Thursday! Remember all names changed 🙂

I wear my new blue-ish undertone pink lipstick – my first ever since I always thought I looked like a cyanotic zombie but apparently I don't – that my OT friend got me as we are working on my makeup skills – and everybody told me how bright my face looked and stuff, so apparently it took 25 years for me to get the right color lipstick. I love my friend. Yay!

I was really, really, really, really proud of some of my OT skills today – it wasn't a perfect day and I was frazzled or unsure at times, but I had several great sessions. 🙂 Which I'm about to share in mind-numbing detail!

Layla, 1 hour: I was ready for her based on the informal visual perception (VP) lecture I got from my OT friend the other day after I went home so stressed out about what VP includes and how to treat with a kid. She is a six year old that is cripplingly shy and has severe VP issues. She is repeating kindergarten. I'm going to end up inserting pictures into this post later of some of the things we did – pictures of the worksheets that is, not her. Sorry.

We started with some basic sensory stimulation – I don't know if I'm necessarily doing anything helpful here, but I figure it's a little playful, which she needs, and that it probably doesn't hurt any to give her hands a little input. We pat our hands, clap our hands, rub our hands, I use a vibrating tool on her hands/fingers/palms, we shake our hands in the air, wiggle our fingers….then we're ready to work out our hands with writing.

PICTURE 1 – PENCIL GRIP

First I gave her a pencil with a pencil grip on it – I like the one shown her because it forces the fingers into a good position but apparently the COTA Miss Charlene, who is a handwriting guru, finds them too restricting, so today we used one that only emphasizes the two main fingers and doesn't have an under-part for the middle finger. Also, the shorter the pencil, the more likely it is the child will hold it correctly, and will also have better control, if you hand a kid a normal sized pencil they tend to hold it closer to the top than bottom (if the kid is a struggler). I want to try out the new Pipsqueaks – short markers. I wonder if Crayola has an OT working for them. They are a doing a good job coming out with helpful utensils.

PICTURE 2 – BACK DRAWING.

I got this idea from my OT friend. I drew lines in various ways on her back, then a circle or two, and some shapes…she had to draw on her paper what I drew on her back. This is complicated for a child who struggles with VP issues – translating the feeling on her back – interpreting it in her brain and sorting it out so that she can then visualize what that was and then give her fingers motor output commands on what to draw. Lots of steps. I butchered the neuroscience of it but you get the picture.

Then I gave her a drawing I copied from one of my two adult coloring books – I wanted her to pick out five circles, five triangles, five stripes etc, and color them, from this very visually distracting picture.

PICTURE 3 – ADULT COLORING BOOK

Then we used wiki sticks – which are like tiny sticky pieces of like, waxy yarn, I don't know, that are really pliable – to have her make shapes out of them. We did like four. Then I had her use AquaDoodles on the wall – a vertical surface, just for a minute . Then I really wanted to do a poem from the book Joyful Noise which are duet poems, but I realized that even though she reads well, the vocabulary would still be too hard. I think I'm going to make her an easier one at the suggestion of my OT. I think it's a great way to work on social cooperation and playfulness.

PICTURE 4 – JOYFUL NOISE

PICTURE 5 –  RAINBOW

Here is a picture of the rainbow she drew for me the other day and the nail polish she gave me on my fingers, LOL…had to put it in somewhere.

PICTURE 6/7 – ALPHABET + FILTER.

Then we worked on a simple maze in her my Little Pony book – she could not do this to save her life – am not exactly sure how to coach her on this? Hmm.

Finally we got to work on the hard stuff – handwriting. She tends to shrivel up her handwriting, so that her bellies look like raisins and her sticks are all osteoporotic, bent over and shrunk. I would verbally coach her to make sure her lines she drew hit both top and bottom line, and even show her, but somehow this was really really hard. Here is what we did – I gave her a sheet of lined paper and made the top and bottom lines extra thick with a Sharpie. Then I had her write a capital letter alphabet from memory, one at a time. For example, she did the letter A. Then we'd look at the letter A from a worksheet- using a red filter i cut out so it was less distracting – and figure out how to make it better, so that she'd end up doing it again with those verbal cues. At first nothing seemed to work to make her hit the lines properly, but by the end of the alphabet, she was doing awesome. But I've been really thinking hard about fun, NOT drill-y, ways to work on hitting her lines top and bottom…I think I'm going to bring in raised bump paper next time and ask her not to stop the line until she hits that bump.

Finally it was time to go. We have a big round rollerboard that I asked her to sit on Indian-style, I mean criss cross applesauce, LOL. She was hesitant. I hadn't realized she had gravitational issues either, but she was rather terrified. I encouraged her and let her know I would go very, very, very slow. And I did. I very very very slowly walked her, her on the rollerboard, into the waiting room. When she saw her grandmother she smiled faintly, but that was her first smile on that board…she was scared…but I think I can get her to get on that board each time we go into the waiting room and with time I bet she'll even like it. In the waiting room I gave her handwriting grip to her grandmother, showing her how to put it on a pencil and how Layla will use it (letting her know Layla already knew how to hold it), and letting her know things she could do – like drawing on her granddaughter's back and having her draw it on paper – to work on skills. I felt very OT-ish giving the grandma these instructions and it was really neat.

