Poop

Poop.  I hate poop. And yet...poop is an integral part of my daily life. Why?

1. I am human. I have to poop. It's unfortunate, but true.
2. Pediatrics. Ah pediatrics. The kids poop. We have one who my CI explained to me (before I met him) that basically he is constantly pooping because he was a conjoined twin and his bowel was incomplete or something so he has no muscle to control it. So, what comes in comes right back out. These poor kids. It can't be any fun at all and I don't say it to be mean, but man. Poop. Yuck.
3. I think at least half of the kids I work with are in diapers. If they poop during or before therapy we have the privilege of changing it.  Poopy diapers go out in the garbage can in front of the clinic. One time we tied the diaper in a grocery sack, but there was air caught in it.  I didn't have to actually change the diaper, but I was the one to take it out and it almost didn't fit into the garbage can (it's one like you find at the park that has a top on it and openings to stick your garbage in).  Oh I was so dreading having to untie the bag and let that odor back out. I made it fit.
4. viruses and germs.  We had one mom call in today and told us that she was going to pick her son up from school because he had diarrhea. She was calling to see if she should bring him in to therapy today.  Uh...how about??? NOOOOOO!!! First, if it's a stomach bug, we don't all want to be pooping all day (see the next comment for more information on that) and second we don't want an accident.  Can I emphasize that?? We don't want an accident.  It happens. Poop happens. But let us be honest. I don't want to be cleaning it up from our gym floor. 
5. My CI is the manager of our clinic. As such, she has her own office (everyone else shares an office in the front).  It's great and dandy and all except that her office sits right next to the bathroom.  It's a small clinic, not a big deal right? Oh wait, except whoever built the building made a "minor" error and the bathroom is vented into the back office.  Every time that someone poops the smells just comes right in. Awesome. And then if you try to cover it up with spray that seeps right in too so you get a nice mix or apple cinnamon glade and poop. Wow.
6. Kids with decreased muscle tone or strength tend to have decreased tone/strength of their involuntary as well as voluntary muscles. This mean they get constipated easily.  Solution? Deep tissue massage to the large intestine.  Usually we don't reap the benefits of this in clinic (usually the poop makes it out after the end of their session), but it still makes poop a part of my daily life. 
7. Pooping in the front bathroom.  This is the patient bathroom.  I don't know if it's the kids of the parents, but a couple of times a week I will walk into the front office and the smell of poop is so strong from the patient bathroom that it fills the hallway too. Awesome.  Sometimes this comes from people actually pooping there or sometimes it is just the changing of a diaper.

The Breakdown...

Alright guys...I'm a crier. Can't deny it. But, generally, I don't cry about clinic.  I made it through our part times and the first full time without any breakdowns. Even if I was way stressed or upset, no crying.  Do not want to cry in front of people.  I finally broke. Darn it. Two very stubborn children, and an exhausted Thursday morning just pushed me over.

Child number one is an 8 year old adorable red-head who is as stubborn as the red-headed stigma would indicate.  She comes in at 8am which is just too early for her because she's never quite awake. We call her "baby jaguar".  I am not sure when, but at some point she decided she was baby jaguar and her mother is mama jaguar. Sometimes my CI also becomes mama jaguar and I have since been deemed auntie jaguar. She is a riot. She cracks me up, but can be so hard to treat.  Honestly the session with her didn't go badly, it was just exhausting. Trying to figure out how I am going to accomplish my goals for the session, get her to wake up, then cooperate, manage the time...bleh. And Thursdays are hard days cause they are our Fridays. To add to this scenario, her mom is one of the local pediatricians.  She's a really nice woman, but my relationships with the parents is really weird because...I don't really have one because my CI always goes out and talks to the them and kind of takes over the conversation, so I really don't know what this MD mom thinks of me and I don't have the opportunity to...get comfortable with her, so I want things to go well with her daughter.

Child number two is also adorable and is one of my favorites.  She is baby doll perfectly cute.  Shes got blond hair that goes to just above her shoulders and is Shirley Temple curly.  It's always perfectly styled with a bow, she is the perfect size of chubbiness- not to big, not too little- and her mother puts her in the most darling clothes.  She about 2 and an only child and she acts like it! :)  She is sweet and a good girl, not mischievous, but she knows exactly what she wants and wants to do everything her way.  Between being stubborn and being 2, she's got determined down pat. My treatment session with her was....a disaster. So frustrating. I got therapeutic stuff done and I made it through the session, but it was so disorganized, all over the place, and totally in her control and not mine.  I was so frustrated. On top of that, I have been sick for most of the time that I have been here and during that hour I was feeling especially drugged up and disconnected, you know those sudafed commercials where the person gets a cold and has the sinus pressure and their head becomes a balloon? That was me- I finished with her and had an hour break so I told my CI I was going to get out for a minute and went to the local Rite Aid to just get away for a few minutes.  Then I came back and it turns out that my CI had been taking notes on these treatment sessions and gave me feedback. She was totally nice and it was helpful, but I was already so discouraged that the last thing I wanted was feedback.  It was all constructive and there was positive feedback in there too, but I just broke down and bawled. It was so ridiculous.  She said she has only ever had one student that hasn't broken down crying while in their peds rotation (and the one that didn't cry she didn't like).  I was hoping and planning that I would be student number 2, but apparently not. And apparently pretty much everyone in peds has days that they just break down and cry.  One of the OT's the other day was talking about a treatment session with a boy and it wasn't going well and he was in timeout so she put him in the ball pit to sit for time out (sensory processing difficulties) and she said she crawled in the ball pit with him and put herself in timeout cause she was mad and it was not good.  So, there ya go.  If you want to work in peds be ready for tears, and out of control emotion.  It's intense.  Still love it- most days- but it's intense.

Funnies...

Nicole referring to a child earlier in the day who is 12 months old and is expected to have some kind of UMN/brain damage (which can't be seen on the MRI) that is causing her problems...

"Oh yeah, the baby we saw earlier, the one with the brain."

The other day I was in the hallway right next to the "gym" and I hear one of the OT's say to the child she is treating:

"You got an 'H'; h for fabulous."

Hmmm...

Today we were talking about PT and OT and how we don't like the idea that PT in lower body, OT is upper. It doesn't really make sense.  We were talking about how BOS impacts ability to perform ADL's and such and my CI says

"Right, if you just knock out my knees, I wouldn't be able to hold on to these folders."