New Year’s 2015 trip to Guatemala focused a lot around physical therapy (PT) as we were joined by PT students and professionals. I have shared about other experiences, projects, and relationships in previous posts, and so here, I plan to share my thoughts on physical therapy. Until recently, I did not have a strong opinion about physical therapy. My core thought was yes, I can see the potential benefits, but is it really worth the expense and time. Today, my opinion is yes. It is worth the expense and time, especially when you have a caring, supportive, educating physical therapist.
Why the change of heart? It started with my own personal PT experience in September 2014 and culminated with spending a week with physical therapy students and professionals in Guatemala over New Year’s. I now see how neglecting rehab as a teenager and young adult results in today’s pain and ailments. I learned that though my knee hurts, the pain actually comes from the misfiring of my hips and glutes (non-technical terminology). Therefore, I now understand why it truly is important to maintain all aspects of the body. It amazes me how I have a better understanding of my body and how it functions. I can do a step down with my left foot and feel/see my knee go in and my hip drop, while doing it on the other side there is a lot more control of the hips and knee. I am not a professional nor can I effectively diagnose myself and put a plan together, but I can better understand what is happening to provide details to the professionals for better diagnosis.
For me physical therapy is a luxury though a necessary luxury if I want to be active outside of my sedentary job. For many, especially those outside the 1st world, mobility and functioning without pain is a necessity to make a living and support thyself and one’s family. Therefore, the importance of providing access to physical therapy like medical, dental, and vision care to patients across the world. The amazing thing about PT is you truly do not have to have fancy equipment and resources to make a difference. My therapist sent me home with exercises and stretches that for the most part required no resources or resources available to me, such as a towel or thick book. I do not have to go to a gym or have a gym in order to continue my therapy, just the discipline to follow-through.
You do need access to trained individuals for diagnosis and development of a plan to address the trouble areas. In Guatemala, there are few clinics that see patients on a regular basis. In the Zacapa and neighboring areas, physical therapy clinics are slowly being setup and staffed on a semi-regular basis, but they cannot support the number of people needing support and are not accessible by many. Carlito, the young boy with spina bifada, would benefit greatly from therapy, but he has no reliable transportation to get him into Teculutan for therapy. On Day 1, the team saw a patient in Esquipulas who then traveled almost 2 hours to come for a follow-up in Teculutan two days later. The clinic in Esquipulas serves people from neighboring villages as well as El Salvador and Honduras. Hearts in Motion (HIM) continues to support and assist locals in the establishment of staffed clinics as well as providing one to two day pop-up clinics when volunteers come to Guatemala. During these clinics, students and professionals spend their day assessing clients, creating a plan for at home therapy, and explaining the plan and the problem to the patient. Each individual completes paperwork to assist in tracking the diagnosis and the plan allowing for follow-up when the next volunteer group arrives or at one of the staffed clinics, if the patient has means to travel.
During this New Year’s trip, I spent the first three days at different clinics. The first two days were pop-up clinic experiences at established facilities for conducting physical therapy. The third day was at the newly established staffed clinic in Teculutan that was seeing scheduled patients only that day.
Day 1, we spent in the mountains in the town of Esquipulas. The entire team went to help Quique and team. Quique and his family have offered over part of their home to create a clinic in the mountains. He saw the need and importance of access to physical therapy after experiencing an accident in 2010. Check out this conversation with Quique and Efosa during our visit and the Quique Ceron Foundation Facebook page to learn more about Quique and the work he is doing in Esquipulas. My time in Esquipulas was spent as a runner getting new patients, gathering the paperwork after consultations, searching for supplies, and playing with the children. An overall amazing day watching and listening to the team assist the community and even making a cast in the kitchen for one of the patients.
Day 2 was in Gualan at the HIM compound with a portion of the group and had a lot fewer patients. Therefore, I spent most of the day playing and assisting with the children in the Nutrition Center. At lunch, I fed Otto, a little boy that was there during our July 2014 trip. Feeding Otto was challenging and required patience and quick reflexes as he had quick hands that would send the food flying to the floor. When I took his plate to the kitchen, Emily informed me that I actually did a great job of getting him to eat. Otto apparently is a very picky eater and does not like most of the traditional foods. Besides playing with the children, this was the day that we put together Carlito’s wheelchair.
Day 3 was an unexpected but blessed experience in Teculutan with Lauren and Efosa. Flexibility is core to traveling on missions especially. I had planned on spending the day in Pueblo Modelo assisting with Carlito’s family home, but God and my digestive system had a different plan. I blame it on the fresh coconut milk from the day before making things a bit unsettled in the morning, but nonetheless to have access to restroom facilities, I decided to experience the clinic in Teculutan. It was only Lauren, Efosa, and I at Teculutan and scheduled patients. Therefore, we were not overly busy which allowed Efosa and Lauren to work together to evaluate and treat the patients. Lauren also acted as our Spanish translator. This provided a great learning environment for not only Lauren but also for me. I listened and watched the two explain to patients their therapy and the importance of posture and doing their exercises at home. I tried hard to work on my own posture throughout the day and worked on my home exercises when we did not have patients. In addition, I tried to help translate the paperwork from English to Spanish thanks to a translation tool in the application and my limited Spanish. Between patients, the teaching did not stop as Efosa shared with Lauren different techniques to obtain the same results. I also helped around the HIM house to clean out an office and move some furniture.
Overall, this experience reemphasized and drilled home the importance of taking care of oneself and following through on rehab. The realization that aches and pains will not improve without properly addressing the underlying problem. Therefore, I did not hesitate going back to physical therapy this summer after starting to play basketball and experiencing inordinate knee pain. I knew that to be able to play basketball, go hiking, or just be able to walk in the future would require me to first understand the cause of the pain and then work to resolve it. My glutes and hips hurt, but I do see some progression towards better control and mobility. Thanks to all the physical therapist that have assisted and educated me over the past year!
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