Daily Archive

Monday, March 31, 2008.  Rick’s gone for Dr. Barber’s bachelor party.  He was really hoping Sammy would come, but predicted correctly that he’d back out.  So the three other people know each other for a long time, and Rick only knows Dr. Barber.  Elderine is sick, and definitely Janet is as well.  I had two new patients, but Sally informed us that one of them had a shoelace around her neck and the 1:1 didn’t seem too concerned.  We had an Asian Indian guy, which is unusual.  This guy finally left; he looked happy.  After lunch, Elderine supervised as I admininstered a safety evaluation to a Spanish speaker (with the help of a translator).  The rest of the day was paperwork: picking up five printed brochures (thanks, Christi!), write-ups.  I left at 5 pm and called Phoebe (Linton, Hannah, and her played scrabble Saturday night).  Then I worked on my activity analysis until 11:30 pm.

Tuesday, April 1, 2008.  It was an…exciting self-care group this morning.  One of our longer-term patients was very cute, complimenting Elderine on her apparent weight loss.  She also apologized for putting her hand in the vaseline (we usually dispense into a cup using a craft/popsicle stick since it’s public usage).  She sort of emulated a new patient who was manic and I called for help.  She didn’t hit me, but she charged into the room, actually nonintentionally flinging the pen hanging from my neck across the room.  Victor had to take her out.  He later said that if Rick was there, he’d just let her be (since I didn’t want her there since she wasn’t evaluated yet).  Elderine explained the implications it would’ve had if someone did indeed get hurt, and she wasn’t evaluated.  I realize that each therapist has a different approach and judgment regarding safety awareness and responses.  I’ll go by the rules.  I played Rummy with a patient until task group started, which she attended.  I met with a patient for reality orientation, and he actually filled out the two worksheets.  I was more impressed by what he knew (I thought he really didn’t know anything); he knew about Obama and Hilary Clinton.  I picked up seven brochures from downstairs (thanks, Jessica!).  I finally called the translator to help me evaluate a Spanish-speaking-but-can-understand/listen-English patient.  And I might as well do a quick re-evaluation with another Spanish-speaking patient (she’s lonely because no one really speaks Spanish :’( boo).  I had a talk with the psych tech Michael Castro while waiting for a patient to come out of the shower.  Get Fuzzy had a funny combo going:  Simon and Garfield :-D

Wednesday, April 2, 2008.  Rick is back, with lots to do.  He demonstrated administering the KELS (which I read three Mondays ago) with one of our patients.  After lunch I did two evaluations I had deferred from before.  We had a family meeting from 2:30 to 3:30 pm.  The new patient was still quite manic and was intrusive with the family so I played Pitty Pat with her (she sort of taught me - didn’t seem all that fun to me).  Someone had a foul odor from her mouth so I asked her to brush her teeth, which she did well.  I wonder why she has halitosis, then.  At night, FBCC had our Ladies Group.  Interesting conversations ensued afterwards:  wanting to pop breasts (like Fergie jiggled hers), eating Cocoa-Dusted Almonds by Harrods when Jessie’s coworker went to London, checking out tickets from StubHub (recommended by Carolyn Lee).

Thursday, April 3, 2008.  During rounds, I stayed a bit to hear Dr. Barber ask the medical students some questions.  Did you know?  Those diagnosed with schizophrenia die two decades before the general population secondary to suicide and other self-harm (e.g. neglect of self-care).  We had ice cream floats and cake at 11 this morning for Doctors’ Appreciation Day.  Afterwards we had a family meeting with a mother and sister, and I felt really bad for them because you can tell they care deeply for the patient but that they were frazzled and didn’t know what else to do.  We don’t quite know either, but we did know that this is not yet his baseline.  All I could give them was a NAMI Family-to-Family information, to maybe help with their emotions with dealing with all this relapse, and maybe get some financial assistance.  After lunch I performed a KELS with supervision from Rick.  After work I went to Hobby Lobby to buy some supplies for doing my activity analysis.  I also went next door to Sports Authority to buy a beach ball (to test if using a dry-erase marker will wipe off).  

