Feeling heavy

  Incredible how you can drop from the top of the mountain within the same treatment... and by the end of the day feel like crawling into a little hole under into the earth. I thought i was so clever today during my treatment, truly a feeling of being on top of the mountain.. though it didn't get me so far.

  A 17 year old boy has been coming in with excruciating back pain, pain that he says he’s had since he was little. His father has always had the same pain and cannot walk now because of it. I did standard orthopedic testing in the first visit and deduced that his pain was coming from his SI joint. Though after a number of treatments that should have helped, he wasn’t getting much relief at all. So, today (from a tip of my clever teammate) I measured his leg length and found out that his right leg is considerably longer than the left. This would make perfect sense then, that his father has the same pattern. I explained all of this to him and how he could get an Xray to find out the exact measurement and then have a sole made for his shoes. I was assured by the interpreter that there was a man down the road who made shoe inserts and that it was both easy and inexpensive. The patient showed that he understood by using the Nepali head waggle to say 'yes'. It looks like an unclear 'no' by US standard, but here its an affirmative yes. Great, i thought, as i filled out a referral for him to take to the health post across the way.

 While working on the next patient i realized that he was still sitting where i left him, referral in hand. An interpreter was talking to him about something still. I came over to find out what the trouble was and i was told that he couldn’t afford to get an Xray (An Xray in nepal is the equivalent of 5 US dollars). Nor could he afford to get a new insole for his shoe. Right. Im in one of the poorest countries in the world. Well, i stayed optimistic in nature as i explained that "no worries, we’ll try to do what we can with the acupuncture." Though, i cannot make his right leg grow. 

  I continued back to my other patient who was in the middle of explaining her knee pain. Trying to keep my happy forward momentum still going from the high, i told her to pull up her pants so i could start needling. I assured myself that i know i can do knee pain! She started hiking up her tights, while mumbling something. My interpreter translated: "oh and i have this rash too." Well, on the lateral side of her lower leg was an open wound, about 2 inches around and oozing a wet discharge. I put on my gloves to palpate it. No pain, hard to the touch, open wound. It fit the exact profile for tuberculosis. Eh.

 In that moment, a scene from the movie Finding Nemo came to mind, when the beautiful light at the bottom of the ocean turns out to be a crazy water monster and Marlin says “good feelings gone” before swimming away.

 How do you tell someone you think they have tuberculosis? Or not pay for a 5 dollar Xray so a patient can get the correct insole made? I dont how to do all that, but i had my first shot at it today. What a heavy feeling.