A few days ago, our planned physical activity of the day was indoor basketball with a 5' tall plastic basket. Steve, my co-worker, who's a case manager with several of the TBI clients I work with, ran the show. He decided that to even things out, he'd split our group such that the two clients with motorized wheelchairs were on opposite teams, another usually wheelchair-bound client was on one of their teams with her non-motorized chair, then he pulled 3 extra chairs out of the equipment closet. Two clients who normally walk on their own took the first 2, and I evened out the teams by taking the 3rd chair.* I don't think I'd ever sat in a wheelchair. It was fun, and I'm glad I don't have to ride in a wheelchair normally.
I've still not read any clients' files, so I'm still creating my own ideas about what they're "like," what's illness, what's part of their former personality. I'm sure it's a relief for them to be somewhere that people _don't_ continually compare their pre- and post-incident selves. There are some general characteristics one finds such as speech problems (softer than normal and/or inarticulate and/or disconnected and/or nonsensical speech) or loss of certain inhibitions (quicker to anger, tendency to make inappropriate remarks of a sexual or non-tactful nature). But then I think that if I'd had an accident that robbed me of, say, the use of a side of my body, and made me talk funny, and meant I wasn't as smart anymore so my spouse no longer found me attractive enough to be intimate with me, I'd probably be grumpy and quicker to anger than normal, too. And maybe have lowered inhibitions because I quit caring about social consequences because my deference to them didn't seem to help me be accepted by the world at large, anyway, now that I was disabled and looked down on or pitied or ignored.
One client seems to have vocabulary straight out of a John Hughes script. Her response to most things said to her is to grin widely, wave her hand, and say "I'm so sure! I'm so sure!" Did she talk like this before whatever-it-was injured part of her brain? Was she always such a cheerful person? Did her grumpy wires get disconnected altogether? Or the client who makes continual inappropriate flirtatious comments to me--maybe he's always objectified women in this way? Is that just his injury talking? My boss leads group discussions about once a month on communication skills and uses that phrase with the clients, telling them that what they said wasn't their best self, it was their injury talking. It's great they're learning explicitly to use other parts of their brain to inhibit certain behaviors. And this reminds me what a fragile construct self and personality are.
What if I had to ride around in a wheelchair as my only means of locomotion, and couldn't think or talk as fast? That would sort of be someone else, except they would have my not-as-functional body and some percentage of my memories.
*If you did the math, you realized that's not many clients. On any given day we have between 14 & 21 clients present. After the lunch that takes up the first hour, they're split into two groups, red & blue. One does the cognitive game/activity while the other does the physical, then they switch, then everyone goes through free-weights/sitting/arm/leg/standing exercises at the same time in the two groups in two different rooms. That day, the client who should've been in the wheelchair I took was still eating her lunch. She typically takes about an hour to eat the meal that most people consume in 10 to 15 minutes.
Sunday, January 24, 2010
Sunday, January 3, 2010
Getting Paid
My volunteer gig has turned into a paid job. The whole thing feels quite serendipitous. The TBI (traumatic brain injury) group had its program moved back to a former location, and its director asked that I move with them, and talked to the right people so that I got hired. The new/former location is quite close to my house, only a 12-minute bike ride or so, as opposed to the original volunteer location which entailed a 30-to-45-minute bike ride south. The move also meant they could switch back to their former hours, as well, which means that my workday fits very neatly into the time between when the Microbiology class I'm taking this quarter ends and when the kids' daycare ends. I can easily pick them up on my way home, in fact. I am still a little shocked that I found a job in my field that fits inside daycare hours and allows me to take the last prerequisite required for my dream program. (I submitted that application on 12/1, won't hear whether I got in until 3/1.)
The first few days of my job I spent washing dishes and barely talking to clients. We aren't running our own kitchen fully. Instead, we're having food brought up daily from the south branch, and having to do our own dishes. I got my food handler's permit the first week, and other than that spent that week getting the kitchen back in order, which felt somewhat like moving into a vacation cabin. The stuff was unused for so long, it all got dusty, it's all needed cleaning, reorganizing. I've thrown away a bunch of random stuff that was either in terrible shape, unidentifiable, or a crappy duplicate. As for the rest of the tasks I was ostensibly hired for, I'm slowly being trained in the why's and how's-of-the-why's: bathroom assists, leading exercises, helping certain mostly wheelchair-bound clients do their particular occupational-therapist-devised standing exercise regime. Each day involves lots of different kinds of tasks, and this makes me really happy and makes the time go by quickly.
