So, how do you choose your physiotherapy clinic in seven easy steps?
Physiotherapy skills and qualifications
The most important question - is the physiotherapist appropriately qualified and is there any evidence of ongoing learning and development? Although principals remain consistent, the skills and style of approach can be different as can the aftercare. Please make sure you get reassurances of qualifications and can see ongoing development of therapists.
If you need physiotherapy, it is important to consider a local physiotherapist or one that is convenient to you. At Nicky Snazell Clinic we do provide specialist physiotherapy to clients from all over the world who come to Nicky for healing, but in general, we would recommend that you consider a therapist who is within a commutable distance of your work or home location. A commutable distance is 40-60mins for the right care, Nicky Snazell Pain Relief Clinic service; Stafford, Lichfield, Cannock, Rugeley & Stone.
Style of approach
Like people, physiotherapists are all different. While we hope that they all subscribe to the highest possible standards and approaches, it is important that you make sure that from the initial consultation you feel connected with your therapist and their unique style of approach.
Consider the following:
- Have your questions been answered?
- Did you feel a connection with the therapist?
- Are you clear on the next steps?
- Did the therapist explain costs?
Getting to the root cause
Spending time to find the root cause of pain is more important than the treatment itself. We find some clients have pain that is the result of unresolved childhood issues, bereavement and work-stress for example. Without spending the time to really understand your unique situation, often it can be like treating the surface of the problem and not the long-term view of the issue.
Ongoing Physiotherapy care
Once your initial condition and pain are 'fixed', ongoing care is essential. As they say, prevention is better than cure, so periodic check-ups and follow-ups will help ensure that you are maintaining your health. We quite often treat sports injuries and also recommend massage for clients which can relax and rejuvenate you avoiding the aggravation of the problem area.
Sometimes you may receive physiotherapy which can show that you would benefit from other services such as electro-acupuncture, the aforementioned massage. Does your therapist offer other services to support your wellbeing?
A good physiotherapy clinic has a team who can facilitate customer support and great customer service, like helping you to book your appointments, reminders and periodic communication in the form of useful insights, tips and observations to help.
If you are looking for a Physiotherapist why not give our team a call: 01889 881 488
In part 1 of this series, Your Pain Relief Plan Introduction I discussed why we feel pain and introduced the concept that the degree of pain felt could vary widely from one individual to the next due to lifestyle factors and that when long term, typically over 3 months, the brain would lock the pain in. Emotional trauma, even as far back as childhood, had been found to lock in pain for almost a lifetime.
In part 2 of this pain relief series, I will get into more detail about how pain works and discuss the implications of aging and the differences between acute and chronic conditions and the most effective ways of treating these. But first, a quick look at the brain, how it has evolved and how this relates to processing pain.
The oldest part of the brain is the reptilian brain, which deals with basic survival instincts. Next came the mammalian brain, which added the ability to feel emotion. The third part is the human brain, the Cortex, which gives us our human qualities of cognition, sensory perception and spatial reasoning and is in charge of the human decision making process.
How Pain Works
Your nerves transmit pain signals. Inside your nerves, you have sensors for temperature, stress, movement, pressure, immunity molecules and blood flow. Similar to car sensors, any damage or fault to any of these sensors will put a light on your dashboard, to alert you of a problem. The nerve does the same thing by increasing pain.
These pain impulses travel up the spinal cord, to a part of the brain which acts like a router(called the thalamus) and as a simple analogy, this router makes phone calls to other parts of the brain.
Hence our brains decide, like a panel of judges, how much pain is appropriate for us to experience at any one time
The pain experience is complex and involves many areas of the brain:
1. Body sensation and location
2. Movement – muscles may need to brace the area
3. Focus & concentration
4. Fear response
5. Memory area recalling a previous similar experience
6. Motivation - processes pain
7. Stress response - weight, digestion, sleep, temperature
All seven areas interact to decide on the suffering experienced. This may have little to do with the degree of injury and hence makes it clear that a qualified and knowledgeable therapist is needed to properly diagnose and treat the injury.
The Consequences Of Aging
As we age, we need to put more care into our diet, supplementation, exercise, and our workload. It sounds simple, but many of us fail to even acknowledge that as we get older, we have to change the way we use our bodies. As we age, naturally occurring enzymes are fewer, inflammation is greater, and the production of inflexible scar tissue becomes much more extensive. Therefore, long-term solutions for pain relief also need to address our ongoing biochemical changes.
