Thursday in the clinic

Back to full strength with 8 and everyone was very excited.

Last night Eena explained the stomach issues to mamma the cook of where we eat and asked for some variety with the meals.

This morning we had amazing empanadas which were perfect after a morning run. It was pretty peaceful running along the beach by myself while the locals woke up and the boats returned from a night of fishing. 

We split into two groups today with Eena and her group seeing mostly PEDS.

My group started with a lady who had primarily left low back pain which has been going on for about 7 months after a fall. She stated it felt very tight and "stuck" on that side. After completing a detailed exam we ended up treated with a left Lumbo pelvic manipulation which relieved  most of her symptoms and exercises to maintain this improvement. We also sent her to a medical doctor for her elevated blood pressure.

Over the next few hours we saw a few teenagers with low back pain, reviewed and progressed the home program for a patient we saw on Monday, and the gentleman with a femur fracture returned to the clinic. He was doing much better so we progressed the exercises as we also performed soft tissue message around the incision. 

The best part of the morning was during the treatment of the final patient. The three students did a phenomenal evaluation and treatment of a young man with shoulder impingement. To see where they have come in these few days has been amazing. 

To see the patient go from 90 degrees of abduction with major pain to full abduction with minimal pain was great too!

After lunch we got a ride back to the clini in the back of a pickup

We saw a total of 13 patients before lunch and worked just as hard afterwards.

My group was able to see a family of four. We started with the daughter, next the mine and after that the grandparents. Each patient presented with different symptoms and we were able to treat and improve each of them 

We got done right on time and got to spend the rest of the night on the beach relaxing until dinner

Thursday was a great day in the clinic and a great day as a group

The blog will be taking a break for the last few days of the trip but we will keep working hard in the clinic

Day 3 in the clinic

Wish I could say we were back to full strength but another day of sickness kept us at 5 in the AM and 6 after lunch.

Everyone is on medications now so we expect to be all ready for tomorrow 

We split into two groups again in the morning and we were still able to see the same amount of patients 

My half of the group saw 5 patients with two of them being ladies in the sixth and seventh decade with back and neck pain.

We also saw a gentleman with extreme left shoulder pain with all motions and activity. It was very frustrating for all of us to treat him but finally after educating him about pain and mobility as well as performing Active assisted Range of motion laying down as well as isometrics in standing.   His Motion and pain improved post treatment which was surprising to him and very helpful for us to make sure he is compliant with his home exercises.

We worked as a group with an 8th month old who was hypotonic and progressing at about a 2 month old developmental level.  It was a great experience to work with Eena and children again.  

During our fresh pineapple break we made a new friend 

The final patients each group saw was an 80 year old couple. We saw the husband who had a stroke 2 years ago. He was in therapy until the therapist had to leave but has improved a lot. Today we progressed his exercises with retro walking, VOR training, side stepping over obstacles and right arm proprioception 

The couple did not know how to read so we had to be very artistic with our home exercise programs. They were able to understand and gave us all hugs and kisses to show how greatful they were. They supported each other throughout the experience and when they started to walk away on the beach the entire group stopped and watch how much love they shared. 

After lunch my group was able to see a young man who was in an accident with a broken femur and had an ORIF 3 weeks ago. He was told to not buy any weight on his leg but told to begin therapy this week. We were able to work on walking without weight bearing, Range of motion, And strengthening. He will be returning every day to progress and work on his exercises. 

Lyndsey, katelyn and I stopped on the way back and got to play volleyball with a few guys but it didn't last long.  It takes more skill to play with a soccer ball and a 10 foot net. 

After dinner we spent some time on the roof playing cards and preparing for the next day

 

We impacted a total of 20 lives today but really I think they each touched our lives more with their compassion, greatfulness, drive, and love for others. 

Day 2

Today was a rough day for the SUPT crew. We started with 8 therapists and ended the day with 5 due to stomach sickness

We are not sure if it was something we ate as a group, the water, or degradation but it was a challenging day.

Luckily everyone is on the mends and we should be full strength in the clinic tomorrow

We split into two groups again but mixed it up throughout the day. The students took a much bigger role in the process and did a much better job with flow and communication with interpretation.

Each group saw 6 patients before lunch and another 3-4 after.

We had a few more children and Ena was able to make a huge impact with education, exercises, and orthotics.

The group also saw a lot of patients with lumbar and cervical spine symptoms which I was able to take the lead with the care. The students were ready picking up on patterns with the evaluation and treatment using past patients withsimilar  symptoms.

One of the most enjoyable patient interactions I had today was with an 80+ year old female.  She was not sure exactly how old she was anymore, she lives alone, and had full body pain. She was not able to tell us much or function well with walking or moving but she did note how she had a lot of upper trapezius pain near her neck besides her back and knees.

Working with the students we decided to do the most supported treatment of functional exercises to tolerance, assistive device for walking and assisted motion for her lacking shoulder mobility.

We also talked about treating with empathy and in asked them to think as if you are treating your grandmother. We talked about the power of human touch and decided to do a gentle massage to her neck region.

We agreed it would not cause any long term tissue changes but hoped that this would cause her to continue to think about our interaction and do the exercises.

It is very hard to only have one or two visits for physical therapy so we are working to do everything we can to increase the chances of a long term impact and success.  

