15 September 2016

The Jenga Episode

"Don't give me anything easy today," H.A. said as he entered the therapy gym.  After three days since his introduction to his first prosthetic hand, he wanted a real challenge!

I gave it a quick thought and suggested the near-impossible: a game of Jenga.

H.A. is right handed.  But after his arm was amputated, the residual limb became infected.  This postponed our progress with getting him a prosthetic hand.  

But his left side was doing great after surgery . . . so we went ahead and introduced him to his first new hand, despite it not being the dominant one.

Being new to this whole upper-extremity prosthetics thing, I decided--for both our sakes--to take it slow.  We would master the application of the hand on the arm then move on to holding a spoon, followed by eating with the spoon, and maybe by the end of the week he'd be able to pick up a cup and drink some water. 
By the start of our second session, H.A. had accomplished all of those goals . . . and had even written me out two pages of text as he practiced using a pen!

Hmmm.  First rule of therapy: always have a back up plan (actually, that's the second rule . . . the first one being the all important "no free shows in therapy!").

I glanced into my OT cupboard of wonderfulness and spotted some foam blocks . . . surely they would be a challenge!

It took H.A. 30 seconds to build a little tower.  

I did a happy dance, but then thought, "Oh crap!  Now what?!?!?"(a good OT probably would have just congratulated him for a job well done, rejoiced in the victory, and pulled something miraculous from her bag of tricks . . . but I'm the best he's got!)

I found some foam rings and made him place them over some tall dowels.

Another 30 seconds later and he was looking, yet again, for the next task.

I brought him a chunky piece of sidewalk chalk, "Come over to the wall, you're going to practice writing."

Using the stump on his right side, H.A. positioned the chalk between the fingers of his prosthetic hand. In perfect cursive he wrote "H. son of A., brother of S., and the student of Madame Déborah."  AND THIS WAS WITH HIS NON-DOMINANT HAND!!!

I was at a loss . . . and beyond impressed!  

"Give me something harder," he said.

I went back to my OT cupboard and found a deluxe shape-sorter that I had inherited from the family of our most recent pediatrician . . . each side contains holes of 3 different shapes, 18 in total.  H.A. smiled at the challenge.

As he lifted a sky-blue piece that looked more like a 3D staircase than a block, I suggested that he find one of the 3 shapes on the top.  

"I thought I'd try the side," he explained.

Not wanting him to be discouraged by failure, I made the suggestion again.  He humored me, lifted a lime-green hexagon and dropped it in its proper hole.

He flashed me an Are-You-Satisfied look, and returned to the sky-blue staircase.  His first attempt to fit the piece in from the side failed.  As did his second.  Inside, I was hoping that this very first failure wouldn't result in his giving up.

Third try. 

The blue piece disappeared inside the belly of the shape-sorter.  H.A. flashed me a smile.  "Okay," he said as he stood up to leave, "Tomorrow we'll do something hard."

As he sauntered into the gym that next day, he said the words I'll never forget: "Don't give me anything easy today!"  

In those next seconds I had a silent debate with myself:

What about Jenga???
Isn't that cruel??  He has no hands!!!
He has a prosthetic hand!!
But it's on his non-dominant side!!!
But he has to do things that challenge him!!
So, I made him set the game up.  That took him all of about two minutes.

I then challenged him to a match.

H.A. had never before seen or heard of Jenga, so I explained the premise of the game: push the pieces out one-at-a-time and place the one you removed back on top.  First one to knock it over, loses.

He smiled at the challenge.  

With each move he readjusted the fingers of his hand, using the table and his thigh to reposition his grip, until he found the perfect angle.  

It was remarkable!  And I've never enjoyed losing so much!

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