Extremely Far Away Mobile

Today at clinic I was on another mobile clinic. To start this was a very far away clinic and you spend 2 hours on a bumpy road that can’t be good for anyone’s spine. But not exactly the point.


Patiently waiting for my patients to arrive in my private treatment room


The Physician Assistant treatment area–not working with much here as you can see

The first patient I tried to see was a female who had cervical neck pain and headaches. I tried to do my interview with the patient and she appeared very hesitant. Once I asked her to start actually moving she denied me completely. I tried my hardest to convince her that there was so much I could do to help her with her pain and that she could be in control of some of her aches but she refused. All she wanted was some ibuprofen for the pain. This was extremely frustrating as you can imagine. I couldn’t force her to let me evaluate her so all I could do was walk away. This was not fun.

The next few patients were way different though. I had one woman who had cervical pain because she was carrying heavy objects on her head for hours at a time. Imagine carrying a bucket of water on your head. Obviously the neck pain was going to happen. As I evaluated her she was very interested in my treatment. This is rare especially in the villages. The villages usually have people who only speak Kekchi and they are usually unwilling to listen to my suggestions and help. This was exciting though because she allowed me to show her different activities and seemed very excited to follow her home exercise program. Every time I bring out a cohune nut (a nut from the trees here that is hard) and give it to a patient as a personal massage tool to get knots out of their back and to break up some tissue, they all just laugh at me. It works so well and they enjoy it but they all laugh at how I am making them rub a piece of a tree all over their muscles. I also tried to use some of the Kekchi lingo that I have picked up from listening to my translators. This is something that everyone laughs at. I clearly am not saying anything correctly but hey whatever I am trying. That should count for something!

I finished the day off with a patient similar to the one I started with. He had low back pain and was eager to get some medicine. When I examined him I quickly learned that he lifted heavy objects in the fields all day long and he was constantly bending at his back rather than his knees. This can cause so much pain and damage to someone if they do it constantly. When I tried to demonstrate to him how to properly lift up heavy objects he blatantly told me that he has been doing it his was his entire life and he doesn’t plan on changing that. Once again I tried my best to explain how it was bad for his back and that he was causing his own pain but he refused to listen. In the end I basically asked him to try to lift the proper way for one week and if he can do that than he might start to feel some improvements. I am not sure if he will listen but it was the best I could do for a non-adherent patient.



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