Friday, April 23, 2010

The Week

Where to begin? It's really hard for me to believe that this week is almost over already and we're going to the beach. Final evaluations of my students are done. We had the despedida last night and said goodbye to our coworkers at our sites. Estoy triste (I'm sad).

There is so much emotion. It was wonderful to participate in the ICC clinic again and talk with all the promatoras that Kristin and I worked with last time we were here; we even got to see some of the same kids. Molly- if you're reading this we missed you! We promised Carmen that we would say hello to you from her. So, "HOLA!"

I thought I had more time but need to go. Love you all!

Sunday, April 18, 2010

Mas photos




First picture is at the market on Sunday and the second is another pic of the restaurant we had dinner at on Friday night.

Sunday




We just got back from Santa Domingo and it turns out that there is a beautiful wedding being held at the campus-talk about picturesque; what a beautiful location for a wedding. The first picture is the view from our balcony of Santa Domingo and the next is our side of the table at dinner Friday night. From the top Left clockwise: Kristin, Me, Maggie, Shawn, Carrie.

Santa Domingo itself was fabulous as well. I feel like this country is giving me so much more than I to it; it's refreshing my soul. The weekend was just fun. Friday night CU took us out for an appreciation dinner and que wow; the food, the atmosphere was just phenomenal. I'll have to upload a pic. The internet is a bit spotty here so the photo uploading isn't the easiest. After dinner we all went out dancing till the wee hours of the morning. Myself and some of the other CIs came home much later 3:30am ish to find that our hotel door was locked. So we spent a half hour making all sorts of noise to get the guards attention to no avail. Ultimately we walked back to the hostel where all the students were staying and woke up the owner who after two phone calls to the guard walked down to our hotel and with a quiet knock to a door to the left of ours got the attention of the guard so easily that we were are stunned-mouths on the ground. So 4:30am we got back into our little rooms at the hotel and slept for a few hours before waking up and going to the beach.

For only 4 or so hours of sleep I apparently had way to much energy and while the other 7 CIs lounged on our chairs on the beach I floated in the salt water and soaked up some sun that way. One of the others did make it into the water for a little bit but I think I'm the only one who took full advantage of such quiet comfortable water. Some pina coladas later and we all got a little toasty in the areas where sunscreen was not applied as judiciously as earlier in the day. During this time our students took a tour of the city and did some of their shopping.

A nap and another splendid dinner followed by another night of dancing...this time we left a bit earlier :-) 2:30am instead of 3:30am. I guess there is a bit of a pattern occurring on these days where we don't work. Sunday was a day for a little shopping at the mercado. I bargained some bowls for Kristin and had a marvelous time and got her an excellent deal in the process. After that I felt like I was really awake.
Sometimes here I have just felt so quiet and I have actually felt challenged to talk to some of the other members of our group rather than just walk and enjoy the atmosphere. There is so much to absorb that I feel like I've really been at a loss for some of the standard conversation that fills so much of our days. Even some of the reflections that I mentioned earlier I feel like I am just absorbing so much that internalizing it is taking a bit more time.

Thursday, April 15, 2010

ZUMBA QUE WOW

So tonight did a fantastic work out that just might get me to the gym at home. One of the estudiantes aqui is a certified zumba instructor and she held one of many sessions and this was the first that I could attend. QUE WOW! Talk about a work out tons of endorphins going after that!

Last two days have been really good. My students and I are communicating well and things are going good. I enjoyed reviewing cervical and SI mobs with them today and I think we all benefited* Tomorrow is their charla, or presentation, to the workers at the clinic. I hope they are prepared. Afterwards we get back to ILAC to get on the bus to go to Santa Domingo para the weekend. EXCELLENTE!

So this is just a short post. It's super late here but wanted to say hi to everyone and that I'm thinking of you all. We had a lovely reflection the other night about perspectives and how they can change and really what it is to be human. Maybe get deeper into it later but for now just a minute aspect so I remember I want to write more is sufficient.

Love you all! PS typing on ILAC Spanish keyboard without a shift key and so unable to properly punctuate even if I wanted to. meh it's overrated anyways.

