Physical Therapy in the Philippines.

Last week I went to Manila for another check-up on the issue of my limbs falling asleep, and I’m so glad that I did because the test that I had to have re-done came back completely normal this time. Apparently, Americans and Filipinos have different normal values for the results of an EMG-NCV test, and that is what caused the confusion in the first test. Anyways, final decision for treatment was physical therapy for my lower back and neck, where I have bulging discs. This was all good news, as of course I was worried that I had some sort of life-altering condition, so PT? Heck yeah. If it can help me strengthen my back, which I’ve always struggled with (I had a ruptured disc my junior year of high school….and ever since, it’s been a slight issue), then I’m all for it.

Since I was in Manila already, my doctor had me squeeze in two sessions of PT there, before coming home. The PT there was exactly like PT in the US – even the patterns on the curtains that separate the little therapy areas are the same! I was quite impressed. Also, I am extremely lucky that my site is in a city, as if I were in a rural area, I’m not quite sure what would happen. I returned home last weekend with instructions to contact my doctor here to get a referral to a rehab doctor. Why I needed to get referred and prescribed PT again, I’m not sure. I was just doing what I was told. So Monday, I used my day off to head to the hospital to get all of this arranged. Since I met someone for lunch, I went in the afternoon. I found my doctor’s office, and his assistants gave me referral forms for the rehab doctor and directed me to the physical therapy department. I arrived and spoke in Cebuano, which little did I know, would cause them to speak to me in Cebuano for the rest of the visit and the next as well. This is normally fine, as I can understand most things and express what I want to say. Buuutttt, when it’s regarding my health and I only sort of understand, sometimes English would be much appreciated, especially since they can all speak it pretty well since their entire schooling has been in Cebuano. Anyways, it turns out that the rehab doctor was not there, as he is only there from 10-12 in the morning. They told me I should come back in the morning, which I should have expected to do anyways.

I showed up at about 10:15 on Tuesday morning, since the assistants told me to show up late in case the doctor shows up late also. Surprisingly, he was there before I got there, but was seeing another patient and I had to wait about 45 minutes. After I presented to him the prescription for PT that my other doctor already gave me, he then had to write out a new prescription. Basically, he re-wrote everything that was already written down. I then took this prescription to the assistants to schedule the appointment. But apparently to schedule the appointment, I had to take the prescription back to my original doctor in order to get it authorized. I then had to take the authorization to the front desk to get a PIN so that they could charge my account. Then, I had to bring the PIN back to the PT section to schedule my appointment. Apparently this wasn’t supposed to be done until the next day, but since they only spoke to me in Cebuano, I brought it back that same day. There apparently was some confusion on my part, as I understood exactly what they were saying but thought the whole process was ridiculous, frustrating, and inefficient. This therefore clouded my ability and desire to even want to understand what they were saying.

I returned the next day for my first session of PT. Facilities here were much different than in Manila, as they looked like they were directly out of a 1980s PT room and/or convent. I wasn’t quite sure. Now, I’ve had PT for my back at two other locations (in Manila of course and back in Wisconsin). I’ve also had PT for my shoulder after surgery a couple years ago, so I sort of consider myself a pro in understanding what they’re doing and why they’re doing it. Obviously, I’m not a pro in all departments, as if I were, I wouldn’t have had to come back for more PT. I’m also not a physical therapist, so for the most part I trust that they know what they’re doing.

The first thing they did was put electric stimulators and heating pads on my muscles and had me lay face-down. This is also the point in which they normally do lumbar traction simultaneously, which is where a machine pulls your spine to decrease pressure on the discs. Well, they weren’t interested in doing all this at one time, because I’m pretty sure it would have been too efficient, even after I mentioned that I’ve had it done at two other places, all at the same time! I told them that then it goes much quicker, because you can do three things at once. “Ma’am, are you in a hurry?” I wanted to answer, “Well, honestly, I’d prefer not to spend my whole day in PT, as I like to save time if at all possible.” But this was not understood, and instead, they continued to ask me if I was comfortable, which my face was shoved into a pillow and I wasn’t able to bend my neck in any way possible. Honestly, yes it was uncomfortable. After this was finished, they did the traction, which took another twenty minutes. After this, my arms and legs were bent into all sort of contorted positions that arms and legs should never naturally be bent in. Again, the answer to the question, “Ma’am, is this uncomfortable?” was, “Yes, my body should not move that way. It hurts.” By this point, I was pretty frustrated at our 2-hour PT session that should have only taken 1 hour and 20 minutes. We did some exercises that I was already taught in Manila, even though I do them at home every day anyways. Then they told me to change, and I was pretty happy about this since I thought the session was over. But no, no. Then they did cervical traction, which is meant to pull apart the vertebrae in the neck, just like lumbar traction. I’ve never had this done before, and the contraption looked like something out of an 1800s hospital, which of course made me slightly nervous. As side effect is that it feels as if your head might pop off of your shoulders and your jaw is clamped shut by the heavy pulling of your chin upwards towards the sky. As you can imagine, the question, “Ma’am, is this uncomfortable?” is slightly annoying. Well, you are pulling my head apart from my body with a strap that is tied around my chin and neck, and I can’t respond to your question because my jaw is shut tight. This was on top of my frustration I already had, and at this point, the tears started. Yay! Crying in public in foreign countries is never something to be embarrassed about. I’m actually pretty good at it.

Well, appointment was finished, they got me some Kleenex, and I headed out the door. Can’t wait for the next one!