Monday, July 2, 2012

Sad Day

During my observation hours today I saw a lot of patients I'd never seen before but also two repeat patients (i.e. I was observing another time when they also had come in for treatment). The first was in her early 30s, had back pain, was doing quite better.

The second a man, much older, had gotten knee replacement surgery. The first time I saw him he was in a lot of pain, had very limited mobility. It had been several weeks since the surgery and his recovery was unusually slow. It was obvious that even bending or straightening his knee was causing him a lot of pain. He ended up having to have manipulation under anesthesia performed (basically they knock you out and the surgeon bends the knee to restore range of motion - sounds gruesome but apparently tends to be effective). That was a few weeks ago.

He was the last patient today and it was kind of heartbreaking. For whatever the reason he had lost almost all of the mobility that the knee manipulation had restored. It was almost exactly the same as the first time I saw him getting therapy. Even with assistance, his knee was not able to bend past 90 degrees, and even that caused him immense pain. He was shaking and kind of whimpering, eyes pressed tightly closed, and when he opened them, they were watery. It didn't seem like it should have caused him so much pain, and the PT I was observing said that even for people of comparable age, this is rare. It just appeared that his body experienced pain differently from most people, that he wasn't able to do - or motivate himself to do - his exercises because of the pain he was experiencing (even with a pretty hefty dose of percocet).

I don't know. It just seemed like, if he cannot do what needs to be done to restore the range of motion in his leg, it isn't unlikely that he will ever be able to walk without pain. I just felt kind of bummed out leaving on that note. The PT was really supportive and encouraging to him, but I think she felt a little bummed out too.


Bbear said...

There's a unique set of problems I've come to associate with older patients in my mind. There are the standard "are they going to live or die?" questions, but there are also metrics involved in their care that measure whether they can recreate a clockface accurately or if they can remember three words you told them two minutes ago. It's a tough place to have someone you care about be in.

Newt said...

Can you explain more what you mean bubs?