Tuesday, April 13, 2010

Monastary and regression: Campo Weekend

So today is Tuesday and clinic was AMAZING this morning. We saw a 6 y/o M with spastic diplegia CP who was just the cutest little guy ever and he had the most amazing dad. What was REALLY nice though was how interested and receptive the clinic workers were to learning our techniques and how much they wanted to learn how to help their patients. I should preface that this PT clinic what constitutes PT for most patients is modalities: heat, e-stim, ultrasound. They do do some other range of motion (ROM) but it is done so quickly that it doesn’t actually aid the patient in improving their ROM. Then we had a gentleman who was 22days post stroke, L CVA, and just completely flaccid on his R side. A lot of education for the family and for the clinic workers on strategies to aid this man. QUE WOW! (that is one of our favorite sayings out here J )

Then, this afternoon was a cultural afternoon where we took an hour plus bus ride up to the St. Mary of something-a benedictine monastary up in the mountains. We participated in their afternoon prayer service and spoke with one of the eight monks who gave us a little insight into their order; theirs is a contemplative rather than active monastary. It was lovely. Afterwards we went for a FABULOUS hike up the river to a waterfall. It was like a 40 minute hike each way with rock climbing in the river de los Padres. My otra Cis decided to nickname me Jane, as in Tarzan and Jane. I’m pretty darn good at getting over those rocks and climbing around. The name “monkey” was also tossed around which I’ve heard quite a few times before- thanks Mom J. The long arms and legs do come in handy. It was such an awesome hike. It’s an absolute shame that there is nothing in Chicago like it. (Yes Colleeno, I know CO is where it’s at!)

So then we got back late and had a cold dinner. Food here is AMAZING. I just love looking at my plate because its so colorful and delicious J. We, the Cis, then just chill and trade stories. One of the other Cis, Sean, she is from Washington and works peds and adult oncology associated with the University of Washington and she was telling us some of the cutting edge tests that her patients are doing for non-hodgkins lymphomas and other cancers. Like allotransfusions and autotransfusions with really good results. Of course she explained it in far more detail. We were on the topic of using umbilical stem cells, which also constitutes as an allotransfusion, and got onto that topic.



OOPS this was supposed to be a regression so you all could hear about my weekend in the campo. We were at Vaca Gorda—yes, that’s fat cow campo, a rural campo close to the Haitian border. I don’t even know where to start. It’s such an experience. I don’t know how to explain campo. We treated 70 plus patients at our 2 day clinic. I did three home visits. We stayed with families who were so generous to open their homes and who gave us their beds, literally they gave us their beds and they slept on couches or chairs or piled all into another bed. We treated patients with all kinds of problems and played with the kids in our families. Widala was the 8 year old girl in our family. She has two older siblings who have graduated from school and whose pictures are on the wall; they work in bigger cities. Our patients were a lot of overuse injuries from farm labor. One of the highlights was on the third day there, a bunch of us took a 30 minute hike to a river and rock jumped into a deep section. SO FUN. Yeah, I got a bit sunburned that day too. Spanish by the way is very hard to understand when the person speaking has no teeth. My own Spanish is doing alright though. Definitely can make myself understood-like everyone though, you have good days and bad, even good hours and bad hours. It’s all good though! We had mosquito nets but are still waging war with them. Some of the girls have these huge bites on their ankles so much that they have pitting edema, ah well more practice for use J. Thankfully my mosquito bites have just remained bites and no swelling. Alrighty, time to go. Hasta luego.

Campo- with part of the family who opened their home to us


Monday, April 12, 2010

First Day of Work

So instead of being at Los Ninos the pediatric hospital I'm actually working at La Vega which is an ortho-neuro site for all ages from 2 mo to however old you might be. My first day taking over for the former CI (clinical instructor) Laurie who is just phenomenal and whose Spanish language skills are quite a bit better than mine-so I felt just a little pressure of needing to fill some pretty big shoes. I should say that Laurie has been a CI for multiple years here in the DR with ILAC and she was an instructor here when I was a student as well. She is a wonderful person and very knowledgeable, her and her husband who also volunteers down here are looking to stay down here permanently as PTs in the community.

