Friday, May 25, 2012

I’m Gonna Take That Mountain!

In my physical therapy observations at Wendell Foster’sCampus (WFC) in the Green Therapy Pavilion, I watched Ryan encourage Jim as he walked back and forth between the parallel bars, even gently pushing him to “keep on keeping on.”   I saw Jim’s determination and his exhaustion.  I sensed he didn’t like doing it, but I see in Jim a will, a determination to do it anyway.  What I didn’t see in Jim was what Ryan saw in him:  his potential to do more.

Before starting physical therapy (PT), the physical therapist conducts a client evaluation to determine and rule out physical problems, assess pain and discomfort, muscle strength, and range of motion from any joint in your body – ankles, knees, shoulders, elbows, etc.  The evaluation assesses the need for equipment to assist in the recovery and/or mobility of the client, adaptive space needs, etc.   Finally, it also determines the course of therapy treatment and the frequency of sessions needed to facilitate goal achievement, healing and/or rehabilitation.  Ryan gets a good sense of what Jim (and any of his clients, for that matter) is capable of doing as a result of this evaluation, in addition to his observation of Jim’s progress since starting therapy.  So at my next observation with Jim, I was stunned when Ryan announced Jim was going to climb the stairs!

The PT area includes a staircase that ascends nine steps up to a landing then turns left to continue up another nine steps to a larger landing resembling a loft area.  Ryan explains Jim has previously done the stairs exercise which strengthens his leg muscle and builds endurance.  This particular exercise requires the help of a PT assistant.  I sit on a bench off to the side of the stairs and watch, holding my breath to the point my body forces me to breathe as I watch Jim take one wobbly step up at a time.  Ryan spots Jim, lightly holding his waist belt from behind for balance and support as he goes up while a PT assistant stands in front of Jim on the ready in the event of a misstep.  Once upon the landing, they let Jim catch his breath for a minute before he begins his descent of the nine steps he just climbed, with spotters in place as before.  Jim does “take this mountain” twice during this session.  Both Jim and I breathe a deep sigh of relief upon his final step onto the floor.
Another activity involves Jim walking the length of the PT area with a walker.  This exercise requires three people:  Ryan who offers the majority of support to Jim by holding on to the waist belt while another person ahead of the walker helps Jim steady the device. A third person, for which I’m volunteered in this session, follows with Jim’s wheelchair so he may sit for rest breaks and as a safety precaution.  Jim travels a few round trips back and forth across the PT room, and despite these exhausting exercises, Jim never complains.

Jim shows up for each appointment twice a week; many patients who have the opportunity don’t.  Jim never quits.  Many patients do.  Jim is obviously pooped by the end of his session.  Ryan teases Jim that he probably enjoys a good nap after his PT sessions.  Jim confirms he does.

But soon, I learn Jim’s access to physical therapy is jeopardized by red tape, bureaucracy, and ironically, the health industry itself.

In the Next Blog Entry:  Hoops & Red Tape: “. . . .the red tape and hoops. . . . a request for coverage for a patient’s therapy was denied because it lacked appropriate information.  She highlighted with a highlighter the “missing” info within the originally submitted text of the paperwork and returned it. . . . .

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