Wednesday, January 25, 2023

A Last Physical Therapy Appointment

(My apologies - my Old English posts have been running on Wednesdays but I find myself a bit behind in research.  Rather than publish something I am not happy with, I am substituting a different post.  To return next week!)

Yesterday I had my last physical therapy appointment.

The fact that this was supposed to be my last appointment was discussed two weeks ago with my PT doctor.  This is something that he had mentioned at my last appointment prior to my going to The Ranch; a combination of me gaining back full functionality after 3 months of PT and the fact that my allocated amount of visits is almost at an end.

When I arrived, I did not have my regular doctor but another one I have seen - no big deal, I had seen them switching patients when one of them was out.  He introduced himself and we went started going through the exercise regime.

Physical Therapy, if you have done it for a while, becomes a semi-individual activity:  the exercise is suggested and quickly covered, then you are left on your own to do the exercise. If new, they will observe and correct, then leave you to it.

And so we rolled through this week's exercises: most the same, one or two new, for about an hour or so as the appointments tend to run.  At the end, the PT assistant looked at my chart, ran her eyes down the list, and said "Okay, you are finished today".

And that was it.

I am not sure what I expected.  Some kind of transition process, commentary, things to be aware of.  Instead it was up to the front for my copay and then off without any mention of scheduling another appointment or checking in if anything occurred.

I am probably reading too much into this - this is a business of course, and they do this all the time - but I honestly felt sad as I left.  Not sad because I was leaving, but sad because, well, I just felt like an after thought.

I had no complaints of my time there - everyone was nice and engaging and frankly, the end result was achieved - my shoulder is back to full mobility and lack of pain (if not completely strengthened yet).

So perhaps there is something else going on here.

I have the tendency - correct or not - to pour meaning into all kinds of relationships that simply is not there.  This is a tendency from youth, where I would see relationships and imagine connections that were real in my mind but were not present anywhere else (when as a teenager and young adult you have the tendency to fall in love five times a week, this happens).  Most went away without any sort of impact but occasionally there would be that moment where the other party looked genuinely confused when you suddenly made a big deal about a moment or a parting which was for them just a two minute event.

I, of course, was crushed.

So likely that is what this is yet again:   a view of the world that I had formed anything other than the briefest of business relationships with a group of individuals who regularly process a fair number of people every week.  They likely meant no more by it than they would for any other patient; in spite of my own imagined good nature, I suspect I make no more impression than other.

But even as I admit this, I cannot help but acknowledge the sense of sadness as I drove away.  I can intellectually understand all of this; the parts of me from long ago still treat such a thing as a dismissal, even if  I have evidence to the contrary.

19 comments:

  1. Anonymous3:05 AM

    Last year, I had some pretty intensive appointments due to a skin infection (cat bite). For 5 months, a weekly appointment to debride the affected areas - took about an hour. Oxygen therapy was needed to completely kill it off. Three hours a day, five days a week, I was slid into a chamber where pure oxygen was pumped into. This went on at least two months. I had to begin my job three hours early to make up for the lost time. So a bit of inconvenence.

    When the time was up, I was told to get a referral from my doctor if the infection came back. And that was it.

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    1. Anonymous, my Father in Law The Master Sergeant had the same treatment for healing of his amputations. Hopefully yours took.

      Perhaps in this modern world, this is the way of things. It certainly was not a satisfying experience.

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  2. When I was in nursing school, our teachers were constantly reminding us to treat patients with caring, respect, and dignity. It was amazing how quickly all that went out the window because the patient care system isn't set up for that. It's a huge industry and like all industries, everything (everyone) is just a widget on an assembly line. And as technology increases, emotional sterility increases. In my opinion, health care is one of the three great failures of modern industrialism.

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    1. P.S. Please do continue with the Eald Englisc posts. You got my interest going so I found a couple of good youtube channels and a copy of Aelfric's Colloquy (in both modern and old English), plus a couple of performances of it on youtube. Seemed as good a place as any to start. Besides Bernard Cornwell Saxon series novels and that so many of my ancestors can be traced to that time period in England, it's a good learning project.

      Delete
    2. Leigh - I am sure it has come to this as it has come to almost any "industry" where the purpose is volume and profit. The jarring thing was there seemed to be that relationship - right up to where they were not.

      I certainly intend on continuing with Eald Englisc. The background is rather broad and I am trying to put a lot into a small post and be (reasonably) accurate. It is also a great incentive to continue to study for me as well!

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  3. I have a good doctor. If I see her, it's a good experience. The nurse practitioners are a different experience. The last two that handled me don't work there any longer, when they left I basically was dropped through the cracks, and I had to seek higher management to take care of prescription refills that never reached anyone for approval. Considering I have one doctor, and an unknown amount of staff, I've reached the opinion medical care is now a business; sloppily run and rife with the ponderous waste of bureaucracy. This makes me question everything to determine if I've reached some point in any treatment that may require something more to complete. They may forget, but I'm going to make every effort to not be lost in the shuffle.

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    1. Jess, I have a "primary physician" that I see once a year or so and put their name wherever it is required, but I doubt he knows me from Adam. For some of the supporting roles, I wonder if part of this is a combination of The Plague and resulting personnel shortages and job movements that have made so many things more challenging.

      What it has made me conscious of is how much - both now and in the future - I am going to have to be responsible for my health, not others.

