sooo tired

Today I was at work from eight to four, went to the gym, went to meet Doug at a Mexican restaurant out east near the gym, went to Kerri/Brent's, and now it is only eight thirty but I am exhausted. Which isn't cool because technically I have a lot of OT-related things I should be doing. But all I want to do is sleeeep. So I'm going to shower and go to bed intensely early and I'm an old lady at heart, what can I say, yo.

My anxiety level/panic levels at work are subsiding…but I still don't like the feeling of not knowing what exactly to do!! Time, practice, experience, blah blah. I need to call my supervisor at this next fieldwork since it's six weeks out. Craziness.

Lester the Lion Kitty is noisily grooming himself, he is very ADL oriented.

One day soon I swear I'll deal with all my OT and Facebook OT stuff.

Gooood nighttt

Victory in Vomit…proprioception in a video game

This came up on a google ad -actually a pretty interesting article on this video game that has utilized PROPRIOCEPTION within its game to make you feel like you're the one in the action – and can therefore cause you to feel nauseated – but in a “cool” way, if that's possible. Proprioception is a big sensory integration word and a big OT word, so it was cool to read this article, I think all y'all will find it interesting whether you like games or not. Just sayin'.

http://www.wired.com/gaming/gamingreviews/commentary/games/2008/11/gamesfrontiers_1117

“Victory in Vomit: The Sickening Secret of Mirror's Edge”

Attack of the dogs. Then work. Then play. Then jack and jill went up a hill. Or something. I don't know.

Today was an odd day.

It started out disturbing – my landlord and his dog (who live in front of me) were attacked by a vicious pack of large dogs, on our street. They apparently belong to the man across the street who kept them penned and the dogs broke out. It happened around 730am and this pack of dogs were looking for action. Fortunately for me and my neighbor with two small children, we came out about 5 minutes after this happened, or it might have been us attacked. Unfortunately for my landlord and dog, they were knocked down and attacked and both hurt pretty severely with lots of bad bites/punctures. The police were called, canine control was called, landlord's friend took him to hospital, landlord's wife took dog to vet, etc. Dramatic. The friend kept me updated with text messages. Pretty scary.

Then I got to work and had my first really “big” day where I didn't have any evaluations or any ortho stuff – purely normal treatments of like deconditioning, stroke, etc. This is a big deal as I'm mostly comfortable with ortho and evals. I did a 3 unit (45 minute) session with a man with a stroke known for being surly to many but he is sweet to me and even laughs at my silly jokes and stuff. He has bad expressive aphasia but his receptive aphasia has lessened. We did some weight-bearing stuff, some visual scanning stuff, some grasp/release stuff, you name it.

Also had a session with another ornery man but he was willing to participate – he was deconditioned – we did some marching in place and stuff since he was hooked up to a chest tube, kinda dancey-like, and he joked we'd do the jitterbug tomorrow. My supervisor popped in to check on me during it and I was like “ooooh” and afterwards the wife came out while I was chatting with my supervisor in the hall and told her I did great. 🙂

ALSO had a session with a really really old lady in bed who was too tired to do much but we did theraband exercises using her bedrails – explained we'd get up and do some movement tomorrow but for today we'd just do a little strengthening of muscles which were important for helping her push up to stand, etc.

ALSO had a session with a lady who has dislocated her hip after hip surgery a lot, we talked about importance of hip precautions, she demonstrated a safe toilet transfer and how to put on underwear, etc etc.

Also there were two “codes” in the hospital.

Also I bought cookies at a bake sale and they were yum.

Also I forget what all else, I realize many of the activities described were not very occupation-based, but this is acute care so some of them weren't ready for occupation-based, and/or had hit too high a level of fatigue after PT came around! LOL.

This morning I had a session with my supervisor and it was good she was there to coach me through the bed mobility, I am still having a hard time with that, but learning a little more each day.

I didn't finish with all my patients until pretty late today….I got to go see a cool movie on Mummies at the Imax at Pink Palace with some friends, then OT Student Becca and I had dinner at a Japanese restaurant and hung there until 930pm, then I chatted with OT student Allison….and now I've prepped for tomorrow and I'm going to jump into bed with Lester the Lion Kitty who is having excessive respiratory issues right now, I may cave in and take him to vet soon.

