Into the Fire

One Week Down...25 More to Go. It's crazy to think that is all the time I have left here. It's going to go so fast!

I am happy to report that my first week as a hand therapy fellow as been great. I enjoy the people I am working for/with, Jennifer, the other fellow, is so great to work with, and I'm learning so much. The therapist that we work with the most has quite a bit of confidence in us and is letting us take on more and more responsibilities each day. And apparently, if you show proficiency in a skill, he's going to make you in charge of that skill. Scary! Such is the case with a certain wrist splint. It seems to be the most common splint they make and I'm been deemed the "wrist splint expert" (yeah, right!). So, if anyone comes over and needs a wrist splint, I get to make it. Very first patient this morning just happened to need one, so I was immediately put to work. Good thing he was young, a med student, not rushed for time, not a jerk, etc. that when I royally screwed up, he didn't mind that I had to re-do his splint. I got a little carried away with the scissors and made his splint waaaaaay too small. Oh well. I made another one and it was just fine.

I have to admit that I have truly missed working with adults. I love the patients I treat at Scottish Rite, but it's nice to be able to sit down to treat an adult and carry on a conversation with them. I have more fun talking to the patients that actually treating them. Being in a new city, I'm getting all sorts of recommendations from my patients of where to go and what to see and do. I'm also learning many Philadelphia (Philthadelphia) terms/phrases. One patient today who is Jewish was teaching me Yiddish phrases. I now know what chotchkas (sp) are and what it means to schlep.

5 Things I Learned on Day #5:
1. Don't cut too much off of a wrist splint. Make sure it comes about half-way around the forearm and cups the hypothenar eminence.
2. "DJD/CMC Arthritis" and "Osteoarthritis, hand" have the same exact ICD-9 code.
3. Paradoxical Extension: When you attempt to contract FDP but instead the lumbrical is pulled proximally, thus resulting in PIP and DIP joint extension rather than flexion (involved finger assumes an intrinsic plus position).
4. Many patients can be a pain in the ***. You try to please them (within reason) and get them out the door ASAP!
5. Less is more when it comes to hand therapy. (Dave's favorite phrase)