still to be served, a debt to be paid.  Then life would begin.  At last it dawned on me that these obstacles were my life.  ~Fr. Alfred D'Souza

Yes, Yes, You've read correctly!

In case you didn't notice, I changed the title of my blog from A glimpse in the life of an OTS, to A glimpse in the life of an OTR! That's right, I have officially passed my boards!! That is one $540.00, four hour test that I do NOT want to take again. I left the testing center feeling like an IDIOT!

And while I have proved to be competent in knowledge to begin my job as an OT, I have not yet passed my strength test. Sigh. So, until then I wait. And budget money. And go to the gym. HOPEFULLY I will take and pass the dang test before September 12 so that I can begin orientation that day. But until then, I figured I'd start blogging again. Not much else to do.

Here is a thought for the day. Sarah and Josh came yesterday for the night, and in the midst of visiting, we somehow began discussing commas. Yes, like the punctuation. Exciting I know. But did you know that there is an optional comma? It comes before the word and in a list of items, and it actually has a name. I knew about this comma, but not that it had an official name. It's called an Oxford Comma.

Here is an example of how it could be used:
Sarah, Josh, Chad, and I went out to eat last night.

The sentence makes just as much sense this way:
Sarah, Josh, Chad and I went out to eat last night.

This sentence would have a completely different meaning without the comma, though:
These items are available in black and white, red and yellow, and blue and green.

Hope you learned something new. :)

Until next time...

Kids say the craziest things...

It really is true. I can’t believe some of the things I’ve heard come out of the kid’s mouths the past few weeks. I’ve decided to start a list. In high school I used to make a list of the crazy things my teachers said to help me get through the class… I’m thinking of this the same way.

One of the hardest things I’ve heard a kiddo say is this: “I just wish they would stop.” This came from a 7ish year old little girl with CP who has RIDICULOUS muscle spasms. They become worse with initiation of a task- in this case, all she was trying to do was write her name.

On a lighter note, here are some other (more funny) things I’ve heard kiddos say.

-          “Happy birthday pops!”- a 4 year old while playing a fishing game. His “pops” was not in the room.

-          “Well, look who’s here!”- when I came back in the room from getting the supplies for the day.

-          “Where you going Scooby doo?”- when my CI left to get something.

-          “Hey, it’s me ‘David’”- an autistic little boy while just chillin on the swing.

-          “There is no ‘try.’ There is can and cannot.”- a 7 year old little boy who refused to “try” an activity.

-          “Trick-or-treat! Happy Halloween!”- today during our session.

-          “Well, well, well, look who it is, Santa Clause.”- when my CI came back in the room.

-          “Goodbye! Happy Thanksgiving!” –today after a session (the same boy who said the above two statements.

-          I was also proposed to two weeks ago during a session, by an 11 year old with Down’s Syndrome. He insisted on being escorted around everywhere after that point. Today he didn’t want to leave, so I offered to escort him. He started humming the wedding march as we were walking.

These are all of them that I can remember right now. I’ll be sure to add to them when I think of/hear new ones!

In other news, Georgetown Hospital system is flying me down (to Myrtle Beach) for an interview next weekend! I have not had a phone interview yet, nor have I really talked with anyone about anything. But they are paying for my flight, hotel (a really nice one), and a rental car! I’m so excited. I’m trying not to get my hopes up though- it just seems too good to be true.

Anyhow, today is FRIDAY! I’m so ready for the weekend! Hope you all are enjoying this fabulous weather (finally)!!!!

Almost the end of week 2

A lot has been happening in the life of this OTS. However, the trade off to these 3 day weekends (working four 10 hour days) is exhausting. So, by the time I get home the last thing I feel like doing is typing a blog.

I'm seeing a lot of interesting things though. Remember my patient from Rehab who had transverse myelitis? Well, I saw a 16 year old with the same thing. She is doing well, but is in a wheelchair. It happened about 2 years ago I guess- and I couldn't get a definite answer about how her onset presented, but needless to say its just as shocking and devastating as my last patient who developed the symptoms overnight.

