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Jenifer’s Journal: The pain train

If you’re going through hell, keep going. — Winston Churchill

Did you hear the one about the grandmother who straddled a rolled-up 8×10 rug, acting as “ballast” so her daughter could pull off its insanely tight plastic wrapping?  

Well, in spite of the initial hilarity of the situation, when the remaining plastic suddenly disengaged, the 76-year-old “ballast” stumbled backwards, still astride the rug, and tried to roll off the damn thing. The punchline landed a little too violently:  a bone-crunching direct hit on my right shoulder. 

Not so funny, although in the next few days it felt surprisingly good with no bruising, a little stiff, a twinge of pain once in a while but, like with other insults my body has suffered over the years — knees, back, and occasional bouts with a surly sciatic nerve —i t seemed that if I just waited it out, this too would pass. 

Well, it hasn’t.  In the past six weeks it’s gotten worse, the range of motion in my right arm increasingly limited.  Accepting that fact has felt like some kind of failure on my part. My self-image took a hit, too.  Lately I’ve become this other me, a woman scared to use her right arm for the simplest things, never knowing if picking up her coffee mug or waving at her grandkid will result in a nasty jolt of pain. 

I know I’m very lucky, in spite of how debilitated and demoralized I feel when my shoulder pain ramps up.  That pain was so persuasive, though, that it actually drove me to a bone doctor for x-rays and everything, including a remarkably ineffective cortisone shot which, in turn, forced me to take my brother’s advice: Call the FIT Center.  

Amy Mobius is the experienced physical therapist that the Shelter Island’s FiT Center is fortunate enough to employ.  Her career so far has spanned over 25 years, 19 of which (off and on, with some time dedicated to producing her three sons) have been spent working at our FIT Center. Now that she may become “my” therapist after she interviews me on March 6th, I thought I might interview her as well.

Amy told me she always knew she wanted a career in medicine, she just didn’t know what kind. Her brother, a doctor, counseled her to pay close attention to what doctors do when they see patients. She realized that an average doctor’s appointment didn’t allow for going “as deep as I wanted to go to feel helpful.”  When she went for physical therapy herself for a sports injury, she realized, “You know what, this suits me. This is where I can really help make a difference.”

I asked her to characterize the general parameters and goals of physical therapy:  

“PT is about giving the patient the tools to take care of themselves. Getting them into a regular exercise program that involves stretching and strengthening their bodies.  It may include lifestyle changes as well.  We try to look at the whole person —the big picture that has brought them to therapy. How can we prevent this from happening again? Our goal is to help them live a fulfilling, happier life with less pain.”

Amy reminded me that most of her patients come to her for post-op rehabilitation. In those cases, once healing and rehabilitation are completed, pain is no longer an issue. Regarding chronic pain, however, she says, “It’s more about teaching a patient how to manage that pain, how to make adaptations, including using assistant devices when necessary, or altering their habits. Smoking, for instance, is associated with chronic pain, especially back pain.” 

According to Amy, the real key is to develop an effective exercise program. “Research has proven that it has a positive impact on all kinds of disorders including diabetes, dementia, and Parkinson’s. The exercise protocols have to be realistic, something the patient will adhere to.  In that regard, compliance is the biggest problem. Exercises can be uncomfortable, but patients have to be clear and honest with me. Everything can be altered or adjusted to make it do-able. We just need to have that conversation in order to find the right exercise prescription for that individual.”

Clearly, Amy is happy with the career decision she made decades ago. “It’s incredibly rewarding. All my patients [to one extent or another] get better and people tell me they’re still doing the exercises from 15 years ago! The loveliest thing has been being a part of the Shelter Island community in this way.” 

As my absurd “rug” incident demonstrates, it’s pretty easy to suddenly find yourself with a ticket to ride on the Pain Train.  Happily, we have someone like Amy available to help us shorten the trip.