What does T mean?

I literally got a "T" for my summer internship.



Is that like the O.W.L. grade?!

Internship Week 10

I'm happy to report that I had a good final week at my internship. Monday was pretty typical, but I was with a good PT so the day went by quickly enough. You should have already read about Tuesday. Wednesday, Thursday, and Friday I got to work in the ICU (Intensive Care Unit) and IMC (Intermediate Care Unit - weird abbreviation!) for the first time. You see some pretty crazy stuff down there. On guy wrecked on his motorcycle. When he first came in, his tibia (shin bone) was sticking through his boot! He's had some major surgeries, including using some of his ab muscles to replace his anterior tibialis (the one in front of your tibia that allows you lift your toes up at the ankle joint), and a major skin graft over that area. He was also nuts, talking about how he needed to get home before the harvest. Kids, wear your helmets. Another guy was trying to evade the Highway Patrol and crashed his car going 100 mph. I never actually got to work with him, because the one day he was on our list he was too agitated to work with (that was fine by me!). There was also a drug overdose victim, a lady with Guillain-Barre Syndrome, and a guy who tried to go to the bathroom in the middle of the night but opened the wrong door and toppled down his stairs to his basement. There is all kinds of different stories in the ICU! I worked with a PTA down there who is awesome. He was always making the patients laugh, regardless of how bad their situations were. A little humor goes a long way in the hospital. A lot of patients really liked him. He is a fun guy who just is himself with patients. I'll have to remember that, because I think that's a great way to interact with patients. He's also very concerned with spending enough time with each patient, and doing what is best for them. Some of the other people I worked with there were mainly just concerned with getting through everyone on their list as quickly as possible. It was a good, interesting last few days.

Speaking of interesting stuff at the hospital, a bunch of new technological advancements sprung up in the last few weeks.

First off is this great DVD rental machine. Renting DVDs for $1, what a great idea! I can't believe nobody's thought of that yet.

The other awesome new hospital advancement is this thing:

It's been there for 5 weeks, but I still have no clue what it is. Probably because nobody ever bothered to plug it in:


Oh well, I guess I will never know what this sweet looking machine does, because I am DONE! No more getting up at 5:30 am, and no more fearing that I'm going to get pooped, peed, bled, or barfed on! (which I managed to successfully avoid the entire time!) I got a lot of good experience, but I'm so glad it's over and I get a few weeks to relax. I still have a few assignments to work on (case report revisions, etc.), but I have all day long to do them now.

I have officially left Provo. And Grimace gave me the one-finger salute as I went.

Ten weeks down, and no more to go!

Why Tuesday Was Awesome

Yesterday was such an awesome day!

It started out with an opportunity to be in the operating room to watch a total knee replacement surgery. I had previously joked around about how cool it would be because of how gross it would be, but all joking aside, it was one of the most fascinating things I have ever seen. Seriously, it was incredible. It's an absolute miracle that a surgeon can remove parts of two bones and replace them with metal and plastic parts that will allow that person to move without pain again. The surgeon has a lot of great tools, but those can't do all the work alone. Dr. Smith, the surgeon I watched, was so skilled. He literally sculpted the bones so the metal fittings would fit perfectly onto them. It was amazing to watch. Possibly the best thing about it was about 4 hours later, when I got to evaluate and work with that same patient in the physical therapy setting. It goes a long way when you can say to a patient, "yeah, I was there watching your surgery. I know what you went through." She is a great lady who actually moved surprisingly well. It's amazing to see the doctors stitching up the quadriceps muscle they had to cut through, and then to see the patient being able to use that muscle just a few hours later (most can't use it for a few days. She is pretty unique in that sense!) So yesterday was a really neat day at the hospital.

On the way home (I had to drive rather than take the bus so I could get to surgery on time), my car reached a milestone:

I hit 100,000 miles! Some might think that is not a good thing (after all, it means I'll probably be needed a new car sooner rather than later now), but it'd definitely something you don't get to see every day. I thought it was cool.

Then came the most random cool part of the day. I was getting ready to go for a run, and I was eating an apple. I needed to set it down on my bedside table, so I grabbed a tissue to set it on, and when I picked up the apple it had made a smiley face!

How can you not have an awesome day when you are getting secret messages from your apple?! It's impossible.

After a 4 mile run and a delicious lasagna made by my great wife, it was time to end the day with the MLB All-Star game. Say what you will about the All-Star game, but I love it. I always have. I can remember my brother and I watching Fred McGriff deliver a walk-off extra inning home run to give the NL a win in 1994 from the little black and white TV we had in our room long after we were supposed to have gone to bed. The National League hadn't won since 1996 (and I HATE the American League), but with the awesome day I had had so far, I knew the NL was not going to let me down this year. Sure enough, not only did the NL win it, but it was because of a bases-loaded 3-run double by a Brave, Brian McCann!

B-Mac capped off an awesome day by delivering in the clutch. And thanks to Bud Selig's ridiculous rule, the National League will have home-field advantage in this year's world series. And it just so happens my Braves are in first place in the NL East, and have the best record in the league. If they keep this up (which they will), McCann's RBI double will ensure that they'll be starting the World Series in Atlanta this October!

Tuesday was epic. Even though Summer doesn't officially kick off until next week when my internship is over, Tuesday was like a sneak-preview to it's awesomeness.

