Brain tumors make fieldwork suck

My OT classmate Kerri gave me permission to post this from her blog. It's a timeline of her first week of fieldwork with a massive twist – worry over a brain tumor!! It all ended up working out and they're pretty sure her brain lesion is “just” scar tissue from an old accident, not a brain tumor, but talk about a stressful week! She didn't miss a day of her rotation either! Way to go Kerri!!

http://kerri0701.blogspot.com/2008/07/timeline-starting-tues-of-this-past.html

Icky Saturday, hopefully a better Sunday

What is it with Singapore!!!

I had tons of nightmares about Singapore!! Grrr!

I think maybe it signifies my idea of hell in a way – just a chaotic far away place where I don't feel in control or know what is going on. I personally find reading dream descriptions to be really boring since I don't have the ability to visualize, so I'll skip most of the details, but I spent over three hours in a tiny office waiting for t-shirt and bloodwork so I could actually visit Singapore, since apparently, this was required. It was really annoying. And some Singapore man was making fun of me for being a little dizzy and wacky…whatever. It was frustrating and scary. I am not sure why I've had so many nightmares every night recently – nervousness about fieldwork? I don't know. Maybe though – the theme of all dreams is the lack of control, being scared and frustrated and sad and angry and blah blah blah. lol. I used to dream about ocean waves and plane crashes and glass in my mouth – all suffocation dreams where I woke up gasping for air. So this is a new era. HMMMMMMM!!!!!!!!!!!!

Yesterday was a rough day…I was NOT happy especially after a night of crying in my dreams. I laid around in bed until 3pm because I felt really sad and depressed to do anything! I finally started cleaning my bedroom stuff, then dropped by Kerri and Brent's for a few hours, so the day got better. I played my own version of chess with Brent's hand-made board and he refused to play with me because he is not an out of the box thinker. (“My pawn cop is riding the horsie and he is going to stampede your pawn!” Then he tried to teach me real chess. I strenuously objected because in my opinion, chess is almost impossible if you can't visualize, since you can never be a step ahead. We played anyway though. The tower and bishop confuse me as I keep forgetting which is which. I finally had to think of the tower as straight (it moves linearly) and the bishop as gay (it moves diagonally) to get their movements right and even then it was a very slow process. Plus I fought with Brent a long time about how sexist it was that the queen was the most powerful in her movements yet it was the king that had to be protected. LOL. ANYWAY.

Today will be a better day…my day probably involves, in no particular order, walking with Christa, going to Costco with Burt and maybe Patsy, seeing friends Paul & Angela, random chores, and headed to hospital to hold babies if there are enough present…hmm.

I also need to work on APA citations (booooooooo) + treatment plans for my four kids of the week!!!!!!!!! I do a lot better when I'm busy. You'd think quiet restful days would be good but then I'm stuck with my own brain as company and that's no good! I think I'm gonna sit around a while longer then get ready for the day. :O

I want to make a post soon that looks at all the bazillion OT blogs out there right now…..but it's probably a while away until I finish the articles and stuff…the nice thing about going back to work tomorrow is the neat experiences!!! We hit the tiny rural town in Mississippi tomorrow again in the afternoon!

AHAHAAHAHA

Scene: Target, 930pm. Me, OT classmate Kerri and her husband Brent.

Me: ::stares wistfully at a red $3.99 plastic divided kids tray::: I wish I had all the money in the world and I would buy this. It would be great for my peds fieldwork for kids to practice handling, plus sorting ::goes on::

Kerri: Yeah, plus the shapes, and matching ::goes on::

Brent: Occupational therapy is a really annoying profession.

augh

Wow. I had nightmares all night long where I cried and cried and cried and was really sad. I dreamt the proposal for the AOTA conference that Natan and Merro spearheaded didn't go through – my neuroscience advisor at my old undergrad college rejected it for lack of evidence and I was like – the evidence base has to start somewhere you goof. Anyway I know I was sad for other reasons and it just showed up in that kind of dream, but it was pretty amusing that I was hysterical over a rejected AOTA proposal in my dream. That's hardcore lol.

Going back to sleep now just woke up a minute. I wrote this with my eyes closed lol

End of first week of Level II fieldwork….phew

I am glad to say I have completed my first week of Level II fieldwork in a pediatric setting – a private clinic in Mississippi. This morning my OT called in a little late because her small daughter hid her keys, lol. So I got to start the first kid off with the speech aid. This is a little boy who has had a rough family history and is very clingy, and smart, but he likes to play dumb for some reason. He had his pet “horsie” animal with him today and I used that to my advantage.

