Only better way to top yesterday's start of the day was today's. Yoga on the end of the pier with the sounds of waves, the sun rising, and clear skies. 5 of us did a little P90x yoga and it was amazing!
After pancakes with peanut butter and fresh fruit we boarded the boat for our clinic day. Kim and I went back to Livingston with the other 5 students. Today school was back and session and we walked into a room with 12 students with disabilities. We got to learn each students story and after that we did screenings of each student to determine if treatment was needed we treated a few of the patients.
The one my group treated was a 17 year old female who was unable to read or write due to a learning disability. However she could sew and was doing that in her community. With some mentoring the students were able to look big picture at the patients needs and came up with a great plan of care to address her thoracic, finger, and balance impairments!
The rest of the morning consisted for return patients from yesterday who were all doing better including the lady with the wrist fracture who presented with 3/10 pain and maintained the Range of motion gained last visit. She was in shock of how well the wrist was doing and reported she felt much better with our care which was great. The students did a great job educating the local therapist on the treatment techniques to improve his skills as well.
We also had a very challenging patient with low back pain. Her high pain levels, 4 year history of pain, and inability to do more than 2 minutes of walking made me aware that this was not going to be an easy fix. I decided to take the reigns on this case and really work with sound clinical reasoning and think about my interventions to show the students how I would handle this. She improved a little, but I am still struggling trying to think of what would have been best for her.
On the way to lunch I met a gentleman from Livingston. He went to the University of Illinois for school and returned to Livingston after college. After talking about Chicago he began to explain to me the changes over the last 4 years in this area. He said that back in the 70s the town of Livingston was all his people (he referred to them as the black people) he said that over the last 40 years the other cultures (he called them the Mayan's and the Spanish speakers) have began to take over the area and racial tension has increased. We also talked about the population shifts, high HIV rates, and assistance from foreign groups. I had a great conversation with this 66 year old man with so much life experience.
(Blood pressure cuff bag from a past Thrive trip being used by the clinic PT Ronnie)
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After a great fresh fish lunch we headed back to the clinic and treated until 5 pm.
(My new favorite hot sauce!!!)
We saw a verity of patients with symptoms from 1 day long to 8 years of pain. We saw as young as 2 and as old as 81. Seeing this much variety really changes the treatment and thought process from visit to visit and has been a great experience for the students.
We got back to the compound and I got to jump in the water for 15 minutes before dinner. We had salads and with my diet it didn't put a dent on my hunger so luckily I got to have 2 more servings and 3 spoonfuls of peanut butter to curve the hunger.
I had a great conversation with one of the students about one of the patients she saw. It was an orthopedic case and I was happy to talk it out with her. After going through the subjective, objective, and diagnosis we talked about other options and what I would have wanted to know. It was so awesome to see her reason through the case and even come to these conclusions on her own. She is a very smart girl but tends to be hesitant to voice her ideas. I think that experience will hopefully improve her confidence and carryover to increased confidence in her knowledge and skills and a therapist. She had ideas that were not used by the group but now she may be more willing to speak up for the good of the patient.
After the meal our group had a great reflection on the day. The students had some great insight on their growth and how much this trip has already shaped their thinking, skills, compassion, and self awareness. I am looking forward to even more growth the next few days!
I got to spend another night looking at the stars and blogging. I now remember why I can see myself living on the beach or in the mountains. Waking up and going to bed with this nature is rejuvenating.
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