Internship Week 9 Recap

If anyone actually reads this anymore (I haven't had a comment to moderate since Grimace was flipping us all off in Week 5), you might be disappointed with week 9. If you want to know how I felt about week 9, just go back and read week 7. Worked with the same PT and had the same feelings of frustration. Nothing outstanding really happened at all. I think I'm just REALLY ready for this to all be over with. Lets all pray for a better week 10.

Nine weeks down, and ONLY ONE MORE TO GO!!!

Internship Week 8

Week 8 was awesome! I worked with a PT who just graduated from the U right before I started. It's really nice to work with someone who didn't graduate from PT school 15 years ago! He was efficient, he let me do a lot, and he was great with the patients. I had a lot of fun working with him, and that made the week absolutely fly by! It went so fast. I loved it! I could use two more like that!

This week I actually have a cool patient to talk about, too, instead of one to complain about! This kid had an accident at work 3 years ago where a huge metal pipe crushed his lower leg. They wanted to amputate it then, but he told them no (which is probably what I'd want to do, too. Can you imagine waking up one day with a foot and then going to sleep that night without one??). So they did a bunch of surgeries and did what they could to save it, but over the years it just wasn't working out, so this time he was in the hospital because they amputated his leg from about his mid-shin down. He was only 23 years old. He told us he was supposed to get married 12 days after the accident, but because of everything that happened and all the complications, they had to put off their wedding for another 2 years. So this guy had probably the worst reason for being in the hospital I've seen yet, and the most to complain about, but I've never seen a patient with a better attitude than his. He was so upbeat, and so excited to get a prosthesis and start getting back to a normal life. He told us that once he got his prosthesis he'd be able to beat us in a race. He told us how tough everything was at first, but how with the support of his friends and family he learned that he could do anything. He was asking me all about PT school because now he wants to become a physical therapist and specialize in prosthetics so he can help other people like him. He was just a really cool guy with an incredible attitude. Hopefully I'll always remember that.

Other than that, the highlight of the week was just working with a good PT who made the work fun and made the week fly by. I'm getting so close to the end now! I can't wait to be finished!

Eight weeks down, only two more to go!

Internship Week 7

Talk about a step in the wrong direction...

Previously, I'd complained about how my CI (Clinical Instructor) took a giant 3 week vacation right in the middle of my internship. Turns out now that I wish he was gone the whole time. I worked with him this week (Monday - Thursday) and it was absolute torture. I'd complained about other PTs working really slowly in other weeks, but nobody is even close to as slow as my CI. He takes FOREVER with patients and is extremely inefficient. The earliest we started a lunch break was 12:30 and we never got an hour. I understand that if there's patients that need to be seen lunch can wait; but it's very frustrating when we easily could have been done by noon but weren't just because he works so slowly.

Typically we start seeing patients at 7:30, but on Tuesday, Wednesday, and Thursday we didn't even start until 8:30 or 9:00 because he spent the first hour doing his documentation on the previous day's patients. (how accurate is your documentation on a patient if you saw 20 of them and waited 24 hours to write up their treatments?) He's ridiculously slow on a computer; he's a hunt-and-peck typist, and it usually takes him 3 tries to get his user name and password correct on the computer. Ofttimes he'll realize that he made a typo 10 words ago, delete everything back to it, and then fix it and type his 10 words again (all taking about a minute). At first it was kind of humorous, but last week it was just frustrating.

He also treated me like I didn't know anything at all. For example, he asked me to go get a pediatric walker, and then explained to me how to find one. Come on, I've been here 7 weeks, I know which walkers are the small ones! Another useful bit of info he gave me was to help support a patient's leg when moving it after they had a total knee replacement. You don't say! I was just going to let them start doing jumping-jacks...

It's also frustrating because in addition to seeing patients, he also does a lot of administrative work (as he is the supervisor). So one day he had me start exercising a patient before we got them up to walk. He said, "do the exercises with them, I've got to run downstairs for a moment. If I'm not back when you're done, just wait here for me". So we did the exercises, and then waited. And waited, and waited, and waited, until 50 minutes later we finally walked. And NOT because my CI had come back, but because one the PTA's saw me waiting that long, so she eventually let me take her aide and go walk with the patient while she did some charting. My CI finally came back right as we were getting the patient back in bed. Ridiculous. So needless to say, it was a long week.

There was one particularly memorable patient this week. She was a 12 year old patient who had spinal surgery to correct scoliosis. I felt really bad for her because she was obviously in a lot of pain (her bandage went the entire length of her spine), but at the same time, she was possibly the biggest brat ever! She reminded me so much of Veruca Salt. (not to be confused with Veruca Salt.) For example, before she walked once, she said, “I want an ice chip”, and her mom said, “I’ll give you one when you get back”, to which she replied, “I WANT AN ICE CHIP NOW!”, (and of course her mom immediately gave her one). She is really, really bossy, and she has no sense of humor whatsoever. She goes to some school called “center for accelerated learning” or something like that and it probably a brat all the time, even pre-scoliosis surgery. (she's 12 and starting high school in the Fall. Yeah.) Everything had to be just perfect or she would just yell at you. She walked all over her mom and dad (figuratively; she didn't want to do any literal walking over anyone or anything). At first she was only taking a few steps, but her doctor wanted her up and moving a LOT more, so we started making her go a lot further. THAT was a lot of fun. I would have felt much worse for her if she wasn't such a beast. She was a cute little girl.

