A Successful Recovery

A Successful Recovery is up to You

 After exploring whether or not orthopedic physical therapy is beneficial in the road to recovery for post operative patients, I have concluded that physical therapy has shown to be successful and necessary to healing but that it is not the only thing to factor into the healing process. Although it seems that many people put all of their faith into the hands of medical professionals to help them fully recovery after surgery it is important for the patient to know a full recovery takes more than that. I believe that with the combination of both physical therapy and a positive mindset recovery time can be more successful and quicker than those who decide to focus on one or the other.
 As I continue my research on the road to recovery, I am not sure that physical therapy works for everyone. There are factors that play into whether or not physical therapy is the only thing they need to recover or if there are other aspects that my inhibit their recovery. I want to explore and do more research on how physical therapy and negative or positive attitudes correlate in the process of recovery. For example, I’ve witnessed a lot of successful recoveries from patients who’ve had a very positive outlook, not only their recovery time, but about their life in general. I’ve also seen patients who were struggling from several problems, not just the injury that they are being treated for, who seem to heal at a slower rate. I haven’t found that one specific factor plays a role in a person’s recovery time, there seem to be many. As I look into the argument essay, I am still pondering thoughts on how a person can make the most out of their physical therapy sessions after undergoing surgery. Some of my other thoughts and concerns about physical therapy that I haven’t yet explored are the costs of physical therapy and whether or not a patient can afford to pay for it. How successful is their recovery and can these people fully heal? For example, maybe a patient can only afford to attend physical therapy for a few sessions when in reality they need to actively attend pt for 6-8 weeks in order to fully heal. I look forward to researching this further for my own personal knowledge. 

Mind Over Matter

I’ve always been a big believer in saying your attitude is everything. I’ve lived most of my young adult years believing this way and for the most part I’ve been surrounded by positive people. Can thinking positively truly help how someone heals from an injury? I came across an excerpt on NPR’s website from the book, Relaxation Revolution, by Herbert Benson and William Proctor that made question how the mental state of patient’s after their surgeries can affect them. The excerpt is about a patient who suffered from back pain and tried numerous treatments like physical therapy, pain medication, and multiple failed surgeries. Nothing seemed to be successful, that was until the patient started doing relaxation techniques or “mind body treatment.” By focusing your mind on healing the injury the patient could start to feel the pain subside. I’ve seen a few gruesome surgeries in the past 6 weeks and when the doctors are cutting through your muscles, tissue, fusing your bones or even breaking them it’s hard to believe a patient can just “think” there is no pain and it will go away. If you continually have a positive attitude towards that injured body part can you convince yourself that there is no pain or that it hurts less? What if you are always thinking about how much the injury hurts or are negative about how quickly you’re recovering, does that make it hurt more, or heal slower? How did the patient mentally take away pain from her back when no surgeon or physical therapist could help heal? It seems like with all of the medical training and advancement in medical technology one of those treatments would have helped.  What if a patient were to attend physical therapy as well as meet with a psychiatrist to help them stay positive? Isn’t that kind of what physical therapists already do? They see a patient for 30 minutes to an hour and in that time frame there is a lot of psychological babble that happens. Is that one of the biggest keys to a successful recovery?  I’ve found that the main ideas being explored in this excerpt was that healing an injury isn’t just about rehab, it also has to do with being connected to your body and believing that you can heal. In the article Anesthesiologist that I referenced in my previous blog it discusses an issue that some patient’s may suffer from that may inhibit the way they recovery after having surgery. The similarities in these two resources are that many factors play into healing the body, you can’t just depend on physical therapy as a way to fully recovery. In contrast, one portrays the idea on how mental awareness of the injury and positive belief in healing plays a large role in recovering. The other article, Anesthesiologist, frames the issue that symptoms of CRPS could cause more pain after surgery and inhibits someone’s recovery time. It also suggests that patient’s should wait until CRPS symptoms subside before considering surgery or physical therapy. At this point in my research my belief is that both of these resources have valuable insight and that physical therapy can be beneficial. I also believe that it takes more than physical therapy after surgery in the road to recovery and I need to explore more into the factors that are really important. I am not purely sold on the fact that mental awareness alone and positive attitude is the best healing option, like the excerpt in Relaxation Revolution suggests, but I do find this excerpt to be more interesting than the article Anesthesiologist because there are many valid points.

