Oh Sh*t!

So, the ALS patient that I have is a pretty tech savvy guy. He's been working on ways to amplify his voice at work, since his volume is very decreased. Today, he brought in this FM transmitter that he had rigged to work through a regular radio. It wasn't working very well, so I suggested that we try out this device that I had been given at a conference.

The device I have looks like a fanny-pack, but it is a speaker you wear around your waist. It has a corded microphone on a headset that the patient wears. The patient then speaks into the microphone and his voice is amplified at his waist level.



Now, my patient has gotten quite used to his voice being soft. As he was leaving, I reminded him that he would have to get used to his louder voice. His balance isn't so good, and now he's using a cane. As he was leaving my office, he stumbled a bit - not too much though - and through his waist speaker I hear "Oh Sh*t" really loud! Needless to say, he turned down the volume just a little!

Oh the problems you encounter as a speech therapist!

This is why...

Today I discharged one of my oldest (longest in therapy) and most favorite patients. She's one of my cancer patients who has done e-v-e-r-y-t-h-i-n-g I have asked her to do. She is one of the most dedicated people I have ever met and her hard work has paid off!

I prescribe facial and swallowing exercises for most of my cancer patients. Radiation creates significant fibrosis (scar tissue), so exercises help prevent and break up that scar tissue. My patient is so faithful in doing her exercises - she does them at home, in the grocery store, while driving, in the waiting room, anywhere. I love hearing her stories about how she does her exercises and all the funny reactions she gets!

I love working with my cancer patients! I was able to fully convey this to my patient today - on the last day she'll be my patient and the first day she'll be my friend. This is one of the main reasons I love what I do!

A Plan Worth Making

Hopefully my renewed desire to blog lasts longer than a week this time!

I have so many plans for my life - plans my best friend would probably say I can't make. Remember, the only one with real plans is God. I've planned so much in my short life and am only now realizing that some of my plans were not laid well.

I have a new patient. Well, not really new to me, but new to my blog.

My patient has ALS and I helped him discover his diagnosis. He is young -too young. He has a daughter my age. He is going to die - very quickly, in fact. But he is so full of life.

I don't really have too much to say about my patient. His is a complicated story that ended in a shocking diagnosis. I want to write about him here because I want to remember him. Though I don't think you could ever forget a man like my patient.

Though my patient is going to die, his one desire, and current plan, is to get his daughter some things from Disneyland Paris, where I happen to be going in a few weeks, and surprise her for Christmas. Now, it would be so much easier to just order something on-line,, but that wouldn't be authentic. He devised this intricate plan of how I could get some things for his daughter, pack them up so I don't have to drag them all over Europe, and send them back to the states. He's thought of all the details - all the way down to finding the FedEx drop box for me to take the treasures to in Paris.

Of all the things he could be planning, this is the most important. I hope I can help him with his plan - it sounds like one God would agree with. My patient doesn't know this, but he has taught me so much already about planning - how the best laid plans never work and how the most out-of-reach things are worth planning for.

Toot Toot

Wow - I need to update this more. Hopefully I can do better....

Life has been a blur lately - "too busy" seems to be the norm. Hopefully time will slow down a bit.

I'm still a speech therapist and I'm still the boss - managing 5 other therapists. Sometimes the boss stuff gets too overwhelming and I would much rather go back to the days of just treating patients. I love "just" treating patients. You never do this job for the recognition, but sometimes recognition is the little push you need to keep going.

Not to "toot" my own horn, but I was named the Employee of the Quarter for the entire Health System. Not too shabby for someone who has only worked there for 4 years.

I was named Employee of the Quarter because one of my patients wrote my boss a great letter about me. Again, you don't do this job for the thanks, but it sure does feel good to know people recognize how much time, energy, and personal investment you put in to care for your patients.

I love being a speech therapist. I love figuring out what is wrong with people and I love coming up with ways to help them. Most of the time, they've been written off by every doctor you could imagine and been labeled hopeless.

What I love most of all is working with my cancer patients. I developed a comprehensive head and neck cancer program where patients are seen by a speech therapist at the beginning of their cancer journey. They are followed regularly by someone (me) who has expert knowledge about head and neck cancer and its effect on swallowing and communication. They are referred to my by a wonderful, intelligent nurse (my mom!) who identifies them as someone who needs to be seen by a speech therapist.

