2/28/17 – Starting to wrap up

Today marked the final day at the clinical sites of Manos Abiertas, Santiago Crespo, the Adult Day Center, and La Posada. It’s hard to believe this is our 7th day of work and that our time of service here is beginning to come to a close.

La Posada 

Today we went the La Posada, a home for teenage mothers.  Many of these moms are fourteen or fifteen years old and come from unfortunate situations where they are either afraid or not allowed to live at home due to their pregnancy.  The mothers attend school and the children attend daycare all on the grounds of the home.

We were able to work closely with a therapist who works with the children and their mothers.  Many of the babies we evaluated have developmental delays, not meeting their age-appropriate motor milestones.  We evaluated 27 babies all under the age of 15 months in one day!  One little girl was so upset during her evaluation I had to take her out into the hall in the hopes of her calming down in a quieter environment.  This was less successful than I would have hoped so I stopped the evaluation as she was just too upset.  The next day I wanted to try again to see if we could evaluate the little girl with the help of Chelsea and Amy.  We took her out behind the building in the quiet are and Chelsea and I played with toys by ourselves while Amy just held her, giving her the opportunity to relax and explore in an environment she did not perceive as threatening.  And it worked! We were able to work with her for 45 minutes and the little girl even started playing with Chelsea and I by the end of the session!

As a group, we hosted classes for the moms with babies with development delays.  Brauna, Tristann, Kyle, and Joan hosted these classes divided by age group of the child. We focused on the importance of play, breast feeding schedules, handling, tummy time, and transitions for the development of their babies. The moms were so engaged in the class, hanging onto Brauna and Joan’s every word, practicing different positions with their babies and playing with them.  The on-site physical therapist attended the classes as well and told us afterwards that she had never seen some of the moms so engaged in their child’s development!  It is so humbling to see how these girls are coping with being so young and having to take care of a child when many other teens worry more about school and their friend group and fashion.  They are doing such a great job with the resources they have and I can only hope that we gave them a few more tips they can use to help them along the way.

Manos Abiertas 

The last day at Manos Abiertas was filled with more presentations and emotions. The morning consisted of individual patient presentations from students, which were all well-received by those in attendance. The afternoon called for one more student presentation and then a final talk from Joan, one of the faculty members on the trip. She fiercely advocated for everyone at the facility to incorporate more PT into each child’s day: get them up and moving more, get rid of the PEG tubes for those who have the ability to feed themselves, all of these little things that could really maximize the children’s quality of life if the time is taken to complete them. After she said her peace, she called upon individual students to advocate for patients that they thought could really benefit from being pushed harder than they currently are. The students, some with tears in their eyes following Joan’s passionate words, choked out a few heartfelt choice words of their own in front of their other proud classmates and the faculty of Manos. The physical therapists at Manos then got up to say a few words, and they were crying as well, saying how appreciative they were of everything that MU has done for this facility and the amazing work that this group has accomplished over the past seven days. The site gifted us with certificates that commemorated the 50 hours of service that we completed over the past week. It was a very powerful afternoon for all.

After that, it was time for Mass, which was highlighted by a beautiful song by Shannon and Michelle M; some students lead readings as well, and overall it was a very nice ceremony. Once Mass was finished, we brought a little bit more of the United States to Costa Rica. It was Fat Tuesday, after all, which meant nothing to the citizens of this country, so we tried to bring in a little purple, gold, and green of Mardi Gras to share. A special King Cake was consumed, and the final day at Manos Abiertas was capped off with dancing and laughter all around in celebration of all that we have accomplished at this site over the past week and the past years.

Adult Day Center

The adult day center was very rewarding today. We finished up screening the adults in the morning and then started treatments! There are 4 PT students from Costa Rica doing a clinical rotation for the next 2 months there. A few of us joined with them to co-treat the patients while Craig, Yasmen, and Lauren designed a group exercise class for the afternoon.

Working alongside the other PT students was interesting. Although the education here is not yet where it is in the US, it was a good reminder of how far we have come and where we were as a profession not too long ago. We discussed different ways of treating the patients without being overbearing. It was rewarding to work alongside these students and see their thought process while sharing our own.

