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January 19, 2011

"What Else Do You Know?"

When one of my sister's was a new mother, my mother was reluctant to give unsolicited advice about child rearing. So, when my sister was having trouble getting my nephew to sleep through the night, desperate for some rest, she turned to my Mom. Turns out my mother's methods worked, which elicited a response from my sister, "What else do you know?"

So when I was visiting a museum with my husband's family, my mother-in-law had symptoms of fatigue and numbness in one of her hips and leg. I immediately became concerned, asked her a few questions, palpated her hip for the extent of the numbness and informed my husband. After a few minutes of rest, my mother-in-law's symptoms abated. I recommend she visit her doctor first thing the next day.

On the day of my graduation, her hip was bothering her again, this time sending pain rather than numbness down her leg. I performed a cursory examination. Her range of motion is excellent, her balance fair, her pain vague. I checked her low back and found a lumbar vetebra slightly out of position, but without getting a bone density measurement first, I was reluctant to mess with her back (she's beginning to develop THAT posture). I gave her some gentle stretching exercises to perform daily for her low back and hip, and threw in a couple of balance exercises for good measure. She was not able to stay for the reception of my graduation because of her discomfort.

After a couple of weeks, my mother-in-law went to visit her doctor. He told her that it was likely that her sciatic nerve was irritated (something I mentioned might be the problem) and gave her some exercises to do. She told the doctor that I had given her the same information and exercise to do daily -- did she still need to pay him? (She did.) He asked if she had been doing the exercises. She said yes, about once a week rather than daily as I had instructed. He suggested she follow my directive and do them daily.

I felt affirmed by this story that my examination and clinical reasoning skills are correct in this case. Makes me wonder, what else do I know?

Posted by linda at January 19, 2011 9:08 AM

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