Catching Up, Part 1

I hate doing these kinds of posts where it's basically a laundry list of what I've been up to, but things have been so dang crazy around here! Rmph!

So last week I had another observapalooza, this one with Molly. We got to see three clients. (I have changed the details as always, never fear...) Client #1 had a TBI (traumatic brain injury) due to an MVA (motor vehicle accident) more than a decade ago, apparently had a Glasgow score of 4 or 5 (which is very low, very bad, and connotes a very poor prognosis), and is really in amazingly good shape, all things considered. She speaks quickly, which is very unusual for someone with a TBI, and has to be told to speak more slowly and loudly. Since I had not heard her history, Molly asked her to tell me about her accident, which she did. It made the little hairs stand up on the back of my neck....another one for the "just slap me if I complain about anything" file.

We were working mostly on her trigger finger, a pointer finger that was stuck in flexion. Molly taped it with kinesio tape and had the client pick up some dice of various sizes and move them around, and then the client pulled out her clarinet and played a little bit. It's a terrific therapeutic activity because it requires you to hold your trunk upright, breathe deeply from the diaphragm, focus the breath into the instrument, and move the fingers over the holes and stops, including that pesky pointer finger. (The client called it "ornery," which made me laugh.)

All in all, the client was very appropriate in her emotions and speech, although she apparently still has some fairly major memory deficits (she still forgets she has a clarinet unless she leaves it in plain sight). Her one quirk, which I found adorable and endearing, was that she kept throwing in little phrases in Italian. She spent a year as an exchange student in Italy less than two years before her accident and spoke Italian pretty well. She loved the experience, and even the accident and TBI could not knock the Italian out of her. Instead of saying "thank you," most of the time she said "grazie" instead. Same thing for "you're welcome," "hello," and "goodbye," as well as a few other affectionate phrases ("I'm so proud of you," "You're very nice," etc.). It was very cute, I thought.

Our second client was the lovely Janet, Molly's ALS client. More kinesio tape for Janet's own ornery stuck-in-flexion pointer finger, discussion of an ALS support group that Molly was scouting out for Janet, and some issues with emotional lability (Janet was very perplexed that she could go from happy to crying and back again at the drop of a hat, and Molly reassured her that this is actually pretty common with ALS and does have a biological origin). And oh yes, the bed maker. Janet had ordered this gadget because she was having trouble tucking the sheets under on her mother's bed. She didn't want to leave them hanging because she was afraid that her mother, who is quite elderly, would trip on them and fall. So Janet, Molly, Janet's sister-in-law who was up visiting from Georgia, and I all crowded around the bed to try out this wondrous-sounding device. Well. It might have worked if the mattress weren't made out of lead bars. Seriously, it was quite possibly the heaviest mattress I have ever struggled with, and it was only a full-size bed! Anyway, Molly tried it a few different ways and finally decided sitting in a chair was the easiest way to use it, but she really had to lean into it and still could barely get the sheets tucked. Janet tried and made an I-give-up face after about ten seconds. Her sister-in-law gave it a whirl and was equally defeated. Janet pointed authoritatively at me, and I too gave it a shot. I did manage to get it to work, but I sounded like Hulk Hogan in the WWF World Championships. The noises that came out of me were anything but ladylike, and everyone had a good laugh over it before we sadly put the bed maker back in its box to return for a refund.

Client #3 was a gentleman who was actually more or less housebound and on oxygen. He had a long list of medical issues, most of which had been exacerbated by a stroke that had left him in a nursing home for months. He had been thrilled to finally come back home and even more thrilled when Molly started working with him about six weeks prior. Understandably, the man had been quite depressed at his feelings of neediness and helplessness. Molly gave him a whole series of strengthening exercises that he could do right in his bed, and as I watched, she had him work on rolling himself over so that his legs hung off the side of the bed, first on one side, and then the other. Then she even had him do it without using his arms to pull himself over. The man was so amazed and happy when he found that he could do it with just his core and lower extremities! It sounds like a small thing, but being able to get yourself to a seated position over the edge of the bed makes it so much easier to get into a wheelchair! And likewise, when you transfer out of the wheelchair and back into the bed, being able to swing your own legs over instead of having your grandson lift them makes a huge difference; it gives you some of your dignity and independence back.

Total time observed this session: 5 hours
Total time observed thus far: 20 hours, 10 minutes

I have so much more to report, but I'll have to come back later...