REP 11: THE WHOLE IS GREATER THAN THE SUM OF ITS PARTS
No man is an island. Even working alone in a private clinic, our advice and treatments interact with the treatments and advice that our patients receive from other sources. When we collaborate mindfully with our patients and interprofessional colleagues amazing things can happen.
In today’s rep, you will hear from a patient who experienced an unprecedented outcome following an innovative combination of treatments.
The Big Idea
I wanted to write today about a patient who has inspired me. We met by pure coincidence in 2012 while I was organizing a conference on Renal Rehabilitation. I was talking to a colleague about the purpose of the meeting, and our interest of exchanging information in the hopes of providing better rehabilitation services to persons with kidney disease. Mid-way though that conversation, she said, “You should meet Karen Nicole.” The rest, as they say, is history.
Since then, as I have grown to understand Karen Nicole’s story and have gotten to know her as a person. I have been inspired by her and her passion, power, and dedication to advocacy – both for herself and for a vision of better care for all persons living with kidney failure. Having the privilege of hearing her speak on several occasions, and observing the transformative impact she had on audiences, I was compelled to ask her permission to preserve her story as a photo-documentary. The purpose of doing this was to raise awareness amongst student and registered health care providers about the needs and rehabilitative potential for persons living with kidney disease.
With the support of the Associated Medical Services Phoenix Project and in collaboration with Kris Abbott, a recording artist and sound editor, we were able to produce a photo-documentary of Karen Nicole’s health story.
In honour of #KidneyMonth, I want to share a section of her photo-documentary, Sick to Fit Journey, with you:
My take on things…
In the above clip, Karen Nicole describes her journey from severe heart failure to fitness through a rigorous combination of intensive dialysis and Cardiac Rehabilitation.
Karen Nicole’s outcome is unprecedented. Upon her graduation from Cardiac Rehabilitation, she achieved a cardiorespiratory fitness that placed her into the 90th percentile for her age and gender, and a MET level that has not previously been reported in the literature for women who are undergoing exercise training and are on dialysis. Through her own words it becomes clear that this unprecedented outcome resulted from a lot of factors going right in her case and from a tremendous amount of work and dedication by Karen Nicole herself.
As a scientist, I recognize the limitations of a single case study. The findings observed in Karen Nicole’s story in a positivist paradigm demand further investigation to substantiate as well as to understand how they may generalize to others living with kidney failure. This notwithstanding, there are many lessons that can be gleaned from Karen Nicole’s story of success. Of these, she reminds me of our obligation as physiotherapists to continue to advocate for medical treatments which hold the promise for better rehabilitation outcomes for our patients.
As physiotherapists, we are obligated to be restless in our curiosity about how our interventions (be these active exercise, modalities, manual therapy, education, or other) interact with and potentially amplify the treatments of our interprofessional colleagues.
If you are interested in learning more about Karen Nicole’s journey and her experiences I strongly encourage you to visit her blog.
This publication was supported by a 2013-2015 AMS Phoenix Fellowship from AMS (Associated Medical Services, Inc.). The content is solely the responsibility of the authors and does not necessarily represent the official views of Associated Medical Services, Inc.
I welcome your thoughts on Karen Nicole’s story, or on how you’ve combined PT with other interprofessional treatments for beneficial outcomes for patients in your practice.
Chime in using the comments box below, or via the CPA Facebook page or on Twitter (hashtag #30CPAReps).
About Trisha Parsons
Trisha is a physiotherapist, scientist, and faculty member at Queen’s University in Kingston, ON. Her work is in the field of Renal Rehabilitation. As an AMS Phoenix Fellow she is evaluating strategies to develop and sustain narrative competence in physiotherapists in order to support the delivery of patient-centered care for persons with complex health conditions.
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Featured image by NASA/JPL-Caltech. This rep was sponsored by
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