When you think about Layla's shyness, and what apparently amounts to a lot of sensory processing problems and fear – you have to wonder a little bit about the chicken and the egg. Did her fear of everything cause her shyness since she held herself back, or did her shyness keep her from ever exploring, thereby fearing new things? My guess is that it's both and that primarily her unstable sensory needs have caused her to hold back. She needs to work on social skills and tolerating others but I think merely tolerating me – more or less a stranger – and me trying to encourage a little playfulness from her – is enough for now.

I don't think I am particularly talented compared to other OTs in most ways, but I think I have a much stronger grasp of playfulness than even most pediatric OTs – in terms of figuring out creative ways to be silly or bizarre in a way that appeals to the child  – so I have a strong hope of encouraging some new forms of playfulness with this little girl in the next few months.

I wonder if I'd get in trouble if I let the little girl put her hands on the copy machine so that she could paint HER nails next time on the paper – (using marker on her copied hands) – hmmm. Okay anyway, I had a wonderful session with this little girl and it was primarily due to the suggestions my friend gave me. 🙂 I think she may be favorite kid to work on because she has so much room for growth.

I have a lot of issues myself with visual perception, sensory processing, fear…and so again I see a lot of myself in her and have a lot of compassion and empathy for her fears…and w
ant to see her one day be able to run and jump and have fun with friends.

Okay. This was a crazy day starting from this point on, the schedule kept changing every few minutes as kids would not show up, or other kids would show up unscheduled or unexpected, plus we had a new OT grad (from UT), come by for an interview, plus we have the COTA out of town, plus we have two PRNs coming in to help out, Vanessa and Karen, plus we have lost our old tech but have a new tech, so things were INSANE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! INSANE!!!!!!!!!!!!! INSANE!!!!!!!!!! Luckily at this point I've now become familar with almost all the kids so it's not so much as a shock when things get moved around.

I next took on my little nonverbal kid that has gravitational insecurities and hypotonia and just needs work on basic EVERYTHING. The first few times he came he wouldn't even get in the ball bath and now he loves it – well, I've basically seen him from session 1 – bearing in mind I've only been here 3 weeks now – and I've tried to get him in the hammock swing in the door a few times, but he never tolerated more than say, I don't know, 15 seconds, before whimpering to get out. I took advantage of the fact he now LOVES the balls, and LOVES throwing balls through a tunnel, and that he had just watched another child swing happily….which is great incentive. I put him in the swing and immediately dumped a load of balls in his lap and held up the tunnel. He was a little unsure at first but eventually ended up swinging happily within the hammock, throwing balls, smiling and giggling, for about 10 minutes. It was AMAZING. A big deal and a big turning point. 🙂

Ok let's see…we had a kid with Down syndrome show up and he had a joint session with a boy who has VP issues as well…what interests me is most of these kids do not  have issues with each other….they all accept each other and play with each other to the best of their abilities. Nonverbal, autistic, Down, VP issues, ADHD…whatever. Pretty cool. I had a little trouble figuring out things to do with my severely ADHD kid in conjunction with another kid – I get a little stumped if I come in partially through a session or if there is another kid in the works.

A kid named hmm Bob showed up that I haven't worked with before – he is like 3 and he is afraid of EVERYTHING and basically cries all the time. His goal mostly involves just tolerating ANYTHING and being away from Mommy. At one point we got out busy bugs (cute colorful bugs like dragonflies) and he was terrified. Afterwards I had a talk with Mom and was letting her know how scared he was and she was telling me about this fake spider her husband brought home because SHE is scared and how he was terrified too  when he saw it because he knows how she responds- we talked about, obviously I am paraphrasing here, how her fears are legitimate and obviously it's ok to be afraid of them (I am too), but pointing out gently that her fears will affect HIM (and teach him to be afraid too), so that might explain HIS fear of these bugs – she wanted to know if it was just spider bugs or everything – I told her it was all the bugs in general, but that he was probably generalizing spiders to include all bugs remotely like it – and that maybe she should consider getting some cute little bugs to play with, to show him there is nothing to be afraid of. The more I spend time with parents the more I realize the power my scrubs has – they treat me like I am an expert – so I need to be careful what I say or do.

