Tuesday, October 21, 2014

P.T. For The M.F.

          Forgive me, I don't mean physical therapy for the mother fu...er. It's for the mallet finger. After having a consultation with the orthopedic specialist, he said that I didn't need surgery even though my middle finger was drooping slightly. He asked me if I needed physical therapy and I said yes, since I felt I needed more guidance with what rehabilitation exercises to do other than just sending me home with Theraputty® like the previous doctor did. 


          So I was given six sessions of physical therapy (three times a week for two weeks). During the first session, the physical therapist asked me about the history of the injury then proceeded test my grip strength
and make measurements of how much angle I could flex and extend the finger to get a baseline. She then told me to show her what types of exercises I had been doing with the Theraputty® and showed her two ways I would squeeze it. She showed me a few more things I could do which included digging into the putty with my fingers and other extension and strengthening exercises. In addition, I was shown exercises I can do with a rubber band and a dumbbell. Afterwards, she held my hand (without even buying me dinner first!), and started torturing me. OK, just kidding, but it sure felt that way initially. What she did was hyperextend the finger ever so slightly to the point of pain indicated by my yelling OWW! She did that a few times until the finger looked slightly straighter. She also did some passive range of motion exercises to the point of resistance which also resulted in some pain. Not that I wasn't expecting any pain at some point. Then she provided me some relief by attaching four electrodes on my fingers - two on top and two on the palm side. She connected the electrodes to a T.E.N.S. unit (transcutaneous electrical nerve stimulation) and turned up the power and started electrocuting me. Well not exactly. She turned the knob slightly and asked me to tell her when my fingers started to tingle and when I indicated as much, she stopped. The same was done for the electrodes on the palm side and a timer was set for twenty minutes. Oh I forgot, my hand was also wrapped with a heating pad. The T.E.N.S. treatment was supposed to improve circulation and break up scar tissue. 

          So I sat there and explored the room with my eyes to pass the time, wishing I had picked up a magazine to read from a rack at a corner of the room. Other patients came and went to do their therapies. Pretty soon the timer started beeping and I survived my time on the electric chair or Taser. The electrodes were removed and kept in a plastic bag with my name on it to be reused in the next session.

Lastly, they tried to make strike anywhere matches with my left hand which was dipped about 5 times in a container of lavender colored hot paraffin wax, then it was wrapped in white paper which somehow reminded me of fish and chips, then the papered hand was inserted in a terry cloth fingerless glove to keep the heat in. When the paraffin wax cooled in 5 to 10 minutes, off came the glove, the paper, and the wax had to be peeled off from the hand like a second skin. The lavender scent from the wax remained in my hand for a few hours and people were probably wondering why I was sniffing my hand so much despite the absence of white powder on it. 

          The session went for slightly more than an hour which I thought would last only half as long, although the time passed pretty quickly. Except for the initial measurements, subsequent treatment sessions were similar to the first. In my subjective assessment, after 5 treatments, my finger feels slightly stronger and more flexible, although I have more work to do by myself for further improvement after the 6th and final session.

          Much thanks are in order for the physical therapist and her assistant for guiding me and helping improve the function of my left hand and more specifically my healing middle mallet finger.  For privacy reasons, they declined to allow me to use their names. Even though the finger injury has been a major inconvenience to my daily activities, whenever I went in for physical therapy and was asked what my pain level was from 1 to 10, I always felt no pain. In contrast, the other patients who came in always mentioned some pain.

Monday, October 6, 2014

Hell of a Night at the Psych Ward

          And then there was this assignment in the most acute Psych Unit of the hospital. The first night was unremarkable and that was when I was able to make those 70 chart packs which I mentioned in my previous post. I was surprised when I was assigned there a second night in a row when things didn't go as well. For starters there was a plugged up toilet because the patients in that room were throwing their trash in it. So I donned a pair of gloves and dug out the trash from the bowl but despite my efforts, the toilet was still clogged and it took a few plunger attempts by the maintenance person later to fix it.
         Meanwhile a female patient was awake and laughing all night long for no apparent reason other than whatever funny things was going on in her head. Another patient was retching and throwing up in his room except for one time when he did it on the full length of the hallway. Guess who had to clean that up? 
         An insomniac who had been complaining of being unable to sleep for days finally did so only to be woken up by the loud snoring of a newly admitted roommate. So he got upset and tried to sleep on the toilet floor (no, not the plugged up one) which wasn't any help because it was too hard. Another man was compulsively pressing the call light near his bed and in the bathroom, and also punching in numbers on the exit keypad. Not because he needed anything or was trying to escape but rather a compulsive habit. 
         A woman was trying to talk to staff all night and was demanding and argumentative at times when she didn't like the responses. A newly admitted religiously delusional pregnant woman who was calm when she was being interviewed, suddenly went postal on a male patient whom she thought was going to harm her baby. She said she was going to protect the baby with her life. The surprising thing was that she went from speaking proper English to ghetto English when irate. Unfortunately she couldn't be medicated at that time due to her pregnancy until properly evaluated by her doctor. After resting for a couple of hours and waking up very early in the morning, she underwent another transformation and started bouncing around the room and talking about how blessed and holy her baby was, all the while bowing and praying and lying on the floor.

          The staff were counting the slow minutes until it was time to clock out. It was just another day at the office. Would you believe I was assigned to that unit 4 consecutive nights that I was on duty?! On that fourth night, 3 patients became menacing towards me because I couldn't give them a second cup of coffee in the morning. I had to request the supervisor for a reprieve and assign me to another unit the following night and thankfully, he did.

Friday, October 3, 2014

Center for Mental Health Orientation, Chart Packs, & Epic Electronic Medical Records

          After hospital-wide orientation, Crisis Prevention and Intervention training, and Epic electronic medical records training, I had unit specific orientation as a Behavioral Health Worker at my new job last month on the Center For Mental Health and Wellness, and I was glad that my preceptor was a pretty cool woman who was gentle with me. We started with the assumption that I didn't know anything, which was what I preferred so I could learn the ins and outs of how they wanted things done. The duties and responsibilities were thankfully very familiar to me since they were what I was doing before I got laid off, and was a stark contrast to my brief foray into the assisted living job. The only problem I had was having to wake up at 4 a.m. so I could work out before what was supposed to be 4 day shifts. Well my body isn't quite used to that since I've been working nights for three decades so the body rebelled and my stomach was in knots. So much so that my preceptor and I requested our director to put me on night shift orientation after just 2 day shifts. After that I got three more nights of orientation from three different preceptors on the three psych units of the hospital. Then I was released to fend for myself.

          One of my first projects was learn how to make admission chart packs. The forms were significantly lesser since the hospital started using electronic medical records on September 1st. What used to be about 40 to 50 forms were down to 14 (even lesser than what I used to handle at the job I was laid off from). On my second night post orientation, I made 60 chart packs even though the supervisors only required 5 each night. Well I'd rather make a lot more during nights that are not busy rather than scramble to make them when there are numerous admissions or when patients are acting out. Later, I was surprised to learn that nobody ever made that many before. Before electronic medical records, I probably wouldn't have either. I just lucked out by being hired there at the time that I was. A couple of weeks later, I made 70 more. Apparently I made so many in such short time frame that the psych units ran out of some forms and welcome folders. To add to that, between the time I made the first 60 charts and the next 70, there were four changes in what forms were needed because they were trying to sort out what they can include in the electronic medical records system. After about three weeks, it appears like they have settled that issue.

         One of my coworkers, upon seeing that I was new, asked me how I became a behavioral health worker. I said I used to be a psych patient, and having observed what BHW's did, I figured I could do the same as well, so I applied for the job. My new journey has began.