WEBVTT 00:00.000 --> 00:30.000 position:50% align:top line:0% *This machine-generated transcript may have errors. If remediation or a manually-generated transcript is needed, please contact NLM Support at https://support.nlm.nih.gov.* 00:26.340 --> 00:29.150 so you have Hansen's 00:29.150 --> 00:29.900 disease. 00:30.540 --> 00:33.010 Even though you may have been ill for some time, 00:33.010 --> 00:35.470 we know that being definitely diagnosed with this 00:35.470 --> 00:38.060 disease has probably been a shock to you 00:38.840 --> 00:39.510 by now. 00:39.510 --> 00:40.560 In addition to shock, 00:40.560 --> 00:43.360 you may be experiencing other emotions as well. 00:43.740 --> 00:45.160 Fear and uncertainty, 00:45.370 --> 00:46.850 dread and dismay. 00:46.860 --> 00:49.400 Or maybe you're just plain scared and angry. 00:49.940 --> 00:52.290 While such feelings are quite normal under the 00:52.290 --> 00:53.210 circumstances, 00:53.210 --> 00:56.200 we'd like to relieve your mind as much as we can. 00:56.210 --> 00:57.350 The best way to do that, 00:57.350 --> 00:57.820 we think, 00:57.820 --> 01:00.270 is by giving you accurate facts and 01:00.270 --> 01:02.570 information about Hansen's disease 01:03.140 --> 01:04.420 and through television, 01:04.420 --> 01:07.080 we'd like to introduce you to five of Carville's 01:07.090 --> 01:09.690 staff members who can give you accurate 01:09.690 --> 01:11.560 facts and information. 01:11.940 --> 01:14.580 We've asked the staff members representing the 01:14.580 --> 01:17.580 clinical and rehabilitation branches to 01:17.580 --> 01:20.190 speak to you briefly on their area of 01:20.190 --> 01:23.050 specialty and how it may relate to you. 01:24.140 --> 01:24.460 First, 01:24.460 --> 01:27.160 we would like for you to meet Dr Robert Jacobsen 01:27.740 --> 01:29.350 as chief of the clinical branch. 01:29.350 --> 01:29.660 Dr. 01:29.660 --> 01:32.610 Jacobson directs our medical staff of doctors and 01:32.620 --> 01:33.220 nurses. 01:37.540 --> 01:40.520 I am pleased to have this opportunity to welcome you to 01:40.520 --> 01:42.880 Carville and to talk to you today on 01:42.880 --> 01:44.790 videotape about your illness. 01:45.310 --> 01:47.890 I believe that what I tell you will answer most of your 01:47.890 --> 01:48.610 questions. 01:48.620 --> 01:49.460 But if not, 01:49.840 --> 01:52.450 please don't hesitate to ask your doctor about 01:52.460 --> 01:54.060 anything that concerns you. 01:54.540 --> 01:57.460 I am convinced that the more you know about your disease, 01:57.460 --> 01:59.460 the more smoothly treatment will go 02:00.820 --> 02:00.960 now. 02:00.960 --> 02:03.360 Hansen's disease is an infection, 02:03.360 --> 02:04.890 which can involve the skin, 02:04.970 --> 02:05.700 the nerves, 02:05.710 --> 02:08.260 the eyes and the nose and throat. 02:08.730 --> 02:11.320 Mild cases referred to as tubercular oId will 02:11.320 --> 02:13.760 involve only a small area of the skin 02:14.140 --> 02:15.470 and one or two nerves, 02:15.480 --> 02:18.220 while more severe types called I'm Orpheus and the 02:18.220 --> 02:21.040 prominence may involve most of the skin and 02:21.040 --> 02:21.760 many nerves, 02:21.760 --> 02:23.010 as well as the eyes, 02:23.020 --> 02:24.160 nose and throat. 02:25.340 --> 02:27.320 It is caused by a bacteria, 02:27.330 --> 02:29.510 which is known as mycobacterium leprae, 02:30.140 --> 02:32.550 which in many ways is like the one that causes 02:32.550 --> 02:33.520 tuberculosis. 02:34.340 --> 02:36.430 Because the disease involves nerves, 02:36.430 --> 02:39.150 it can lead to loss of feeling or numbness in some 02:39.150 --> 02:41.760 areas or weakness in the hands, 02:41.770 --> 02:43.060 feet or face. 02:43.740 --> 02:45.810 Some of you will already have these. 02:45.810 --> 02:48.160 When your disease is diagnosed, 02:48.170 --> 02:50.920 we can help you adjust to it and often at 02:50.920 --> 02:53.310 least partly correct any weakness with 02:53.310 --> 02:53.960 surgery. 02:54.840 --> 02:57.390 Those of you who have no significant weakness or 02:57.390 --> 03:00.000 numbness have an excellent chance of avoiding these 03:00.000 --> 03:00.690 problems. 03:00.920 --> 03:03.590 If you faithfully follow your doctor's directions 03:03.590 --> 03:06.590 regarding treatment while you are 03:06.590 --> 03:07.620 here at Kerrville, 03:07.630 --> 03:08.070 you will, 03:08.070 --> 03:08.580 of course, 03:08.580 --> 03:11.370 see many patients who have severe deformities or 03:11.370 --> 03:13.490 blindness in most of these. 03:13.490 --> 03:15.130 This occurred many years ago, 03:15.130 --> 03:17.810 before we had so many effective medicines to 03:17.810 --> 03:20.740 manage this disease and therefore probably 03:20.740 --> 03:22.360 would not have occurred today. 03:22.940 --> 03:25.830 In a few of these things are the results of not taking 03:25.830 --> 03:28.550 treatment as it was prescribed and could have been 03:28.550 --> 03:31.180 avoided had they followed their doctor's advice. 03:31.640 --> 03:34.430 It is very unlikely that any of you will end 03:34.430 --> 03:36.000 up with severe problems. 03:36.740 --> 03:39.720 Treatment will usually be with a drug we call depth sonar 03:39.720 --> 03:41.610 DDS although some of you, 03:41.610 --> 03:42.710 for various reasons, 03:42.710 --> 03:45.590 may be advised to take other medicines or more 03:45.590 --> 03:46.460 than one medicine. 03:46.840 --> 03:49.560 Your doctor will always carefully explain the 03:49.560 --> 03:52.540 reason for this to you and ask that you sign a 03:52.540 --> 03:55.270 consent giving your permission for him to prescribe 03:55.270 --> 03:56.670 these for your case. 03:57.540 --> 04:00.460 Those of you with mild disease may need to take treatment 04:00.470 --> 04:01.730 only a few years, 04:01.910 --> 04:04.710 but those of you with severe disease will need to 04:04.710 --> 04:06.060 stay on it for life. 04:06.540 --> 04:08.900 This is necessary because we know that a 04:08.900 --> 04:11.620 few living bacteria may still 04:11.620 --> 04:14.250 remain hidden away in nerves or elsewhere. 04:15.240 --> 04:17.820 Taking medicine for life will then protect 04:17.820 --> 04:20.720 you from the disease ever becoming active 04:20.720 --> 04:21.060 again. 04:22.040 --> 04:22.780 Periodically, 04:22.780 --> 04:25.470 we will check the effectiveness of your medicines and 04:25.470 --> 04:27.850 treatment by routine tests such as skin 04:27.850 --> 04:29.960 smears or skin biopsies. 04:30.740 --> 04:33.410 All of the drugs we prescribe are very safe, 04:33.530 --> 04:35.260 and you can take any of them at home. 04:35.820 --> 04:38.600 Those of you taking an investigational drug may 04:38.600 --> 04:41.450 have to return every 2 to 6 months for 04:41.450 --> 04:41.990 follow up. 04:42.000 --> 04:42.550 However, 04:43.140 --> 04:45.330 even if this is not the necessary, 04:45.360 --> 04:47.980 any of you with more extensive disease may 04:47.980 --> 04:50.410 benefit from returning here every year or 04:50.410 --> 04:53.380 two for a brief visit to let us evaluate 04:53.380 --> 04:55.160 how treatment is progressing. 04:56.040 --> 04:58.850 How long this your first visit here will last 04:58.850 --> 05:01.400 depends very much on how many problems you 05:01.400 --> 05:01.940 have, 05:02.010 --> 05:04.650 but usually 1 to 2 weeks is sufficient. 