Disability, Impairment, Handicap: Learning from the OTs

Some doctors have a “thing” against integrative management. Me? I love working with Occupational Therapists (which one day my baby sister hopes to be), Physiotherapists (or physio terrorists as they call themselves) and the many other allied health professionals. More about them later.

During our current theory rotation we have had quite a number of classes by Allied Health Professionals. The discussions of disability/impairment interested me immensely. Growing up with a visually impaired father and a mother whose daily work often involves working with the outcasts of society, disability was never strange to me. But these definitions opened my eyes (and mind).

The words “disability”, “impairment” and “handicap” are often used interchangeably… but they actually don’t mean the same thing.

IMPAIRMENT: loss of normal anatomical, physiological or psychological structure or function.

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The Importance of Clarity: A Story

Today is fibromyalgia awareness day. I find it quite apt that this happens the day before Mother’s Day.

For as long as I can remember, my mom has suffered from pain. She has always been particularly sensitive to noise, bright lights and abrupt touch. It was only when we were little and clumsy that it didn’t seem to bother her. An overriding maternal instinct I suppose.

I inherited my migraines from Mom. I remember trying to occupy my little sister and baby brother when I was eight and nine, because Mom was in pain and I wanted her to rest and feel better.

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First Psych Consult

At a recent community volunteer clinic, I had my first proper psych patient. I have dealt before with suicide attempts, but those were unconscious patients in casualty and thus did not present the opportunity for a consultation.

This patient came for help herself – something I though was a good sign. Her affect was blunted and she was clearly depressed. There was a positive history too.

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We See a Light

As part of Infectious Diseases, we must learn about Syndromic Management. It is not the best approach for a qualified doctor, but it is important to understand – especially in a primary health care setup.

During one of these tutorials, the doctor in charge made us close our books and asked us about our approaches to the full waiting room and the possibly accute patient.

We answered well.

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Antibiotics: So Now What?

Reuters reports that antibiotics are not useful for most sinus infections. Excessive prescription of antibiotics has lead to large-scale resistant organisms.

Okay, this I know.

But now what? Antibiotics make patients feel better. A frequent sufferer of sinusitis, I know this. So now my patients walk away from a consultation feeling that their doctor doesn’t care about their suffering. I don’t see many doctors being happy with that.

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Le Document Pour MB.ChB.III

The inspiration for this document came during my second year while studying for an end-of-block test. At the same time, the then-first years were studying for Pathology, aided by “Le Document”. Somewhere in this time period I looked at a fellow second year, threw my hands in the air rather dramatically and exclaimed,

“I wish I had a Le Document for Second Year!”

Le Document pour MB.ChB.II can be found here. It focussed mostly on holistic wellness during a tough theoretical year. Third year is a whole new ballgame, with students finally set wild in the clinical environment. Theory modules are unfortunately still a reality and at my school, third years are haunted by Neurosciences and Musculoskeletal System.

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Grouchy Smurf is Grumpy: On Globally Relevant Research

I’m a bit of a Grinch. Or a grump, or maybe just a cynic.

Anyway, I read this article about how poor dental health can lead to pneumonia, therefore you must brush your teeth twice a day and floss once a day. The research was done by the Yale University School of Medicine, so I don’t for a moment doubt its legitimacy. They were also open-minded enough to mention that the precise relationship between oral bacteria and pneumonia must still be determined.

However, I fail to see the importance of such research in the context of health in the 21st century.

The countries where the general standard of living is high enough to worry about regular teeth brushing also happen to be the countries where health care is of such quality that pneumonia need no longer be a death sentence.

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