The speech aid first pulled out a busy bugs game where you match plastic bugs to a row of bugs on a card by color and type – ie yellow dragonfly, red grasshopper, etc. I told him once he finished a card horsie would be able to have his lunch and so he was willing to keep up his work. He would light up whenever his horsie got included. The speech aid probably thought I was crazy because I used the horsie so much but I like to play at a kid's level. We also worked on some coloring so that he could teach his horsie how to draw circles, and a few other things. Partially through another kid came in – they try and match kids up for social interaction purposes, especially because a lot of these kids have no friends. This other kid was nonverbal with a massive gappy smile. The first kid is really white and the second kid is really black and they looked beautiful together with the contrast…I got several pictures of them grinning together (for their future website collection…yep I'm still taking pictures!).

The OT showed up and um, we saw other kids. LOL. I forget so quickly what I do. I know we saw an older black boy with Down's syndrome who loves to flirt and tickle although that is discouraged. We did some SpinArt with him – you know, the thing where you use paint on a paper and spin it to make it spread. The autistic kids (I mean kids with autism!!) especially love to watch it spin.

We also saw a little girl with autism and several other boys with varying degrees of autism and/or developmental delay. There was a lot of painting done today, along with some swinging, ball pit, coloring…

This morning we saw a family, let's call them the Smiths, that live an hour away from the clinic but it's still the closest one to them. The grandma's take care of 5 kids, 3 of which need OT. Since siblings who don't need OT aren't really willing to sit around for hours, they typically end up included in sessions as a playmate. The kids who got OT and speech received it, and the OT did a group painting session with them. This kind of stressed me out as groups are too chaotic for me. Anyway, then, about two hours later, it should have been time to go, but their free transportation van didn't show up. And didn't show up. And didn't show up. We left for lunch and they were sitting there. I met a friend and we had BBQ, it was yummy and fun. Then I came back and they were still sitting there – two grandma's and five kids. It had now been HOURS. My OT found me and had cash in her hand from where some therapists had chipped in, and we went to Krystal's to get them a family pack since it would be cheap. The kids hadn't eaten in like 5 hours at this point and it was way past lunchtime. My OT and I ended up being late to come back because of traffic/lines, but at least the family got to eat. I needed to get them seven cups of ice water from inside in the kitchen so I grabbed a small mirror that was lying on the table waiting to be hung, to use as a makeshift tray, I was like OT POWER, ADAPTATION! LOL.

The van finally came but it was many hours late. In the meantime those kids were running around a lot of the time. It sucked for us but it sucked more for them of course. 🙁

By around 5pm tonight I had zonked out. I was watching a session with a little boy working on cutting and tracing and I was like I can't take this anymore. I almost wanted to go ask the OT if I could go sit in a quiet corner somewhere for a few minutes because I was starting to feel panicky, but it passed. I kind of feel like kids scheduled close to 7pm end up getting shortchanged because all the therapists are tired after 10 hours of kids and so we're all a little zombie-ish. Plus a lot of times parents bring their kids like an hour and a half early and so you end up with more kids at once than expected, blah blah blah, it gets chaotic. I do not thrive on chaos LOL.

We had a kid at the end of the day who was incredibly impulsive and couldn't listen. This little boy was so damn cute but soo bad. He had no safety awareness and was a danger to himself and others in his enthusiasm to do things. He got put in time-out multiple times and he would be so sad and cry and I felt sorry for him – he could not control himself. He did not WANT to be bad…poor kid.

We got to leave 15 minutes early at 645 which was cool. I headed home to nap a while, then ended up eventually meeting my friend Christa to go to Wal-Mart in Southaven since I forgot to go on the way home. i wanted a swimsuit and some of those boy shirts that come in a pack at Walmart to wear under my scrubs. She needed a few things too. We also picked up bake-able cookies and then went to her house to watch Scrubs and eat cookies for a while. I was originally planning to visit Kerri and Brent but they already had a few friends over and I wasn't feeling social enough to handle that many people….plus I was exhausted. So it worked out well I guess and I'll see them Saturday instead. 🙂 They are awesomeeee.

I've talked to Allison, Kerri, Brooke, and Virginia some and so far from what I have heard they are all doing fine. Allison is following a COTA a lot and I am bouncing between an OT and COTA when she is there. COTAs are sooo under-appreciated, they do so much work for less glory. I love COTAs.

