Monday, February 22, 2010

Good Day at Work

I had a good day at work, a good occupational therapy day. I had enough patients, but not too many. Enough time to give my patients what they need. Good patient interactions.

I had a discharge today, one of my long-timers. Someone who has really come a long way- one of the people who reminds me why I do this. I'll miss her.

I think the day was almost all stroke patients today, which can be very intense. Plus I had one workmen's comp patient, and the case manager came today to observe therapy, which can be a little awkward. But I think it went OK.

This evening I am exhausted, but not from work. It is that time of the month, and when I get my period I always have 2-3 days when I get really severe exhaustion. I feel like I can't move. Usually it comes with depression, this time it did not. I just have the exhaustion. This is why I take the pill so I only get my pill every 3 months. I couldn't deal with this every month. I used to spend a lot of days in bed. Or, I used to get crazy every month. To say nothing about the cramps I get- but now I've discovered Aleive, and if I take it at prescription strength, I'm pretty OK.

So no, I didn't make it to the gym, or clean, or study hand therapy this evening. I just sat in front of the TV and melted into the couch. Until I finally got enough energy to get up and eat, and now to sit in front of the computer before I take meds and go to bed.

I hope I have more energy tomorrow. One of my co-workers is out, so I will have some extra patients, it is going to be a busy day. Not like today. I have a feeling I won't have so much time for giving my patients the individual attention I want to tomorrow.

When I am treating orthopedic patients, I don't mind treating more than one patient at a time. In fact, the idea of just treating 1 hand therapy patient at a time, all day long, sounds really boring to me. But most of my caseload is neurological right now, and I feel very differently about that. My neuro patients I do wish I could give one-on-one treatment for all of their sessions. Unfornately, most places don't work that way anymore.

The stroke patients coming to outpatient therapy are getting more and more involved, as patients get kicked out of inpatient rehab quicker and quicker. Many of them come to us and they can't walk, they can't transfer independently, they can't dress themselves, they can't sit unsupported- I am starting to feel like I'm doing inpatient rehab at times. And I just feel bad for the patients, because outpatient doesn't give them the intensity of therapy that they need. They need more- and we are their last stop.

Of course some patients will continue to improve on their own, after the end of therapy. These are usually the higher functioning patients. The patients who have less function, and can do less on their own, they are much less likely to make gains on their own- and more likely to decline after discharge from therapy.

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