surgery So You’re Considering Surgery… I want to share an experience I recently encountered that may give some insight into a common trend that could potentially lead to unexpected and serious complications. The intended effect of this article is to persuade the reader to consider physical therapy prior to invasive procedures to treat neck and back related symptoms - and here’s why. Last week I met a very interesting client in the home health setting that had a story that impacted me. A story that made me feel sad, angry, and frustrated with our money-driven healthcare system, and ultimately made me want to share his story to help prevent others from becoming victims of a flawed system. Ronnie is a 45 year old male referred for physical therapy due to poor balance, muscle weakness, and severe pain from his neck down to his toes. His pain is relentless, his walking unsteady as he takes short steps and shuffles his feet while moving across the floor, with rolling walker in hand. They call the sensation disturbances he experiences “neuropathy.” 1 year ago, Ronnie had some moderate numbness and sensation disturbances in his right hand’s ring and pinky finger, interfering with his ability to grasp objects at times, otherwise not causing much of a problem with his daily life, but as a health conscious individual he decided to seek treatment to prevent worsening. Ronnie walked into an orthopedic clinic where he was ultimately referred to a neurosurgeon. The neurosurgeon ordered an MRI of Ronnie’s cervical spine and found a disc herniation that appeared to be compressing a spinal nerve root. The neurosurgeon said he could fix this herniation with a simple surgical procedure, and recovery would be a breeze with a hospital stay of no more than 2 days. Fast forward 80 days, Ronnie is finally discharged out of the hospital after 1.2 million dollars of medical bills were racked up. But Ronnie is not driving himself home…Ronnie is not expected to ever drive again. In fact, the hardship placed on him has affected not only his physical function, but also his independence as he is now relying on his family to help him get dressed, bathed, and perform simple daily activities. The burden on his family has become so great that he is currently facing divorce. I asked if he had an opportunity to see a physical therapist prior to his surgery, and he told me it wasn’t an option the surgeon had given him. To minimize any additional frustration with his situation, I refrained from informing him that the symptoms he was experiencing were not uncommon and I’ve had several patients that were successfully treated with complete symptom resolution. Physical therapists everywhere understand that many surgeons do not educate patients on all of the options available and often go for the most costly treatments first. Surgery should be ONLY considered as a last resort, when conservative treatment fails or other alternatives are not realistic. Many surgeons are also labeling steroid injections as “conservative” treatment, and will give them with the understanding that surgery will follow. This is not reflective of putting the patient first, but is taking advantage of the position of power of those in the medical community. It is the best interest of the patient/client that should be prioritized when managing their care. Not the physician, not the physical therapist, and not the payors. It is the patient that is of greatest concern to us. Alas, I also want to emphasize that not all surgeons, physical therapists, mechanics, or landscapers are alike, and not all surgeries have complications as severe as what Ronnie has experienced. In fact, successful surgeries are performed every day with great outcomes for patients that ultimately allow them to return to performing activities that they couldn’t before, and resume their lives as they had prior to whatever complication got them there. However, it’s important to understand that there are significant risks associated with all surgery, and complications can happen. We can minimize these surgery related risks by seeing your Physical Therapist FIRST! Do your research and look for those professionals who have done theirs as well. And remember – #GetPT1st!