Next week I get my own patients, quite a few of them. I get the little boy who is clingy/whines/plays dumb but is actually pretty smart….he comes twice a week for an hour. I also get a little autistic boy who is massive. He is cute and they said he was really hard but I have optimism. He comes twice a week for an hour.  I also got two 4-year old girls with developmental delays…they have a brother too as they are triplets (sometimes I think rehab corporations fund infertility clinics since so many multiples end up in therapy, lolol) but I'm just getting the girls who are a little easier to handle. They are seen together since they work on the same things. So I have four patients next week, I guess maybe that's a lot, we'll see, I don't really know.

It will be interesting to learn more about documentation/insurance and all those things and to kind of have the whole process/system make sense to me…

Oh, a funny thing. Most of these kids have difficult names (at least to me), you know, just an example name not from clinic, like Martavius or Shekelia or Zequalius or who knows what else. It's really funny to me when a therapist is dictating to the kid to spell their name but has to falter to check the chart on the spelling, lololol. Some of these poor kids are going to be like 30 before they can spell their name because it's so long and unusual!!

I am glad this was a short first week….I really like my OT and everyone else at the clinic. 🙂

Next Friday is National Cow Day at Chick Fil A or whatever…me and my friend Christa are probably dressing up like cows to go get free food after work…..we'll see. ahahahhaa

Have a great Fourth of July everyone 🙂 Take care of your pets and kids tomorrow night to make sure the noise doesn't drive them all crazy!!! Auditory defensiveness anyone?!

Day 3 of Pediatric Level II Fieldwork Completed. Including a home visit, my first :)

It's not even 10pm and I'm an old granny lying in bed to write this! Fieldwork is wearing me out, yo! Today was pretty interesting.

The director accidentally booked a 4 month old baby at the same time as a rambunctious and hard-to-handle little girl with Down's syndrome, so I saw the little girl with the speech aid and the OT checked on me some, they won't bill for it is my understanding although maybe you can, I still don't fully understand how that works. I had observed this little girl, let's call her Bonnie, once before. She requires a lot of “heavy” work like pushing chairs and jumping, before she can tolerate sitting down and doing something else. We started by having her push me in an office chair up and down the halls and we'd take turns with that. Once she was worn out, we sat down to work on stringing some giant beads with a pattern, which she didn't like and tried to refuse, but we made her do six beads (which took her a while) before moving on. She used Aqua Doodles a while and then we did some more heavy work by letting her jump on the trampoline and then using a scooter board to push each other up and down the halls. This wore her out and she was ready to do coloring. My OT, let's call her Jane, had warned me she didn't like coloring or writing, so I wanted to attempt it. She wasn't thrilled with it but she did a T, a O, and an I, at least, and then we were starting to work on making circle/stick puppies when her time was up. We also played Hi-Ho Cherry-O, and she loved it. It was my first time playing it and I will put it in my “Thomas Kinkade Pile” aka “Things I hate” LOL. Overall she did pretty well since she can be very stubborn. It was cool because although it was a co-treat with the speech aid, I was in charge of most of it, and it was like, my own OT session, lol. Then I got to watch the tail-end of a session with the 4 month old who only a few weeks previously was not grasping at ALL and was now grasping a little bit. This was right up my alley because I want to work with the babies.

Then it was time to gather up stuff and head to a small rural poor town in Mississippi. We were going to be doing a home visit, my first one ever. I've observed or volunteered in tons of different OT settings so it was neat conquering a new one. Me, my OT Jane, and the speech therapist/director of the clinic went. We stopped and ate at a home cooking place first, then checked out the brand new clinic she is in the process of opening, then went to the projects for the home visit. They could not remember exactly which apartment she was in so we wandered around a while, in colorful scrubs carrying colorful toys and wedges, lol. We finally found it as they finally recognized it. The door opened up into a small living room. There was a girl in her teens sucking her thumb on the couch. A child clad in only a diaper was running around, and three other girls + another little girl were also in the area. They got the baby we were visiting, a deaf-blind baby who was close to a year old but looked more like a 2 month old. We spread out a little mat on the ground and the OT started doing sensory stimulation and trunk strengthening stuff with the baby. The “aunties” all watched expressionlessly on the couch, not out of interest but because there was nothing better to do. It was clear we were aliens to them, three chicks in scrubs invading on their turf. The two siblings were jealous and wanted to see all the toys but were strictly kept in line and eventually kicked out of the room.