Soo, my two students are Drew and Nicole. Drew is a good guy, needs a bit of help with his Spanish and just takes a bit more time to process. Nicole is from Hawaii and is doing well-a bit more progressed with her Spanish. Although, hey we all have trouble. We were talking to one of the workers at the clinic and a word similar to practicar and sounded like practicaba or something like that with a meaning of increased tone or rigidity was what I got out of it. Anyways, it took some work to figure out and still not quite sure of the meaning. Our patients are SOO INTERESTING! We have a couple of spinal cord injury patients, some CVA, and a few ortho. The ortho patients really help me see what life would be like if there were no PTs in the USA post surgery. Our patients have such bad contractures. One man, ORIF of the R knee has approximately 20 degrees knee flexion 6 months post surgery! Another man who was post fracture of the R lower extremity as well, had only 2/5 MMT 4 months post operative and his R thigh was almost half the size of his Left. Talk about having our work cut out for us! It was interesting being a CI instead of a student this time. I actually think I liked being a student a bit better. Here I really have to take a bit of a step back and although I'm there and talking through the patient care it's about getting my students the most out of their experience.

The afternoon was open clinic at the ILAC center and that was really fun. We followed up with some of the ortho surgeries that were done in January-there I really felt like I contributed something showing some different mobilizations for knee flexion that students could really put to use. Then there were two cases of Guillon-Barre both younger. I was happy that one of the walkers I brought down was taken home for use by the older of the two. Excellent cases! Learning a thing or two as well not being of the neuro background :-). I wish I had taken a picture or two more at that point. Mental memories though are wonderful.

This is a free evening tonight and thus the opportunity to sit down and type. The other night the other instructors and I were total PT junkies and were showing each other various mobilizations and trying them out on each other :-) Picked up some new thoracic spine and C/T junction mobs that I can't wait to use with more patients! OHHH I LOVE MOBILIZATIONS! I love the constant professional dialogue that comes from so many different backgrounds! We have people from all over the country with specializations in pediatrics, neuro, orthopedics talk about one huge continuing education course. I just love picking everyone's brain and hearing about their favorite unique patients and cases. Exposure, exposure, exposure. Some fun facts about GB that I just found out via another professional: prevalence is 1/100,000 and they think it doesn't matter what country. Often starts out in peds as numbness/tingling in the feet. Kids aren't as often trached as adults and mostly make a full recovery. Differential diagnosis with kids is with transverse myelitis and those patients with TM are less likely to make a full recovery as is a more central nervous system problem than peripheral. In GB deep pressure and temperature are the first sensations often to return and light touch is the last. SOOO just some fun tidbits for you PTs that might be reading this and need the same review I needed.

So much for now on this day. It's good to be down here. There is a difference.

Went to late night mass last night as well. I love the Jesuits. It is something I really feel I have missed out on since moving away from Creighton. I was talking to Krisitn about it too and she feels the same way. For me there is just an energy and a power of reflection and peace that I feel that I don't always get from other church experiences. It could be that it was just such a smaller community mass, a Sunday evening mass-I haven't found a Sunday evening mass yet at a Church nearby. Maggie goes to one not too far that I think I'll check out when I get home but I'll have to enquire as to whether or not there is a Sunday evening service. But who knows. It's just a different world down here.

Friday, April 9, 2010

I HAVE ARRIVED

and it is a GORGEOUS 80 something out with humidity and it is blissful! Some music always present on the breeze keeps everything pleasant. I am in HEAVEN!! Got in late last night, everyone else but Hector and Martinez who picked me up from the airport were asleep. I got settled into the casita I'm sharing with another clinical instructor (CI), Kristin-we were in the same PT class so this morning was a reunion of sorts. It was so nice to fall asleep listening to the crickets and frogs with nothing but a sheet and being perfectly comfortable. I LOVE IT!

Woke up in the AM and had a lovely breakfast of eggs, cheese, bread, and fruit. Oh, and I can't forget the coffee. I don't own a coffeemaker at home but here the coffee is divine-truly ambrosia. Myself and two of the other newly arrived CIs went on a run and I discovered that there is a reason my old running shoes are my old running shoes. I had to cut the run short to avoid blisters! Well, I'll put some different insoles in them and hopefully that will remedy the situation. There are four of us total who are new here, myself, Kristin, and then Maggie, and another CI whose name I don't remember. We all were given the day to recover from our travels so we have the morning off till 2:30 when we leave for the campo near the Haitian border. Exciting! The break is definitely needed; getting here was quite tedious.