I also saw two boys with SCI, both at the cervical level, both 18. One has a complete lesion, one has an incomplete lesion. ...two little letters that make a big difference. The one with the complete lesion is in a power  chair, and unable to wiggle his toes, has no active finger/wrist movement, but is in great spirits. The one with the INcomplete lesion I literally saw WALK without an assistive device- with only hand held assist and an AFO. I couldn't believe it. It was amazing.

Next week I start treatments on kiddo's. I have 5 kids that I'm treatment planning for, and one of them I'm going to be doing completely independently because my CI has a meeting. I can't believe that.

Anyway, I have to leave for work. Two more days of work, then I get to go home. :)

Placement 2, Week 1, Day 2

So, Cincinnati Children's Hospital. Today is Day two, even though most weeks I'll have Monday's off. It has definitely been a transition from working with adults in inpatient, to working with children in outpatient. It's not the things I thought it would be that have me semi-disappointed. In patient adult- you think slow and boring... in fact it was anything but. Outpatient ped's you think wild and crazy busy- again, anything but. I saw a total of 4 patients today- in a 10 hour day! Once I start doing treatments and documenting I'm sure I'll be grateful for the breaks and chance to catch up- but right now, those 6 hours of "nothingness" are almost painful.

Don't get me wrong, the facility is AMAZING, the therapists are GREAT, and the kids are adorable- I think the issue is that I don't like outpatient- even the day I observed adult OP I was NOT a fan. Once I'm more  comfortable with the therapists, and this setting, and doing treatments I'm sure I'll enjoy it much more. Its just a transition- and one that I went through with IP too.

My CI's are great and SUPER helpful; willing to do anything to make this a great experience for me. I got to use some assistive technology for the computer today which was fun, and I saw a pt get a new wheelchair- it had been 8 years since he has had a new one. It was neat to see the adjustments and changes with that.

That's all I have for now... time to make dinner. Hope everyone is well!

11 days and counting...

Yes, you read right. There are 11 days left in this fieldwork. I'm not quite sure how that happened- it's gone SO fast. Many things have happened in the last two weeks.

I did a home eval for my transverse myelitis patient, because she WENT HOME! She's using a walker, rollator, and a few other pieces of adaptive equipment. I was so excited when she left, but it's only been a week, and I already miss her like crazy! We gave her a gait belt that we all signed and wished her well. She started crying when we gave it to her, and I'm not going to lie- I got teary-eyed too...

I got to observe surgery on Tuesday; a total knee replacement, and a Birmingham Hip Resurfacing. It was amazing. On top being enthralled with what was going on in surgery, I was definitely impressed by the precautions that were taken for sterility, and the professionalism and respect towards the patients while they were under anesthesia.

Maybe this weekend I'll describe the surgeries in a little more detail. But it's been a busy week, and I'm exhausted.

Week of firsts

This has been a week of firsts for me.

-First time I had to use a sick day.
-My first double treatment (I treated two pt's at one time.)
-First time reporting on more than one pt at the team meeting
-First time transferring a person with a max assist of 3. (I was sweating like crazy, and my bicep was killing me!)
-First time I walked with my transverse myelitis patient (I video taped it too... but I don't want to post it on here due to HIPAA- even though I have her permission, and its only from the back)
I'm sure there are more. This is all I can think of for now.

What is not a first for me is all this snow. It can stop any time now... really....

Branding, Buffalo's, and Wii.

What is it about my nose? I've now had two patients comment on it. The first, a few weeks ago, asked if I'd had a nose job. The second, yesterday, the sister of a patient said she loved how my nose curled up. Really? Thanks, I think... If I was going to compliment someone I don't think it would be on their nose. Just sayin'.

I've had a full caseload for the last week, and it's been good. Challenging but good. Luckily I've seen the same patients every day, so that makes it easier for me to treatment plan.

One of my patients is highly medicated for pain. I've realized this since I began working with her. Her stories are always outlandish and crazy. She has done just about everything. She was a nurse. She is a pilot. She has a "retreat room" that she rents out to people who come to Colorado. Oh, thats right, she came from Colorado to have surgery at the Clinic- because the doctors out there said she would be paralyzed. She told me today that she used to interview boyfriends of women she knew- to see whether or not they would be good together. "Of course" she had to "charge them five dollars." Oh, and she's never heard of chocolate covered popcorn- but she said that it must be better than mountain oysters. (If you don't know what they are- don't google it, they are testicles of some animal or something.)

