I am wide awake preparing for an upcoming exam. The topics that I’m obliged to finish are wound physiology, burn rehabilitation, amputation etc. It’s already dawn and I’m not even halfway done. A lot of thoughts strike and bother me plus the alcohol that my room mates and I drank a few minutes ago is still penetrating deep into my veins. I’m already floating literally. I wanted to sleep but I feel guilty. I am so intoxicated. The feeling is like having a newly amputated stump showered with a bucket full of beer. How’s that sound to you? Well, that’s how my achy – breaky heart feels. And so I’ve decided to coin the concept phantom love which is defined as the sensation of love that is no longer there. Kaboom! According to Pedretti’s Occupational Therapy 6th ed., there are three stages of wound healing namely: inflammatory (which is synonymous to breaking – up in my lexicon), reparative (letting go), and scar maturation phase (moving on). Nosebleed? Me too. Hmm…what stage am I right now? In the first phase, the over – all intervention is to reduce edema by resting and protecting the involved structure (my achy breaky heart). On the next phase, neovascularization or the development of new blood supply takes place. Care must be taken not to increase the inflammatory response by overaggressive motion. I’ve reached this phase but sad to say, I did not succeed so I regressed to the first stage. The feeling is like scratching a newly formed scab and it bleeds a lot. Then finally, the scar maturation phase which is supposed to be the final chapter in the wound healing story. It usually takes 12 to 18 months. But I guess it will take me years to reach this. Perhaps moving on is the hardest part. To end this mashed potato story, I’d like to share an excerpt from the song SCARS by Papa Roach. I’m not so sure of the lyrics but the thought’s like this,“…my weakness is, that I cared too much. The scars remind us that the past is real. I tear my heart open just to feel.”

The common problems that I have observed from the patients that I have handled in the Philippine Cerebral Palsy, Inc. are the following: age – inappropriate work behaviors, fluctuating muscle tone, bilateral equinovalgus deformity, delayed hand functions, delayed cognitive skills, and ADL dependence, specifically feeding. I think I did well on the gentle passive stretching to assist relaxation and in preparation of the patient for other procedures or activities. The three patients that I have handled are diagnosed with CP spastic quadriplegia and the other one even has mild hydrocephalus which I think is fragile and is difficult to manage.

I was also given the chance to position the patients in different developmental positions such as prone – on – elbows, supported short – sitting, and weight bearing on hands and elbows. It was such a good thing to prepare myself for the upcoming actual treatment session. Although I was not able to handle the three of them for a longer period of time, I was able to make good use of the time allotted to assist and observe. I think I will be able to be more prepared for the next fieldwork, the evaluation part, because we were assigned to a specific case. At least, we can review the case background and on what specific intervention/strategies to apply.

Observing an actual OT treatment session is like putting myself one step closer to being an intern. It’s nerve wracking because I can already feel the pressure of having to not just pass my subjects but also to internalize what it is like to be a real occupational therapist. While I was visualizing myself conducting an actual treatment session, I can’t help but wonder what frames of reference and intervention strategies will use? Will I be able to extract from my memory the appropriate intervention technique to be used?