Friday was much better because my CI was gone. He scheduled me to work with the guy who talks to everyone like they're 5, but he didn't want to work with me and assigned me to someone else. This all happened before I got to work, so I didn't catch the whole story. But I was still mildly offended. I'm not that bad to work with, am I? One of the aides told me later it's because he's typically a jerk with the patients, but he has to be somewhat nicer with me around. Pretty much nobody there likes him, I think. In the end I ended up working with the one PT I have really liked who lets me actually do PT work, so Friday was actually a good day. It was nice to be efficient and get a lot accomplished for once!

In the end, it was a pretty long week. It didn't go by nearly as quickly as some of the previous weeks had. But I'm sure glad it's over. I'm getting extremely trunky for this to be over...

Seven weeks down, three more to go.

(this picture is not an authentic picture of me sleeping
on the bus, but it does a good job showing you what my
typical mornings and afternoons consist of.)

Internship Week 6 Recap of Awesomeness!

(It actually wasn't particularly more awesome than any other, it's just another attempt to make the name of the blog more exciting)

Week 6 went by pretty quickly, but unfortunately not as quickly as 4 and 5 did. I really can't afford for it to start slowing down, either; I'm starting to get really exhausted and am ready for it to be over. I'm getting tired (literally) of waking up at 5:30 every day and going to bed at 9:30-10:00 (yes, it is sometimes still light outside. That's what I've been reduced to). I'm starting to get really trunky for this to end. All the fun stuff I have planned for after it isn't helping, either.

So this week I worked with another new PT I hadn't worked with yet. Overall, it was a good experience. He let me work with a lot of patients on my own like I did last week, except whereas last week me and the PT divided the caseload and both worked to get things done more quickly, this time I'd go see a few patients and then I'd find my PT and he'd be out talking to people by the nurses station, and hadn't seen anyone else. This guy REALLY loves to talk. He'll give you a 10 minute answer to a yes-or-no question. I should have been prepared for this from the start, because Monday morning we didn't start seeing patient until 9:00 (we usually start @ 7:30) because he spent all that time talking to my CI (who was back for Monday but then off Tuesday-Friday again) about how the changes they are about to make aren't going to work. It was the worst conversation to ever have to sit through; the PT never stopped to let my CI get a word in, so it was 90% of just him talking and 10% of him and my CI trying to talk at the same time.

See, I'm right in the middle of a major shake-up they're having in terms of staffing. Management wants them to be more cost-effective. Up until now, there has been 3 PTs, 3 PT Assistants, and 6 aides on every day. A few weeks ago they cut out 1 PTA, and soon they're going to be taking away 2 aides too, but the amount of patients to see will stay the same. In fact, last week we had a LOT more patients than any other week. Most days there were quite a few that we just didn't have any time to get to. So I understand why they're complaining. What I fear is that after all this (I think the reduction in aides starts this week) I'm going to be utilized as more of an aide than a student PT. I expressed this concern to my CI, so hopefully it doesn't happen, but the people here are generally a lot more focused on getting their jobs done than accommodating a student. (plus, after 6 weeks of being here, I still don't see much evidence that my CI ever talks to any of the PTs about me or get any feedback from them about my working with them. Then again, maybe that's just because he's been gone for half of the time.) So anyway, all the staff is feeling a bit mutinous right now. I guess we'll see what happens.

Last week I saw both ends of the patient spectrum. We had a few really awesome patients, and a few horribly awful patients too. The awesome ones were the type of people that I've already explained in past blogs- people who have been active and healthy their whole lives, so their hospital stays were short, pleasant, and productive. It's patients like those who are actually a pleasure to work with. Unfortunately, there's not enough like that. There were two patients I can think of that stood out for opposite reasons. One was a girl a bit younger than me who had a back surgery. I've never heard someone complain more in my life! She was a total redneck (missing front teeth and everything) who completely over-exaggerated her pain. Any time we'd touch her she would freak, yet other times she would move herself around in a much more harsh way yet be totally fine. She complained about everything so much that I began to think she was just looking around the room to find things she said she hated. She complained so much that she started crying, and then complained that her eyes were all itchy and wet. Seriously. The other bad one I'm thinking of was a 35 year old guy that was your typical basement-dwelling video game player. He had back surgery and was a bitter angry guy who complained that nobody told him that recovery from surgery would hurt. Really? They cut open your back. It's going to hurt. Patients like those are fun to laugh about now, but they're never fun to have to deal with.

So I guess we'll see what's in store for this week. Every week is a new adventure. I'm nervous to see who I'll be with this week and what things will be like. Hopefully I can get some quality work done like I have the last two weeks, and not be resigned to be someone's aide.

Six weeks down, four more to go. (pray they go fast).

******

6/21/10 - Week Seven Sneak Preview: I'm at my lunch break on Monday. If the rest of the week goes like this morning, it's going to be a looooooooooooooooooong one :(

6/22/10 - like, REALLY looooooooooooooooooong.

Internship Update, Week 5

I'm half done! As Jenny would say, "Holy Smokes!".

