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Oh, by the way, I have a bone spur
Good morning all,
I just wanted to relate an experience that I had last week and see if anyone has any feedback or comments.
I had a call from a new client who was in pain. She scheduled ASAP and during the intake she mentioned neck pain, that an x-ray showed arthritis in her neck-she had to ask her MD what that meant. Her doc wanted to do an epidural injection. From the way she spoke, I gather she didn't really care for her doctor. I spent several minutes describing the neck anatomy using my skeleton, she listened and was grateful that someone finally was explaining the anatomy to her. There were no obvious contraindications, so on the table.
The session went very well, she was very pleased with work I did on her upper back and shoulder and neck, "this is just the attention I've been looking for." nice
So, five minutes before the session was over she told me that she had a bone spur in her neck. huh? A bone spur??????? Well, now I understood about why she couldn't find relief. I finished the session and then explained to her what the bone spur could mean.
Before she left, she thanked me for the treatment and the information, she didn't reschedule and I imagine was on the way to a shot.
So, what seemed the most disturbing was that she didn't mention or understand the bone spur even after I spent over 10 minutes showing her the skeleton and asking questions. I thought my intake was diligent enough to have found this.
I'm wondering if there's some way to elicit more details from clients who are inexperienced in anatomy or lack understanding of their problems, in addition to a written/oral history?
Cheers,
jody
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Replies to This Discussion
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Permalink Reply by Walt Fritz, PT on
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Great question. I start with a written history form that I have clients fill out prior to their first visit. They download the form from my website. On the form I try to get all of their pertinent medical history, including surgeries, therapies, trauma, etc. Invariably they forget things, as we all do, or consider things not relevant to what is bringing them to me. At our first meeting, I probe and probe, both verbally and physically, trying to bring out any mechanism of injury/pain that they may have forgotten. I've gotten quite good at this, but am always amazed what people forget to mention, often until a much later date.
My advice? Question them in as many different ways as you think possible. It is often not until you touch a certain area that they will recall something that they had forgotten.
Good luck.
Walt Fritz, PT
www.FoundationsinMFR.com
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Permalink Reply by Peter Lelean on
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Hi Jody. Yes, it often happens, so I try to remember to ask new clients (a) how long has this been troubling you? (to establish chronicity . . (b) do you have any xrays you'd like to bring along? Pretty obvious, I know, but its easy to let go of these tools when your juggling appointments etc. Another useful question is to ask whether this is possibly an inherited problem. This a lovely intro to future additions to you customer base and to intuit what else you might find during your initial assessment of the new client. Have fun . . cheers Peter
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Hi Allan J, Always looking for the report . . . sometimes that's all you get. Having said that, accurate interpretation is sometimes lacking. Moreover, as you would know, xrays don't show everything of interest. Its really to identify potential red flags before you start heaving things around.
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In the 46 mins since the last post, new patient . . .13yo hip hop dancer with LBP and headaches had . . left Sij reset, pub symph corrected, several flexed closed lesions released, thoracic fascia adjusted, bicip ligaments reset, two rib heads relocated, atlas reset. Tps. in scalenes treated and 2 mins postural education. She just left with mum, no pain, no headaches, blissfully free movement. no xrays . . .no ten sessions . . . next please . .
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Permalink Reply by Nels Gullikson on
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Could it have been an intentional neglect in telling you about the bone spur, for whatever reason..? We are asking our clients for an incredible amount of trust, and self knowledge too, for that matter. And visa versa.. I would venture to bet that she returns ,with more complete information, knowing what she knows now ..
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Permalink Reply by Kelly Grounds on
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I am reading this post right after something similar happened at our school's clinic. Our intake forms are thorough and we train our students to ask questions beyond what's on the paper. However, many people don't get that massage is not just being nicely petted but a medical procedure. We just had two ladies in who wanted hot stone massages. One just had a pacemaker put in and was on her way to her cardiologist after the massage for her follow up (!!). She did not put this on the form because "she didn't think it was important for a massage person to know!" Her friend has HBP (untreated) and the worst varicose veins I have ever seen. Because we are a school, we do everything very conservatively. As clinic director, I had to explain to these ladies that massage is part of the healthcare industry (our massage school is a unit of a beauty school) and that they both would have to have doctor notes in order to reschedule their massages. On the way out, the lady with the new pacemaker said to her friend "I knew I shouldn't have opened my mouth. Next time, I'll just lie and I can get my massage. Let's go over to Massage Envy and see if we can get in."
I called my friend who is the manager at ME and warned them these two might come in-and they did. I don't get clients who want to lie about their health. I explained in detail why we could not massage them. These two didn't care, about their own health or the careers of the people who worked on them. It's epidemic in the area I live.
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