05:06.740 --> 05:09.450 I am sure many of you worry about where you got your 05:09.450 --> 05:10.160 disease. 05:10.540 --> 05:11.490 For most of you, 05:11.570 --> 05:13.060 it will never be known. 05:13.540 --> 05:14.280 It probably, 05:14.280 --> 05:14.720 however, 05:14.720 --> 05:17.680 resulted from unknown contact with another patient 05:17.680 --> 05:18.760 several years ago. 05:19.320 --> 05:22.180 The reason for this long time between exposure and 05:22.180 --> 05:25.090 appearance of the disease is that the bacteria that cause 05:25.090 --> 05:26.490 it grow very slowly. 05:27.340 --> 05:29.460 The numbers of your family 05:30.040 --> 05:32.630 have less than one chance in 10 of 05:32.630 --> 05:34.410 also developing the disease, 05:34.420 --> 05:35.720 and even if they do, 05:35.720 --> 05:37.690 they may not have gotten it from you, 05:37.700 --> 05:40.550 but from the same contact that gave 05:40.550 --> 05:41.950 you your disease. 05:42.340 --> 05:44.700 If you take your treatment regularly, 05:44.710 --> 05:47.210 your disease will become non contagious very 05:47.210 --> 05:49.840 quickly and will stay that way as long as you 05:49.840 --> 05:52.360 continue the treatment as prescribed by your 05:52.360 --> 05:52.960 doctor. 05:53.640 --> 05:55.560 Because your family has been exposed. 05:55.560 --> 05:56.260 However, 05:56.320 --> 05:58.610 they should be checked by your local doctor 05:58.610 --> 06:01.270 or the doctor here at Kerrville once or 06:01.270 --> 06:04.160 twice a year for at least five years and 06:04.160 --> 06:04.830 sooner. 06:04.900 --> 06:07.000 If any unusual skin changes, 06:07.010 --> 06:09.450 numbness or muscle weakness occurs 06:10.140 --> 06:11.150 when you leave here, 06:11.150 --> 06:14.030 you should be able to lead a completely normal life, 06:14.040 --> 06:16.630 except for any limitations that numbness 06:16.640 --> 06:19.570 or weakness you already have may impose on 06:19.570 --> 06:19.860 you. 06:20.340 --> 06:21.750 You can live with your family, 06:22.140 --> 06:24.970 work at your usual job and associate with 06:24.970 --> 06:26.960 your friends just as you always have. 06:27.340 --> 06:28.500 You can in fact, 06:28.500 --> 06:30.670 expect to have a normal lifespan, 06:30.670 --> 06:33.650 since this disease has no significant effect on 06:33.650 --> 06:35.160 how long you will live. 06:36.040 --> 06:36.510 Finally, 06:36.510 --> 06:39.440 there are a few things that you should keep in mind 06:39.490 --> 06:40.660 when you leave. 06:42.340 --> 06:43.290 First of all, 06:43.300 --> 06:46.230 if you have any areas of numbness that might be 06:46.230 --> 06:48.680 injured in the course of your normal daily 06:48.680 --> 06:49.610 activities, 06:49.850 --> 06:52.770 learn the various ways you can protect them while 06:52.770 --> 06:55.420 you are here and put into practice what you have 06:55.420 --> 06:56.760 learned When you get home, 06:57.240 --> 06:58.100 your doctor, 06:58.110 --> 07:01.000 occupational therapy and others will be glad to help 07:01.000 --> 07:01.830 you with this. 07:02.440 --> 07:04.280 If you do develop any injury, 07:04.290 --> 07:06.360 see that it is promptly cared for. 07:07.100 --> 07:07.870 Secondly, 07:07.880 --> 07:10.650 some of you will later get what we call reactions. 07:10.880 --> 07:13.870 Your doctor will talk to you in more detail about this 07:13.870 --> 07:15.330 and advise you what to do. 07:15.590 --> 07:16.370 But briefly, 07:16.370 --> 07:19.110 this usually appears with fever and 07:19.110 --> 07:21.980 tender red bumps on the skin or swelling of your 07:21.980 --> 07:23.360 old skin spots, 07:24.040 --> 07:26.980 pains and some of your nerves aches in your joints and so 07:26.980 --> 07:28.360 on may also occur. 07:29.140 --> 07:31.930 It is very important that you see your doctor at 07:31.930 --> 07:32.300 once. 07:32.300 --> 07:33.380 If this should happen, 07:33.690 --> 07:36.050 since it can be treated and in this way, 07:36.050 --> 07:38.960 damage to your nerves and skin can be reduced or 07:38.960 --> 07:40.260 avoided entirely. 07:41.040 --> 07:43.620 In some cases where reactions last a long 07:43.620 --> 07:44.200 time, 07:44.270 --> 07:46.550 we may advise you to take one of our 07:46.550 --> 07:48.960 investigational medicines to control it. 07:49.740 --> 07:50.330 The problem, 07:50.330 --> 07:51.020 by the way, 07:51.020 --> 07:53.450 is not caused by any of your medicines, 07:53.460 --> 07:56.140 but instead it is the result of either a 07:56.140 --> 07:59.050 kind of allergy to the products of the bacteria being 07:59.060 --> 08:01.950 killed by the medicine or to an improvement in 08:01.950 --> 08:03.860 your immunity with treatment. 08:05.040 --> 08:05.730 Thirdly, 08:05.740 --> 08:08.570 although there are no major limitations on 08:08.570 --> 08:09.410 your activity, 08:09.410 --> 08:12.400 you should avoid excessive exertion or emotional 08:12.400 --> 08:14.240 stress as far as possible, 08:14.520 --> 08:17.130 since these may sometimes lead to the reactive 08:17.130 --> 08:19.050 episodes I have just described. 08:19.440 --> 08:21.660 Get plenty of rest and eat properly. 08:22.540 --> 08:23.260 Lastly, 08:23.270 --> 08:25.910 always take your medicines as prescribed. 08:26.200 --> 08:29.150 You can only hurt yourself by missing doses of 08:29.150 --> 08:31.160 the medicine again. 08:31.540 --> 08:33.700 Don't be afraid to ask questions. 08:33.830 --> 08:36.550 We're all here to help you in any way we can. 08:36.940 --> 08:37.450 Thank you. 08:43.140 --> 08:43.450 Next. 08:43.450 --> 08:45.530 We would like for you to meet Sister Merida, 08:45.590 --> 08:47.550 chief of the pharmacy department. 08:50.340 --> 08:52.250 This is your pharmacy, 08:52.280 --> 08:55.230 and I would like to familiarize you with the pharmacy 08:55.230 --> 08:55.880 service. 08:55.890 --> 08:57.560 You'll receive well cardio. 08:58.540 --> 09:01.450 The most important medication used in this hospital 09:01.840 --> 09:03.590 are the anti leprosy drugs. 09:04.540 --> 09:07.280 There are several types of medicine available for the 09:07.280 --> 09:08.950 treatment of hands and disease. 09:09.340 --> 09:12.280 You may be put on one or a combination 09:12.280 --> 09:15.060 of some of this medication as 09:15.060 --> 09:17.130 your place on this medicine. 09:17.140 --> 09:19.940 The effect of each will be explained to 09:19.940 --> 09:20.260 you. 09:20.940 --> 09:22.620 It is very important, 09:22.630 --> 09:24.640 and I cannot stress enough the word 09:24.760 --> 09:27.530 important that you follow your doctor's 09:27.530 --> 09:29.260 order regarding your treatment. 09:29.940 --> 09:32.350 This includes your compliance with drug 09:32.350 --> 09:33.060 therapy. 09:33.940 --> 09:36.750 The pharmacy is talked in such a way as to 09:36.750 --> 09:38.950 meet any kind of therapy you might need. 09:39.440 --> 09:41.660 Like in the course of your stay at Carville, 09:42.440 --> 09:44.700 the doctors treat the whole person 09:45.540 --> 09:48.530 so you could be placed on additional medication 09:48.530 --> 09:49.190 if needed. 09:49.720 --> 09:52.120 An example of that will be if you're a cardiac, 09:52.180 --> 09:55.120 you'll be placed on medication for your 09:55.120 --> 09:55.590 heart. 09:55.600 --> 09:56.770 And if you're a diabetic, 09:56.770 --> 09:58.650 you'll be placed on medication for your 09:59.240 --> 10:00.050 diabetes. 