This week was "Throw Up During Physical Therapy" week. Fortunately, it never turned into "Throw Up On Your Physical Therapist" week. But once again, there were many close calls with bodily fluids. I don't know why everyone was barfing; a lot of them were because some doctors want their patients up the day of surgery, and the anesthesia hasn't fully worn off yet, but it seems like all those people were nauseous all week. I didn't count, but I think I saw barf at least 10 times this week. I have some gross details, but I'll spare you them. You're welcome.

The more notable (and cool) event of this week is that I actually did a lot of work by myself! I worked with the PT I was with during week 2. She has always been willing to let me do a lot, and this week they were short-staffed (thanks to my CI's mega vacation, a PT quitting, and them scheduling one less PT assistant every day), so I actually got to take an aide and work with patients on my own. I was pretty much given the easiest patients to work with, but it was great anyway to actually feel like I was a PT doing PT work. I had some great aides with me that helped out a lot, so I'm grateful to them for their help. I'll probably not work with that PT again, so who knows if any of the others will let me do as much. I might not be this lucky in the coming weeks.

And just like last week, this week flew by. I think it felt even faster than last week did. If it keeps up this pace I will be done in no time! I'd better get cracking on my assignments...

One last thing: I walk past this neon Grimace in the McDonald's window every day as I'm going from the bus stop to the hospital. I've been thinking about taking a picture of it for the blog for a while, because a neon Grimace sign is pretty sweet:

But after I'd taken the picture, I noticed something. Click on the picture to view it full size: does it kind of look like Grimace is giving everybody the finger?! It totally does! But I suppose that if I was stuck in Provo 24/7, I'd be giving everyone the finger too.

Five weeks down, five to go!

Internship Update, Week 4

This week went by REALLY fast, which was nice! A few more quick weeks like this one and I’ll be nearly done!

This week was the week of the obese patient. Not just overweight or mildly obese, but huge gigantic morbidly obese patients. Tons of them! It seemed like every time we went to see a new patient they were ginormous. One lady was probably about 5’5’’ and weight 345 lbs (I looked when they weighed her). We were helping her back in bed after standing and typically one of us will help guide a patient’s trunk and the other will help with the legs, but I couldn’t lift both of her legs. After giving up, I had to lift one and have the aide get the other. Another guy weighed 491 and he would never even let us work with him. He’d always say “I just don’t feel up to getting up right now”. Another giant guy (I don’t know his weight but he was probably over 350) would tell us the same thing. I’m pretty sure they’ve never felt up to getting up in their whole lives, and that’s why they’re in the hospital now. It is already challenging working with hospital patients, but when they are that huge it presents a whole new set of problems.

This week has really helped me appreciate how grateful I am for a healthy, functioning body, and for how important it is to take care of it. It’s not just the morbidly obese patients (although they are a big part of it) that have pointed this out. I’ve realized that there are basically two kinds of people in the hospital (and probably in the world, although it’s a much bigger generalization): those who are active and take care of themselves, and those who aren’t and don’t. I can pretty much put every single patient I’ve seen into one of those two categories. The ones who have been active and taken care of themselves may have still ended up in the hospital for a joint replacement, back surgery, or some other reason, but they are usually in good spirits, willing to do what they need to in order to get better, and generally have a quick hospital stay. The ones who have sat on their butts their whole lives do much worse, always have something to complain about, and are generally miserable, grumpy people. And they are overwhelmingly the majority of hospital patients.

I don’t want to be a miserable, grumpy person who is more likely to end up in the hospital. I don’t think I have ever been in that second group, but I’m happy to report that I’ve been much more active and have taken much better care of myself this year than I have in a long while. I’m up to running 6.7 miles now, have focused on eating healthier, and I’m proud to report I’ve lost 24 pounds since the beginning of the year. I feel so much better. I love it. I am definitely planning on making this my lifestyle. I guess I just want this to be my soapbox where I encourage you to take care of yourself and be active. Trust me, when you’re 68 and not in the hospital, you’ll thank me.

In other happenings, I learned this week that one of the orthopedic surgeons who does a lot of our patients’ operations is a Dr. Jeffrey Smith, who lived in my neighborhood when I lived in Hawaii. I thought he looked familiar when I first saw him, and when I saw his first name it finally clicked who he was. (I lived in Hawaii when I was 10, so you can’t blame me for not recognizing him right away.) When I told my parents, they reminded me that he was our bishop, which I had completely forgotten. I introduced myself to him and he said he remembered me, but certainly wouldn’t have recognized me (I can’t blame him; it’s been 17 years since we moved to Hawaii). But I really want to see an knee replacement surgery while I’m on my internship, and now that I know one of the doctors, maybe that will help my chances. Wouldn’t that be the coolest thing ever, to see someone’s knee get cut open, ripped apart, and replaced with metal parts?! I think so!

And I worked all week with the PT who talks to everyone like they’re children. There were pros and cons. The pros: he’s a nice guy (but a little too nice; ie, super patronizing); he takes the stairs (everyone else seems to take the elevator, even if they’re going up (or even down) just one floor. Annoying!); he documents what we did with each patient right after we work with them (other don’t, so you have to remember 10 different people 4 hours later. My memory isn’t that good!); and he knows everyone’s names and is friendly with them, especially on the nursing staff, which seems to help. With a lot of other PTs, it seems like they and the nurses don’t like each other for some reason, despite the fact that they are ALWAYS working together.