Friday, April 4, 2008.  I reported on the KELS in rounds as instructed by Rick (since we OT usually don’t participate in rounds on Fridays) then left.  At first I thought Team B had 4 new evaluations, but that would total 11, so just 3.  After lunch, I found out that actually the third one was Team C since the doctor written down was Dr. Coverdale.  Thus instead I performed the KELS on one of the patients.  His records came over from HCPC and I wanted to go through it but really I didn’t have the time; Sonja said it might help me with writing up the KELS, though.  Since I had so many evaluations, Rick was nice and did bingo in the afternoon so I would have more time to write up my paperwork.  I left at 4:45.  Inch called as I was on the bus home.  He asked me if I was available Saturday.  He said that Sarah’s leaning towards staying in Houston, for multiple reasons: her family is in Houston, changing her major from Biblical counseling to Christian Education with a Counseling Certificate to cover/learn more, etc.  I wonder what my hand/finger size is.  I read Siwei’s new blog, and went to this website:  yujawang.com.  She’s a pretty, girly, talented, young pianist :-)

April is National Poetry Month.  And it’s also Occupational Therapy Month.  And Cancer Control Month, Alcohol Awareness Month, Stress Awareness Month, International Guitar Month, Keep America Beautiful Month, National Anxiety Month, National Humor Month, National Welding Month, National Garden Month, Uh-Huh Month….

Uh-huh, so the Houston Chronicle publishes a daily poem selected by books editor Fritz Lanham.  Today’s is titled “Cherubic” by James Tate.  My reaction after reading the below is, this is more disorganized than my patients!  Most of my patients are circumstantial in their thinking, or at most tangential.  The following content seems to display flight of ideas, to my inexperienced eyes:

I took my daughter Kelsey to the train:
station. As the train was leaving, we waved
and waved to one another. I never saw her again.
She went on to become the first woman on the moon.
How she got there nobody knew. And she never
came back, as far as I know. And she never wrote
me a letter, she never called. I just hope she’s
happy, my moonbeam. Every night I’m at my telescope.
I’ve seen dinosaurs, snow leopards, flamingoes.
I saw a one-eyed dog wagging its tail. I saw a
mail truck. I saw a sailboat, but, of course,
there is no water. I saw a sign for water pointing
to the earth. I saw a sign for hamburgers
pointing to the earth. And I saw a little girl
fall off her tricycle. A poof of atomic tangerine
dust, that’s all. I never saw the girl again.
The tumbled tricycle’s wheels kept spinning.
Sleep, I said, sleep, little baby.

I like this one (http://www.ddaze.com/04LVResource/zVillanelle.htm) suggested by someone who commented.  It’s “Voice Mail Villanelle” by Dan Skwire:

We’re grateful that you called today
And sorry that we’re occupied.
We will be with you right away.

Press one if you would like to stay,
Press two if you cannot decide.
We’re grateful that you called today.

Press three to end this brief delay,
Press four if you believe we’ve lied.
We will be with you right away.

Press five to hear some music play,
Press six to speak with someone snide.
We’re grateful that you called today.

Press seven if your hair’s turned gray,
Press eight if you’ve already died.
We will be with you right away.

Press nine to hear recordings say
That service is our greatest pride.
We’re grateful that you called today.
We will be with you right away.

And the commenter Salicional also mentioned the following poem by Austin Dobson.  It’s called “When I Saw You Last, Rose”:

When I saw you last, Rose,
You were only so high;–
How fast the time goes!

Like a bud ere it blows,
You just peeped at the sky,
When I saw you last, Rose!

Now your petals unclose,
Now your May-time is nigh;–
How fast the time goes!

And a life,–how it grows!
You were scarcely so shy,
When I saw you last, Rose!

In your bosom it shows
There’s a guest on the sly;
(How fast the time goes!)

Is it Cupid?  Who knows!
Yet you used not to sigh,
When I saw you last, Rose;–
How fast the time goes!

And Chingo Bling reads “Wind and Water and Stone” by Octavio Paz, a Mexican poet, writer, and diplomat who won the 1990 Nobel Prize for Literature.

That’s what my clinical instructor said to me as he came in the occupational therapy office.  He said that because I was “slammed” today.  Initially in the morning it seemed like Team B (the one I’m working with) had four new patients.  After some calculation, I was perplexed because each team (there are two) can only have 10 patients, totalling 20 patients, and the four new ones would equal 11 patients for me.  Fortunately, two were switched over to Team C.  Not only did I have a re-evaluation today as well, but this is the third straight day that we have administered the Kohlman Evaluation of Living Skills (KELS). 

Briefly, the KELS helps ”determine ability to function in 17 basic living skills in five areas: self-care, safety and health, money management, transportation and telephone, and work and leisure. Can be used in many settings and with many populations, including with elderly in nursing facilities, inpatient units, and outpatient settings; in acute care units in hospitals; for people with brain injuries; and with adolescents in training programs.”  It says it takes 30 minutes, but that’s if the individual is high-functioning.  Most of the time it takes an hour, as it did this afternoon because my patient demonstrated some psychomotor retardation (was slow in performing his movements because his processing of information was a bit decelerated though accurate).