Sunday, June 15, 2008

Failed treatments

During my musculo placement, i treated a 25yo male who had a hx of anterior shoulder dislocations. He was part of the 10% bracket who'd had surgery to repair a bankart lesion and it failed resulting in contined dislocations. He was an ongoing patient at the clinic and on reading his notes i saw that he was progressing quite well and the last student who'd treated him recommended him for d/c as his ROM was WNL and his strength was up. He cancelled his first appointment with me and rescheduled for the following week. when i did my initial sx ax with him he told me that the reason why he's cancelled his appt was that when he woke up that morning he'd stretched as he got out of bed and re-dislocated it. so from being ready to d/c my patient was now back to limited ROM in F, Abd and ER and weak rotator cuff. He was now back to basic ROM exercises and strengthening and this is the continous cycle he goes through and has repeated many times over the past few years. as far as he is concerned another operation is not an option as his wife is not working as they have a 3 month old and a 2 year old, they've just bought a house and he's just started his own business. it was so frustrating not being able to "fix" his problem because both the patient and i knew that he's been through the exact rehab i was doing with him many times before and it had no effect. over the few weeks i treated him he progressed really with full ROM and increasing strength in rotator cuffs. on speaking to another student who took over this patient when he left, i found out that the patient had recently re-dislocated and was back to basics. i was so disappointed on hearing that the outcome of all our hard work over the weeks had not changed anything even though everyone involved in the rehab program were realistic about the outcome. it made me feel like my whole treatment program had been for nothing. looking back on my treatment i know there's nothing i could have done differently but i cant help feeling that i've let the patient down, does anyone else take failures personally?

2 comments:

Erin Post said...

Just wondering if the patient was continuing all the exercises etc. at home?? I just thought maybe that if he had done less exercises cos it was feeling better it might have hindered the hard work you had both put in?
Sounds like an annoying situation for both of you though.

Hendo said...

Every now and then there are a few patients of which i do feel as though i have failed them. Especially those patients that you try every type of treatment option you have in your arsenal including massage, mobs, stretches, posture, epa modalities etc. I think its at that type of point where you need to consult more experienced practitioners to help you out or refer them onto a health practitioner that can help. A very frustrating situation to be apart of though.