10:00.940 --> 10:03.800 The role and the responsibility of the pharmacy 10:03.800 --> 10:06.330 personnel is to counsel the 10:06.330 --> 10:06.870 patient. 10:06.880 --> 10:09.200 As to the safe and effective use of 10:09.210 --> 10:10.050 medication. 10:10.940 --> 10:13.850 Communication is a tool that we will use. 10:15.240 --> 10:18.030 We have by the pharmacy window a poster 10:18.030 --> 10:20.740 which reads before you leave. 10:20.750 --> 10:23.640 Please be sure you understand all directions 10:23.650 --> 10:25.760 on how to take your medication 10:26.940 --> 10:29.280 to better understand your doctor prescription 10:29.410 --> 10:31.920 read and follow the instructions on the 10:31.920 --> 10:34.160 label of your medication containers. 10:35.640 --> 10:38.260 They will tell you exactly when and 10:38.260 --> 10:39.870 how to take them, 10:39.880 --> 10:41.660 and they are properly labeled. 10:44.240 --> 10:47.220 Should you have any question whatsoever 10:47.430 --> 10:49.850 regarding your drug therapy piece? 10:50.640 --> 10:51.060 Uh, 10:51.070 --> 10:53.820 feel free to contact your pharmacy or your pharmacy 10:53.820 --> 10:56.740 technician will be very glad to 10:56.740 --> 10:57.260 help you. 10:57.940 --> 10:58.450 Thank you. 11:03.410 --> 11:06.100 Now meet Mr Harry Berg called chief of the 11:06.100 --> 11:07.560 physical therapy department. 11:08.940 --> 11:11.770 The physical therapy department is concerned 11:12.100 --> 11:13.760 with hands and feet. 11:14.540 --> 11:17.160 Hansen disease often 11:18.140 --> 11:20.950 involves the nerves, 11:21.440 --> 11:24.410 which affect your feeling in your hands 11:24.490 --> 11:25.250 and your feet, 11:25.840 --> 11:28.600 and also sometimes affects how your muscles 11:28.780 --> 11:31.250 work and your hands and your feet. 11:31.840 --> 11:34.360 So physical therapy primarily works 11:34.840 --> 11:37.720 and is interested in how the hands and feet 11:38.540 --> 11:39.050 work. 11:40.140 --> 11:43.070 Now we mainly work in three 11:43.080 --> 11:44.250 general areas. 11:45.040 --> 11:45.850 The first. 11:46.740 --> 11:49.110 If you just have been admitted to the hospital, 11:49.120 --> 11:52.090 you would come for an evaluation in which we 11:52.090 --> 11:54.880 would check for the 11:54.890 --> 11:57.270 nerve damage by several different methods, 11:57.270 --> 11:58.860 which we'll talk about it a little bit. 11:59.730 --> 12:02.690 The second thing is we often teach exercises 12:03.640 --> 12:05.080 for your hands, 12:05.090 --> 12:06.180 feet and lower legs, 12:06.180 --> 12:08.890 which can sometimes strengthen muscles and 12:08.900 --> 12:11.050 prevent some deformity. 12:11.910 --> 12:12.780 The third thing, 12:12.780 --> 12:15.040 and probably the most important thing we have to offer, 12:15.040 --> 12:17.990 is to try to help you, 12:17.990 --> 12:18.760 the patient. 12:19.200 --> 12:22.180 Understand the problems that you may have 12:22.200 --> 12:24.560 with your hands and feet so that you can do better 12:25.200 --> 12:27.640 at your home and prevent 12:27.760 --> 12:30.050 more problems that may arise. 12:30.940 --> 12:33.160 Let's look at some of the tests that we may 12:33.540 --> 12:36.130 use when you first come to the physical therapy 12:36.130 --> 12:36.660 department. 12:37.540 --> 12:38.140 One. 12:38.250 --> 12:39.960 We take a footprint test. 12:40.840 --> 12:41.860 I'll show you one. 12:42.640 --> 12:44.700 This is an example we have. 12:44.700 --> 12:45.760 You walk on a mat, 12:46.820 --> 12:47.800 and when you finish, 12:47.800 --> 12:50.250 it shows where the high pressure points are on your feet. 12:50.640 --> 12:52.460 As you can see in this footprint, 12:52.840 --> 12:55.670 the largest pressures in the center of the 4 12:55.670 --> 12:55.980 ft. 12:56.120 --> 12:58.850 This may be an area that may take a special 12:59.110 --> 13:01.220 sort of in Seoul in your shoe. 13:01.220 --> 13:03.840 If you had some problem with 13:03.840 --> 13:05.860 sensation or the feeling in your foot, 13:07.140 --> 13:09.510 another thing we would probably do is check your 13:09.520 --> 13:10.360 sensation, 13:10.740 --> 13:12.910 how well your hands and feet feel. 13:13.640 --> 13:16.070 We often use a little nylon, 13:17.140 --> 13:19.980 and we would check different areas and see how 13:19.980 --> 13:21.080 well you feel. 13:21.170 --> 13:23.160 We may do this on your feet as well. 13:24.240 --> 13:25.020 Another test. 13:25.020 --> 13:26.460 We would test your muscle function. 13:27.140 --> 13:29.980 We would see how well your foot works. 13:29.980 --> 13:31.250 Can you pull your foot up. 13:31.940 --> 13:33.790 Can you put your foot down properly? 13:34.440 --> 13:35.740 We may check your hands, 13:35.940 --> 13:37.800 See if you can make this sort of position. 13:38.240 --> 13:39.780 If you can't make this position well, 13:39.780 --> 13:42.760 you may have a little nerve damage and your hand may get in this sort 13:42.760 --> 13:43.360 of position. 13:44.740 --> 13:47.570 We would also test your 13:47.570 --> 13:50.340 nerves and see if they are working properly or not. 13:50.350 --> 13:53.260 And we use an expensive type of machine 13:53.960 --> 13:56.450 to do this sort of test called a nerve conduction 13:56.460 --> 13:57.050 test. 13:57.940 --> 13:59.560 We also sometimes check 14:00.240 --> 14:00.960 temperature. 14:01.540 --> 14:04.460 We have another expensive machine that finds 14:04.460 --> 14:06.160 if you have areas that are hot 14:07.140 --> 14:09.760 and these point out to areas 14:09.890 --> 14:12.660 which are inflamed and may lead to an 14:12.660 --> 14:14.310 injury if they're not treated properly. 14:15.140 --> 14:17.840 And this is really important when you have a 14:17.840 --> 14:20.560 hand or foot that lacks proper feeling. 14:21.840 --> 14:22.280 Okay, 14:22.280 --> 14:24.750 now that we have evaluated your problems 14:25.140 --> 14:28.000 and have an idea of what is 14:28.000 --> 14:29.760 going on with you, 14:29.770 --> 14:32.740 we try to do something about the 14:32.740 --> 14:33.750 ones that we can. 14:34.340 --> 14:37.000 One thing we mentioned before we teach you some 14:37.000 --> 14:39.320 special exercises to prevent 14:39.590 --> 14:42.060 any increase in your 14:42.640 --> 14:44.860 weakness or in your deformity, 14:45.640 --> 14:48.630 these exercises that you can do on your own at your 14:48.630 --> 14:50.860 home when you were discharged. 14:52.140 --> 14:53.720 If you have a lot of weakness, 14:53.720 --> 14:56.610 we may make a special splint for your hand 14:56.720 --> 14:59.340 or for your foot to maintain the proper 14:59.340 --> 15:00.050 positions. 15:00.940 --> 15:03.460 If you have a wound on your foot, 15:03.470 --> 15:05.120 we may make a plaster cast, 15:05.120 --> 15:08.060 such as somebody would have when they had a fractured leg 15:08.600 --> 15:11.310 in which you could then get up and walk around while 15:11.410 --> 15:12.760 the wound healed. 15:13.940 --> 15:14.660 Mm hmm. 15:15.340 --> 15:16.470 And most important, 15:16.470 --> 15:19.300 we try to help out you to 15:19.300 --> 15:21.660 understand how to take care of your own problems. 15:22.110 --> 15:23.370 If you have dry skin, 15:23.380 --> 15:25.510 which is often a problem enhancing disease, 15:26.240 --> 15:27.910 we can instruct you. 15:27.910 --> 15:30.820 Or the occupational therapy department may help you learn 15:30.820 --> 15:33.540 how to soak in water and then put a 15:33.540 --> 15:36.460 lotion or vast lying on your hands and feet to keep them 15:36.460 --> 15:38.360 moist and to prevent cracks. 