Tag Archives: physical therapy

Last days! Or so I thought..

Tomorrow will be my last day at the hospital. Feels a bit weird actually. I have got so used to this daily routine that I don’t know what I will do after tomorrow. Actually yes I do, I will travel! But it will probably feel really weird. I have learned a lot during these 11 weeks I have been on the practical training. Maybe not the things I thought I would or should but really important things never the less. I learned how much positive complimets affect your working motivation and mood, how it is always important to be kind and patient, how it makes a world of difference if you smile or not. Of course I also learned some actual PT stuff like assessment and treatment etc but those you can learn every where! I also learned some local specialities since my teacher wanted to teach me his own method of soft tissue release and joint manipulation techniques. Then there were some acupuncture points, acupressure technique and hydrotherapy.

All in all this time was really awesome. And now it is over. Or so I thought untill last Friday when I heard that there is small possibility that I could still get accepted to this summers Traditional Chinese Medicine and culture course. My teacher promised to look into it and yesterday I got an email that said “you are in”. So my time here is not over after all! Feel even more weird.. I will have about one month time to travel and I already have my plans made for that time but after that I will come back here. And study for a month. How weird is that? It is like actually living here. If you want to read more about my future course, go here

When I got here three months ago one of my biggest disapointments was that I couldn’t get proper lessons on Chinese medicine. That kind of was the reason why I wanted to come here at the first place so now when it suddenly is possible after all, I feel like king of the world. My life is awesome. There is some small problems like I don’t have any accomondation at the moment and I might need to skip the first day because of my previous plans overlap with it, but that is small. This is kind of once in a lifetime situation.

aikataulu

part of my future schedule.

Will be nice to have actual lessons here. Even though I’m really excited about this, it is also a bit scary. In July I will be the only Finn here. I would have been a long time abroad and I already miss home a bit. Things will change again and change is scary. It is nothing I coudn’t handle but it is still scary.

Special Week

This week had many special events to offer me. I got to see total hip replacement surgery, visit assistive technology center and say goodbye to my Finish friends here.

When I heard that we can go to see the surgery this week I was a bit unsure if I should even go. I felt a bit weak still after my flu and I was afraid that I might disturb the operation by fainting or feel sick. After one day I started to feel a bit better about this possibility to experience real surgery. Of course I had some horror pictures in my head about the tools they needed to use and how disgusting noises and smells I would experience, but I wanted to go. The day of operation I felt a bit nervous, but so did the other two students that came with me.

We went to the operation floor and were told to change our clothes to the operation clothes and cover our hair and shoes. We also had to wear a mask, of course. Then we went to the operation room and one nurse told us to go to the other room to wait. We waited for more than 30 min before this nurse came back to get us back inside.

In the table there was a patient and in the room 7 to 8 other people just doing their stuff. One of them showed us the patients x-ray and it looked really bad. The head of femur was so worn out it wasn’t even round anymore. No wonder the patient has been experiencing some pain.. This person, maybe a doctor, told us what was going to happen in the surgery. He was really nice and friendly. The last person to come in was “the boss” meaning the head surgeon. He also expalined to us what the surgery was going to be and then just walked to the table and started cutting.

To be hones I felt a bit dizzy. But I think it was not because of the blood (there was not that much of it) of smells (there was not any of those either). I just needed to have a bit lover view to the surgery site. Actually that was really good thing, because when I was standing I didn’t see much because there was 3 people ll the time standing really near to the surgery area. When I lowered myself I could see under their arms.

I think the surgery really demostrated well the restrictions THR patients have after the operation. When surgeon wanted to pop the femur head out of the socet he just told one of the assistive doctors to put the leg to a certain position and the bone just popped out. Would be really interesting to see more operations because it gave such a good insight for the patients condition. In this case the surgeon showed us the femur head after sawing it off the rest of the bone and it was in a terrible condition! Even though it was really intersting to see all of that I think most surprising thing to hear was the fact that the patient was awake all the time! They only put her to spinal anesthesia or something. I don’t know if I could handle that myself..

Then the assistive technology center with some pictures:

puikot

Assistive chopstiks (some westerns would need this too..)

pelikortit

Playing cards for blind people!

mahjong

Blind mahjong

kynsileikkuri

Assistive nail clippers (I would need this sometimes..)

keittiö

Peeking mirror for wheelchair users

There were also some nice wheelchairs and mopeds we tried and one one compuret mouse that was operated by eyemovement. Impressive!

I have been travelling here with two other Finnish girl who came here a bit before I did. We have had so much fun here and we met almost every weekend. Now they both leaved. One this Sunday and other next week. It will be a bit weird without them.. I’m happy that I won’t be alone because my classmate is still here, but I think I will miss the other girls.

museo

Girlpower!