Sleep quality tends to deteriorate and ongoing deprivation can lead to symptoms virtually indistinguishable from widespread pain, fatigue and diffuse tenderness. Early evidence also shows that anxiety, depression and sleep disturbances have been common reactions to the COVID pandemic. Thus the problems faced by Long COVID sufferers are likely to be with us for many years to come.
What is the difference between Acute and Chronic Pain?
Chronic pain, by its nature, may not be resolvable
Chronic pain is long term pain, beyond 3 months, as the brain has hard wired the pain in by that time. Chronic pain can occur because of numerous conditions, such as emotional pain, joint wear and tear (osteoarthritis), spinal disc thinning, bulging or rupture, bone thinning
Suffering is not related to the degree of injury
(osteoporosis), unresolved tendon or ligament damage, to name but a few. Chronic pain, by its nature, may not be resolvable. It may need a lot more treatment than acute pain to bring down to acceptable levels and will benefit greatly from ongoing maintenance or wellness treatment to prevent reoccurrence.
Modern science confirms benefits of a more holistic approach
The latest neuroimaging technology, which can see the electrical activity in the brain in response to different lifestyles, has allowed the world to delve deeper into the understanding of chronic pain. It has been confirmed that pain is modulated by factors such as attention, anticipation, empathy, placebo, meditation, fear, anxiety, posture, emotion and movement. This, in turn, has confirmed the benefits of a more holistic approach to assessment and treatment.
This new insight into chronic pain helps explain why, for example, X-rays showing the degree of osteoarthritis in joints has no correlation to the pain being felt.
To summarise, we have shown how each person's brain can process pain differently, to the extent that one person may feel tremendous pain, when another, with essentially the same condition, might feel little or no pain at all.
The availability of the latest MRI scanning technology has verified that many non-physical factors can impact the way pain is handled in the brain. This in turn supports the benefits of a more holistic approach to assessment and treatment.
Acute problems are usually caused by a recent injury and are best treated promptly, whereas chronic problems are longer-term and tend to be related to the ageing process. Chronic pain in many cases cannot be resolved and lends itself to a longer-term control of symptoms, rather than treatment of root cause as with an acute injury.
In my next blog Your Pain Relief Plan Part 3 I will explain neuropathic pain and the effectiveness of both exercise and drugs and where these may be the wrong solution.
Pain is a very complex problem. It’s also such a common problem that every person on the planet will at some point in their life suffer its consequences, perhaps only a little, but for some unlucky souls, it will be life-changing for the worse.
There are many factors that can affect the severity and longevity of the pain which is suffered. Many of those factors are in our individual control, so the good news is that each of us has the potential to dial in pain relief and reduce the impact of pain on our lives.
In this series of blogs, I will take you on a journey to help you gain a better understanding of pain and its causes so that you will be able to reduce its consequences on your quality of life.
My Qualifications In Pain Relief
For me, the study of the cause and treatment of pain has been a lifelong journey. As a child I witnessed first-hand the suffering caused by long term severe pain when my mother was bedridden for years with back pain. My childhood also came to an abrupt end when I was handed many of the responsibilities and duties my mother could no longer fulfil.
Needless to say, this episode was life-changing for me and it embedded an irreversible need to seek a better understanding of pain and more effective ways to treat those suffering pain. It started a lifelong journey that I am still on to this day. A journey that has taken me to many places around the world and given me the great fortune of working with experts in their fields.
At the outset, I had observed first-hand the inability of our western medical knowledge to effectively deal with severe pain and I thus vowed I would never restrict myself to the boundaries of western medicine alone. Why would I? After all, we all know that the best way to improve is to seek out those who excel. Thus my outlook has always been broad rather than narrow, inclusive rather than exclusive.
As a result of this approach, I will take you to places that perhaps you had not imagined, introducing factors that you would never have considered. I am highly qualified in western medical methods and only too aware of how it has, or in many cases has not improved over the last 40 years in dealing with severe pain. I thus make no apology for introducing ideas and concepts not considered by many of my peers.
However, I would forever regret not communicating my knowledge on pain relief to you and at the same time potentially leaving you to suffer more than needed. Ultimately it is then up to each of you how you choose your own future pain relief journey.
Why do we feel pain?
Pain is a normal human experience and we need it to survive. Pain is nature’s warning system which is designed to protect us. Pain is the symptom and not the cause of a problem.