15:39.140 --> 15:40.990 If you have calluses on your feet, 15:41.000 --> 15:43.280 we can show you how to care for those heavy 15:43.280 --> 15:46.260 calluses become problems and 15:46.260 --> 15:47.330 can create wounds. 15:47.340 --> 15:50.290 We can show you how to use sandpaper to remove those 15:50.290 --> 15:52.680 and keep those down to a minimum level. 15:53.840 --> 15:56.600 One can go over what areas on your 15:56.600 --> 15:58.920 hands and feet that you need to inspect for injuries. 15:58.920 --> 16:01.630 If you have a sensory loss and don't have proper 16:01.630 --> 16:02.120 feeling, 16:02.840 --> 16:04.850 there's certain things that you should look for 16:05.840 --> 16:08.120 and probably most important for your feet. 16:08.120 --> 16:09.120 If you don't have feeling, 16:09.120 --> 16:10.650 is that you have the proper footwear. 16:11.750 --> 16:12.680 There's a shoe shop, 16:12.680 --> 16:13.300 which is nearby. 16:13.300 --> 16:14.690 The physical therapy department, 16:14.700 --> 16:15.900 which orders shoes, 16:16.340 --> 16:17.650 modifies them, 16:17.730 --> 16:20.610 makes any sort of changes that they need for you to do 16:20.610 --> 16:21.050 well. 16:22.250 --> 16:25.240 Some other things that you may see going on in physical therapy when 16:25.240 --> 16:28.030 you were here is that we help people before their 16:28.030 --> 16:28.570 surgeries. 16:28.570 --> 16:31.360 If they have some sort of major hand or foot problem, 16:31.740 --> 16:32.880 they perform surgery, 16:32.890 --> 16:35.140 and physical therapy would help them with their 16:35.140 --> 16:36.190 exercises. 16:36.220 --> 16:39.150 And they're splitting around the surgery surgery time. 16:39.840 --> 16:40.460 Also, 16:40.470 --> 16:41.280 physical therapy, 16:41.280 --> 16:44.050 usually and other hospitals takes care of the 16:44.050 --> 16:46.740 aches and pains that you get in your shoulder or your sprained 16:46.740 --> 16:47.310 ankles. 16:47.420 --> 16:49.930 And so we give exercises and have various 16:50.340 --> 16:52.760 heat treatments to help the needs. 16:53.440 --> 16:55.240 But our main purpose at this hospital, 16:55.240 --> 16:55.670 I think, 16:55.670 --> 16:58.610 is to try to help you understand the 16:58.610 --> 17:01.200 problems that may arise or that you 17:01.200 --> 17:03.960 presently have and be able to deal with them 17:04.340 --> 17:05.060 yourself. 17:05.940 --> 17:08.290 And if you ever have any questions while you're here, 17:08.290 --> 17:11.190 we are always open to try to 17:11.200 --> 17:14.090 help you and answer them any way we can or send you to 17:14.090 --> 17:16.050 somebody else who could answer your questions. 17:19.840 --> 17:20.520 Helen Rahm. 17:20.520 --> 17:23.220 Sammy is chief of the occupational 17:23.220 --> 17:24.300 Therapy Department. 17:26.440 --> 17:28.920 I'm going to talk to you about the care of your 17:28.920 --> 17:29.670 hands. 17:30.740 --> 17:31.660 Basically, 17:31.660 --> 17:34.530 there are three problems that could arise. 17:34.540 --> 17:36.620 You may have one of these problems. 17:36.620 --> 17:39.540 You may have all of them or you may never have any of 17:39.540 --> 17:42.520 these problems they will 17:42.520 --> 17:45.310 have to do with you're 17:45.310 --> 17:46.060 feeling. 17:47.040 --> 17:49.950 They also will have 17:49.950 --> 17:52.290 to do with the texture of your hands, 17:52.290 --> 17:53.850 whether they're dry, 17:54.740 --> 17:56.770 rough and scaly. 17:59.140 --> 18:01.720 And it will do also have to 18:01.720 --> 18:04.170 do with the motion in your 18:04.540 --> 18:05.170 fingers. 18:08.740 --> 18:10.940 The problem of you're 18:10.940 --> 18:13.350 feeling mhm 18:14.240 --> 18:16.160 may come about 18:16.840 --> 18:19.500 when you notice that you're 18:19.500 --> 18:22.170 cooking and you had 18:22.930 --> 18:24.160 part that 18:25.730 --> 18:28.400 was boiling and you put your hand 18:28.410 --> 18:31.360 over it and found that you burned your arm 18:31.360 --> 18:33.260 and you really did not feel that 18:34.640 --> 18:37.440 you could get yourself cut and not 18:37.440 --> 18:38.360 feel the pain. 18:39.240 --> 18:41.890 You may have some Kleenex in your 18:41.890 --> 18:44.870 pocket and you're reaching for 18:44.870 --> 18:45.370 that, 18:45.380 --> 18:48.070 and you can't feel that Kleenex any longer 18:48.080 --> 18:51.000 because you've lost the light touch in your 18:51.000 --> 18:51.560 fingers. 18:54.000 --> 18:56.880 These problems can be solved 18:56.880 --> 18:59.550 by wearing protective 18:59.940 --> 19:02.670 mittens when you're cooking or 19:02.750 --> 19:04.950 gloves when you're doing your gardening. 19:06.140 --> 19:07.110 Perhaps, 19:07.120 --> 19:07.670 uh, 19:08.140 --> 19:10.850 you have a key to open your door, 19:10.860 --> 19:12.960 and it is giving you 19:13.940 --> 19:15.670 traumas on your fingers, 19:15.680 --> 19:18.650 your breaking your skin Every time that you 19:18.650 --> 19:19.490 turn your key, 19:19.940 --> 19:21.820 you can pad all of these things. 19:22.910 --> 19:25.640 These are daily living items that you 19:25.640 --> 19:27.670 must watch and 19:28.640 --> 19:31.550 see that you take care of them 19:32.140 --> 19:33.490 so they're not hazardous. 19:35.940 --> 19:38.760 The problem of your dryness in your 19:38.760 --> 19:41.020 hands can be remedied by 19:41.240 --> 19:43.620 soaking for 20 minutes 19:43.820 --> 19:44.710 every day, 19:44.720 --> 19:46.450 at least once daily. 19:47.140 --> 19:50.020 It's best to try to soak before you go to bed 19:50.050 --> 19:52.940 because you're going to put Vaseline on your hands to hold the 19:52.940 --> 19:53.860 moisture in. 19:54.940 --> 19:57.540 And at the same time you're going to do some massaging 19:57.540 --> 19:58.510 exercises, 19:58.940 --> 20:01.690 and you will also be doing some 20:01.700 --> 20:02.660 exercises. 20:03.140 --> 20:04.030 Two. 20:05.140 --> 20:07.060 Remedy the 20:07.630 --> 20:10.460 contractors that you might get 20:10.540 --> 20:12.670 in your middle joints of your fingers. 20:13.340 --> 20:15.680 The nerves that that 20:15.950 --> 20:18.600 govern your motion can 20:18.600 --> 20:19.810 become involved, 20:19.960 --> 20:22.710 and you may notice that your 20:22.720 --> 20:25.220 middle joints on your fingers are starting to bend 20:25.220 --> 20:25.800 downward. 20:26.520 --> 20:29.200 It may start with your little finger and your ring finger 20:29.200 --> 20:29.730 first. 20:30.740 --> 20:32.520 But if you notice this, 20:32.850 --> 20:35.650 then these exercises will be 20:35.650 --> 20:36.670 very good for that. 20:37.640 --> 20:39.170 You put your 20:40.940 --> 20:43.740 palm of your right hand 20:43.740 --> 20:46.370 on the palm of your left hand and 20:46.370 --> 20:48.700 stroke out to the ends of your fingers. 20:48.700 --> 20:51.050 If you already have some slight 20:51.050 --> 20:51.830 contractors, 20:52.240 --> 20:55.220 this will help to give motion in your joints and 20:55.230 --> 20:57.270 also stretch your skin. 20:58.940 --> 21:01.440 You do that with the opposite 21:01.440 --> 21:03.270 hand the same way. 21:03.740 --> 21:05.220 Do these exercises, 21:05.230 --> 21:06.950 perhaps about 20 times 21:07.640 --> 21:10.370 and maybe two or three times a 21:10.370 --> 21:10.760 day. 21:15.640 --> 21:16.960 On your 21:18.240 --> 21:21.030 admission to this hospital, 21:21.200 --> 21:22.670 you will have, 21:23.740 --> 21:24.360 um, 21:25.100 --> 21:27.770 the opportunity to come to occupational therapy. 