Hospital living

My classmate from Finland made a video from the Ortho clinic at hospital. If you want to see more about our surroundings go here to see it.

He has been taking a bit more photos recently, so if you are interested, you can go to see them from his blog.

Overcoming my personal obstacles

This week has been already huge for me when it comes to personal growing. This Monday we had our first lesson of Chinese medicine and of course the topic was acupuncture. Some people might know that I don’t like needles. I hate going to the blood tests and I feel sick if I watch my friends using insuline. But I will tell more about that later, first some first expressions. I had thought that we would go to some back alley clinic. Somewhere small and cosy with strange decoration. Oh no, I was wrong. We went to this huge hospital that had many floors and there was one department for Chinese medicine, just like there is a department for pediatrics for example. In this department people were sitting in (kind of) orderly rows waiting for their turn just like in a normal clinic. This is when I came to realize that Chinese medicine is treated really differently here than it is in Finland. Of course.

tch

Hospital where we have our lessons.

More about the needles then! First thing we witnessed was acupuncture for stiff nose (after flu or something). The terapist just put two needles right besides the patients NOSE. He told us that he only puts them 1-2 deep because the patient is a bit scared. This was the first time I left the room feeling dizzy and a bit sick. We were told that usually the needles will be at place for 20-30 min, 1 hour if patient has time and doesn’t have any bad symptoms from them. It just happens to be that fainting is one of the most common symptoms. Ha..

acunukke

First lesson!

We had about 30 min long lecture about Chinese medicine and acupuncture and then we got to try it. Gah! But before this we went to see another treatment. This time it was renal dysfunction and he got 14 needles. And this was the second time I left the room. But this time it was a bit easier. I think that some part of my ill feeling came from not eating dinner, sleeping really badly and smelling the moxibustion stuff in the clinic. I didn’t want to get any needles to my skin, but I was brave enough to put one through our teachers skin. It wasn’t that bad actually. It is worse to look and to get the treatment. I also think that if I have tried the treatment myself it might not be that bad either, but considering my feeling of the day, maybe it was better this way.

neulamatti

Matti is so brave!

All in all it was really interesting evening! Our teacher categorised me as a heat (like not cold) person just by feeling my pulse and looking at my tongue. I cant wait for next Monday to get our second lecture. I wonder what will the topic be then..

Monday was also my first hydrotherapy day. When I first heard that we are going to have therapy in the water I was really horrified. I don’t like water. I feel that I can’t swim that well and I’m usually always a bit afraid of the water. Also, I can’t see without my glasses.. But as I have heard my classmate talk about his classes (his hydrotherapy started two weeks earlier) I started to wait for my turn quite eagerly. Our teacher is awesome! She is really into this water therapy thing and I can see that from all she does. My first class was nice. I got actually much praises for my swimming skills (not all people can swim here like in Finland) and I learned much new and interesting stuff! This will be great! From the new stuff I think Watsu is my favourite this far.

Hydro

My awesome hydrotherapy teacher.

Honeymoon is over!

That was fast! After all the great feeling about my clinical practise last week, I had some not so good ones this week. For starters I had my first patients in the clinic. Practice patients only, they were my tutors, but the way this is done here came to me as a bit of a shock. When intern here has his/her first patients there is no teacher to help. Student is expected to do the treatment from the beginning to the end by his-/herself and if there is something they don’t know, then they discuss about it with the teacher afterwards or go to check it out by themselfs (if they are afraid of asking the teacher). This includes taking the history, observing the patient, assessment, treatment and home exercise. In finland we have the teacher standing by our side and helping every time when we don’t know something or don’t know how to do something and they can also prevent us to do any harm to the patient. I have had two of these situations now and they are highly stressful and I don’t have any confidence to my level of knowledge. There is good sides too. I’m forced to think about the situations myself and try to connect all the symptoms and see through the secondary ones to the one that is really causing everything. Still, for me this is extremely difficult and I get a huge rise of my stresslevel in these situations. Again, there is also good sides. After the second one (that went a bit better than the first one) I got a huge feeling of success because I have had some effect to the symptoms. Only with my thinking and performing some treatment. Ha!

Other PT’s sometimes ask me to do some small tasks to help them out. This is really nice! I can do some simple things I know how to perform, not only stand around and watch.

In addition there is my bedside practise. Oh, how I love the bedside. I know how to perform treatment and I feel that I learn every day something. I can be relatively independent in some of the tasks and my teacher is amazing! She is also really strict and asks me to write a lot of patient data. Which is a good thing and I learn a lot, but it takes so much time! This week I have been to the library after the clinical training every day at least for an hour and yesterday I had to wake up a bit earlier so that I had time to finish my assignments. Trying to concentrate to learn over 10 hours a day is really challenging and doesn’t work out for a long period of time. At least not for me. So when my last day on the bedside was over yesterday, I felt both sad and relieved.