This morning she told me she thought she was being over medicated, so she decided to cut back on her pain medication. She said "Every time I lay down I fall asleep, and I shouldn't be doing that, I'm not working." Needless to say this afternoon I went up to her room to see why she was late for therapy and she was curled in the fetal position in bed, in terrible pain. She decided that she still wanted to come down for therapy, but started talking non-sense when we were getting in her wheelchair.

"Are you my Beth? I'm going to take you back to Colorado with me and find you a cowboy. A good cowboy. You know, you'd be good at branding the animals."
"Me?" I said? "You think I'd be good at branding the animals!? I'm a vegetarian."
"Oh, well maybe not. You know, there are people in India starving."
Her sister interjects at this point and says- "She's heavily medicated right now..."
The patient starts in again. "You know, my church sent 8 water buffalos there."
"What about water buffalos?" I ask.
"My church sent 8 of them to India. You know, because there are people starving there."

Needless to say, we stayed sitting, and played Wii to work on her UE strength that session.

Oh, one other thing. Another patient I'm seeing right now made me laugh today. She is an 87 y.o. admitted for a CVA. Another therapist was helping me with her today, and he was explaining what he wanted her to do. She looked up at him- all 90 pounds of her- and with her big brown eyes and Italian accent siad, "say what?!" when he was finished explaining what to do. Never did I think I would hear a woman of her age say with such seriousness "say what?". It made my day.

I <3 my patients. I really do. They make everything worth while.

It's our job...

There are so many misconceptions about occupational therapy; we help people find jobs; we only work with hands and upper extremities; we wipe butts all day. None of these are true. It is our job to make sure people, especially patients know this.

The patient I've been seeing with transverse myelitis was a perfect example of this. She was evaled 1/4, the day after I started my fieldwork. I'm about to enter my 7th week of fieldwork, meaning she has been a patient, receiving OT and PT for 7 weeks. Thursday when my CI was sick, I had a full caseload by myself. Some of the other OT's helped me with some treatment ideas since I hadn't seen some of the patients before. When my transverse myelitis patient came in for her afternoon session, Stephanie, another OT, suggested that we stand with her. She has been walking with knee immobilizers and a non-swivel 4 wheel rolling walker in PT. We've been working with her for weeks on UE strength so she is able to use her arms where she once used her legs. When she heard Stephanie say we were going to stand with her, she flat out refused and said, "I have faith in my legs, but I don't have faith in you two." This is not like her. At all. I've never heard her refuse. And she did. Not only that, but she said she didn't have faith in me and Stephanie. I would have said "okay" and picked something else to do, but Stephanie didn't give up. We stood with her. She required a min assist of one to stand, but required two people to be there to block her knees. She seriously popped right up. We did this a few more times, and then she and I started talking. She asked me "Isn't that a PT's job?" I told her, "While PT's tend to focus on walking and standing, they are looking at it for mobility reasons. We, as OT's focus on walking so that you can get in and out of the shower  by yourself, you can get on and off the toilet by yourself. You can stand up to pull your pants up. We both focus on LE's but for different reasons." She was shocked that we were trained in helping people stand. That is our fault. That is MY fault. This is exactly why we need to get people up and walking/standing/transferring while they are in therapy. It is OUR responsibility to make sure these misconceptions and stereotypes are broken.

Friday when she came into therapy the first thing she said was, "I need to apologize. I was a crab yesterday, and I shouldn't have been. I didn't know you guys did that [standing] too." That meant more to me than the harsh words she said the day before. She told Stephanie the same thing, and gave her a hug.

Other than that, not much is new. I can't believe that I'm half way done with my first fieldwork. It is going so fast. Crazy.

Same old, same old.

Not much is happening in the life of this OTS. One thing I would like to mention is a website: prescriptionhope.com. This website is one that I heard about through HASCI. It offers name-brand prescriptions for $15 dollars a month for those who qualify. I was skeptical about it at first, but mentioned it to a social worker during a team meeting and she has been able to get several patients name brand medication. I think this is a great resource- and want as many people as possible to know about it!

