I finished my externship at Wytheville this past Tuesday. I was able to get 120 hours (I was aiming for 100) with a variety of experiences in different age groups and disorders. Although the drive was long (45 min one way), I think it was worth it for the experience and all the hours. I really liked my supervisor and got along well with her.
Here are some more stories about some of my patients.
In my other post about my externship, I mentioned the 80 year old doctor who had a stroke. He made a lot of improvement throughout the summer. When I left, he was working on some conversational speech he could use at his granddaughter’s wedding next week. He has a hard time with long words and words with several consonants in a row. In just a session or two he was able to say “speech” very clearly and made great improvement on “difficult” and “beautiful.” Some more interesting facts about him…. Although he has a house in Bluefield, WV; he’s now living with his son and daughter-in-law in Wytheville. They don’t think he can ever live alone again. However, my supervisor and I disagree. Even living with his son he has a caregiver around the clock. He can communicate and can walk. Other than difficulty speaking, his mind is working well enough for daily life skills. Because he has to have a caregiver, it seems to me that he could live just as well at home as with his son. The other more interesting bit of information is that he owns about 5 miles of property along the New River. The New River Trail actually borders his property. He and his son both have a “cabin” there. Apparently these cabins are very nice. His son just built a picnic shelter, and his shelter is being constructed (out of stone). I can’t help but wonder how much that property is worth.
The other patient I mentioned in my other post was the man who pocketed the fruit and was being treated for a swallowing problem. I really enjoyed working with him. He was very funny. During the summer he retired from his job. Now he plays golf several days a week. He says funny things like “now that I’m retarded” (instead of “retired”) and “your generosity is overwhelming me” (once I told him I wasn’t going to make him eat during our session). One time he mentioned Shoney’s, and I asked if they still had their strawberry pie. I told him I love strawberry pie, my mom has the Shoney’s recipe, and I’ve never had a piece from Shoney’s. He told me I should go get some. The next time he came he asked if I had gotten my strawberry pie. I told him I hadn’t, and then he surprised me with a piece for me and my supervisor! I thought that was very sweet of him.
Another patient I didn’t mention was there for swallowing and voice problems. To make a long story short, he had cervical neck fusion surgery that should have kept him in the hospital for 3 days. Instead he was in for 21 days and couldn’t swallow anything (even his own saliva). At some point from when he was put under anesthesia to when he woke up someone had damaged his cranial nerve which resulted in not being able to swallow and vocal fold paresis. A stomach tube was incorrectly installed which got infected. Apparently, he should have died several times. Just last week the doctor told him his vocal fold was functioning at 90%. He has eaten a hamburger several times (with great care!), and he should be getting his stomach tube removed soon. This man has a garden, and he brought my supervisor and me cucumbers and yellow squash a few times. It sure was good!
We had some new patients such as two foster brothers. One was being seen because he doesn’t speak much and the other for articulation. The boys are supposed to be going back to live with their mom in a few weeks even though it sounds like she is violating some of her rules (such as letting the boys’ father be around). I guess since the 4 year old boy has been the one making comments about the violations the social worker is giving the mom the benefit of the doubt?
I evaluated and began seeing another boy these last few weeks. He is four years and eight months old. Most of what he says is unintelligible. He is not potty trained and he doesn’t know his colors. He has been in Head Start for 2 years and will begin a third year (because his birthday is after the cutoff date for kindergarten). I don’t understand how a child can go to preschool for 2 years and not even know his colors! I wonder how much of his problems comes from his environment.
I worked with two autistic siblings. The girl is 13. She has some speech, but she mainly uses it to quote lines from movies and who knows what else. Her mom wanted her to work on pronouns. It was very hard to get her to focus and even harder trying to teach her what to do. Apparently, the mom thought the girl’s autism was a result of vaccines. When she had her second child, she didn’t get him vaccinated…and he has autism too. Situations like that make me think that there MUST be a genetic component in some autism cases. The autistic boy is about 8. He regurgitates food in his stomach. He also hits, scratches, pinches, spits, and bites people. He is basically non verbal, although we can get him to say words when looking at picture cards. He improved some when I saw him so that he didn’t get too violent with me. I didn’t work with him by himself though! He also started pool therapy for occupational therapy. We didn’t think he would do well with speech therapy before or after the pool, so we sort of combined the therapies. We went to the pool and helped him get changed and used a visual schedule to prepare him for the pool. After being in the pool, we took him back and got him ready to go. I had never seen autistic children like this before. It was fascinating in a sad sort of way.
The last patient I’ll share is about a little boy about 3 ½. He is being seen because he doesn’t speak much. Apparently, he has made progress before the summer. This child seems to need some discipline. The last few weeks when we’ve tried to get him to say his words he pouts and says, “NO!” It gets pretty annoying. I also think some of this child’s problem is his environment, especially his mother. Apparently her other 2 children (teenage or older) have been in trouble with the police. My last day we saw this boy. He had a fever, but his mom brought him in anyways. Wednesday, my first day of vacation, I got a call from my supervisor. After we did therapy with this boy, his mother took him to the hospital. He was diagnosed with Swine Flu. Because my supervisor, the occupational therapist, and I all had contact with him, the hospital wanted us to take some medicine to help prevent us from getting sick. Andrew and I drove to Wytheville Wednesday night to pick up my medicine. Thankfully I’m still healthy. Hopefully it will stay that way!
That’s just a few of the stories from my externship this summer. In the fall I should be at the elementary school down the road. That will be very convenient because it will be within walking distance. When that externship is completed, I will be graduating with my master’s! I’ll post more about the externship when the time comes.