I said check back with me in 5 years and I’ll let you know if I think the surgery worked. OK it did. With a million other changes and interventions and time and thinking and on and on and on. Do I think 5 screws in my bones is the end all be all to my success. No. Do I think it helped. yes. Can I explain why I got better, and stayed better and others have not. Nope. And let me tell you I hate that as much today as I did 6 months post-op.
I treat people with Low back pain, SI pain, hip pain, butt pain etc etc every day. What I want to share today… it’s not as simple or clear cut as you think. When it’s YOU doing your own differential diagnosis. Looking up your symptoms, researching possible conditions, trying to put the pieces together, coming to a conclusion/ direction, and developing a treatment plan… Well, YOU are aware of ALL your symptoms, not just the stuff you’ve managed to get out during our session. You know YOU and YOUR body and the self evaluation of others you have met along the way. You are smart. You are informed. Or you are scared to death, or frustrated beyond the telling, or all of the above. Then you walk in to see me at the outpatient physical therapy clinic…..
Im treating 6 people who all have the same symptoms you do. They are all responding to different things. I have put together a “story” in my head about why – BASED on all those same people you know and their symptoms, PLUS the school I went through, plus all the piles of papers I’ve read, the other clinicians I have met and learned from, my current PT AND your story. It makes what once looked so easy and clear…. less clear.
For example, a debate that went on for a long time in the Facebook groups was release or not to release the psoas. A debate among clinicians is can you even GET to the psoas. If your my patient and you believe releasing it is going to unstabilize your whole spine and cause the world to come crashing down – I’m skipping it and working around it. If you think it HAS to be done or you will NEVER get better, well then we will utilize that as I explain I am not sure we are getting at what you think and try other ways to get rid of that niggle your feeling.
You think your SI joint is “out”. Well I am going to educate you while we are working together about how pelvic positioning isn’t the same as the position of the SIJ and I am gonna show you your landmarks can change without doing all those mobilizations your last PT taught you. But if you REALLY feel like they help – keep doing them, just asking you to be open to other explinations.
More than anything I’ve learned each medical person has their influences and ways to distill the information into bit sized pieces to explain to YOU the patient the story of why you hurt and are having trouble functioning. I have gone from NEEDING to know the reason ( singular reason) to explain my own pain and realized in the last 5 years it’s d. ALL OF THE FREAKING ABOVE. I hate D. But it is. It’s mechanical, chemical, emotional, it’s personality, it’s perspective, it’s the way your doctors have treated you, it’s the response you have to interventions, it’s ALL of it.
5 years and I feel like a different person. Inside and out. I am harder and softer. I am more open and see endless shades of grey. I am tired by people who don’t want to listen to the experience and intelligence of others as they head into treatments and choices that others have tried before them and seen terrible results. I am tired of Medical professionals who offer false hope. I am tired and sad by the people who continue to have their lives impacted negatively by my profession.
I love my job. I love love love having people I can help. I can’t help them all, and that makes me sad. I want to know EVERYTHING about EVERYTHING. SO yeah that isn’t so realistic… but it keeps me sharp and looking and not settling. I get sympathy pains for my LBP and pains in the butt patients. They grip my heart, I think of all the times people got it wrong on me and I try to be better. I never promise anything and work on giving them the ability to help themselves. I ENCOURAGE movement and staying engaged in life. I PRAISE walks to the mailbox, the ability to sit through a full day at school, a return to a sport or work. I use manual, exercise, relaxation techniques, machines, pain theory, and anything and everything else I have to unlock movement for my patients.
I want them to feel as good as I do. I want you all to feel as good as I do. Keep learning, keep fighting, keeping HOPING. you must keep hoping 🙂