09 September, 2010

Just another day at Rose Rehab

Below you can see a couple of treatment sessions we had today in our therapy room, which has recently been transformed from a dingy, windowless, unfunctional room. It's been painted, windows, lighting and a fan installed, and had the attached bathroom cleaned up. So while still without equipment, we have now started treating in this area with the use of a mat on the floor.
So this is what occurred in there today:
Sokny and I met and assessed 29 year old Srey Tung. She has never visited a doctor or any medical professionals until now. When she was just 7 days old, she developed a fever. Her family took her to see a Khmer traditional healer, and after 3 days, her fever settled and she was better. However, they recall she had poor neck control as she developed, and had no power in her arms and legs. So for 29 years, Srey Tung has been lying down. She doesn't leave the house, and has no form of assistive seating. All day, she stays at home on the floor. She is able to roll to her left side, and her right side independently. She would like a wheelchair so she can get out and about in the village.

After assessing Srey Tung, we can see that she has significant leg muscle contractures that prevent her from being able to sit up on the floor, as well as poor strength. She does, however, show signs of power, and it does seem we will be able to work on her strength and function. When we talked about this with her, she said she is very happy to learn exercises to help get her stronger, and stretch out her muscles. Whilst it was probably quite a scary day for her, coming to see us, at the end of the session she stated that her body felt very comfortable! It would have been the first time her body has ever been in some of the positions it went into today, and provided a great stretch for her.

Here we tried supported sitting on a stool - because of her tightness in her legs, it is too hard to do on the floor. She has very weak trunk muscles and is unable to hold herself up, but it is something we can work on.

Lying on her stomach next - something she has never done before, and we got quite a laugh out of her as she rolled the whole way over!
With a bit of assistance, and re-positioning, we were able to get her into a reasonably comfortable position, but remember, this is stretching her out into positions she's never stretched before, so was quite uncomfortable initially. It is also a position that enables her to use her back, arm, and neck strength to prop up on her forearms and look out infront, and to the side.

It was a big session for Srey Tung, but she'd like to see us again, which is great to hear. She says she's going to practice these activities at home with her parents. Next time, we will visit her at home at see what the setup is there, and how we can incorporate activities into her homelife.

Next we saw 15 year old Srey Mien, who has nasty back pain after working in the rice fields with her family. The back pain is so much that it stops her doing activities around the house. She left school many years ago, and has been working at home since.

After a treatment session today, Srey Mien reported she felt better than before she came in, though she was still obviously in significant pain with certain movements. With exercises to continue at home, we will see how she is next week.
Cambodian farm life involves incredibly hard physical labour, with prolonged periods with the body in full flexion, or bent over. It really doesn't surprise me to find a 15 year old farmer in severe pain from such work. Many many people here report back pain, but not many seek help, or do not know that they can. They do not see anyway they can change their habits, as the work and the farming has to be done in order to make a living.

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