As for the cons: he treated me like his aide a lot, so when he’s doing stuff I should see like exercises and evaluations, I was out finding walkers and oxygen tanks; he’s super slow (all the other PTs were always done and we still had 5 patients to see); he goes and does home health visits during his lunch breaks, so he’s always like 20 minutes late after lunch; he doesn’t listen very well to patient’s complaints (he hurts them a lot and doesn’t seem to care); and the tone of his voice is just super annoying after working with him too long. You have to hear it to really know how bad it is. It really is like talking to everyone as if they were five years old.

So, much like the other PTs I’ve worked with, there are good things and bad things about each (although it usually seems like there are more bad things than good!). Hopefully I can take the good things and use them in my practice, and remember not to use the bad things. Because talking to everyone you meet like they are 5 is not a good thing.

Four weeks down (already!), six to go.

Internship Update, Week 3

I decided that 10 straight blogs called, “So, how’s your internship going?” would be a little much. I also decided that my last two were too pictureless, so I’ll try to add a few. Here’s my hospital:

Well, nobody died this week. …except of course Gary Coleman. But he wasn’t my patient. But that is pretty weird that Gary Coleman died in the hospital I was working in. I didn’t know he was there until the news broke, but he was probably in the ICU which is just 2 floors below where I am. We do have PTs that work in the ICU, but I’m not allowed to tell you if he was one of their patients or not. That would violate HIPPA laws. So you’ll just have to speculate…

Week 3 wasn’t too noteworthy. I worked with the PT I mentioned from week one that I didn’t like too much on Tuesday and Wednesday. On Tuesday it was more of the same, he didn’t really get me involved, talk to me much, or care much that I was there. Wednesday was a little better. We didn’t have an aide Wednesday, so he was forced to talk to me. He’s ok, he’s good with patients, just not a good teacher. I was supposed to work with him all week, but he took Thursday and Friday off to go to Vegas because he took a job down there. So he’s quitting, which is good, because that means that I won’t have to work with him anymore.

Thursday I worked with another PT I hadn’t worked with yet. He was ok, but talked to everyone (especially patients) like they were 5 year olds. The most patronizing voice I’ve ever heard, especially the tone. It got real old real fast. I am scheduled to work with him all next week, too, so that should be fun. He’s also a really big guy and not very gentle with patients. There was this old guy with a broken hip who he practically picked up out of bed and stood him up, even though the patient was telling him not to. We walked about 20 feet and the guy 100% ran out of gas, so the PT practically carried him back to his bed.

And, I actually worked with my CI twice this week! Amazing. Maybe he felt guilty because he’s now leaving for 3 weeks and I won’t see him again ‘til the end of June. I learned this week that most of the staff really dislikes my CI (who is their boss). We were on a breakfast break (I know that sounds like we’re lazy, but it’s while the patients are eating breakfast so we can’t do anything with them), and all the other PTs, PTAs, and even aides were badmouthing my CI. They just really hate the way he runs things. Apparently there is huge turnover with therapists there; nobody can stand to work there very long. (There has already been a PTA and a PT that have quit in the 3 weeks I’ve been there). They were also telling me that he’s always really protective of his students and never lets them do anything. They were having a laugh about how I’m basically another aide that doesn’t get paid. Most of the aides and PTAs here seem really cool. They are quite normal and actually have personalities. It’s just the PTs for some reason are all really odd. There are a few I haven’t worked with yet, though, so we’ll see how they are in the next few weeks.

I had my mid-term visit with Reva (my teacher who is our Director of Clinical Education) this week, even though the middle of the term won’t be for two more weeks (again, the result of my CIs mega vacation). It was nice to express some of my concerns, but I don’t know if anything really came of it. I think she was mostly just checking to make sure there weren’t any major concerns with me (I think I passed. In fact, I know I did, because my CI didn’t really have anything specific to tell me because he never works with me!)

Other notable stuff from this week:

I watched the Life Flight helicopter take off one day as I was leaving. That was pretty sweet to watch. I remember as a kid thinking it would be sweet to fly helicopters, but for some reason I never pursued that. They still fascinate me, though.

I still am yet to be pooped, peed, barfed, or bled on. Although I’ve seen more of those 4 things in 3 weeks than I had the previous 3 years (and probably more, but 3 years sounded better).

And this just made me laugh. It was lying on the sidewalk right across of the hospital.

I don’t know much about the Provo Police, but I know now not to trust Scott Nielson. Because if someone went through all that work to make such a nice sign, it must be true.

Three weeks down, seven to go.

So, how's your internship going? [Week 2]

This week started off with the worst omen possible: a patient died. Yes, died. That's something I never really expected, but looking back, I guess I'm not all that surprised. We're dealing with some pretty old people, and when one of them falls and breaks a hip, the odds of survival aren't super. I am fortunate that it wasn't one of my patients. Another therapist and his aide were getting a man out of bed when he went pale and non-response. He had DNR (do not resuscitate) orders, so they could only stand back and let nature run it's course. I would have totally freaked if it were my patient. One thing I generally don't worry about with the PT profession is having your patients die on you.

My opinion that I don't want to work in this kind of job after school is beginning to solidify. Acute care combines two things I'd like to avoid in my profession: old people and body fluids. You have a range of patients; a lot of them suffer from dementia and have very low levels of functioning. Maybe this sounds horrible, but most of these types of patients are going to die soon anyway, so there's not that much motivation to try to help them get better. ...ok, that definitely sounded horrible. It's not that I wouldn't be motivated or try any less hard with these patients, it's more that they're such a lost cause that I wonder how effective any intervention we give them is. At the other end of the spectrum, you have a handful of patients who are really nice to work with and you can really get attached to them in the few days you're with them (but it really is just a handful).

