Friday, September 26, 2008

I lost count . . .

I just returned from my first physical therapy session of my new knee. Now, my previous experience with physical therapists has not been good. A little background will help you appreciate my point of view.

Four years ago, after my ACL reconstruction, I was assigned to post-op PT at a local place that amazingly accepted my insurance. After my initial consultation, where the licensed therapist measured the maximum angle at which I could bend my knee (in degrees, not radians . . .), I was told to return 4 times each week for treatment. No problem, I thought. THEY are the professionals. They have special training and fancy equipment that will help me get back to 100% sooner. Much to my dismay, my insurance was paying for something I didn't really need. The first several visists involved nothing more than me doing leg lifts, the same ones I was doing at home. The therapist wasn't even counting for me. I had to do it by myself, just as I was doing at home, except at home I was able to watch Sportscenter. At the office, I was watching a wall and a therapist who was scribbling into his notebook. When I showed up the morning of the day I went into surgery with the first infection (see yesterday's blog for the chronology), I expressed some serious pain when doing (and counting) my "heel slides." "Pain is normal when you're recovering," was the reply. I remember it was a rainy morning, and I was sitting on a bench in major agony sliding my heel along a bench all by myself while my therapist was getting coffee or something.

"Is my knee supposed to be this big? this red? this painful?" I kept asking, but the walls wouldn't answer. It was later that afternoon when I called my doctor and told him my symptoms. We immediately went back into surgery to get try to get rid of the infection.

It was with this experience that I went to my PT visit today, albeit at a different location. The two ladies at the front desk didn't give me much confidence with their casual demeanor. The overdressed, blond, perfectly manicured male joking with them behind the desk only strengthened my belief in the tremendous money-making scam these "professionals" were pulling off. My "script" as I later learned it to be called, was not prescribed by my doctor, but instead, the length and duration of my treatment was left up to the professional judgement of the same people who were joking about the color and style of my checks. My distrust and animosity was almost boiling over.

Having walked into the place without crutches, without pain, and having successfully completed the entire regiment the yesterday of exercises prescribed by my doctor (counting all by myself!), I envisioned the office prescribing 3-4 visits per week, in the middle of the day, for several months, with a $20 co-pay required each time, all for me to show up, lift my leg, and count to myself. I told myself that this would be my first and last visit if I wasn't pleased with what they had planned for me. I was not going to be fleeced! I could do my own rehab at home on my own floor, sliding my foot along my own wall. . . .with Sportscenter.

Soon afterwards, Katie, my PT, came and retrieved me from the waiting room. I shook her hand with reluctant skeptisism, but with sincerity. As I asked her what her plan was, she immediately put me at ease by telling me she was just going to assess me first. She was very impressed that I was walking without crutches and without a limp less than 48 hours after surgery. I was trying desparately to give her every indication that I did not need her services, and that I was only there on doctor's orders. Because a former calculus student of mine was on staff there, she knew I was a math teacher, which meant she knew that I KNEW HOW TO COUNT, especially for only 3 sets of 20 reps of leg lifts. I was SO waiting to let her have it! I wanted so badly to walk out of the place on a gimpy leg only to let them take advantage of someone else.

But I didn't . . . .

Katie had a very calming effect on me. She was the real deal. She actually counted with me as we did our preliminary exercises, which she only made me do to make sure I had proper form. She was impressed. I had done them so many times before. In fact, at one point, I admitted that I had lost count while talking with her through my "knee flexes." She joked that she wasn't the mathematician, but that I had exactly "three left." Very nice! At least she was counting. The most impressive thing about her was that she fearlessly "undressed" my wounds without squirming or using gloves. With this afternoon being the appointed time to change my very bloody dressings, I had to go to PT with the original surgical bandages on. I really wanted to change them prior to going in, but they were still "oozing" slightly. She not only took off the bandages, but she helped me clean up the area with alcohol swabs. I was won over.

In the end, she prescribed me 4 weeks of therapy, with 2 sessions each week. She even went as far to say that if I showed such promise that I wouldn't need her services, the therapy could be abbreviated at any time. She also promise that we would be doing activities that weren't so "boring" as leg lifts. I TOTALLY owe Katie everything for restoring my faith in the physical therapy profession. It's going to very hard to cut our sessions short, because I don't plan on doing 8 sessions at $20 co-pay a piece. I'm going to get it done at home and much, much sooner.

Perhaps I'll send her a gift certificate for the difference in what I save in co-pays to make up for her "lost income."

Thanks Katie! You actually seem like someone that would acknowledge a puss-filled sack around my knee as "irregular" and not just a requisite painful part of rehabbing on your own but paying others for.


Thomas Korpi said...

we JUST got back. i need to read all the e-mails... but wow. had no idea :( glad yer okay.

i like that yer legs make a figure 4 in the picture. reminds me of all the headlocks you used to put me in.

Anonymous said...

Well my opinion of PT's was about the same as yours until I went to one for the frozen shoulder I had a couple years ago. At first I thought this was pretty silly stuff not doing much good but low and behold about 4 months later I was back to normal and I have had no problems since. Hard to argue with success. Hang in there and just do the exercises, thats the key to getting it done in the shortest possible time.