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  4. It is not how PT is suppose to go... In fact the new term for a Physical therapist as Doc is an new contrivance. Same with the audiologists who now are called "Doctor." Simply an minimum online effort to achieve over much controversy. Its been a few years since my stint in Health Care Admin... as then... you are to see the PT in person. The use of a PT Assistant has stringent requirements, She/he must be in full view at all times of the physical therapist.. No walls in the way. Nursing homes have an exception. Unless the rules have changed in the last year or two, that is my recollection. You have been poorly treated. Both ways and especially on a personal note.

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    1. Bunkverville - Thank you for the feedback. To be clear, the PT Doctor and the assistants were all in the same room and the Doctor was giving guidance as needed (and perhaps, based on my time there, I needed less guidance). Everyone was certainly professional and I never felt like I was being asked to do something I did not understand or could not. It was just that last little bit that left me with a bitter taste in my mouth.

      The Ravishing Mrs. TB had PT last year and used a different facility as well as the one I used. Her comments about how it ended at this facility were similar to mine.

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  5. Nylon126:35 AM

    Perhaps the last three years have accelerated patient care into a conveyor belt but if someone were on the ball there should have been at least an acknowledgement of treatment ending. A handshake, a verbal "Well done" while keeping eye contact and a smile. A little more humanity into the medical sciences.

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    1. Nylon12, I suspect it had a lot to do with my regular PT doc not being there. Which is a shame - I would have liked to say thank you personally.

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  6. Man, TB. We are twins. I had the exact same issues as a kid, and still today. It has abated a little as I've gotten older, but it's not done with at all. Sentimentality? Unrequited love??

    I have a good rapport with my doctors. And I try and connect with them and their staff on a deeper level than just why I'm there. It has made me memorable to them. (OH! Mr. X! Hows it going??) Probably for the wrong reasons (I take too much time visiting, etc). But, it helps me remember they aren't just my torturers dejure. They are hoomans too. And those last time through the door visits are hard on me, too. We are wired atypically. Nothing wrong with that, as long as we know it.

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    1. STxAR, we may very well be brothers from another mother!

      This is first time I have had to do this in a while. Maybe this is just the way it is now.

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  7. I still have my prescription for a physical therapist for my torn rotator cuff. I never did go see them. Instead, I just did all the exercises they sent home with me, which were extremely painful and tiring for awhile, until it wasn't painful or tiring. Then I did them a bit longer and quit. I have never been to PT though, figuring it to be just like you described it.

    I guess, I think the lack of communication on the final day should be taken as a compliment. Knowing you, you probably took your exercises seriously and it showed. They had no doubt that you would go back into society completely healed. Had they sat down with you and talked with you, it probably would have been about the lack of progression and problems you might experience going forward.

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    1. Ed, I will say the advantage of the PT in this case was accurately diagnosing the issue (a strained muscle head instead of a torn rotator cuff as I thought) and some deep tissue massage (which was amazing).

      I hope it was as you say, although I equally wonder if it was simply that as my normal PT doctor was out, no one knew anything different.

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  8. It happens to everyone. When hubby "graduated " from daily hyperbaric treatment (for two months I think it was. Maybe longer), to bi-weekly wound vac treatment at a different part of the office, we were sad to mostly not see them any more.

    It's only when something has been less than amiable that we don't miss it ending.

    Congratulations, TB.
    You all be safe and God bless.

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    1. That is fair Linda - if I had an unfortunate experience, I would likely been almost relieved to have it end.

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  9. This, and the comments, are interesting to read, TB. I can relate. I had around 12 PT appts last spring and this summer for something and I pretty much adored the young lady who was my PTist. I'd never experienced such a good fit. I was ready for it to end, though, as I was soon heading into hand surgery, but it did feel a little sad to me. I wrote her a sincere, but gushy thank you and included a couple of gift cards to commemorate the ending of the "relationship" and that helped me. Actually, what was really nice was a couple of months later she sent me a super nice thank you for the gift cards. I never expected that.

    Fast forward to the ending of my hand PT (mid December). The whole ordeal was a most frustrating experience (mostly due to terrible communications within the organization I was using, not due to the PTist - much), but as the end of my time approached I was very anxious about it all ending. I was still in a great deal of discomfort (some real nerve pain), and I just didn't want to be set free yet. The last day of PT, though, after a very weird "I'm kicking you outta here" - seriously the PTist said that, or something very much like that, I walked out a bit dazed, not very impressed with the send off, but by the time I got to my car I was practically skipping. I was so happy to be done with the weekly visits and the endless terrible communications, I felt like I had been set free!

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    1. Becki, one of the very interesting things that always surprises me when I post is how often some of the experiences I feel are quite odd and unique to me are shared in some for or fashion by a great many people.

      Thanks for sharing your experiences. I feel like the last visit you relate "I am kicking you out of here" - may have been meant in some other way than it was (obviously) received, thus pointing to the well known phrase that it is not what we say but how it is received that matters.

      In some ways this reflects my own experience: My PT doctor was great and I am really going to miss seeing him. In point of fact my notes very well not have said this was to be my last visit and so no-one reacted differently; that said, after what was overall a pleasant experience, it left a bit of a bad taste in my mouth. I suppose in their defense I could have spoken up more and asked into it, but there is always that thing that makes one feel like one is intruding on a process.

      I am glad that the appointments are done, however. The rest is up to me.

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