Okay I only want to talk about one more big thing. The severely autistic kid I had a good session with the other day, is having medication problems, and is on a patch that, when it wears off, sets him off nuclear. He had an okay session although was agitated about wanting his mommy, although when it was time to go and surrender the spongebob toy, he FLIPPED OUT. He was screaming and throwing himself around and it was all my OT could do to keep him from hitting his head…this is a tall boy. She would hold him in her arms firmly to restrain him and he would calm down and stop moving, but when she would finally loosen her grip slightly, since historically he'd be calm at this point, he kept going. After about 15 minutes of repeating this, we finally took him out to his mom. She immediately put him in a restraint that was clear she had practice – she said he had a behavioral plan and so she had undergone training – she wrapped his arms around himself like a straitjacket, put her knee against his bottom, and pushed him against a wall – not meanly, but gently, and solely to immobilize and calm him. He was immobilized against a wall and it was clearly calming to him, although if she eased up at all, he'd start flipping out and kicking his feet again. She had to hold him against the wall in this position for a good 10+ minutes, and was telling us they needed to go back to the neurologist to discuss this, as this is now what happens when the patch wears off, which is obviously unacceptable…it was pretty amazing. I was actually really glad to see this restraint and while I hope I never need to use it, it was good to learn.

By the time we finished with him and I did some cleaning of the absolutely chaotic office – remember it had been a ZOO – it was almost 7:30pm. I met Allison at the track near the dorms and we walked a while and talked about our days….I got home around 9pm and was exhausted ….and realized that the only thing I had eaten that day was my bowl of yogurt with cherries and almonds at 1pm. Oopsies. LOL. I'm a little overweight because I eat when I'm bored – and I was bored a lot in June – plus I sat around a lot. But I have the opposite problem in general – when I'm busy, I forget to eat until I get sick from low blood sugar. Today I was so wired that adrenaline kept my sugar from dropping too low until I finally chilled out. So I had a tomato cheese baguette around 11pm for dinner. I'm slowly losing weight I gained in June since I'm on my feet all day long and don't eat that much.

I got frustrated because I had so many e-mails and Facebook messages I wanted to respond to, many of them from strangers about OT, plus I really wanted to blog about my days, plus I wanted to clean, but I was sooo tired. I finally got to bed around midnight without hardly doing any of that stuff. Oh well. I got the call Friday evening to meet in the office around 930pm and that we'd be done by 2pm. Great. (These hours sound cool, but remember that I've worked overtime like every single day (without pay of course since we work for free and actually pay tuition for the honor of it), plus we work 10+ hours on Tuesdays and normally Thursdays, so it's not as awesomely little as it sounds). Anyway, we're going to Oxford, Misssippi for the day. I didn't realize how far away this was – it was almost 200 miles roundtrip. A speech therapist wrote down directions and unfortunately messed them up slightly since it was from her head – so we got a little lost – we left around 930 but didn't get there until a little past 11amish.

Then we did an eval with First Steps people + some speech therapists at Ole Miss, of a little boy with expressive aphasia, following in the footsteps of his older brother. Because the speech therapists didn't have a lot of experience with First Steps and therefore hadn't done evals with OTs before, there was some confusion over assessments, and so we didn't get done until 12:30pm. Oh, let me add in that I had had a bad headache from the middle of the night and it hadn't gone away, so I was in a lot of pain and definitely not feeling up to being very um, mobile. Anyway, the first steps people wanted to grab a bite to eat with us, so we ended up eating at Chili's. Unfortunately we got a waiter that probably could have benefited from First Steps as a child, as I'm not sure we've ever had a waiter be so slow to catch on. I ordered a cup of soup
, a piece of corn on the cob, and a chocolate shake for lunch…I had to ask about the shake at least 4 times. Then he completely screwed up our easy bills…etc. And it was sooo slow. Good thing he was pretty, but he had odd mannerisms and we ended up being at this place forever. On the plus side, the first steps coordinator re-taught me the method of calculating a child's age in months based on the current date, which can get complicated (like an eval on 7/17/2008 for someone born on October 20th). You can also just kind of figure it out on your head/fingers, but I wanted to reknow the formula for it.

ANYWAY then we went back to the health department so that they could give my OT the evals/forms on the kids we'd be treating once a week from now on since their OT is leaving…so now we will be doing Oxford once a week too I guess. That's a looong drive, luckily an easy one. At this point though, it was ridiculously late. We got back into town at 430pm instead of 2pm. 🙁 I had promised Patric, a 13 year old boy I try and take out for fun every once in a while, that I'd get him at 3pm, and I had to switch that to 430pm. He has been asking me when we'd next do something for a LONG TIME, and so even though I was tired with a bad headache and frustrated with being 2.5 hours late, I didn't want to let him down.). Note: I asked a friend what she thought a 13 year old boy would like to do, and her answer was “You”, LOL. Luckily he is immature enough that I don't think he's quite at that point…hmm. Anyway, I picked him up and we went downtown to eat sushi, play at Jillian's, and have ice cream….and he has grown a lot lately and I dunno, I did get to think he is starting to get to a point where he likes girls and likes me…but not in a creepy way at least. It was sweet. We played a lot of air hockey and I kicked his butt even though I tried not too – I have really good reflexes.

