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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    Lucky Wellness Center 4379721888 295 Eglinton Ave E,Unit 7,Mississauga We had two girls today, Niko and Kiki. They were both young, pretty and cute. The massage and back massage were great.
  35. AliceSpa:
    WEDNESDAY at ๐—”๐—Ÿ๐—œ๐—–๐—˜ ๐—ฆ๐—ฃ๐—” 416-298-0898, 4915 Steeles Ave. E, Scarborough 3 very nice girls here today. Open 10am to 9pm: APPLE: from Hong Kong, very small body, 5' 100Lbs, petite with natural C Cups, small waist, pretty baby face, smooth skin, very clean. Shaved tight Pu**y, strong professional massage. Available FS bbbj cim cof rim. BEBE is a young slim Vietnamese girl with a beauty face
  36. Nu spring spa888:
    ๐ŸŒน๐ŸŒน๐ŸŒนsexy hot Philippine ๐Ÿ’– ๐Ÿ’– Malaysia ๐Ÿ’– ๐Ÿ’– Korean girls ๐Ÿ‘working at Nu spring spaโ˜Ž๏ธ416-669-8508๐ŸŒน๐ŸŒน๐ŸŒน
  37. wilson holistic centre:
    ๐Ÿ’•๐Ÿ’•Beautiful Korean girl working at 382 Wilson Ave ๐Ÿ’•๐Ÿ’•โ˜Ž๏ธโ˜Ž๏ธ416-840-0071โค๏ธโค๏ธ
  38. Lilyspa1:
    Lily Spa :๐Ÿ’•๐Ÿ’• Wednesday Schedule ๐Ÿ‡ฎ๐Ÿ‡ณ๐Ÿ‡ฎ๐Ÿ‡ณKajal 23, Punjabi girl ๐Ÿ˜ˆGFE & bbbj โค๏ธโค๏ธElena ( Latino ) Big Nature Boobs & SuSu ( Asian )Slim , ๐Ÿ˜๐Ÿ˜Porn Service ๐Ÿ”ฅDuo ๐Ÿ”ฅ,โ˜Ž๏ธ 6475318288
  39. 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
  40. Moneylee:
    Full season wellness center: Young girl Big-breasted big big butts Aris , Young girl big breasted beautiful buttocks charming temperament big boobs Rose,Young girl big breasted beautiful buttocks charming temperament big boobs Julia ,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 ๐Ÿ‘…๐Ÿ‘…๐Ÿ‘„๐Ÿ‘„๐Ÿˆต๏ธ๐Ÿˆต๏ธ๐Ÿฆต๐Ÿฆต
  41. Golden Flower Spa:
  42. BlueXado Therapy & Spa:
  43. Pink Flower Spa:
  44. 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 Feifei๐Ÿ˜˜Our new Taiwanese beauty Feifei specializes in creating an intimate and deeply relaxing massage experience tailored to your desires. Her soft, skilled hands glide effortlessly, easing tension and awakening your senses
  45. HollywoodSpa:
    Wednesday at ๐ŸŽญ๐—›๐—ข๐—Ÿ๐—Ÿ๐—ฌ๐—ช๐—ข๐—ข๐—— ๐—ฆ๐—ฃ๐—”๐ŸŽญ, 4578 Yonge St, Unit 100, North York, ON: NICOLE & SISI. โ˜Ž๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿฎ๐Ÿฎ๐Ÿฎ-๐Ÿฑ๐Ÿฑ๐Ÿฑ๐Ÿฐโ˜Ž NICOLE is petite, slim and very pretty, with C Cups , long hair & a slim waist. She has nice massage and great services. SISI is a sweet slim beauty, 5โ€™2โ€, with a beauty ass, excellent massage, and amazing services. Come and see why she is so popular. When you visit ๐ŸŽญHollywood
  46. HolidaySpa:
    Wednesday 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: EMILY, KIKI & CINDY. EMILY is a VERY tiny petite SPINNER superstar of the highest quality. Emily has a pretty face, natural A Cups, slim waist, and a lovely spinner bottom, topped off with the very best of services. Kiki is very attractive, young, about 5โ€™4โ€ and 110 Lbs., slim with a banging body.
  47. wonderspa:
    ๐ŸŒบ๐ŸŒบWonder spa,(9421Jane st unit127)call416-5000-800โ˜Ž๏ธbest massage in vaughan,Wednesday RMT available,๐Ÿ’„sexy very young girl Joey natural c cup,very good looking nice body slide,really popular ๐ŸŽlong hair Q Lucy good strong to relax oil massage, Relieve pain and remove stress,more experience,young very beautiful new girl Cici, back walk ,body slide,amazing the end,give you warm and comfortable time must try๐Ÿ”ฅ๐Ÿ”ฅ
  48. SugarLoveSpa:
    Wednesday at โค๏ธ๐Ÿ’™ ๐Ÿ’œโŽ๐—ฆ๐—จ๐—š๐—”๐—ฅ ๐—Ÿ๐—ข๐—ฉ๐—˜ ๐—ฆ๐—ฃ๐—”โŽ ๐Ÿ’–๐Ÿ’—๐Ÿ’˜: LISA, LUNA, SUSAN & TIFFANY. 1270 Finch Ave W (at Keele St), Unit 18. North York, ON โ˜Ž ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฏ๐Ÿฒ๐Ÿฑ-๐Ÿฎ๐Ÿฒ๐Ÿด๐Ÿด โ˜Ž LISA is a cute & petite Thai/Chinese mixed beauty with decent massage skills and liberal services. LUNA is a slim, VERY PETITE and capable Vietnamese beauty, nice natural 34C Cups. Luna can do everything. SUSAN is small, slim
  49. bnwellness_wilson:
    We have 4 young girls are working today, young sweet Mia 25โ€™s with curve body and pretty Ella, fun Vicky with curve body 25โ€™s and flirty 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
  50. Soul Relax Spa:
    โœจ Looking for a relaxing escape? โœ… Click Here Meet๐ŸŒธTina๐ŸŒธJessica๐ŸŒธAlettaCall us today for the best treatment and service experience. Click on our Username and FOLLOW US for updates ! Call now โ˜Ž 289 - 298 - 5662โ˜Ž๏ธ Your ultimate relaxation awaits! โœจ
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