Vampy's Weblog - Life of a Medical Officer

I was asked to observe a patient undergoing a new therapy that is available for rehabilitation of stroke patients today. It's called constraint therapy. As the name suggest, the therapy encourages the patient to use the affected limb rather than use the unaffected limb in daily life. This is achieved by constraining the unaffected limb.

The patient I saw had a stroke several years ago. Today was the 6th day of a 10-day programme. As I was observing him go through the exercises to help him gain control and use of the affected limb, I was suddenly struck by the amount of effort and concentration needed for him to achieve the most simple movements which we all take for granted. For example, how many of us would be typing on the keyboard and reaching out to grab a cup of water to drink.

That action of extending the arm, manipulating our fingers so that they have a firm grip of the cup, then withdrawing the arm back towards the mouth while still maintaining a firm grip of the cup and ensuring that the cup does not tilt and finally placing the mouth of the cup on our lips takes maybe a few seconds to accomplish.

For a stroke patient, those series of actions will take probably a couple of minutes to achieve. With each movement, the patient needs to concentrate on the task, will his muscles and nerves to fire correctly. Make fine-tuning adjustments to prevent water from spilling out, before he can have his cup of water to drink. While I can see that as the afternoon wore on, he is becoming fatigue, he refuses to give up on any of the exercises he was asked to do and was determine to improve his control.

I must also praise the physiotherapist for her amazing patience and never-ending encouragement. No matter how many times, the patient would drop the object or forget to move the affected limb in a certain way, she never once became agitated. In fact, each and every time he completes the task, she would say "Well, done!". That is the epitome of what a great health professional should aspire to be. I hope that someday I can achieve her level of patience.

Whee! I got my Wii a couple of weeks ago... (Sorry for the corniness). I manage to play some Wii in whatever spare time I have. I must say it is quite a good workout... which in my case is probably a good thing. I have been increasingly paranoid about having a heart attack or a stroke one of these days due to my lack of exercise. I know that I should probably to doing more exercise in view of the fact that in less than a year, I would have to encourage patients to exercise. How hypocritical of me if I don't exercise and yet ask the patients to exercise. I can just imagine this situation:

Me: Mr. So-and-so, you have hypertension, diabetes and high cholesterol. You are at a high risk of heart attack and stoke. To reduce the risk, you must exercise regularly say at least half hour a day for at least 3-4 times a week.
Patient: Yeah? Really? I read somewhere that you don't exercise.
Me digging a hole right there and then with my fingers

In other news, my time at the community hospital is drawing to an end. I have enjoyed myself there - the doctors and nurses are great... Most of the patients are rather cute with their little quirks. I learned a great deal from my supervisor about common issues in rehabilitation as well as from the physiotherapist.

Finally, it's about 2 weeks away from Chinese New Year. After missing 3 Chinese New Year, I must admit I'm looking forward to it this year particularly the cookies and delicacies I'll be able to eat.. Yum! My friends are coming over to my place on the 3rd day of the new year and I guess we'll be spending some time eating as well as playing Wii.