Whenever the rainbow appears in the clouds, I will see it and remember the everlasting covenant between God and all living creatures of every kind on the earth." Genesis 9:13

Wednesday, July 18, 2007


Today was my OT eval. The one in which I am the patient, not the professional. It's not done yet, but the worst is, I think. It was hard, mainly because it is hard to have a stranger with expertise in your field watching you and not feel you might be judged (even though she is not there to say anything about my clinical skills she is obviously watching them).

She made some good recommendations just initially, mainly things the manager can do to facilitate communication, education, etc. It was so good to have someone substantiate what was a hotly contended statement I made in the spring, that on very hot days it was dangerous for me to be outside and my time out needs to be minimal. Can I walk to my car? Yes. But every trip, every minute during the day I'm out adds up, and I become sick, shaky, dizzy, and exhausted. Just a little too much heat and I'll have definite lithium toxicity signs. Not true for everyone, not even the way it used to be for me, but after the toxicity my body just seems to have a built in safety system that triggers flushing of lithium as soon as the levels go up a bit.

It was hard listening to the manager explain how my assistant gets angry and feels like I'm expecting "special treatment". I'd love to know how. All of us have flex time. It's the nature of the work. I do expect my effeciency requirements to be reduced. I have cognitive impairments so that seems fair. Beyond that, I do my entire caseload, every single day. I do a large proportion of our administrative stuff, like screens, ordering equipment, etc. I am not very organized. I make paperwork errors more often than I should, but very rarely in a way that really impacts her. She hates sharing desk space with me because she doesn't want any of my stuff out, and it bothers her when my inbox contains things other than paper. But it is my inbox which she doesn't get into so I don't really care. She tries to put away my things, especially my stressball frog with funny eyes, but I have learned to just get them right back out. I probably would feel sorry for her and try harder (and I did when our desk was smaller), but she keeps pictures of her boyfriend and family out in a way that means I sure couldn't put pictures up if I wanted, and frankly her boyfriend scares me a bit. Not him, but the camera angle. I think it's supposed to make him look interesting and exotic or something, but to me it just looks slightly scary because he seems disportionately large, which I'm sure he isn't really. So I figure we can trade creepy frog for bad photography.

This does however leave me questioning how much I do leave her to compensate or expect her to? Or if I leave that impression somehow. I think some of this goes back to this patient who used to get kind of agitated with afternoon treatments. Another assistant noticed this and suggested he be treated in the morning. I was not there in the morning because I was in another building, so I did ask she treat this gentleman. It had nothing to do with me at all, other than I wasn't fulltime in the building.

I was finally able to point out that nobody ever asks me about my illness. I'm not sure the people I'm working with completely understand that I know my illness and myself very well and that if you ask me why I am doing something I may be able to answer, and if it's unintentional and needs stopped I usually can. I can control 99% of my behaviors a majority of the time, it's just I am not aware of all of them.

I just wish I could pour the contents of my head out and let them try to really understand. The OTR said the same thing everyone else who ever has evaluated me has said, that I have some amazing skills in unexpected areas. Obviously I also have amazing deficits in others. I understand perfectly why it seems so discordant to people that I have trouble remembering to do routine paperwork sometimes, but am totally able to remember all the treatment codes for each person at the end of the day if I don't write as I go which I generally do. I can remember incredible amounts of what I read. I used to have a nearly photographic memory, so this is a decline, but I still can accurately give most patient's doctor, medical history, etc. as long as I've treated them once. Yet I have trouble remember a lot of verbal stuff.

I need to turn off now; more later I am sure.

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