So I'm at work this afternoon...

[bluegoose]

...and this female patient comes in who I am treating for sciatica. Young, athletic, attractive. So here is how the conversation goes...

Patient: So I was out with some friends this weekend and I fell and fractured my coccyx.

Me: You did what?

Her: I fractured my coccyx.

Me: Did you go to the beer and wine festival or something?

Her: No, it was actually our 10 year class reunion. I had one too many, went to sit down, missed the chair and fractured my coccyx.

Me: Has this already been confirmed with your doctor?

Her: Yep, had xrays on sunday. I fractured my coccyx.

Me: Ouch.

Her: So is there anything that you can do in physical therapy to treat this?

Me: (looking off into space, thinking back to school about what we learned on coccydynia, see link: http://www.coccyx.org/medabs/maigne5.htm . Sorry if link does not work. I can't seem to figure it out.)

Her: So is there anything that you can do in physical therapy to treat this?

Me: Oh sorry. Nope, you're just going to have to wait it out and let it heal on its own.

Her: Oh, that's too bad.

Me: Yes it is.

For anyone considering PT as a profession or a second career, don't let this persuade you one way or the other. It's not everyday that attractive young ladies present you with these types of questions. Sorry.

[ute4ever]

Are you gay?

[bluegoose]

I think our Ute friend needs a little lesson in human anatomy.

This would not be something to look forward to under any circumstances.

[Archaea]

did it require an examination?

I've wondered but rarely asked if men examining attractive and shapely women created a problem for you. I imagine you can become clinical about anything, but it's difficult for me to become clinical about shapeliness, but perhaps I'm whacked. I can readily admit that a high maintainance gal is no longer attractive. All I see are huge credit card bills.

[creekster]

actually told her about the therapy options? Having quietly but unahppily endured my last physical, I can tell you that I would rather suffer the pain of the fracture without therapy than go through the pain and discomfort from the injury AND the therapy.

[bluegoose]

I think that this gal may have been aware of treatment options. she is a nurse and actually asked if treatment would be similar to what her physician told her may be required to relocate a displaced coccyx (digital examination and manipulation per Rectum - sorry if anyone is eating lunch). Coccyx fractures are very painful and i think she was reaching for any sort of relief she could get.

Regarding Arch's question, you try to maintain clinical objectivity of course. Fortunately in my line of work, i very rarely am placed in an awkward situation, especially when "shapliness" is involved.

As Mike may know, I'm sure the answer to that question would be much different for a physician with different "responsibilities" than what I have.

[MikeWaters]

I think you shoul dhave told her "yes there are some therapies that may help, but I am not able to perform those. I can however suggest some people that may be able to help."

From the sound of it, she is going to walk away thinking therapy is not an option, when in fact it is your discomfort about it that is the issue. my two cents.

[bluegoose]

For time and space reasons I was not able to post the entire conversation.

I did make it very clear that there are treatment options, and in fact that there are specialty clinics across the country that do work exclusively for coccydynia.

In her case, she was very acute, had a complete non-union fracture of the sacrococcygeal joint and really was not an appropriate cantidate for any form of physical therapy treatment.

Sorry if I misrepresented our discussion. Thanks for calling me on it anyway.

[MikeWaters]

thanks for the clarification.

[Parrot Head]

I thought you would have asked her if she had been riding four wheelers on the dunes.