References:

Benson, Herbert, and Proctor, William. Relaxation Revolution. Simon & Schuster. Excerpt from National Public Radio. NPR, 2010. Web. 13 Nov. 2011. Relaxation Revolution.

Reuben, Scott, S. M.D. “Preventing the Development of Complex Regional Pain Syndrome after Surgery.” Anesthesiology. Ed. David C. Warltier, M.D., Ph.D. Vol. 101. Nov. 2004. 13 Nov. 2011. Anesthesiologist. 

Important Factors that Must be Explored

My research this week brought me to some great articles and resources that continue to help answer whether or not physical therapy is beneficial after surgery. What my research has also taught me is that there are many factors that play into my research when answering this question. What are those different factors? How does a patient chose what physical therapist to see? The first article I read was PTJ: Physical Therapy Journal titled, "Open Versus Closed Kinetic Chain Exercise: Issues in Rehabilitation After Anterior Cruciate Ligament Reconstructive Surgery," by G Kelley Fitzgerald. In her article she discusses a type of procedure done by physical therapist called open and closed kinetic chain exercises or OKC and CKC. First I want to clarify for my readers what this means. OKC exercises are where forces applied by the body are strong enough to overcome the resistance. Some examples of this are squatting, a leg press, or any exercise that allows for the load to move away from the body. CKC exercises typically incur compressive forces where your foot (for leg exercises) stays in contact with the object. Push-ups, pull-ups or dips are some examples of CKC. Fitzgerald’s article compares the two types of exercises used when treating a patient who underwent an anterior cruciate ligament surgery also known as ACL surgery. I have found through this article that there isn’t a better of the two and that again it all falls back to my statement of every person heals differently. The important finding in all of this is that CKC might work better on one patient and OKC may work better on the next. My question is how does the physical therapist know which one to use when treating patients who had ACL surgery? Is there a way to combine both OKC and CKC into the patient’s therapy program?

I also found a very interesting article in Anesthesiology titled, "Preventing the Development of Complex Regional Pain Syndrome after Surgery," by Scott S. Reuben, M.D. Complex Regional Pain Syndrome (CRPS) is known as chronic pain with an injury that typically gets worse over time. Reuben’s article discusses ways that can help patients to avoid CRPS if possible. There isn’t a known cause for why a patient suffers from CRPS or who will suffer from it, but Reuben’s article discusses that patients who have undergone orthopedic surgeries are known to be effected by it. Reuben also discusses the benefits of physical therapy before the patient has surgery to possibly avoid CRPS. Do physical therapist test for CRPS or discuss it during the first initial appointment? If a patient has suffered from CRPS prior to their surgery and starts a physical therapy program after, that patient may believe that physical therapy hasn’t been beneficial to their recovery when in reality there are other reasons that could be factored in.

 Since I work both in the physical therapy department and spend time with patients at the surgery clinic and in the OR I've always wondered if positive thinking and atmosphere play a role in recovery time? Does having a negative attitude inhibit you to recover as quick? I am looking forward to researching this further.

References:

Fitzgerald, Kelley, G. “Open Verses Closed Kinetic Chain Exercise: Issues in Rehabilitation After Anterior Cruciate Ligament.”  Physical Therapy Journal. Ed. Lynn Snyder-Mackler, ScD, PT. 12. Dec. 1997. 13 Nov. 2011. <http://www.physther.org/content/77/12/1747.full.pdf+html>.

