My least favorite diagnosis (sigh)

Winter Glory

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Really....I don't even want to hear it anymore...
client:
"My doctor says I have arthritis"
me (because I'm just mean...)
"Oh, that's interesting. Where do you have arthritis and where are you experiencing problems?"
client:
"Oh, all over, my doctor says it's arthritis."
me (because I'm feeling particularly mean...):
"What diagnostic tests where done that led your doctor to this diagnosis?"
client (blank stare):
"Why my doctor didn't do any tests, but he says it's arthritis."
me (because I'm just gonna push the envelope here):
"And what treatment did your doctor prescribe for your condition?"
client:
"Why, nothing. My doctor says it's arthritis."
me (inside):
"ARRRGGhhh gahhh." :x
 
My least favorite diagnosis (sigh)

Bad thing about that is... probably not even the same doctor seeing all those arthritic clients.
 
My least favorite diagnosis (sigh)

Yeah, I get those too! :P How about we channel our frustration into a useful dialogue about how to handle these cases? Here's how *I* might continue from where your example conversation left off:

Me: Okay, is it rheumatoid, psoriatic, osteo, or some other form of arthritis?
Client: Oh, just arthritis.

Me: Okay, then - if your doctor didn't tell you what type or where it is, we can reasonably assume it isn't a severe form. Where is it most affecting you?
Client: Oh, it's all over.

Me: What are your symptoms?
Client: Well, it hurts.

Me: Show me where it hurts.
Client: (Points at a bunch of different areas, shows me their hands and feet.) Pretty much all over.

Me: Are you disabled by it?
Client: No! It just hurts.

Me: Okay, can you... (turn head, raise arms, make fist, etc. - a variety of very simple functional tests common to ADLs)?
Client: (performs tests, occasionally making a face or otherwise indicating more discomfort in certain movements) Yes, but I feel sore.

Me: Okay, I can see that you have more discomfort in certain positions and movements than in others. Your range of motion in many areas isn't bad, but we clearly have some areas that are more limited. One of the few things guaranteed to make arthritis and its associated symptoms worse is lack of movement. We need to get more movement into the areas that are most affected so your body can recover and feel less discomfort. It may be possible to eliminate most of your discomfort, and we can talk about some things you can do at home after today's session. Other than your arthritis, what else can I help you with today?
Client: I just want to relax, I've been very stressed recently...

And the dance goes on... ;)
 
My least favorite diagnosis (sigh)

This is also a pet peeve of mine and as a matter of fact it came up in conversation tonight with a client. Sometimes the doctor in question might have even taken an x-ray but seriously, what does that prove? As I've explained to many of my clients, if you x-ray 100 people over a certain age who have no pain at all, I'd bet that the majority of them would show at least some arthritis in one of their joints.

Just because you have pain and some degeneration in a joint, doesn't mean that the wear 'n tear is what's causing the pain.

:roll:

Angie
 
My least favorite diagnosis (sigh)

This reminds me of all the clients who self diagnose with carpal tunnel syndrome.

I mean if your wrist hurts, it MUST be CTS... right?

:confused:
 
My least favorite diagnosis (sigh)

Oh yeah, BIG pet peeve of mine!!! Doctors make lots of "diagnoses" without any testing whatsoever, but that is by far the most common. I handle it basically like Jason does - I can't do a thing about arthritis, but if we can get more mobility in the muscles, they won't be pulling on the joints and increasing the arthritis pain. Fairly often, the "arthritis" pain goes away, too.

I do ask about what type of arthritis and what diagnostic processes were done for the doctor to come to that conclusion. That question alone will cause some to realize that they don't KNOW that it's really arthritis.

Usually the conversation reviewed to me goes like this: Patient: "My knee hurts." Doctor: "You are over 60, you have arthritis. You'll need it replaced at some point." :irked:
 
My least favorite diagnosis (sigh)

I had a lady once who said you can't touch my thumb, i have severe arthritis there. Ok... well I'll work on you and I'll avoid your thumb and then you can tell me how you feel. (I was doing hand or foot massage in a dental office) So I worked her forearm, paying attention to the attachments near the elbow. Then asked her how her arthritic thumb was. OMG, the look on her face was PRICELESS! She was pain free in the thumb for the first time in 2 years!