Fieldwork is going well. Friday is midterm already... I don't know where the last 6 weeks went. They flew by! It has been a great experience... and I definitely like working with adults more than I thought I would.

Hope you all are well!

Finding the humor...

I'm exhausted, cold, and sore from shoveling 8+ inches of snow in the last two days. Not to mention Jillian Michaels DVD kicked my butt last night. But I wanted to share a few funny things from the past week or so. Have to find the humor, otherwise I couldn't make it through the day.

1. Twice in the past two weeks I have been asked (while treating a patient) what I'm going to be when I'm finished with school. Really? lol

2. My patient with Transverse Myelitis is doing AMAZING! She is able to "march" while seated, and can even kick her leg some. I informally tested her LE today and noticed that she is now about a 3+/5 for knee extension while seated. I was so excited! Since I've known this patient from the time she was evaluated (I started 1/3, she was evaled 1/4) and I'm really close with her. I was excited that she has some movement back in her legs and I went to give her a hug. Right after, as I was sitting back, she lost her balance forward and had to catch herself on my legs. I was so excited about her legs, I "forgot" her balance was still poor. We both laughed for a few minutes after that.

And finally.... 

3. A retired OB/Gyn is currently in therapy now after having a bilateral knee replacement. During therapy today, the therapist asked, "So, are you completely retired, or do you still keep your hand in it." I realize it's just a saying... but really? With the kind of work he did, there are better phrases available. lol

Hope you are all staying warm with this crazy weather.

Things I've discovered since beginning fieldwork:

- Even though I'll be in debt forever, OT is definitely the job for me.
- It doesn't take long for a patient to crawl into your heart.
- The snowbelt is not for me.
- I cannot live without cable forever.
- I miss Charleston.
- Working with older adults is not that much different from working with children.
- I love having a washer and dryer in my house.
- It's amazing the type of friendships you can create while spending ALL day in a classroom for 19 months with 40 people. I miss them.

Mr. Inappropriate

Luckily my inappropriate patient is being discharged tomorrow. Here are some excerpts from our conversations today:

First session:

Patient: You look different today.
Me: My hair is wavey.
Patient: So, what you're saying is that you got out of the shower and didn't do anything to it, just let it kinda dry naturally (while shaking his head as if to toss his hair).
Me: Yeah, I guess...
Patient: Yeah, my wife does that sometimes, she says its easier.
Me: It is.

Second session of the day:

Me: I want to work on your standing tolerance. What would you like to do while you're standing?
Patient: I don't know. What do you want me to do? Dance? ...No, if you were older I'd tell you what I'd really want to do.
Me: Rob** that is not appropriate. We don't talk like that in therapy.
Rob to another patient: What can I say? I like women, thats what go me so many kids.
Me: ROB! That is inappropriate.
Rob: What, I'm not even talking to you, I'm talking to him!
Me: I know, but I heard what you said and it's inappropriate.
Rob: Everything to you is inappropriate. College kids talk about it all the time... you know that.
Me: Yes, but we're not at college. We're at therapy, and we don't say those things here.

**Pt's name is changed for his protection. ha


Rob ended up making designs on a peg board while standing. He dropped one. Because he has bad balance I told him not to get it, that I would get it for him. As I was bending over to pick it up he said "Can I have your cell phone number? That way when I drop something at home you can be there to pick it up for me?" I looked at the therapist that was sitting nearby and just gave her a look. I then told Rob that "I don't make house calls."


Rob is 79. Has had a "whole handful" of wives- those are his words, and "every one of 'em had a kid." He has 9 children. The youngest of which is 24. His wife is 22 years younger than he is, and they have been married for 30 years. I don't care if I'm 27 and single, you couldn't pay me to marry a man who is 49. Especially a man like Mr. Inappropriate.

What a day...

Patient 1: Did you have a nose job?
My thought: Is that a compliment?


Patient 2: "Are you Holly?"
Me: "No, I'm Beth. Don't you remember me from this morning? I did your eval with Meghan."
Patient 2: "Of course I remember you. How could I miss you? You could be a dancer."
Me: "uhhmmm..."
Patient 2: "You know some girls do that in college because they think it's funny."
Me: "Well, not me..."
My thought: Is it the color of my shirt, my boobs, or my size?