One of those patients was an old lady we had last week that fell and broke her hip. She was in her mid 80s, and when she first got out of surgery and into our wing of the hospital, she was extremely confused. The whole morning before we ever even got in to work with her you could hear her moaning and groaning 50 feet outside of her room. Our first time working with her we were just trying to help her sit up in bed. She was screaming bloody murder, telling her husband to make us stop hurting her. Obviously she was in pain, but she also wasn't in her right mind. Sitting up would clearly be good for her, but she wanted no part of it. We did 100% of the work in getting her sitting up, and by the time she was laying back down again I was literally sweating like I'd just worked out. Eventually as her anesthesia and medications wore off, she began to be more and more cooperative, and it even turned out that she was a sweet old lady. I was amazed two days later when we actually got her to stand, and even more so two days after that when we got her to take a few steps to the wall and back. Remarkably, the last day we worked with her before her discharge, we got her all the way out of her room and about 10 feet down the hall. I never thought it possible.

In fact, she probably could have gotten even more than 10 feet into the hall if she hadn't pooped on the floor. But she did, and we needed to turn around. You see, even that handful of patients you come to enjoy working with can do something like poop on the floor to make you want to not work with them. You can imagine us on either side of this barely-mobile 80-something year-old lady, and it's easy to picture how close that poop came to making contact with my shoe.

In other close-encounters-with-bodily-substances news, a patient had a bad IV placement and dripped blood all over the floor when we stood her up. This time the fluid was literally millimeters away from me, and I'm still a little shocked that I didn't get blood on my new pants or shoes. But after two close encounters in a week, I'm afraid that it's only a matter of time...

I only worked with my CI once this week; the other 4 days were with that same PT I was with on the Thursday and Friday of Week 1. She is good and teaches me a lot and is even starting to give me a few responsibilities, but she is also extremely quiet and not very outgoing. Working with her can be, well, a little boring. My CI is supposed to evaluate me at the end of this week, but I'm not really sure how he'll do it because he has spent so little time with me.

So, I'm hanging in there. It's not the worst internship in the world, but it's certainly not the best either. One good thing is that it's going by fast. I'm already 1/5 of the way through it.

Two weeks down, eight to go.

So, how's your internship going?

It's the question I'm sure I'll be asked a lot this summer (unless nobody cares), so here are my thoughts after one week. (If you don't know, my internship is in the acute care ward of a hospital.)

I catch a 6:35 bus from Sandy to Provo, which lets me off about half a mile from the hospital. All in all, it takes about an hour and 15 minutes from the moment I leave my house to the moment I set foot in the hospital. So that's 2 1/2 hours of commuting every day.

My CI (Clinical Instructor) is nice enough, but I'm not sure how much he cares about having an intern. I was with him Monday and Wednesday, but Tuesday, Thursday, and Friday he sent me off with other therapists. Monday was just following him and his aide around (basically acting as an extra aide). On Wednesday it was just us, so I got to help more, and he showed me a bit of how their computerized documenting system works (ie, notes/billing for everything you do with the patients). The guy I was with Tuesday was terrible; he didn't show me anything, tell me anything, or seem to care at all that I was there. The therapist I was with Thursday and Friday was really good at teaching me and letting me do stuff, but she is really quiet and hard to hear at times, especially if someone is wheeling a noisy cart down the halls or something.

The patients are quite varied. Most of them are elderly, but there are all sorts. The job is generally to get them up out of bed and walking after surgery (so they don't stay bedridden and lose too much strength, or so we can get their joints they've just had surgery on working again). Most of them have catheters in them, so I am often handling bags of people's pee, and frequently clipping them to my pocket while I walk with them. Most of these elderly folk are just in hospital gowns, too, so I've already seen my fair share of old guys' junk. Yep, you read that right.

My feet are absolutely killing me. Combine buying some brand new nice shoes for this internship that are not yet broken in with being used to sitting at a desk for most of the day and you have some tired feet at the end of the day (and week).

I frequently get asked if this is a paid internship. The answer is no. In fact, I divided my tuition cost by the required hours (400) and calculated that I pay $6.80 an hour to be there. That's right, I'm making -$6.80 an hour.

Yet, with all that said, I don't really mind it. I have surprisingly been able to tolerate getting up at 5:30 every morning, and I'm so tired by the end of the day that I haven't had any trouble falling asleep at night. I may have a super long commute, but at least I do it on a bus. My bus pass is free from the U, so all it costs me is the very little gas it takes to get to and from the Sandy trax stop. Usually in the mornings I just sit back and close my eyes and relax (I think I'm too scared of missing my stop to actually fall asleep, but I get a good rest in), and in the afternoons I usually have a book. Today I have my computer, and I have been bringing you this blog during my commute home (despite UTA's ridiculously slow wi-fi. Oh well, I should just be grateful that they have it).

Some of the patients are in a lot of pain and miserable, and some wouldn't want to get up and walk with you even if they weren't in the hospital, but for the most part they are quite nice and they want to get up and walk so they can start to recover. I'm surprised at how many of them are aware of how important it is to get up and moving so soon after surgery; I thought I'd have to do more convincing. Even though we're generally only with them for 3 or 4 days, it's nice to be able to see the progress they make in that short time. They are excited when they can walk 150 feet when last time they could only go 100.

