We are excited to have a guest blogger today! Amanda Wherry, a former Children's Therapy TEAM Occupational Therapist has spent the past 6 years living and working in China. Amanda has paved the way for the first generation of "therapists" working in Western China, providing education and leadership for this new group of occupational, physical and speech therapists. We are beyond blessed to know Amanda and hope to continue this partnership with her!
it was an amazing time. the therapists have come and gone, but the impact they left behind is indescribable and unmeasurable. in just a short week and a half they conducted 24 hours of trainings covering 17 topics, we saw more patients than i can count (one day, we saw 10 patients for OT, PT and ST and introduced speech therapy eval techniques to the head of the stroke rehabilitation and neurology department - all in just a 2 hour time span). and the department now has some pieces of equipment that it's been needing for the past 6 years. did i mention that this all happened in 8 days? i can't explain my thankfulness. it's more than just the fact that this department took some great leaps forward in the areas of PT/OT/ST, and it's more than the fact that now this therapy department is the only department offering speech therapy and having the potential to work within the NICU in all of central and western China. for me personally, for a week and a half, i had a little piece of home by my side. i had former coworkers and friends right here, seeing and gaining understanding about what my life has looked like for the past 5 years. they experienced the smells of flooded sewer streets and unclean squatty potties, of people who haven't bathed in who knows how long, and of greasy food that's more oil than it is vegetable. they saw people with devastating diseases that could have such a better life, such a different life, if they lived somewhere else - somewhere that was developed enough and valued ALL life enough to offer proper equipment and help to those in need. they slept on beds that probably made their backs ache, smiled through exhausting 10-14 hour days, and never complained. ever. and they also saw the joys that i get to experience over here. they got to know the local therapy staff at the hospital - how unique these young therapists are, how eager and teachable, kind, gentle, loving, and fun they are. they saw parents' eyes light up with hope over their children with cerebral palsy walking (with the support of AFOs), a non-verbal little girl expressing choices and therefore empowerment (with the assistance of a talk board), a man with severe aphasia spontaneously speaking words for the first time since his stroke a year ago (to fill in the blanks in prompted sentences), and a 3 year old little boy who may now have the opportunity to go to school if he regains function in his affected side (through constraint induced therapy). i was more than just grateful for the professionalism, the life, and the light that these ladies brought here - i was inspired - to keep pressing on.
my top ten highlights that came quickly to mind (which means there are probably more). in completely random order:
10. julie's text of "back that thang up" which she wrote to me a mere 10 minutes after saying they were finally boarding the plane in houston after a day of delays. the aforementioned "backing up" was because the plane had once again encountered mechanical problems and they would, in fact, not be boarding for several more hours.
9. cheri and carmen's joy over eating spaghetti at a westerner's house their 2nd to last evening here. chinese food was NOT a high for them on this trip.
8. when our driver moo-ed like a cow and stuck his hands on his head like horns to tell macey that the mystery meat we were eating was beef.
7. the guy therapists twittering like junior high girls in mortified embarassment over us asking them to take their shirts off so that we could demonstrate some kinesiotaping methods on them. guys here walk through the streets with their shirts tucked up above their bellies ALL THE TIME if it's 75 degrees or above. what's the big difference?
6. macey's laugh. have you heard it? if not, you should find her immediately and say something funny.
5. raiding their stash of american snacks. luna bars. raw almonds. trail mix. life is good.
4. seeing how pumped my staff were when they found out that carmen was a cheerleader and wanted to teach them the hog call. the youngest guy therapist even rushed over to the table to grab the pom-pom that we had just been using to practice PECS book methods. he shook that thing and "woooooo-ed" like a champ.
3. the fact that, now after learning articulation methods from cheri, my entire staff can say "TH-ank you" instead of "S-ank you"
2. julie, wearing her sweater on her head, delicately walking on the curb while grabbing tiny tree branches for balance to avoid getting soggy shoes in the flooded hospital driveway.
1. reading the encouragement cards that people at Children's Therapy TEAM wrote me. i cannot believe that people took the time to do that. i've read 1-2 a day over the past several days - spacing them out to make them last longer. and i've smiled, i've laughed, i've cried, and i've been reminded that i'm not forgotten. thanks for that ladies. it meant the world to me.
More culture fun! Did you know that Tibetans have a tendency to stick out their tongue when they're embarrassed, when they're excited, or when they're nervous? Well, we now do. While evaluating a sweet Tibetan grandpa, Amanda might have had to tell Cheri that his tongue sticking-out issues were cultural and not a disorder. In fact, it meant he liked us very much. Perhaps being evaluated by 3 American women was the fulfillment of a lifetime dream. But we'll never know, not only because his stroke had made him a little mumbly, but also because he could mostly only speak Tibetan, which Amanda does not.
When introducing how to use a Big Mack switch, Carmen first explained how to record a spoken message. She explained that the message often is used to gain a person's attention; for example, "Come here please." Amanda then prompted one of her male therapists to think of a message so they could practice recording using the switch. Amanda hit the button to turn on the recording, he spoke the message, and everyone but Cheri and Carmen were falling on the floor laughing. When we finally got a translation, we found that his message was very attention-gaining. "I think you're hot... Is it ok that I pursue you?" Later that afternoon, it came back around, when during our final teaching session, he was asked to go help a young quadriplegic girl transfer from her bed to her wheelchair. He asked Amanda if he could quickly leave the class, and she said, "Sure, no problem. Would you like to take the switch with you?" At first he was puzzled and asked, "Why would I need that?" To which she replied, "Just in case you needed to ask the girl out on a date.... You could get permission to pursue her."
