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Journey of a DPT Student

Repeat Patients -- Same Approach?

Published February 24, 2014 4:54 PM by Lauren Rosso

For the first time ever, I'm treating a patient who returned for repeat therapy after being discharged a month or so ago. This patient, who is impaired following an anoxic brain injury and transfemoral amputation, has been through the medical ringer in the past six weeks.

His first course of care was very challenging, however we made some great progress prior to his discharge. Knowing that multiple medical complications occurred while he was away, I was honestly scared to see how he was functioning when he came into the clinic on Friday.

The evaluation was interesting. I knew what we had measured and worked toward in the past, so I collected similar outcomes. But I couldn't help but think that I needed to be doing more. Unfortunately, I correctly predicted that this patient would be well below his previous performance.

Bed mobility, contracture management and sitting balance were back to pre-PT days. In the middle of the evaluation, it occurred to me that I might have to take a very different treatment approach this time around rather than plugging away at the same old goals that we set last time. A new episode of care with a new focus.

I think it may be hard to phase out the old program and start a new one. It took so long to develop an effective and efficient treatment plan for this patient, and I fear that he and his family may not be interested in taking a step back to work on some basic functional skills that seem more important this time around.

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2 comments

I'm sorry the above post was meant for a different blog.

jean March 24, 2014 11:52 PM

I find myself in the same situation, nearing the end of my education that is. However all I can think about is getting ready for my comprehensive final in a couple weeks, trying to figure out how to wrap up my research to present, and what my study schedule for boards will be. I think that most of these problems are because our class schedule was structured differently than yours was at the time. I feel like my life revolves around those things right now and it's hard to see the light at the end of the tunnel. I feel like I have to do all these things and start applying for jobs so that I can start supporting myself after I graduate. Maybe it is just for me, meaning I am just letting myself get wrapped up in the small details to allow me to enjoy everything I have accomplished at this point. Reading this has made me realize that I need to start enjoying this stage. At least find a happy medium between the two ideas, enjoying this time and being productive at the same time.  Thanks for this post because it was really eye opening as to how to handle all of this without getting overwhelmed.

Jean March 24, 2014 11:50 PM

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