Day 1 of clinic

Sunday was a pretty relaxing day spent in a small beach/surf town 1 hour away

We got to experience the food, shops, and beach.  One dollar fresh made empanadas while sitting in the sand were phenomenal 

The group spend the last night before clinic began getting to know each other.  We have really meshed well but you could sense some anxiety about clinic beginning 

The walk to the clinic was about 15 minutes but today we took a truck to bring all of the donations

When we arrived 3 patients were already waiting outside ready for us

We quickly got unpacked, organized our supplies, and split into two groups.

Each consisting of a group leader, someone who spoke Spanish and both years of PT students

From 8 to 1:30 our group evaluated and treated 5 patients and the other group completed the same amount.

After lunch we saw another 4 patients per group until 530

We had a wide range of patients from age to diagnosis and functional level

The youngest patient seen today wa s 8 months old with slow developmental progress and hypotonic. All the way up to a 90 year old man with severe bilateral knee Osteoarthritis which has severely limited his function.

The focus for me today was to let the students get used to asking questions, struggling with the process, but also thinking critically.

They all did a great job applying what they have learned and know to really

Make an impact today.

To see first year students thinking critically and interact with a patient with confidence and poise in a new situation and different language was phenomenal.

For myself it was great to apply the residency training I received with UVA-Healthsouth. The evaluation and thought process really streamlined the treatment plan and helped me to feel confident that if I can only see a patient one time I am giving them the best care and long term plans that I possibly can.

It was very different to sit back and have more of a teaching role with the students. At first it was very hard but as the day went on I enjoyed the experience a lot. None of the students have learned about the spine so I get to treat all of these patients while still showing skills to the students 

The most rewarding patient interaction today for myself was a 34 year old male with a report of a disc compression injury two years ago. He no longer works as a fisherman or plays soccer due to his pain. His symptoms stayed very local to his back but he was very afraid to move and had severe cramps with each motion.

We spent time talking about his back and really worked on movement patterns and how positive the motions were for him.

After the talking, motor planning, joint mobilization, and exercises he left with full motions, 1/10 pain, and will be playing soccer between now and Friday when we see him again.

It is hard to see such great in session changes with an evaluation and even harder in a different culture and language so it was great to experience.

As a group we had a great reflection and sum up of the day

Excited for day 2!!!

First day in Puerto Lopez

After a 1 hour nap we started the day with a traditional breakfast and a camera crew. The small fishing town of Puerto Lopez is very excited for us, the mayors wife is heading up the clinic and she has been talking about us on the radio and TV.  They will be following us around all week and documenting our trip on Channel 3

Our group spent the rest of the day on a boating adventure. We packed into a boat for an hour trip to Isla de la Plata also known as the poor mans Galápagos Islands. The island has many birds that inhabit Galápagos including the Blue Footed Boobies. A two hour hike had some of the best views I have ever seen. 

We spent the rest of the afternoon snorkeling in the deep blue water off the reef. We saw every fish in Finding Nemo, blow fish, trumpet fish, star fish, and more that are above my fish knowledge.  Jake got some great videos on his Go Pro but sadly we could not add them here.

Did get some close ups of sea turtles before we anchored our boat 

Still didn't get my exercise fix in, so a group of us went on a beach run, sprints, and soccer with locals.

I am still very confident that I am a terrible soccer player and need to practice before I travel again

After another great meal with the group we did some reflection and enjoyed the beautiful beach weather

One more day until our clinic begins....

Day in Quito

Before bed last night (Thursday) we got to visit he new area of Quito which is very modern with tons of restaurants, bars, stores, and shops. We were shocked by how nice this was but learned from our local leader that this was built with the boom in tourism

On Friday we were able to maximize our day in Quito starting with an early breakfast.

We spent the morning visiting 3 churches with one being the largest in South America! The best part was the fact that we were able to tour while a mass was in session giving us the full spiritual effect. It also was pretty amazing climbing narrow stairs on the outside of the church to reach the bell tower.  I have climbed to the top of a church before in Europe but it was not close to this risky.

The other churches were much smaller but had a lot of great history and intricate artwork

We headed to the town center to see the presidents house, political buildings, and learned a lot of Ecuadorian history from our local leader Miguel.

After lunch at a local restaurant that consisted of meatball soup, meat, rice, lentals, plantanes, and salad, we took a trip up the mountain to a statue of an angel which can be seen all throughout Quito.  

The view was something out of a magazine with the Andie mountains cradling this vast city 

The final stop before dinner was the local market. The smells, sounds, and sights reminded me of my other experiences and made me remember why I love the cultures around the world 

The real adventure started after dark when we embarked on our 9 hour overnight bus trip from Quito to Puerto Lopez. 

Packing 16 bags and 8 people in a 12 person van without a trunk was hard enough.  Adding a wheelchair was an adventure. Luckily the bus was much more spacious but I can say it wasn't the most sound sleep of my life.

Travel day

Today was a busy day of travel for our thrive group

We left Winchester at 4 am and met as a group of 8 at Dulles bright and early

Preparing as a group beforehand really helped to quickly form a bond

We had a 5 hour flight to Panama and then a 2 hour layover before making the final leg to Ecuador 

Our group was able to collect a lot of donations (wheelchair, crutches, braces, splints, theraband, and other supplies) which is great, but the bus we had for the hour long trip to the hostel so we had a nice cramped ride

We had just enough time to put our bags down before grabbing some authentic Ecuadorian cuisine 

 

Equator is a very clean and organized country so far. It has such a better infrastructure compared to the Central American countries I was been to before.

Headed to bed early for a tour of Quito tomorrow