The week ended with a flurried picture-taking session after the staff gave us beautiful gifts of Pashmina scarves and Tibetan hand-painted wall hangings. Hugs all around, and a bittersweet last walk from the hospital.
Get ready for it.... Are you ready? Amanda's OT/PT (and now ST) staff were taught the Hog Call! Yes, one little corner of China is now calling the hogs - Chinese style... "Woo pig soey, Wazough-back!" And yes, we have a video!
Stay tuned! A surprise guest blogger will be joining us tomorrow.
Today was filled with more patients and teaching. The highlight of the day was implementing behavior modification with a little 3 year old boy. For a full hour, Carmen wrestled him, enticing him with fun toys but not rewarding the crying. He literally cried the whole time, reaching toward the door because his parents had left the room. This little guy knows how to work the "system". Just picture a little guy barely able to walk, picking up his sucker, drink, and dad's iPad, and trying to get to the door. "I'm getting outta here - this American lady is calling my bluff - NOT cool!" Oh my goodness! This little guy is a smart cookie! It was a good lesson for the staff on calm persistence.
The staff has totally taken the new concept of speech-language therapy and RUN with it. Today they did an evaluation on an adult stroke patient after just learning the techniques yesterday. Behavior modification was introduced just yesterday, and one of the staff members explained some techniques very thoroughly with the parent of the 3 year old cryer today. They are amazing rock stars!
Our day started in the neurology department with Cheri doing an oral motor and speech-language evaluation with a stroke patient. The hospital staff was very involved in the evaluation and showed enthusiasm with what they learned about adult evaluation yesterday.
Following the neurology department, Carmen taught the staff about behavior modification techniques. The child-raising culture here is quite different, and behavior modification is like a new idea. In order for us to keep our sanity for the next 3 days, we realized not only did we need to teach behavior modification, but the staff need to implement it immediately. Ha! There was a moment when the penny reinforcement boards were brought out, where pure pandemonium broke out when the therapists were so excited to see American coins. The translator said, "It's Lincoln," and we all applauded.
The Boardmaker program was brought out, but a slight glitch was observed. The program requested was for a Mac, which is what the hospital staff has, but the program received was for Windows, which the hospital does not have. Bummer! But, everything that Boardmaker can do was reviewed and demonstrated with picture cards, schedules, and picture boards printed from the program and brought here. Upon returning home, the program will be exchanged and sent back to Amanda.
In the afternoon, we saw 2 beautiful American children, and we were pumped to get to speak ENGLISH with them!!! And once again, it was culturally appropriate for Carmen to touch little kid heads (it's not ok in this culture). They were so fun. Carmen gave articulation tips, and both kids caught on very quickly.
The final teach for the day was on speech-language checklist evaluations. When talking about the oral motor part of the checklist addressing drooling; suddenly, one of the staff members threw her hands over her face with a sigh of despair, gasped, and whispered, "Sometimes at night I drool when I'm sleeping." What she was asking was, "Do I need speech therapy????" Hahahaha! Good times in speech training!
We hit the ground running introducing speech-language therapy to the hospital staff. We first evaluated and gave recommendations to two little sweeties in an ex-pat family who moved to the area a few weeks early just to meet with us. Then Carmen did a teaching session on intro to speech-language therapy, defining articulation and receptive and expressive language. Speech development and articulation therapy tips were introduced. The staff was super receptive and enjoyed playing with speech sounds. They took lots of notes on this new area to begin in their therapy repertoire.
Following the first teaching session, another little kiddo came in for an evaluation. Recommendations were given to his mother and grandmother, and they repeatedly thanked the therapists. It was heart-warming to give them concrete things to work on at home that they never realized they could do. They were encouraged.
Cheri then evaluated an older stroke patient with hospital staff observing the eval. He was a super sweet little man and gave such good effort for tasks that were very difficult for him. It was exciting to hear him say words with sounds the staff had not previously observed him using. The hospital therapists were very involved, and tried many of the oral motor evaluation tasks themselves while looking in the big mirror. It was lots of fun!
The day ended with Cheri teaching the oral motor and communication evaluations for adults that had just been demonstrated.
We got up this morning and headed to the streets to hail a cab to Amanda's home independently..... We actually got there on the first attempt! On our walk to church we got to experience the joy of the Chinese open air morning market. It was slightly larger than the one in Fayetteville. There was anything and everything you could imagine, and even a few things you couldn't imagine!!!
We had a refreshing service with a group of people from a variety of countries including the US, Australia and India, before heading out to ANOTHER lunch. This time it was with some of the directors of the hospital. They wanted to treat us to a western meal, but still ordered around 10 different platters of food and insisted that we try everything!!! They were very friendly and enjoyed sharing cultural stories from their past and asking us questions about our lives in America.
After lunch, we visited a few more homes. The first was a family from New Zealand who are fostering a child from a local orphanage with spina bifida. WE. FELL. IN. LOVE. He had only been in their home a couple of months and was super happy and full of life! He has undergone several surgeries. One to correct his myelomeningeocele and 2 others for his hip and foot. He had received AFOs, HKFOs, HKFOs with a TLSO attached, and a stander from a recent trip to Hong Kong. We made some recommendations and the family was very thankful that we came.
Next, we visited friends of Amanda's whose son needed a speech eval. The made us dinner and we visited about living in China before Carmen got busy! She made some recommendations and may see him later next week at the hospital. Enjoy the pics!!!