My co-workers all love to run. I hate running. I can’t relate when everyone talks about whatever race they are doing next. Someone else swims, some play tennis, some lift weights, some bike. One guy surfs. I do yoga. That really is the thing that I do that helps me with myself, my body, my life. I don’t do the Americanized version of yoga, where you try to do all these crazy poses in a limited amount of time. I like to do gentle, restorative yoga. I like to calm my mind. I like to lie on my back, do spinal twists, breathe, stretch my muscles that get worked out from doing maximum level assistance transfers. It’s important to have good posture and breathing techniques, especially as a therapist. For 2012, I look forward to deepening my yoga practice and taking care of myself more than I take care of my pts. It sounds selfish, but it’s the only way I’m gonna make it to be an old OT. I have to make sure my body can last in this type of physically demanding job. I don’t want to end up like one of my pts and have spinal surgery or a hip replacement. I want to stay as healthy as I can.

I was talking to one of the volunteers and she has never experienced death in her life. My grandpa died when I was 5, my uncle when I was 11, and my dad when I was 23. I know what value life has, the memories that someone leaves with you, the imprint they have on this earth. That being said, I mourn for my pts, but on the inside. I don’t outwardly show this to my co-workers and I don’t really talk to my husband about it. I internalize it, for better or worse. I belive in reflection, which I do often. I think about my dear pts that have passed away or have a terrible prognosis. I care for them with compassion, but I cannot let it bother me so much that I cannot go on living. I would be a terrible therapist if I let that happen. You need to be able to appreciate humanity but also respect the circle of life. It’s the only way you will survive being a therapist.

This leads me to my headline. What I take for granted is realizing that in my everday life, I will probably see a penis and a butt. Maybe a boob. But, who cares? It just goes without saying that I will see that during my day. I forget that not everyone sees penises and backsides on a daily basis. My husband does not have anything to be worried about. These are not fine, anatomical specimens. I see wrinkles…lots of them. For example, last week, I was working with an elderly gentleman with Parkinson’s disease. We were working on standing. He was so weak that he couldn’t stand…not his baseline. Upon standing, I smelled an aroma. I informed my pt that I would be wiping his bottom when he stood up (he couldn’t do it himself, he was concentrating so much on just standing). He then stated to me, “In my age, there has been some shrinkage. There is a secret compartment there.” What?! What a strange thing to say, but not so strange if the medical team is working up for delirium. Anyway, it was funny. But his butt was wrinkly and shrunken. Woo hoo.

Another story I must share: a new volunteer had never been around inpatients. I took her with me. She wanted to help and reached down at the foot of the bed to move something. When she looked up, there was an old, wrinkly penis in her face! The patient’s gown had ridden up. She was shocked. She’d never seen that before. She didn’t know what to make of it. It makes me bust up laughing, just thinking about it! Despite all the body parts that I have seen in my career, I still try to allow pts to have as much modesty as possible. Some people are so sick though, that they just throw modesty out the window. I guess it makes for an entertaining therapy session.

I don’t typically spend my days wiping butts. It is not in my scope of practice. Part of my job, as an OT, is to train and educate people on toileting, toilet hygiene, safely getting to the toilet. It’s possible to educate someone who has had a stroke how to wipe with the other hand or advise a pt on assistive devices for wiping.

Today I wiped three butts. It’s a nursing thing to do that but some times, at work, the nurses and aides are so busy. I only have so much one on one time with my pt, I don’t want to waste it waiting for someone to wipe the butt. The thing that made me laugh today was that one of my pts had explosive bowel movements. One thing that delays pt discharge is whether the pt has had a bowel movement or not. This one pt had not pooped since Saturday. The MDs had ordered 6 different items to help with his poop. Metamucil, stool softeners, lactulose. Poor guy. He was so blocked up one minute, the next he’s rushing to the bathroom with explosions. I mean, he almost fainted, he was so tired from all the exertion! It could have been a real emergency if he had fainted in the bathroom after having all those bowel movements! Poor guy.

It was just part of my day.

One pt had abdominal surgery. He has a large belly, bigger than Santa Claus. It is getting in the way of getting in and out of bed. He has no problem walking. He’s steady on his feet.  Another pt has abdominal pain and bloating. She is also very weak from cancer. She is so bottom heavy that it’s hard to get the right momentum to get out of a chair. The extra poundage is hard to move against gravity and the less you move, the harder you have to work to get better. I’m doing my part by seeing these pts daily and encouraging to move around more. It’s working but not without its challenges. You can seriously injure yourself trying to move a heavy pt. Do not do it by yourself. I usually have the pts do as much as they can for two reasons: 1. it’s therapeutic for them and 2. I want to limit my exposure to injury as much as possible.  Nursing staff, on the other hand, feel they are limited in time so they try to do more of the work, instead of giving the pt a few minutes to do it on their own. As a healthcare worker, you need to protect yourself first, before the pt.  If you hurt your back trying to move someone, you would be no use to them or yourself.

It’s important to have good problem solving as a therapist, to be able to get yourself out of a jam when needed.

During the last hour of work, a person was literally stroking out in the bathroom. Here’s what happened (as summarized by a supervisor):

Mrs. M was referred to outpatient PT for a complete rotator cuff tear by Dr. M. She arrived via a transport van from her assisted living facility. She was evaluated by Julie, PT. The patient was able to participate in the evaluation, walk into the treatment room and actively move her left arm. After the evaluation, the patient was very tired and required maximal assistance to transfer to a chair. At this time Julie actually wrote Dr. M and recommend Home Health PT as this trip to outpatient PT seemed to really exhaust her. The ambassador team was called and DP arrived with a w/c in which the PT transferred the patient to. The lift team was paged by the PT department to assist the ambassadors with the patient’s transfer to the car. As the patient was waiting for her ride, she told the ambassadors that she had to use the bathroom. Ambassadors SS and BR decided it was best to bring the patient to the hospital’s PT/OT department because the bathroom was big and the therapists could help if needed. They did not know the patient actually came from outpatient PT.  Mariel, OT and Matt from the lift team were in the department when the patient arrived and kindly helped the patient go to the bathroom and get back in the w/c. It was then that Carter, PT and Resie, OT noticed that the patient was not talking and slumping to her left side. They evaluated the patient’s cranial nerves and noticed that the patient was drooling, exhibiting signs of left neglect and not moving her left arm. They paged Julie who came right over from the outpatient department and confirmed that there was a change in Mrs. M’s presentation from when she walked in to the department at 1:00. Mrs. M was immediately taken to the ED, conveniently located around the corner from hospital Rehab and a stroke code was called by the ED physicians. Mrs. M was found to have a hemorrhagic stroke and is now in the ICU.

It was great teamwork from everyone involved. As an inpatient therapist, I am now directly involved in Mrs. M’s care at the hospital. It was convenient that I was there when she was having her stroke because I witnessed it. It was an amazing day.

I am going to have my first OT student. I want it to be a success. I need to make myself complete my hands and physical agent modalities certifications. I have been procrastinating long enough! I will get LSVT-BIG certified. Big and expensive goals. But I can do it!
Yay, OT!

Today, several therapists got together for a Happy Hour and that was very therapeutic for us. We work as a team, in life/death situations and we can be kind of intense in our daily work routine. We take our jobs seriously but really try not to let it overwhelm us. Going out and just talking about regular life was very good for us. It was one way of not letting emotions build up or get out of control. This is all part of the very important, work-life balance.