Today I went on another mobile clinic. One patient I had today was experiencing back pain in her thoracic region. As I did my evaluation I discovered she was very hypomobile in her thoracic spine. In any other setting I would be seeing this patient 2-3 times per week. This would allow for me to do some mobilizations to her thoracic spine to help improve her range of motion. In Belize that is not the case; especially on mobiles. We only see these patients once every 2-3 months. This makes treating someone like this patient difficult because ideally I want to help her improve her range. Instead I have to provide her with some self-mobilization techniques that she would have to do on her own. The issue with her spine was she had decreased thoracic extension all throughout her thoracic region. I had her sit in a chair and do self-mobs over the back of the chair. She was advised to line up the level of the spine that she had pain with the chair and do the mobilization there. This is hard enough to explain to someone in the United States, let alone a woman who doesn’t speak English and lives in a village where they don’t have any idea what physical therapy does. Finally she began to understand what I was trying to have her do. Hopefully she continues to do this on her own to help decrease her pain and improve her range.
Once I was done treating this patient the med team came up to treat her with a pelvic floor exam. She had with her a 2 month old baby and a 2 year old baby. As the med team arrived she quickly handed me the baby and left me in a room with her two children. I looked at this in two ways: 1. She trusted me enough after our examination to watch her kids during her exam, and 2. She was happy to get them off her hands because the 2 year old would NOT stop crying. I had the 2 month old in my arms sleeping as I am trying to entertain this 2 year old boy who was just not having it. Finally someone else came up and helped calm the 2 year old while I hung out with the 2 month old for about a half hour. My preceptor kept laughing at me because whenever he came upstairs I was still playing with the baby rather than actually working on my own patients. Whoops. But he was so darn cute I wanted to steal him away. Not the 2 year old though. He was not so cute but more on the evil side.