Thousands, Upon Thousands of Words

They say a picture is worth a thousand words.  Well, I have several for you today.  I also have a few hundred written words, probably.  And clinical situations involving words.  Among other things.  But where to begin?  Hmm.  I could start any number of places, really.  So, I think I'll start in the clinic for a change.

It has been up and down.  No shades of gray there.  For every patient where I feel like I know exactly what I'm doing, I get one or two that make me feel like I'm never going to be a good therapist.  I know that isn't necessarily the truth, however.  I'm not particularly efficient in documentation (I'll get there, the process is just very uncomfortable).  I am not especially creative most of the time (I have moments of brilliance).  And almost worst of all, I don't know what to do with personalities I don't mesh with.  We had some great instruction on the topic, and I know, in theory, why I don't mesh with the other party (usually). The problem is that I don't know how to work through/around it.  I have one elderly lady that will not speak to me.  No matter what I say, or how I say it, she won't speak to me.  She is perfectly sweet and friendly toward my CI, however.  I also a really hard time when a patient talks- and won't stop.  I am generally pretty good at slipping in the "let's do this exercise next... I'm sorry, what were you saying about your nephew?"  However, there have been a couple where they so dominate the conversation that I can't even slip that in there.  I don't want to be rude, but I struggle heavily with knowing how to redirect a 95 year old woman who cares more about the fact that she is getting new glasses than the fact that I am there to try and evaluate her as a fall risk.

That being said, I have some patients that I absolutely love and cannot wait to chat with- even if we don't speak the same language.  I took a tip from our cultural competency class and always address the patient, looking them in the eye, even if they need a translator and don't understand a word I am saying.  I have had some of the best conversations of the whole trip with a patient from Guatemala- mostly through his son, serving as an interpreter.

I've also seen some unusual cases in the clinic... my CI evaluated a patient for vertigo who seemed, upon further questioning, to be suffering from low blood sugar.  After nearly vomiting and passing out during a Dix-Hallpike, I questioned him further to find he hadn't eaten anything in three days.  Come to find out at the follow-up visit, a bowl of oatmeal cured his dizziness that afternoon and he had been fine since.  Not exactly therapy, but proof that we, as a profession, need to be aware of pathology originating in other realms of wellness.

Now, what have I been up to?  Oh, not much, I guess.  After going home for the wedding of some very dear friends, I spent the ensuing weekend doing a lot of nothing- watching hunting videos on Youtube, reading, writing, hanging out in coffee shops, etc.  But this past weekend, I went on an adventure.  I went to Palisades State Park (near Garretson, SD)...

And Sioux Falls!

Now, Palisades was beautiful.  Those of you who are Facebook friends with me can see the rest of the photos there, but let me tell you a little of the story.  So, I started exploring.  Of course, I thought the park was quite beautiful.  I hiked for a while before all of a sudden I hear a loud rustling behind me.  I can't quite get turned around in time before I feel something soft slam into the back of my legs.  I yelled and tried to get a better view of my assailant, only to find that my assailant wasn't an assailant at all... it was Bailey.

She was super friendly.  She had been vaccinated in Moscow, Idaho, so for a minute, I was worried about how she ended up with me on the trail.  The phone number, though, was a local one.  So, I hiked on, with my new friend loping along beside me, occasionally dashing off after a squirrel or going for a brief swim in the river, but always returning, tail wagging and asking for attention.  She proved to be a good trail guide, though.  At one point, I encountered this guy.

While I am no Trey Harrison, I was quickly able to determine this snake was not venomous.  The problem was, I wasn't sure what kind of snake it was (my first thought was kingsnake, but correct me if I'm wrong), or if it would be aggressive at all.  So, I stood for a bit, trying to decide what to do, when Bailey got impatient, ran forward, and began pawing at the snake.  He slithered off into the underbrush, leaving the trail totally clear.  Bailey turned back toward me, wagging her tail, and looking rather like she was smiling, obviously quite pleased with herself.  Onward we went. 

In the end, Bailey was with me for about an hour and a half, a good portion of which I spent walking through the campground trying to see if anyone would claim her.  No one did, so I left her at the park office.  The head guy (whatever the term is... I somehow don't think Park Ranger applies to state parks) wanted me to take her.  I would have loved to, but aside from the fact that she obviously belonged to someone, I had no place to keep her.  So, after parting ways with my new friend, I went on to Sioux Falls.

My adventures there were actually not so adventurous, probably.  I had lunch with a local celebrity (a meteorological whiz, let me tell you).  Then, I made an excursion to the South Dakota Peach Festival.  Judging by the line of cars, I would have thought this was a pretty big deal.  As it turned out, it was darn near a waste of time, unless you

      A)  Had little kids that would have been able to enjoy the countless inflatables

      B)  Came hungry, as there were tons of tantalizing food truck options

      C)  Had lots of money to spend on crafty things ranging from scarves to peach preserves

That being said, I came away with a bag of trail mix and free peach cobbler and peach ice cream.  Not a bad haul for a 45 minute excursion.

Later that afternoon, I visited Downtown Sioux Falls.  It started raining almost immediately, and I took refuge in Duluth Trading Co.  One free coffee, a few manly books, and a wide variety of items necessary for complete manliness ogled later, and I decided Wichita needs one.  I'll be starting a petition soon (complete with hashtag).  #ictneedsduluth

After the rain stopped (and after sitting in the Duluth front window with three employees and a friendly old man, watching some pour soul's Volkswagen convertible filling with water, all of us drinking coffee and discussing what a shame it was), I continued along.  There were a great many shops and restaurants I wouldn't mind re-visiting, should I return.