She thought I had magic hands! LOL
 
My least favorite diagnosis (sigh)

JaeMarie said:
This reminds me of all the clients who self diagnose with carpal tunnel syndrome.

I mean if your wrist hurts, it MUST be CTS... right?

:confused:

Yeah, this one irks me, too. :irked: Ask least most physicians have stopped recommending CT surgery... it's a step! Unfortunately, massage is rarely utilized as an early intervention, particularly in cases of musculoskeletal pain that are not yet severe enough to require surgery or PT.

I have a recent case involving trigger finger in both hands. There is extensive medical documentation from the year+ of hand therapy she went through, plus she saw a massage therapist for other things. She is now symptom-free, with her dexterity and hand strength improving rapidly. If I remember to write the case review, it should make for interesting reading. :grin:
 
My least favorite diagnosis (sigh)

You didn't know any pain was just arthritis? LOL

Yeah, I love doc's and there diagnoses. BUT often the client (patient) doens't really pay attention to the doctor and they just want to know what they have, it needs to have a name. So the doc gives it a name and sends them on their way.

You get the "Doc said I pulled a muscle."

What muscle?

The rotator cuff muscle.

WHICH RC muscle?

I don't know, he didn't say.
 
My least favorite diagnosis (sigh)

softy515 said:
You get the "Doc said I pulled a muscle."

What muscle?

The rotator cuff muscle.

WHICH RC muscle?

I don't know, he didn't say.

I can top that one.....I once had a client who insisted that the doctor told him that he'd fractured his rotator cuff!!

:shock:

I tried to explain to him that his rotator cuff was a group of muscles and that you can't fracture a muscle but he didn't want to hear that and insisted that he'd broken it.

:smt017

Angie
 
My least favorite diagnosis (sigh)

Maybe he was so insistent because he was talking about his rotator CUP being broken lol
 
My least favorite diagnosis (sigh)

I have a client with myofascia. You know, the condition where everything hurts?

She comes to me for myofascial release.

Makes sense, right?

;)
 
My least favorite diagnosis (sigh)

JaeMarie said:
I have a client with myofascia. You know, the condition where everything hurts?

She comes to me for myofascial release.

Makes sense, right?

;)

This kind of ignorance regarding one's own health is what makes me feel bad for Dr's and why many of them probably 'dumb it down' to giving such generic answers as 'you've torn your rotator cuff'. Dr's are only human also and I imagine many do give the least complicated answer possible. Also, probably more Dr's DO give the correct information, only to have their patient not be able to understand what they have been told and remember (or mis-remember if that is even a word LOL) what they were told. Kind of like the game of telephone.

It is pretty common in my experience to talk to people who have no idea what is wrong with them or what they could or should do about it after a visit to the Dr.

Me: so what did the Dr. say at your appointment?
Them: oh i've got this stomach thing, I don't know what it is called. I got a prescription.
Me: what kind of pills? what are they called and what do they do? what else are you supposed to do or not do to help get better?
Them: oh I just take these pills. I don't know what they are, I just have to take them 2 times a day.
Me: for how long do you take these pills? forever?
Them: Oh I don't know. I have another appointment in 4 weeks and the Dr. will tell me if I have to stay on these pills or get different ones.

:shock: Seriously. I've had these conversations... with people in my own family. :roll:
 
