The first student today was a great therapist. We are working with Cohort 6 which is the next grade. They have taken al of the didactic coursework for the is residency and half of the mentorship. His patient had low back and knee pain. With a sound foundation I was able to challenge his thinking and reasoning. His reasoning was strong and his examination was one that I would compare to a third year DPT student from America. After this session we had great discussion about movement patterns, muscle activation, and clinical reasoning principles.
After that patient, I co-treated with one of the lead therapists Wilfreda. She has been practicing for over 30 years and her son is Martin. Her patient was very challenging. He is coming with radicular leg pain and a Severe lateral shift. She has been working with him for 8 visits with almost no change. After redoing a subjective examination and objective examination we tried a few interventions with little to no pain changes or shift changes. However she had not done much active intervention including exercise so emphasis on graded exercises with function and movement as the goal was added today. I also emphasized patient education and explained what I was thinking and the purpose of my education so she could understand how the implement it herself. After this session, I believe he would be benefit from a surgery based on his objective exam and response to treatment thus far. However, in Kenya it can take between 3-5 months for this to occur so either way we need to continue conservative care as the process continues. I am hoping the education and movement will cause some more changes and allow him to avoid surgery.
After the treatment session my student from this morning walked to lunch with us asking more questions. It was refreshing to have someone eager to soak it all in like a sponge. He stayed for an extra hour just to talk with me about patient care!
After lunch I mentored one more therapists with her patient. The students were done for the day so they sat in on the session also. I think the large number of people in the room intimidated her and she seemed pretty flustered. She learned the most about how to prioritize and differentiate multiple pain locations to provide effective care.
After clinic we returned to the Grace house for tea and reflection. We had a great discussion with Martin about the students involvement at the hospital and ways to work on sustainability growth with the relationship. I felt that they came up with great ideas and had a productive talk.
After a workout I spent some time working on a lecture before going to bed. It was nice to get back into the clinic.
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