Tuesday, July 27, 2010

The Board Exam Looms

I take the NPTE in a couple of days, and I am not as confident as I would like to be.  I’ve learned a lot and taken four practice exams, but each exam throws out things I haven’t studied.  I guess they can’t cover every scenario in the big review book.  I just hope these practice exams have exposed me to enough to pass the real thing.

I’ve been a little surprised at myself all along for “going public” with my dream from the beginning.  Usually, if I have a goal and I don’t know if I can accomplish it, I keep it quiet as I work toward it, so that I won’t be embarrassed if I don’t succeed, or change my mind and decide not to go for it.  This time, though, as soon as I was seized by the notion of reviving my license and going to Haiti, I put it out there.  I’m not sure why, but I think it is because the idea seemed so fitting that I saw it as a foregone conclusion.  I also wanted to pressure myself to keep at it, in case my resolve wavered.  Plus, I am getting lots of support from all of you!

So, here I am at the brink of the Big Test.  Will I pass?  I think I will, but I might not.  I have no buffer zone, as my results so far are just passing.  And if I don’t pass?  I will be seriously bummed.  But I will carry on, because Haiti needs me anyway.  And I can try again.

Wednesday, July 14, 2010

My Heroes

This patient population is a dream clientele.  They are pre-selected, by temperament, choice, and training, to be hardworking, compliant, and respectful.  They don’t complain.  They are determined to get on with their lives, whether that means returning to their posts or moving on.  These qualities, along with the fact that they were willing to sacrifice for our freedom, makes it an honor to work with them.

The sailor who was injured on his Harley was telling a comrade that the main problem he’d have getting back on his ship is pain management, because no one can be on narcotic pain meds while serving.  But he said that, from his commander to his therapist, everyone was willing to facilitate his return to duty, and that seems to be his goal.

A soldier, who lost his right leg below the knee and had severe fractures with external fixation on the left leg, had been an Army corpsman, or medic.  As for returning to duty, he told me he was “closing that chapter.”  He just signed up for classes through the GI Bill to start working towards a psychology degree, because he likes to talk and listen to people and wants to “help people who have been through what I’ve been through.”

Another young man, “Benton,” is from Belize but was injured serving in the American military.  He has an above knee amputation on the left and a large area of skin grafting on his right foot.  For him, as for many with IED injuries, the rehab for the salvaged leg will be more complex and long-term than the adjustment to the prosthesis.  Still, it is usually more functional and less energy-consuming to walk with a rehabilitated, intact limb than with a prosthesis, so that's why they work so hard to save them.

Benton charmed with his quiet manner, wide smile, and mischevious humor.  He had been a teacher, working with children from first to eighth grades, before joining the service.  He is also very determined.  When he had only done a couple of days of walking in the parallel bars with his new leg, he really, really wanted to take it with him overnight (most of the clients live in rooms in another building on the base during their rehab).  He managed to cajole his therapist to allow this, insisting that he wouldn’t wear it for too long and would be careful to note any pressure areas on his skin.  He left the PT department that day with his prosthetic limb tucked beside him in his wheelchair, the above-knee socket draped over his shoulder and a big smile on his face.

At one point when I told Benton what I was hoping to do in Haiti, he responded in his quiet Caribbean lilt, “You’ll do it.  I can see it in your face.”  Imagine, this young man encouraging me!  Benton, you’ll do it too, whatever it is.  I can see it in your heart.

The Admiral Visits

On July 1, the 5C PT department received a visit from a VIP, an admiral with an entourage that included his wife and half a dozen uniformed personnel.  The admiral was there to show his concern for injured military members, whether or not their injuries were sustained in battle.  His demeanor was equally sincere with the sailor who suffered an incomplete spinal cord injury from a rocket propelled grenade as with the one who got his foot mangled when, as he explained to the admiral, “I was T-boned on my Harley, sir.”  And if the admiral noticed this sailor’s t-shirt touting the Chicken Ranch brothel in Las Vegas, he didn’t show it, pressing a medallion in the man’s palm as he shook his hand.

Afterwards, I Googled Admiral Robert Willard, and learned from Wikipedia that he is Commander of the US Pacific Command. “He is responsible for the world’s largest fleet command, encompassing 100 million square miles and more than 170 ships and submarines, 1,300 aircraft, and 122,000 Sailors, Reservists and civilians…he is the supreme military authority for the various branches of the Armed Forces of the United States serving within its area of responsibility… only the President of the United States, who is Commander-in-Chief of the Armed Forces, and the Secretary of Defense advised by the Joint Chiefs of Staff (JCS) have greater authority.”  Well, OK, then! 

First Day at NMCSD


My first day went fine - I jumped through all the hoops to get on base, cleared through security, briefed on regulations, and photo-badged, all on time.

In Casualty Care PT, I saw several young men with unilateral and bilateral amputations.  In most cases, there is major involvement of both limbs due to the mechanism of injury.  The first person I saw was injured at the end of April in Afghanistan by an IED, resulting in bilateral trans-tibial amputations - unfortunately, a seemingly classic scenario.  He was a very nice guy.  I started by asking him about his workout (he was doing mat exercises on his own) and he just started talking - he has 3 sons, he can't wait to see them, as he hasn't since he deployed in February, and the military is working on getting his family transferred out here.  He was at Walter Reed earlier and was treated like royalty - lots of celebrity visits (military bigwigs, including General McChrystal, visited him).  His wife is with him, and he's pretty independent with a wheelchair, but is just getting started with his prostheses.  I hope to see him each day.

There's lots of new, computerized equipment that I've never seen before, and I got to observe a gait evaluation in the Gait Lab.  There are 12 cameras mounted around the ceiling perimeter of a large room, in which the volume has been calibrated.  Small reflective balls are placed over all the significant joints of the person, just like the motion capture technique you've probably seen on TV.  There are force plates in the floor that capture step forces.  The images are converted to a complex stick figure and graphs to analyze different motions.  Very cool.  Plus, this particular individual, a young woman who is a dependent of a military member (hence able to be seen at this facility) with a congenital deformity and a new prosthesis, had her 8-month-old baby girl with her who needed feeding, and guess who had open arms?  Yay, baby fix!

I'm pretty independent - there is no hand-holding or leading me around, but they welcome me to observe and ask questions.  It will be up to me to seek out opportunities, so I have to be bold and speak up!