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Recalibration, reframing valued activities and reconceptualization

21 May, 2020

Resciesa looking towards The Dolomites, 2019

Recalibration, reframing valued activities and reconceptualization: the title of this blog sounds like I am going to write about our new life post COVID. What will it mean? Where will we be? What will we be doing? What’s going to be our future? (And I am being metaphorical here- I am talking about the bigger picture).

I chose this photo from our last European trip because it aligns with my thinking about the title. That trip to Seceda certainly recalibrated our thinking about overseas holidays. From then on, our trips were always going to involve mountains and we were going to try and avoid cities. And we hadn’t even contemplated in our wildest dreams something like Coronavirus! We made the decision based purely on the beauty, solitude and majesty of mountain scenery. We had decided it was our happy place. (We were also fairly confident our children felt the same and if we chose some place special they would leave the city of almost 9 million and join us in a tiny Italian/Swiss village for a holiday). 

But the phrase I wrote this blog around is actually taken from a recent article called: ‘What influences patient satisfaction after a TKA (which stands for a Total Knee Arthroplasty or what we know as Total Knee Replacement)? A qualitative investigation. (Klem, N et al 2020)

Now I am not going to analyse this article here, but it is defintely worth reading- especially if you are contemplating surgery for your knee or your hip- but when this article was posted on Facebook by a physio in one of the myriad of groups I belong to – it just hit my like a ton of bricks. I love this phrase.

Recalibration, reframing valued activities and reconceptualization.

This is what we pelvic health physios do every day when treating women, men or children with continence issues, prolapse problems or persistent pain. Through education we recalibrate their body functions – the most personal, private bits of their day. We tease out their story, collect data (like from their bladder diary) and then use this to rejig the system. 

We have to change up their thinking about the old ideas, beliefs and habits (some which have persisted since childhood when their mother taught them) and reframe the patients’ thinking into a new direction. We have to drag them (sometimes screaming) out of their comfort zone with their bladder – stopping them from going so often to the toilet to teach their bladder how to store better.

We have to reframe their valued activities when they have persistent pain with intercourse with their partner. This mostly may be temporary, but for some it might be forever and we also may have to reframe the partner’s expectations and bring them along on the journey. We may have to point out the beauty of intimacy without penetration if penetration causes agony and tears. 

The Ohnut – available from Pelvic Floor Exercise (Fiona Rogers online site)

For every single patient we reconceptualize what their new work life, social life and family life will be like in their new post-treatment era. We give them the confidence to set goals they thought were unachievable; to have hope when they thought all hope was lost and the ability to understand that fear mustn’t dominate their thinking. 

And all of that applies directly to what is happening to our lives through COVID19. 

As a society we must recalibrate, reframe valued activities and reconceptualize what the future will be. 

Lots of people feel this time is a wake up call – a chance to very literally stop and smell the roses. Others can’t adapt to the imposts on our freedoms. There is indignation about closed borders to Queensland – but there would be indignation if they opened them and COVID started to spread like wildfire through our community. We have to be patient. Like Nelson Mandella. Like Anna Frank. Like those who have been in detention for SEVEN years.

And those borders aren’t really even that closed. There are exemptions on compassionate grounds. There are exemptions on work grounds and exemptions to seek out health appointments. Ask the authorities if you want to cross the border.

But I have colleagues and family who live in countries who can’t even comprehend how we have done what we have done in Australia. As of today Australia has 7,079 confirmed cases of COVID19 and 100 deaths. The United States 1,501,876 confirmed cases and 90,203 deaths. The United Kingdom has 248,822 confirmed cases and 35,341 deaths.  

Sobering statistics. 

And I for one am grateful that we have strong leaders who are copping the criticism and being cautious as we enter our flu season. We don’t want to look back in horror and wonder why we rushed back from lockdown. 

As you read this, if you haven’t yet downloaded the COVIDSafe app could I ask you to contemplate doing it? If your aunty or grandchild or mother or best friend get a diagnosis of Coronavirus, you’ll be wanting the experts to be able to trace every possible carrier of this insidious virus. That’s what the app can do. Nothing else. 

Stay safe, keep washing your hands and be grateful for our sunshine, our health professionals and our scientists.

And until we can get back to some mountains, here is some more mountain spam. That was a beautiful day. 

Mont Blanc, 2017

(1) Klem, Nardia-Rose BSc (Physio) (Hons); Smith, Anne Postgrad Dip Sports Physio, BAppSci(Physio), MBiostats, PhD; O’Sullivan, Peter Dip Physio, Grad Dip Manip Ther, PhD, FACP; Dowsey, Michelle M. BHealthSci, MEpi, PhD; Schütze, Robert MPsych(Clin), PhD; Kent, Peter BAppSc(Chiro), BAppSc(Physio), Grad Dip Manip Ther, PhD; Choong, Peter F. MBBS, MD, FRACS, FAOrthA, FAAHMS; Bunzli, Samantha BPhty (Hons), GradCert Res Methodology, PhD (May, 2020): What influences patient satisfaction after a TKA (which stands for a Total Knee Repalcement)? A qualitative investigation.  Clinical Orthopaedics and Related Research: May 12, 2020 – Volume Publish Ahead of Print – Issue –doi: 10.1097/CORR.0000000000001284

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