We started off our Tuesday morning with a little therapy ourselves. Julie and Cassie joined in with some seniors who were dancing traditional Chinese dance set to techno music.
We spent most of our Tuesday at the hospital. Bright and early, we met an ex-figure skater with lower back pain. Shannon and Cassie provided him with pain relief via electrical stimulation followed by some exercises for strengthening. Carmen and Cassie then worked with a child with CP teaching the therapists treatment strategies and educating the parents on functional speech and functional play with bilateral hands. He was also taped for wrist extension and forearm supination. Julie and Shannon worked with a patient who lacked range of motion in his shoulder following being hit by a car. They then headed up to the NICU to present to the nurses about positioning and handling techniques. This was a big open door!!! PTL!
Julie then taught on kinesiotaping, building on the knowledge they had gained last year. They really appreciated this teaching session as they utilize kinesiotaping quite a bit!
Lunch in the cafeteria again proved to be equally as tasty. After lunch, Julie and Shannon revisited the 11 year old with a degloving injury and made plans to make a splint as soon as her staples come out. Shannon then went to the NICU, which is a HUGE breakthrough!! Cassie teamed up with one of the therapists making rounds to see patients, including a woman with bone tuberculosis in her wrist, a man with a broken leg, and a woman with a knee prosthetic. Carmen was able to work on oral motor skills with a woman who had a stroke.
Wrapping the day up, we broke off into teams with Julie and Carmen meeting with the entire staff of the international school in this province. They were able to educate teachers and staff on classroom strategies for children with sensory issues, low vision, articulation problems, and fine motor weakness. The teachers were very receptive and encouraged by this session with the teachers sharing their email addresses for further correspondence. Cassie and Shannon taught the therapists about electrical stimulation. They discussed how it works, patients appropriate for use, and logistics/settings for use. They thoroughly enjoyed trying this out on each other!
As if this wasn't a full day already, we then were off to dinner with some of the teachers from the international school at a traditional Chinese restaurant equipped with a lazy susan. We had good conversations and good food to end the day!
Getting back to the hostel, we were greeted at our door with water bowls and the information that we have no water for the next two days. Your prayers are welcome and needed!!
Monday in a nutshell was a whirlwind..... We're sitting here trying to remember this morning!?
When we arrived at the hospital we all ran in different directions. Julie assessed a little princess with scoliosis and torticollis. She was a spicy thing, but that's nothing new to Julie.
Cassie and Shannon visited the NICU step down unit to see a baby who had been in respiratory distress after birth. She displayed left sided weakness and some positional torticollis. Cassie and Shannon were able to give the treating therapist some pointers and praise her for the good job she was doing thus far.
Afterward, Shannon and Cassie were able to see the 21 year old boy with cerebral palsy. Cassie was able to share some treatment techniques with the treating therapist while getting the boy in quadriped to work on improved trunk stability and strength. He has already made much progress over the past three sessions. Shannon was able to teach two of the PTs how to cast for AFOs. Only one or two therapists almost lost a finger. The boy that was casted for AFO's was very curious and expressed that he was happy and excited! He got to pick his own design: red straps, yellow foam and motorcycles!
Carmen then taught on Autism and behavior, including treatment strategies such as identifying emotions and PECS. During lab time the therapists showed their playful side.
We broke for lunch at the hospital's version of a Chinese buffet, cafeteria style. Mmmmmmm......
We met with several foreign doctors and discussed several of the patients.
Shannon then went on the rounds with one of the doctors from the our meeting, we were late getting back for afternoon patients (and Cassie had to go to the bathroom!), so Cassie and Julie decided to climb 15 flights of stairs back to the therapy floor. Whew!!!
We were straight up bombarded with people to see during the afternoon- including, but not limited to, an ex pat's child with sensory/articulation concerns, a teenager with spinal stenosis, several children with cerebral palsy, a child with a de-gloving injury, and a two month old with a history of multiple surgeries and complications.
After that, Shannon taught on wounds and burn care with emphasis on treatment strategies such as splinting, positioning, and wrapping. Julie paired up with a translator to translate the PEDI to assist with providing further standardized testing for kiddos at the hospital.
We may or may not be back at the Yak burger place while writing this blog. It's super yummy!
The weekend wrap up!
The weekend was full of cultural adventures. We rested a bit on Saturday morning before heading out on a souvenir hunt. Amanda took us to a sweet local shop that sells goods made by Tibetan women to help support their families. We cleaned up for a good cause (and it's really cool stuff)!
After an explosive lunch (if you get our drift), we headed to the orphanage with some of the hospital staff. We got to love on some sweet kiddos, while educating the teachers as well as the hospital staff on positioning, range of motion, posture, oral motor and sensory techniques. The teachers were receptive, writing down everything we said. Afterward, we were taken on a tour of their very well equipped facility that included multiple PT rooms, sensory rooms and a fiber optic room. As we left, the director approached Amanda and inquired about us coming back next year for training on how to best utilize their facility with the children. The door has been opened. Praise The Lord!!!
For dinner, the adventure continued. We dined on Yak Burgers at a restaurant called Snow Mountain. They were surprisingly yummy! We topped it off with ice cream and headed back to our home sweet hostel.
On Sunday, we joined Amanda and some friends we met last year, and we had a great morning with them.
We ate at a traditional Chinese restaurant that was extra yummy! We then headed out on more cultural adventures which included visiting a Tibetan Buddhist temple followed by sipping on coffee at the brand new Starbucks in town.
Tomorrow we are heading back to the hospital to see more patients and provide additional training for the staff.