Around 715pm I dropped him back off at home and headed to a Vietnamese restaurant to meet my friend Doug…and I talked to him about my little girl and the lines and how I wanted to think of fun ways to work on connecting lines…then we went to my OT friend Kerri's and Brent's and they had their friends Eric and Melinda there so it was the six of us…we hung out and played games….but I was sooo tired that I spent most of the night lying on their carpet as if dead. We played scattergories and I agreed to play only if I could come up with whatever words I wanted because I don't care about points and I have very bad recall, so coming up with ethnic foods that start with “W” for example, isn't going to happen. I just make up things like wenchiladas. Eventually I got to the point that I was wandering around like a patient with dementia as they played their game…and finally left around 11:15pm because I was completely and utterly useless, period. I love being so busy in some ways because I am thriving mentally and physically (minus the headaches and such), but my exhaustion is pretty complete by the end of the day….and things have been extra tight because I'm trying so hard to see Doug a lot since he leaves Monday for England again to finish his dissertation.

Now I've been writing for several hours and once I get done blogging today I'm going to take a nap and THEN dance I think, LOL…I'm tired again. On Monday we go back to the new clinic but we only have two kids as far as I see, both of which we have seen before and I love, and then my kids in our normal clinic are all familar except one little kid with a mohawk but I'll read up on him….only one new kid, shouldn't be too bad of a day. Plus I've enjoyed meeting Allison after work at 6 or 8 or whenever I get off work to just walk around the track and talk about our days for a little while, and since she lives so close it's really convenient since by then I'm ready to collapse. It works best if I don't ever even get home until 9 or 10pm, because if left to my own devices I'll end up napping inappropriately. I always thought working would suck out my soul, but I've discovered NOT doing anything sucks out my soul worse – being busy all day, then seeing friends/working out, then collapsing, is pretty awesome, health-wise, for me. LOL.

Okay…the COTA is only gone one more week, plus I am getting to know like all the kids at this point, plus we might be hiring a new OT, so I'm thinking that life will get easier if I can just get through one more week of chaos…not that the chaos will stop, or the drama, but it should improve at least. My goal for this week, discussed with the OT on our drive back from Oxford, is to do an evaluation by myself. I'm already treating many patients a day (a full caseload in the sense I typically see patients nonstop), so with the exception of maybe starting to see two kids at once, I don't think there's much to add onto, treatment wise. And knowing the chaos of work, probably starting this week once I do my first eval, I'll probably end up doing most of the evals!

Since I've never been a Level II student before and my OT or clinic has never had a student before either, I'm really not sure what's normal…like I don't know if having a full case-load at 3 weeks is normal or not, but since there isn't a lot of documentation, and since its basic developmental peds, it seems pretty okay, I guess.

I do love my OT and the clinic and the people and the kids and everything…the chaos is a little much, but I'm proud of myself for keeping my frustration levels, fatigue levels, tolerance levels, stress levels, to an acceptable level…those of you who know me well or knew me in previous years, know how HUGE HUGE HUGE HUGE HUGE of an accomplishment that is for me, since historically I was an anal stress-filled overly prepared rigid freakoid 🙂 Now I'm just a somewhat stressed freakoid, woot woot. LOL

Let's go back in time to chronicle this day of insanity. It is lucky it is 3 days removed or this blog would be WRITTEN LIKE THIS!! OMG AUGH!!!

Get to work. I see my two little girls and we work on our basic skills of cutting, gluing, coloring – we do a worksheet and they both seem to be improving. I was in a silly mood and so I kept singing the colors they were using – like “You're using the grrreeee——-eeeeeen mark—–errrrrrrrrrrrrr!!” They would laugh hysterically. I am an extraordinarily silly [read: weird] person, and luckily young children appreciate this more than anyone else, so it works out well that I am on a pediatric fieldwork placement. 😉

We hurriedly head to our tiny Mississippi town with a load of plants and toys for the clinic – me, my OT, and our boss/clinical director/speech therapist person. We go to several dollar stores there to see if we can find a slow-flow nipple, finally get one. Go to lunch.

Then we go do our home visit to see our little baby that is deaf/blind…we spend the entire session, working on feeding. I got to hold the baby and feed her – which made me a little nervous but also glad – since I wanted to do everything right – we were experimenting with different positions, different levels of stability, and the new slower-flow nipple, which made the baby work a lot harder for her meal – and she was frustrated. She was used to it coming out so quick she could hardly keep up, and now she was having to suck and suck and suck as hard as she could. At first the hole was so little it took her like ten minutes to get almost nothing…so we made it bigger…and then bigger enough…after 30 minutes she had probably only had about 1/5th as much as normal…we discussed with the mom about how it was really important she had to work so hard because it worked on her oral motor skills and that she should start with the harder nipple flow when the baby was hungry, make her work a while, and then if the baby got frustrated, switch back to a more normal flow so she could actually get all her calories. I held the baby most of the time, periodically getting reassurance from the ST and OT I was doing the right thing. Then we let the mom feed her so that the OT/ST could give her some tips on stabilization etc, so it worked out well. It seemed crazy I am sure to Mom that we spent entire time on feeding, but that's a big deal and it affects everything else.

