OUT-PATIENT OT at CMC

I have delayed in writing and posting the blogs on occupational therapy in India. I’m not really sure why, other than I’ve had so many thoughts whirling around in my head that I can’t seem to organize them all. Last week I spent each day in a different unit of occupational therapy at the CMC, thus getting a broad overview of each area. I was then allowed to choose which area I wanted to be “posted” in. I spent time in the OPD ward (Out Patient Department), A2 (basically acute care for those who can pay), Q3 (acute care for those who cannot pay), Psychiatry, Rehabilitation Institute, and CHAD (Community Health and Development). I plan on taking a post for each area. Today I will attempt to tackle Out Patient OT. Disclaimer: All photos were taken with permission from patients and OT staff. No real patient names will be used.

Where to start? I guess I should start by describing the facility. The “waiting area” for both adult and pediatric OT is the same small space with a cement bench along one side. Across from the bench is the “reception” desk where Guru sits and manages business (patients, students, and staff). Once you walk into the therapy area, the pediatric clinic is a small space to the right filled with small, brightly colored treadmills, a low matt/plinth, dusty toys, and therapy balls. When patients are in, the space becomes even smaller as family members crowd around their little tykes to learn and deliver therapeutic treatment. Families play a large role in therapy as many people come from very far away to receive treatment for a month, then go home for three to six months before returning for a checkup of fine tuning of treatment. Family is expected to carry on therapy at home. The system is chaotic, but it works.

This is the view to the right as you walk in the clinic space. This is the pediatric clinic area.

An overview of the pediatric clinic space. The doorway at the top right hand corner of the photo is the "waiting room."

Little colorful treadmills!

To the left of the clinic, as you walk in, is a similar sized space for adult therapy. There is a table, plinth, and work station there. The main clinic space is also adult, but shared with older pediatric clients as well. There is one main mat table that will have four to six patients on it at any given time. The adult clinic is run on a similar system as pediatrics. The therapist will get a patient started with treatment, and while family monitors the repetitions, the therapist will go on to the next patient and get them started. The therapist will, roughly, circulate through their patients as needed.

This is the view as you look to the right after entering the clinic space. It is the adult treatment area.

Some upper extremity equipment.

This is that same clinic space from the opposite corner. The mat table you see in the background is the first thing you see when you enter the clinic space from the "waiting room."

Another view of the same area.

This is the main clinic space. The mat table there is used for both older pediatrics and adults. This is pretty much what you see when you walk into the clinic space.

This is the same clinic space from the opposite direction. The "waiting area" is the doorway in the background of this photo. 

One of the tables used for lower extremity range of motion exercise.

 There are a few small rooms towards the back and along the sides of the clinic space. The rooms are offices, classrooms, a library, electrical stimulation/documentation room, and toilet. I took a gander through the dusty library shelves and noticed Willard & Spackman, Case-Smith, and a number of other textbooks I have grown all-too familiar with. Feels like home to me.

This is the splinting room. I believe it acts as a storage room as well.

This is the little side room where electrical stimulation and documentation occurs. 

This classroom in the back also acts as a staff lunchroom. (From left to right: Paul, Donna, Paul, Elizabeth, and I do not remember the other three. I have met so many people in the last few weeks.... hard to keep them all straight)

The library.

Proof! There is the old edition Willard and Spackman!

The patients seen here have a variety of diagnoses; traumatic brain injury, amputation, some spinal cord injury, and stroke for adults. Cerebral palsy or developmental delay seems the most common diagnoses for pediatrics. I have included photos to help give a sense of the outpatient occupational therapy department. If there are any specific questions, please ask me. If I don’t know, I will certainly do my best to find out. 

This little guy was quite taken with me photographing him. How does your heart not melt?

Family has a very large role in therapy. Here is dad was helping him with dynamic sitting balance.

This little doll was spending some time standing with support from braces and a standing apparatus. 

Smiles abound! 

Mom was there to provide entertainment, encouragement and a helping hand.

An adult patient working on a time management task.

A typical view of the clinic space during working hours.

Family offering support for a stroke patient.

Alok working on some documentation. You might remember him; he is the one that found me at the Chennai bus station and guided me home.

Some patients I asked to take their photos, others asked me to take their photo. Again. And again. And again. This patient has a lower level incomplete spinal cord injury and is working on strengthening his quads with theraband.

One of the students (standing) is getting ready to take some measurements on a patient. 

Alok educating a patient, the patients family, and CMC students on proper wrapping technique for the residual limb after an amputation.

 Side note: I have updated the food post. More photos here.