Walking the talk

In a recent article called “The pain of pain relief“, I outlined some of the ways that I’m trying to become a better patient by advocating for my needs. I had a recent opportunity to “walk the talk” with these approaches at an initial appointment with a new-to-me athletic therapist. In short, the experience left me with renewed hope that I can reclaim control over my care while also rebuilding trust with medical practitioners.

A new treatment option

A new friend of mine, a neighbour down the road, suggested I try out a Kinesiologist she is seeing for some recent hip pains. Also a certified Athletic Therapist, he’s helping to get her mobile while she waits for a hip replacement. She boasted about how she got a full 90 minutes with one-on-one attention and about the thoroughness of the assessments and treatments.

Hearing about a new treatment brings up lots of emotions. The first one is usually hope, which is quickly replaced by doubt and skepticism, followed by curiosity, then desperation, and finally if I think it may have some promise, excitement and impatience. These default reactions often put me in vulnerable situations when I find myself committing to a therapy that I’m not entirely informed about, particularly when I show up expecting the pain to be gone after the first treatment, and no doubt disappointed when that doesn’t happen.

Doing my research

I had to do the homework to find the best possible provider for me, factoring in the type of practitioner that is within my means to afford. Athletic therapists are often not covered by extended health plans. So although I have easy access to health care as a white Canadian female, some therapies are still out of reach. Oftentimes it’s the “unconventional” or “non-Western” approaches that are conveniently not covered. I’m finally at a place where finances do not exclusively prohibit my access to new services, meaning I can pursue the treatments I think are most helpful.

In my attempt to learn from past mistakes, this time I reached out to the therapist I was being recommended to and asked if we could meet for a consultation. During the short call, I was able to ask him questions about his practice, what his process looked like with new patients, what his experience was with treating persistent pain, and, most importantly, whether he thought he was the right person to treat me. All from the comfort and safety of my home and without any obligations.

He took the time to answer my questions and even asked me questions of his own to get a better sense of what I would want out of our visits. I am always on the lookout for any claims by therapists that they will be the answer to all my problems, a major red flag. Especially when they haven’t done a history on me yet or even examined me in person. I had one such red flag during our conversation in this regard when he said:

“If I can’t help you, the only other option might be surgery.”

Building trust

I couldn’t help but think, surgery on what? Although it wasn’t enough to deter me, I still noted to myself the statement, and my reaction to it, then continued on with the conversation.

He went on to tell me that his primary goal with patients is to get them to a place of recovery where they don’t need his services any longer. He wants to work with fewer patients at a time than what you would see in a traditional physiotherapists office. There, you would be one of sometimes 15 other patients vying for the therapist’s attention, each of you in your own curtained cubicle or patiently waiting in the entry. His approach is to give his clients his utmost attention for as long as he’s with you, in a walled room, with a door.

This meant that it might be a couple of months before he would have room in his schedule to see me, prioritising patients already in his care. I was intrigued by this because, although it meant I had to wait, it also meant that when it was my turn that I would be the one being prioritised for care.

Knowing my limits

My intrigue outweighed my single red flag, so we agreed to set up an initial 90 minute appointment. To prepare, I reflected on past experiences with therapists and on my expectations for this new treatment.

This is my chance to get it right, I thought.

I began by writing down my intentions for seeing an athletic therapist, followed by what my needs would be during the sessions. Here’s what I came up with:

Intentions:

1. Explore another option to add to my pain management plan.
2. Learn more about my body’s mechanics. What are my limits, why? What are my strengths, why?
3. Release tension related pain in neck/chest/shoulder/ribs, and left glute/thigh/low back.
4. Progress slowly to start. Begin with mostly communication on the first visit.
5. Understand and agree to the plan before any treatments begin (manual or technically assisted).
6. Get a head-to-toe assessment and treatment plan (ie. no piece-meal limb treatments).
7. Share findings with my Nurse Practitioner after each visit (or monthly if meetings are frequent).

Needs:

1. Be part of the process.
2. Be able to say no to a treatment before it starts (I have difficulty speaking up before it’s too late).
3. Be informed and educated on the findings.

Speaking Up

The day of the appointment I brought along my notebook with my list of intentions and needs for the session. After he greeted me at the door, followed by a personal tour of the building, I changed into some comfortable clothes for movement and met him in his treatment room.

“Before we start, I have a little ‘spiel’ I’d like to give you if that’s all right?”

“Of course. Go ahead”

I took a deep breath of air and read through my lists, trying all the while to ignore the feeling of nervous sweat dripping down my arm and the small tremors in my voice. While I spoke I saw him taking notes and nodding along with me, never interrupting me. I added at the end that I am aware that I have a limited mental capacity to handle physical treatments, especially those that may cause pain, which is why I want to spend most of our time communicating rather than treating to start.

He caught me by surprise by answering with compassion and empathy.

“It sounds like you’ve had a lot of negative experiences in the past. We’ll focus on getting a full body assessment today and go from there. How does that sound?”

My shoulders slumped and I breathed out a sigh of relief. “That sounds great. Thank you for listening to me.”

Paying attention to my inner voice

From the beginning, I was treated with respect and more importantly as an equal participant in the session. I felt I was part of a team. While he took on the role of Kinesiologist, or body movement expert, I was the historical expert. I know my body and my history better than anyone else. We took turns both educating and learning from each other.

And we both gained something in return. He got money from me for his services, and I got valuable information to help me become more mobile again.

I asked a lot of questions throughout the session, even interrupting him at times to ask him things like “Why do you want me to lie down? What are we doing now? What does it mean that I get pain when you move my leg like that?” He was extremely patient with me and answered all of my questions.

We also made use of the anatomy posters he had throughout the room. He would point out to me what muscles he thought were too tight or not engaging the right way. Something I wish more therapists would do. I often feel like those posters are just there as a distraction while you’re made to wait for the therapist to come back into the room. This was the first time a therapist made use of them as a tool for the session. I even used his body to help me point out where the pain presents itself in my shoulder and neck.

I felt calm and safe throughout the session. The pace was exactly what I needed even though we didn’t complete the full initial assessment. We stopped after reaching the hips so that we could use the rest of the time to discuss what he thought was going on and to demonstrate ways that I can stretch and strengthen the muscles and tissues in my ankle and hips until our next appointment.

Celebrating my achievements

I am so proud of myself for trying a new approach to physical therapy. After my last session with the physiotherapist, I was ready to swear off treatments for good.

Even if this one with the Athletic Therapist doesn’t cure or even reduce my pain enough to return to “normal” life, at least this experience will not leave me traumatised.