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.