She told us she had lost all her old paperwork on her baby's visits to the neurologist and such (she didn't even know who she had seen) so they are having to start over with the visits. To me that is crazy – it seems like a system should be in place so that it isn't possible for all that paperwork to fall through the cracks like that when it is at taxpayer's expense. Maybe I didn't fully understand what was going on though. The mom is doing her best to show she cares – she's been threatened by child services so she is scrambling. I was asking some friends why parents who don't want their kids would even care if the kids were taken away, and my friends said it's often a combination of pride and money. The mom did say the baby was turning 1 next month and she didn't want to have a party because “she can't do nuthin'.” Us therapists were aghast at this comment but we could understand why she was saying that. She said her mother was forcing her to have a party though like she did for the other two kids which we thought was good. Even if this baby is at about a newborn level and can't fully participate, it's important she get recognized and not be hidden away as a shameful thing. This baby has beads in her hair – you have to imagine that wouldn't be very comfortable for any baby that spends a lot of time on her back – but I guess it's common, I don't know. Okay anyway.

We head back to meet a first steps coordinator at the new clinic for an eval – so there is four of us alone waiting. And waiting. The eval is at 2pm and we have patients scheduled for 330pm back at the normal clinic and it's a 40 minute drive. Well, time goes and goes and goes and they are talking shop, I'm looking at my OT book because I want to get some ideas/refresh my memory, so that I don't have another horrid day like I did Tuesday. Around 2:45pm I'm like hmmm time to go back I should think. Well we are about to go walk out the door, and the eval shows up. Nice. The dilemma is that we came all that way partially for this eval, plus the first steps guy is there, plus this family lives 45 minutes away, and this is the second attempt at a visit…they decide we should try to see them for like, 15 minutes…and we would just be a little late heading back.

Nice thought, but life doesn't work that way…there is quite a bit of paperwork that has to be done with first steps and all that, and so we end up not leaving until 3:30pmish…meaning we will be 45 minutes late for our clients at the normal clinic. There are phone calls flying between office staff at normal clinic and boss and OT, and scrambles to figure out how to handle this, and then we find out a kid not on schedule showed up and was put on my schedule as a double treat (meaning I've had two kids at once for an hour, this new kid being one I knew nothing about, the other kid being the one that had freaked me out the day before), and we all got frustrated because as a student in my third week of my first rotation, they shouldn't just add kids to my schedule randomly and at the very last second, especially not a doubling-up,  plus the kid my OT has is severely autistic and needs consistency/experience, so it's not ideal to just switch our schedules, plus I am supposed to babysit at 530pm and my OT has to work at another hospital that night (ie, we both wanted to leave on time!)….anyway it is going back and forth between the two clinics as we drive, all of us stressed out for different reasons related to scheduling, and ends up with my OT frustrated enough to be sniffling, which was a bummer and I felt bad. It's just been so chaotic with all the expansion and the trips back and forth and then kids showing up and blah blah blah – true chaos and craziness. Anyway, we do end up switching – which is not ideal- so I have the severely autistic kid  – but we actually had a great session. This kid does really well with reinforcers – so if you are .like, 2 minutes this, then 2 minutes Spongebob (his obsession), he'll more or less do it. He is very auditory defensive and spends a lot of time with his fingers in his ears when he hears other children, and kids like this do best with simple speech – even though he is like, 10 or something. He also needs to hear his name instead of “You”, so it ends up sounding like unnatural speech you wouldn't even use with a baby. Let's call this kid Jonathon.

“Jonathan writes letter D. Good job Jonathan. Not done Jonathan. 1 minute. Draw D. Draw D. Spongebob later.” Okay loud noise, 5, 3, 2, 1. Spongebob time.” So we worked on things like basic puzzles and writing D's….but he has lost that skill, he makes half circles if left to his own device while spelling his name. Then we'd play with Spongebob for 2 minutes, then back to something else. Near the end we actually went into straight work on social interactions where we worked on closing circles of communication and would have both Jonathan and Spongebob go to sleep and turn off the lights, turn them on and have it be morning, etc…so to some extent we were playing together/interacting/communicating, which is big considering his SEVERE autism. He has interesting neurological deficits – he fumbles with his lips a lot with his finger, he does weird jerks and makes odd noises, and is just an interesting case overall. I was pleased with what he did overall, Greenspan (who wrote my favorite book called The Child With Special Needs, on the concept of Floortime, play therapy), would have been proud.