21:28.510 --> 21:31.420 And we can explain more of these 21:31.420 --> 21:33.630 exercises and 21:33.640 --> 21:36.570 why we do them give you 21:36.570 --> 21:38.790 any literature that can help you 21:40.340 --> 21:41.960 refresh your memory on them. 21:42.740 --> 21:45.320 And be glad to answer any questions 21:45.320 --> 21:48.130 that you will have about these 21:48.140 --> 21:49.670 things that we're speaking of. 21:53.740 --> 21:56.360 And now meet Dr Margaret Brand of the 21:56.360 --> 21:57.850 Ophthalmology Department. 21:58.740 --> 22:01.380 I want to welcome you today to 22:01.390 --> 22:03.940 the eye clinic where I am right 22:03.950 --> 22:04.450 now, 22:05.040 --> 22:07.850 and in this place 22:07.850 --> 22:10.050 with Sister Labrie as my assistant, 22:10.540 --> 22:13.060 we see every patient who comes to the hospital. 22:14.040 --> 22:16.960 Perhaps you already have been here by the time you see this 22:16.960 --> 22:17.760 video tape? 22:18.140 --> 22:18.350 Mhm. 22:19.240 --> 22:20.410 Now you might say, 22:20.420 --> 22:22.930 Why do I have to come to the eye clinic? 22:22.950 --> 22:25.910 I had my glasses checked and I'm under a doctor 22:25.910 --> 22:26.620 at home. 22:26.860 --> 22:27.160 Well, 22:27.160 --> 22:27.960 that's fine. 22:28.440 --> 22:29.040 Uh, 22:29.050 --> 22:31.740 so if you don't have glasses that suit you, 22:31.750 --> 22:34.670 let me just say that we'll be pleased to try and help you 22:34.680 --> 22:35.550 while you're here. 22:36.940 --> 22:38.530 But coming back to the question, 22:38.540 --> 22:40.860 why should people come to the eye clinic? 22:41.240 --> 22:44.160 Is there some reason in this disease that we 22:44.160 --> 22:46.160 want to know what's going on in the eye? 22:46.940 --> 22:48.200 The answer is yes. 22:48.830 --> 22:50.430 There are definite problems, 22:50.430 --> 22:53.410 and some individuals may escape without 22:53.410 --> 22:53.960 any of them, 22:54.340 --> 22:56.770 and some people might have quite a lot of trouble. 22:57.340 --> 22:59.770 And we want to know if they're likely to 23:00.240 --> 23:03.190 what's going on and then be able 23:03.190 --> 23:06.130 to take the necessary steps and precautions so 23:06.130 --> 23:08.160 that we can control those problems. 23:08.640 --> 23:08.850 Mhm. 23:09.830 --> 23:12.430 Now you might want to know what kind of 23:12.430 --> 23:13.960 things we're looking for. 23:15.340 --> 23:16.160 First of all, 23:16.170 --> 23:18.060 like any other parts of the body, 23:18.530 --> 23:20.860 this disease affects the surface, 23:21.240 --> 23:22.940 the surface nerves. 23:22.940 --> 23:25.350 You've probably been told about the nerves, 23:25.350 --> 23:26.770 your hands and your feet. 23:27.070 --> 23:28.860 Perhaps you already have trouble there. 23:29.640 --> 23:32.460 Perhaps you haven't realized that you've got a nerve that comes up in the 23:32.460 --> 23:32.860 face, 23:32.870 --> 23:35.390 and that makes the muscles of your 23:35.400 --> 23:38.310 eyelids work so that you can blink so that you can close 23:38.310 --> 23:39.660 your eyes when you go to sleep. 23:40.640 --> 23:40.880 Now, 23:40.890 --> 23:42.850 if something happens to that nerve, 23:43.240 --> 23:45.270 you may not be able to do these things. 23:45.530 --> 23:48.460 You may just find that you don't sleep with your eyes closed 23:48.840 --> 23:51.460 or that you might have a blink that doesn't 23:51.470 --> 23:52.320 always work. 23:52.330 --> 23:55.150 Doesn't go the whole closing every 23:55.150 --> 23:58.060 time you try to close your eyes to shut, 23:58.540 --> 24:01.450 and you should be blinking about every 20 seconds to keep your 24:01.460 --> 24:04.170 eyes nice and moist and seeing well and 24:04.170 --> 24:04.900 feeling good. 24:06.140 --> 24:07.720 So that's one thing that can happen. 24:07.940 --> 24:10.670 Another thing is that you might just lose a little bit of the 24:10.670 --> 24:13.670 feeling in your eyes so that even 24:13.670 --> 24:14.780 if they got dry, 24:14.790 --> 24:16.170 you perhaps wouldn't know it. 24:16.740 --> 24:18.140 And this can be serious. 24:18.240 --> 24:20.810 We want to find out whether you have a good feeling in your 24:20.820 --> 24:23.170 eyes good enough to protect them. 24:24.640 --> 24:26.900 And then in certain individuals, 24:27.120 --> 24:29.770 the bacteria actually can take up 24:30.670 --> 24:32.310 residents in the eyes. 24:32.310 --> 24:34.890 You might say they get into the front part of the 24:34.890 --> 24:35.350 eyes. 24:35.940 --> 24:36.370 Now, 24:36.380 --> 24:39.260 perhaps you know something about your I Maybe you know 24:39.260 --> 24:41.860 what I'm saying when I say the cornea that's like the 24:41.870 --> 24:43.680 crystal on your watch. 24:43.690 --> 24:46.640 The front clear part of the eye through which you're 24:46.640 --> 24:48.360 seeing is the window of your eye. 24:49.140 --> 24:49.570 Well, 24:49.580 --> 24:52.470 we can find out if you've got the organisms in there and 24:52.470 --> 24:54.660 they can get their quite early in the disease. 24:55.240 --> 24:57.980 And we want to know because it's 24:57.980 --> 25:00.820 important that we know exactly what is happening. 25:00.820 --> 25:02.350 What is the status of your eyes? 25:02.940 --> 25:04.050 You won't feel them. 25:04.060 --> 25:05.060 They won't hurt. 25:05.440 --> 25:06.700 You won't have any redness. 25:06.710 --> 25:08.070 You won't see any differently, 25:08.540 --> 25:09.930 but we can find them. 25:09.990 --> 25:10.750 We can see them. 25:10.750 --> 25:11.660 I'll show you in a minute. 25:12.120 --> 25:13.860 The instrument that will sit you at 25:14.940 --> 25:17.190 and chick and then some 25:17.190 --> 25:19.260 individuals can also get 25:19.640 --> 25:21.200 inflammation in the eyes, 25:21.640 --> 25:24.050 and this can lead to problems if it's not 25:24.060 --> 25:24.760 controlled. 25:25.140 --> 25:27.610 We want to find out if you have that inflammation, 25:27.770 --> 25:30.720 if you're likely to get it and or even to be able to tell 25:30.720 --> 25:32.220 you that you're not likely to get it, 25:32.230 --> 25:33.170 and that will be good news, 25:33.170 --> 25:33.430 too, 25:33.430 --> 25:34.060 I'm sure. 25:35.340 --> 25:38.320 Then there are some individuals who have a problem 25:38.320 --> 25:39.320 with glaucoma. 25:39.480 --> 25:41.960 It may be related to the Hansen's disease. 25:42.210 --> 25:44.060 It may be quite independent, 25:44.440 --> 25:45.980 but we want to find out about it. 25:46.060 --> 25:48.460 We want to know we want to be able to control it 25:48.840 --> 25:51.560 so that your eyes will stay good the rest of your life. 25:52.640 --> 25:54.980 And so why you here at Kerrville, 25:55.240 --> 25:57.460 you will come to the eye clinic 25:58.030 --> 25:59.950 and we'll take your vision. 26:00.340 --> 26:01.750 Sister will do a tear test. 26:01.840 --> 26:02.580 By the way, 26:02.780 --> 26:04.990 you will meet sister elaborate when you come to, 26:05.110 --> 26:06.740 she's my clinic nurse. 26:07.020 --> 26:09.160 She will do some tests and I will do something. 26:10.040 --> 26:12.730 And then I will look at you with this instrument. 