Indelible Roots

This morning was busy. I got my two total hip replacement patients up and going, but one of them complained of increased pain, so I had her sit it out. I then placed them outside the consultation room in wait for Dr. Jim. When he came out of surgery I had him take a look at the two. He wanted to send both home until I told him one was complaining of significant pain; so only one went home today.

I then finished my finger extension splint for my mute finger contraction girl; ugly, but effective. Next was the mastectomy woman whom I got up and blowing on the spirometer. She improved mildly, blowing a 90 as opposed to 85 yesterday. Both are very poor results, but her chest is wrapped and compressed.

My acid burn patient then showed up with Tary, the physiotherapist. I made him two splints as she watched and added the Velcro pieces. However, I am all out of strapping material, so Tary will add those when they get back to PT House. I try some joint mobilization also, but he doesn’t tolerate any at end ranges.

Sopha Vann then comes in with her sister and I see that she has -25 degrees of active and -15 degrees of passive elbow extension. The scar seems to be thinning out a little, at least distally. I also get her up to flexing and extending with a 3kg dumbbell. I also increase the extension on the night splint. She and her sister leave me lunch consisting of rice, chicken wings, and soup. So at lunch I get a lot of ribbing for my ‘special lunch.’

Dr. Ratha walks by as they leave and is amazed at her progress. He mentions to me later that he always tries therapy first as the elbow tends to lose range during the one to two weeks of immobilization after skin grafting. He also mentions that most of the other surgeons just want to do the skin graft. He wants her to keep wearing the splint at night for up to a year.

After lunch I spent walking around as all the patients had been seen. I get a new eval from Dr. Bonvath for a facial palsy patient. He can’t move his lower lid on one side, so the cornea is ulcerating. Dr. Bonvath has transferred part of the temporalis muscle to the lower eyelid so he can now move the lower eyelid when he grits his teeth.

I get him in the therapy room and he grinds his teeth noticeably, moving the lower eyelid about one millimeter. He is needs five millimeters of movement to close the lower lid. I get him to stop grinding his teeth and need to find Suphy, the nurse, to translate to get him to contract the transferred muscle more slowly. He is up to one second of activation at a time now.

After work Lyna drives me home to pick up my belongings. We then head to the OK Guesthouse where I look at a couple of rooms that are nice and clean, but the manager won’t budge from the $7 a night price even if I rent for the month. So I have Lyna drive me to the Viseth Guesthouse that we looked at the night before with the clean, but small room.

We go to the first room and it’s the one without the window. I ask for the window and it turned out I was saying Thursday instead. The man then tells me the room with the window I saw the other day is rented out and that I could stay here and move into that one when it opens up probably tomorrow. He mentions that there is a room on the third floor (fourth floor as the ground floor is not counted here), but he says it in a way that shows he doesn’t think I would want to climb that many stairs for it. This is really funny was the upper floors are usually cheaper everywhere for this very reason, though the view is better if there is one, and the ventilation is better.

I have him take me up there and I walk into this room that is twice as large as the one I was expecting and it has a TUB! Among other things it has a wardrobe (is that what you call it, a wooden box to hang clothes in?) and the bathroom is large and has storage space. Truly I’ve hit the jackpot if something unforeseen doesn’t present itself. It’s only about four blocks from my first hotel and three blocks or so from the riverfront, where all the tourist related shops are, ie internet cafes! Now all I need is a curtain of some kind to separate the tub from the rest of the bathroom, a wooden wedge for the main door as there is nothing to latch on the inside, some cleaning suppliews, bed sheets as there is only the one on the mattress and the cover, and some hangers.

I take Lyna to a nice restaurant as a thank you. Here we see Pitong (Kanya’s cousin) and his wife Sophos who both work at Chenda Polyclinic. There are waiters everywhere here with one hovering near the table at all times. We have soup as usual where you add items to a pot of boiling water on the table as you go. It’s the same meal everywhere it seems, but here the tab comes out to $16, three times the cost at a mom and pop restaurant where kids come in to sell you magazines as you eat and you throw your paper “napkins” on the floor.

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This entry was posted on Saturday, December 1st, 2007 at 9:59 am and is filed under Khmer. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.