Tomorrow will hopefully be less busy and maybe I'll even get to the gym who knows. Few other things in the works too. And I need to buy my plane tickets still!!! Oh well tomorrow is another day, lol.

Poo and compassion, uniquely combined

Today involved a combination of poo and compassion.

I did several quick ortho evals, then went in to do a therapy session with an older lady who just had a hip surgery the day before, and also had COPD so she was on oxygen at all times. The physical therapist and I went in together to get her out of bed and into the chair, except she needed to use the restroom. The PT helped her use the rolling walker to get to the bathroom in her room, which has a bedside commode over it, meaning it was higher/had rails. She was untethered from her oxygen for this. The PT then left to give her some privacy and I stayed in the room as I was going to finish treatment with her. Unfortunately she was having difficulty completing her bowel movement and was in a lot of pain. I contacted nursing, nursing did what they could do without a doctor's order, and in the meantime, to make a long story short, the old lady was becoming increasingly short of breath, agitated, dizzy, and in a lot of pain – and still sitting on the commode. The nurse was doing a fabulous job but this lady needed to be back in bed with oxygen back on, asap. The PT was paged and he wheeled the hospital bed all the way to the bathroom door – the nurse and PT and I all kind of helped her transfer – she was somewhat, understandingly, feeling panicked at this time. We got the room back in order (ie oxygen back on, IVs plugged back in, etc), and the nurses prepared to do fecal unimpaction – ie, literally use their lubricated gloved fingers to scoop the hardened stool from inside her bottom. We rolled her onto her side which pained her greatly considering her recent joint surgery, not to mention the trauma she has just been going through. While I technically had nothing to do with the actual unimpaction, I was kind of an extra pair of hands helping with little things like communication, moving things around, etc – and the session had started with me thinking “Ok, in a minute this will be resolved and we can do our therapy” and eventually of course I realized that wouldn't be the case. While the lady was on her side, I sat next to her facing her and stroking her shoulders and hands, as the nurses did their thing behind her. It was one of those things where its productivity versus compassion and compassion wins. All in all I spent about 45 minutes in the room with her and 30 minutes of it was non-billable – but it was one of those times where “therapeutic use of self” and compassion and patient-therapist rappoire was more important than billing units. Now if I had like sixty patients waiting on me that would have been a different story, but my student schedule is such that I could spend that time with her. It was definitely a learning experience on many levels, and I know the lady appreciated having someone sit with her for the sole purpose of comfort. I went back and checked on her in the afternoon and she was feeling “100% better” and thanked me.

In the afternoon I had a quick session with a patient who had a CVA – stroke – with R. sided neglect. I asked his nurse if I could see him and she was like you can try, he says no a lot. That hadn't been my experience with him though in the last few days. I went in and he was lying in bed instead of sitting on the couch like normal, he looked sad. I sat down next to him and talked to him a little. He is aphasic but can get basic points across, and understands pretty well. He was able to communicate that he was feeling rather sad, and also that his arm was improving. I sat next to him and stroked his right arm for a while, just for some sensory input, as we chatted. I didn't want to push him and be cheery and be like let's get up and move! because I knew this patient well enough to know it would agitate him/potentially cause him to become combative, which he has become before. He allowed me to do some passive range of motion exercises with his arm – like shoulder flexion, shoulder abduction, elbow flexion, etc -and then after we had done a PROM a few times I would have him show me his ability to do the motion himself – I had to facilitate the movement because his control isn't very good – but it's improving.

After work today I went to the gym, went to my friend Kerri's to check on their cat (her husband's grandmother died so they were away for funeral, very sad), then met up at a Mexican restaurant for an OT meet-up. OT student Jason, Mary, Minda, Brooke, Virginia, Me, were there…plus Virginia's husband, Brooke's boyfriend, Minda's two roommates…so a big crowd. Very fun. Then I went to Walgreens to get my FIVE DOLLAR GENERIC DRUGS BABY! and then came home to my crazy cat….something is now wrong with his ears, he is like flicking at them buzzing around and it's really weird. I'm keeping an eye on him.

I have so much more to share but it's 11pm so I want to go to bed. I have like FORTY OT-related e-mails, many of them personal, that I'd like to respond to and/or post on this blog…ONE DAY I'll catch up. ONE DAY. Getting my AOTF scholarship done was a big deal, I did some banking tonight related to the financial issues of the break-in, and tomorrow night after work my goal will be going to the gym, going to Bingo, meeting a friend for dinner, and buying my San Diego tickets home for Christmas.

