Hotel Bound...

Today was a great day.  A little chaotic for my liking but it was very productive.  I arrived at the clinic and I had two hours to co-treat with the therapists before my presentation.  I had a patient that was 8 months post-op menisectomy and was only receiving modalities.  She had developed patellofemoral pain (pain in the front of her knee) so she had been using a wheelchair and had not been walking.  I demonstrated an evaluation, prescribed a home program and relieved the pain with McConnell taping and a Mulligan mobilization.  She was so excited to learn that she could do the technique at home that she didn't stop doing the mobilization all morning! She walked out of the clinic! They told me it was 'magical.'  I had therapists all morning saying they had patients they wanted me to see and said they were bringing them to the presentation so they could learn!!! So, I arrived in the room where I was supposed to give my presentation and the room was so full with patients and healthcare providers I could barely move.  I was a little unsure as to what I was supposed to be doing but decided to get creative and have all of the patients serve as examples of different Mulligan techniques.  As it turns out, I had to evaluate each and every one of them before using the techniques or giving them exercises since the therapists in Peru do not do evaluations (they do not document anything).  The scripts say 'pain'.  So it was a rather arduous task (since everything I did had to be translated and I had to make sure my translator understood!) but the therapists learned so much that it was well worth it.  I am having two of the therapists, Douglass (pictured below, practicing a knee eval) and Jolio follow me closely and demonstrate so that they can be the liasons when I am gone to help the other PTs. They are excellent clinicians and very eager to learn.  An interesting case this afternoon; a patient that suffered a calcaneal fracture 7 months ago.  He walked in non-weightbearing with two crutches.  He was unable to move his foot.  This was primarily due to being casted for many months, and once out of the cast he did not put any weight on it or move it.  After treatment, he had functional range of motion and was walking.  This was the perfect example because the gains in range of motion are often the greatest after cast removal.  Needless to say I never got to my presentation but the patient examples were far more valuable and covered almost everything I was going to talk about/demonstrate!

I went to lunch at the hospital cafeteria with Maria (my translator, pictured above).  I am still fascinated by the size of the lunches! It was during lunch that I developed 'travelers distress'.  Something that I have taken great caution to prevent but I am plagued with it; hotel bound.  I have had some time to think since I cannot leave.  I have two theories: First, it could have been that I accidentally put my toothbrush in the sink water, then touched my toothbrush to the bottled water as I cleaned it off (then took a drink from the bottled water this morning forgetting that my toothbrush had touched it).  Or, it could have been that I ate a couple of mussels...hmmmm.  At any rate, I will say that if it was the mussels, at least they were good.   I am hoping this will not last into the morning since it is a long commute and I have a long day ahead of me.  One of the PT's is taking me to see the glass churches and 'mirrar montagne' (see the mountain????) tomorrow, should be fun.