Tuesday, September 25, 2012

New OT

Another apple picking picture

We have been having some scheduling problems with Allie's occupational therapist (OT) lately.  In the span of two months, she went on vacation for two weeks without offering to make up the missed sessions, went to our old apartment once instead of our new house and blamed us for not telling her (even though I'm sure that I did), and had a colleague call one morning and abruptly cancel for her and say that she wouldn't be able to make the session up.  And then we were out of town for a week in MN.

So, instead of getting OT every week, she had 3 sessions in the span of two months.  She also wasn't very good at responding to calls or emails and there was often several days between my call or email and her response.  I was annoyed and called the office to see what we could do about switching OTs.  The manager that I spoke with assured me that the scheduling/communication issues could be resolved and the OT agreed to make up the session that she abruptly cancelled and we will have a substitute OT to make up two of the others.

On top of our scheduling problems with her, she has always had a downer attitude about Allie.  Every time Allie would get frustrated and cry, the OT would say "Oh, typical Allie... (sigh)".  I'm sorry but Allie is not a whiny kid, especially given all that we put her through.  

Jonathan had the unfortunate duty of meeting with the OT for the first time after my call to complain.  He said that she seemed annoyed and started making dismissive comments about what Allie would ultimately be capable of doing with her right hand.  We chalked this up to hurt feelings and hoped that it would be better.

I had the next session with the OT today and things were just as tense.  We spent the whole session working with Allie's left hand.  Then, the OT said to me that she doesn't think Allie will ever be able to do much more with her right hand than she does right now.  I understand wanting to lower expectations and we know that we are being incredibly optimistic that her hand will be moderately functional, but we don't expect it to be perfect.  We just want to make sure that we push Allie now while her brain is plastic so that she can ultimately have more function later, even if it isn't perfect.

The OT also said that she doesn't think that constraint therapy resulted in any functional improvement for Allie even though the "medical evaluation," as she put it, showed notable gains.  She said that it doesn't matter if Allie can move her arm so many more degrees or whatever if she doesn't use it.  I understand her point that we want Allie to use the skills that she has gained more often, but I think the point is that she now HAS the skills.  She is a little kid and of course she doesn't understand that this more difficult arm is useful because most of the things she currently does can be done with one good hand.  But I think that if we keep these skills possible for her, she is going to figure out how and when to use them.  It is like what we noticed when she started cruising: Righty became very useful and---lo and behold---she uses it to stabilize herself and transition between furniture.  She also uses her right arm to hold herself up while she plays with a toy on the ground with her left hand.

I said these things to the OT and she said that those things were all fine but Allie still only uses Righty when she "has to."  My ineloquent response: "Well, yeah, duh!"  Of course Allie is going to favor her left hand!  That doesn't mean that we shouldn't still work on the right.  As she and I were talking, Allie scooted over to her mini pink piano, pulled herself up on it, and started banging on it with both hands.  Then she grabbed onto the side of the piano with her right hand to stabilize herself while she more delicately pushed the keys with her left.  I pointed this out to the OT and she said "Yeah, Allie will use her right hand but only if she has to.  You really have to contrive a situation for her to use it."  How was this at all contrived?  To me, it seemed like a perfect example of Allie using skills that we have worked hard to cultivate through therapy.  I told her that I thought she was being incredibly dismissive of what Allie will ultimately be capable of doing and that I didn't think that was at all constructive.

There was then a long, probably two minute, silence that she broke by asking if we would like to switch OTs.  I said yes.

It will probably take a couple weeks to find a replacement and we will continue seeing this OT during the transition, but good riddance!  We are looking forward to the change.  Hopefully we get someone who can see all the potential that we see and will be as proud of her accomplishments, no matter how small.  

2 comments:

  1. Oh my gosh!!!! That is horrible! I'm so sorry. Good job staying strong and sticking your ground. I wish there were OT's that only work with hemi kids, then they would really truly understand. (Ok maybe not truly, but much better understanding) I had a similar situation with Karsen's PT. but to top it all off she had zero patience for my oldest, who is three, and would snap at him so easily. Needless to say, I fired her. Glad you guys are getting a new OT.

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  2. You need a committed OT on Team Allie. I'm with you..time for a change. The right person can make all the difference in how far she can go. Kisses to Allie. Love, Gama

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