Anyway,
I finally got done a little bit after 5pm –  so I went straight to go babysit. The kids and I played with the sprinkler outside and they got my scrubs DRENCHED – not that I wasn't expecting it – so I ended up in a towel skirt for a while, LOL. We had pizza for dinner – and the kids had feta and blue cheese as their sides because they are PSYCHO awesome kids who like bitter cheeses :), and then we messed around a while before it was bath time. The older kid who has sensory issues balked when he saw I had added some soapy bubbles to the bath – it turns out he hates soap in his eyes and bubbles are a threat to that apparently – so I convinced him he could sit in the bath and wash his body and then we'd do his hair under the faucet instead of his typical thing of just kneeling over to get his hair wet. Then the other kid decided he wanted to shower, so I let him, putting his shampoo down low so he could reach it. Well instead he apparently grabbed some invigorating minty shampoo and used a ton of it and so it got in his eyes and made us both cough from his strength, lol, it was actually amusing. But now I know he can't take showers alone without a little coaching/help on the shampoo aspect! ANYWAY, I get them in bed by 830pm and then the parents come home shortly after. I spent some time with them because they are awesome. My OT called me around 10:15 to let me know what time to be there Thursday (1pm, phew) and then I called Doug, my good friend who had just gotten back into town and only had a few days left before going back to England, to let him know I was on my way home. He met me at my house around 11pm. By now I was feeling really sick since I wasn't being distracted  anymore- on the drive home I realized I had not eaten nearly enough food that day considering I had been active starting at 7am – so I was hypoglycemic and now had a really bad headache. I really wanted to give him some time since he had had a traumatic week with his father being air-lifted to a hospital in FL after he wrecked his bike – with five broken ribs, a broken pelvis, and a pneumothorax, along with a bunch of contusions – he would have been dead if he hadn't been wearing his helmet. So we lay on my giant foambag while I was in my twilight zone in delirious exhaustion until around 2am and then he left. Looong day.

Speaking of long day, this blog is ridiculously long…I just got a call from my landlord Jim. His mom died last week (I am so sad for him :(:(:(:( ) and they are dispersing her furniture. I just got a really nice wall hugging lazyboy chair to keep and then a hutch that needs to stay in family but I can use while I live here, it has glass doors and would be perfect for my snail collection! I'm excited. Plus I might get her guest bedroom mattress which is like new, plus some of her Ethan Allen furniture. She also had a bunch of kitchen stuff I can have – I don't personally need it, but since I'm working at a clinic that caters to Medicaid, I'm thinking I can find people who can. 🙂 Yay now I have two Lazy Boys, but I have to figure out what to do to fit them all in my house! That will be hard.

Okay anyway. Time to move onto Thursday. Another long entry. But Friday shouldn't be long, and then my other stuff should go faster, so that's good…I want to wrap this up within an hour so I can move onto dancing and other stuff! But this blog is for my memory and for my therapy and so I refuse to get behind or neglect any days.

I'm rested! Yay! 10am on a Saturday morning! I'm in my work-out clothes listening to music with piles of OT stuff around me! My plan is to catch up on my Weds/Thurs/Friday blogging + talk about some other random OT stuff + catch up on some random chores, then I'm gonna practice belly-dancing/work out, shower, then be ready for the real world. LOL. Oh man, it kills me I waited 3 days to blog about my days, because I forget things so easily. 🙁

Ok, ::takes a deep breath:: let's start with WEDNESDAY!!!

I am in a daze from fatigue. Going to sleep. Writing about my last three days in morning.

It's almost midnight and I'm exhausted, but I desperately want to write about the last two INSANE days, but I also have 50 emails to deal with, and about 10 Facebook messages, and a big pile of papers on my desk related to OT, and there are just not enough hours in the day. 🙁 Why oh whyyyy!!!  I guess I'm just going to go to sleep – I'll jot down what i want to write about so i dont forget. Check back this weekend for Wednesday Thursday and Friday's entries I guess. Sorrrrry.

Those of you who have written me in last month about OT – I promise your mail is in my box to be looked at – not ignored – just give me more time please.

Wednesday….oh I so badly want to write up my Wednesday…which was quite an interesting day from start to finish….but alas I need to run and omg it's KILLING ME! i WANT TO WRITE IT UP NOW!!!!!!!

Also, in the last few weeks, I have officially gotten like one long e-mail a day from people interested in studying OT. I think most of them I'll end up having phone conversations with this weekend, since they have so many questions, telling them how awesome it is and to go into it. AOTA, feel like picking up my phone bill? Thanks, lol.

Anyway, i am going to tear myself away from my typing crack and go see kids from 1pm to 7pm, then meeting up with friends. Maybe I'll write late tonight.

