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home > community > viewpoint > therapy dialog, part i

Therapy Dialog, Part I
“Hi, I’m Chris Russell, I have an 8:00 Appointment with one of your Physical Therapists?”
“Yes…Mr. Russell…Is this your first time here?”

  
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By Chris Russell
Posted Monday, 13 September, 2004

“Well, yes and no. I’ve been to physical therapy before, and I’ve been to this hospital before, but I don’t think I’ve been to this physical therapy before…”
She looks up from her paper pile and examines me. I smile.
“Do you have your doctor’s paperwork?”
“Yes, here’s the scrip.” I hand her a form with some cuneiform inscriptions.
“What is your insurance? Who is your primary care physician?”
Blue Cross Blue Shield. It’s a PPO and I don’t need a primary care, but it’s from a car crash and will probably be covered by my car insurance.”
“O.K. Read this one, fill these out.” She hands me a stack of paper on a clipboard. The clipboard is neon-blue. It is evidently a gift from some zealous young pharmaceutical rep.
“I’m going to hang my suit over here, OK?”
“That’s fine, but there are lockers in the men’s room if you want.”
“Nah, it’s ok, nobody is going to steal my clothes.”
I had worn shorts to facilitate the therapy, but carried a suit and tie in dry cleaning wrapped blue-plastic. I had to meet some clients afterward and wouldn’t have time to go home and change.
I slouched in a waiting room chair and began filling out. No, I’m not allergic. No, I don’t have heart problems. No, I’m not on drugs… I think we should just mock up those forms on the laptop with a picture of my insurance card scanned in. Then I could just print it out and hand it to them, or better yet give them a CD every time I see the doctor.
I dutifully turn in the forms and curse myself for forgetting to bring one of the 4 books I’m reading, especially that old Steinbeck novel from before he was famous.
I sift through the stack of old magazines and settle on a copy of “Outdoor Life”. It should have a couple exclamation points in the title. Its pages are filled with young, skinny bohemians mountain biking off cliffs and shooting through churning rapids in kayaks.

“Mr. Russell?” A cheery voice. “Hello, I’m Lauren, I’ll be working with you. Come on in.” She leads the way back and has me hop up on one of those padded bed/table things. It has a piece of white paper on it, like butcher’s paper that crinkles and slips under my weight.
“So, what’s the problem Christopher?”
“Well, I’ve got a cracked patella, right here.” I touch the knee. “And the patella tendon is smashed up, here.” Tracing a line down from the knee cap with my finger.
“And you’ve seen the doctor?”
“Yup, the orthopedic surgeon.”
“From Where?”
“ProSports Orthopedic, in Waltham, I’m a runner and I try to go straight to a sports doctor.” I say. “I got X-rays at Mass. General, but they didn’t show much, so he sent me for MRI, that showed the crack and the tendon.”
“On a scale of one to ten, how much pain are you in?”
“I don’t know. It doesn’t hurt too much right now…”
“So a two?
“No, More like a five.”
“Are you running now?”
“No, the doctor told me to take some time off. I did run on it for a couple months before I realized it was broken.” I say. Then I add for clarification, “So I’m off for six weeks. That screws up my fall race plans.”
“What are you looking for out of therapy?”
“I want to run.”

She puts her hand on one of my feet dangling off the table and grips it.
“Ok, push against my hand.”
I extend the knee.
“Does that hurt?”
“No”
She witches feet and tries it again.
“How about now?”
“No”
“Ok, Lay on your back” She says picking up what looks like a big protractor from the bedside table.
“Let’s see what your range is.”
“My quads are good, but my hams and hip flexors are tight.”
“Not too bad, are you doing any stretching?”
“Just basic achilles and hamstrings, plus core strengthening exercises once a day.” I show her examples of my routine.
“Do you do your quads?”
“No, I’ve never had any problems with them. My hip flexors are tight, but my quads have always been loose.”
“You should add in some simple quad stretches to try to lengthen that patella tendon and take some of the stress off of it.”
“OK, I can do that. What’s next?”
“We’ll put some Ionto through the tendon.” She walks away and returns with a little plastic razor.
“We’re going to have to shave some hair off the knee to get the electrode to stick”
“Yeah, I can do that. Can I get a little soap and water or something?” I say, looking incredulously at the little white razor.
“I’ll see what I can do.” She leaves again to rummage for a paper cup.
Some other patients have arrived by now and are happily pulling on weights and other apparatus. It’s seems to be a lark for them, to be here chatting up the staff with their sore shoulders and bad backs.
Lauren returns with a mixture of hand soap and water in a tiny Dixie cup.
“Thanks, that’ll do the trick.” I say and I take it from her. I judiciously scrape away at my pink knee, quickly overwhelming and clogging the little razor. “That’s nothing, you should see my back.” I think to myself, but wisely choose not to share out loud with Lauren, who has meandered off in search of the Ionto device.
I manage to provide a little clearing for her and she swabs it down with Alcohol.
She attaches the medicine soaked electrode patch to the knee and affixes the sister patch high on my thigh, (no shave required).
She turns on the juice and it stings.
“It stings a little.” I say.
“Yes, It will until it establishes a channel, then it won’t sting as much.”
“I can deal with it, it’s ok”
I lay back and look at the kayakers and mountain climbers some more.
“Ding!” 11 minutes later my timer goes off, and like a Butterball in the oven, I’m done.
“Ok, you’re done.”
“Yup.”
Lauren unhooks me and leads me back out to reception.
“Ok, We are going to have to see you twice a week for the treatment.”
“Twice a week?” I look at her like she’s insane. “I travel a lot.” I say in way of explanation. “ My wife and kids don’t even see me twice a week.” I conclude with a lame smile.
“We’ll need to at least get through the Ionto treatments.”
“All right, I’ll try.”
I schedule another appointment. I retire to the men’s room with my clothes to suit up. I’ve got a meeting in Connecticut. It will be three hours windshield time both ways. Yikes.
“Bye.” I wave to the receptionist.
“Have a great week.”
“You too. Hasta Luego”

 

 

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