So Many Needs...

Today was another demanding day in the clinic. It rained heavily the night before, so it started out a little slower, which may have lulled us into a false slumber for the day…

As medical services, particularly those provided by specialists, are limited in availability or if available, costly or difficult to access, sometimes you are seen as the “Western Medical Expert” for anything medically related. This can put an incredible amount of pressure on you to be expected to work outside your comfort level and an ethical dilemma on whether to help knowing that your medical knowledge still may be more than what may be reasonably available for the person. Today there were several instances of this. You never know what is going to “walk in the door.”

I saw my first ever pediatric neuro-developmental delay patient! A mother arrived first thing in the morning with her 9-month-old who she was concerned was not progressing with his motor development at the “normal” rate. Fortunately between drawing on my PT school pediatric training almost 20 years ago and my more recent experience as a mother (with a set of PT eyes), I was able to assess the child for developmental milestone achievement and make some recommendations to get them started on a program. We are fortunate to have a trained German Pediatric PT, Enrique, in the area who comes in one day a week to support the area’s pediatric needs. The mother was willing to come in a couple of days later to be seen by her. I was relieved to know that I had gotten the patient on the right track with her program after checking with her (though perhaps she was placating me :) ).

Another patient was sent down from the medical clinic by the General Practitioner to be “checked out by a PT” as I suspect he was unsure what was going on and was looking for a 2nd opinion. After much questioning, the young woman I suspect had an unusual type of migraine presentation with transient “stroke”-like presentation. I was able to discuss the case with Dr. June Hanks, the program director. She will consult an internist back in the US and determine if she can get some of the medications which inhibit the onset if the migraines. I feel fortunate that we may able to help this woman who, when the migraines occur, is very functionally limited.

Another cabinet worker in clinic had nicked his finger on a saw and looked to me to provide first aid to it. Still another patient was complaining of “stomach” pain who wanted me to assess his needs. Again, with consultation from Dr. June, she suspected it may be acid reflux. We advised him to be seen by the doctor and in the meantime, gave him some general positioning advice and self-care ideas. What a lot of responsibility you bear to meet the medical needs of patients here!