HAVE A GOOD DAY!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Today was a looooooooooooooooooooooooooooooooooooooong day. Longcat is looong. I am waiting for 316 pictures to download from the last few weeks of fieldwork. :X

Let's start at the very beginning…very best place to start…when you sing you begin with a b c…when you blog you begin with ….umm.

It's 1110pm and I was gone from 7am to 10:50pm. I was just going to jump in the shower tonight but the water pressure is insanely low from my landlords doing laundry I guess (they just got back from a funeral 🙁 ) so I will wait until morning. So I'll just therapeutically blog then go to bed with my mind emptied.

7am: Get up.
7:30am: Leave for work almost an hour early due to open house for new clinic in small Missisippi town about 40 minutes away from this one.
8:00am: Meet my OT at the normal office. Plan was for everyone to drive down together. Drama ensues as this turns out to not be the case. Try to follow other people once finally catch up, but they speed and I draw the line at catching up with them after I steadily go 80 MPH and there is still no chance of catching up. More drama as we get slightly lost. Finally catch up.
845am:Everybody assembles in new clinic. Open house commences with catering, chamber of commerce, mayor, others present. People mill around, get tours, chat, blahdey blah. I take hundreds of pictures because that's how I roll, yo.
10amish: I inform the mayor of this town that he has balls.

Undetermined time: Any faculty that reads my blog has immediate heart attack.

10amish+ 1 second: Mayor laughs hysterically. (I had encouraged the mayor (who was very personable) that he should get into the ball pit for a picture. He laughed and said he could see the caption now, something about mayor losing his marbles. I said no, it could say “This mayor has BALLS!” because I had talked to him enough to know he'd find it amusing and not offensive. :P) (Just for the record, the clinic director thought it was funny too. But in retrospect it was really stupid of me, yeah. Just sayin'. )

Undetermined time: I receive mail expelling me from my OT school and a stern letter from my fieldwork supervisor.

11amish: We pack up leftover catering to take to our home visit for the baby that is deaf-blind. I drive  me and my OT + two speech therapists to projects. I sit on sofa entire time so that the two young speech therapists (who have never had exposure to this sort of thing) can participate fully and get to hold baby and such.

Side note: I'm proud of myself…one of the home therapists had brought a neat battery-operated fan-foil thing the baby loved but it ran out of batteries while we were there. It also needed a screwdriver to open….I dug out my eyeglass kit in my purse for a tiny screwdriver, then took two of the batteries I had been about to discard because my camera had used them up, and put it in there, because I had rsuddenly emembered reading that cameras use a lot of juice but the batteries that aren't good enough for a camera anymore might be good for small items. So yeah, it worked. 🙂 YAY!

Noonish: Head back to town, me driving three therapists….anybody who knows my driving history knows this is an amazing event (I've always been a scaredy cat of driving, especially others…not anymore I guess).

1pmish: Have been warned that afternoon will be crazy. Run to gas station down street to buy some honey nut cheerios/milk to gulp down for lunch and eat in 10 minutes. See schedule for first time. Cry inwardly 😉

1:30pm. Quietly grab first client, umm Pamela. She is a little girl that is so brutally shy it almost hurts. I have watched maybe a few minutes of sessions with her, enough to know she is there for visual perceptual difficulties, and problems concentrating, and social interaction because she is sooooo shy. I'm usually a little outgoing with kids but I know to be quiet/calm with her. I prepared some My Little Ponies stuff I knew she liked while I ate my cereal, in advance, so I was ready for her. I had her write down the six words she was going to search for in the puzzle (I color coded each handwriting line with a different colored circle), then we would systematically search for it in the word search, then she could circle it and cross it out on the other sheet. This was soo slow and it would have been slower if I had sat on my hands more…but A) I suck and B) this was my first session with her and I knew she was very shy and easily frustrated and didn't want it to be torture. Anyway. Then we did some fun Pony things that involved tape and I had to keep from cringing as I watched her struggle just with taping things. THEN I found some good worksheets and went to hurriedly copy them, leaving my fingers on the sheet as I did so without thinking…well the worksheets had my fingers copied onto them. I told the little girl she might as well give me some nail polish (color my nails in) on her worksheet, and as she did so with a red marker, I got the one and only smile for the session – that's how shy she is.

2:30 until 6:30pm: Start getting stressed. All the kids I see at this point on are more or less strangers to me, and are older and have issues with visual perception and/or handwriting, for the most part. My OT is caught up in several mini crises and other issues and is with the boss a lot, and I'm getting frustrated because while I know I need to be flexible, I'm having trouble even finding these kid's birth dates, or knowing their most recent goals/progress, so in other words, I feel like I'm going into it blind, with very little clue as to what I should be working on, and, worse, I feel VERY unsure about myself when it comes to these older kid skills like cutting, gluing, handwriting, visual perceptual games, etc – I have my play therapy down cold with developmental young kids, but the academic skills I haven't had a lot of exposure to. And since I have severe visual perceptual issues of my own, I struggle in that area – I can't help kids with puzzles because I can't do them myself without thinking a while (not even four piece ones – I'm not kidding 🙁 ) – I can't do mirror images or rotation, I can't copy items, I have a very hard time finding items in the I Spy books, you name it….I was getting very frustrated with myself and feeling out of ideas and the kids just kept on coming so it was like I had no time to sit and regroup (or at least it felt that way even if it wasn't exactly true).

