The Hand to Shoulder Solution
Your new resource for hand, shoulder, and elbow pain. Together, we are giving pain the middle finger and gaining knowledge to live a better, pain-free life!
Discover what might be causing pain in your fingers, pain in your hand, pain in your wrist, pain in your arm, pain in your elbow, pain in your shoulder.
Learn about your body, arthritis, tendinitis, tennis elbow, fractures, golfer's elbow, and carpal tunnel syndrome.
Hosted by Carl Petitto, OT, CHT, and Certified Hand Therapist specializing in orthopedic conditions of the hand to shoulder. Also an expert in fabricating custom orthotics.
The Hand to Shoulder Solution
Ep 19: Preparing for Your First Physical Therapy Visit: Essential Tips from a cerrified Hand Therapist
This episode discusses how to optimally prepare for a visit to your healthcare provider. We provide essential tips, information organization strategies, and communication techniques to ensure that you walk away with clarity and understanding of your therapeutic journey.
• How to prepare effectively for your healthcare visit
• Importance of prior coordination with the office regarding records
• Organizing personal records and pertinent information to bring
Hello and welcome to the new show, The Hand to Shoulder Solution, with me, Carl Petitto.
If you are experiencing pain in your arms and hands, this is your resource.
Subscribe, listen, and share to help us give pain the middle finger for good!
This is a resource to help you mitigate pain at home and become more educated on what to ask your doctors and therapists. No medical advice will be given, and you should always see your medical professional for any questions.
Thank you, and welcome to the show!
Welcome back to the Hand-to-Shoulder Solution Giving Pain the Middle Finger. I'm your host, carl Petito. I'm an occupational therapist and a board-certified hand therapist. I've been practicing since 2000. I specialize in the rehabilitation of orthopedic conditions affecting the fingertips through the shoulder.
Speaker 1:Today I'd like to talk to you about how to prepare for your visit with your healthcare provider. There's several considerations and what I really want is people to understand how to be optimally prepared and what kind of questions is your provider going to ask you? What kinds of things do you need at the front desk for in-processing, so that we really ensure that you have all of your records from any previous providers, any previous tests that were done, etc. So let's start from the top. So, when scheduling your appointment, there's a few main things that you'll need. You'll need your insurance information the name of the company, your insurance number, the account number for your insurance. You're also going to need your social security number and demographic information, so your date of birth, your full name, of course, your address. Most of the time, most places nowadays will ask for your email address, so that it's another form of communication. Don't be afraid to ask what are you going to do with this information? They'll explain the reasons why they are requesting the information Now, before your first appointment.
Speaker 1:It's important to prepare for that and really get everything in order. So one thing that I recommend that you do is call the office, ensure that the office has any requested records from other providers, such as test results, etc. I strongly recommend that you call your insurance company. So it's your insurance coverage. You're responsible for really ensuring that payment is going to be made, so you don't end up with a bill. So what we don't want is that anybody get any billing, that there shouldn't be any surprises, okay. So if you call your insurance company and say, hey, I have an appointment with the doctor, I have an appointment with the therapist, I have an appointment wherever, what is covered, cover the service that we're going to perform. But as an extra layer of information gathering, it's always optimal for the patient to call their own insurance company to really ensure that nothing has been missed, that everything is covered and the insurance company knows that you're going to be going in for this service and also you'll be able to find out do I have a co-pay and what is my co-pay? Sometimes it's $10, $20, $40 a visit, and one thing that I do as a provider is.
Speaker 1:I work hard to minimize people's visits to the office. So when they're in the office I'm doing things for them as a therapist that they can't do for themselves at home. And then I want to give the patients a thorough home exercise program, prescribed, tailored directly for them, designed to get my patients well in minimal time. So, for example, I'll give a treatment in the office and then say, okay, at home. I recommend that you do these things and not something to absorb a lot of time or take an exorbitant amount of effort, but that would be very focused and support the treatments that I'm doing in the office and allow for more recovery. And then, when the patient comes back in a week or a week and a half or sometimes even two weeks, I would reassess and then give further treatment if further treatment is needed, and perhaps change or modify that home exercise program to tailor again to their specific needs and then wean the patient off of therapy. But, going back to knowing the limits of their insurance coverage, you really should know what are your charges, if any, going to be out of pocket.
