Friday, January 27, 2012


Back to my blog home page:

Peace is something many of my patients cannot capture.

I see several reasons why people can't reach this place:
  • Pain
  • Lack of sleep
  • Psychosocial or behavioral issues
  • Impaired cognition (decreased insight/attention/high distractibility)
  • A general lack of self awareness.
  • A simply "bad day!"

It's a difficult task for each of us at times to be peaceful. It was especially so for Tom yesterday. He arrived the day I returned to work last week following a total knee replacement at the smacking young age of 93.

Most of the time we don't see total knee replacements done in the 90's unless the person is very active with good physical strength and sharp cognition.  This guy checked out out fine on all the above.

Tom came in planning to leave on day #2. However, a team meeting with him and his daughter delayed his departure because of impaired posture, balance and activity tolerance, all of which put him at risk for falling and doing more damage. When he would go from sit to stand, you could hear a chorus of crepitus throughout his body.

crepitus: a medical term to describe the grating, crackling or popping sounds and sensations experienced under the skin and joints (thanks, Wikipedia).

My dear Lizzie had been on an all night performance of byyyyy-by-by-by-byyyyyy up and down the halls of the nursing facility. Poor residents. This happens occasionally when she stays up for about 24 hours and then sleeps 24 before getting back on track.

Tom, of course, got no sleep. He was new and every sound was unfamiliar, including that of a 99 year old lady singing all night. The natural progression of not wanting to be in a place like this,  listening to noise all night, terrific knee pain and overall frustration was the inability to participate in meaningful treatment.

"I can't do a thing. I want out of here. I can't take a shower until the staples are out, and it's making me crazy!"

Plans to take him to the gym for exercise? Out.

"I'll tell you what. You want to feel clean and fresh - I'm going to get some warm, soapy water and some linens. I'll be right back."

He gave himself a great clean up, just the way he does at home. (Many seniors can't make the step over the tub to take showers later in life.) I rubbed some lotion on his back and did a little manual therapy on his neck and shoulders (full of spasm which, I'm sure contributed to his feeling "out of sorts.")  I had the ability to assess his independence in bathing and dressing, his sitting balance edge of bed, his upper body range of motion and strength as well as his memory, sequencing, and safety awareness.

During this process, he began to talk. He was from the Midwest, too. He had loved to travel and spend time outdoors. He had built his own fishing boat. He was a terrific man!

Freshly bathed and dressed, his temper had softened. He smiled. He even felt up to some exercise.  He had returned to a place of peace.

I left him feeling peaceful as well.

How lucky that we, in our service to others, help transport others past their times of turmoil and reach a personal peace that sweeps us through our day.

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