So today I went and shadowed in the OT department.
There are only two OT’s who work in Anuradhapura Teaching Hospital, who are both male, a bit different from the female dominated profession at home. In the morning I stayed in the department in one of the clinics the one OT holds. I saw a variety of patients ranging from patients with skin grafts, burns, infections, Rett’s syndrome and muscular dystrophy. I learned about the role the OT has measuring for pressure garments for patients’ who have had skin grafts, and their role in burn care; pressure garments, creams, tape etc. One patient I saw had suffered from an infection, firstly he had used natural remedies to help and then the inflammation continued to increase and surgery was needed for the abscess’ formed. As a result the range of movement in his wrist and hand had been severely reduced. The OT had an infra-red massage tool that also encompassed some sensory stimulation to the area. The OT talked through sensory assessments and showed me different guidelines and assessments they follow and carry out.
The one patient we saw was a 3 year old girl with Rett’s syndrome, she was developmentally delayed for a child of her age and was hypersensitive to certain stimuli. After carrying out a sensory assessment we talked about how they are hoping to build a sensory stimulation room in the hospital for the OT department. Jane, the qualified OT, who is on placement here has been helping to design this new room.
I was also given the opportunity to watch the OT fit a dynamic splint that he had made for a patient. He had measured up the dimensions the previous day and made the splint from scratch in the department and allowed me to try moulding some of the material myself. I made myself a finger splint, which was very fun! It was very interesting to see the materials being used to make the splints and how creative they were.
I was intrigued by one piece of equipment, called a hand web, I thought it was really useful for mobilisation, grip strength and general strengthening of the fingers, wrist and hand.
At break we had some traditional Sri Lankan tea and coconut biscuits and we discussed the segregation between doctors and dentists and other healthcare professions. In Sri Lanka the doctors seem to have a very large locus of control with a definite hierarchy.
In the afternoon we went to a plastic surgery clinic where one of the consultants was reviewing a variety of different patients. There are only 10 places in the whole of Sri Lanka where you can go to have plastic surgery and all surgery is free of charge.
Today in clinic I saw patients who had skin grafts, cleft lip, Charcot’s foot, diabetic patients, patients with external fixations, a baby whose ear was split into 2 on one side and patients who had suffered Viper bites and the list goes on. It was interesting to see the different skin grafts and contractures that had occurred along with patients who were having amputations and made me think about how I could manage them from a Physiotherapy perspective.
It has been a very interesting day, I have learnt a lot and have seen various new conditions/ pathologies.
This evening I have another language lesson to try and learn the names of some common conditions and pathologies that occur in Sri Lanka.