Friday was full of activity and adventure!
We started the day at the hospital, where they have a new OT/PT area. The new area is very spacious and has a large gym space, an office area, and 3 very large treatment rooms. The floors are pink, like bubblegum pink. #TIC (This Is China)
Today's teaching was all about sensory. Foundations of sensory, why we treat the way we do, what we're really doing. (We don't just do obstacle courses because they're fun, although they are...) Teaching was finalized with lots of entertaining which included a "sensory lab," where our Chinese friends learned how badly they need sensory treatment. They might decide to quit after the slightly challenging obstacle course and prone on platform swing 2-step task. Even the scooter board proved to be a challenge. Although how many of us have really tried these activities ourselves... Hahaha!
Treatment was crazy hectic! We saw the gamut of disabilities and age ranges. From little screaming ones, to an 11 year old with severe neck pain, to a 24 year old patient with TBI, to a 40 year old man with low back pain. Carmen also evaluated an Australian 3 year old for articulation.
Cassie and Shannon worked with a 21 year old guy with CP, who recently lost the ability to walk. They were able to get him standing with a new pair of AFO's, utilizing the parallel bars. He was able to walk between the parallel bars 7 to 8 times while playing tic-tac-toe with Cassie on a vertical surface. He also worked on weight shifting in static stance while reaching for darts to throw at a target. His mom seemed very pleased with his progress throughout the session.
Shannon has a new pen pal. One of her adult patients was insistent on getting Shannon's phone number. We highly recommended that she not call that number for fear of incredibly large phone bills.
Breaking for lunch on a Friday in China can be quite the adventure... We had an authentic Muslim lunch, after which Cassie joined the local Muslim ladies in creating their signature dumplings. Cassie might have struggled with this. Just a tad. In her own words, "the struggle is real, ladies."
While walking through the market after lunch, Carmen decided if she lived in China, she would definitely be a vegetarian. Watching chickens getting their heads blown off with a blow torch was all it took. Various other carcasses were hung all around. Not to mention, we had just eaten one of said chickens, complete with thick skin and neck. Luckily, Amanda took the neck for us. Whew!
After work, as if our jet lagged, wearisome bodies hadn't had enough, we went for more. #TIC We went to the homey apartment of an ex pat family to assess one of their entertaining children and have a scrumptious meal of chicken fajitas. Their little guy was so fun and cute. He was adopted by this family here in China. Shannon assessed the fit of his prosthetic leg and after much problem solving, determined that this little guy has grown since the beginning of August (when he received his leg). His leg was 1/4 of an inch too short. Easy fix by dad.
We're gonna sleep good tonight!
We made it to Xining!!! It was a super smooth trip with lots of room to stretch out on our long flight and no added fees for extra baggage! We were met at the airport tonight by our team where they took over for us rolling our luggage to our cool ride. Thank you for all the prayers! We have felt them.
re·la·tion·ship
rəˈlāSH(ə)nˌSHip/
noun
the way in which two or more concepts, objects, or people are connected, or the state of being connected.
Today we lived by this definition. We returned to a government run orphanage for children and adults alike. This is our third time to visit this orphanage and each time we go to build relationships. Our hope is through these relationships, the therapists, nannies, and other employees will see our hearts and desire to engage with their residents.
We feel our relationship was deepened, if only a little, today. The therapists were more engaged and willing to collaborate regarding the residents with whom they work. Much laughter, smiles, and treatment ideas were shared. The therapists requested we assess their residents as if we were seeing them for the first time.
Kelly spent a majority of the time in their new multi sensory environment. It was amazing! They had a tactile and auditory wall, ball pit with self activating color changing buttons, a bubble tube, a water bed with LED lights, and a cloud swing. The therapist were using it as a circuit of input so, Kelly help work with them to adjust the sensory input to fit each child. She was able to demonstrate with both sensory seekers and residents with low activity level. The first little boy they brought was diagnosed with autism and was very sensory seeking but, also had many behaviors. Kelly was able to show how to use their room to best calm his body and how to modify his routine to decrease his negative behaviors. During lunch, Kelly was able to help out some of the child residents learn to eat independently. It was nice to work with the nannies to help improved functional independence.
Paige spent the whole day helping the social worker, nannies, teachers, and psychologist with oral motor, speech production, language, and behavior. Paige was able to help a girl who was very motivated to speak use placement cues to make specific sounds. Late in the afternoon, she came up to Paige and independently used her placement cues to make those same sounds. Paige was very encouraged by her self-initiation to speak.
During the afternoon, the staff asked Nicole to help them with some PT ideas to complete in the sensory room. This was a difficult environment for PT due to limit space for the movement these individuals were seeking, but Nicole was a trooper! She was able to work with a sweet boy using strengthening techniques at the the tactile wall and was able to fit him with braces and shoes for the first time. He was then able to stand independently for the first time and take steps with minimal assistance. It was so great to see all of his therapists clapping and yelling " Bravo!!".
We were also able to speak with the therapists about what they would like help with in the future. We are encouraged by our blossoming relationship and are excited for our future partnership with this program.
Unfortunately (or fortunately), we were too busy to take many pictures. Here is a story about a boy we worked with at the orphanage. We are happy to say he is now a sweet, gentle young man.
http://www.elespanol.com/enfoques/20151017/72242790_0.html
We are excited to go home to our families but, we will definitely miss our Guatemalan family (Tio Juan, Anita, and Diana)! We are lucky enough this time to take our translator, Leo, back to the States with us! Until next time....