OT tales from South America

I am copying/pasting from a Facebook note I wrote a few days ago – now it should be a little more since I've gotten to watch a few more days. Today I watched the OT start a plaster of paris mold so that a splint could be made – but I had to go before the process was complete so I could do an informational HR interview using a Skype phone number regarding a potential job! You have to be creative job hunting from Bogota, lol. I also got to watch the PT work with a 2 year old boy with a prosthetic leg he got a month ago, plus a 50+ year old man with a prosthetic after losing his leg in a landmine, and a 70+ year old lady with a prosthetic due to vascular disease. They call the LLE (left lower extremity)/RLE the “miembro inferior izquierda” or derecha, so MII or MID, I guess.  Tomorrow I have to go get a yellow fever vaccination! Yikes! 🙂 I have some pics on FB I should post on the blog re OT stuff….will try to remember to simultaneously post the OT notes on both as I've been slacking on the blog. So, without further ado, here is what I wrote a few days ago – only slightly edited – as always rapid streamof consciousness so forgive errors. 🙂 Am loving the OTs! 

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 I've been following two OTs now for a total of 18 hours now (6 days x 3 hours) – I continue to be REALLY impressed with their abilities. They make all sorts of interesting splints using yeso which is like plaster of Paris (thanks Juliet) and then it gets molded with polyethylene by the O&P lab and then gets sent back to the OTs so that when the patient comes next, its ready for the OTs to adjust on them with lighters or heat guns or whatever necessary. They also make their own copper figure 8 splints for Swan neck deformities etc. No ordering splints out of a catalog, it's all done there. They also do A TON of wheelchair measuring. I think every day they do at least a few wheelchair fittings. In this week I have seen more children with severe CP than I have never seen in my LIFE. These kids are so spastic their legs are sticking straight out in the air or their arms are sticking out behind their bodies in ways you only see in horror movies – I've honestly, in all my time at children's hospitals and OT areas and real life, NEVER seen such severe cases of CP. Maybe I am sheltered. Every single one of these children has been about 7 years old and are carried in by their parents. The OTs lay the child down on the mat and then use thick cardboard to mimic the chair and do all their measurements to submit for a wheelchair. Pretty intense. All these parents have shown so much love to their children, truly devoted, but I don't know if I'm just seeing the worst of the worst since this place is special, or if a lot of kids here just end up with extra bad CP issues due to lack of appropriate medical care/access (ie the contractures and severe spasticity that things like Botox and surgeries can alleviate). The kid today was basically doing splits in his chair, his legs were so abducted/extended.

I've also gotten to help/observe several men with amputations of their upper limb. One was born with a monoplegic arm with deformities and then his good arm was cut off in a work accident recently – so that sucks a lot since he effectively has no use of arms now except for a few inches of his residual limb. But he has a great attitude!!! Today we got to see MyoLab where the OT put electric sensors on the man's residual limb, bicep and tricep to work on isolating/increasing strength of muscles so that he can open/close his prosthetic (a myoelectric one). It lets him see the strength and the isolation, ie feedback, so he can work on it while watching the monitor. Very old school machine though, looked like TENS unit.  Sorry if I didn't explain that well.

It's AMAZING how many people are walking around at this center with prostheses. Today I saw a little boy with bilateral lower limb amputations and he had this bizarre AFO/prosthesis/locked contraption that I've never seen before but it basically allowed him to stand up although his father had to move him like he was a stiff doll – kind of like when you see kids so incredibly bundled up in winter clothes they are like a unit you can push? I'm not sure what it was for, maybe just preparing him for standing up, I dunno. Plus there was like a 3 year old walking on a prosthesis in the next room, plus lots of old ladies, young men etc, all walking on the parallel bars with their prostheses in various forms of undress/cosmesis.

At this point a typical afternoon seems to be at least 1-2 wheelchair fittings, usually of children with severe CP, a pool therapy session, a splint making session, and a session of strengthening/preparing an upper limb amputation for a prosthesis. Basically every afternoon is a combination of the most difficult stuff of many different fields.

As always i'd like to be clear I'm blogging about my PERSONAL experience at ONE place, so I'm sure there are gross exaggerations or misunderstandings on my part – but overall a really neat experience. I want to try and figure out an angle so that I can submit it to Reflections of the Heart in OT Practice after I get home.

All right, time for bed….muy cansada.

buenas noches….

Nov 17, 2010 | Category: Occupational Therapy | Comments: 6

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