The OT rubbed various textures on the little baby as well as used a vibrating toy. She also put her on the wedge to facilitate trunk extension and such, and some other classic baby OT things. Then the speech therapist did some oral motor and oral sensitivity things, and then I got to take a turn. I tried to act confident…which I kind of was since I have spent a lot of time with babies in the hospital. I basically did what the OT had already done – I propped her securely against me then did vibrations on her feet and arms, rubbed soft things on her, wedged her to work on her neck extension, grasping, things like that. It was neat. In the meantime we could hear various aunties screaming at the other children to shut up, plus spankings and screams. Quite an experience. When it was clear the baby was hungry, we asked about feeding a bottle…the auntie had to first find her bottle, then call a neighbor to bring over formula. It was interesting being an intruder in their house.

I was briefly in the homes of very poor people while doing the MIFA runs (like meals on wheels) but hadn't been in a house like this where it was a very small apartment yet had at least 4 teens + three children actively living there. The baby's bottle was made and the OT fed her…she needed lower lip support by holding the bottle in such a way that one finger could be used to hold the lip to the bottle, and she did best sitting up so gravity wasn't making the flow too fast for her. Then we left, ta da. My first home visit.

We headed back to the new clinic to do an eval on a 2 year old boy who was more or less at age-level. It was really funny because the mom explained the boy only listened to men, and/or women with big “hooters” because he was fascinated by them, although he liked to do a little too much touching than appropriate lol.

I asked her if she had ever tried lowering her voice to that of a man, because I've read that it's possible the child is responding to the male's deep tone, not the fact it's a male specifically. She said she hadn't tried. My OT thought that probably wasn't the case, but I guess it's worth a try, right? LOL

I spoke with the director and my OT about my blog and HIPAA, and we determined that it seems that as long as I don't give specific names or locations (or name any characteristics so astonishing its obvious, like that girl who had eight legs in India), that I am not in violation. If anyone feels otherwise (especially AOTA people) please tell me.

It was a fun day although I didn't get to leave until 5:30 which was 30 minutes late…I met Allison at the gym and we did these awesome new bikes where you like, have to actually pick a trail and steer and do a path. I did about 5 miles which for me is like, stunning. And my back is starting to feel better, yay. I didn't take any painkillers today for the first time in a looong time. After the gym I went to the grocery store, then sat outside with a coffee popsicle, then showered and ever since have been in bed catching up on email and blogging….and now going to bed.

Tomorrow I am gone 830am to 7pm and it's a normal day at the clinic…meeting a friend for lunch AND it's the last day of my first week!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!  And it's also OT classmate Virginia's birthday tomorrow, HAPPY BIRTHDAY TO HER. 🙂 Gotta check in with her to see what's going on for fun tomorrow night and all that.

My goal for tomorrow is to finish my OT Practice Article and that is it. It's pretty close at this point, yay!

Boy with amputation plays baseball :)

Letter reversals – tips from PediaStaff

Food for Thought, written by "Cookie Gimp"

Reflections on Fundraising     by “Cookie Gimp”

How do occupational therapists feel about fundraising relating to disability? I know it's important and necessary but I still find both telethons and other imagery of disabled children as using pity and humiliation to raise funds. And I find this deeply troubling. It sets up rehab workers, including OTs, as seeing disabled people as pitiful and pathetic rather than equals. And with children, the consent is always murky as it could simply be the parents who agree. I saw such an ad by the local rehab hospital today in my local paper about a pressure sore mat that will better diagnose pressure sores and it talked about an occupational therapist that could help her. I think that's great but they gave the example of a 13 year old girl with spina bifida and prominently featured her picture. Everyone is different but having spina bifida myself, I sure wouldn't want all my friends to see my picture associated with pressure sores on the coccyx and the need for funding. The message it sends is one of pity and misfortune when really these are services that should be a matter of right. So I think it's time OT reexamines how it portrays disabled children. It should be possible to raise money without using exploitative imagery that likely will be highly damaging to the child.

Slow morning

This morning I had to be here at 9am. We had two kids – brothers, scheduled, but transportation didn't show up, so my OT caught up on writing up evals for Medicaid. We also dealt with a mini carpet emergency. A kid knocked over a “Snoezelen” like thing – a big pole thing that contains water and fake fish and lights up – and soaked the brand new carpeting as well as stuff within the OT room. This happened late last afternoon after OTs were gone- the kid wasn't even supposed to be in there, he was there for a speech appointment. So this morning the OT and I and the apologetic speech therapist dragged the carpet outside and draped it over tables to dry and avoid mildew. Anyway….we have six kids scheduled between 130 and 7pm so I guess the afternoon will make up for the slow morning- I mostly read a book on play therapy for abused kids while sitting by my OT writing up the old evals, and then from noonish to 1ish (now) I just went to a BBQ place and read….la la la la