"WHAT YOU CAN HEAL FOR TODAY, DON'T HEAL IT FOR TOMORROW"
"PAY ATTENTION TO OTHER COMPLAINS OF YOUR PATIENT BEFORE JUMPING TO YOUR OWN DIAGNOSIS ABOUT WHAT THE EXACT PROBLEM IS"
>the last quote was the most neglected phrase among clinicians, based on my observation. I had a friend who went to a "doctor" because of her acute low back pain a year ago. Pain is exaggerating everytime she is wearing high heeled shoes. According to some Kinesiology books that I've read, wearing such shoes alters the biomechanical properties in our body (center of gravity, base of support). This will give too much stress on dynamic (muscles) and static (tendons, ligaments) stabilizers of our body. Stress will induce pain. Pain lead to dysfunctions. Dysfunction lead to suffering..so on so forth. This obsolete practicing doctor advised her to take Arcoxia for pain for 2 weeks and scheduled for another consultation. My friend was asking for medical certificate that will clear her not to wear any high heeled shoes anymore because of her condition, her workplace strictly mandated the rules about wearing such shoes during office hours and she don't want to bear the same pain, but this stupid doctor refused because she already prescribed a medicine for her. IT IS CLEAR ACCORDING TO THE PATIENT THAT THE SYMPTOMS WORSEN WHILE WEARING THE SHOES, WHY GIVING THE CRAP NOT TO GIVE HER ANY MEDICAL CERTIFICATE? IT'S THE DOCTOR'S RESPONSIBILITY TO GIVE MEDICAL CERTIFICATE UPON PATIENT'S REQUEST. WHY HAVE SUCH FAITH IN PAIN KILLERS? ARE THEIR MEDICAL REPRESENTATIVES AROUND YOU THAT PROMISED YOU TO GIVE YOU COMMISSION ON EVERY ARCOXIA YOU WILL PRESCRIBE? HOW GOOD IS YOUR ASSESSMENT TOOL TO IDENTIFY THE PROBLEM AS ACUTE LOW BACK PAIN?
According to Pharmacology Book by Ciccone and Differential Diagnosis for Physical Therapists by Goodman and Snyder, pain killers in NSAID form will have a side effect of gastrointestinal irritation because in our body, we have these type 1 and type 2 prostaglandin. Type 1P is the one that causing us pain and type 2P protects our stomach wall. Their typical drug reaction is to wipe out every prostaglandin in there way, regardless if they are type 1 or type 2. Are these things were explained by your doctor? There are also pain killers that induces hypertension. Before getting some over the counter drugs, THINK IT OVER.
To the budding physicians out there, I CHALLENGE YOU TO BECOME A GOOD PHYSICIAN/CLINICIAN YOU COULD BE..THAT SHOULD BE. Specially my fellow Physiotherapists, look closely to the problem of the patient. Do not rely on what has been taught to you years ago. Human body processes and reaction to various stimuli changes, so as your approach dealing them. Keep an eye on other precipitating factors, compensatory mechanism to other structures, the primary vs secondary problem, red flag vs yellow flag signs and most important, the LEVEL OF PAIN of the patient. Your patients will love you if you deal with their ailments accurately.
I bet you don't want to be one of this kind of doctor