If I would neet to study here for the whole 4 years I think I would have a heart attack. Or a peptic ulcer. Or a panic disorder. Or all of them.. I don’t cope well with stress.

Even thought this week has been.. challenging.. I think I’m still learning a lot and I’m still enjoying my time here.

SOAP and vinyle gloves

If someone was envious about our first two weeks, there is need for it anymore. My first week was quite busy. Usualy I was walking home after training day about 5.15-5.40 PM. After dinner I went to library to write some small assignements to one of my clinical instructors (yesterday I was there a bit less than 2 hours) who wanted to have them printed. I’ll be home around 7-8 PM and then I’ll go trough my notes if there is still something my teacher has asked me to find out. Some food, shower and to bed. It hasn’t even crossed my mind to go wander around the city or plan some travelling. Today I feel that I have started to adapt to the enviroment. I’m not that tired or hungry after hospital hours.

kyltti2

One of our departments.

I think that my favourite part at the moment is the bedside therapy. Maybe because it is a bit familiar to me beforehand. Still there is lots of differences. Here we use vinyle gloves every time when we see a patient and we wash hands after every patient too. It feels that it is more important here to wash hands after seeing the patient than before seeing them. Therapist is not the only one who is taking care of the exercises, because there is always a family member or a caregiver, so it is their responsibility to see that the exercise is done. That means that progress is faster. Because of the caregiver we can also stop the therapy when patient is able to ambulate intependently (even though walking might not be that good). There will always be someone to take care of them. Therapist will write initial notes and daily notes of patients. I think the daily note aka SOAP is much better than our writing down things. This is because in soap there is always progression and a plan.

In the clinic I have been a bit of confused. Everything seems so different. Thay use much modalitys here. First there is electricity or something similar combinet to heat packs to save time. Then maybe some manual therapy and short exercise teachng and then some more modalitys like ultra or traction. To understand why, you need to know a bit about the politics behind the health enviroment here. There is a common healt insurance that is really cheap and everybody can afford it. This insurance pays for some health care things you need to have, for example physical therapy. So the insurance pays the hospital to treat patients but the amount of money is not that much. Hospital wants to have enought money to pay all the salaries so they insist that terapists see many patients a day. It can be as much as 40 patients in one day. Because of this demand therapist may use only modalitys to treat some patients and then they take those who seem motivated enough to make some exercises. It is recognised that this is not as effective as manual therapy or exercise would be but there is just not enough time.

terapiatila

A therapy room. All the therapist will be here at the same time.

After first week I feel that studying in Finland is really lazy. Not that we don’t have much to study about, but we are not expected to know that much even after the courses. I feel that teachers hope that we will mainly learn in the practice periods. Still, when I was in my first practice period, I wasn’t expected to know much. I wasn’t even expected to find uot that much new stuff. Here, if I don’t know something teacher askes me to find out for next day. One time when I didn’t remember one abbreviation that teacher had told me the day before, she looked me a bit funny and said: “but I told you that yesterday.” More demandin enviroment suits me well. I’m a lazy person and if I feel that I can survive without making much effort I wont make any. Here I feel that if I want to do well, I need to make some effort and it feels great. Usually interns here are fourth year students so they do have more knowledge, but I think it is nice to be expected to know something. Learning is facinating when the enviroment is good. Even though my teachers seem to be quite strict and demanding they are also really nice and they give good feedback.

Any other things in my life at the moment? Nope. Haven’t had time..

kirjat

Study study study!

Ears full of Mandarin

Today it begun! My first real clinical practice day! I can admit, I was a bit nervous. My boyfriend will probably roll his eyes for this, because he needed to call me from Japan in the middle of the night because I was panicing. Just a bit.. Well, lets be honest, I might not have slept all night. In other hand, I must have slept some, othervise it wouldn’t have been possible to wake up so many times. I didn’t feel like the sharpest tool in the box when I started my walk forward the hospital in the morning.

kyltti

Our hospital!

sairaala

And the actual hospital too! That is the white building in the center of the pic.

Luckily just few meters before hospital door I met my good friend David (one of those local students who was in Finland last fall). He showed me where to change my clothes and kept me company for some day. Then other of my saviours arrived! James is one of the research students and he was my life line today.