When someone brings us bad news, we don’t shoot the messenger, do we? No, instead, we listen to what the messenger has to say, and then we go and find the real cause of the problem. It is exactly the same thing when it comes to pain. It is only trying to warn us that there is a problem, and it is up to us to seek out the true reason behind that pain. Where is the pain coming from and why? You can’t put a fire out if you don’t know where the fire is. Pain is no different.
Chronic pain has more to do with sensitive nerves and how your brain processes your lifestyle than the injury itself
Pain signals are sent to the brain for processing through the nervous system. Some nerves send control signals from the brain to the rest of the body. Others send signals from the body to the brain for feedback and processing. Each of us has around 45 miles of nerves connecting all our body parts to the spinal cord, so that provides a lot of opportunities for pain signals to be sent to the brain. The brain has to decide how to express that pain signal and that expression can vary wildly from one individual to the next.
As an example, I have seen patients with bone on bone contact in their knees and yet feel almost no pain, whereas others with far better cartilage cover suffer severely.
Our perception of pain is related to everything we are experiencing in our lives at that time. When we move better, eat better, are happier and less stressed, we minimise the pain we feel.
One secret to conquering pain is to find out what you have too much or too little of. It’s all about balance, and any disruption in the delicate balance of your body can be a strong contender for the root cause of your painful life.
If pain is suffered for too long, typically more than 3 months, the brain can hardwire it in. One reason chronic, or long term, the pain has increased is that there has been too much focus on the localised injury and not enough on the significant contribution made by the nervous system and brain. In so doing, we have allowed the pain to be locked in the brain and no amount of localised treatment of where the pain is perceived to be felt will make any difference. Sadly, it’s not uncommon for perceived pain to be felt when the cause of the pain is in a different part of the body.
An extreme example of locked in pain is when it has been caused by an emotional trauma many years earlier and often from as early as childhood. This trauma has caused a locked-in physical condition which expresses itself as never-ending pain. The trauma and pain are intertwined so tightly that both have to be released at the same time.
I have witnessed first-hand many such situations where the release of a muscle locked in spasm caused an emotional outflow and replay of the emotional trauma which was the root cause of the problem. This emotional venting led to a release from pain suffered sometimes 20, 30, 40 and even 50 years!
To summarise this necessarily brief introduction to why we feel pain, it should be clear that assessing pain is not a simple matter if the intention is to get to the root cause.
In my next blog in this series Your Pain Relief Plan Part 2 I will discuss the consequences of ageing and the differences between acute and chronic pain and why these need very different treatment protocols.
This is the fifth part in a series of blogs looking at the process of a physiotherapy assessment and treatment plan. If you have missed the 4 earlier blogs, then here are the links:
Your prescription is the final part of the physiotherapy assessment process. After we've got a connection. We have learned who your authentic self is. We’ve gone through the four keys analysis, to assess your immune system and general health. We have worked out what’s going on with you in terms of food, movement, stress, lifestyle and the way that you use your mind. And we’ve looked and listened to your physical being, all the sensations that are going on your physical being. How sensitive you are. How much warmth, your circulation. The hesitancy when we move part of the body, the link with your eyes and your brain. The tone in that part of the body. And we've worked out what's going on, at that moment, to the best of our knowledge.
Only then do we decide on a tailor-made prescription for you, which can be a combination of many things. These may need to be in my clinic, or there may be a lot of things you can do at home as you don't really need us to be there for you, apart from just encouraging you along the way. It may also involve physical treatments, via just laying on hands, massage, that connection, dry needling, acupuncture, shockwave, manipulation, exercise advice. You name it, there's a myriad of physical hands-on treatments that we do.
We will write a prescription that's tailor-made just for you. It will be based on that moment in time, your immune system, your mind, your lifestyle and your available time. It will then progress to help your body get to the best you can be for your age, with whatever problem that you have. That is what tailor-made means. It means being listened to. And it means prescribing that medicine, be it in terms of a pharmaceutical drug, be it in terms of herbal medicine, be in terms in what we do, which is physically treating you and listening to you and looking at you holistically.
That's what we do.
If you are in pain right now and you feel confident we can help, then why not call. Erica, Jean and Charlotte will be happy to help.
The Physical Assessment
In my three previous blogs on physiotherapy assessment
I discussed concepts and steps which for most will not have been considered and most will have assumed that the physical assessment was the first step.
