Podcast: Listen to 'This Is Why'
My first job as a physical therapist (PT) was at a home health agency in a rural area. One day in the middle of January, I was called to the home of a 78-year-old gentleman. He had a diagnosis of pulmonary fibrosis and recently had been released from the hospital on 5 liters of oxygen per minute.
He and I worked together for 4 weeks. At discharge, he again was riding his exercise bike for 20 minutes a day and had resumed climbing stairs in his house. His oxygen saturation values, or "sats," however, regularly dropped to about 85% during physical activity, even with his oxygen device. I offered to look into securing a scooter or electric wheelchair for him, but he simply would not hear of it! He was too proud, and considered himself too strong, to rely on a motorized device to get around. I discharged him to an independent home program and went on my way.
Just a few months later, in April, I got a referral to see this same gentleman. He again had been hospitalized. This time, he returned home on 6 liters of oxygen, with sats of 82% at rest. He finally was willing to concede that difficulty breathing was limiting his mobility. I again broached the subject of getting him a scooter. He now was receptive to the idea. I had to do some homework, as I hadn't yet conducted a scooter evaluation at that point in my career. But I waded through all the necessary steps, which included submitting a progress note that was 13 pages long. (Those who work in home care can relate!) I secured the scooter.
It was delivered to the gentleman's home on a Friday. As it turned out, this device that he'd once rejected outright proved to be a huge hit. Not only did he warm up to it immediately, but he liked it so much that he even paid the rental cost to keep it over the first weekend, since the paperwork hadn't yet cleared for his insurance benefit to kick in.
When I pulled up to his house to discharge him from physical therapy the following Tuesday, I was greeted by a new ramp leading up to the front door. My patient's son had built it over the weekend to ensure that this father would get full use of his new device. I found my patient to be in great spirits. "This scooter has given me a whole new lease on life!" he exclaimed. I again discharged him, and drove away that day with a big smile on my face.
Later that same week, however, I was surprised and saddened when our case manager phoned me with the news that this gentleman had passed away. I asked her what had happened.
The case manager said my patient's wife told the following story: Her husband, celebrating his new mobility, decided he'd ride the scooter "uptown" to meet some buddies at the Tastee Freez and have an ice cream cone. He'd had a good visit and had ridden the scooter back home. As he was coming out of the bathroom a short time later, he said he didn't feel well. Soon after that, he collapsed and died.
I cried on the phone that day, feeling a mix of emotions. On the one hand, that gentleman had had so little time to enjoy the respiratory relief and greater freedom the scooter had brought him. On the other hand, though, it had let him breathe easier as he did the things he enjoyed, and it had allowed him to savor one last ice cream cone.
That "ice cream social" was a gift for him, and I had helped make it happen. The experience sums up, for me, what being a PT is all about.
Brittany Johnson, PT, DPT, is an outpatient PT at Altru Outreach Therapy Services in Devils Lake, North Dakota.
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