26:12.740 --> 26:13.820 It's a microscope, 26:13.830 --> 26:15.540 a rather nice microscope, 26:15.550 --> 26:18.040 and I can see a lot of detail that wouldn't 26:18.050 --> 26:19.460 ordinarily show up. 26:20.440 --> 26:22.510 And you will come here for the first 26:22.510 --> 26:23.450 examination, 26:23.460 --> 26:26.340 and then you will come subsequently every 26:26.340 --> 26:28.360 three months if you were going to be here. 26:28.740 --> 26:30.770 But perhaps if you're going home, 26:30.780 --> 26:31.810 then we'll just say, 26:31.820 --> 26:33.020 Whenever you come in, 26:33.060 --> 26:35.550 come back and see us and get another check up. 26:36.040 --> 26:38.860 We want to keep monitoring you carefully. 26:39.840 --> 26:40.100 Well, 26:40.100 --> 26:40.820 you might say, 26:40.970 --> 26:43.350 Is there a chance I could actually go blind. 26:44.340 --> 26:47.330 And the answer to that is not very much chance 26:47.460 --> 26:48.270 providing, 26:48.740 --> 26:51.240 providing you one take your 26:51.240 --> 26:53.090 medicine like we tell you. 26:53.120 --> 26:55.920 And two that you would know what to look 26:55.920 --> 26:58.910 for if I problems occur and that 26:58.910 --> 27:01.360 you would go to see a doctor or come back here. 27:02.040 --> 27:04.990 And if we give you instructions and give you drops 27:04.990 --> 27:07.850 like I was showing a minute ago and 27:08.540 --> 27:09.750 and you use those, 27:09.870 --> 27:12.290 then the chances are very good that whatever your 27:12.290 --> 27:12.880 problem, 27:13.100 --> 27:14.560 it can be controlled. 27:15.540 --> 27:18.470 But you might say even since I've been in this 27:18.470 --> 27:18.940 hospital, 27:18.950 --> 27:21.120 I have seen people who have gone blind. 27:21.340 --> 27:22.460 Couldn't you help them? 27:23.640 --> 27:23.800 Well, 27:23.800 --> 27:26.380 the answer is for most of those people. 27:26.620 --> 27:29.440 They came here too late for us to do very much 27:29.440 --> 27:31.840 for them or they had not had 27:31.960 --> 27:34.880 treatment or they started on treatment and they didn't keep it 27:34.880 --> 27:35.170 up. 27:35.840 --> 27:37.270 Perhaps they thought they didn't need it, 27:37.730 --> 27:40.160 and their disease became worse again. 27:40.740 --> 27:41.690 And sometimes it is. 27:41.690 --> 27:43.560 Harder is the second time. 27:43.940 --> 27:45.190 If the disease gets worse, 27:45.190 --> 27:48.020 it's harder to take care of the eye problems. 27:48.030 --> 27:49.460 They can often be very severe, 27:49.840 --> 27:51.700 But don't let that happen to you. 27:51.710 --> 27:54.540 You just take your medicine like you're told and be 27:54.540 --> 27:55.390 faithful. 27:55.400 --> 27:57.960 And the chances are that even if we find the 27:57.960 --> 27:59.070 disease right now, 27:59.070 --> 28:00.270 the first time you come, 28:00.840 --> 28:02.110 we can say to you, 28:02.220 --> 28:05.170 probably within months or within a year or two, 28:05.530 --> 28:07.670 the disease will have cleared from your eyes. 28:08.540 --> 28:11.510 This doesn't mean to say you could never have another eye problem. 28:11.520 --> 28:13.360 Supposing you can't close your eyes. 28:13.510 --> 28:15.240 You'll always have a little bit of a problem. 28:15.240 --> 28:18.230 You'll always have to do something like using tear drops 28:18.230 --> 28:19.850 or shielding your eye at night. 28:20.340 --> 28:22.260 But we'll give you instructions about that, 28:23.040 --> 28:25.290 or you might have a little problem with inflammation, 28:25.540 --> 28:27.860 and we'll have to tell you what to do about that. 28:28.640 --> 28:31.380 The main thing is that you don't have to go blind. 28:31.390 --> 28:34.150 We've got you here in time and there's a 28:34.150 --> 28:36.670 good chance that you won't lose any site at all. 28:37.710 --> 28:38.800 And as I said before, 28:38.800 --> 28:41.340 we will watch for changes of your 28:41.340 --> 28:42.500 glasses prescription. 28:42.940 --> 28:44.240 If you have to have surgery, 28:44.240 --> 28:47.050 we can offer that we can do a lot of special 28:47.050 --> 28:49.810 investigations and if we can't do them here, 28:49.820 --> 28:51.710 we will send you over to New Orleans, 28:51.710 --> 28:54.570 where they've got a very well equipped by department and 28:54.570 --> 28:55.860 they'll take care of you there. 28:58.240 --> 29:00.600 And so we can look forward to some very 29:00.600 --> 29:03.480 hopeful and very happy years together. 29:03.490 --> 29:06.430 I hope that you'll always come back and see us and that 29:06.430 --> 29:08.340 you will come any time. 29:08.340 --> 29:09.270 You have a question? 29:09.840 --> 29:12.550 We're here every day throughout the 29:12.550 --> 29:12.960 week. 29:13.540 --> 29:15.460 If I can't immediately see you, 29:15.470 --> 29:16.240 just elaborate, 29:16.240 --> 29:17.590 perhaps can answer your question. 29:17.600 --> 29:20.580 Or she will set you up with an appointment to talk to 29:20.580 --> 29:23.330 me and to share with me any problem that you 29:23.330 --> 29:23.670 have. 29:24.040 --> 29:24.760 Don't worry. 29:25.240 --> 29:26.170 We do care. 29:26.540 --> 29:27.590 We have equipment, 29:27.750 --> 29:30.280 we have the experience and we know 29:30.700 --> 29:32.360 that we can say fairly confidently, 29:32.650 --> 29:33.760 You're going to do fine. 29:34.240 --> 29:37.050 So let's just get on and work 29:37.050 --> 29:39.950 together and make sure that your eyes keep seeing 29:40.340 --> 29:41.450 just as they do today. 29:46.440 --> 29:49.390 We hope that you now have a clearer understanding of 29:49.390 --> 29:51.970 Hansen's disease and understanding 29:51.970 --> 29:54.410 based on accuracy and not 29:54.420 --> 29:55.050 hearsay. 29:55.840 --> 29:58.210 We have a few more things we would like to show you. 29:58.490 --> 30:01.250 But first we would like for you to meet the director of our 30:01.250 --> 30:01.930 hospital. 30:02.240 --> 30:03.760 Dr John Trautman. 30:07.140 --> 30:08.060 Hello. 30:09.010 --> 30:10.860 Speaking for all of us at Carville, 30:11.640 --> 30:12.860 I want to welcome you. 30:14.340 --> 30:17.300 We're going to try to give you the best care possible 30:17.300 --> 30:19.890 at this hospital and help you to the extent 30:19.900 --> 30:20.460 possible. 30:20.460 --> 30:21.170 Otherwise, 30:22.240 --> 30:23.400 I hope you stay here, 30:23.400 --> 30:23.790 however, 30:23.790 --> 30:24.850 will be a short one. 30:26.400 --> 30:26.620 Now, 30:26.620 --> 30:29.480 I know that hospital life is oftentimes 30:29.480 --> 30:30.360 not pleasant, 30:30.840 --> 30:33.820 but we are going to try to make it as comfortable as we 30:33.820 --> 30:34.670 can for you. 30:36.140 --> 30:37.760 And we want you to feel at home, 30:37.780 --> 30:39.770 no matter how long you stay here. 30:41.060 --> 30:43.950 Carville is a much better place to be than it was some 30:43.950 --> 30:44.690 years ago. 30:45.020 --> 30:46.360 We don't call it a leprosy. 30:46.360 --> 30:47.100 Very um anymore. 30:47.100 --> 30:47.780 For instance, 30:48.240 --> 30:51.160 the official name is the United States Public Health Service 30:51.160 --> 30:51.860 Hospital, 30:52.240 --> 30:55.050 and soon it will be called the National Hansen's 30:55.050 --> 30:55.800 Disease Center, 30:55.800 --> 30:58.060 which I think is another step in the right direction. 