A real story or shall we say slice of life from a physiotherapist who was pronounced as the best physiotherapist by her own patient? Afterall, what it takes to being a physio?! Read on, in her own words.
During our college days when we were being trained to be a physio, we were told a story. It was about this huge ship which gets stuck in the middle of the ocean. No one among the marine engineers on the ship could rescue the ship. Help was sought from far and near. But absolutely no one could help. After a while when all the efforts start to seem waste, someone suggested a local mechanic staying on a nearby island. Not leaving any stone unturned, he was brought to the ship. This poor local guy comes, observes and examines the engine and then takes out a tool out of his backpack and taps a few times on a particular area of the engine. To everyone’s surprise engine starts whirring in no time. When they ask him about his service charges, he demands a big amount. No one expected a visibly poor and local basic mechanic lacking any fancy degrees to charge so much. When he demands such an amount, they ask him for the split of the services to justify the bill. He calmly replies, “The technique I used to solve your problem doesn’t cost much, but having an understanding and knowledge about which technique needs to be used for this particular problem and how effectively it needs to be used is costing you so much.”
Painful knees are a very common occurrence among the elderly and so was with Mr Narayanaswamy. He continued to live with painful knees which eventually hampered his everyday activity. There was chronic pain and despite medication his walking and general movement began to decline. He continued to console himself that the reduced activity and stamina was owing to his increasing age.
But after a prolonged period of about two years, by when he was bed-ridden and almost totally inactive – he underwent total knee replacement as advised by his doctor.
After an initial rehab of knee replacement, an average person usually reports significant improvement in walking and other movements. Unfortunately Mr Narayanaswamy was not showing any signs of recovery. Instead he consistently suffered from fever and weight loss. Eventually a TB infection was diagnosed that had affected the TKR implant too. So a revision surgery had to be performed on him shortly, thereafter.
It is at this stage that I got to meet Mr S. Narayanaswamy – who had gone through so much in the last two years. Not just being physically weak he was feeling mentally drained too. He recalls “After I came from the hospital, I was very low on physical as well as mental strength. I was depressed also. Even the slightest of movement made me breathless.”
I was to be his home visit Physiotherapist from ReLiva. On his initial assessment, I realized that it was not just his stamina, he was even having difficulty balancing himself while standing. He had been bed-ridden and completely inactive for more than a year.
As a physiotherapist, I identified that his immediate goal was to improve his balance, regain strength and thereafter build up his stamina. All of these eventually will help him regain self-confidence.
Together we worked hard day-in and day-out. I would visit him regularly at his place and work on his goals through a combination of therapy and exercises. Gradually he showed signs of recovery and began to stand properly on his own. We systematically progressed to the next set of exercises. Now I had prescribed him several movements to be done on his own during the rest of the day. The committed and sincere person that he was, he would do those home exercises diligently on most occasions. We were moving from one strength to another.
It was at the end of another session of physiotherapy when he broke the news with a beaming smile that he was thinking of visiting his daughter abroad!
We had come a long way. Here was a man who was completely bed-ridden for a year and a half and could not even speak on the telephone for more than a minute and NOW – he wanted to travel overseas! He was daring to dream and together we shall have to make his dream come true! We now worked towards a deadline when he could walk independently to take this long journey on his own.
After another bout of intense physiotherapy, he reported, “my energy level has gone up, I have regained my emotional strength, there is no depression, no breathlessness! I am walking properly and climbing stairs.”
Last, I saw him the day before he was to take his flight and he walked on his own with his walking stick. We did some strengthening exercises which he would continue doing on his own while he was away. He told me that “I am a happy individual now. I am back to life!” … what he didn’t realise was : What a happy and delighted therapist he was leaving behind in me watching his dream come true!
As shared by Dr Shrutika Parab (PT). Dr Shrutika is a home visit physiotherapist with ReLiva Physiotherapy. She is popular among her clients for her enthusiastic and positive approach.
Let’s take this chance to give someone what most breathless patients miss! We don’t know and most of the time THEY also don’t know that it is possible to better manage and even reduce the Asthma Attacks / COPD episodes and AVOID related Hospitalisation. Share this story with someone you know…
“Your Victory is right around the corner. Never Give up”
I think this quote very appropriately fits one of my patients – Mr Anand Rai (Name changed for patient privacy).
