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Thanks for the help, Lisa. Remarkably, he is
quite functional - Ind simple self care, Ind meal prep. His main goal is
to be well enough so he can care for his wife who was recently transferred from
acute care to SNF as he is unable to care for her. My functional goals are
certainly to reduce pain and maximize functional use of his arm, as well as to
decrease the difficulty he has with self=care and home management.
Our Goals -
reduce
pain
maximize
functional use LUE
Ind donning
of coat
Ind
showering
Ind
laundry
Very LTG - be able to care for wife, assisting with
her minimal transfers and min self-care.
In spite of his pain, I was wondering about sending
him to outpatient a little sooner so that he can try ultrasound - what do you
think?
Thanks again, Donna
----- Original Message -----
Sent: Monday, February 26, 2001 5:03
PM
Subject: Re: UE treatment
HI Donna. What are your goals for this
patient? I am assuming pain control initially so that he may participate
in both rehab of his injury as well as ADL retraining. Please forward me
his goals, I will assist as able.
Lisa
I know this question will drive Ron nuts, but
I'm requesting help from those OTs who treat UEs.
I work in home care and currently have an 80
y.o. patient with a recent (2 weeks) torn rotator cuff from a fall.
Due to his age and cardiac status, he will not have this tear surgically
repaired. It was just diagnosed this week, although I certainly
suspected this diagnosis since I met this patient a week ago. He is
currently homebound, possibly for 2 weeks, due to his pain level - I will
then refer him to outpatient.
Current status - AROM - maybe 20 degrees
flexion. PROM - difficult to fully ascertain due to pain but I can get
around 45 degrees flexion and he has minimal rotation. AROM elbow
flexion is only to 45 degrees due to pain. His pain level is severe -
8/10. Please advise on appropriate treatment.
Ron, I am a well-seasoned OT. I certainly
embrace and utilize an occupation-based approach with all my patients and
certainly hope you will give me and all the other OTs who prescribe to this
listing the respect that we deserve. It is clear that you feel you are
the only one to practice pure OT, and that you envision yourself as the
ultimate OT; however, believe it or not, there are many of us out there who
are also competent, and leave our patients more capable (physically,
emotionally, psychologically) of living the life they want and fulfilling
their roles/occupations. I have found your postings over the past few
months to be very condenscending to other OTs and have been personally
insulted by you a number of times, in spite of the fact that this is my
first posting to the list and that you have never written to me
directly.
Donna
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