Lima Peru

Just finished a great week in Lima. Working in the hospital Almenara has been a fantastic experience. It is a large hospital with over 1000 beds. The rehabilitation department is quite large. I spent most of my time in "the gym" where there are large and small treatment beds. The doctor or physiatrist does all the examining and then refers the patient for the treatment. Treatment usually includes electrotherapy modalities of some sort. They are well equipped with hydrotherapy tanks, and modern electotherapy equipment. I saw lots of people exercising so that was great.

Manual therapy is beginning to take off here and of course there was much interest in what I had to say and show. Sometime during one of my practical sessions there might have been about 30 people around watching. This included the staff physios and there were also a great group of students on placement. The students were very receptive and fun to work with. Many times the doctors (and residents and interns) would also come down to see what I was doing.

I was invited to give a talk at a International Conference (It was National, but after I agreed to talk they changed it to International!!) on Rehabilitation for the Geriatric Population. I talked about OA of the knee and options for manual therapy. One rheumatologist came to talk to me after and asked if I could see one of her patients, 26 years old male with Ankylosing Spondylitis. He had had hip replacement earlier in the year, but now the other hip was getting bad. I had a look at him and taught his sister how to do passive range of motion stretching, gentle traction and showed him some strengthening exercises....he had never been given any exercises to do...not even in bed.....they were all very grateful.

I was also asked to see a patient that had lacerated his extensor pollicis longus tendon of the thumb and hurt his wrist. He had undergone a tendon transfer...it had been successful, but a bit of scaring and a very stiff wrist. They were all grateful to be shown the mobilisation techniques for the wrist and thumb as they had not addressed this and were only managing the tendon and skin scarring. The mobs in one session improved his mobility greatly and the therapist was grateful to learn the techniques.

The therapist that is taking care of me is Ana Hererra and she is amazing. She works so hard to get volunteers  to come to the hospital. She can speak english so is great at translating. I have been using my Spanish and I can 80% of the time stay in spanish, but it is great to have the translation backup.

I am off to Arequipa now for my second week. It is the 2nd largest city in Peru.

Here are some photos of Lima. The balconies were so that the women could stay out of sight and not be seen by the public as they watched the events going on outside.

Staff and students at the hospital. Ana is to my left.

Main Cathedral

Costa Verde. Green Coast

Balcony

View of Costa Verde and region of Mira Flores where my hotel is.

Main square. Plaza de las Armas