Today in PT

Halloween Magic

Despite the fact that Halloween isn’t until tomorrow, today I have seen all manner of costumes being displayed around town. In one crosswalk, a tall black cat was seen escorting a tiny silver-winged princess across the street, and I could swear the Devil aggressively drove past me this morning on the way to work … then at lunchtime, I saw Diana the Huntress carefully packing pumpkins into the back of her red minivan.

Halloween may be a fun holiday for the little ones to dress up and embark on a sweet adventure, but it’s also traditionally a time for remembering the dead. Some cultures believe that a veil separates this world from the Other Side and is especially thin on All Hallows Eve, providing an opportunity to honor and communicate with beloved ancestors while fending off evil spirits that may try to break through.

This year, I am hoping for a little of both: I plan to hand out sweet treats to the little ones tomorrow evening, but perhaps a little Halloween magic will allow me to dream about the loved ones who have gone on ahead of me on Halloween night. Either way, I hope for more treats than tricks.

What does all this have to do with PT? Nothing much, other than to wish you all a safe holiday with no new injuries to treat at the end of it, and to remind you to keep your black cats inside where it’s safe. Now, it's time to go and carve a pumpkin with a scary face to help ward off any evil spirits that may want to stop by.

What are your plans for Halloween?

Anne Ahlman, MPT

Close Calls

This morning while innocently drinking a glass of mixed orange and grapefruit juice while watching the news before work, I was sickened to see the Australian news clip of a baby stroller rolling off a train platform and falling beneath the wheels of an oncoming train. The mother, who had let go of the stroller for just for a moment to tuck in her shirt, can be seen trying to dive forward and save her baby, but sadly not in time. She looked to be in hysterics – as I’m sure the engine driver was – but the happy ending is that after being dragged 130 feet by the train, the baby actually survived with only a minor bump on his head. It took me quite a while to shake the horrifying image from my consciousness ... A moment’s inattention very nearly resulted in fatal consequences.

As I drove home on the freeway at lunchtime, I was startled to find a little red car drifting uncomfortably close while passing me in the fast lane – I slackened speed so as to be ready for evasive action, and looked over to see why the driver was apparently losing control of his vehicle. Imagine my surprise to find the young driver cruising along in a reclined position with both hands behind his head, steering with his knees! What an idiot – in his efforts to look cool, he was endangering everyone on the road. As I fell back and watched his progress down the highway, he continued to weave in and out of traffic at high speeds, only once removing a hand from behind his head for just a moment to tweak his steering wheel, offsetting an imminent collision. Again, near-fatal consequences, this time from a moment of hubris … I’m only glad we all survived to tell the tale.

Close calls are part of the human condition, and as therapists we sadly get to see the after-effects of inattention and stupid decisions as certain patients roll into our acute care hospitals, rehab centers, and outpatient clinics. Sometimes, it’s hard to feel sympathetic toward someone who has become injured by their own hand, but if you think about it, most of us have had similarly close shaves growing up, and learned from them.

Have you had any close calls lately?

Anne Ahlman, MPT

Physical Terrorists?

Today, a patient who is being seen s/p TKA told me what she referred to as a “PT joke”:
Q: What happens when a sadist gets together with a masochist?
A: The masochist says, “Please hurt me!” and the sadist replies, “No!”

Hmm. How is that a PT joke, again? After all, since patients don’t really want to feel pain they aren’t masochists, and since therapists have to sometimes unwillingly create pain in the name of healing, we can’t be true sadists! Ah, the stereotypes abound … and as I carefully mobilized my patient’s healing knee into flexion, I assured her it was all in the name of Tough Love.

Being a PT demands that the therapist performs a dynamic balancing act of pushing forward and holding back, of encouraging while resisting, and of stressing the body's systems in a way that stimulates strength, endurance, and flexibility, yet doesn’t significantly increase the patient’s pain level — as they say, it may be simple, but it’s not easy. I have to admit, there are times I briefly feel tempted just to comfort and reassure stressed-out patients, holding off on the tough stuff for another day … but I know in my heart I would be doing them a disservice for their future mobility.

Do you know any good PT jokes?

Anne Ahlman, MPT

Speaking Directly

It’s National Physical Therapy Month! And to start the month off with a bang, it looks like we have some cause for celebration: This morning, the Senate Finance Committee unanimously passed an amendment that would add a program to the Centers for Medicare and Medicaid Services Innovation Center to examine the expansion of direct access to physical therapy services for Medicare patients living in rural areas. 

Even if you and your patients live in an urban area that will not directly benefit from this piece of legislation, the amendment represents a small step forward in the struggle for PT direct access across the board — and as a California native and healthcare provider, I find this struggle for direct access particularly stifling and irksome — so I applaud the effort, with kudos to the APTA for facilitating the conversation.

Can you think of other ways to help patients get the care they need, when they need it, and by the provider of their choice? Let me know!

Anne Ahlman, MPT