La la la

My two stories of the day:

1) I saw a little girl (like six-ish?) with SEVERE adhd today…I wore her out with some “heavy” joint compression work like pushing me in the office chair in the carpeted halls, then we worked on tracing letters and basic writing skills, while prone on the floor on tummy with slanted surface….she kind of freaked me out because she always wanted the doors closed and kept asking about locking it, and she kept pushing herself at me wanting hugs, but was really aggressive about it. I know a lot of kids have sensory needs and she needs a lot of input, but there was something off about her. Which was confirmed when we were drawing and she said, clear as day “Draw a stripper!” I said “I don't know that word” and she said “STRIPPER!” And I repeated deliberately, “I don't know that word. How about I draw a bubble”. I really emphasized the word bubble (we were working on circles)… AHAHAHAHAAHAHA. She looked at me like I was the biggest dumbass on earth, but let it go.

2) I saw my shy little girl with visual perceptual issues and severe sensory processing deficits…we did a word code thing where you match like numbers and letters to read a code…and we wrote a letter, I need to put a stamp on it…but I pushed her today. We have a big hammock swing in the doorway only a few feet off the ground but of course being off the ground period, if you have gravitational insecurity, is a huge deal. I encouraged her to get in it and helped her, and she was almost frozen with fear. I was at eye level with her, holding her, promising her she was okay and making sure she was okay and all that, and I had to put a chair in the doorway so that she was LITERALLY sitting in the chair, in the swing…I had her throw these little farm animals she loves, down into the tunnel (I'm telling you, tunnels are magic OT tools)…she liked this and had a hint of a smile on her face doing this, but was very much tense, even with the chair underneath her. I didn't even bother trying to swing her that's how scared she was…and I wanted her to not be deathly afraid of ever getting back in. I eventually kind of moved the chair away but kept my hands around her body, like literally wrapped around her, and she tolerated this for only a few seconds…she clearly wanted out so of course I agreed, but the getting out part was the most traumatic. She was truly petrified. She was 100% safe within this hammock swing, a few feet off the floor and not moving, but scared out of her mind at the idea of me letting go of her at all to adjust to be able to pull her out, or even be able to re-grab the chair…luckily Haley, the speech aide, has an office right by the room, and so I said Miss Haley, can you please come here and help me with Taylor, she is safe but really frightened, and I'd like you to put your arms around her in the swing so she feels safe, while I move this chair back under her…so with Haley's arms around her I moved the chair back underneath her and she was SHAKING in fear even though both of us had her arms around her. I didn't push her again and let her just play with the animals on the ground, although I did get her grandma to show her how brave she was (the session was up), and then encouraged her to get on the rollerboard for the walk back to the waiting room…which she did with no problem, so she wasn't too traumatized.

Haley was shocked at how scared my little girl was at the swing…I was surprised a little bit at the intensity, but could understand it, and I'm not sure exactly if her intense fear is such that I shouldn't even try it again, or if I should encourage it, or if there are better steps before doing the swing. I don't know. I think I'm going to encourage it and if she is adamant, I'll back off, but I get the feeling she'll try again relatively soon…and I'll try a few other gravitational challenges of a lower degree, in the meantime.

I was proud though that I could stay calm and not get panicked/anxious that she was so scared, cuz I could have been like AUGH she's freaking out AUGH get her out, quickly trying to pull her out..which would have escalated the situation and scared her more…..if you watch physical therapy on someone who is in a lot of pain, the physical therapist has to learn the slow controlled movements and the poker face….even though the PT may be like OMG this is freaking me out, the PT can't just let go or look panicked at the screams of a client…the PT has to look as if nothing is wrong. I used to watch the PTs at St. Jude work with kids with osteosarcoma who had limb-sparing surgeries, and the kids would be screaming and crying, and the PT just had to keep slowly pushing…wow. Intense. Not that this compares physically, but mentally, whoah.

Okay anyway.

My random day:

Today I left my house at 8am and got home at 9pm 🙂 I got a text at 8:30ish asking me to start my OT's 9am kid because her daughter was sick and she would be running late. Luckily, her 9am client and my two 930am clients, are all one family – triplets – and they didn't show up – so that gave me a little extra time to start the day, since I started with Christy's 930am kid, an adorable young boy we'll call Bob. He has horrible body schematics -(jumping jacks are very revealing tools), and visual perceptual issues etc….it took him about 10 minutes to do a basic 24 piece ocean puzzle.

Saw a little bit of little girl with autism who always says “Whooooah” and she reminds me of one of my favorite people because she says things like “Fish?! i LOVE fish!” LOL….saw a little bit of a little boy with various issues including major lack of safety awareness and impulsivity and is quick to apologize then repeat the incident. Saw my kid with severe autism and we did a mixture of SpongeBob + various activities like matching, puzzles, blocks, etc…

Did some worksheets/puzzles with a little boy with delayed skills…saw a kid with Down syndrome who makes me feel like I suck as an OT because it's like he slips through my fingers and never gets any “work done”, saw a little boy with severe ADHD and did a lot of trapeze swinging/hitting balls with his feet…saw a little boy with autism who seemed extra calm today and his parents reported they had just started him on fish oil…he normally wants to spend all his time in the balls but today was better about not being in them…BTW, he and several of the other children with autism we see, seem to do remarkably well, social interaction/eye contact wise, when using a tunnel…the kind you crawl through….like the kid sits in the ball pit and the other person is on the other end of the tunnel, and i dunno, somehow it helps the kid focus…I guess since the tunnel is kind of like blinders…and extra fun…

Okay a few other random tidbits…I had to dispose of a decomposing bird the other day at the clinic…which included my OT and speech aid shrieking and hiding AHAHAHAHAHAAHAHA ….it was sooooo gross.

Also, my friend Virginia who is working with a TBI who loves KISS, printed out some pictures of KISS, and today he tracked with his eyes for the first time, with that picture…and they have a few KISS mp3s to play for him now…one of which is thanks to one of my blog readers, who is really sweet and thank you so much!

I left work around 7:20pm after seeing a total of a thousand bazillion children…I still have a few notes to write but I was like dude, I've been here 11 hours, I'm going home…and crap, I forgot to get my medication refilled, I just remembered. Oh well.

Oh, and I have no idea what tomorrow will bring, but I do know it involves a visit to our new clinic, so it probably involves about 4 kids in the morning plus two kids in the afternoon plus a few evals, I guess. I don't know exactly.

I went straight to UT dorms to visit my OT friend Allison and we went walking on the t
rack with her DPT student roommate….who talks about “spondylos” and “vertebral body fractures” and “shearing forces” nonchalantly, LOL.

I had a piece of cheese, frozen cherries, and Baked Lay Chips for dinner and I'm about to go jump in the shower, then answer OT e-mails while my hair dries, woot woot.

Jul 23, 2008 | Category: Occupational Therapy | Comments: none

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