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Toni Talks about PT Today

Unintended Consequences

Published November 22, 2011 5:37 PM by Toni Patt

Last week, Congresswoman Giffords went on national television and spoke about her ordeal. What she did took a lot of courage. She gave the public a look into the scary world of brain injury. By speaking candidly, she gave hope to the victims and families of TBI. Her interview also created some consequences.

The day after the interview aired, I began hearing families demand the same care the congresswoman got. I don't know if this happened anywhere else but it wouldn't surprise me if it did. Each time I heard the statement, I was in the NICU assessing new TBI patients. In each instance the patients were non-responsive. They have a long way to go before any meaningful therapy can begin.

What these families don't understand is that every injury is different and recovery takes a long time. They saw only the end result. Therapy like that must be paid for. Congresswoman Giffords had excellent insurance. Most people do not. Many don't even have insurance. Even when therapy is covered, insurances limit what can be done and for how long. I can't think of one carrier who would pay for the level and intensity of therapy she received.

Another family member told me her son wasn't going to leave the hospital until he could walk out of there just like the congresswoman. The congresswoman walked out of a rehab facility, not an acute-care hospital. I don't know where that young man will walk again or not. If he does it will be out of a rehabilitation facility, not my place of employment.

I could give other examples of things I've heard in the last week resulting from that interview. The sad reality is that the congresswoman got the best therapy money could buy at an intensity level above and beyond what patients normally receive. As a result, she had an excellent outcome from her injury. No one begrudges her that. The viewing public wasn't made aware of what went into her recovery. It only saw the end result.

Obviously families and victims of TBI are looking for any hope they can find. Seeing someone who made such a wonderful recovery makes them want the same thing. If it worked for one person, it should word for another. That just isn't possible. The congresswoman was a special case. I'm glad for her. I can only imagine what she went through. I'm sure she had the best intentions with her interview. Sometimes the best of intentions have unintended consequences.


The other thing patients miss, or their families, is that not all injuries are the same.  A millimeter left or right, up or down may have made a big difference in what was left and how capable the recovery may have been.  In the Congresswoman's recovery we cannot leave out the word - miraculous.

Carl, PT December 14, 2011 5:17 PM


Great perspective.

When I was doing home health I saw a young man who was in an MVA.  Some three years post injury, he was now a teen in high school.  He was completely dependent for all activity and had no purposeful movement.  His status had not progressed in two years, yet he was still receiving some type of therapy daily.  He was receiving some therapy at school, some therapy at home, and the mom was taking him to other therapies, including traditional (OT,PT) and nontraditional (acupuncture).  

Upon initial evaluation, his mother gave reports of activities I couldn't ilicit.  So, giving her the benefit of the doubt, I followed the patient for a few weeks, three times a week as demanded by the patient and physician.  During this time, I scheduled visits at different times of day and watched the mother work with him to try to replicate these purposeful movements she insisted occured routinely.  It never happened.  During these visits I was also teaching mom what to do with her son once I was no longer coming.  I also tried to walk the delicate line of delivering a dose of reality without completely stripping her of hope.  

After I was convinced this young man was beyond any reasonable therapeutic medical intervention, I discharged him.  This action was met with an uproar by both the patient and physician.  If this young man is still alive, I can only imagine what this interview would have done to his mom.

Jane Goude November 23, 2011 3:10 AM
Lexington SC

I was quite disappointed that they never mentioned the word aphasia, missing a wonderful opportunity to explain it. They can prep for obscure Olympic sports  but couldn't bother to research this.

dean reinke, recovery - survivor, home November 23, 2011 1:45 AM
minneapolis MN

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