PNF Review

I found this site this week that had a great review of PNF definitions

http://physical-therapy.advanceweb.com/Article/The-Truth-About-PNF-Techniques-1.aspx

Pica Disorder

Pica disorder is a disorder when a person eats things that are not food items, like clay, dirt, laundry starch.  This week I learned about Pica because I heard of a patient eating laundry starch, this is called Amylophagia.  This has been a long term habit and this patient craves the starch and feels like she needs it to feel better, in reality laundry starch is harmful to the kidneys and bladder.  The reasons for this behavior is still under discussion, the lack of iron, social behavior, frontal lobe problems, what ever the issue this patient was eating herself into a bad situation.

Links for more info:
http://medical-dictionary.thefreedictionary.com/amylophagia

http://www.ncbi.nlm.nih.gov/pubmed?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=20595493

http://www.webmd.com/mental-health/mental-health-pica

Death and Dying

I know work at my first job at a SNF.  I am coming up on my one year anniversary and one thing I have learned a lot about in Death and Dying.

 Today I got to work and one of the cleaning personnel.  Reported we had lost a patient during the night.  I was shocked, I was not ready for this patient to be gone.  I was just working with this patient. yesterday and now this life is gone.  This wonderful patient was a handful at times but I still grew to love and cherish this patient.  Dying is something we are all doing everyday we live, but when death  of a patient comes unexpectedly my day gets turned upside down, but yet you need to continue on treating all the patients on Your list, because they are just as important.  Finding a way to grieve for all those who have left us is not always easy to do.

This is one lesson I am still learning
Lord help me to remember each one and rejoice in the lives lived and memories we shared and all the wonderful lessons they each have taught me along the way.

ORIF

Learning that it is ok to add resistance to add/abd with an ORIF at 3 and 4 weeks . 

Exercises that are good. 

Sit to stand maintaining weight bearing status.  Have them stand for 10 sec repeat 10 times.  

Clam shells  in side lining with T-band, pillow between knees. 

In supine knees flexed with ball between knees, and t band  let them do adduction for 5 sec and than switch to abd for 5 sec. 

Downward parachute

Stimulus: Downward momentum toward a solid surface
Response: in the upper extremities: Extension of shoulders and elbows to support self
Response in the lower extremities:  Extension of hips and knees to support self.
Normal age of response: 4 months through adulthood

Source:  Dreeben p. 424

Protective in Standing

Staggering response at 15 to 18 months

Stimulus:  Loss of equilibrium
Response: Placement of lower extremities to reestablish equilibrium

Stepping strategy

Source: Dreeben p. 424

Protective Reactions in Sitting

Forward at 6 months
Lateral at 7 moths
backwards 9 months

Stimulus: Loss of equilibrium
Response: Extension of the arm to support the body and keep from falling

Source: Dreeben p. 424