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How to approach tomorrow's physio in the right way?

I’ve got a physio appointment at the hospital tomorrow, and am really dreading it. The underlying problem is that I never wanted a physio appointment in the first place, but a review of my Baclofen, which has stopped being effective, after a couple of years, so that I am in more-or-less constant pain.

I don’t think this is particularly a physio problem (if anything, I am fitter and more active now than I was at diagnosis), but I accepted it only because I wasn’t offered anything else, apart from “coffee and a chat” (even less likely to be helpful).

Now I’m concerned I’m going to get off on the wrong foot (no pun intended) straight away, with the physio, because my reluctance to be there, and that I have been steam-rollered into it, is going to be obvious.

I can’t pretend to be positive and optimistic about an appointment I didn’t really want in the first place, and which I don’t believe is going to be the answer. I think I should have had an appointment with the neuro, to assess my meds, and recommend changes. I don’t think he would OK an increase to the Baclofen, because he wasn’t happy with how much I was already on, but I need somebody to authorise an experiment with something else. My GP wouldn’t, and I’ve not been offered an opportunity to see the neuro (nest scheduled appt. end of July), so I was left with physio or nothing. I reluctantly accepted the physio.

Now feeling a bit regretful I’ve accepted something I’m not convinced will help, and think I should have pressed harder to see the neuro. I’m not having a relapse or anything - just stuff that used to work isn’t, and I’m virtually back in the situation before it was treated at all. I feel like I’m taking nothing (or that I got a batch of Baclofen that mysteriously had no Baclofen in it!)

Tina

Hi Tina Understand and appreciate everything you are saying, I’d be exactly the same tbh. I’m not convinced either that you need physio. However, all that aside, you are going tomorrow, and by tomorrow night the appointment will be over. How do you tackle this appointment in the right way? I think you do need to go along in a positive frame of mind, when you meet the physio, be polite (not suggesting that you wouldn’t be anyway) and clearly and concisely explain the problem to the physio. Is it possible that the physio might suggest referring you back to dr and recommending a change of mess for you. I don’t know tbh. Certainly do say that that is what you really want and need. Also don’t be afraid to tell the physio how far you can and do walk. I can’t understand why your gp won’t just write you a prescription to try zanaflax, my gp did this for me years ago, maybe things have changed. I’m not much help really, sorry, but good luck with your appointment and do let us know how it goes. Cheryl:-)

My recommendation would be to tell the physio that you aren’t really sure why you’re there, but that if they can help in any way that would be great. I suspect that you will get into a conversation about spasticity / spasms and you will get the opportunity to say that baclofen isn’t working at your current (quite high) dose and they can include that, and a recommendation for a new dose or med, in their report. I saw a physio a while back when, coincidentally, I was having no luck with clonazepam. She recommended baclofen instead and my GP prescribed it quite happily when I told him. Maybe you’ll have similar good luck? Also, although you are pretty active, you may have particular muscles that need some attention in order to improve your mobility and strength - physio can help with that, and all sorts of other things. So, you never know, it may not be a waste of time at all. Karen x

Hi Tina, if it helps at all, I saw a physio year or two back and what I found most useful is that she knew a heck of a lot about MS and was really useful to talk to. She gave me some good advice about living with long-term illness in general.

She also taught me stuff that helped my balance a lot.

So might be be useful… might not… but perhaps worth giving it a go.

And I think you should tell the physio what you think about the med’s situation. You never know… might be able to help.

Anyway hon hope it goes ok and it does turn out to be useful. I hope so.

Pat x

Hi Tina

I feel exactly the same as you when my Physio appts come up. She does help though even though I hurt more for a few days after the appt. Give it a go and see how it goes.

My main problem with physio is that the room that the therapist uses always has the heating on full blast and then she asks me to do exercises for her to look at and even though I say that my symptoms get worse when I get hot she doesn’t get the message so on my next appt I am going to say that I can’t exercise in a room with the heating on full blast and see how that goes.

She does help though.

Good luck and take care.

Shazzie xx

Hi Tina,

Just be honest with the physio, i’m sure you won’t be the first or the last to feel ambivalent towards them.

At the very least if it proves to be a fruitless excersise for you, when you next see GP or Neuro you will have already explored one avenue of treatment which then by elimination should bring you one step closer to getting new meds/treatment sorted out?

Hope it goes well for you

Laura x

Thanks all,

I know the time has long since passed for putting my foot down (sorry, 'nother pun), and insisting it’s not the right type of appointment. It’s all arranged now, including - after much hassle - the transport, so I’ve left it much too late to say I’m not playing. Got to go along with it whatever, now.

As you say, Cheryl, all be over by tomorrow night, come what may, so silly to be getting myself in such a state.

I just have to hope it won’t be a complete waste of time, but maybe, even if it is, I’ll at least be able to get her to say the meds need changing, and I, for my part, will be able to say I’ve gone along with everything that’s been proposed, so if it still doesn’t work, I’ll have a stronger case for what I really need.

I know I’m not my GP’s only MS patient, but she’s admitted in the past she has only two or three others, so that may explain what seems like a lack of assertiveness with day-to-day management of it. I know I shouldn’t technically need a hospital appointment every time symptom relief needs adjusting, as that’s not an emergency, nor beyond the authority of a GP to sort out. But she just doesn’t seem very proactive that way.

Tina

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