We went to meet the first one of my six clinical advisors or teachers as they seem to call them here. My first expression was a bit shocked since this guy didn’t greet me, didn’t talk to me and as far as I could tell he didn’t even look at me. Just told James to show me the places. I was a bit confused and a bit scared. Would it be like this all the time? I am a person too you know.. But after the first four hours my impression was totally flipped. My teacher seemed like a really serious guy, but near the end he was smiling more and more all the time. Even thought he spoke only in Mandarin and James worked as a translater he started to aske me questions and I even got to do something small in my first hours there. I was told that since they usually have not that busy hour just before lunch, I can just tell them what I want to learn and they will provide me with lesson. My teacher also told me that my posture tells him that I might have some hip problems (and I do, my legs are not even) and that he likes to combine chinese medicine to the western way. This is a gold mine I tell you!

My first four hours were at orthopedical practice. It was a big room, full of tables and busy with physical therapists. One therapist had couple of patients at the same time and they used a lot of modalities like electricity and ultrasound. There were tables for cervical and lumbar tractio machines where patients were just put to the machine and then the therapist went to treat other patients while machine did the tractio. There were one other intern and some second year students as well. It was really nice to talk with other students and think about some problems we were given. I liked the athmosphere because it felt like people were discussing about treatments rather than just given one right solution from the teacher. James also praised my skills all the time, so what there is not to like??

sairaalanikkuna

View from the hospital window.

Other four hours were at orthopedic bedside. I felt familiar since my first clinical practice was at same kind of department in Finland. It was nice to notice that I had really learned something from my first training period and I had some selfconfidence about the treatments. I liked Matti’s teacher (mine had a meeting and wasn’t there today). She was really good at explaning everything and she provided enought info beforehand about conditions we didn’t know before.

In bedside department we discovered some unique features. All the patients we saw today had either a familymember or other caretaker at their bedside to take care of them sonce nurses didn’t have time for all of the patients all the time. And those familymembers really seemed to almost live there too! Well ofcourse it is a bit different here since they have different customs of taking care of parents and family. But I liked the feeling about it. Finland could use something like that..  Therapist used a lot of time to educate those familymembers about their relatives condition since they were the ones that were going to take care of them. They seemed to take it really seriously too. Two of them were taking pictures with their phones when the terapist showed some exercise stuff or how to for example sit down with a full hip replacement.

nohevat

Nohevat.

What else.. All the info we saw about the patients were on paper. Thay had one file per a patient and everything was put there. I don’t even know if they have files on computer. We also had to use masks all the time when we were with patients. This was more strict at the bedside than at the other department. Before this day we were also told that we should put neat clothes on (some local students even wear suits to make a good expression when they visit hospital), have shoes that don’t show toes (no sandals!) and we were given a white jackets to wear. I feel like a doctor when I’m wearing those! Our days are 9 hours long because between our two 4 hour periods we have 1 hour lunch brake that is not included to the hour count. There is no other breaks than that. So 4 hours straight without a break is a rough work I tell you.

All in all, I’m really happy about my placement at the moment. I have no doubt that this will be challenging couple of months, but it will be worth it. Even though would be easier if I could speak chinese. Today only one of the patients spoke English with me..

First ending

This first two weeks has been amazing. We have had a lot of time to get used to the country and these habits here. This far we have only had some lessons at university and next Monday our actual clinical training begins. It is exciting and at the same time a bit sad. We have met many students here and some teachers as well and all of them have been really friendly and nice to us. It is sad to think that some of those I have met last time now. It makes me think about the time when I will leave here and see all of this last time. But maybe this is not a time for that!

In these two weeks I have learned some new skills! This week we tried pilates torture machine. It might have had another name too, but I don’t remember it at the moment. It was actually really interesting machine and I started to think how could I make on of those for myself. It is funny how much different exercise machines people have made and there is no end to it..

pilates

Using the torture machine.

pilates2

Actually this wasn’t that bad..

pilates3

It was even slightly fun!

We also tried some gyrokinesis. It seems quite okay. We only had one lesson so I cant say much about it, but it seemed interesting and worth trying some more. That also has some kind of a torture machine but we didn’t see that one. In addition to these we have dug into our brains trying to solve some case assignments and I already opened my Magee to check out couple of things. (Magee is a really heavy book about musculosceletal assessment.)

häkkyrä

One can measure muscle strenght with this “häkkyrä”. I forgot the name..

Our Chinese improves all the time. I get small learning experiences almost every day. I still have no idea what these people are talking about..

chinese

Trying to learn new words. This is difficult because locals know their marks better and writing something we will understand takes some time usually.

I have also learned that I get really tired if I try to go out every day and do something awsome. But I get really bored if I just sit in front of my computer. Maybe I need to learn to do something a bit less awesome but still active. I guess I will be in best shape of my life when I leave here. I have decided that in the end of the exchange period I will run these stairs up. 😀 I have improved really well these two weeks I have stamped those stairs. Every. Day.

portaat2

Small portion of my everyday stairs. Okay, maybe half of them if I go up only once.