The Jackson Clinics

Today was the beginning of my second week at Black Lion Hospital and I was ready! I actually got 10 hours of sleep last night and got up at 6 for a quick run around the block. I may be more adventurous tomorrow and try for longer, but I still uncomfortable with the area, even though it is safe. I saw some pretty amazing mansions along the way. It is sad that there can be such a difference between the rich and poor class, only blocks away from one another.

We had our three shoulder patients return today for follow-up treatments. I can see that the residents are getting it now. They can verbalize the primary and secondary impairments, and, they are thinking outside the box and limiting themselves to a single joint. With our clavicle fracture patient, we were able to work on joint mobilizations to increase her motion by about 5 degrees, but we significantly reduced the pain in the back of the shoulder that she initially reported.

The second patient was our cervical radiculopathy patient who had reported that he was feeling much better with only 1/10 pain over the weekend. However, after watching a lot of TV last night, he woke this morning with 4/10 pain in the left shoulder. After addressing his cervical spine, thoracic spine, and neural tension, we were able to move into the posture and strengthening phase of his rehabilitation, which is the more interesting and fun part of our job. I tried to challenge the residents by giving them a piece of equipment and having them create exercises that would target both posture and upper back strengthening. It was interesting to observe them interact with their patient and to see the poor quality of exercise that their patient got away with. However, when this patient left today, he had no pain in the left shoulder and was educated thoroughly on proper sitting posture.

We enjoyed lunch today with Tes again in Ambassador Park where we sat outside. I enjoyed my tuna sandwich and 7up while we talked about our families, PT in the USA, and life in Addis. It was interesting to learn how much inflation has occurred in this country in the last few years. He told us that 5 years ago the price of a coke was 1.25 birr. Now, the price is more in the 5-6 birr range.

Our final patient was the proximal humerus fracture. During our treatment today, I was able to help the residents think outside the shoulder, and we addressed cervical, thoracic, elbow and scapular mobility in all different positions. When we had finished, her cervical range of motion increased 6x the initial measurement into extension and her lateral flexion doubled. This was so important for the residents to see because we accomplished all of this without the use of modalities. They have been stuck in their pattern of modality usage and modality usage, that they have not seen the potential of their manual skills. Both the residents and the patient left very happy.

This afternoon is a rainy one. It POURED as we waited for our driver to come pick us up today. On the way home, we saw yet another accident, this time involving a dump truck and a small car. Right in front of the accident was a very large stream going across the road in which a taxi was stuck. To avoid possible difficulties with cars in the water, we decided to alter our initial evening plans of going out to explore to instead, walking over the Korean restaurant. This restaurant was a little more pricey (my entire meal was $5), but very very good!

I’m excited to come home in 4 more days. I am really looking forward to seeing my boyfriend, my family, my dog and taking a very long, hot shower with soap. I’m excited to do laundry with a machine, drive my car in a city with traffic lights, and see patients that have “normal” pathologies. While I have enjoyed my time here and I want to return again, I am ready to return to my convenient lifestyle and simple luxuries.