This old Chinese idiom, give a man a fish and you feed him for a day; teach a man to fish and you feed him for a lifetime, has resonated with me all my life. That is why I can’t fix my car. I can open the hood, stare at the contents of the engine and say, “Yep, I need a mechanic,” because I have no idea what any of this stuff is in here. My dad taught me to fix sprinklers, paint citrus trees, mow a yard and clean pools. Fix cars? Not a chance as my “teacher” had a different set of skills. I found my calling elsewhere.
My mom went back to school to become a registered nurse after raising us, six kids. My older brother went to medical school, and my sister went into nursing. I saw medicine as my calling from mom and siblings. Landscaping in Phoenix, Arizona, didn’t appeal to me. Years later, I would become a physical therapist to teach people to stay healthy.
Empowering the elderly to stay healthy and manage pain in healthcare
This week as I was finishing up my electronic documentation of my patient visits, I noticed that the overall age of my patient population has gotten older and older over the past three decades. The current age range of my patients is from fifty-five to eighty-eight years old. I even have two 90+ year olds. When I graduated from PT school in 1984, my most senior patients were in their low eighties. We are living longer and healthier these days, and I like to think that we are all making healthier decisions throughout our lives. Healthcare has made huge strides in providing information to us consumers about maintaining a healthy life. We can train smarter, exercise more efficiently, track our health with more electronic gadgets, and listen to our healthcare providers about staying healthy. Preventative healthcare is a huge business, and we all tune in when we hear the latest guru blogging or vlogging about the latest supplement, diet, gadget, salve or device that will heal you from all your aches and pains. I like to teach my patients how to fish as often as needed and know if they need a little extra help to figure it out.
I’ll start with a short story of my patient, Wade (not his real name).
Wade is a 77-year-old retired teacher who is married and lives in Penn Valley. He has five acres to take care of, along with two dogs and a cat. Wade came to see me for his chronic back and shoulder pain. After the initial exam, I explained to Wade that his back pain should be something I can help him ease within a few visits. He will then be able to manage his symptoms on his own. It took us a handful of visits to get him to where he could easily manage his back and shoulder symptoms with a series of stretches before and after he did his chores. He has a foam roller, a large gym ball, and a yoga strap to help him stretch. Wade didn’t need any strengthening exercises as his back was as strong as an ox. To make sure that my hypothesis was correct, I asked him to show me his strengthening exercises. We found that his crunches, planks, and superman’s (lying on his stomach and lifting his arms and legs) all made his back feel tight, created joint stiffness and pain that eased after a few minutes. I informed him that his strengthening exercises were his daily chores of bending, twisting, carrying heavy objects, watering and digging. We focused on flexibility before his labors, and he was a happy camper. His back pain went away quickly with the knowledge that he was making his back hurt with the strengthening and that he will get better and have less pain if he had better flexibility. Wade now has a series of head, neck, low back stretches that take him 10 minutes to do several times a day. And the best part – he is managing his symptoms on his own. Wade knows how to fish. He will come back and see me if need be.
Wade’s type of musculoskeletal problem is quite similar for all of us physical therapists in the community. We see our patients for a series of appointments and then send them off with a home exercise program that should keep them independent and pain-free for a long time. When they need a tune-up, we are there to empower them with some hands-on treatment and self-management. I love to empower my patients to become independent in their musculoskeletal health. I like to tell my patients, “I can’t wait to hear you say, I don’t need you anymore.”
I ran into a patient in SPD the other day, and after he gave me a hard time about what was in my basket, he said, “Hey John, those exercises you gave me in 2017 are still working, I don’t think I need you anymore!”
I taught him how to fish, and he is feeding himself.
John Seivert is a doctor of physical therapy and he has been practicing for 34 years. He opened Body Logic Physical Therapy in Grass Valley in 2001. He has been educating physical therapists since 1986. Contact him at [email protected] yahoo.com