end of week 2

Thursday 23nd of October 2008

Michael**

Thoughts and feelings in the presenting situation…

Michael is a 17 year old boy with left hemiplegia. It has been four years since his Motor vehicle accident. Michael also suffers from some memory loss due to the damage to his right side of his brain. He has left side weakness and has a foot drop on bhis left side. He is always friendly and remembered my name after only 2 days, and it took him over a year to remember Jenny’s name. He is very happy and loves hanging out with his mates. Jenny and I see him twice a week at the gym for over an hour for an intensive workout. He is very strong emotionally and his strength is improving from therapy. He also receives speech therapy aswell.

How I managed the patient…

I think because I am young I get along with Michael really well. Also I’m a girl so that helps, apparently he chooses equipment which is located near girls. I always pushed him to continue with words like ‘keep it up’ ‘almost there’. I just treat him normally, and speak completely normal. I think Michael and I get along well. We do 25 minutes of cardio on the treadmill running, watching his heart rate, which rises and falls very quickly. He then has an element of control out of two machines for the next task. On the treadmill we watch his gait and make sure he does not get more than 3 toe catches. We will stop him because he could be fatiguing and may fall.

What I did well…

I think I was very friendly, and I am just myself. He enjoys conversation and humour/jokes. I think I also prompted him when necessary to correct his motion on the machines or his technique. I used tactile response with tapping his muscles when I wanted him to correct his posture or use different muscles.

What I could have done better…

I could have asked him questions in between sets about how he is going to use the machine this time round, and what things he needs to remember.

Forward plan…

We want to organise with his dad to pick up his new orthosis to use in therapy.

Changes for next time…

Manage time a bit better, and less chatting before getting into exercises.

Overall thoughts and feelings of how today has gone…

Today was a very long day. I was involved in a group class and we had one little boy with down syndrome. He was very hard to control and was not very well behaved. That was very enhauasting but a giant learning curve, because at times you have to be strict and be a little forceful. It’s a little awkward when the mum is there, but she understood that he was being a difficult. It was very interesting watching how Jenny approached the situation, however she has worked with this boy before and this was my first time.

Strategies to improve my performance…

Don’t be afraid to have a stern voice at times to control the children. I think I just don’t want to sound mean, but towards the end of the class I was a little less nice because it was exhausting him not listening to everyone.

Questions…

I had a few questions about the little down syndrome boy and other members of the group and asked whether they were making any progress in therapy.

**Name changed