Acetaminophen, pupusas and hammocks.
Moisés Rodríguez Jurado
5 de Septiembre, 2018
ISLA TASAJERA - After spending approximately 2 months in the San Rafael Tasajera community, I can focus my "diagnosis" as a physiotherapist in 3 major fields. Ignorance about pain, lack of healthy eating and lack of exercise.
In the first place, there is a great lack of knowledge about the field of pain (in this post I will talk about the types of pain that concern my professional field, see articulate, myofascial and neural), even by the health promoter, to whom It can be blamed since its main task is to be able to detect red flags that refer to the nearest health center. This lack of knowledge about the possible causes that can have a pain, lead the islander to resort to the only thing available, Acetaminophen. Headaches, neck, knee, hip, etc. absolutely everything has its cure in Acetaminophen, with the consequent risk that this type of medicine has. When the Acetaminophen does not work, the promoter tries, with the best of her intentions, to calm that pain, beginning then to try different anti-inflammatories and analgesics until one is able to calm the pain of the patient. Because of this I see a possible line of work in a training in different areas. Firstly, to the health promoter, talk about the different causes of pain, and how medications, in many of these causes, are nothing but a symptomatic treatment that does not reach the etiology of the problem and therefore returns to require future intakes of the same medication. A training on joint movements, muscle stretches, strengthening exercises for muscle decompensation, etc. could solve some of these cases without having to resort to the drug. On the other hand, this information has to be made available to the islanders through group work before or at the time of pain, e.g. approximately 70% of the patients treated referred to spinal pain that was solved with stretching without having to resort to the pharmacological approach.
Secondly, poor diet is leading islanders to overweight, especially in the case of women, but it also affects many men. Excessive consumption of fats (cheese, mainly) and lack of fruit and vegetables are the main problems. This, avoiding the respiratory and cardiovascular problems that it entails, also generates a source of musculoskeletal pain such as articular degenerative processes, mainly osteoarthritis of the knee. Many patients report knee pain, sometimes bilateral, which is recommended to "lose a few pounds" and yet that night you see them eat 3 pupusas again. Overweight is also the cause of many of the spinal pain that patients accuse, and that have the solution in the same action: lose weight. Because of this I believe that a plan is necessary to make the islanders understand, from the earliest stages of life, the importance of a healthy diet for their body. In this field there are advances, for example, by a state government plan, in school recesses and you can only give fruit and natural juices to children. It may seem like a small step, but it is the path of change.
The third, and not least, aspect, is related to the lack of physical activity. This aspect touches more to certain groups such as women who work mainly in the home and the elderly. It is common to see these people spend their afternoons in the hammock, sheltering from the heat, to go to the cult later and then to the pupuseria to dinner. The lack of exercise, as is well known, is a big problem, not only because of the secondary overweight, but also because of the weakening of the muscles, which may not be of vital importance to women who work in the home, but if in the elderly, since in them this weakness aggravates the risk of falls, and a fall in a community as isolated as Tasajera, can cause a hip fracture to immobilize them for life. This is why it seems to me of vital importance to educate the islanders in the exercise in all stages of life. At this point I also have to say that I feel optimistic, since I have known first hand groups of women who go to the beach to exercise in the afternoons and I have personally managed an exercise program for the elderly that has awakened the desire of these people to have a better quality of life through exercise.
As we see, the three problems are interrelated and are the whiting that bites the tail: the lack of exercise causes overweight, which in turn causes back pain, which makes the person move less and therefore increase more weight. I think there is a lot of work to be done in these three aspects, but I am also optimistic, because I know that the seed is already planted and it is only necessary to continue watering so that Tasajera is a place with less pain and healthier inhabitants.