Speaker 1:Now let's talk about the day of the first appointment. Now some in-processing has to occur where you might have to fill out a couple of forms or answer some questions at the front desk. Some other information might have to be obtained. That administrative process tasks, those administrative things can be completed. Please allow extra time for that. It's always a good idea to show up probably 20 minutes early before the first appointment and be ready to have a photo ID. And I always, when I go to my doctor or any healthcare service, whether it be the dentist or anything if I have had any previous tests, anything that's relevant, that even though I know they might have a copy of it, I still hand carry it. I just put it in a nice neat folder and in case they I don't know, their computers are down, you know anything I just have it with me and I also keep a list of maybe what symptoms am I experiencing. Also, I recommend that patients bring in any splints that they're currently using. Nowadays people can just go to the store and buy splints that they think will help and very often the wrong splint will actually cause harm and increase symptoms. Sometimes the splint that was purchased over the counter. I can adjust it and make it appropriate. Other times I can't adjust it and I might have to fabricate a custom splint from scratch, but if you bring in what you've been using, that really helps us out a lot and will, moreover, help you to get better quicker. Also, lists of medications and supplements. It's good to keep an ongoing summarized list and always have that as part of your packet For the provider. Here's some things that you'll need In orthopedics.
Speaker 1:We want to know when did your symptoms start? Did you have an injury? What was roughly the date of your injury? And I'll tell people right up front that you know, this is sort of it's like an investigation. Let's get to the bottom of this. Let's find out what's the source of your pain, of your discomfort, and I might interrupt along the way with some specific, pointed questions, because if the patients start telling a story and going on and getting ahead of me, that starts to confuse my clinical reasoning. It gets me off track, and then I might stop the person and redirect and ask pointed questions to figure out specific information before we move ahead further.
Speaker 1:So some of the main things are date of injury or the start of the symptoms, and a lot of times you want to naturally remember when did these symptoms start? So I'll say, you know, was it six months ago, was it four months ago? And oh, then the patient might say, oh, it was a couple of months ago or a couple of weeks ago, and that really helps narrow it down. And then I'll ask well, how did the injury happen? What was the method of injury? Oh, I fell. How did you fall? I reached out. Did you reach out in front of you or did you fall backward or forward? Because that makes a big difference in how did the person land? So what I'm thinking in my head is, if a person fell and they reached out and if I know they fell to the front and they hit their hand first and it was an outstretched hand I'm already thinking about what bones probably struck the ground first and where they're having their discomfort, if the pieces are starting to come together and if this method of injury is making sense and aligning with their symptoms.
Speaker 1:I also want to find out, since the pain began, have the symptoms been getting worse, are they beginning better or have they been largely staying the same? A lot of times, you know, people will say you know, my elbow pain started, oh, about three or four months ago. Okay, that was in the spring. What were you doing then? Were you starting a garden? No, you know what? I was hammering fence posts. Okay, and then, before I do the physical exam, I'm picturing the activity of hammering fence posts and I'm already having an idea of why the outside of their elbow may be hurting, for example.
Speaker 1:So it starts with some basic questions and then I want to find out, you know, what kind of work does the patient do? What kind of hobbies do they have? Basically, how do you use your hands and arms during the day? How do you use the body? And so those are some further basic questions. And then I want to do a thorough evaluation. If there's any wounds, I need to measure those. I need to look for signs of infection, any excessive inflammation. Are there any complications? How is it healing? I also want to take measurements, circumferential measurements, for example swelling. I want to also use some tools to measure range of motion. Is the wrist really really stiff? You know, I'm going to go through specific movements. I'm going to have the patient move and I want to compare it to the other side as well, and I want to see where there's any problem areas and if there's any stiffness, I'm going to measure that and get baseline measurements so that we can track progress and make sure that our treatment is working. So we want to get baselines at the initial visit and then recheck as we go.
