Tuesday

I had one of the most complicated cases ever today at work. Lord have mercy! I found out that I am getting moved from the inpatient and TLC units to only do outpatient long neuropsych batteries for the time I have left at Casa Colina. I'm looking forward to the change, because it is a good opportunity to get way more involved in a case from a neuropsych perspective. Before, many of the questions I've sought to answer for cases have to do with whether a person is able to continue living at home alone or needs a higher level of care, if they're competent to make their own decisions, or if there is a progressive neurodegenerative process at work. On the inpatient unit, that's about all we have time for (I'd see 3-5 patients a day there) and specific diagnoses and long-term prognoses aren't important. At TLC, I have done more intermediate batteries to help with planning for how to work with the patient in rehab, what their strengths and weaknesses are, and what kinds of needs they'll have after discharge. But now, I'll be doing more diagnostic and prognostic work to try to really tease out what is going on with these patients by doing 8 or more hours of testing on these patients, with more consultative work with other disciplines. In many ways I'll especially miss doing my SEP cases on the inpatient unit, and I'll miss the opportunity to follow patients for a long period of time at TLC. But for the most part, this will be much more predictable and I probably won't be bringing as much work home actually!

I had what seemed, on paper, to be a pretty straightforward case today. I should know by now that when things seem like they'll be clearcut, they're likely to be anything but. As it turns out, the real issues going on with this patient have nothing to do with why she was referred for testing, and we ended up having to have her 5150d (involuntarily admitted to the psychiatric unit because she was a danger to herself). I'm completely horrified by the way in which this person was pushed through the educational and medical systems and no one ever took the time to see that she had serious, serious issues and no one ever addressed them. So many years simply wasted because her family didn't have the education to realize she needed serious help, didn't have the resources to seek out help if they had realized, and no one else was invested enough to care. I have such a massive headache this evening! But hopefully now that she is plugged in with resources, she can get some help and things will get better for her. They certainly couldn't get much worse...

But I digress...

Nanny Rebecca was back with us today! We were glad to have her back. Rebecca had a good day with her and enjoyed an outing to the park with Ramy after he came in today (needless to say, I had worked late). I found out that my friend Raquel's baby was born healthy last Friday. After 9 years of infertility treatment, the tragic death of her triplets born at 25 weeks gestation, 2 miscarriages, and the death of another baby at 19 weeks gestation, I can't think of many people who deserve the joy of a baby much more than she does.


We're looking forward to the Easter weekend ahead! We've got breakfast with the Easter Bunny and an egg hunt on Saturday.