Another PT appointment is done and dusted and apparently — prepare for a shock — I’m slow. That’s all I gleaned from an otherwise confusing and frustrating experience, other than to not be so obliging next time. To accommodate a scheduler who couldn’t find any timely openings in the neurologic PT’s schedule, I agreed to finish part two of my evaluation with a PT assistant. Within a few minutes of sitting down across from her, I realized I’d made a mistake: she didn’t seem to know the first thing about Parkinson’s.
Before starting the physical tests, she asked questions about my health and sleep. It shouldn’t have surprised her when I said my sleep is garbage; that’s normal with Parkinson’s. Instead she wasted at least five minutes conducting fruitless computer searches for a relevant printout to give me about YOPD and sleep. When that failed, she printed a general Parkinson’s information sheet that contained nothing my doctor and the APDA’s welcome kit hadn’t already covered.
Our conversation was frequently insipid; she seemed to want to play doctor and address Parkinson’s in general more than the specific symptoms I was there to treat. The neurologic PT hadn’t wasted my time with any of that, which I remembered wistfully while fielding questions and comments like “Have you tried a weighted blanket?” and “Your medication should take care of your dystonia.”* Never did she ask when I last took my pills and whether I was ‘on’ or ‘off,’ which were two of the neurologic PT’s first questions, and rather than observe how I naturally performed tasks, she coached me through doing each one her way. Then came the evaluation.
When Crankenstein called on her lunch break to ask how it went, I asked whether that sounded right to her and she was annoyed: “Whether you’re ‘on’ or ‘off’ is important. And that’s how you do ortho PT, not neuro PT. Don’t see her again.” But her deepest irritation was still to come.
“She said it’s normal for a woman my age to be worried about walking in rain and snow and ice,” I reported.
“No,” she said flatly. “I’m a woman your age and don’t worry about those things because I don’t fall all the time. You do.”
“She said she’s not worried about my balance, just my slowness.”
“What the fuck?” she exclaimed. “You’re falling several times a month!”
“Yeah, I told her that’s why I was there,” I said, glancing at my notes. “She said to use a walking stick on walks but she’s not worried about my balance or rigidity, even though I think it’s the rigidity that’s causing some of the falls. But she also said I’m close to needing some kind of brace. I don’t know what that’s about and would rather ask the PT anyway.”
Then I reached the part that really pissed her off: “Her top two goals are to make me faster and get me back to work full-time. I’d love to be faster but I’m not sure how it will change all the other problems, especially with my arm.”
“It won’t!” Crankenstein ranted. “That’s what you say to an ortho patient! Saying that to you is like telling an ALS patient, ‘OK, we’re gonna get you movin’ faster and it’ll be right back to work!'”**
Indeed, near the end of the appointment, fairly certain I’d have to redo half the tests for the neurologic PT in July, I asked the assistant how she’d gotten into this line of work. She said she’d graduated with a degree she only learned was useless after starting her job search, so she went back to school to become a physical therapist and quickly realized meeting the prerequisites would be too onerous.
The pathway to becoming a PT assistant was shorter and allowed her to earn a living faster, so she went for it and has found it to be a satisfying career. “I wasn’t always in neuro,” she volunteered. “Actually, I spent years in ortho.” That Crankenstein’s a regular Kreskin.
* If there was any point in trying a weighted blanket, my doctor would’ve already recommended it. Those can hurt more than help if your legs remain active, and it’s already hard enough for me to physically maneuver out of bed in the morning without fighting a heavy blanket. As for the medication, it requires cooperation from my intestines that it’s probably not getting. But there are more unpleasant reasons why it might not work for some patients and she should know enough about atypical Parkinson’s to be sensitive to that.
** I understood what she meant but it stung anyway.