For the most part, the people I work with are pretty cool. There are a few odd ones, but I guess you get that anywhere you go. As for my CI, I guess we'll see how that situation goes. I just don't see how he's going to evaluate me if he's not working with me the majority of the time. (Oh, yeah, I forgot to mention: he is taking a 3 week vacation right in the middle of my rotation. Not really sure why he signed up to take a student...)

So, to answer the question, my internship is going ok. I don't love it, but I don't hate it either. I don't see myself wanting to go into this kind of therapy; I'm going into this field to help people heal and get back to doing what they want to do, and even though I can see these acute patients make a little progress, we're only with them for a few days and they still have a lot of PT to go through after they leave us. But I'm thinking this will be a good learning experience, and I'll be glad to get my acute and geriatric rotations out of the way first.

One week in the books. Nine more to go.

Who is uglier??

I just commented on how ugly Chris Anderson (aka the Birdman) was, and my wife said Steve Nash was uglier. I vehemently disagree. What do you think?? Vote on the poll up in the top-right of my blog!

UPDATE!!! The polls have closed, and Birdman DESTROYED Steve Nash, 13 - 2. It was a landslide.

The NBA Playoffs: Where Creepy Happens Part III

Well, it turns out that our mysterious courtside stranger isn't the spawn of Satan, Van Helsing, a wizard, Jonah Hex, or any other theory that we may have come up with. My good friend Ryan Kaltenbach has informed me that he is none other than one James F. Goldstein, an eccentric multi-millionaire who enjoys basketball, fashion, architecture, and hanging out with famous and/or attractive people.

So, he still a pretty weird dude. I'm still frightened of him, but not as much.

http://www.jamesfgoldstein.com/home.html

http://www.americanwaymag.com/jim-goldstein-nba-los-angeles-clippers-los-angeles-lakers

The NBA Playoffs: Where Creepy Happens Part II

BWAAAAAAAAAAAAAAAAAHHHHHHH!!!!!!!!

Captain Creepy was SITTING NEXT TO THE NUGGETS BENCH TONIGHT!!!! Just like I asked in my blog last night!

On the one hand, I know this mysterious stranger is currently in Salt Lake City. I don't doubt for a second that he knows where I live. I fear for my life a little.

But on the other hand, the Jazz won. So he was clearly jinxing the Nuggets. So maybe we're on the same team here...

The NBA Playoffs: Where Creepy Happens

Do you know why the Lakers played so poorly tonight?

Was it Oklahoma City's tough defensive presence? (no.)

Can you blame it on unfriendly rims? (nope.)

Were they just lazy and lethargic? (negative.)

Was it OKC's 6th man, the sell-out crowd in their generic white NBA Playoffs shirts? (no. ....but you're getting closer.)

It was part of the crowd, but not one of the thousands of screaming, double-shirt wearing fans. It was this guy:


WHAAAA?!? Who is this guy?! Clearly he doesn't belong courtside at an NBA playoff game! He had to be there for some other reason, say, I don't know, hexing the Lakers!!! I've never seen such a creepy dude in my life! Let's be honest, right now as I write this I fear for my life; I'm afraid that as soon as I post this, close my computer, and go to sleep he will appear in my dreams and steal my soul. Or at least make me miss some free throws.

It can't be mere coincidence that this guy was sitting just a few feet away from the L.A. Bench, and suddenly the L.A. roster looks as if it's been replaced by the residents of Silver Acres Retirement Community. One look at that guy and I'm certain he somehow time-warped to Oklahoma from the 1800s and cursed the entire Lakers team.

Other theories include:
-He is a Vampire Hunter (I've always had suspicions about that Phil Jackson...).
-Jack Nicholson sold his soul and his Lakers tickets to the Devil.
-He has been sitting in the same spot in Oklahoma for the past 200 years and they just built the arena around him.
-He is this guy that I remember from an episode of Batman: The Animated Series.
-He gets his evil powers from his scarf (which is probably true, but doesn't rule out any of the other theories).

One thing that really freaks me out is how obviously powerful he is. Besides how bad he made the Lakers look tonight, there is also the fact that he doesn't hide his creepiness from the world. He could have lurked in the shadows and done just as good of a job making L.A. lose, but dude is sitting courtside. In plain sight! He must be powerful enough that he knows nobody will mess with him. And I'm not the only person who noticed him. Evidence suggests that others have seen him and felt his creepy vibes, AND that apparently he has been spotted at other Laker games!

This is clearly disturbing. We may see a result this year that nobody ever thought possible: the Lakers getting knocked out of the first round. Granted, I won't mind a bit.

...in fact, do you think we can get him to go sit by the Nuggets bench too?

Kobe Bryant, arguably the best player in the NBA, can only manage
12 points in the presence of this mysterious stranger.

Who Is This Guy??

This picture is hanging on the wall at my school:

Who is this guy, and how long did it take him to grow such a sweet beard?! He looks like a wizard, or possibly some kind of elf. Perhaps he is even an elvish wizard. But why is he hanging in the Health Professions Education Building? That's what I want to know.

