Patience with Patients

Posted by Filed Under: Health & Fitness, Running Injuries

injuriesI see quite a few runners in my practice, and it appears that they are comforted by the fact that I too am a runner. However, these patients can be both the most rewarding and challenging patients to treat. The reward is to see them back running healthy again. The difficult part is dealing with some of the more unique personality types that make our encounters more of an adventure. Here are some of the more colorful types of patients I have run into in practice.

  1. The “I’ve-Watched-Every-Episode-of-‘House’- and-I-Know-How-to-Google-My-Injury” patient. The presumed clinical and diagnostic expertise gleaned from watching TV or doing searches on the internet is unfortunately not anchored by the years of formal training and board certification it takes to be learned in the healing arts. I generally realize this when a vacant glazed look appears on the persons face when our academic discussion delves into areas such as pathology or biomechanics they neglected to find online or missed during primetime.
  2. The “Flavor-of-the-Month” patient. These people are always seeking the latest treatment fad. Unfortunately many of these “new and improved” treatments have little or no evidence to support their use. They generally are more costly than conventional treatments, and may inadvertently do more harm than good.
  3. The “Black-is-White” patient. These patients simply disagree with every thing you say. Possibly this is a control issue they have, but they did come to see me. What’s up with that?
  4. The “I-Can-Contravene-the-Natural-Laws-that- Govern-the-Universe” patient. These people can understand that it may take anywhere from four months to a year to properly build up to run a marathon, but when they are injured, if they are not 100 percent better within days they are devastated.
  5. The “Denial-is-a-River-in-Africa” patient. These people simply refuse to accept that they are injured. Obvious issues with treatment and down time arise with these folks, since they usually arrive at the clinic with an injury that has had time to really set in and do some damage.

The point is not to gripe about these traits, because I think we all have some elements of these quirks in all of us. I for one can think of at least two or three of the above that I am guilty of.

What I want runners to see, is that they must strive to moderate these quirks and if they are receiving care, recognize that it is a cooperative effort between patient and clinician that often yields the best result.

Clear communication, realistic expectations and a openness to explore which factors—may they be training issues, biomechanical issues or otherwise—that are at fault for an injury are essential in building the foundation for a successful outcome.

About Lee Miller D.C.

9536 - 87 Street Edmonton, Alberta T6C 3J1 Phone: (780) 426-6777 Fax: (780) 469-6930

  1. Melisa (Irish Blue) on January 24th at 10:32 am

    This is cute. (Well, if you’re not a physician.)

    I’m a #1. I love House and Google every illness I get. I also provide this service to my non-computer savy friends and family. 😉

  2. brit on January 24th at 11:24 am

    This reminds me of being pregnant. I have had two babies in the last three years, and now three of my running friends are pregnant with their first babies. I keep telling them that ‘normal’ people (those without personal trainers and nannies) are looking at at least 12 weeks to get back into comfortably running 3-5 miles. That whole six weeks recovery? Yeah apparently important. I signed up for a half ten weeks after my first baby, I ran six of those miles and I ran them 10 mins on 10 mins off and my milk dried up and I had major back problems. With my second baby I waited the six weeks before running, First I got to the point where I could walk three miles then I started running that same three miles 5 mins on and 5 mins off. all in all it only took me 8 weeks plus the 6 weeks of recovery to get back up to running 3.5 and then I spent the next twelve weeks training for a half, which went much better the second pregnancy than it had the first.

    My second baby is 10mths now, I’ve been much more successful at breastfeeding, no back problems, I’ve run one half and am training for another. I feel ten times better than the first recovery.

    Like me,during the first pregnancy, my runner friends don’t believe me that you will get better and you have to let your body heal naturally.

    One friend has signed up for a half three weeks after her due date.

    It’s surprising that as runners we consider ourselves so healthy but are unwilling sometimes to believe that we may need time to heal from an injury.

    to clarify I don’t consider pregancy and injury but it is a medical condition, and sometimes post delivery you are also post surgery.

    Great piece, made me think obviously..thanks.

  3. Dr. Lee Miller D.C. on January 24th at 4:22 pm

    Thanks for the kind feedback. Sometimes I feel that I’m more of a psychologist/cheerleader/butt kicker than a clinician. Another really interesting and rewarding element of care, besides helping get a person better, is also helping them get to know themselves better regarding their body and what it can and can’t do. Some people require kids gloves, others an iron fist to get the point across. Whatever the case, never a dull moment!

  4. Mark Iocchelli on January 24th at 7:25 pm

    I loved this. And “nope”, I’ve never, ever been even one of these kinds of patients. That’s my story and I’m sticking to it. 😉

  5. Dr. Lee Miller D.C. on January 24th at 8:20 pm

    Ok Mark. Moment of truth. Are you a #1,2,3,4 or 5 or some devious combination? Confess now and ye shall be free!!

  6. Mark Iocchelli on January 24th at 8:30 pm

    Well, I think I’ve been all of those but never more than one of them at a time. 🙂

    And those are just my *running* related “issues”. 🙂

  7. Dr. Lee Miller D.C. on January 24th at 8:42 pm

    Mark. Call me at the office. I know some people who can help you and they are really affordable!

  8. Aaron on January 25th at 6:29 am

    If it weren’t for all of my injuries I wouldn’t even use Google…..even my computer for that matter!

  9. IHateToast on January 25th at 7:32 am

    absolute science podcast interviewed a dr who now is a writer for house (lots-o-dough and no malpractice ins). he said that the other writers, comedians not docs, get all excited if they guess a friend’s problem and diagnose it similar to their friend’s doc or guess a dx correctly if they’re watching some “real life” er show. you can imagine them as patients.

    i was a 5 and ran on a broken bone, but now i’m anti-4 as i am doing everything the doc says so i don’t bugger it up further.

    only thing i don’t like about docs are those creepyass models on their desk to help show you what your leg would look like were you to be killed, dismembered and fed to piranhas. blech.

  10. Dr. Lee Miller D.C. on January 25th at 9:33 am

    Some people are visual. Is this a case where the medium is the message?

  11. Irene on January 25th at 9:21 pm

    Great article…

    A couple of years ago I went to my Dr. for stabbing knee pain, while in the middle of training for my first marathon. Her first response was “Oh, you’re one of THOSE people.” Then she went to explain that surfers and runners have this “do or die” mindset. Then the x-rays came back and the Dx was arthritis. I was amazed that she said to keep running, just not as fast and not so much, but I did need to take some time off to recoup a bit… I’ve heeded her advice and I’m doing okay, and did the marathon, but not as fast as I intended. Denial will get me no-where. It’s okay to take time off to recoup. 🙂

  12. Dr. Lee Miller D.C. on January 26th at 9:26 am

    I’m glad this article resonated with a lot of runners. Sometimes we are so wrapped up in our own little running universe we can’t see the forest for the trees. I thought it would be fun for everyone to see what it is like when the “shoe is on the other foot!” Thanks for the kind feedback.

  13. Dawn - Pink Chick on January 26th at 12:25 pm

    Reminds me of a friend who split his chin open early in the morning while skiing. He threw on a bandaid and at the end of the day went to the clinic where he ended up getting several stitches.

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