PT Evaluation...P O Day 74

At physical therapy today I was evaluated or reevaluated, as it may be. As I began therapy, about three weeks post op, I was asked to fill out a questionnaire rating ten different activities by how easy to how difficult they were to do. "I can wash my hair, I can reach an item on an upper kitchen shelf, I can put on a pull-over t-shirt, I can pick up something weighing ten pounds, I can reach behind my back to scratch it," were typical questions. Of course, these apply only to the operated arm/shoulder. The higher the level of difficulty you assign a task (10=not able to do it at all, 1=duck soup) the higher your total score. My initial score was 80, I couldn't do much.

That was the evaluation. Today, after eight weeks of therapy, was the reevaluation. I've made tremendous progress and both I and the therapist are pleased. But that is not to say that there is not still some difficulty in everything I do with the operated arm. Three actions on the list are definite "don't even think about doing this" activities, like scratch your back, lift a ten pound weight, or remove your wallet from your back pocket. Not that I carry my wallet in a back pocket, this is obviously a unisex exam. Today I scored 40, a huge improvement. Good for me.

The good reason for the test is to objectively measure one's progress. The real reason for the test is to decide if insurance, Medicare in my case, will pay for continuing therapy. In some perverse* corporate/government rationalization, if you are not showing improvement, not getting better, if your score is not going down, Medicare will not continue to pay for therapy. Wouldn't it seem like the person who has not improved needs continuing therapy more than someone like me who is well on the road to recovery? Therapy for the unimproved patient now falls into the category of "maintenance" and is not covered.

My test results and the therapist's notes will now go to my surgeon. He will look them over and, most likely, recommend more therapy sessions. And Medicare will, most likely, cover the cost. It just seems backwards to me.

1. perverse"

   • contrary to the accepted or expected standard or practice.

     "in two general elections the outcome was quite perverse"

     synonyms:

     illogical, irrational, unreasonable, wrong, wrong-headed "a verdict that is manifestly perverse"

   • 
     

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