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  36. Jennyโ€™s Spa:
    ๐ŸŽ‰๐Ÿ’JENNYโ€™S SPA๐ŸŽ‰๐Ÿ’ โœ…5170 DUNDAS STREET WESTโœ… ๐Ÿ‘ŒETOBICOKE ONTARIO M9A 1C4๐Ÿ‘Œ โ˜Ž๏ธ( 647-893-5196)โ˜Ž๏ธCall or Text โ˜Ž๏ธ( 437-888-3759)โ˜Ž๏ธCall Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…GRAND OPENING๐Ÿ’ฏNEW GIRLS EVERYDAY๐Ÿ”ฅEXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNYโ€™S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅTWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY๐Ÿ”ฅ ๐Ÿ’ฏREAL PICTURES OF ATTENDANTS๐Ÿ’ฏ ๐Ÿ”ฅ๐Ÿ’‹Limited Time Special Promotion๐Ÿ”ฅ๐Ÿ’‹ โœ…๐Ÿ’ฆ30 Minutes Nude Mass
  37. Spa in Markham:
  38. Moneylee:
    All season wellness center : New Young girl big breasted beautiful buttocks charming temperament big boobs Mia๏ผŒyoung girl pretty face nice figure Thai deep massage Aad,Young girl big breasted beautiful buttocks charming temperament big boobs Yoyo,Young girl Big breasted saucy naughty Ella ,Enchanting sexy petite deep massage Sherry ๐Ÿ address: #5-30 Rambler dr Brampton ,Ontario L6W 1E2โ˜Ž๏ธ4376655510 ๐Ÿฆต๐Ÿฆต๐Ÿ‘„๐Ÿ‘„๐Ÿˆต๏ธ๐Ÿˆต๏ธ๐Ÿ‘…๐Ÿ‘…
  39. Moneylee:
    Full season wellness center: New Young girl big breasted beautiful buttocks charming temperament big boobs Ivy , Young girl pretty face big boobs nice figure deep massage Jessica ,Young girl Big-breasted big Big boobs big butts Linda , Young beautiful face sexy body and good deep massage Maggie,Enchanting sexy petite deep massage Mary . ๐Ÿ  2560 Shepard Ave Mississauga unit 1 โ˜Ž๏ธ 4379857899 ๐Ÿฆต๐Ÿฆต๐Ÿ‘…๐Ÿ‘…๐Ÿˆต๏ธ๐Ÿˆต๏ธ๐Ÿ‘„๐Ÿ‘„
  40. BlueXado Therapy & Spa:
  41. Pink Flower Spa:
  42. wonderspa:
    ๐ŸŒบwelcome to wonder spaโ˜Ž๏ธ416-5000-800,L6a4H8๏ผŒopen10 to10,Ensuit shower available ๐Ÿ…beautiful young Jessica deep tissue to relax massage back walk,hot stone๐Ÿ…long hair vietname Amy is very good looking,slim body ,nice body slide sweet sensual touch ๐ŸŒนbeautiful sexy face ,big boob Joey ,amazing massage, starting to ending,really popular girl,must try๐ŸŒน๐ŸŒน๐Ÿ‘
  43. bnwellness_wilson:
    We have 4 young girls are working today, young sweet Taiwanese Victoria 25โ€™s slime open mind and young flirty Tina with sexy body open mind 30โ€™s,young pretty Lily 25โ€™s with curve body and Cute GFE Lina are providing deep tissue massage, pls call 4163985777 book appointment and walk in always welcome,back entrance and parking available, 350 Wilson Ave North York
  44. ForeverWarden:
    Friday at ๐Ÿซฆโค๏ธ๐Ÿ”ด๐ŸŸฅโ™พ๏ธ๐“•๐“ž๐“ก๐“”๐“ฅ๐“”๐“ก ๐“ข๐“Ÿ๐“โ™พ๏ธ๐ŸŸฅ๐Ÿ”ดโค๏ธ๐Ÿซฆ 2190 Warden Ave, Unit 201, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿด๐Ÿฌ๐Ÿฌ-๐Ÿณ๐Ÿด๐Ÿด๐Ÿณ : Bobo, Mimi & Sasa. Bobo is a small, slim and sexy lady, petite with all natural busty melons for your enjoyment. Mimi is a nice slim lady with a big bottom, & great oral skills to take you to paradise. Sasa is a slim & sweet Korean lady, about 5โ€™4โ€ with C Cups.
