Saturday, September 27, 2014

The seasons are changing, and so is my mood

Earlier this week my mood really started to dip. I finally started doing my light therapy. But the problem is- when I feel depressed I don't want to get out of bed in the morning- so then I am late and don't have time to do it before work. But I finally have got myself to do it. I also have this alarm clock that wakes up up by slowly turning on a light. The problem is, the last time my mother was here she unplugged it to clean, and I haven't set it back up. It is a pain to program, and I keep forgetting until I am too tired and in bed.

It is a lot harder to get out of bed now that the sun is not there to wake me up. I love waking up with the sun- and the birds.

I have signed up for a yoga class on Monday, and a nature hike next weekend. So I will be doing something. Today I have felt like I am just recovering from the week. A couple of days this week I felt really feverish- I almost wondered if these were hot flashes, but I think I'm too young still plus I take the pill. And then I had chills too. One day I almost didn't make it through the day.And another day this week I had a headache so bad I wanted to cry, despite taking painkillers. So physically it wasn't a great week. And I have been pretty irritable too.

I did get some interesting patients this week- including the first case of pure anterior interosseous nerve palsy that I have ever seen. If I hadn't had to study for the CHT exam, I wouldn't have recognized it- because the doctor just put down some really vague weakness diagnosis. And I have a doctor requesting the new post-surgical Dupuytren's tension-free protocol that I have heard and read about- but never had a chance to do before.  And I have been having success treating a patient for trigger finger by immobilizing the DIP joint- something I am trying for the first time after reading about it and talking to a couple of therapists who are doing it.

We hired a new therapist, so my inpatient coverage days will come to an end, probably at the end of October. Which is good- I really don't like acute care anymore. When I did it at the hospital where I first works, we actually did comprehensive evaluations and- for selected patients- gave meaningful treatments. But we didn't see everyone. Here the OT's are really just there to write up the note saying where the person should go and what equipment they need. It is all about how many patients you can see in a day. I'm not that productive, I can't do what the last therapist used to do. So I am glad to stop doing it.

Time to go back and watch another episode of Dr. Who.

1 comment:

Unknown said...

Menopause can start at different times...I was 34 although it took a while to figure it out. My mom also started having sx that early. My hysterectomy speeds things up b/c part of the blood supply to the ovaries was cut but based on symptoms I'm almost done. I only have hot flashes every few months and have only had 1 episode of night sweats in maybe 6-8 months. I'm 38 now so statistically from the hysterectomy will be done by 40. Of course I was made more aware of the sx early because my periods became so awful that I needed to track them and doing that made it clear that I was also having hot flashes.

The treatment of trigger finger with immobilizing the DIP is fascinating. I always hated trigger finger in the nursing homes because I could do so little for it and people would refer the same patient over and over because it is so awful looking and painful. The last 9 months I was working in a nursing home I had one doctor who was practically forcing me to do something (the patient was VERY demanding, a little confused and did not understand or chose not to listen to any explanations that didn't appeal to her and I think he was tired of it) so I did all this stretching and ultrasound for a while and taught her to release it (although she had no concept of gentle so usually if she tried she bruised it) and of course that didn't help. I was more miserable treating that one patient than any other patient ever because I couldn't help, knew I couldn't help, had the patient's doctor and family insisting that I continue even if it wasn't covered, and then I came in one day and the doctor (NOT a hand surgeon) had released the tendon in his office. But he didn't clear out the old scar tissue or anything so it was an even bigger mess. I left before it was past surgical healing and I remember being so glad that I did not have to handle that recovery. I could still walk right to that patient's room because I was there so often and dreaded it so very much. Immobilizing the DIP would have been so much easier than any of my increasingly creative treatments with that patient.

I'd forgotten how refreshing a challening new diagnosis can be. Right now I seem to be that for my therapists; neither have treated this before and since it seems to be a rare surgery this isn't surprising. I suspect they could be more aggressive but whatever, we'll be going faster after Wednesday I hope.

Hope that the meds are fixed and you feel better. I hate when generics get moved around too. My old pharmacy put stickers on when the appearance changed. This one doesn't and so I had to look up the numbers on my klonopin with the last refill as it was a color klonopin as never been before. I had a home health patient who asked me to retrieve a bottle of pills for her once. I did but they were PM meds. She told me that she knew pills to take by color but when she entered the donut hole she went all generic and they were different colors and shapes and so she just guessed every week what to put in her pill box. Her daughter worked with me and so she took over but we were all kind of horrified because it was so reasonable for that to happen. And the woman became less confused and in a lot less pain in about a week so clearly things had been off for a while. She'd been mixing up antibiotics, BP meds(major ones), blood thinners, pain pills, etc.