Next, I visited Falls Park, the highlight of the trip, I think.  It was a really neat set of waterfalls, which formerly powered the Queen Bee Mill, a key player in the commerce of a developing Sioux Falls.  There was even a restaurant, the Overlook Cafe, in the park.  It would have been a great place to grab a bite to eat, but it wasn't quite dinner.  So, on I went.

After grabbing dinner and a few grocery items, I returned to Marshall, which, I realized, I haven't posted any photos of.  So, here are a couple.



 This is a statue dedicated to Marshall's birthday...

And this is the 9/11 Memorial that gained national headlines a few years ago.  I'll let you look it up if you really want to know more.

Anyhow, that's my update.  I feel I've exhausted my words... so... until next time... La revedere.

An Update

Hello all!  It has been a little while since my last update, but part of that could be because not a whole lot of any real interest has occurred.  I still feel somewhat obliged to provide you with an update, so that you are aware I have not fallen off the face of the planet.  So, here goes.

When last I left you, I was about to go to Cottonwood Lake to try my luck at walleye fishing.  A nice lady who was walking by with her grandson told me her neighbor had caught several decent walleyes on the other end of the lake and told me how to get there.  I was about to pack up and go when I had my first bite.  And soon thereafter, lost the fish.  This game continued for some length of time- several bites, followed by lost fish, which activated the competitive streak that resides within me.  After awhile, I finally hauled in a handful of my bait-robbing adversaries- bullheads.  They eat as good as anything, so I took them home, cleaned them (with significant difficulty), and fried them up a few days later for dinner.  This, however, is almost unheard of in Minnesota.  Patients and coworkers are shocked and I might even go as far as to say disgusted to hear that I would eat bullheads.  Nearly everyone has asked me if I have ever heard of walleye, and why, if I had, I would ever eat bullheads.  Upon explaining that I love walleye but that I find nothing wrong with catfish, the locals are equally shocked upon discovering that bullheads are, in fact, merely a small species of catfish.

Speaking of patients.  I have been enjoying the caseload that I share quite a bit.  I now see maybe 3 patients a day somewhat independently- with my CI observing and offering advice here and there.  I've really started enjoying working on functional balance with elderly patients.  I was reminded why I'm doing what I am doing by one particular lady in the local retirement community that laughed at me when I told her I wanted her to stand on an Airex pad while playing catch with me ("You realize I'd have to let go of my walker, right?")  The excitement she exhibited when she was able to do so (with my CI lightly holding a gait belt) was energizing.  The next treatment, I held a can of tuna in one hand to simulate a high shelf, and suggested that my other hand, at waist height, was a countertop.  With confidence, she started moving the tuna can from shelf to countertop and back, absolutely beaming all the while.  As she left that day, she took my hand and told me I was crazy, but that she loved me and knew she was in good hands.  If I barely stumble through the rest of this rotation, that makes the whole thing for me.

I've also found that the "pretzel" exercise that our very own Mike Rogers introduced us to very early on is somewhat of a novelty- but a very highly valued one.  Same can be said for progressing 4-Way Ankle exercises with a resistance band by adding a toe curl.  I'm excited to see how the two posterior tib patients I'm seeing respond over time.  Don't worry, Doug, I'll throw the TC manip in there soon enough.  The dorsal glide has already had some results.

Away from the clinic, I rented The Force Awakens the other day.  I'd give a movie review, but the DVD drive on my laptop has apparently stopped working, so I was unable to watch it.

My latest wilderness adventure was Lake Shetek State Park, the site of a Lakota raid on a settlement near the lake.  I believe twelve settlers, including women and children, lost their lives, and the rest survived by hiding in a slough, now called Slaughter Slough.  The twelve deceased were buried in a mass grave which is now marked by a very large, though very plain monument.  The original site of the cabin at which the first lives were lost is also marked.  The foundation has sunk deep into the earth, leaving a fairly deep impression in the forestland that almost serves as monument in itself without the added historical marker.

What has been interesting to me is the number of bird species I have seen in Minnesota.  There are the expected- cormorants, a variety of ducks (teal, wigeon, wood duck, mallard), plenty of shorebirds (including a Green Heron, which I had never seen before), etc.  There are several species of flycatcher, I've seen evening grossbeak (not a species I've seen in KS), bobolink, yellow-headed blackbird, a flock of cedar waxwings, pine siskin, goldfinch, and more species of swallow than I ever realized even lived in the continental US.  What I have not seen are snakes and turtles.  I've also noted that the deer are considerably larger than what we have here.

Oh!  And note I said "here."  Like, the 316.  Wichita.  I am back.  Briefly.  I was honored to be a part of a terrific wedding of two people I care very deeply about (you know who you are).  So, that means I had to make the journey back- all 8.5 hours.  And you know what?  I wasn't even bored until the stretch between Omaha and Topeka.  Why?

Well, driving through Iowa was pretty great.  Good radio station, for starters.  Secondly, I-29 from Sioux City to Council Bluffs follows some really pretty country.  Also, there is something to be said for leaving at 6 AM.  It didn't feel like traveling ate up my whole day.

Well, anyhow, that brings you up to speed.  I return to the relative cool of SW Minnesota tomorrow (high of 77).  I look forward to bringing you an update of hopefully hauling in a nice Northern sometime soon.  That's really why I'm in Minnesota, right, to catch pike, not anything about an education or anything.

Hopefully you can detect the sarcasm in the above statement.  If not, my blog is perhaps not for you.

Until next time, God Bless, and enjoy this picture that holds no real significance.