My Free New Shirt

One of my favorite web sites is SnorgTees.com, where you can purchase all sorts of funny shirts. I am a fan of SnorgTees on Facebook, and not too long ago they held a contest. They posted a status that said, "Free t-shirt to the best 5 answers: We just got this email from a customer. How should we respond? I've always been impressed with the humour of snorg as well as their ability to spell right and do everything correctly. However I've recently come upon a t-shirt that says "Nothing is unpossible". Although the picture is okay, "unpossible" is not a word and does not contribue to the humor of the design in any way."

My suggestion was, "our carelessosity on this shirt is imbelievable. Please disaknowledge this shirt when considering your purchase." And they actually picked it! They didn't respond to the e-mail with mine, but it was one of their 5 winners. (The one they responded with was, "I fail to see the issue. "Unpossible" is a perfectly cromulent word that embiggens the English language.")

So I got to pick any shirt and they would send it to me for free. After much deliberation, I went with the one I remember seeing the very first time I ever went to Snorgtees.com that has always cracked me up: The Death of the Kool-Aid Man.

Amy's New iMac

For as long as I've known her, Amy has complained to me about how old and out-dated her iMac was (it's 7 years old now, which, let's be honest, is like 46 in Computer Years). So this year we used part of our tax refund to get her a new one. Here is a picture (with the old iMacosaurus in the background):


Now, there's few things I hate more than people arguing about Macs vs. PCs. It's the least productive argument ever. And it's even worse is if the argument is taking place online. I use PCs not because I think they're better, but because I know how to use them. I don't know my way around a Mac, so what I can do in one minute on a PC would take me ten on a Mac. But nothing gets my goat more than people who are snobby because they think their computer is better than yours, regardless of which kind they have. (So don't even try commenting about why one is better than the other, or I'll just delete it and it'll never see the light of day. You've been warned).

Amy's computer is pretty snazzy. The entire thing is in the above picture; the computer is built right into the monitor, and it's incredibly powerful for being so compact. But clearly it's best feature (ok, not really the best, but it's the only one I know of and it's really fun) is the Photo Booth. There's a built-in web cam and you can take pictures with all sorts of hilarious effects. Here's a few examples:

Running Update Part II

In a surprising turn of events, I'm actually running somewhat frequently and even starting to enjoy it. I can't yet say that I love running, but I think I can safely say that I like it. I still don't have a lot of desire to get up and go running, but once I actually do get out there I enjoy it. And I've been able to see a lot of progress lately, so that's encouraging.

Today I ran 2 1/2 miles, my longest ever without stopping (and maybe even my longest ever with stopping, who knows?). That's a far cry from the 0.8 mile I could go without stopping when I first started running, and even pretty far from the 1.25 miles I went at my last running update. And not only am I running twice as far, but I don't even feel like dying anymore after I'm finished. Sure, I'm tired, but I more feel good and happy that I accomplished something, rather than feeling like digging my own grave.

Also, I've lost 10 pounds in the last couple months. I think a lot of that is from running, but I don't doubt that part of that is nutrition too. Unfortunately, I'm down to 185, which is pretty much where I've been for the past 10 years (how I crept up to 195 is beyond me; I think it snuck up so slowly that I never even noticed it). So the good news is that I've lost 10 pounds; the bad news is that I'm sick of being pudgy and still have 15 more to lose. But now that I'm starting to like (not love) running, I think I can do it.

So your job is to make sure I keep motivated. I'll try to keep the blog updated, and you can check out a log of my recent running activity right here. If you're a real friend, you'll check it occasionally, praise my progress, and taunt me if I've been slacking.

A Post For Posting's Sake

I've been getting grief from my readers (both of you) about not posting enough. It's tough to keep coming up with stuff to post about, but I'm going to make an effort. I can't promise that they'll be long, interesting, or exciting, but I will promise to try to make them more frequent. (Promising to try to do something is way easier than promising to do it) :D

So for this post, I thought I'd include a picture I took that made me laugh. Apparently, Target doesn't want customers to enter their store.

Dear Peanut Butter,

Dear Peanut Butter,

I'm really sorry about the way we broke a few months ago. I just decided that our relationship was too unhealthy--for both us. I was overweight, and you kept getting eaten all the time. When we got together, I just couldn't stop myself; you are just too delicious. I needed some space.

Things have been hard for me ever since we broke up. I'm sure they've been hard for you, too. I'm sorry if I've made things confusing for you. Those few non-committal snack-out sessions we've had certainly didn't help. I'm sorry if I lead you to believe we'd be getting back together sometime soon.

The good news is that I've lost almost 10 pounds since we broke up. Check out this graph from the Wii Fit:
(And no, I didn't photoshop the results; it just looks funny because it wouldn't all fit in one screen, so I had to put two pictures together. The results are accurate.) Now I can't say for certain that it's all because of our breakup. It might be because I've been eating much healthier sandwiches since then, and the fact that I've been running a lot on the weekends. All I know is that breaking up was the right decision. I've felt really good the past couple of months.

I'm sorry, I know you really want to get back together. So do I. I think about you all the time. But I just can't do it. Not yet, anyway. I do see us getting back together someday, but we can't get together with the same passion we used to have. Give me about 15 more pounds, and then I'll give you a call. But we're going to have to be just friends. I promise, it will be better for both of us.

Hope you are doing ok without me. I'll talk to you later.

Love,
Sam