Bonding Time

One of my new patients has an amputated right leg. Now, like any professional in the health profession, whenever you receive orders for a complex case, the first thing you think of is how interesting it will be. What a great learning experience. In a way, that may seem a little selfish. But I'm sure we see it as a chance to provide skilled service to someone who really needs it. So when I met my new patient last week who had his right leg amputated, I was excited to start my eval and treatment.


Let me tell you, that was one of the most physically draining 75 minutes of therapy I have experienced. My patient, who I will call Frank, required moderate to maximum assistance for every transfer -to get out of his wheelchair, out of bed, on and off the toilet, on and off the shower chair. And we had to do all of that since he needed to use the toilet as soon as I walked in and since I told the CNA that I'd help him with his scheduled shower. After the draining task of showering himself, which many people take for granted until they can no longer do it independently, I had to call the CNA to help me lift Frank back to his wheelchair. Despite all this, I am finding that I really enjoy working with the physically challenging patients. Because the way I see it, there is really no other direction for them to go but up (at least that it what I hope for my patients even though it is not always the case). And when they do "go up" or make the slightest bit of progress, I get excited like a little girl opening presents on Christmas morning.

I usually take a lot of time thinking about how to best position my patient and his environment (his wheelchair, the height of his bed, to recline or not to recline) so that he can safely perform whatever it is he needs to do in the easiest way possible. In working with Frank last week, he would discover easier ways to do things, and I would learn from him. When he'd ask me if he could do it a different way instead, I would tell him, "You can do whatever you feel works for YOU. I will give you my suggestions and if I feel your safety is at risk, then I will jump in." He likes that I listen to him. He told me once after his shower, "WE did pretty good!" I like that he includes me in his accomplishments.

There was one day that Frank did not want to participate in therapy. He layed in bed till 10:00 AM and the CNA came in to ask me if I could help him get up and dressed because she had been trying since 8:00. Well that was not going to happen. When Frank decides he doesn't want to do something, he DOESN'T want to do something. I learned later from his nurse that his family had just sold his home that he absolutely loves and will be moving in with his daughter when he gets discharged. He needed an anxiety pill. That broke my heart. I went in to see him and we talked for awhile. He told me he felt that if he layed in bed and rested that day, he would be emotionally and physically prepared for therapy the next day. I told him I was ok with that. I walked in at 9:00 AM the next morning and Frank was ready to go. He told me, "I am going to get out of this bed and into my wheelchair and you are just going to watch me because I did it all by myself last night". Uh, you did? That made me nervous. I stood there with my hands an inch away from Frank's skin and every time I slightly brushed him, he'd stop and tell me to back off. "I am just killing you right now, aren't I?" he said, laughing. "Yes, Frank. Yes you are." He made me so nervous, it took every ounce of me to stop myself from helping him. I trusted him, but I felt that if he accidently slipped, I would not be fast enough to catch him. "Can I AT LEAST put my arm under yours? I won't help. It'll just be there if you need a little oomph." "No." I wanted to pout and stomp my feet. Frank thought it was hysterical. But you know what? He was right. Given time, and excessive perspiration on my end, Frank carefully (and safely) made it to his chair with no help. He sat there with a big smile on his face. Awesome. He sang the whole time he was in the shower that morning.

Today, Frank made my Monday by telling me something I will always remember. I wrote it down as soon as he said it because I knew that if ever there was a day that I doubted myself or felt down in the dumps, I could read it and remember why I love doing what I do. Frank told me, "You are one of the highlights of my being here. We talk, we have conversation. You are not just my occupational therapist. You are also my shrink." I almost cried.