The past two weeks have been slower with the holidays. I took Christmas and Boxing Day off. I stayed home on Christmas, and while it was a lonely experience, I enjoyed my solitude.
I took advantage of my extra time and baked a loaf of bread and some cookies. It was my third loaf of bread, slightly better than my first two. The first loaf I let rise for too long and the second one I burnt. I also made some peanut butter cookies :).
‘On Boxing Day, I was invited to a friend’s house for a meal that included rice, potatoes, different meats, and a salad. We enjoyed the food while watching a soccer game. The English Premier League is super popular here.
My Swahili is coming along. I can understand 10% of the conversation, which is encouraging and much better than where I started. I’m really hoping to be conversational in Swahili by the time I leave.
This week had few challenging cases. The one that stands out is a 14 year old boy with a developmental brain injury. He presented with marked spasticity in all four limbs and recently lost his ability to walk, which was not great to begin with. The children I’ve seen with brain injuries leading to spasticity have poor balance and a poor ability respond to challenges in the environment (rocks, hills, steps, etc). As you might imagine, when the build environment is not accommodating, it becomes really tough for these kids to engage in society.
What really stood out in this boy were the multiple non-healing sores on his hands and face. They appeared to be there for a while and in the week I saw him were unchanged. He also had dry gangrene on the tip of one of his fingers. It’s tough seeing that level of deterioration. I gave the family some simple exercises for the spasticity. For the other conditions, we referred him for other management.
In total, I’ve had 158 visits. Of those, 77 are first visits or new patients, and the rest are people returning for follow-up visits. Mechanical back pain still tops the list as the main diagnosis. The most common region of complaint is still spinal.
Also, the word is out now that women who are pregnant might benefit from coming in, so I imagine there may be more pelvic pain cases coming in, in the next few weeks.
Here is a photo of a couple kids with cerebral palsy. We are working on a few exercises with the mums.