I know that this is a weird subject line, but for whatever reason….we had a bunch of volunteers faint while up on the floor! Most notably, they were with our pregnant OT. Weird.

Picture this: I walk into a room in the ICU. The volunteer is shadowing me, so literally, she’s like my shadow. This pt has just had his whole leg amputated! He has a drain coming out of his body, he has huge incisions and some blood. The volunteer is grossed out because he has eye mucus! She didn’t get grossed out by the missing leg, but the eye stuff! I thought that was hilarious. She said she almost vomited because of the eye mucus.

Fast forward several months. Same volunteer with the pregnant OT. OT is just finishing up with a joint pt. Volunteer is by the door. “I need to get some air.” Other OT is just outside the room at nurses station. Volunteer almost passes out, looks white and clammy because she didn’t eat breakfast! Not eating is a big no-no as a therapist. You are running around all day long. You’re moving your body, moving pts bodies, writing notes, on the go. It is very important to stay hydrated and keep something in your tummy. You do not want to be the person that wakes up with a nurse running towards you with a wheelchair and blood pressure cuff!

I can say all this stuff because I have fainted several times in my life. So like the Boy Scouts say, “Be Prepared.”

We have had a spate of OT interviews this past week. It’s been a very interesting process. I haven’t had to go on a job interview in 2 years, so it was interesting to remember what that was like. Having been an OT for a few years, it makes me think that you really need more than one interview with a person. I mean, how do you know if the applicant can handle stress well, or has good time management or has good clinical skills?  You just never really know so you have to make a gamble when you hire someone, I guess.

You’ve got to gather all the facts and variables you can.  It’s just like OT. You’ve got to break everything down. Is the grammar on the resume correct? Is the person groomed and dressed nicely? Polite? Thoughtful with the answers? Asking good questions? Glazed look over the eyes? Sweating because it seems overwhelming? I really appreciated that my boss had me sit in on the interviews. I feel that I work in a very good environment right now and I want to keep that even keel. In all, it was nice to meet OTs from other parts of the country.  I can’t wait to work with my new team member because… OT rocks!

I work in the acute care setting. This means that I am no stranger to foley catheters (urine bags), projectile vomiting (from post-anesthesia pain meds), diarrhea (from c-difficile), Dignacare (rectal tubes to collect feces), or other strange bodily fluids. I wear a lab coat at work, which I wash weekly. I also wear business casual clothes with shoes that I can stand around for 9 hours in. This is just because some times, I want to look cute. Other OTs wear scrubs to work, which are great because you can just throw them on and boom- you look professional. It’s true…you get down and dirty. I sometimes wish I could wear the new, cute clothes that office workers wear. They just sit on their butts and type all day long.  They can wear pretty jewelry, nice blouses, skirts, tights, boots. I would never wear that stuff to work because 1. I don’t want a pt to rip out my earrings! 2. I have to bend down and squat a lot. 3. I don’t wear anything that I can’t wash urine or poop off. I find it much more rewarding to not look so cute at work so that I can help someone get their activities of daily living on. But just like another co-worker, as soon as I get home, I take a shower so I can wash all the MRSA and skin flakes off. Ugh!

I’m grateful for my career. I’m grateful for all the experiences with my pts that have enriched my life, better or worse. I’m grateful that I’m able to grow and expand my OT skills. Happy Thanksgiving!

Today was awesome! I had a pt who came via ED. The neurology team was doing all the tests to rule out stroke or transient ischemic attack (TIA). The physical therapist had already cleared him because he had great balance and gait. The patient felt pretty good. He even told me, “I’m making your hospital a lot of money with all the tests they’re doing on me.” Hmm…what was I supposed to do? He felt completely fine.

I talked to him. I asked him specifically about his symptoms. He had some weird heaviness going on with his head but also, he had tingling coming down his right arm, from the elbow down.  I have experience in outpatient hands. I’m used to looking at the hypothenar and thenar eminences to look for flattening. I do quick coordination tests. I check for sensation. I typically ask my hand pts about their sleeping habits. I asked this pt about his work situation. All the things he was telling me seemed to point to cubital tunnel syndrome or ulnar neuropathy. I thought in my head that he was having 2 different things going on, not one scattered phenomenon. I educated him on sleeping habits, ulnar nerve gliding and answered his questions regarding his arm tingling. I saw the attending neurologist and let her know my theory. Leave it to me to forget to use other important diagnostic tests to really determine if it was ulnar neuropathy. Well, that’s okay, because the neuro residents had fun doing the tests on my pt. It turns out I was right! Ha, he does have ulnar neuropathy! It was so satisfying to know with all my education, skills and training, I am an integral part of the team.