Later on:
Me: Ok, sir, I'll see you in the morning, have a good night.
Patient 2: Who are you? Are you Holly?
Me: No, I'm Beth.
Patient 2: Who the hell is Holly then?
Me: She's the PT who evaled you right before we did this morning.
Patient 2: Oh, is she overweight?
Me: ...uhhh....
Patient 2: Is she bigger?
Me: ...Yes.... but so am I...
Patient 2: Yeah, but you are in all the right places, if you know what I mean....
Me: Goodnight, Sir.
Patient 2: You know, you could lose about 20-30 pounds real easy if you try.
My thought: Why do old people think they can say what they want. And was that a compliment, or should i be offended ?

Funny how one day your patients can make your day, and the next they make you want to go to bed at 6:00.

My week has been made, and it's only Tuesday

It's only Tuesday, and my patients have already made my week.  I didn't have a patient at the end of the day, so I was observing some other therapists who had decided to have their patients do therapy together. Before they came the therapists alluded to the fact that this would be interesting.

One patient is a white woman in her 70's. I'll call her patient 1. The other patient  is a black male in his 50's. I'll call him patient 2. Patient 1 has a rehab diagnosis of LE weakness (She also happens to be the patient I referred to last week about forgetting her teeth- she's kind of crazy). Patient 2 has had a CVA and is a L hemi. Here is how the afternoon went.

The therapists tried a few things with the patients before finally deciding to have them bounce a ball back and forth to each other, (functional... i know...). Before they could bounce a ball to the other person they were supposed to say a type of ice cream.

Patient 1: What am I supposed to do? (bounce)
Patient 2: butter pecan (bounce)
Pt 1: (bounce)
Pt 2: chocolate (bounce)
Therapist: Wait, before you bounce the ball you are supposed to say an ice cream flavor.
Pt 1: Huh? (bounce)
Pt 2: Strawberry
Therapist: You need to say a flavor of ice cream and then bounce the ball.
Pt 1: Oh ok (bounce)
Pt 2: Double chocolate (bounce)
Therapist: Now you have to say two flavors.
Pt 1: Oh I do. Two flavors of what?
Therapist: Ice cream
Pt 1: Oh.... Lemon?
Therapist: ...It's a stretch... sure...
Pt 1: chocolate peanut? (bounce)
Pt 2: vanilla (bounce)

Therapist: Why don't we try fruits and vegetables instead?
Pt 1: Broccoli
Therapist: We're on to something now!
Pt 2: apple
Pt 1: celery
Pt 2: banana
Pt 1: did i already say celery? I did, ok... how bout broccoli. ...all the ones i don't like
Pt 2: strawberry
Pt 1: grapes... i'm trying to think what comes in my fruit cup
Pt 2: pineapple
Pt 1: how bout pecans, i don't like pecans
Pt 2: Pecans aren't a fruit or vegetable. Watermelon.
Pt 1: Drugs
Pt 2: (Pt laughs) Did you just say drugs? Ok... marijuana.

Therapist: (laughing) NO!!! We're doing fruits and vegetables! Let's keep this "G" rated!!

Therapist: Ok lets try something else. How bout places to vacation?

Pt 1: I haven't been many places,  but my son lives in vegas. So, vegas.
Pt 2: California
Pt 1: Ashtabula (For anyone who is not from here, that is a teeny tiny town in ohio that has NOTHING)
Pt 2: New York City
Pt 1: What was i just thinking? I had one in my head. I can't remember. What one did i just have in my head?  I don't know...
Pt 2: (interrupting pt 1) ...I give up.

Needless to say, myself and the other two therapists were dying laughing. It was hilarious. I hope it was at least a little bit funny while reading it. I also find it necessary to note that Pt 1 is crazy. She is fully capable of doing the activity. She is there for LE weakness... not for a neuro/cognitive reason.

Other reasons why my week has already been made?

-An MS pt that I transferred yesterday told me "You do that good." (Maybe its because I don't transfer her by pulling on the gait belt... just sayin.)
-The transverse myelitis patient who is paralyzed from her waist down walked yesterday. Granted- It was with a lite gait (a machine that supported her about 95%)- But she was able to use her hip flexors to move one foot in front of the other. Seriously one of the coolest things I've ever seen.
-I only had to work 1/2 a day since I had a doctors appointment this morning.

