It was a bitter-sweet physio appointment I had today, although I must admit that it was a very productive appointment.
Baring in mind, I haven’t actually spoken to my Physio since Easter, we had a bit of catching up to do. She wanted to know where I was with regards to medications and what my management plan was with my rheumatologist and also which joints are bothering me the most. It didn’t actually take very long to explain that I hadn’t actually seen my rheumatologist since December or heard from her since Easter so essentially, I have no management plan at all. My Physio, was not just shocked by my Rheumy’s treatment of me but she was actually quite angry and said that she was going to phone my Rheumy tomorrow to find out why I haven’t been seen in a year. And with regards to medication, she was slightly annoyed that I hadn’t told my Rheumy that I couldn’t take the medication she had prescribed because of the extreme headaches I got as a result of taking them, but she also agreed to mention that when she was speaking to my Rheumy.
This appointment was quite unusual given the fact that I didn’t get examined, do any exercises, or tests of strength or range of movement but, we did discuss in quite a lot of detail what was going on with my joints. We talked about the swelling, and I showed her pictures of the redness. We discussed the joint pain and morning stiffnesses that I was experiencing and apparently before I had even come into the room my Physio had noticed that my knee and neck/upper back were still stiff (A* for observation skills there) despite my appointment being in the evening.
My Physio felt that it would take over an hour to examine each of the joints that were bothering me well enough to work out what was actually going on so we decided that we would skip that bit and talk about our management options since I had explained in enough detail what was happening. The first option I was given was to be referred straight back to my Rheumy and not do anything with regards to physiotherapy intervention but we both felt that it would be extremely hard going if I was to carry on as I am and wait for an appointment with no treatment at all, so we the second idea was the better option. My Physio suggested that I should be referred back to my Rheumy as well as being sent for 6 sessions of hydrotherapy. My Physio said that if the hydrotherapy helped me then that would indicate something “arthritis-y” is going on. However, since I wouldn’t be able to get referred to hydrotherapy till the new year my Physio is going to send me out some basic exercises for me to do in a normal swimming pool, even though it will probably be the heat of the pool that helps me most. What is quite ironic is that I have just been writing a report for college on the availability of physiotherapy services, including hydrotherapy, and found that in many NHS trusts there is not enough evidence to justify the costs of hydro in JA patients.
My mum did ask what my Physio thought was going on with me because quite frankly, we are both at the end of our tether. My Physio felt that given my fatigue, joint pain, morning stiffness, swelling and redness of my joints and taking into account the consistently abnormal blood results I have, something is definitely going on but she cannot definitively say what is actually happening, though she feels that it is related in some way to arthritis, but may or may not be arthritis itself.
I don’t really know what to think about that appointment, it was quite overwhelming actually. I mean yes, I am happy that I do have some sort of plan now and I am going to be referred for hydrotherapy, which should hopefully really help me. But I am upset that my symptoms point to arthritis, even though I have known that for years, and I am upset that we don’t actually have any other options than to send me to hydrotherapy because my physio feels that I am getting worse. I’m slightly stunned too, that I have a plan of action and it IS actually going to be carried out. I feel like I am finally entering a new chapter of my journey, though I have been in this position before and it lead me right back to the start. I’m trying to stay positive and digest everything that happened today.
I have been booked in for another appointment with this Physio in early January but I have absolutely no idea what to expect, this appointment was a surprise, maybe next year will start off on a high!