The final straw came after a few hours – maybe 4ish – when I was at the tail end of a struggling session with a kid with visual perceptual issues, and then a therapist walks in ready to hand me a SEVERELY autistic child who is very difficult to handle, that I have never worked with, and I'm supposed to overlap them for 15 minutes. I almost cried. Luckily the kind therapist had no body else right then and she stayed to watch that kid for like 15 minutes while I just treated my kid alone since realistically I would have found it hard to babysit those two in a room, let alone do something therapeutic enough to bill for! Luckily things calmed down after that, I got to watch my OT deal with the child with severe autism and get some clues, etc. So while I make it sound like I was like completely tossed into the deep end, that was just my perception as I w
as frazzled and tired and unused to dealing with these kinds of kids (our COTA is on vacation as of today for two weeks). So I guess I'll get used to it soon, wow. Craziness. Between vacations, mini constant crises/emergencies/dramas, personell/staff vacancies/hiring, new clinics expansion, home visits, etc, it's pretty insane!!

When I finally left today I was pretty stressed out and frazzled and feeling bad about myself and my abilities…I know everyone else was stressed too. My good OT friend had invited me to join her family for dinner tonight, luckily, though, and she gave me some GREAT tips on how to handle some of the things I faced today. I literally sat down on the floor with a piece of paper and pen as she gave me ideas/explained things about visual perception, trunk control, etc. Very very very very helpful….will write that up in a second. She also gave me an AWESOME scarf!!!

I stayed with her family a while and then visited my friend Kerri's and Brent's who live down a few streets for about 15 minutes around 930pm, and they gave me two tomatoes randomly. Then I went to my friend Paul and Angela and their son Patric, on the way home for about 30 minutes and they gave me twelve beautiful orchard peaches, made me watch several YouTube Videos on a really insane show, let me play with their adorable dog, and just overall entertained me…and oh yeah I chatted with my friend Suzy on phone on way to Paul's and with friend Doug on way home from Paul's, and also must mention Talli who I ranted to on phone on way to OT friend's from work, and um so anyway, then I got home around 1050pm and now we are full circle, time to write up the great OT tips I got and then go to bed…midnightish.

Tomorrow I think my OT and I are down in the new clinic a lot, and then I babysit…..i hope tomorrow is a less stressful day.

And I REALLY hope Thursday is a short day since 45 minutes more the other day, 45 minutes more this morning, leaving only 15 minutes early tonight and having only about 15 minutes for a lunch, plus working most of a full day on Friday, means that if I have to work until 7pm Thursday, that I've worked like, way over time! Okay yeah I'm going to stop now. Tips, tips, gotta remember tips. Okay wow I feel like a cheater to keep saying I'd write it, but now I'm too tired to write up the full version tonight because she gave me lots of stuff to write about/think about, I think I'll have more brain power tomorrow, but for now, the MASSIVE key….HUGE HUGE HUGE key to my sanity, that she handed me tonight along with lots of individual ideas I'll write up tomorrow…..

SANITY KEY: SINCE OFTEN YOU CANT PREPARE FOR PATIENTS IN ADVANCE IN SITUATIONS LIKE TODAY, YOU SHOULD BE PREPARED WITH A “HOW TO COOK WITHOUT A BOOK” LIKE RECIPE – WHERE YOU HAVE GENERAL ACTIVITIES PLANNED OUT THAT YOU CAN JUST GRADE/ADAPT/MODIFY FOR VARIOUS CLIENTS…SO THAT EACH PATIENT MAY DO SAME THING THAT DAY ACTIVITY WISE, JUST MODIFIED FOR THAT PERSONS WEAK SPOTS. Like instead of thinking, what specifically do I do with this specific kid with visual perceptual problems, it's, here is a bunch of activities good for visual perception skills, now let's figure out how to grade it for this kid on the spot.

Since I'm so tired I don't have any ideas right off the top of my head that I want to share as an example but check back tomorrow, lol. And man I hope that tickling I feel on my leg is like my blanket and not a spider. AUGHHHHHHHHHHHHHHHHHHHHHHHHHHH.

Today was my worst day yet – based solely on the afternoon since the open house went really well which is great for the clinic – but it could have been a lot worse. My mental health level is surprisingly good, considering…and my OT friend helped a ton with making me feel better about the rest of this week 🙂

Picture is of me and my OT at the gazebo in tiny new clinic town today 🙂 And the ball pit I spend so much time in. That is, if the pictures show up.