Recently I have just felt drained by the end of the day at work. I have felt just exhausted some days, like yesterday. But today I didn't. Then again, I didn't come in early and stay late either like I did yesterday. I also took an eighth of a milligram of klonopin in the afternoon (no coffee), when I typically start to feel anxious. It is sometimes the anxiety itself that can wear me down.
I felt good today. I have interesting patients. I was discussing a patient who has some really devastating injuries going on- and another therapist said to me- "You can help her if anyone can. You like a challenge." And I realized that this is true. I like a good clinical challenge at work. Paperwork challenges are another matter.
I also made a cool splint today I think. I hope it works for her. The first one I tried- a different design- didn't. I was hoping to do something that would give her more hand function but it wasn't enough. So I made a bigger splint- and I hope that the patient doesn't think I am an idiot for trying the other first.
I just hope that I can feel like this other days when I get out of work. Today was a late day- not much time to do anything than grab a salad for a late dinner, watch 30min of news (why do I bother?), and now I'm in bed. But if I can feel like this on my early days, I can maybe start to have a life outside of work on weekdays.
I just joined a reading group on Meetup about political revolutions and revolutionaries. In my original bio that I tried to post, I realized that I almost sounded dangerous. Of course it was too long to be posted- so I kept things pretty general. All the same- I can see this group being a ruse of the CIA, or some government agency, to seek out people interested in revolution. Maybe at the first meeting I should ask all of the government agents to identify themselves!
I am joining the group because I am interested in change. What can be changed? Where? How? How does power work?
America is too big for revolution- it is a lost cause at the moment. When I turned on the news and saw that they are going to have more hearings on Bengahzi, well American politics is a lost cause.
I think the things you CHTs can do with splints are incredible. In school for a while I wanted to do burns, partly because of the splinting. And then the path never went that way (I wasn't near a big burn center for level IIs and wasn't ready to take on a huge city by myself to reach one). I didn't make that many splints and always was frustrated b/c I knew what i was making was simple but it was hard for me. The best molded splint I ever did I wound up nearly crying b/c it was on a psych patient and just as the thermoplastic was still pliable but almost ready not to be and I would have it perfect he would reach over and bend something. I finally had to get 2 people to distract him, someone to hold his hand and someone else to hold down the rest of the splint that I couldn't hold until it set. I then made them order me a different type of splint material.
ReplyDeleteThe best splint I ever did was the best because it was extremely creative and worked amazingly well although I'm still not precisely sure why. The patient had a small stroke and came to the nursing home with dominant weakness and some neglect. She was doing a lot better and we had this enormous snow storm so she had a very fast Friday treatment where she was fine and Monday her hand was as tightly fisted as I've ever seen, and was pulling up into flexor tone for the whole arm. It took 2 hours to get the nurse to believe she'd had another stroke. When she got back from the hospital 2 days later it took me over an hour to get a lubricated finger into her fist. Over a few days I figured out how to open her hand and that if her fingers were separated she had more extensor tone. I wound up making the equivilant of one of those foam pointing fingers for hockey (Only it was all fingers) and then strapping each finger individually at each joint with a lot of wrapping in figure 8s so that her fingers could not touch. For whatever reason (I assume a fetal reflex) that kept her open enough to work on the hand and she was learning to write with it when I moved on about 6 months later and was not wearing any splint at all by then (she progressed through several into a regular resting hand at night for a month and 5 months later just wore it if she felt her tone increase, usually because she was upset. It was ugly and very funny looking and I don't know that I could have done it for an outpatient but we were pretty sure it saved her hand function. I will never forgive that nursing home (it was one of the worst I was in) for having nurses who didn't notice a bad stroke (she nearly had to have had ankle amputated because of a severe inversion plantar flexion contracture that was treated with experimental surgery after her family took her to a doctor not on the nursin home's list b/c all of the list dr's said she was faking). It was a horrible situation which made me more happy that I helped.
Just ME