Sunday, July 1, 2012

Fieldwork – Going on month 3!

Things are settling down for me here in New Orleans! I am loving my new, rat-free home and I have one month left of fieldwork – I can’t believe how fast the past 2 have gone by.  I’m learning so much and I wish I could share more but between fear of violating HIPPA and time constraints, I know I have not shared much sans for my experience of going through fieldwork – which I hope has at least been a little helpful/ entertaining/ semi-worth reading?
Going on my 3rd month I feel much more confident alone with patients.  My CI basically sits behind her desk occasionally checking on me or answering any question I may have.  Though I can’t give details on the patients I have been treating, I thought it might be a good time to give an overview of some of the diagnosis I have seen on fieldwork:
Lots of shoulders – adhesive capsulitis (frozen shoulder), humerus fractures, rotator cuff syndromes, rotator cuff repairs,  high functioning stroke patients with shoulder pain
Wrists – distal radius fractures and distal ulna fractures
Flexor tendon repairs
Mallet finger
Various fractures of the hand: phalanx, metacarpal
Ulnar neuropathy
Carpel tunnel
Radial nerve palsy
Elbow – olecranon fractures
Scapula fractures
Cervical myelopathy
Tendon transfers
Nerve repairs
Strokes – both ischemic and hemorrhagic
Hmmm I’m sure I am missing some, but this gives a general overview.  I have also seen many patients with co-morbid diagnoses that we are not specifically treating in this setting including:
Bi-polar disorder
Schizophrenia
Traumatic brain injury (TBI)
Severe anxiety
One interesting thing about my cite without giving away too much info (talked to my CI and she is also unsure if I should post my actual cite even though it is superly unique and I want to share) is that we see a lot of trauma.  So often we see multiple injuries/diagnosis at once that we have to work with.
Owww another cool thing – I got to see hand surgery last week!  I spent one morning with a very nice hand surgeon who let me watch 3 procedures.  I saw 2 ORIF (open reduction internal fixation) of metacarpal fractures (one was 4 months old and one was new so it was interesting to see the difference) and one very unique injury which of course I can’t share because it would be identifying, but I can say it was basically someone who completely destroyed their hand.  They opened it up took out a lot of damaged nerve to prevent neuromas, removed some badly damaged muscle and tried to put him back together as best as possible… hands down my favorite surgery to watch. 
Not sure if I mentioned this ever before, but prior to discovering OT school I had pretty much pinned down going to school to be a surgical PA (physician’s assistant) – just like my mom did).  I have always been fascinated by surgery – ever since the first time I saw my mom doing heart surgery when I was about 6 and banged on the glass shouting “where is all the blood?!?!” BUT as I was going through my undergraduate career I realized over and over again that my heart was really not into medicine and that I also wanted to make a different career choice for lifestyle reasons (I wanted low stress, no call, and the luxury of my career being a balanced part of my life rather than all-consuming entity.)  Luckily, during my search I found OT and fell completely in love with it, but before that I had almost reasoned myself out of medicine.  If I may have ever had any slightly little doubt about my choice of OT over surgery, all of that and more was put to rest after watching surgery for 5 hours.  It was amazing, but incredibility exhausting – just to watch! I had a small pang of “what if” when I saw the first incision, but after 5 minutes in I was completely over the feeling.  Let me say I was extremely thankful and fortunate for the experience and I would still have done it in spite of this, but I was miserable about 20 minutes in! We had to wear these vests  because the surgeries required lots of real time x-rays (which were awesome to watch), but the vest weighed like 20 lbs and combine with the odd positions so that I could actually watch what the surgeons were doing, my back was in more pain than I have ever been in since my injury.  If that wasn’t enough to confirm my career choice, I talked to 2 residents at 9AM who had worked 7PM-4AM the night before and were already back ready for surgery.  They were also talking about the weekend work schedule and call schedules, and after hearing about 10 of those conversations, and watching in pain for 5 hours, I was more than happy to go back to the therapy gym, stretch out, and finish my work-week so I could go home and enjoy my weekend.  I think the people who choose that type of work really have to love it and have a passion for it, but that was and is now more clearly, just not for me, which is very convenient since I love OT.. even though I am glad OT is not 99% of my life… because after school I want to study to be a yoga teacher… and learn Spanish… and play the piano…  and sooo much more I want to do everything!
Speaking of doing everything, I still want to post on occupation-based OT in out-patient and I want to write a really good post about mental health issues that have been on my mind for quite some time– instead when I sit down to write I find myself rambling and figuring out things about myself rather than actually sitting down to efficiently write what I want to share … oh well,  it can wait – it’s Sunday after all!  Have a great week!