Never say Never

Hi guys, I hope you guys are enjoying the placement. I am currently in my neuro placement and I would like to share my little experience with you guys. I am treating a patient who had a 6 months post head injury during work. On assessment, he presents with L hemiparasis with no voluntary control of hamstrings and ankle DF/PF, no voluntary control of upper limb and no sensation in the L side, but he has no problem with cognition and perception. Treatments up to date include gait retraining and UL retraining.

During treatment, even though there was no muscle activation in UL he is still very motivated and keen for the exercise and welcome to let me to do any stuff on his UL. On the next day during physio session with him, he became quiet and inattentive that was different from what he behaved normally, then I asked him what happen and after a while he started tell me that the doctor told him his arm is not going to come back. Then he asked me if it is true and how many chance his arm can function as he was, at that moment I did not know how to answer question because I have no experience at all and also I did not want to give him a false hope, so I consult my supervisor and she explain to my patient that there is no guarantee the arm will come back and there is no guarantee the arm will not come back either, the arm still need physio input rather than give up but be ready to the worst and be realistic.

On my self reflection, initially I was quite upset to treat neuro patient because on the one hand I as a therapist do not know when his arm will be activated again, on the other hand I also need to give him motivation and think positively. But one thing I learnt in this incident is that never say never. No one will exactly know the time frame of the neuro recovery because it varies from person to person and no one will fully understand the brain activity, it makes neuro rehabilitation full of potential. At the same time I learnt that the goal needs to be realistic otherwise patient will not have a false hope that will impact on the patient significantly. So in the future, I will know how to deal with this kind of situation and I will not be upset but think positive.