The doctors may balk at the fact that my mom refers patients to me, but it is the best care out there and it is what got my Employee of the Quarter. Again, don't want to toot my own horn, but it sure does feel good.

My Favorite Little Devil

I think I met my most favorite patient of all time - I'll call him Juan for blogging purposes. Juan is a twin and was most likely deprived of oxygen at birth. He looks nothing like any other members of his Hispanic family; he has a huge head, the thickest hair you have ever seen, almond shaped eyes, big chunky feet, and is the size of a seven-year-old though he is only five. When I first met Juan, I knew he must be mentally retarded - the way he was so friendly, called everyone "mama", and had not a clue that what he was saying made absolutely no sense. He became one of my favorite kids instantly.

The best thing about Juan, but unfortunately the reason why he had to come to therapy, was the way he talked. He literally sounded like the Tasmanian Devil - complete with his tongue hanging out and the hand motions to match! And it wasn't like Juan just turned on his Tasmanian Devil impression for certain people - he talked that way all the time and to every person he met. Everyone in the office loved working with Juan because he was so compliant and fun - and you got to practice your Tasmanian Devil impression (complete with hand gestures!). Juan did progress in therapy and was eventually able to functionally communicate but always seemed to go back to his Tasmanian Devil voice. I wouldn't blame him either, it was the best voice ever!

"Lots" - read "more" - Time on My Hands

I have definitely been MIA for quite a while, dear blog. My apologies. It's not that I don't have any good stories, it's just that I have been so swamped at work. There are no words to describe how busy we have been. But, that's not why I'm back to blogging. I'm back to blogging, at least for the short-term, because I have a little more time on my hands and no time on my feet!

On Tuesday (1/4/11) I had my bunion on my right foot corrected. YEA! Well, not YEA yet, but hopefully soon. I'm off from work at least until the 12th (and maybe later, depending on how I feel) and should have plenty of time to update.

But for now, I'm in quite a bit of pain and am itching like crazy (thank you pain pills!) so I'll be attempting to sleep soon. Tomorrow I plan on telling you about my absolute most favorite Tasmanian Devil. Stay tuned!

Wise Beyond Your Years

Since I was young, people always told me that I was wise beyond my years. Either that or they told me I was a 30-year-old trapped in a teenagers body. But that's not the point.

The point is that lately I've been feeling like I must be wise beyond my years. I have a patient and he is dying. He will probably die tomorrow or the next day. He is young; he has young children and a wife; he has a terrible disease; and he is in pain.

There are things worse than death and this man is living those things. His body is failing him but his mind is intact. He knows he is dying. He has accepted it. His wife has not. She grips to every fiber holding out hope that he will survive. But he won't and he knows that and he is ready to die.

I can't imagine being his wife. I can't imagine a doctor coming to me and asking me if I was ready to let my husband go. If I had brought our children to see their father one last time. I can't imagine....

But I have to imagine that. We all have to imagine that. Because you have to know what you would do in that situation. Have you talked to your spouse or your parents about a living will? Do you know what they would want. You have to do that; you have to know. You have to do it so that you can make those decisions for your loved one when they can't make them for themselves.

I was talking to this patient's nurse today. She lost her husband to cancer when he was 40. He was a nurse as well. She told me about the day before he died - they had a party. He joked with his friends and they celebrated his life. He was pain-free and at home. Had she not known her husband's wishes, how might he have died? Alone? On a ventilator? Without saying goodbye to his family?

If you have never asked your spouse or your parents what they would want in a situation like that, you need to. Do they want a feeding tube? Do they want a tube in their neck if they stop breathing? Do they want someone crushing their chest with CPR?

When I was talking to my patient's nurse she asked me how old I was. I told her and she was shocked. "When I was younger, I thought we were all invincible." "You are wise beyond your years to know that is not the case."

Please, go visit a hospital. If your spouse has never been to the emergency room or intensive care, take them. Show them what it is like. And then tell them what you would want them to do if you were ever the patient.