At Work

Navajeeana

I took some quick pictures at the end of the day today. Just to give the people back home what a physio gets to work with in Sri Lanka. Enjoy!

 

Me and my 83 year old osteoperotic hip fracture patient. She is a trooper, coming for 2 one hour sessions each day.

Maru, Genius (his nickname) and me. Students we are workingwith from Colombo university. They taught us how to wrap amputee stumps today!

One of the curtained off treatment areas. Complete with untrasound machine. Vindya the rehab assistant is way ahead of the RAs in Canada and uses that thing "like it aint no thang".

Outdoor parallel bars. Enough said.

Shelf o' toys and the first stationary bike ever.

The rehab gym with the neuro bed. 

The fan was broken until yesterday. So this room just got a whole lot better!

First Weekend

We planned on going to Ho-o maniya Blowhole with some of the therapists and staff from the centre. But when we showed up at the centre we were shooed away by the security man. We decided to wait outside the gates for our friends to meet us. We waited for 45 minutes allowing for some rubber time. We thought that the rain probably kept them away. So we left. We called home talked to some of our family members for a bit, then headed to check out the beaches.


Our beach dog

Unfortunately that afternoon it was really rainy. It is the monsoon season after all.  While we were walking along the side of the road, a dog decided to start following us. We were wary at first thinking it might want our snacks or have rabies or something, but no, she just wanted some company. She was a very nice looking dog and really friendly. She would jaunt up ahead of us and then turn back to make sure we were still there.

Empty urchin shell

We check out the two beaches close by, and after getting caught in a minor rain shower we went for some rice and curry in a 2nd floor restaurant with a killer view. Rice and curry and Coca-cola. Life doesn't get much better. Our dog friend came with us of course, and the woman at the restaurant told us that this pooch follows all the travelers and even tried to hop into their vehicles. While we were eating lunch the local house crows kept trying to get into the buffet. The did manage to get a few papadoms.

View from the restaurant

After we went to the beach again and found some really awesome shells. The it really started to rain. And get windy. So one of the guys under a beach hut beckoned us under. Turns out this is the fat, bald guy that our Canadian liaison warned us about. Ooops. Luckily we managed to escape after a brief converstation.

waves crashing the point rocks

That night our landlord made us dinner and we watched copious amounts of GLEE.


On Sunday we arranged to travel to Kalemetiya lagoon via our landlords nieghbour/brother's tuk-tuk. We got up pretty early and then headed out. On a scale of granny to death gripping the side rails of the tuk-tuk, he was about a 7. So it was a nice peaceful drive.

Kalemetiya turned out to be amazing. Its not the right time of year for birds, as most are in their summer nesting grounds, bu we still saw  fair few. We also saw crocodiles and monitor lizards and water buffalo. In the park we hired a man to paddle us around the lagoon. That was pretty neat. Krista and I aren't sure how to boat actually works being that physics is neither of our strong suits, but we didnt tip and got back to the shore in one piece and dry.

stretch of unoccupied beach opposite the lagoon

crocodile

After our boat guide cut us own some young coconut to drink and eat. MMMMMMM, Refreshing!

land monitor lizard

 Krista wondering if the boat is going to tip

wild peacock

wild buffalo

Water flowers

the lagoon

water lily

mmmmmm, coconut water!

Week 1 - Change of Pace, Change of Perspective

At Navajeevana they just recently instituted appointments for their patients. Previously they were just having patients arrive when it was convenient for them. Then it was decided to be more effective appointments would be instituted, however, given the nature of the culture, this is not strictly adhered to by the patients. They are still getting used to the system. Also appointments are supposed to be about 45 minutes according to one of the therapists, however, patients usually end up staying much longer than that, especially if they are living at the centre while receiving treatment.

Coming from a culture where being on time is paramount to how things get done, this has been a difficult adjustment for me. Its not that I like knowing what is coming through the door, I actually don't mind that part. Its the pace of waiting around not knowing when someone is going to show up. It seems like the Sri Lankan therapists are used to the down time and make use f it. I like having my down time scheduled. For example, in Canada we would know that there would be no patient coming until 9:30, so it would be a good time to start tacking a larger project. I have adapted by bringing my resource book in and have taken to looking up conditions and the treatments for them to fill the time. Also, I don't think 1 hour appointments (aside from initial assessments), let alone appointments that drag on for 3 hours are for me. I like to do my assessment, provide my treatment and education and then move onto the next patient. By the 45 minute mark either I have exhausted the patient or I have run out of ideas for the day. And really the patient doesn't need me there to stand over them while they do their isometric quad exercises. Maybe the first couple of sets but after that they usually have it. So the last couple of days and y aim for this week is to see if I can change, become more of a neuro therapist who would love to have unlimited time with patients to be able to get the reps in and to think more like a Sri Lankan and take my tea in the middle of seeing a patient to let them have a rest. Perhaps changing my North american frame of reference will help me be a better therapist in the Sri Lankan system. When in Rome...