Speaker 1:Now, also on the same visit. After the testing has been done, the examination has been done, I'll explain to the patient my findings and you know here's what I think is going on and here's why and here's how I recommend we treat this, and it's very important to always get you know. The most important part of the team obviously is the patient. So the patient has to provide informed consent. So I want to inform the patient to this is what I recommend and why. And do you agree with this? After agreement is obtained and I explain everything, I also want to do some treatment on that same visit.
Speaker 1:I don't want to just evaluate and then, okay, all right, go home and come back tomorrow for treatment. You're already here, you're right here with me. Let's do the treatment right away Because, again, the goal is to get you well in minimal time. Do the treatment and then educate the patient to home recommendations, whether it be ergonomic modifications, or why a person shouldn't lean on the inside part of their elbow, perhaps why the person should take the arm rests off their desk chair or pad their forearm when they're sitting on their living room furniture and or exercises or icing or heat or whatever the home recommendations are and I also want to always explain the why, so that the first visit with me usually takes 30 minutes to an hour and if a custom splint needs to be fabricated, for example, that might take about 20 minutes or so, but I'm going to fabricate the splint and put it on the patient and teach the patient how to use it all in that same visit. So I want to be very, very efficient with the time.
Speaker 1:So other tips and recommendations is to just, you know, maintain a positive relationship with your provider. You know common courtesies arrive 10 to 15 minutes early, so you're ready to go with the providers ready to go, and what happens sometimes is you know when a person is late, you know that takes away time from their visit, because you know it wouldn't be fair if I took that time away from the next person. We want people to be on time a little bit early so they can really gain the full amount of benefit from the full entire visit. Also, it's to be patient with your provider. Basically it's a relationship and the patient really needs to be ready to commit themselves to getting better. And what do I mean by that? What I mean is to do your very best to follow home recommendations.
Speaker 1:To do the icing, the heat, for example, to do the stretching If there's a lot of stiffness, and you might have been educated to stretch specific stretches, to do three or four times a day to lengthen tissues, to decrease pressure on tissues, to decrease pain. There might be some strengthening exercises. A person really needs to be committed to do the exercises, whether it be twice a day or perhaps three times a day. And you know we understand if you can't always get to it, that's okay. But really we want to make ask everyone to really make the highest effort that they possibly can to their own recovery. And you know we try to minimize the visits to the office and be as efficient as possible. And you know I always say that mother nature has her ways. We don't make the rules.
Speaker 1:As far as why should we do these things? Why does heat have to be done, for example, arthritis pain? Why should we use low heat only in the morning? Well, you know that's inconvenient for me. I'm in a hurry, I have to get out the door. Well, you know, if you get up 10 minutes earlier and use the heat for 10 minutes right when you get up first thing in the morning, that's really going to help you through the rest of your day and then your lunch break. If you can use the cold for 10 to 20 seconds just to get those tissues deeply cold to reduce your inflammation, that goes a long way. When you go home from work, if you can use the cold for 10 or 20 seconds to reduce the inflammation in your wrist, for example, that's going to go a long way. So some basic commitments really make all the difference.
Speaker 1:I like to put my patients at ease. I like a nice, comfortable environment, and the environment is really based on education. I want the patients to understand why am I recommending what I'm recommending? Why am I doing in treatment what I'm doing? Why am I asking you to do at home what I'm asking you to do? So a great working relationship is always highly appreciated and any questions please write in. Put your questions below. I'll be glad to answer whatever I can answer. Thank you for watching. Talk to you again soon.