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Toni Talks about PT Today

I Didn't Recognize My Patient

Published June 15, 2010 10:46 AM by Toni Patt

I had the most wonderful experience last week. One of my patients came back to see me. This doesn't sound like much until you consider where I work, an acute rehab unit. Some patients never make it beyond hospital gowns. They are often either overweight or underweight. Some have NG tubes for feedings. Others have facial droops. No one really looks like his or herself.

Ms. D was my patient three or four months ago. She'd had a stroke but was doing well. When discharged, she was walking with an AFO and small-based quad cane. Her gait was characterized by slow cadence, poor foot clearance, right foot drag and right pelvic drop. Her hair had been in braids but had grown out. Every time I saw her, she was in a sweat suit or tee shirt and sweats.

Last Wednesday, she walked into the gym wearing a dress and two-inch, open-toed sandals. Her hair and nails were done. She was wearing makeup. More importantly, she not only didn't need her AFO but was also walking in heels without deviations. I nearly cried when I saw her. She was a patient I had gotten attached to and hoped she would get better. She did. She had a doctor's appointment earlier that day and decided to stop by. She dragged her mother and daughter all over the hospital. Neither one complained. They were happy for her.

I rarely get to see how my patients come out. I get them walking but don't see the results. I tell them my job is to get them home so the real work can start. Even though I tell them to come back and see me, few do. Seeing someone like Ms. D makes my heart feel good. It reminds me how much I help people. Sometimes I can predict how much improvement a patient will make, but not often. Usually the best I can do is reassure them they'll walk independently and get on with life.

I imagine this doesn't happen in all settings. Outpatients tend to look like themselves. The same is true of total-joint patients. Unless there are complications I doubt they look too different. Children are probably more amazing. Children change quickly in normal circumstances. I can't imagine how much one could change over a few months or a year. That must be an extra special feeling. My patients are usually set in their lives whereas children are just beginning.

I wish there was a way I could follow up on more of my patients. Outcome numbers don't tell the whole story. I want to know if they got back to life. I think that's the outcome measure most therapists are concerned with. I just have no idea how to measure it. Seeing my old patients again helps make me a better therapist. I look at them and know I'm doing the right stuff.


This is too true.  Very few times have I followed a patient from acute care to snf.  Once they leave our services they rarely come back.  And how right you are, when they do come back for a visit they look completely different.  Often I don't recognize them with their street clothes on.  I also think some of them do not want to remember their experience as a patient in a hospital or SNF.  

Jason Marketti June 19, 2010 3:12 PM

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