First few days.... this is, um, different

Work here is going to be very different. That was evident on the first day. The patients sort of saunter in at anytime they feel like. One of the physios was telling us that they just recently switched to the appointment system, but the patients are still getting used to it, as most of them just come whenever they want to. This makes the day really interesting, because you never know what is going to walk through the door! Rubber time is what they call it. And often the patients stick around for a long time because they come from far away and their appointments are not frequent. We are not entirely sure ho long appointments are supposed to last here. 

There are currently 3 other students here from Colombo: Isha, Samantha and Manoj. All boys. Its been interesting working with them and seeing what they do. For instance they don't know a of manual therapy, but they are very good at giving exercises. They have been especially useful in communicating with the patients as most of them don't speak English. Sinhaha is the language here and it sounds beautiful, but its, going to be a challenge. Although today I did learn to count to three. And the colors blue, red and green. Other than that I am lost.

Everyone's made us feel very welcome though, offering advice on staying safe and travelling and letting us use the pool and wifi at moonstone. 

Navajeevana, the rehab centre for the whole southern country.

Cleo, Raelene's dog

View from Ralene's place at Moonstone Villas

After our second day on the job. So sticky.

Home Seet Home (for the next 5 weeks)

 We arrived jet lagged and absolutely shattered on Friday to our new place. Our landlord seems very helpful and they are even going to teach us how too cook a bit. We also found out today that they're going to change our sheets and towels every few days! What a treat since we are such sweaty messes! Anyways, I always get asked what my place looks like when I am staying somewhere new. So here are a few picts to tantalize the senses.

This is our kitchen. Complete with a extra bed! I have to admit when I first walked in and saw this I thought that this might be the entire apartment. 

This is our actual bedroom. The mosquitos seem to like Krista's side of the bed better. 

What would an apartment in Asia be without a toilet that combines the shower?

This is officially my favorite room of our place I like to eat here and to do my morning yoga. 35 day yoga challenge anyone. I am going to give it a shot anyways.

Semester Wind Up

This semester might have actually been my favorite one yet.

Perhaps it was being able to see the light at the end of the tunnel, perhaps it was the variety of course material that they bombarded us with, perhaps it was feeling a little more steady in manual therapy classes, perhaps it was that the last month of classes was during the rest of UBC's summer intersession and the place was nice and quiet. Or maybe it was just not feeling like a total dingus while taking the OSCE. 

All in all I am feeling relatively prepared for what lies ahead, I mean really, it just a couple of practicums and a few weeks of research and cased based before we have our first terrifying day on the job.

In other news, the fish are back on this blog. Please, feed them. It was either that or a daily picture of a puppy.

I am planning on writing on this blog for the duration of my time in Sri Lanka. I can't promise how frequent it will end up being or how many details and photos I will be able to upload, but stay tuned. More to follow.


Fun Fact:
Sri Lanka has the highest density of gem deposits compared to its landmass.

Finding Something You Remember You Love!

Soooo, by Dec 14th, 2012 I was almost 100% sure I didn't want to be a neuro-physio and was re-considering if this was the right choice in career.

Christmas vacation was great. Lots of family time, rest and a fantastic chest flu. 2 weeks of no responsibilities and absolutely nothing to do with school, except a small, quiet and sophisticated class social. It was a great holiday season, and I wasn't exactly looking forward to returning on the 2nd to start the next practicum at 7:15 am after a couple of weeks of sleeping in and eating bon bons.

But on Tuesday I was reminded how much I actually do love being a physio (student).

My placement is basically a private practice but on the military base in Esquimalt.

I feel competent and I feel like I am able to use the technical skills we have learned in class.

But its more than that too, its the and problem solving nature of orthopedics. You have to find out what is causing the pain from what the client is telling you and what you find in your objective assessment. This takes piecing together and using your clinical experience (which I have little of) to determine what the problem is then base your treatment on your findings. As a logical individual I find this extremely gratifying, especially when the treatment is effective. Even if its not, I like that you can try again with a different theory or have another look for something you have missed.

And then I was thinking to myself, well, why should I like this placement more than the last one? Maybe its because my preceptor is a more think out loud person who verbalizes and talks me through the steps of determining the problems with a client. In hindsight this is probably the reason. I didn't realize it at the time, but we rarely talked through what we were doing and why during the session. Its a little awkward for the patient, but I feel like its how I am going to learn a lot this placement that way. And maybe it is because of the natural light that comes into the clinic instead of the basement fluorescent light area I worked in last.