I would suggest hand exercises as well as regular use of hands in daily activity. I think this may be a mind over matter thing where the use of exercise as a modality may build his confidence in his ability to use his hands. In my opinion, just because we are OTs does not mean we cannot use exercise and strengthening. Audra Ray
--- On Mon, 1/19/09, Ron Carson <[email protected]> wrote: From: Ron Carson <[email protected]> Subject: [OTlist] An Occupation Approach to a hand patient To: [email protected] Date: Monday, January 19, 2009, 6:45 PM Evaluated a man last week who is s/p hospitalization for multi-organ failure. Basically, the man died but recovered. During the eval, the patient's primary c/o was bi-lateral hand swelling, decreased sensation, decreased gross and find motor strength/coordination. He reported that about the only thing he couldn't do was buttoning. But, he also said that "things are getting much better". I instructed him to keep doing what he was doing, use his hands as much as possible to get back to "work". I told him I would be back in one week. Today, the man's hand were minimally improved. He stated that yesterday he couldn't open a set of jumper cables and had to call his wife. She said that he was literally crying. The patient seemed frustrated at his situation, but still said things were getting better. I asked him to show me the cables that he couldn't open. So, we walked outside and he showed me the difficulty he had. Once again, I suggested that he get in his shop (he's building an ultra-light aircraft) and that he get busy using his hands. I again, said I'd be back in one week. I don't know what is wrong with this man's hands. I'm sort of torn because he is able to do so much, but is then somewhat limited. I strongly believe that if he will increase the use of his hands, they will improve. But, it seems that my suggestions were met with some skepticism. The patient's wife wanted to buy an exercise ball, the social worker, who just happened to be there, suggested hand exercises. I just sort of shook my head and reiterated that the best exercise was using his hands. Am I wrong in my approach? Not to bring up the PT ~vs~ OT thing, but the PT wrote "OT can address all the patient's needs". I always feel a double-edged sword when PT dismisses UE patients. Ron -- Ron Carson MHS, OT www.OTnow.com -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
