Archive for category Observation Hours

Thursday.

So the week is ALMOST over. Thank goodness! It has been crazy, and my life is about to get even more crazy this weekend (YAY!). I have been running around all week going to class, taking tests, working, going to my internship (last week is next week! eek!), and getting ready to go to BLACKSBURG this weekend!

Monday I headed down to Burke and was on the Stroke floor all morning (which, oddly enough, has become my favorite unit of rehab). I worked with 3 patients and then in a group therapy session. The first woman was in her early 50’s and had a stroke a few months ago. She had the most inspirational attitude and was more than determined to be able to live at home again. She has little to no use of the right side of her body, but she has been able to learn how to use a walker to take small steps and how she can re-arrange her house and lifestyle in order to be able to move independently throughout both. She was determined to not have to have a live-in nurse or healthcare provider and rely on her friends and family for the support that she needs to live at home again. I have seen time and time again that the patients with the supportive families are the ones that have the best outcomes. I hope that when I am older, I can have people that can motivate me to work hard to reach all of my goals.

The second patient I worked with was an older man, in his 80’s, who had a stroke a long time ago and had been in rehab for a few months. He didn’t speak any English which made things hard because it is very difficult to communicate your needs to someone who wont open his eyes and can’t understand what you’re saying. Not to mention his native language is RUSSIAN, so there are obviously very few people in this area that are fluent in Russian. However, we were lucky that his daughter came to the session and could act as a translator, which was WONDERFUL. During this session, I was working with 2 OT’s, one who was older, and a girl who had just graduated from OT school. It was great to work with someone so young and close to my position. I could see how all of the other OTs were supporting her during her first week there, and it made me really excited to embark on this journey! While she struggled with this patient (I think its crazy that they would give HER this patient who didn’t speak any English as one of her first patients), trying to get him to move his legs with her assistance, the other OTs would give her help and show her how things worked. Luckily, with the help of his daughter, we were able to safely go through his therapy session, and even get him to walk down the hospital hall to his room!

The third patient I worked with had a stroke on top of a ton of hip issues. He was fairly young, and was nearing the end of his stay at the hospital. Most of what we worked on with him were endurance in walking with a cane, as well as transfers from wheelchair to walking to sitting and how to maneuver around his home so that he can live independently again. We also showed him all of these different tools that he could use to pick things up off the floor (since he can not bend down because of his hip precautions) and stand for a longer period of time if he needed to (like while cooking).

The final slot of the day was spent in a group rehab session. There were 3 stroke patients, and during most of the 45 minutes we did various exercises that will get the blood moving throughout their bodies and keep them as agile as possible. We also played a game with a balloon that practiced hand-eye coordination. The spectrum of abilities after a stroke. Some patients are incredibly willing to work to be able to live independently or at least with minimal assistance around the house, while others have accepted being “vegetables” and do not work at all in their sessions.

While I only have one more week of observation at this hospital, in October I’ll be observing at the Elementary school near my house and am looking forward to seeing a different side of Occupational Therapy!

I’m glad that this week is almost over! I hope everyone had a wonderful week and have some fabulous plans for the weekend! I know I sure do 🙂

xx
Ashley

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Internship, week 4

Today I finally got back into the grind of the internship, and running entirely TOO MANY errands! It was so warm in my room last night I couldn’t sleep, so my alarm going off at 7am was not pleasant. I got to my internship early (thank God!) and was in the Ortho unit for the morning. I worked with 2 OTs and worked with 3 patients and a group session.

The first patient I worked with was the CUTEST little old lady EVER! She had a knee replacement, and was scheduled to be discharged this afternoon, so most of our time was spent working with her to get her back into the community. We worked on getting her in and out of the shower, getting around the kitchen, cooking, doing laundry, and getting into a car. This was the first patient I worked with that was close to discharge, and it was incredible to see the progress that people can make in such a short time period.

The next patient that I worked with was an older woman who was almost ready to go home, but did not feel comfortable enough to do so, and was trying to get out of having to work to make herself better. I watched the OT work with complete confidence that she would be ready to leave the facility soon, and her attitude change within the session was amazing. Someone who was so pessimistic and down-talking themselves had a complete attitude change and was ready to embark on the next part of her journey in rehab. Since she was so close to being ready to go home, we taught her exercises to do while sitting in her wheelchair, or while lying in bed. We also worked with her on transitions, similar to what we did with the first patient.

The third patient I worked with was a younger woman who had had a double knee replacement. I can honestly say that joint replacements are some of the most incredible surgeries out there. They take people from barely being able to walk as a result of extreme arthritis, put a new joint in, and within 12 hours of surgery, the patients are up walking around! I can’t say that it isn’t also a VERY painful experience for the patients, but the fact that they have the ability to just get a new joint absolutely blows my mind. This woman, who was probably in her 50’s, was not excited about being in a center with such intense therapy. She was very easy to give up on herself, and was hesitant to do anything that we asked her to. However, we pushed through, and while it was a long, drawn-out session, finally ended.

