DrHGuy and Treatment Adherence - It’s A Stretch
The above graphic
- Answers some longstanding questions about DrHGuy while prompting many others
- Serves as page 1 of The Kama Sutra Coloring Book For Hip Tykes
- Illustrates a contemporary version of an especially effective torture originally devised during the Spanish Inquisition
- Demonstrates proper positioning of a patient for transsexual surgery
- Indicates why the next several Heck of a Guy posts may be especially trivial, incomprehensible, or missing altogether
I Ache In The Places Where I Used To Play1
Almost a month ago, I was blissfully vacationing with no more than the ordinary allotment of health hassles common to a guy of a certain age. 
On the last full day of the one week trip, I began the same morning run I had completed each previous day. A half-mile later, a pain in my right leg became severe enough to abort the effort and limp back.
Contrary to my expectations that the problem would resolve itself in a day or two, it has persisted for over three weeks, producing a pronounced limp and enough discomfort to make me wince whenever I place any weight on that leg and keeping me awake at night.
Consequently, last week I finally saw my personal physician, who tentatively diagnosed a pulled adductor2 (adductor muscle pictured in graphic on reader’s right) and recommended anti-inflammatory medications and physical therapy.
If this regimen does not bring relief, testing for other disorders will take place.
The physical therapist has now performed his examination, the goal of which is apparently to locate my most vulnerable and sensitive anatomical regions to assure that the maximum pain can be efficaciously inflicted. Toward that end, he has prescribed the exercises pictured in the graphic below as well as ongoing PT sessions.3
The Compliance Conundrum
As ongoing readers know, my professional focus these days is on patient compliance. At the risk of fulfilling the cliché that doctors are bad patients, I admit to concerns about my own adherence to treatment.
The facts are simple:
- The prescribed exercises are routine, consisting of three stretches and one strength move that require perhaps 20-30 minutes a day and cause some discomfort but fall far short of excruciating pain4
- The PT sessions are similarly routine
- My injury, while hardly catastrophic does cause me pain throughout each day and significantly limits my activities
- I understand the disorder and the treatment
- After only two days, I’m convinced that the treatment is likely to help; my only pain-free periods since the strain occurred have been the 15-20 minutes that immediately followed completion of the exercises
- I have a reasonably good relationship with the physical therapist who seems competent and invested in my care
So why is compliance to this regimen worrisome to me? After all, I already integrate a 1.5 - 2 hour workout into every day (missing perhaps 10 days a year) for health reasons. And, my schedule, while full enough, is flexible enough to accommodate the exercises and appointments.
Well, knowing that approximately half of all patients don’t adhere to their treatment in almost any healthcare situation may be a factor.
And I loathe stretching.
The only other negative that comes to mind is that I’m moderately miffed that I contacted this rehab facility because they advertised a satellite office near my home, but when I requested that office I was told that no appointments were available there for over a month - although they could fit me in to the schedule of their central, much less less convenient for me facility right away. I have no way of knowing the legitimacy of these circumstances, but I do have a sensitivity to being played for a sucker and the drive as well as the sessions themselves do take up much of the time I now use for writing posts, so there may be some residual negativity on my part.
Otherwise, the treatment proposition seems a no-brainer: Do a few stretches a day and drive a few miles for a few appointments in return for a high probability of eliminating a painful, restricting disorder.
Nonetheless, on only the third day of the exercises, I feel the need to force myself to start the exercises and find myself looking for excuses to postpone them.
I don’t, by the way, have a solution. I’m just impressed with the problem.
Footnotes
- From “Tower of Song” by Leonard Cohen ~back~
- A “pulled adductor” is better known by its inelegant but evocative jock moniker, “groin pull,” which, it turns out, is apparently not synonymous with a favored nighttime activity of adolescent boys ~back~
- It is a little known fact that the “PT = Physical Therapy” equation is a relatively recent innovation; as part of an astute marketing strategy, “Physical Therapy” became the accepted correlate of “PT,” replacing its original definition, “Polyperverse Torture.” ~back~
- The illustrations for all the exercises, however, do have that lewd and crude look to them. Put a black bar over the exerciser’s eyes and paint on a pair of black socks and you’ve got yourself a porno cartoon ~back~
I have xerox copies of most of the exercises.
Don’t follow up with them much either.
But…. do agree frequently with one of the best of Leonard Cohen’s always on-target lines.
Have you recently considered…. “I can’t forget, but I don’t remember what”?
Comment by dick — July 12, 2007 @ 6:05 pm
Why would a Dr. go to another Dr.
Sounds like you need to see a shrink.
Comment by ben — July 13, 2007 @ 9:51 pm