On Tuesday I went back to physio, short on sleep, low on pain relief, but feeling surprisingly good about it all. There’s a running pattern where I just don’t sleep at all the night before my first session with a new physio – A good physio (C2, my wonderful dark mistress, physio to whom all others shall be compared) is like a good friend, meeting them can be a slightly life-changing experience, and a bad physio (C3, looking at you) can make your life a misery.
New physio, Physio G, seems to be closer to the former than the latter, but time will tell. He immediately focussed on two things; That I was probably dealing with a lot of emotional fallout from having been so fit, and now being “nothing” (His words, not mine), and that I was not interested in being fed bromides about wellness, I wanted the truth without the supserstition.
Firstly, I think that he was projecting his own experiences onto me a little bit; He’d been a semi-pro rugby player, got horrendously injured in his early twenties, and fell back onto physio as a “useful thing he could do”. He seemed far too keen to put his own experiences of feeling like the world had left him behind onto me, but on the other hand, they seemed fairly congruent to mine, so I don’t mind running with that. He’s also in agreement that CBT for Pain will do me the world of good, and that Stanmore (Where I get the impression he’d been a patient) will be a game-changer for me. So, well, he’s happy to accept that my mental health and physical health are linked, but that the physical is still very real as well.
Secondly, he seemed relieved that I’d already accepted that “pain free” was an unrealistic goal. He visibly relaxed after having asked “So, what do you expect out of physio?” and having me give the answer of “A set of strategies that let me make sense of which pain is dangerous, and how to minimise and control the pain that I do get. Which should, in turn, let me do more things with less risk”. He admitted that 90% of the worst part of his job was getting people used to the idea that they might just be in pain forever.
Thirdly, he was happy to point me in the direction of improving my own knowledge – I’d said that my goal was to reach the point where I didn’t need a physio, I just needed a textbook so that I could devise my own course. He approved of this as an idea, which was amazing, since most medics seem to hate the idea of an autodidact, especially one that seems to be gunning for their job. Took me through a dissection of the wrist, thumb and elbow, explaining the hypermobility in my thumb, checking that I knew the difference between a synovial pop and a subluxation (Sadly, I do get both, and I’ve now collected two days’ worth of data to show it, so his edict of “Stop cracking your wrists” is going to be reformulated to “I will stop cracking my wrists as a nervous habit, but will still do it when I need it”) and reassuring me that my elbow was really unlikely to subluxate when it was at full extension – But that I should stop hanging on it at full extension, because that was leading to muscle weakness in the arm, due to lack of use.
I now have hand exercises – Not the patronising “Two exercises at a time! You’ll forget more!” but four fidgets to strengthen key, pince, tripod and opposed grip (Using plasticine for better and tighter grip, and a stress ball for convenience when I’m out), finger situps to strengthen the palmar interossei and the flexor digitorum (Gripping a towel for greater resistance), and finger extensions (Elastic band around all the fingers, open and close hands) to strengthen up the various pollicis and stop the thumb from sliding past the tendons. And, indeed, every week I’ll get a new set of exercises for a new set of joints. Sets three times a day, taking about ten to fifteen minues a time, plus other stressball-mushing as required.
I also have a small notebook, in which I’m recording exercises as I get them, along with pain episodes, PRN medicine consumption, swim durations/distances and exercises. And I have physio textbooks on the way.
You know that motivated, rational, compliant, interested patient that everyone says that they want? I’m going to try to be him. I’ve got something like eight months before Stanmore, and if I’m not in the kind of shape that makes the ward sisters a bit wistful by the time I get there, I will consider myself to have failed.
Swam again on Tuesday – 800m, took about 35 minutes with plenty of breaks. Going again tonight. Was comfortably overtaken several times by a guy training for the Land’s End to John O’ Groats cycle, so I need to work on that. Hopefully see him again next week.