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There were never any "good old days" — they are today, they are tomorrow
clashing modalities 
28th-Feb-2008 01:22 pm
note to self
I think I'm turning into the sort of patient that the average doctor considers a pain in the neck. I'm not a hypochondriac, and I'm not showing up at my appointments with 20 pages of webpage printouts about unproven treatments, and I don't go in saying "I want medication X, and I want it now." But I am becoming someone who knows her body, pays attention to it, and has begun to figure out what works for me and what doesn't, and is willing to say "No, I'm not going to do that."

The next time I need a referral to Physical Therapy (and it would be PERFECTLY FINE WITH ME if I never need another one), I'm going to push to get the right physical therapist for me — which is going to be a therapist who has experience working with acupuncture as a complementary modality.

The therapist I got assigned to has zero experience with acupuncture, and the treatments she has been recommending directly contradict what my acupuncturist has told me.

PT says "use icepacks, several times a day." Joel says "in TCM terms, this results from an excess of cold and damp, so keep it warm and dry." (And as I mentioned earlier, he's said that ice should not (not not NOT) be used after the first 24 hours following an injury.

PT says "do these stretches, several times a day." Joel says "you can't stretch this out, work it out, or walk it off. You need to REST. Go HOME, lie DOWN, and DON'T MOVE."

So when I went to my second PT appointment, what I had to report was that no, I hadn't been doing any of the things she wanted me to. I wasn't using ice, I was using a heating pad. I wasn't stretching, I was on as-close-to-bed-rest-as-I-can-manage. I have a feeling that I made it onto her mental list of "non-compliant patients", and I just want to say to her "It's not that I'm NON-compliant, I'm just complying with a different modality whose recommendations happen to contradict yours. Furthermore, I've been seeing that practitioner on and off for about five years now for various things and have experienced significant relief and improvement from the treatment. I've seen you twice now, and felt noticeably WORSE after the treatment."

So I cancelled the appointment I had scheduled for tomorrow. It just didn't seem to make sense — I'd have to take time off from work (either by burning sick leave or making the time up later), schlep up to Oakland Kaiser, and fork over the $15 co-pay, just to tell her "The only one of your recommendations I've followed is the ibuprofen; I haven't been stretching or using ice; and the pain is significantly reduced and is continuing to improve. Thanks for... um... Well, have a nice day."

I mean, $15 will pay for 1/4 of an acupuncture session or two bottles of Zheng Gu Shui — and those actually help.
28th-Feb-2008 11:38 pm (UTC)
Does Kaiser let you choose physicians? I thought it was a "take who we give you" place.. or at least that was the impression I got when insured by them.

Ice is good to reduce initial inflammation, but otherwise is only nice in the summer when it is hot. It slows the flow, so stalls bad reactions but also stalls healing. Sounds wise to get someone else.

(Acupuncture sessions cost that much? I had no idea.)
29th-Feb-2008 01:40 am (UTC)
Find someone who works WITH you! Can you request another PT?

I'm doing yoga and weights and water aerobics which is helping my chest/shoulder/arm stuff way more than PT. I have the exercises, just need to do 'em!
29th-Feb-2008 02:55 am (UTC)
Ugh. A bad PT fit is ... bad. For what it's worth, the PT clinic where I work uses techniques that are quite compatible with acupuncture. And we spend considerable time unwiding the No Pain No Gain myth. Among other things, the idea that every human (and accompanying body) will respond favorably to the same style of rehabilitative work every time is silly and not useful.

Here are some PTs in your area that might be a better fit, should you need one again. I went to the Upledger website and looked for SF practitioners who are PTs and have studied craniosacral therapy and, ideally, lymph drainage therapy. These are gentle techniques that are wonderfully effective, in my experience. And, generally speaking, PTs who embrace their value tend to be less inclined to increase tissue irritation/inflammation as part of "therapy".

Amy Compasso PT, LLCC
San Francisco, California 94112-3544 USA
Tel: 415 469-7763

Athena Kyle P.T.
San Francisco, California 94109 USA
Tel: 415 563-1616

Bettina Neumann RPT,CST,LLCC
San Francisco, California 94102 USA
Tel: 415 282-4083

Ilana Bernstein P.T.
San Francisco, California 94134 USA
Tel: 415 452-9879

Bonnie Brill P.T.,M.S.
San Francisco, California 94114 USA
Tel: 415 621-0988

Also, ice an absolutely be effective after the first 24 hours. How it is applied makes a difference, of course. I'd be happy to share as much as you'd like to hear about what I understand about that.

Bottom line? Do what works. :)
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