3 days down

Who knew Baby Jesus had hypotonia!

Day 3 over!

So…I struggled last night and this morning with dread over going to work. I'm a creature of habit, I don't like unpredictability, I don't like not feeling competent, blah blah. But I swallowed it!! My OT had a packed schedule with her neuro day program, so she sent me to the gero inpatient ward to do a chart review, and then I came back. I practiced the LACLS and made myself a cheat sheet of what to say and did some other reading, while she saw her patients.

She had this one patient in a wheelchair attempt to take his jacket off one-armed (since his other arm had no function from a stroke), by using a pulling/shaking method, and WOW, it was hard to watch. He was struggling and getting frustrated and she was skilfully helping him, but after about a minute I was (internally) like OH PLEASE FOR THE LOVE OF GOD LET ME HELP. And you know, my OT training teaches me that its important for him to do it by himself independently, and then my “gimp” perspective taught to me over the year from my “gimp” friend, makes me wonder, Why?? If it doesn't really bother him to get help getting his jacket off, why bother frustrating him so much doing it one-handed?  It was painful to watch him struggle!! My OT, btw, has awesome knowledge and skills. She has done a ton of continuing education and loves alternative therapies and is very smart and talented at OT-osity.

Then when it was time for the eval I did the chart review on, she had to do something really quick, so I went up to start. I wheeled the lady to her room – she had severe depression/anxiety – and she cried a lot. And when asked why she was there, her answer was “My stupid husband brought me here thinking it was an emergency room”. I feel so sorry for these people who just feel utterly betrayed and lost. She kept saying she just couldn't stand to be alone anymore, and crying. I just wanted to throw my clipboard of evaluation questions down and give her a hug!! I started asking questions and then my OT came in and finished up, then I did the MMSE with her – her short term memory was horrid, so she scored pretty badly. The doctors LOVE the MMSE and so when I went to turn it in (they do most of their stuff via paper charts!!), they had me give it directly to the doctor who had that lady's chart, and he was really nice. He apparently worked with the people who developed the MMSE so he gave me some cool information on it, and pointed out it's a great tool to use repeatedly (ie every few days), to determine whether a person has delirium versus dementia. Oh. And her sentence creation? Was “Love is God's greatest gift”.

I think of everything, the sentence people write on the MMSE, is most revealing. Breaks my heart. Think about it. You ask them, off-guard, to write you a sentence, about anything, and that which is most important to them, is what flows out of their fingers. The lonely lady craves love. The euphoric lady is, uh, euphoric (Euphoric Lady is Euphoric, Sarah), and the lady with circular logic/dementia just wants to be understood.
Lady with dementia: “Please understand”
Lady with euphoria: “I am a happy person and I love everyone”
Lady with fear of being alone: “Love is God's greatest gift”

I also got to give the LACLS for the first time, to an older hearing impaired man. I did the running stitch and whipstitch, then my OT took over for the single cordovan stitch, I'm not quite there yet (but probably will be tomorrow)!! Poor man could not untwist the lace for the life of him.

The coolest part of the day was unfortunately not directly related to my rotation. I joined the psychologist for his group in the stress disorders unit (I was with him Monday morning as well). I LOVE that unit because most of them aren't that dangerous or unpredictable, or at least less aggressive. You have a lot of sad people there, but not people ranting and raving and screaming and tearing off their clothes. It's subdued. The group was very small. One of them discussed some very painful memories, the other one was just very very sad and quiet. One lady kept picking at her clothes as if not sure what to do, I wanted to give her a Tangle toy to hold onto! I contributed a tiny bit to this session. I REALLY REALLY REALLY would like to work with this population of people debilitated by depression/anxiety. I have so many ideas for things I would do with these people. I realized that this morning that when I enter the gero inpatient psych ward, I'm scared and/or saddened, and don't feel like I have much to offer besides compassion…but when I am with these people with depression/anxiety, my soul shouts and sings with ideas of things to do.  I'm thinking that maybe, when the gero ward is quiet, if my OT is busy, that I would be allowed to do some non-billable work in the stress disorder unit….doing a lot of activities that focus on soul-searching through (mildly) creative outlets.
You know how Care Bears are like CARE BEAR POWER or whatever, and then like their stomach shines with this huge light that focuses on the person/thing, and changes it? I want to be like SEROTONIN POWER and have my necklace burst into this spotlight and infuse them with happy chemicals and thoughts.

Ok….my posts have gotten back to being really really long, but it helps me to spill it out. Tomorrow I may do an evaluation, MMSE, and LACLS with supervision…ie the whole tamale!! And maybe some ADLs…

After work I hit the Curves gym and have been hanging out with my friend I'm living with!! Lester the Lion Kitty is curled up next to me. I just talked to Brooke who is at John Hopkins and she loves it so far (although she's only been in orientation but it's obviously an awesome place). Also talked to another good friend for a catch-up chat and that was also awesome. Now I'm going to hang out some more and go to bed. YAY for being ridiculously overdetailed.

Jan 08, 2009 | Category: Occupational Therapy | Comments: 1

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