  45. Annie Spa:
    ๐ŸŽ‰๐Ÿ’ANNIE SPA๐ŸŽ‰๐Ÿ’ โœ…7-1001 SANDHURST CIRCLEโœ… ๐Ÿ‘ŒSCARBOROUGH ON M1V 1Z6๐Ÿ‘Œ โ˜Ž๏ธ (647) 891-9688โ˜Ž๏ธ โ˜Ž๏ธ (416) 291-8879โ˜Ž๏ธ (FINCH & MCCOWAN) OPEN 9:30am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…NEW MANAGEMENT๐Ÿ’ฏNEW GIRLS๐Ÿ”ฅ๐Ÿ”ฅ ๐Ÿ”ฅGORGEOUS NEW YOUNG ASIAN GIRLS - TODAYโ€™s ROSTER INCLUDES: ๐Ÿ”ฅ Ivy๐Ÿ”ฅ๐ŸฅฐA stunning new Korean massage girl with a captivating presence, long silky brown hair cascading down her back, and a petite, elegant figure that exudes charm. Her warm touch and intuitive skills promise a deeply relaxing
  46. HolidaySpa:
    Friday at ๐ŸŒด๐Ÿ˜Ž๐ŸŒ…๐“—๐“ธ๐“ต๐“ฒ๐“ญ๐“ช๐”‚ ๐“ข๐“น๐“ช๐ŸŒ…๐Ÿ˜Ž๐ŸŒด3517 Kennedy Rd, Unit 4, Scarborough โ˜Ž๏ธ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฎ๐Ÿฐ๐Ÿณ-๐Ÿญ๐Ÿญ๐Ÿต๐Ÿตโ˜Ž๏ธ: FIONA, LINA & CINDY. FIONA is a slim hottie with long dark hair, great melons and ass, and nice services. LINA is very well known for her great services and her impressive shapely ass. Come and see why! You will be glad you did. CINDY is a slim & incredibly sexy lady with
  47. AliceSpa:
    FRIDAY at ๐—”๐—Ÿ๐—œ๐—–๐—˜ ๐—ฆ๐—ฃ๐—”, 4915 Steeles Ave. E, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿฎ๐Ÿต๐Ÿด-๐Ÿฌ๐Ÿด๐Ÿต๐Ÿด. 3 ladies waiting for you. Two Very Hot ladies (Qiqi & Summer) have returned to Alice spa today. Open 10am to 9pm: JOJO: is a busty JAPANESE girl, nice DD Cup boobs, short, petite small body, pretty face AV S2tar, bbbj cim cof rim, special services available. LUCKY (11:30am-9pm): is Vietnamese, small body, busty D
  48. Lilyspa1:
    Lily Spa : โค๏ธโค๏ธ SuSu ( Asian )Slim , ๐Ÿ˜๐Ÿ˜Porn Service ๐Ÿฉท๐ŸฉทElena 22, Latino French, 36 DDD and ๐Ÿ‘๐Ÿ‘ASS, ๐Ÿ’‹๐Ÿ’‹Vicky 22, Philippine mixed White , very open-Minded , ๐Ÿ˜ˆbbbj , DFk ๐Ÿ”ฅDuo ๐Ÿ”ฅ,โ˜Ž๏ธ 6475318288
  49. Lulu1980:
    Phoenix Blossom Spa ๐ŸŒน๐ŸŒน๐ŸŒน3 girls ๐Ÿ˜˜Table shower ใ€body scrub ใ€ Sea salt bath๐Ÿ‘5124 Dundas St W Etobicokeโ˜Ž๏ธ416-817-3366๐Ÿ‘ Young girl Cherry (Student)๐Ÿ˜˜๐Ÿ˜˜โ€œcharming breasts.โ€beautiful curvy hips.โ€very provocative service๐Ÿ˜˜๐Ÿ˜˜๐Ÿ˜˜, professional super Luna deep tissue massage, has therapeutic effect to loosen bones and relieve muscle pressure and will bring you unexpected service effects, she will bring you a little surprise๐Ÿ˜๐Ÿ˜๐Ÿ˜๐Ÿ˜โค๏ธ You are welcome to make an appointment at any time or walk in the
  50. Lulu_Villa_Spa:
    Jessica Pretty Girl with amazing personality and super easy to get along with. Sasa friendly Vietnamese Judy is a gorgeous model type Vietnamese Girl Sami Vietnamese Girl Cherry ๐Ÿ’ From Malaysia Part time School girl โ˜Ž๏ธ647- 446-0886
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