Hope everyone is doing well!!

The things they say.

My favorite quotes from today:

"He's my nephew." -My aphasic patient.
"I'm going to miss you." -My central cord syndrome patient who is leaving to go to a SNF tomorrow.
"Good luck to you. You have a way with patients that will take you far. You'll do great." -The first patient I saw by myself from eval to discharge.
"It's hard to talk when you forget your bottom teeth in your room." -My crazy patient.

That pretty much sums up my day. Glad its finally Friday. It's not even 9:00 and I've been in bed for an hour. Time for the weekend.

Always Learning

I now have three of my very own patients. We have a low census at the IRF, so my CI went home this afternoon. I was supervised by another therapist, but I treated the last three patients of the day by myself. I came up with the activities and carried them out on my own. Right now, coming up with the actives is the hardest part. I second guess myself, and I'm frustrated because they are not "functional" activities. In school they always stressed function- but sometimes you need to use the bean bags, or the weights, or the arm bike to  build strength, endurance, and ROM in the patient before you can get them cooking in the kitchen, or dressing themselves. I feel like school prepared me as best as possible- but its still unbelievable how much I'm learning. I know how to do an eval, and I know how an aphasic patient presents- but school doesn't tell you how to eval an aphasic patient. I know the difference between supervision and modified independent- but when you are in a facility and watching the patient preform a task (supervising)- how do you know when they are at a MOD I level?

I love to learn. Even during breaks from school I've missed learning. So I'm making it my personal goal to educate my patients as best as possible. If I can't make an activity functional, I'm going to at least explain to the patient why I'm doing it. There is a patient I have right now. She has Central Cord Syndrome- essentially the middle of her spinal cord was stretched when she fell, and because the the motor tracks to her upper extremities are in the center part of the spinal cord, she is unable to use her arms and hands very well. She has significant pain, swelling, and decreased ROM. She has been in the IRF for 5 weeks. Monday when I was working with her, I was trying to explain to her why her thumb was painful when she moved it, but not when I moved it. I said "When you fell and hurt your neck, you hurt your spinal cord too..." I didn't get a chance to finish my sentence and her eyes got big and her jaw dropped. She had no idea that she had injured her spinal cord. Tell me how she has been in rehab for 5 weeks and NO ONE told her WHY she couldn't move. I don't understand that. I have her do "silly" things like use a peg board, or stack one inch blocks. But I explain to her that I'm working on her pinching grasp, and the more that she uses it the sooner the motion will come back. I explain that she is strengthening it. I explain that using it decreases the swelling, which in turn, will help to decrease the pain. It blows me away that no one has taken the time to do this.

My aphasic patient is doing better. She is VERY emotional, and cries frequently during therapy. She is unable to express why she is upset- but I tell her that I understand that she is frustrated by not being able to talk. She tries so hard to use her right (effected) upper extremity. She tries so hard to talk. So far I've heard her say yes, no, well, I don't know why I'm here, and I don't remember her. It's a huge break through. I'm so excited for her- knowing that came only 3 days after she was admitted; she's frustrated that she can't say more. I don't blame her.

That's all I can think of to update now. Hope you are all doing well.

Speachless...

I did another eval on a patient today. She has expressive aphasia. How is it, then, that I'm the one left searching for words? She has a history of depression, and I'm worried about her. She's 84, and was completely independent, living on her own, and even driving before her stroke. I could see the frustration on her face as we asked her questions and she tried to answer. A tear rolled down her cheek as she tried to tell us her name. I had to continue with the evaluation despite it. It's hard to be "the therapist" and put my feelings aside. I wanted to stop everything and just sit and talk to her. As heartbreaking as it is, I have to remember that this is why I went into this field. To help people regain what they've lost. I just hope she can get back what she lost.

Found the energy for an update...

Today was a big day. A weird, but big day.  I couldn’t get out of bed this morning and got a late start. I then left for the hospital 15 minutes later than normal, and got to the hospital with only 2 minutes to spare- literally. Then I realized I forgot my ID and wallet. I couldn’t think straight today. But I survived.

