I've had some TOUGH patients this past week. Some difficult because of diagnosis, some because of personality. It's been a strange mixture of fun and frustration. And through it all I still love my job. Go figure!
I mentioned not so long ago that I got one of my patients to take a step. Well, now he's walking outside of the parallel bars! I worked with him all weekend and some this week too. He's making such great progress I'm so excited. But he's REALLY involved and large so having a lot of treatments with him can be tiring. He had a stroke with some severe hemiplegia, and he has trouble speaking and swallowing as well. But he's such a great guy, always motivated, always ready to work. And we worked SO HARD in the parallel bars last weekend and now he's doing well enough to be out of them. I'm SO excited for him. :) That's why I love rehab. I love working with the same patient and seeing their progress, and getting them excited about their progress and just helping them achieve their independence again. TEE HEE!!!
I've had some fights with patients also. Dementia, cranky old men, advanced Parkinsons Disease, pusher syndrome, angry 7 year old boys... It hasn't bee a ton of fun and games.
One patient has a combo of Burns, Dementia, and Parkinson's Disease. Sometimes he's great and sometimes he's so argumentative, it's impossible to get him to do anything. "I'm a stubborn Irishman and you can't make me!!!" Kinda funny when you look at it from afar. But serious when you're trying to get him to do his exercises.
There's one woman who had a CVA, but she's DIFFICULT because she's a pusher. What does that men??? Most of the time when you have a stroke and you have weakness on one side, you lean to your strong side, you rely on your strong side for balance, mobility etc. A pusher has the additional brain malfunction that the brain thinks that upright neutral is 18 degrees to the weak side. So for instance this woman has left side weakness/paralysis. So she is constantly leaning/falling to the left. It's REALLY hard to get her to sit upright in a chair. And the more you push a pusher to neutral, the more they push to that side. Think about it. This patient, her brain thinks that she is in neutral, and you're pushing her over. If someone pushed you over you'd fight back, so she pushes harder to the involved side. It's REALLY hard to work with a pusher. A lot of mirror work, a lot of reaching and balance activities all trying to get the patient to realize her position and self correct to upright. But at the same time it's SO INTERESTING because pushers are rare, and you have to throw everything you know about treating CVA's out the window and start with completely different tactics.
Don't forget the 7 year old shoulder burn patient who shouldn't have been playing with a lighter who didn't want to get out of bed for the sole reason that I asked him to. So he hit me, kicked me and tried to bite me. HARD! I actually felt kind of bad for the kid, there's a lot going on at home, his father just passecd away and DCF was involved with the case, and there's just a ton going on and I can see why he would be upset and angry. It didn't make hitting and kicking right, but somewhat understandable. Either way, it still hurt.
Oh yeah and then there was the incidents with the massive amounts of poop and projectile vomiting.
And to top it off I had the cranky elderly man who just didn't want to do anything and required a TON of encouragement to get him to participate at all let alone the whole 3 hours a day. And it's funny, whenever I gave up and said fine you don't want to participate I'm bringing you back to your room, he suddenly wanted to do the therapy. It was EXASPERATING!! He was a sweet man at heart and he realized we had his best interests at heart and he said he wanted to participate, but when it came down to do the exercises and to do the walking, he just didn't perform. I like him as a person, and I want so much for him because I know he has the potential to go far with his rehab if only he'd believe in himself and the process enough to do it. So that's been frustrating and rewarding all at the same time.
And that was my week. Fun and frustrating. Awesome and happy, and yet cranky at the same time. I guess it's just a part of being a PT. You get SO frustrated when a patient isn't doing as well as you'd want and yet it's such a thrill when a patient meets a goal or blows through goals in his progress. It's like a drug when that happens. You get so happy and excited for your patient and you're trying to convey it to them and all the hard stuff, the complaints of others, the back pain from all the lifting and arm pain from the kicking, it just disappears. It's the PT thrill, and I love it. :) Being a PT is great. Yeah it's difficult sometimes, but still, it's great and I wouldn't trade all the poop in the world for another job. :) I guess I'm just lucky that way.
YAY for PTing!!!!