I've especially enjoyed the one-on-one time I get with clients when I help them with the standing exercises. I've found my experience with Iyengar yoga and its emphasis on alignment and physical adjustments really helpful in this endeavor. We go to a bar facing a window, I fasten what's called a gait belt around their waists, and help them to do things like stand up with both feet facing forward and parallel to each other, or to put weight in their heels (one client would constantly be on his toes otherwise). My help consists of reminding them of the exercise routine and staying by their weak side, holding the gait belt, in case of falls. They're bearing most of their weight themselves. Because of the yoga stuff, I've been able to brace a heel, or support a calf, so that a client can move the other half of their body more freely, or with more control.
TBIs--and maybe their aftermath, like life in a wheelchair for some? I need to research this--lead to common muscular conditions, one of which is called "high tone," which occurs especially in the lower extremities. Their quads are always contracting, meaning it's hard for them to bend their knees much. Many TBIs involve only one side of the brain or the other, so clients have no control over one side of their body. But both sides, the side with and the side without control, have this "high tone" problem. One client always asks us to tuck (force) his left foot back onto the footplate of his wheelchair. If we don't, his whole lower left leg springs into the air and stays there. With his right leg, he can do the forcing himself.
During standing I end up chatting with the clients. I've found out that the Beatles fan in the wheelchair isn't quiet at all, and that when he's standing up he's about 6-foot 1. His TBI was from a car accident when he was 16 years old. He says he was in heaven 2 to 4 years after the accident, that God sent him back, and that he doesn't really remember the time he was in heaven. This does not come across as delusional rambling in the least. He's incredibly polite, and quick-witted, except that his perfectly articulated, soft speech is produced at about 1/6 of the speed of average speech. One day I called him a "rockstar" because of his hard work; I know from what my boss tells me that he's improved his mobility a great deal, and that this is due to his determination. He replied, immediately, carefully, and slowly: "I prefer to call myself a stud. That's what I was called in high school. I was a wrestler and played soccer." He's 29. He managed to finish high school over the course of several years after the accident, and thinks he survived for a reason. This has something to do with the time he spent in heaven. He wasn't driving the car.
The first few days of my job I spent washing dishes and barely talking to clients. We aren't running our own kitchen fully. Instead, we're having food brought up daily from the south branch, and having to do our own dishes. I got my food handler's permit the first week, and other than that spent that week getting the kitchen back in order, which felt somewhat like moving into a vacation cabin. The stuff was unused for so long, it all got dusty, it's all needed cleaning, reorganizing. I've thrown away a bunch of random stuff that was either in terrible shape, unidentifiable, or a crappy duplicate. As for the rest of the tasks I was ostensibly hired for, I'm slowly being trained in the why's and how's-of-the-why's: bathroom assists, leading exercises, helping certain mostly wheelchair-bound clients do their particular occupational-therapist-devised standing exercise regime. Each day involves lots of different kinds of tasks, and this makes me really happy and makes the time go by quickly.
I've especially enjoyed the one-on-one time I get with clients when I help them with the standing exercises. I've found my experience with Iyengar yoga and its emphasis on alignment and physical adjustments really helpful in this endeavor. We go to a bar facing a window, I fasten what's called a gait belt around their waists, and help them to do things like stand up with both feet facing forward and parallel to each other, or to put weight in their heels (one client would constantly be on his toes otherwise). My help consists of reminding them of the exercise routine and staying by their weak side, holding the gait belt, in case of falls. They're bearing most of their weight themselves. Because of the yoga stuff, I've been able to brace a heel, or support a calf, so that a client can move the other half of their body more freely, or with more control.
TBIs--and maybe their aftermath, like life in a wheelchair for some? I need to research this--lead to common muscular conditions, one of which is called "high tone," which occurs especially in the lower extremities. Their quads are always contracting, meaning it's hard for them to bend their knees much. Many TBIs involve only one side of the brain or the other, so clients have no control over one side of their body. But both sides, the side with and the side without control, have this "high tone" problem. One client always asks us to tuck (force) his left foot back onto the footplate of his wheelchair. If we don't, his whole lower left leg springs into the air and stays there. With his right leg, he can do the forcing himself.
During standing I end up chatting with the clients. I've found out that the Beatles fan in the wheelchair isn't quiet at all, and that when he's standing up he's about 6-foot 1. His TBI was from a car accident when he was 16 years old. He says he was in heaven 2 to 4 years after the accident, that God sent him back, and that he doesn't really remember the time he was in heaven. This does not come across as delusional rambling in the least. He's incredibly polite, and quick-witted, except that his perfectly articulated, soft speech is produced at about 1/6 of the speed of average speech. One day I called him a "rockstar" because of his hard work; I know from what my boss tells me that he's improved his mobility a great deal, and that this is due to his determination. He replied, immediately, carefully, and slowly: "I prefer to call myself a stud. That's what I was called in high school. I was a wrestler and played soccer." He's 29. He managed to finish high school over the course of several years after the accident, and thinks he survived for a reason. This has something to do with the time he spent in heaven. He wasn't driving the car.
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