Today I found myself reflecting about Suzie’s story – and her battle with headaches, neck and arm pain following a work-related injury over three and a half months prior.
Suzie is a 43 year old Theatre Nurse, whose left shoulder and neck were “compressed” during a patient transfer as part of her Operating Theatre duties. She presented to me at one our gold coast clinics appearing tired, considerably anxious, wary and frustrated.
On her own admission, Suzie was upset. She was upset at the pain, emotional, social and physical impact her injury was having on her, her family, and her ability to return to work.
The number of people involved in her recovery was (in her own words) “striking”. Her GP, Employer, Insurance Case Manager, an Occupational Therapist, an Upper Limb Surgeon, an Orthopaedic Spine Surgeon, an Independent Medical Examiner, a Counsellor, and myself – the third physiotherapist Suzie had seen since her injury.
Fortunately both surgeon’s had told Suzie she didn’t require surgery, and just needed time and treatment – yet she still felt she was no closer to recovery.
She felt she had a complete lack of understanding about her injuries. She was confused by conflicting opinions from various “experts” involved in her care. She was concerned about information she’d received from her case manager regarding pre-existing, degenerative findings on her scans and X-rays – specifically in body parts she’d never had pain before the injury. She was frustrated by the need to continually re-tell her story, and prove that “there must be something wrong”. She felt isolated, disempowered, and wondered if she would ever be able to get back to “normal”.
From what i could reasonably see on assessment, Suzie’s demonstrated mechanism of injury and subsequent headaches, neck and shoulder pain were very easily explained.
It was moreso that the messages conveyed to her about what her pain was, what it wasn’t, and what she could do about it remained very unclear.
Compounding this were the typical delays associated with having work-related injuries assessed, reported and accepted – all contributing to an inability for Suzie to purely focus on her recovery.
Suzie and I had an initial discussion about what I believed her injury to be, and then a more indepth discussion about how her pain and other symptoms were consequently normal and relatively simple to get on top of. We talked about how “hurt” isn’t necessarily a measure of “harm”. We talked about the need to approach her rehabilitation by addressing both the human and diagnostic aspects of her pain. We talked about her initial and ultimate goals as part of a durable and meaningful rehabilitation and return to work plan. With Suzie, I spoke with her GP, Counsellor and Case Manager and relayed what we had discussed – and it was clear all parties shared common ground as to what we wanted for Suzie’s recovery – we simply needed to define and appreciate our own individual roles in assisting her to achieve same.
Suzie has since undertaken a structured, and progressive rehabilitation program which has consisted of aquatic, floor and gym-based exercises, active psychology focused on mindfulness and refining pacing techniques, and regular reassessment with her GP for certification and communication with her Case Manager. Concurrently, she has sensibly been increasing her capacity at work, upgrading from lighter duties and hours, to those which are more typical of her role as a Theatre Nurse. She has returned to walking her dog daily, and is able to manage most daily chores she does as at home. She reports having improved sleep and energy levels, and much more confidence with her role in her recovery. She has had a couple of mild flare-ups throughout the process, but understands how to manage these without worry and settle them down, before re-attempting her essential daily activities.
I reassessed Suzie in rooms last week (now 5 weeks since our initial consultation, and almost 5 months post initial injury) and asked her openly what she believed to be the single most important factor which had influenced her ability to “turn the corner” so successfully?
Her answer was simple, and not suprising – “Knowledge”. Knowledge to know she had been validated, and had learnt skills to understand her pain and injury, build strength and mobility, and develop confidence and trust with all parties involved in her recovery.
Suzie’s story unfortunately isn’t uncommon – and I’m afraid to say we see it all too frequently.
What should be a straight forward recovery for people who have suffered certain work injuries, is often in reality a laborious process compounded by variables typical of those mentioned here with Suzie’s story.
Clear communication, goal setting, and human considerations are essential ingrediants which can often be “what’s missing” in the initial stages of one’s recovery. By addressing these – it only helps to empower the individual to become an expert in their rehabilitation pathway, and therefore help them play an integral role in their own recovery.
For more information visit programs4pain.com.au or email me and I’d be happy to help.
*Suzie is not my patient’s real name.