Finally, in the last slot of my time today, I got to observe a group OT session. This was focused on patients who had hip surgeries (mostly hip replacements). It gave the patients a chance to talk about their questions and concerns about their recovery with others who know how they feel. Everyone seemed to enjoy participating and I was amazed at how many precautions that these patients have to take during recovery, and for the rest of their lives. I learned that these men and woman must be incredibly strong emotionally in order to endure surgeries like this because the road to recovery is LONG and takes a lot of hard, hard work. Every time I go back to these sessions I see how rewarding this profession really is. Since I have been observing here for so long, it is hard for me sometimes to not jump in with suggestions and helpful hints that I have learned along the way. There has been so much that I have gained from my experience thus far and am SO excited to see what the next phase of my life has in store! Let’s just hope that I get into a program somewhere!!

xx
Ashley

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Busy, busy couple of days

What an eventful few days it has been! Such a change from the last few weeks!!

This past weekend, a few friends from VT came to visit, which was such a nice treat! I picked up Carrie from the airport and went to get Lesley in NYC from the BoltBus Stop near Chinatown. It was definitely an adventure getting down and back, but luckily, my Dad drove, so I did not have the opportunity to get us seriously lost or even killed, haha! We got back to my house and obviously immediately started the festivities of pong on the deck, and catching up. It felt so wonderful to actually have people my own age around (not that I don’t love the company of my parents), and be able to just have fun! It was a late night, but completely 100% worth it!

Early Sunday morning all of us headed into NYC to have lunch and take Lesley back to her bus. The trip downtown was great, and we got there quickly, however, the return trip was not as easy. We ended up walking over 5 miles around NYC looking at shops, and little restaurants, getting Lesley back to her bus, and then attempting to find a subway to take us back to Grand Central. All of the uptown 6 trains were not in service unless you wanted to go on a wild goose chase to find one, so we attempted to take a cab, which ended up sitting in traffic for $5 worth of our time before we realized we were going to miss our train anyway. At that point, we took our time wending our way back uptown. Stopped at Magnolia Bakery in Grand Central for cupcakes, and finally got on the train. Getting home from that point was uneventful, but since we had missed our early train, we had to rush to get back down to LaGuardia to get Carrie to the airport! Luckily, the drive down was quick and easy, but, I had no such luck on the way home. It took almost 3 hours to make the drive that usually only takes about 40 minutes. So not fun. Needless to say, I was completely exhausted when I finally got home, and went straight to bed!

Yesterday was the 3rd week of my internship at the rehab hospital. Every time I walk out, I realize how much I love this field. The feeling of being rewarded everyday is something that I look forward to when I finally get through grad school and get a full time job. I was lucky to be able to pick which unit I wanted to observe in! I love the spinal cord and brain injury unit, so I jumped on the opportunity to stay there for the morning. The first patient I saw (with the CUTEST OT ever! such a crush!) was an elderly woman who had had a stroke in 1994. She did not have the ability to speak, and she was definitely not all “with it.” The OT fitted her for a brace for her hands, because her brain is not sending the right messages to her hands to let them unclench on their own. Therefore, her hands are stuck in a fist position and she cannot really move them on her own without having someone stretch them first. The brace that we ordered was one that would allow doctors and nurses to stretch her fingers, and then place the brace on her wrist and hand so that her fingernails would no longer be digging into the palm of her hand causing breaks in the skin, and eventually infection.

The second patient I saw had suffered from a heart attack and was in a coma for almost two weeks before he came out of it. He was in OT to work on his balance and his endurance while standing, walking, and doing other daily activities that he would need to put himself back into the community. It was remarkable that he had only been in rehab for two weeks and he was making such progress. We did activities like sliding across a bed in order to build upper-arm endurance, as well as stepping on a block to build the endurance in his legs. I could visibly see how tired he was after each of the tasks, but he was determined to finish so that he could be healthy enough to go home as soon as possible!

The next patient I saw had a flare up from his MS. He had lost almost all of the feeling in his right hand (mostly his fingertips) and it was his first day at the rehab center, and I worked with the OT to do diagnostic tests to see where he was at, and compare his right and left sides to see what needed to be worked on. We did a timed test to see how long it took each of his hands/arms to grab 9 pegs and place them one by one into slots. He was timed on each side to compare the coordination. In his case, there was not much difference, which was good for him. He was then given a test where he had to close his eyes and we placed different objects in his hands and he had to feel around to see if he could figure out what they were. In his left hand, he was able to identify every single object, and pretty quickly (they were mostly easy things, such as a key, or a coin, etc.). However, his right side was not so great. If things were placed in an area where he had lost feeling, he could not even feel the objects in his hand. The final test was for him to close his eyes and he had to decide whether we were poking him with the sharp side of a pin, or the soft side. It was incredible to see how different his responses were depending on which arm/hand we were working on. He was quick to respond to everything on his left hand, but he had a lot of hesitation on the right side.