Another patient with a very rare disorder was admitted today. I did her eval; my first solo eval. It went well, I only forgot a few things, and I was much less nervous than I was the last time my CI required me to do only MMT.

I also was given my first confidence boost by a patient. She is a 71 y.o. in rehab after a cerebellar CVA. She has a tremor in her right (dominant) hand, a below the knee amputation and prosthesis on her right leg, and her stroke affected her left side. Oh, and when she was in the hospital, she forgot to take out her dentures when she went to bed, and they fell on the floor and broke. The poor thing is falling apart, but she is as sweet as can be. I wrote my first note on her. I did my first solo treatment session on her, and I got my first confidence boost from her. But before I get there, I have to give you some background information. She relies on her son to do most things, basically because she can, not because she needs to. So she doesn’t like cooking because “my son will do that for me when I get home, why do I have to do it here?” She doesn’t like games, and she HATES theraputty.

Well, last Friday she got up in her room alone, and fell. She banged up her arm, tailbone, and head pretty bad, but she is ok. So this week I decided to work on walker mobility and safety in the kitchen; reviewing the precautions with her. I thought we’d throw some balance in there too, so I had her unload the dishwasher. Because of her tremor when she went to put the coffee mugs away they were really rattling.  My CI suggested that she use her left hand to put them away instead, but she couldn’t get her left arm above her head. Ok, she’s admitted for a stroke that affected her left side… so up until this point why has no one addressed her left shoulder ROM!? The next day I decided to do passive ROM on her shoulder while she was lying down. (My CI told me to use pulleys! {My goal is to get through both fieldworks without using cones or pulleys.}) J So, on to my confidence boost. Today I didn’t have her as a patient, but I saw her in the gym and asked how she was doing. She said, “I’m ok. But you know, those stretches you did on my arm, I could really feel it. It feels good, and so much better today.” I did that. I saw a problem. Addressed it. And helped her. I did it. It’s not monumental. It’s nothing that any other therapist couldn’t have done. But the thing is- no one else did it. I identified it as a problem and treated it.

Last week a man was admitted after a TIA. He has a previous diagnosis of dementia as well. When he was in therapy he said that he was hungry. My CI asked him if he had eaten lunch, and he said “not to my knowledge!” So my CI decided to call his nurse to see if he could have a snack. She told the nurse what he said, and started laughing hysterically on the phone. When she hung up she told me that the nurse had said that he ate about  ¼ of his lunch, and said he was finished. Nursing came in, moved his tray, readjusted him in his bed, and put the tray of food back in front of him before leaving. The man said “Oh, lunch came!” (not remembering that he had already eaten some of it!) So, not only had he eaten lunch once, but he ate lunch twice, and didn’t remember either time. Needless to say, we gave him some pudding, and he was happy.

Ok. I need to go to bed. This 40 hours of work a week stuff is killing me.

One of these days...

I promise- as soon as I have more time (and energy) I will give a more detailed update of my experience thus far. I have some pretty good stories already. Suffice it to say that I am at a great facility, with great people, seeing things I have learned about but that I really didn't think existed. So far I have seen both cerebral and cerebellar strokes, TIA's, Central Cord Syndrome, Transverse Myelitis, Left neglect, and amputations. Being at a hospital in the Cleveland Clinic network is exposing me to rare diagnoses and giving me an amazing opportunity to learn.

In the beginning....

It is my hope that over the course of the next 24 weeks, I will be able to keep track of my experiences as an occupational therapy student. I have officially been on fieldwork for 7 days. Day two of week two is successfully finished, and I have already experienced and learned so much. I'm finding that one of the hardest things to do is "forget" about my patients when I come home. I feel so guilty that I am able to come home every night and relax; that I'm able to leave the hospital behind and go on with my life. I get a chance to talk with my family, be with friends, and take care of myself all while the patients I have been helping all week are still in the hospital, still struggling, still relying on others for their most basic needs. I hope in time, with experience, as well as the opportunity to see patients through until discharge and recovery, I will be able to let them escape my thoughts while I'm at home. For now though, I continue to think about them, worry about them, and for now, that is giving me the determination and strength to be the best student I can be.