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PPP Management How to help PPP patients.

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Old 04-12-2004, 12:04 AM   #1
nari
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Default The elderly and PPProblems.

I met an 80 year old woman yesterday whose XRreport (she couldn't bring them, too heavy) looked as though she had been through a mincing machine. Severe degeneration at every level L1-S1, compromise of at least four nerve roots, ostephytes (posterior), arthrosis, etc etc.
She was hospitalised twice, and the second time she went to the Aged care unit, where she experienced more trauma; she was expected to "pull her socks up", was yelled at and told she had to get home; the neurologist requested a CT, but the ward discharged her home and it was never done.

Her GP suggested physiotherapy, but the experience in the ward was so traumatic she arrived in a state of terror, independent on her seat-walker.
So I told her, after reading the XR report, I was not going to touch her back. Once her fear dissolved, she talked about her own strategies: walking twice a day with other residents, she had set her own goals, her GP told her she did not need the walker, but she wanted it for "pain contingencies", so I said she needed it. Despite the horrific report, this lady manages her own pain in her own way; quite cheerfully.

why do some physiotherapists - and others- seem to think the only way is to verbally abuse and bully? There is a sizeable contingent, it seems, who insist on delivering what they believe is required, according to the books, to deliver an efficient service. An efficient service, I ma sure, can be achieved with a bit of lateral thinking and listening....


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Old 04-12-2004, 04:33 AM   #2
Diane
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Could it be because we evolved in close proximity to the armed forces? Not just us, all aspects of medicine, hospitals to a large extent, nurses... As I delve into the past of my profession sometimes I'm not ecstatic about what I find..
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(the one with a quiet voice, especially since I stopped working in hospital..)
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Old 04-12-2004, 05:36 AM   #3
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That's a notion I had never considered before. Interesting..
Draconian nurses are legendary, and doctors too- and harking back to the mid sixties, in the battered old enormous hospital system in Queensland, some draconian physios.
My massage/movements teacher goosemarched wherever she went and could wither your brain with two words. I thought it was more to do with the fact the war had ended only 20 years previously.

Is it the armed forces - not only but also the I-know-best-do-as-you-are-told medical model that is at least showing signs of changing.
I think that is partly due to the migrant factor; especially the Asians who are almost without fault, quiet and polite, and get on with the business of being doctors.

Delving into the past for physiotherapy is useful, and it does not look promising, but sometimes I think we have still an awful lot to learn, about managing patients, and not a disease or a joint or a muscle.

When I worked as a childbirth educator, we ran questionnaires every year.
We considered ourselves highly skilled (taught for two and a half hours, once a week, for eight weeks) about every aspect of prgenancy and labour you could think of....and yet, with the replies we received off the questionnaires, one comment was standard. Not..'I learnt so much' or 'I understood so much better'...but: The physio was great/good/delightful and listened to us/was kind/ was interested in us', and so on.

I've never really forgotten that.


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