Ugh. What a Monday. The only good thing in my book was watching Rep. Giffords return to the House floor. Who’d have thought it?
On the half full side … I did manage to remember to bring my lunch to work (yeah!), where I discovered I had a bag of oh so precious Resse’s Peanut Butter cups (score, solves the chocolate problem). Unfortunately, by 8:30, my day had pretty much been tanked.
Granted, Monday and I are not the best of friends, but yesterday, I had a 7:15 physical therapy appointment. Already feeling snarky over not getting to see my PT, and because of this whack-a-doodle contract I’m working, I was forced to use a location close to my temporary office that has hours from 7-7 and is affiliated with a major teaching hospital. 15 minutes into the evaluation with the new PT, I made the decision I’d ride out this prescription with her and not return. Yup, it was that bad. My number one pet peeve of anybody (but especially those working in the health care professions) is not listening/not reading the chart. She didn’t do either.
Your doctor writes a prescription for physical therapy. Most scripts are simply the impacted joint with treat/eval. My ortho wrote a detailed script: I have a complicated ortho history (usually 28 ortho surgeries indicate that …) and he wanted specific modalities as well as more extensive treatment than a simple ankle/knee one. At one point, out of sheer exasperation, I said, uh, it’s on the script. She asked me what I was doing to alleviate some of the symptoms: I went through a detailed list of PT excercises that I do daily. She then printed off the same exercises substituting a tennis ball for a racquetball for the plantar and told me I needed to loose weight (thanks). I was mildly irked: first appointment, yet to check range of motion, strength, laxity and she is giving me (the same) exercises as homework. I had yet to take off my shoes.
Part of me was just laughing: the other part was livid. She then told me I was sitting wrong. My hip was flexed past 90 degrees. I said, truthfully, my surgeon has seen me sit like that and he is ok with it. She pulls out her measuring device (don’t ask me to spell goniometer) and says see, you are past 90 degrees. I was at 91. I still had my shoes on. 35 minutes into this painfully slow ordeal that made me wish for even a student (and I checked – she has been at this facility since ’89), she finally gets around to examining me, you know, seeing what is wrong. (Note: patients really don’t like FILLING out forms only to have you not read them). I heard I had my last hip revision done at the wrong hospital (Hi, you don’t know *who* did the surgery, and he is one of the top 10 in the country), that I didn’t have plantar fasiciitis (um, ok, 2 mri’s noted it, plus the huge tightness on the ball of my foot, I have a high pain tolerance and the point of tenderness is in an atypical place), and why did I have knee surgery (read the surgical history: you’d see ACL repair).
Finally, I was asked what was bothering me: Tightness from the bottom of my hamstring to the ball of my foot because I can’t get my right leg into full extension. My two orthos agree this is an issue: that probably isn’t skeletal but muscular and the best course it to try intensive PT before doing releases of tendons/muscles. She looks at me and says “there isn’t a different in your leg length, your pelvis is even”. Head:desk. I demonstrated.
After more back and forth she asks about my insurance: I tell her. She says “oh, I can’t treat you.” For real? I have 45 visits a year left (I used 15 when I strained my shoulder). Apparently she needs to get authorization and why didn’t I tell them this when I called. At my limit (which actually takes a bit with health care providers), I said “Nobody asked.” She launches into a tirade of now she would have to do work to get authorizations. Ok, look, I get medicine has become a paperwork nirvana. I also know that a well written (probably an issue) evaluation will generate approvals. I also know that because of the screwed up system, I can’t take my prescription back and get a new PT because it’s a double evaluation.
My hope is that she is a better practitioner than evaluator. But after finding where she wrote on my heel cord with green ink? I’m not so sure.
I know I’m picky about my health care. I know that I have a complicated history. It’s why I’ve found away to pay close to 6K a year for my health insurance. I know there are a ton of good health care providers out there: and for all I know, she might be an excellent PT. But I also know that if a provider doesn’t appear to be paying attention, I question his/her ability to practice. And I also know, that telling somebody she can’t be treated is not the best way to start a relationship. For all she knew, I could have paid out-of-pocket. I also know, I’m not interested in hearing about the stresses of your job: I’ve got my own and we aren’t friends. And it would have also been nice for you to ask my name.
(off soap box)