I really really love going to my internship every week. Like I said before, I am SO excited to be able to do this for the rest of my life (provided I actually get into a school somewhere!). I just wish that I could do this NOW and I did not have to go through all the applications and standardized testing and pre-requisites before I could begin on this journey!

Today was also quite busy, getting everything together for my classes at community college this fall. I’m taking an Anatomy & Physiology I course (and the lab) as well as Intro to Sociology. I had to gather tons of different documents for registration, so I spent most of the day doing that. The afternoon was spent with Corbin running errands and getting things together for our vacation on Friday!! I got a new iPod Shuffle so that I can use it when I run (the iPod Touch is SO inconvenient for exercising!), so I’m excited to get back to that routine! Tomorrow is going to be spent running even more errands and getting more things together for vacation! For now though, I’m beyond exhausted!

Hope everyone had a great weekend!!

xx
Ashley

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It’s only Tuesday!?

I’ve already dropped the ball and forgot to update the blog yesterday. I’ve been ripping down that damn wallpaper for 4 days, and I had my internship yesterday, so by the time I was finished with dinner, I was ready for bed! Whoopsie!

Monday I woke up early and went to the rehab hospital that I’m “working” at. Unfortunately, once again, I was late, but this time because of a horrendous storm that closed half of the highway. By the time I finally got there, I was 20 minutes late and felt terrible. Luckily, my supervisor was also somewhat late so she understood.

I got to work with a bunch of groups throughout the morning, and I think I can eliminate one branch of OT.. Cardio-pulmonary/respiratory. It was so BORING compared to orthopedics and spinal injuries! The first woman I worked with had heart surgery about 2 weeks ago and we had to teach her how to stand and balance on her own. I really did not even understand why she was there, or more so, why her surgery had thrown off her balance and her abilities to stand and walk, but I guess thats just how it goes.

The second patient I worked with had a double knee replacement a few days ago, and we worked with him on getting in and out of a shower properly, how to get into a car, and go to the bathroom. It’s amazing to see that only a few days after surgery, he was up and walking around, and getting back to his “normal” self!

The third patient I worked with was t-boned in NYC. He is a NYC police officer and was hit by one of the suspects that him and his partner were chasing. He had major internal bleeding, a broken leg, ankle and foot, and had to have a craniectomy to relieve the swelling and pressure in his brain. His accident was in April, and he JUST got out of the ICU on Friday!! The most interesting thing that I learned during my time with him was that when the doctors take a piece of your skull off of your head, and plan to replace it, they store it in your STOMACH! The environment in the stomach is considered it’s “natural” environment and it reduces the risk for infection once the skull is replaced. We worked with him on his memory skills, giving him a page of common household objects to memorize and testing him 15 minutes later (to see if his short term memory was still there, which it was!) as well as a memory-prompting game where he was instructed to place cards with pictures of household items in 2 piles. One pile was things that he had seen on the sheet, and others were things that closely resembled these same items (such as a different style of dress shirt). This was to test whether or not the information was being stored and simply needed a prompt to bring out! The man did fine, and everyone was thrilled that his memory seems to be fully functional! Finally, we taught him some exercises to do in his room to build strength in his arms.

The last thing I did was observe a group OT session, where there were patients there with different problems. Two had had strokes, and one had had some sort of spinal surgery. One woman who had a stroke was given the task to separate utensils into forks, knives, and spoons. It blew my mind that she could not recognize a given utensil and put it in a group with other utensils of the same type. We had to keep teaching her what each one was, but this was only for her to quickly forget. The other stroke patient had to place clothespins on a wooden rod in a certain pattern. I noticed that his speech was phenomenal and he had great memory, he was only struggling with the use of his hands. The purpose of the clothespins was to work on his fine motor skills and get his fingers working again. Once he had successfully completed that, I placed marbles into silly putty and he had to dig out the marbles from that. You could see how his fingers were getting so tired by the end, but he felt great that he was able to use his fingers in a much finer setting where he needed more control of them.

I find that I leave the rehab center each day with something fascinating that I have witnessed or someone that I helped to get a life skill back in use. I look forward to each session because I know that somehow, I will be positively affecting people’s lives and that makes me more than excited to go to grad school. I’ll have to remember how this feels as I’m taking classes this fall and next spring, and having to leave the house at 630 every morning to get to class on time.

All of the wallpaper in the house is FINALLY gone! Tomorrow we start painting, and I’m excited for everything to be done, hopefully by September! Hope everyone is having a wonderful week!

xx
Ashley

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