30:58.740 --> 30:59.880 We have rules, 30:59.920 --> 31:02.890 but we try to keep things a little bit relaxed and 31:02.890 --> 31:04.410 still give you the care you need. 31:05.240 --> 31:07.000 Carville is an excellent hospital, 31:07.010 --> 31:07.760 believe me, 31:08.140 --> 31:10.960 But we also know there is always room for improvement. 31:11.540 --> 31:11.760 Now, 31:11.760 --> 31:14.550 if there's anything you feel we can do 31:15.040 --> 31:16.810 to make your stay here a better one, 31:17.240 --> 31:18.410 please let us know. 31:18.790 --> 31:21.740 Now the best way to do this is to contact a 31:21.750 --> 31:24.060 representative of the patient federation. 31:24.540 --> 31:26.880 But the hospital staff and I are also 31:26.880 --> 31:27.550 available. 31:27.550 --> 31:30.060 If you feel you need to contact us personally 31:31.240 --> 31:32.070 still, 31:32.410 --> 31:34.660 we know we won't be able to please everybody. 31:34.670 --> 31:35.650 All of the time. 31:35.730 --> 31:38.420 We're going to do the very best we can. 31:39.140 --> 31:42.110 The staff that is going to care for you is the best in 31:42.110 --> 31:42.770 the world. 31:43.340 --> 31:45.950 Each of each of them is here to help you. 31:46.740 --> 31:47.760 So again, 31:48.140 --> 31:50.450 please accept my sincere welcome to 31:50.450 --> 31:51.170 Kerrville. 31:52.140 --> 31:52.330 Now, 31:52.330 --> 31:53.140 at this time, 31:53.140 --> 31:55.440 we would like to tell you a bit about Carville's 31:55.440 --> 31:58.130 history and then show you some of the 31:58.130 --> 32:00.710 unique aspects and activities of our hospital. 32:00.720 --> 32:01.460 Thanks. 32:05.140 --> 32:05.560 Mhm. 32:06.040 --> 32:06.270 Mhm. 32:06.640 --> 32:06.840 Yeah, 32:07.540 --> 32:07.770 yeah, 32:08.340 --> 32:08.540 yeah. 32:10.040 --> 32:12.700 When the first eight patients 32:12.700 --> 32:15.640 arrived in 18 94 from New Orleans, 32:15.950 --> 32:18.860 they found this crumbling plantation site 32:19.140 --> 32:20.970 known as Indian camp, 32:21.250 --> 32:23.290 the old Woodlawn Plantation, 32:23.940 --> 32:26.760 the deserted home of a Confederate army general. 32:27.940 --> 32:30.520 The patients remained basically alone 32:30.520 --> 32:32.810 until four Catholic nuns, 32:32.890 --> 32:35.500 Sisters of Charity of ST Vincent de 32:35.500 --> 32:38.100 Paul came to minister to them in 32:38.100 --> 32:39.800 18 96. 32:40.340 --> 32:43.220 After being run by the state of Louisiana 32:43.230 --> 32:44.530 for 27 years, 32:44.870 --> 32:47.580 the hospital became a federal institution 32:47.890 --> 32:49.360 in 1921 32:50.540 --> 32:51.210 today, 32:51.210 --> 32:54.200 the United States Public Health Service Hospital 32:54.360 --> 32:57.260 still stands near the banks of the Mississippi River 32:57.640 --> 33:00.230 with a proud international reputation 33:00.240 --> 33:01.420 for treatment, 33:01.430 --> 33:04.210 research and training related to 33:04.210 --> 33:05.560 Hansen's disease. 33:07.210 --> 33:09.990 The hospital is staffed by uniformed commissioned 33:09.990 --> 33:12.750 officers of the United States Public Health 33:12.760 --> 33:13.440 Service, 33:14.240 --> 33:15.700 the Sisters of Charity 33:16.840 --> 33:19.660 and federal Civil Service employees 33:20.040 --> 33:22.980 who you may see either in uniform are in 33:22.980 --> 33:25.980 civilian clothes today. 33:25.990 --> 33:26.540 Carville, 33:26.540 --> 33:27.920 like any other hospital, 33:27.920 --> 33:30.540 has departments such as X ray 33:30.550 --> 33:31.530 admissions, 33:31.540 --> 33:34.170 the laboratory surgery and others 33:34.640 --> 33:35.750 routine areas, 33:35.750 --> 33:38.310 which you have probably already seen our 33:38.320 --> 33:39.950 Macy during your stay. 33:40.840 --> 33:41.460 Right now, 33:41.460 --> 33:41.940 though, 33:42.020 --> 33:44.970 we would like to give you an inside glimpse of some 33:44.970 --> 33:47.510 of the other activities and services 33:47.510 --> 33:48.700 around Carville, 33:48.780 --> 33:51.430 which are available and might be of interest to 33:51.430 --> 33:51.850 you. 33:52.940 --> 33:55.630 A great deal of the activity at Kerrville centers 33:55.630 --> 33:57.560 around the recreation building 33:58.840 --> 34:00.970 on the first floor of the recreation building, 34:00.970 --> 34:02.950 you will find the patient's canteen 34:03.740 --> 34:05.430 as a focal point of activity. 34:05.430 --> 34:07.670 The canteen sells a number of items 34:07.880 --> 34:08.460 drinks, 34:08.470 --> 34:09.280 sandwiches, 34:09.280 --> 34:10.140 canned goods, 34:10.140 --> 34:11.620 fruit and toiletries. 34:12.040 --> 34:15.000 You will also find the canteen is a lively spot for 34:15.000 --> 34:17.590 socializing and exchanging bits of news 34:17.600 --> 34:20.110 between friends are new acquaintances 34:21.840 --> 34:24.570 next door to the canteen is Carville's many 34:24.570 --> 34:27.220 post office offering all of the regular 34:27.220 --> 34:28.400 postal services. 34:28.570 --> 34:31.510 The post office gives mail service five days a 34:31.510 --> 34:33.940 week and an important note. 34:33.950 --> 34:35.470 While you're here at Kerrville, 34:35.470 --> 34:38.170 your mailing address will be Pointe 34:38.180 --> 34:39.350 Claire Branch, 34:39.360 --> 34:39.850 Carville, 34:39.850 --> 34:40.610 Louisiana, 34:40.620 --> 34:42.320 707 to 34:42.320 --> 34:44.960 1. 34:48.640 --> 34:50.380 Find to television lounges, 34:50.380 --> 34:53.320 each furnished comfortably and with color televisions. 34:54.040 --> 34:56.870 You'll also find the movie theater, 34:56.880 --> 34:59.850 where late run movies are shown several nights 34:59.850 --> 35:00.640 each week, 35:00.650 --> 35:03.600 some of them with Spanish language soundtracks. 35:03.610 --> 35:06.160 You can check the bulletin board by the 35:06.160 --> 35:09.100 canteen for movie titles and times and 35:09.110 --> 35:10.470 other special events. 35:11.240 --> 35:14.020 There's a patient library 35:14.030 --> 35:17.010 on the first floor to which offers an excellent 35:17.010 --> 35:18.970 selection of current newspapers, 35:20.660 --> 35:23.560 popular magazines 35:26.220 --> 35:28.590 and lots of best selling books. 35:28.710 --> 35:31.560 Library also has a wide selection of 35:31.560 --> 35:34.330 talking books available both on record and 35:34.330 --> 35:35.260 audio cassette. 35:38.590 --> 35:41.210 the stairs and on the second floor of the recreation 35:39.340 --> 35:42.590 Climb 35:41.210 --> 35:41.620 building, 35:41.620 --> 35:43.760 you'll discover a grand ballroom 35:44.240 --> 35:46.000 often used for bingos, 35:46.000 --> 35:47.120 musical programs, 35:47.130 --> 35:49.980 dances and fairs throughout the 35:49.980 --> 35:50.360 year. 35:50.840 --> 35:52.700 On a daily basis in the ballroom, 35:52.700 --> 35:55.660 you'll probably be able to find someone to challenge 35:55.670 --> 35:57.180 in a game of ping pong, 35:57.200 --> 35:59.640 maybe a hand of 35:59.640 --> 36:00.760 dominoes. 36:03.190 --> 36:05.050 Our a game of pool 36:06.080 --> 36:08.760 and you'll also find to recreation 36:08.760 --> 36:11.130 specialist to assist you if needed. 36:13.100 --> 36:15.610 Looking out from the balcony of the ballroom, 36:15.610 --> 36:18.440 you can see a nine hole golf course used by 36:18.440 --> 36:19.110 patients, 36:19.240 --> 36:21.680 staff members and their invited 36:21.680 --> 36:22.310 guests. 