Some times, it just gets repetitious and I don’t feel mentally challenged. So today was a good day.

It is somewhat crazy at work. I think the fact that the holidays are just around the corner is a big factor. I’ve got a big caseload in the ICU again. One lady…I thought she was gonna die. But miraculously, she is getting stronger and doing better every day. She still has obstacles. She can’t eat, walk, talk or clean herself. She is a very good example of someone who needs physical and occupational therapy plus speech-language pathology. She is making headway and it is rewarding to see that progress.

Another pt is a young father who has a malignant brain tumor. It’s so heart-breaking. He’s not even 50, has a young son, his wife might be pregnant again. He has a terrible brain infection and his body isn’t regulating the cerebrospinal fluid properly. All we can do is get him up and see if he can follow commands or answer simple questions. It is very challenging when you have pts who cannot communicate with you.

About a month ago, I saw Taylor Swift in concert. What does Taylor Swift have to do with OT? There were several times in the concert when she was just looking at out the audience and you could just tell she was in awe that so many people were there to support her. It seemed that she was genuinely touched and amazed at the love and energy coming from her fans.

That’s how I feel about OT some times. When I am working with a pt who is just having such a hard time but we are able to relate on something genuine and unique about his/her life, it just brings tears to my eyes. I’ve never cried in front of a patient, but there have been several times in my beginning career when this pt just says or does something and I just feel so proud to be part of that moment in his/her life. It is so rewarding. I love OT.

One of my old patients took her life experience and wanted to share and educate the public. Thus, brainpotential.org was founded. She is a young stroke survivor offering a variety of resources and support to other young stroke survivors. Check it out! It is a really good resource.

Sometimes, you have a pt who is so weak. This pt has been in the hospital for weeks at a time. The pt and the family have been through a roller coaster of hospital admission, nursing home admissions, return hospitalizations. It’s almost like a never-ending cycle. When pts have been in bed with varying degrees of activity, it can be very hard to get moving. If I can, I like to get the pt’s family involved.

Typically with these pts, just sitting up at the edge of the bed is hard. I get the pt sitting edge of bed but the pt won’t lean forward to help maintain the balance. I like to use the family member as an incentive. Say Mrs. X keeps wanting to lean backward. I ask Mr. X to sit on a chair, facing her. I ask Mrs. X to lean far enough forward (so that I can get her pelvis to get into a neutral tilt thus getting her body to move more normally) to kiss Mr. X. I hope that the idea of having a kiss from a loved one is incentive enough to move around, but some times it is not. 

A while ago, I had a pt who was in the hospital for 6 weeks and counting. I did this little trick with him and his wife and they were overjoyed. They started tearing up because with all that time in the hospital, they had no exchanges of affection! His wife was too scared to touch him because he had so many wires and tubes sticking out of him. Prior to his hospitalization, they were a dancing all night, touchy-feely kind of couple. It just blew my mind. I don’t know how I could live if I didn’t have a hug or a kiss from my husband. Love really does make the world go ’round (and make therapy easier)!

This post is not to freak people out. It is just a casual observation. Why are young women (under 35) who are taking birth control pills experiencing strokes? I am on the Pill. Clearly printed on the birth control pills label is a warning for stroke. The warning hasn’t stopped me or millions of other females from taking it. The speech-language pathologist at work and myself have noticed many young females experiencing strokes. The interesting thing is that the most common impairment status-post stroke with these young women seems to be speech (particularly the word-finding) and right behind that is, fine motor skills.

I don’t have an impairment but feel like I have word-finding difficulty already (maybe it’s all in my head). I can’t imagine what these ladies feel. It can be quite a challenge, just trying to articulate your thoughts. Think about what that involves. First, thinking of what you want to say. You have to find the right words that fit your idea. Then opening and using your mouth to form the sounds. It can be really hard! Now, think of all the fine motor things only women do. Applying mascara, hooking your bra, braiding/styling hair, applying jewelry, doing the straps on strappy shoes. These are all important activities of daily living!

Perhaps the common denominator is the Pill…or is it? I don’t know. There seem to be other factors, such as migraines, hormones, thyroid problems that can be discussed on different posts. I don’t have solid evidence, nor do I have a research article to reference. This is just a curiosity. It seems that I will need to do some research.