92 pounds of luggage I dragged onto the "El" and suffered the blatant stares of the other passangers who clearly thought that I was crazy. I just wanted to put a sign up that said my destination and a label on the luggage that said "donations." One gentleman, as the train emptied of regulars the closer we got to the airport was kind, after enquiring as to where I was traveling he offered his assistance getting into the airport. So generous. Him and another young man helped me with my baggage at various points otherwise I would not have managed nearly as well. I was SOO happy to check my bags and to rid myself of the stares I attracted-people were curious but as the train was packed the stoney silence of resignation of being sardines took over and no one asked the question that was quite palpable on everyone's minds. The train was so busy the resentment that my luggage took up the standing equivalent of 2-3 people was a bit tense. I think getting to the airport was more of a trial than anything I will face in the DR. A shot of tequila with another passenger helped ease the stress prior to boarding-she was fed up with the airline hooplah too. Sigh. Ah well, I put all the donations in the equipment room to where they will be taken to the various sites and put to excellent use. Only one bag coming home :-)

I can't quite get over the temperature here. Sorry I keep reverting to it but it is just so ideal. Chicago was so cold when I left! Most people say the weather here is humid-NOT ME :-) I'm the woman who doesn't own an air conditioner and would rather be outside in the heat and humidity not laying out but working out! Mom and Dad, you know me-nothing new in that description. I can't wait till we really get in the swing of things. I am a sponge and I will just keep soaking up this atmosphere, the air just wraps itself around you and is the best welcome I have received in a long time! It is a perpetual hug. My translucent skin is already beginning to gain a bit of color. :-) Pictures to come. Needless to say its lovely lush and green with colorful flowers everywhere.

PS: feel free to share this with people I forgot to email the link to-- sorry Grandpa! I love you and hope you enjoy these little updates as well :-)

Wednesday, April 7, 2010

anticipation

I thought I was packed. That is, I thought I was packed until I printed the suggested itinerary. Ooops. I'm glad that my flight doesn't leave until the afternoon because tomorrow morning I've got a list of things to stop by the store to buy including but not limited to: bug repellent, flashlight, granola bars, crayons, and neosporin. The other list I have percolating in my mind consists of other places I want to stop by, the library-to return Fire in the Blood (an excellent quick read if anyone is interested), the used bookstore-to pick up One Hundred Years of Solitude, and another book by Salman Rushdie I've been meaning to read for some time now, the dry cleaners, the post office, and I'm sure I'm forgetting something else.

Today at work was interesting. I was alternately insanely excited and extremely anxious. Anxious because I was trying to figure out what all I need to remember or what I may be forgetting. Excited, well, I'm flying to the DR!! I love to travel and that was only reinforced by seeing one of the women at work who just got back from Rome. How I miss Europe! One of my friends is moving to London in the fall and between the two of them I think a trip to Europe is in the near future. There are just so many places I want to go and just not enough time. Where else would I like to travel? Well, Egypt is pretty high up in there with South Africa, Peru, Brazil, Greece, Australia, and some of my friends have me convinced I need to see some of Asia but that is a bit further in the future. As for my current destination, I decided to go back to the Dominican Republic for a couple of reasons. One, it's familiar-I've been there before. Two, I felt I needed a bit more experience and again the familiarity was comforting. Three, the time commitment was the most doable at this point in time. Lastly, I felt the crazy need to do something somewhere else. I went into physical therapy to help others and I just needed to go somewhere and really give back. I get bored and I need to do something new and although the DR isn't a new location the capacity in which I am acting is. Luckily enough for me I am able to entertain my desires and reach out to some distant destination.

PS: What finally calmed me down from being over anxious was a glass of red wine from IOWA (Summerset Vintage Red) and just some chillin in front of the t.v. I am bummed that I will have to wait to watch the 100th episode of Bones (relatively newly addicted).

Monday, April 5, 2010

Starting Out

I'm thrilled that I now have a bag in which to take the donations I've been collecting down to the Dominican Republic (DR). It's been a bit of an issue for me because I have two walkers and they didn't quite fit in my suitcase; I was despairing that I would have to leave one and the other I would use-pretending my foot was broke and take it on the plane that way. Well, my dad solved the problem for me; he lent me a huge canvas boyscout bag that fits the walkers and everything else! Good ole boyscouts!

Next on the agenda for tonight is to get my actual suitcase put together. Clothes. This is not a fashion statement but a professional-volunteer outing with the exception of a weekend on the beach so the packing should be rather easy. SHOULD being the key word. I have this "be prepared" background in me and so I like having something for every contingency. Sigh. Maybe this will take a bit more thought.