Day 13 – To treat or not to treat?
The day started off with the presentation of a chocolate tart I’d made during my day off yesterday so happy moods all around. Furthermore, I asked for full treatment responsibilities of a patient and after a conversation I deemed far more lengthy than the required permission of yes or no between my educator and my patient’s PT, my request was granted. I’d chosen this patient because he was the only one I knew the name of and because I hoped I could see potential.
He was late, of course. I was glancing at the clock constantly to see when he would arrive and when he eventually did, I turned my head to act like I never saw him and waited for someone to call me over. It worked perfectly. Then I wanted to do a full Ax and ask questions about goals.
I started off in Bangla because he spoke no English, ‘Tomar Lokhko ki?’ What is your goal? He didn’t understand so I asked another PT, Diti, to help. She said, ‘Tomar Lokkho Ki?’ And he understood. That is EXACTLY how I said it! Anyway, I kept Diti with me to finish my interview. He is a complete T10 paraplegic spinal cord injury with no sensation and limited muscle movement. I asked after his occupation and his long and short term goals and then I asked if there was anything he wanted to work on specifically today. He waved his hands in the air and I didn’t need a translation to tell me he just wanted general therapy. I nodded. ‘Ok.’ If there’s one word you can rely on in every country, it’s ‘Ok’.
With an hour on my side I worked through the standard procedures I knew from manual technique lessons doing PROM, then AAROM of the UL and LL, sitting, lying, transfers and then finishing with STS which he needed to do with a standing frame. But this guy is so COMPLEX. He has a flicker of movement around the hip flexors, quite good resistance to hip extension but only to 90 degrees, some abduction and little to no adduction. It’s so confusing! I have such limited knowledge on this kind of thing that I don’t know what is possible to achieve! Will this man ever walk unaided again? Is it possible to improve his hip flexor strength? I’ve never faced such a challenge.
I’ve made (or at least hope I’ve made) some new friends from the SCI department that I tend to deviate to when the room becomes claustrophobic with testosterone and a bit of a girly giggle is needed. Salma offered to go shopping with me after we joked about the salwar kameez I’d been wearing; specifically the orange tie dye (I know, it’s as bad as it sounds). So Salma and her friend who is basically her twin, Shifa, took me shopping. After a bit of misunderstanding and communicating, we finally decided we’d find some material at a good price and then take it to the tailors to be made. Sounds easy, right?
We were out for almost 3 hours. You’d find the perfect one and then the price would be too big. You’d find the perfect colour, but the material would be wrong. You’d find the perfect pattern, but the colour would be hideous. Oh, and there’s the difference between Pakistani and Indian design. And I’d found shopping hard before. All I could hope was that I wasn’t being too awkward and that my new friends would still be friends after.
More – worse – blisters from wheelchair basketball, might take a break from it tomorrow.