36:24.570 --> 36:26.070 Golf carts, 36:26.070 --> 36:28.990 equipment and a few initial lessons are available for 36:28.990 --> 36:29.370 you. 36:31.560 --> 36:34.430 Invitational golf tournaments are held twice yearly at 36:34.430 --> 36:37.370 Carville and include golfers from surrounding areas 36:37.370 --> 36:39.300 who compete with the local golfers. 36:40.110 --> 36:42.270 If you enjoy the outdoors and water, 36:42.270 --> 36:43.540 you will find fishing, 36:43.540 --> 36:45.330 picnicking and paddle boating. 36:45.550 --> 36:47.300 Available at Lake Joe Hanson, 36:47.730 --> 36:50.700 located on the back corner of the hospital grounds, 36:53.310 --> 36:56.180 several fishing rodeos are held on the lake 36:56.190 --> 36:57.720 in the spring and summer. 36:58.990 --> 37:01.710 Back 37:01.710 --> 37:04.500 indoors now and actually in house 24. 37:04.500 --> 37:07.020 Near the Recreation building is a unique feature at 37:07.020 --> 37:07.660 Carville, 37:07.830 --> 37:10.610 the shopping mall run mainly by patients. 37:12.430 --> 37:13.870 Inside, 37:13.880 --> 37:16.050 you'll find a barbershop 37:16.630 --> 37:19.530 to novelty shops, 37:20.330 --> 37:22.040 Washington area, 37:23.030 --> 37:24.050 a beauty shop, 37:24.930 --> 37:27.770 bicycle repair shop and a 37:27.770 --> 37:30.710 bank office offering most banking services. 37:32.720 --> 37:32.960 Now, 37:32.960 --> 37:35.950 if you should have to stay at the hospital for a longer period of 37:35.950 --> 37:36.370 time, 37:36.370 --> 37:39.040 you'll be assigned a room in one of the dormitories 37:39.430 --> 37:42.040 and you'll be able to take your meals in the 37:42.040 --> 37:43.350 patient's cafeteria 37:48.210 --> 37:48.940 and again. 37:48.940 --> 37:51.340 If you have to stay for a longer period of time, 37:51.340 --> 37:54.320 you may be interested in the services of the vocational 37:54.320 --> 37:55.940 rehabilitation department. 37:56.520 --> 37:58.660 A counselor is available who can, 37:58.660 --> 38:01.600 after an interview suggest an activity for 38:01.600 --> 38:01.910 you, 38:02.140 --> 38:03.340 such as testing, 38:03.350 --> 38:04.140 training, 38:04.520 --> 38:07.450 employment are attending the local school. 38:08.820 --> 38:11.300 Various test can be conducted by the 38:11.300 --> 38:14.250 department and are usually done before a patient is 38:14.250 --> 38:14.900 sent for. 38:14.900 --> 38:16.100 Vocational training, 38:16.230 --> 38:19.210 which is available either at a local trade school or 38:19.210 --> 38:19.800 college, 38:19.810 --> 38:22.740 are which may be arranged at a school in 38:22.740 --> 38:23.940 your home state. 38:25.420 --> 38:28.280 Also within the vocational rehabilitation department 38:28.290 --> 38:30.840 is an area known as manual arts. 38:31.420 --> 38:33.670 If you enjoy constructive activities, 38:33.810 --> 38:35.960 you'll be able to work with wood or 38:35.960 --> 38:37.650 plexiglass projects. 38:39.720 --> 38:39.950 Mhm. 38:41.520 --> 38:44.310 Patient employment may be a possibility 38:44.310 --> 38:46.900 for you if you're at the hospital for several weeks. 38:47.420 --> 38:49.970 Jobs may vary from hospital tour 38:49.970 --> 38:50.840 Guide 38:52.930 --> 38:55.220 research Animal care attendant, 38:55.720 --> 38:55.950 Mhm 38:57.720 --> 39:00.450 Housekeeping aide 39:01.700 --> 39:02.130 Yeah, 39:02.620 --> 39:03.940 printing press woman 39:04.920 --> 39:07.910 are maybe work in the 39:07.910 --> 39:10.830 sheltered workshop making popular fishing 39:10.830 --> 39:11.450 lures. 39:12.820 --> 39:13.030 Mhm. 39:13.620 --> 39:13.950 Mhm 39:18.220 --> 39:20.040 Carvilles Local school, 39:20.040 --> 39:22.870 fully accredited with two full time teachers, 39:22.870 --> 39:25.030 conducts classes eight hours a day. 39:25.420 --> 39:28.290 You may check with the teachers if you're interested in 39:28.300 --> 39:30.040 educational opportunities. 39:32.620 --> 39:35.430 Aside from the various occupational and educational 39:35.430 --> 39:36.120 activities. 39:36.130 --> 39:38.880 A social work department is available at Carville 39:38.980 --> 39:41.970 and interested in talking with you and your family 39:42.220 --> 39:43.740 about aspects of your life, 39:43.740 --> 39:46.150 which may be affected by a Hansen's 39:46.150 --> 39:46.800 disease, 39:46.800 --> 39:49.330 diagnosis and hospitalization. 39:50.020 --> 39:52.490 Whether in your room or in their office, 39:52.510 --> 39:55.270 you may ask to see a male or female 39:55.270 --> 39:58.160 social worker and discuss any personal 39:58.160 --> 40:00.850 or family matter financial concern, 40:00.860 --> 40:03.640 housing or transportation problem you may 40:03.640 --> 40:04.250 encounter. 40:05.210 --> 40:08.020 We might also mention that to full time 40:08.020 --> 40:08.830 chaplains. 40:08.970 --> 40:11.790 Protestant and Catholic are available at 40:11.790 --> 40:14.530 Carville for matters of spiritual concern. 40:14.540 --> 40:15.830 Our counseling. 40:18.010 --> 40:20.710 You'll probably see the chaplains as they make their 40:20.710 --> 40:21.250 rounds, 40:21.250 --> 40:24.210 either in your room or possibly out in the hospital 40:24.210 --> 40:24.990 corridors. 40:27.210 --> 40:27.440 All right. 40:30.110 --> 40:32.480 Located near the front of the hospital 40:32.480 --> 40:33.130 grounds, 40:33.130 --> 40:35.030 the Union Protestant Chapel 40:35.930 --> 40:38.750 and the Catholic Sacred Heart Chapel are open 40:38.750 --> 40:41.720 at all times and offer regular services. 40:46.540 --> 40:49.350 service times and many other announcements of 40:46.610 --> 40:50.540 Church 40:49.350 --> 40:52.070 events and activities are published in the 40:52.070 --> 40:54.860 hospitals Weekly paper called the Question 40:54.860 --> 40:56.880 Mark our QM. 40:56.890 --> 40:57.640 For short. 40:58.110 --> 41:00.990 This is a free publication distributed at 41:00.990 --> 41:03.460 various points around the hospital by the 41:03.460 --> 41:04.740 school's students. 41:06.910 --> 41:09.910 Another very unique activity at Kerrville we'd like 41:09.910 --> 41:12.560 to tell you about is the patient owned 41:12.570 --> 41:15.300 and printed International magazine 41:15.300 --> 41:16.810 called The Star. 41:16.870 --> 41:19.760 The Star disperses educational information 41:19.760 --> 41:22.660 on Hansen's disease to more than 100 41:22.660 --> 41:25.240 foreign countries and the United States, 41:25.470 --> 41:28.160 with the circulation of about 100,000. 41:28.510 --> 41:30.620 Its purpose is to provide vocational 41:30.620 --> 41:33.620 rehabilitation to patients while promoting 41:33.620 --> 41:36.130 an educated public opinion on 41:36.130 --> 41:37.460 Hansen's disease. 41:40.010 --> 41:42.930 We'll mention also that reprints and educational 41:42.930 --> 41:45.780 materials about Hansen's disease are available 41:45.780 --> 41:48.500 at the hospitals training branch for your family and 41:48.500 --> 41:49.070 friends. 41:49.410 --> 41:52.340 The training branch will mail the materials for you at 41:52.340 --> 41:53.250 your request. 41:53.910 --> 41:54.450 Finally, 41:54.450 --> 41:56.090 during your stay at Kerrville, 41:56.090 --> 41:58.800 feel free to ask questions when something is not 41:58.800 --> 41:59.610 clear to you. 42:00.100 --> 42:02.810 All of our staff members are here to serve you 42:02.990 --> 42:05.670 and make your stay as pleasant and 42:05.680 --> 42:07.800 profitable as possible. 42:27.700 --> 42:28.120 Mm 43:13.900 --> 43:14.620 mm 43:17.100 --> 43:17.310 mm.