Mr. Rai (Or Rai uncle, as he prefers me to call him) is 71 yrs old retired Engineer who was diagnosed with Chronic Obstructive Pulmonary Disorder (COPD) about thirty year back! When I first saw him for consultation, I was looking at a very tired, breathless and weak looking old man. Despite his many difficulties, he seemed to own an amazing ‘spirit’, a great ‘will’ to get better and a beautiful ‘smile’ on his face.
I was told that Mr Rai had an episode of severe breathlessness, excessive sweating and total black-out one month back, when he was shopping for vegetables. He was immediately taken to the hospital, and admitted there for a week. He had been home bound, since then. After month-long restrictions, due to severe breathlessness and lack of endurance, he was now even scared to go out! Imagine the mental condition of a person, who loves outdoors, travelling, socializing, but because of his condition, is restricted to his house. I still remember his first words to me, “Dr. Kashmira, please make me better, so that I can go out and enjoy the rains when it comes and take a walk in the garden independently.” Another significant factor in his history was that he was a chain smoker for over 30 years, and still smoked 4 cigarettes a day.
Further assessment and observation revealed that he had very-less to no air-entry in the lower zones of his chest. The whole chest was filled with congestion. His overall endurance was very poor, the sputum was greenish yellow in colour, which meant presence of infection in the lungs. All these factors together contributed to severe breathlessness, which could happen even when he was JUST SITTING, without doing any activity! After further (simple) tests and viewing his reports, I discussed his treatment protocol with him.
I have always felt that a patient should be an active participant of his treatment protocol, he should know what his condition is, what protocol we are following for him and how will he benefit from that. His whole and sole goal was to go out for a walk. Even though this seems quite simple to us, imagine how difficult it would be for a person, who cannot walk even a few steps without halting to catch a breath. But what is life without a few challenges in it?! We started working towards our goal together.
When we started with the protocol, my first and foremost goal was to remove or reduce the
main culprit for his severe breathlessness – accumulation of secretions in his chest. So, I started with a combination of steam, Chest Physiotherapy, positioning for the patient and various other techniques. In the next few days, secretion had come down a bit, but the process was painfully slow. But as the saying goes, ‘Slow and steady wins the race’, we continued. And soon his secretions were under control, he was able to move with minimal breathlessness within the house.
Our next challenge was to improve his endurance so that he would feel less tired. So we started with endurance training and secretion removal on alternate days. There were many ups and downs during the therapy. One such incident was when, his friend visited him at his place, and they were chatting continuously for hours together. And when I met him the next day, I was shocked to see him again severely breathless; I felt I will have to start all over again from ground zero. But luckily his condition improved the next day, when he sincerely followed my instruction of not talking the whole day, unless absolutely necessary. He still laughs till date, remembering the stern expression on my face.
Finally after 20 sessions of therapy the day arrived when, it was time for him to step out for a walk, I still remember the joy and also the anxiousness on his face. Before we went downstairs together, I gave him a few important tips, and simply asked him to believe in himself. And we did it! He was able to walk with minimal breathlessness inside the building compound and he was able to climb the stairs as well!
I continued the therapy for 10 more sessions, because we still needed to improve his endurance during walking and stair climbing. On 30th session, I discharged him, I still remember the words he said to me that day, “Dr. Kashmira, I don’t feel like calling you a doctor.” A bit confused I asked him why.
He answered, “I feel like calling you ‘beta’, because now you’re like a daughter to me.” And I didn’t know how to reply to that, so I just smiled.
Contributed by Dr. Kashmira Khedgaonkar (PT). She is an ever smiling Physiotherapist with ReLiva Physiotherapy & Rehab ( www.reliva.in ) who has a special trait of gaining confidence of the toughest of people. She deserves it rightly so, with her skills to put her learning to practice to enable their recovery.
DISCLAIMER: Picture of Pulmonary Physiotherapy session does not represent the patient in the story and used for representational purpose only.
Most people have no idea that THIS is what patients of Asthma and COPD have to face during acute episodes of breathlessness. Read on to discover how he got back to his everyday life ! If you know a fellow Asthma/ COPD fighter, please SHARE this story.