Productive Work With Nacho

There are certain types of work in life that allow you to immediately see the fruits of your labor. Things like mowing the lawn, painting the walls, shoveling the driveway or washing a sink full of dishes. When you finish, you can step back and admire your work. Working with the human body isn't always this consistent or immediate. It can take time depending on where the body is in it's life span, the number of co-morbidities and the compliance of the patient. I've had my fair share of patients where I've felt like I was spinning my wheels. But on the other side of the coin, there are those easy patients where you see results with hardly trying. Nacho is one of those patients.

Nachito is no stranger to the medical clinic here at NPH. From what I understand he has a respiratory disease in which the cilia in his lungs don't work, which makes him a lot more susceptible to infection. He also has a hard time taking in enough food so comes up to the clinic to weigh in after every meal.

I see him for what they used to call chest PT. Essentially I get to play the drums on his back and chest and vibrate his ribs while he breathes in different positions. I haven't done these techniques since PT school because respiratory therapists have taken this role in most hospitals the US. In fact Nacho re-taught me everything I know, showing me exactly where to put my hands and how to position him...he's quite the little teacher. I do the techniques until he gets a good cough going, then he gives me a nod and I grab the garbage can and then spits out a bunch of phelgm. It's not the most glamorous of jobs but it's literally productive work.

As you can see from the pictures he's really a fun and playful kid, not to mention a good dancer. He insisted that I get a close up of his bicep. His first day he was jealous that some other kids were "working out". He asked for some other exercises because he was tired of being flaco (skinny). I've appeased him with some arm and core strengthening, but unfortunately the results won't be nearly as quick.