Tạm biệt, Saigon...

Goodbye, Saigon!

Our work is now done here in Vietnam.  Sigh.  As always, these 2+ weeks go by so fast.  Tomorrow (Saturday, the 11th), Amy and I will leave HCMC at 355p and will arrive in San Francisco on Saturday, the 11th at 630p.  You do the math...it's a lot of time in airplanes. 

We finished up our time at the Pediatric Hospital #1 today and wow, it was an amazing week!  I saw some great patients today with the Physiotherapy staff and had many interesting conversations with them about these patients.  Here's a little bit about our day together...

Tam Tam, Quyen, Amy and Yen.  Yen is the former director of the Rehabilitation department.  She retired a few years ago from the hospital and she is now working as a Speech Therapist, working with patients with Cochlear Implants.  It was great to see her today. 

 My first patient today, was an 18 year old young man, who is attending University, studying Psychology, and who has a diagnosis of Spastic Diplegia Cerebral Palsy, which means his trunk and lower extremities are impaired in their movement.  He was such a great guy and his mom, Lan, was lovely too.  He is having progressively worse hip pain on the right with walking and the orthopedic doctors here in Vietnam don't have a great plan for his hip.  He is going to have another x-ray to see how his hip has changed (worsened or stayed the same?) soon. 

He was so interesting, thoughtful and enjoyable with which to chat.  He speaks English well and spoke about life as a young adult with cerebral palsy.  He commented when he was young, he didn't think having CP was a problem at all, but now, feels very different than his peers and wants to be able to talk with younger children about having CP and how to grow-up with it and manage life here in Vietnam.  We discussed with Giao, the director of the rehabilitation department, perhaps having this young man and his mom talk with other families who have children with CP and that he could talk with the children too.  He was so insightful and amazing. 

Here he is walking.  You can see how laborious walking is for him, but he's proud that he can walk.  He does have a manual wheelchair that he can push independently, but he said he doesn't like to use it much, as he feels people are looking at him and that they won't think he's smart.  He's very smart.

This is an x-ray of my first patient today.  This was taken 5 years ago and his right hip isn't located where it is supposed to be and he now has pain. 

This kiddo was great.  He had some fantastic facial expressions and worked really hard with me and his PT, trying new exercises.  Because culturally, the PTs don't make the kids work that hard and much of their therapy is more passive (although it is much less passive than it was several years ago), the kids get really, really tired fast when I am working with them.  He is 10 years old and has cerebral palsy, but walks independently. 

These are his AFOs (braces), which were made in the Rehabilitation department.  These are paid-for by the family directly.

Here's another set of braces, worn by a 6 year old boy, who also has cerebral palsy.  These are pretty great for the limited technology they have available to them here.

The final patient I saw was a 9 year old boy, named Viet.  Here he is below.  He recently underwent a surgery, called Selective Dorsal Rhizotomy, which was done by a visiting neurosurgeon in November 2019.  This surgery is done for children with spasticity (muscle stiffness/increased muscle tone) and during the surgery, the nerve roots that run off of the spinal cord are stimulated to see which muscles they activate and then a portion of those nerve roots are snipped to decrease the spasticity in the lower extremity muscles.  This is a surgery that gained popularity in the US around the time I was graduating from PT school in the early 1990s, but now, this is done with less frequency, as there is a very specific patient type that benefits from this surgery, rather than a broad category of kids with cerebral palsy.

Viet was very smart and his father was very dedicated to doing exercises with him at home, so we tweaked their exercises a bit to focus more on strengthening his very weak muscles.  Underneath a child's spasticity, in CP, the muscles are usually profoundly weak, so when the Rhizotomy is done, the child requires intensive Physical Therapy to work on strengthening the muscles.  In Vietnam, this intensive program doesn't exist and falls to parents to execute at home, under direction of a Phyisotherapist at the hospital.  

He was able to take some steps in his walker, but his weakness is significant.  I think he is a boy who, with really hard work and consistency with the exercises, can get stronger and make improvements.  His father is very dedicated and took copious notes as we put together an exercise plan for him that integrated some of his current exercises with some new exercises.  I enjoyed meeting him and his father.

Standing in his walker.  He was very determined to stand and walk.

 
Each day this week, I was asked to do one lecture on a pre-decided topic.  Over the past 2-3 days, during our patient evaluation time, more topics came up, so I spent part of my lunch time writing additional 'short' lectures on several topics.  This is the list of topics I lectured on today.  The final topic, "Fitness Exercises," was the only lecture I was scheduled to complete today.  We got through all of the lectures in 90 minutes, except for #6.  Phew...I need a little break from talking.

Tonight, the hospital staff, including Giao, the director, invited Amy and me to dinner for a party to say thank you for our time.  It was a really great evening and the dinner was filled with all manner of seafood delights and so many other foods there are too many to name.  In Vietnam, the Vietnamese don't often (if ever) go out to dinner, as it's so expensive for them, so they always are a bit 'giddy' and excited to have these dinners.  There were many photos taken with the staff and me and Amy and a selfie stick definitely made an appearance.  (not mine or Amy's, I should say)

It was a wonderful evening and week and it's time to say, 'that's a wrap,' on another successful mission trip to Vietnam.  I feel so fortunate to be a part of this team, to work with Amy and I can honestly say, I always get so much more from this experience than I think I can possibly give to it.  The people of Vietnam are welcoming, kind and so hospitable!  Vietnam and its people are so special to me.

Thanks for reading.

xoxo
Stacy