The afternoon was fun-filled! Craig led the group exercise class and did an excellent job. We had DJ Susanna manning the music which all the adults enjoyed very much. We were able to walk around and help the residents understand exercise better. The residents were so thankful afterward, saying we showed them things they have never experienced before. The smiles on their faces was truly rewarding and I am sure we will all carry these memories with us as we begin our professional careers as physical therapists.

 

Santiago Crespo

T0day was our last day at Santiago Crespo, which is crazy to think about. The past 7 days at this facility have been filled with laughter, love, friendship, learning, and of course movement. Our morning started out traditionally enough with the exercise class; both Marymount and Costa Rican students led the residents in a fun class. We moved into completing wellness screens and taking residents through some exercises in the gym we made our own which we’ve come to love so much. It was difficult saying goodbye to patients, especially the ones that have shown us so much love and are so happy to be exercising with us on a daily basis. We know that the patients that we’ve worked with over the past week are in great hands with Melissa and Berto, but it definitely has been easier for them to get extra movement with so many hands on deck, and one can only hope that they’ll be able to get the same amount of exercise and activity after we’re gone. Prior to lunch, Christina led a teaching moment about cervical spine palpation and mobilization techniques for the Costa Rican students, something their curriculum does not necessarily touch on.

The day started to wrap up around 2:45 and it was expected that we head back to La Purisima to catch a bus for Mass at Manos Abiertas at 4 pm. At that time Melissa, the PT at Santiago, told us that she needed for us to come down to the large activity area where we eat lunch. We entered the room, and there laid out before us was a surprise party!  Turns out we wouldn’t be heading to Mass with the rest of our classmates, for the board of directors and the PT department planned and carried out a party in our honor to show their appreciation for all that Marymount has done at Santiago Crespo over the past week and over the past 6 years. There was celebration of culture – a young woman dressed in traditional Costa Rican garb danced and sang beautifully for us, and celebration of thankfulness – high ranking members of the board of directors, as well as Melissa, gave speeches about how thankful they are for all that we have done for them. They said that the doors of Santiago are always open to Marymount University, and we all felt our hearts swell with pride and happiness, along with a twinge of sadness knowing that we wouldn’t be coming back tomorrow. At the end of their wonderful words, Jody, our team leader, was called up to receive a gift. It was a beautiful, colorful plaque, commemorating the friendship between Santiago and MU.

It reads: “Thankfulness is to recognize the surrounding generosity; for this, we want to lift up your support and friendship throughout the years. You all have become great friends of this institution, and we greatly appreciate all that you have done for us…With love, El Hogar de Ancianos Santiago Crespo Calvo”.

The party continued with dancing, coffee, food, and fun; it was a wonderful way to wrap up our time in this amazing place. Before the work week started, we were given a talk by Jody (if you remember from an earlier blog post about mindfulness and being nice to yourself) in which she attempted to drill into our heads that we are enough, that our presence here is enough. We don’t need to be world-expert PTs with the answers to the problems that all of these patients face. Us being with them, doing our best to help them, challenge them, respect them, that is enough. Most of us left that presentation feeling refreshed, invigorated, but yet still a little skeptical. What if we aren’t enough? Was she just trying to wriggle water wings onto our arms before we got launched into the deep end? No, it turns out that she was completely right. It did not matter that we are still students, that we have so much more to learn, that we might not have all the answers ready: we came to these people with open hearts and minds and wanted to do the very best that we could for them with what we have, and it showed. I personally witnessed it all week: my classmates and friends giving it their all with every patient in an attempt to maximize their well-being and function, and the patients were so appreciative for it. We brightened their day every day when we walked into that facility, the silly bunch of Americans that we are, and we brought compassion and drive and laughter into those clinics. It was so bittersweet to walk out those doors of Santiago yesterday knowing that we wouldn’t be back but knowing that we made a difference in the short time that we were there.

The Santiago group with the board of directors and PT faculty 

It has been an honor and a privilege to have a chance to serve these clinical sites. We’re all so very thankful for the opportunity to come down here and share what we know and our passion for PT. Wednesday and Thursday we go into The Precarios, aka the slums, to set up three free PT clinics to give screens and exercises in attempts to decrease pain. The service adventure continues!

Goodnight from Costa Rica.

• Written by Hayley Hammond, Matt Lockard, Tristann Brown, and Brittany Kania
• Pictures: Christina Holl, Michelle Maryfield, Kyle Samek, Nikki Ritner