Equine-assisted Therapy

I have always associated horse riding with machismo until today, when I got a file in which the patient who suffered from autism and also Asperger's syndrome was referred for equine therapy.


In an Equine Assisted Activities program, a certified or specially trained riding instructor teaches a person with a disability how to ride a horse. However, the environment of the horse can provide more than just riding skills. The programs which offer the equine environment to people with disabilities can teach companionship, responsibility, leadership, vocational, educational skills as well as offer competition venues in the different horse disciplines. Riding a horse provides a unique and often profound recreational or leisure activity for many people. There are many sports which people who have disabilities can participate in for enhancing their lives which offer social and physical fitness as addressed in the Special Olympic programs for people with a cognitive disability. There are hundreds of programs around the world as well as many organizations dedicated to the various forms of horse riding or horse care which address many other disabilities and may not have a cognitive disability.

The student who interacts with their horse may extend this to others and to form meaningful relationships with people. Building a relationship with an animal is very rewarding in many aspects; for a person with an emotional, social or psychological disability, the trust and loyalty of an animal demonstrates to the student how important they are and then they may extend these attributes to personal relationships. Horses also help people feel in control of their situation because there is a direct correlation between action and reaction. To learn how to care for and ride a horse, a student must also be able to communicate efficiently with the horse and the instructor. In this way, riding is a very social activity, but is less daunting to people who are uncomfortable in social situations. However, the experience of riding a horse is very different. Riding helps to empower people and enables them to connect on a personal level. The sometimes unpredictable nature of animals and situations also creates a real-life environment in which students will be able to confront fears and make adjustments to situations beyond their control.

Types of Anesthesia

Usually in operative report and procedure notes, we come across terms like local anesthesia, regional anesthesia, and general anesthesia.  What is the difference between all of these?


Here's a basic look at each kind:


Local anesthesia. An anesthetic drug (which can be given as a shot, spray, or ointment) numbs only a small, specific area of the body (for example, a foot, hand, or patch of skin). With local anesthesia, a person is awake or sedated, depending on what is needed. Local anesthesia lasts for a short period of time and is often used for minor outpatient procedures (when patients come in for surgery and can go home that same day). For someone having outpatient surgery in a clinic or doctor's office (such as the dentist or dermatologist), this is probably the type of anesthetic used. The medicine used can numb the area during the procedure and for a short time afterwards to help control post-surgery discomfort.


Regional anesthesia. An anesthetic drug is injected near a cluster of nerves, numbing a larger area of the body (such as below the waist, like epidurals given to women in labor). Regional anesthesia is generally used to make a person more comfortable during and after the surgical procedure. Regional and general anesthesia are often combined.


General anesthesia. The goal is to make and keep a person completely unconscious (or "asleep") during the operation, with no awareness or memory of the surgery. General anesthesia can be given through an IV (which requires sticking a needle into a vein, usually in the arm) or by inhaling gases or vapors by breathing into a mask or tube.


source:  http://kidshealth.org/teen/your_body/medical_care/anesthesia_types.html

Parathyroid and thyroid gland

Hypothyroidism and hyperparathyroidism are one of the most common diagnoses in dictated notes.  The former is related to thyroid gland and the latter to parathyroid gland.  Now, although thyroid and parathyroid gland are similar sounding, and are endocrine glands, there functions are entirely different...

The sole purpose of the parathyroid glands is to control calcium within the blood in a very tight range between 8.5 and 10.5. In doing so, parathyroid glands also control how much calcium is in the bones, and therefore, how strong and dense the bones are. Although the parathyroid glands are intimately related to the thyroid gland anatomically, they have no related function. The thyroid gland regulates the body’s metabolism and has no effect on calcium levels while parathyroid glands regulate calcium levels and have no effect on metabolism.  More information can be had from here.

HHectic

Phew....last few months have been a little hectic.  Apart from my work, I am also doing DIFA which stands for Diploma in Indian and Foreign Accounting, at the end of which I will be eligible to also appear for IAB level 3 examination.  Also I have to appear for 4 papers in my Masters examination scheduled for next month.  All this have resulted in a mad scramble which has left me with very little time for MT diary, but I will be back next month with my MT findings...:)

Pink, blue, and white sheet

In psychiatry files, one usually comes across scenarios where it is dictated that patient was pink sheeted or blue sheeted! What exactly is the principle behind this pink sheet or blue sheet or white sheet?  I searched the web and came across Eric Tadehara's blog where he had described this in his own jocular way. The gist of which is, in case of a pink sheeted patient, the admission is involuntary and the form is filled out by doctor or any other medical professional and they are placed in residential setting for a specified number of hours.  The only difference between pink and blue is that blue sheet is filled by a law enforcement officer and white sheet is for commitment hearing and filed so that patient may be held until seen in court.

Sound alike list

I have been thinking of making a sound-alike list of late.  It will serve as a guide to newbies in this profession and also a database to those active...I have started recording them now seriously...yesterday I got one....heard "strict 9 overdose", was actually strychnine overdose.


Thank you

HELLP??

February being a 28-day month had left me with no other option, but to work both mornings and evenings.  As like always, I found a lot of words, terms, procedures, but could not blog about it immediately, anyway managed to keep a log of all of them and will try blogging about at least some of them as and when time permits.....


I got this term "HELLP syndrome" in an OB-GYN file....The acronym HELLP disguises a very serious complication, which if not diagnosed early, can prove to be quite serious.


HELLP syndrome is a group of symptoms which occur in pregnant women and stands for


H:  Hemolysis (breakage of red blood cells)
EL: Elevated liver enzymes.
LP:  Low platelet count.


HELLP syndrome is the complication arising out of preeclampsia and eclampsia.


More info about this serious condition can be had from here and here.


HELLP symptoms can also lead to misdiagnosis such as hepatitis, gallbladder disease, ITP or TTP.


Although there is no way to prevent HELLP syndrome, early prenatal care can help the care provider to find and treat the symptoms before they get out of hand...