Maybe this weekend my goal will be to complete thank you notes from my birthday, catch up on gmail, aol mail, facebook mail, and blog entries. Yeah right. But I can dream.

Hemianopsia…later.

I've been kinda quiet on the blog. A lot going on in my head though.  I have bilateral cerebralobloggoneglect due to an acute infarction of my frontal lobe.

My normal supervisor is out of town so I have a very different PRN supervisor for 3 days – tomorrow is day 3 – been interesting having a different style – haven't seen anything too crazy lately except an awesome case of hemianopsia – more on that later  – ohhh the visual tracking – – going to bed. Oh and I submitted my AOTF scholarship application tonight. Dear AOTA High Peeps, Please Bless Me With Your Financial Goodliness. Thank You and Good Night

Tomorrow goals: Do some evals, treatments by myself with different supervisor observing. Buy my San Diego Ticket. Deal with my Financial Stuff from Car Break-In. Catch up on Gmail and Facebook. Go to the gym. Not all in that order.

Donning/doffing socks: miracles

Today I did a session with a pleasant older man who had just had a knee replacement surgery, two days prior. His knee had been bothering him for quite some time, so it had been a long time since he had been able to do things like put on his own socks. I showed him to long-sit on the side of the bed with his surgical leg, his non-surgical leg hanging off the bed. By externally rotating his surgical leg slightly and bending it, he was able to don/doff his own sock, for the first time, in many months. He commented that he didn't think he was going to be able to do it, and his family members present were all happy for him. It really made me happy! It was a big moment for me for this physical dysfunction rotation that I am struggling so much with – showing somebody how to do something in a new way that allows the person to feel a sense of accomplishment – wow. Very cool.

SO many other things I want to share – had my midterm today – got some feedback good and bad – did some interesting courtesy consults and had a lot of paperwork – but as always, I end up too tired. I'm always exhausted!

Today I went straight home from fieldwork, passed out for a while, met my friend Sarah for dinner, prepped for tomorrow, and now I want to go to bed instead of write!!

I got my OT Practice today and my article is in it – the one weird thing is that in the mini bio it says my blog is the otinpublicschools blog, which it obviously isn't. I'm not sure how that got put in there. And the very last line acknowledging Merrolee Penman for all her help, was cut off – it starts to thank her but ends abruptly. The editor told me it was fixed in the website version.

Other than that, I'm pleased with the editing/formatting etc…yay, that makes my third thing in OT Practice…

Ok, this weekend I need to finish up the essay portion of the AOTF scholarship, deal with all the financial stuff of the new checking and banking and credit card stuff I've gotten, have some social stuff, etc etc.

GOOD NIGHT!!!!!!!!!!!!!!!!!!!!.

Good night finally

I just officially counted because clearly I have nothing better to do in life, like, for example, get ready for work tomorrow — 31 of the remaining 41 mails are about OT! The other ten relate to finances and other things in relation to the car break-in and all the stuff stolen!

Apparently the November 3rd OT Practice has started arriving in mailboxes – a friend texted me tonight about it – so look in it for my article on online social community! I haven't seen it yet but hopefully it's gorgeous and informative and all that.

GOOD NIGHT!!!!!!!!!

PS: Note to self – tomorrow write about today's patient load – icu eval, pancreatitis eval, ortho evals, tx sessions, unit coord compliment, being bossy, inservice, having own pager, writing lots of note, tomorrow is midterm discusssion

PS2: I haven't done a blog blizzard in a long time so no fussing at me. I probably have one to two more blizzards to go in next week before I'm caught up.

Fellow OT student…

Ok I've gone from over 150+ mails today to less than 45…and about 35 of the remaining ones are also OT related, but since I've just blizzarded the blog, I'm going to stop for the night. I did want to post one last email though, name/state removed as always. I think it's nice to see the perspective of other nationwide OT students.

Living in a nursing home as a younger disabled man

Ouch! A friend sent this article to me – about a severely disabled man living in a nursing home – and his experience. Nursing homes are hard places to live in, and also hard places to work in – I know some are better than others, but still, scary. The article comments are also interesting.

http://www.theglobeandmail.com/servlet/story/RTGAM.20081105.wfacts05/BNStory/lifeMain/home/

Hands Away