Reuben, Scott, S. M.D. “Preventing the Development of Complex Regional Pain Syndrome after Surgery.” Anesthesiology. Ed. David C. Warltier, M.D., Ph.D. Vol. 101. Nov. 2004. 13 Nov. 2011. <http://journals.lww.com/anesthesiology/Fulltext/2004/11000/Preventing_the_Development_of_Complex_Regional.23.aspx>

Minimal Invasive and Invasive Surgeries

My search over the past few days has guided me to an article Spine-Health titled, "Physical Therapy After Minimally Invasive Back Surgery," by Carol M. McFarland, MS, PT, OCS. In this article McFarland discusses minimal invasive back surgery, such as a symptomatic herniated disc, and the importance of post operative physical therapy to help with recovery. McFarland suggests that “a concerted effort at re-conditioning through physical therapy is still an important aspect of the patient’s recovery. Improving strength, flexibility and aerobic conditioning will prevent or at least minimize the chances of any recurrent back or leg.” It is clear that through her findings and personal experiences patients have had more success in recovering from a minimal invasive back surgery after doing physical therapy. Not only do patients recover quicker but it also helps to alleviate pain.    

After I read McFarland’s article I wanted to learn more on if a patient who had an invasive surgery such as a total knee or hip replacement would have similar success rates as a less invasive surgery? This brought me to another great article Everyday Health called, "Hip Replacement Surgery: Working with a Physical Therapist," written by Marie Suszynski. In Suszynski’s article she consistently communicates to her readers the importance of having a physical therapist work on the patient’s range of motion (ROM). After undergoing a surgery as serious as a total hip replacement it is important that a patient learns how to properly strengthen and use the muscles in and around the hip so that injury doesn’t occur. It seems to me that physical therapy on this type of surgery is beneficial in the long term recovery process, but how long does a patient have to continue to go to physical therapy? 

How long after the surgery should a patient wait to start physical therapy? Does that play a role in the recovery time? I am starting to read an abundance of positive sides to post operative physical therapy but there is a lot more research to be done. I found that with both of the sources believe physical therapy is a must for a post operative patient and that a lot of benefits can come out it. 

References:

Suszynski, Marie. “Hip Replacement Surgery: Working with a Physical Therapist.” Everyday Health.  Ed. Lindsey Marcellin, MD, MPH. 6 July. 2009. 7 Nov. 2011. <http://www.everydayhealth.com/hip-pain/hip-replacement-physical-therapy.aspx>

McFarland, Carol M. “Physical Therapy After Minimally Invasive Back Surgery.” Spine Health. Ed. Peer Reviewed by Doctors. 17 Aug. 2007. 7 Nov. 2011. <http://www.spine-health.com/wellness/exercise/physical-therapy-after-minimally-invasive-back-surgery>

Post Operative Therapeutic Technology

Is Orthopedic Physical Therapy Beneficial in the Road to Recovery for Post Operative Surgery Patient’s?

Orthopedic physical therapists are healthcare professionals that treat patients with many different injuries, including rehabilitation after orthopedic surgery. There are many questions that I have concerning physical therapy when applied to post preoperative procedures. What is the main purpose of physical therapy for post operative patients? The ultimate goal in physical therapy is to help the patient regain maximal function for the injured body part. Physical therapists evaluate, manage, and treat each patient differently. Physical therapy plays a vital role in recovery after undergoing surgery but how effective is it for a 42 year old patient who has had a total knee replacement compared to a 75 year old who had the same surgery? The problem that I see with physical therapy is that every person heals differently, so what steps are being made to adjust to each person? What factors play a role in this? It's incredible to learn about the advancement in the types of modalities used in physical therapy. What did therapists due before Iontophoresis or electric stimulation? How is the duration of the recovery time affected with the use of the newer technological implementations as compared to the standard procedures? How are the procedures and exercises different in a patient who has an acute injury from one that has suffered from a chronic ailment? Again, these are the basic questions I have when researching how effective physical therapy is after surgery. With the advancement in technology doctors, therapists and researchers alike have been able to grasp a better understanding of how the human body works relating to recovery time in post operative patients.  

There is so much information out there regarding how physical therapy can help or inhibit your post surgery recover time. I hypothesize that I will use my resources at both the physical therapy office and surgeon’s office to help find answers to these questions and to broaden my knowledge on this topic. I will use the internet as an addition resource to further gain insight. There are websites such as: webmd.com, mayoclinic.com and many more that may guide me along the way.