That is the mistake that so many make, missing out on the vital steps of creating the right environment to build connection and trust and gaining a deeper understanding of your important beliefs. Make that mistake and you are destined to gain so much less.
So the physical part of the assessment. What do we do? Well, in a private room we may ask you to take off some of your clothes, so you might want to be wearing clothes you're comfortable in and can take off quickly. If you're too shy to take off your clothes, just say it, it's not a problem.
Many of the assessments we make at my clinic are not common in the UK or anywhere else in the world. I am fortunate to have studied and qualified at the highest level in specific pain relief techniques and as a result I have learnt and ingrained advanced assessment techniques in myself and the rest of my team.
Then we'll be looking structurally at your skin. What does it look like? How healthy it is? What are the hairs like? Are there hairs missing? Does that mean the nerves are not working properly in that area? What's the temperature of the skin? Is it sweaty? Is it dry? How does the limb move? Does it move normally? If not, it will tell us is it’s likely to be arthritis in the joint that's blocking it. Or is it likely to be a tendon? Or a muscle or ligament? Or is it the nerves? Are they transmitting messages normally?
Or is it the brain? Has your brain created the pain felt in the body, possibly locked in from an emotional trauma many years earlier, even back to when you were a child? Chronic pain is created in many parts of the brain (evident in scans). Mindmapping physiotherapy techniques help to unwire the pain felt in the body.
So we're assessing the physical aspect. And that tells us so much about where we believe the problem is, or which systems are mostly causing the problem. Is it mostly the muscles? Is it mostly the nerves innovating the muscles? Is a blood flow problem? Is it something to do with what you are eating or if you don't move enough you are too weak. Or are you so stressed up, that you’re just pumping out inflammation into the area and you’re getting a more aggressive form of arthritis. And you don't need to. By looking at and at the same time feeling the response of your body, we learn a lot. If we hold a patient's hand that's sore, your eyes tend to move very differently than if you hold part of the body that isn't. Also there's a feeling about the hand, there's a hesitancy and there's a sort of a difference in the tone or strength.
There is so much in our senses, that we pick up on when we're assessing physically. Clearly this can only be done physically, face to face. Most of the above would be totally impossible to achieve by virtual means.
In my next blog Your Physiotherapy Prescription I’ll take you through how we develop a Physiotherapy treatment prescription, or plan, which takes you through the steps needed to achieve a successful outcome and let you get on with your life.
In the meantime, if you are in pain right now and you feel confident we can help, then why not call now. Erica, Jean and Charlotte will be happy to help.
In my two previous blogs A Different Perspective On Your Physiotherapy Assessment and The Subjective Physiotherapy Assessment, I discussed the importance of getting that connection and really listening to get the patients story. Why are you here, what are your beliefs about treatment?
Now it’s time to go further, honing it down with specific questions about the problem.
Let’s use an example to help illustrate. Someone comes to me and they've had chronic pain in their foot for a very long time. I would be asking questions about the possibility of arthritis. Questions regarding the nervous system. Looking at the way that the body moves. Seeing if the pain is transmitting down from the spinal cord, because it could be a problem in the spine itself and not the foot at all. Having a look at the function of the foot, seeing if biomechanically the patient is walking in a strange way, and is that is making it worse?
How does it feel? How does the tissue feel? Is there any swelling? Are there problems with circulation? Is the sensation there? Are the nerves working properly? Is there an amplification of pain so that when I touch, the tissue is overly sensitive? What are the clues as to what's going on?
This is a very important start to this part of the assessment, which leads to the physical assessment.
To recap, the first part is establishing the connection and the story, the background, the beliefs, the values. The next part is to do with the Four Keys, to do with your immune system and your general health.
The next part is to hone it down into the particular problem today and how it's starting to manifest itself physically.
The final step is to go into the physical, which we can't do remotely by zoom. The physiotherapist has to get hands-on and assess physically, face to face.
In my next blog The Physical Assessment I will delve into the actual hands-on physical assessment. Many of you may have thought that this would be the first step in an assessment and that is the mistake that so many make, missing out on the vital steps of building connection and trust and gaining a deeper understanding of the all-important beliefs of the client. Make that mistake and you are destined to gain so much less.
In the meantime, if you are in pain right now and you feel confident we can help, then why not call now. Erica, Jean and Charlotte will be happy to help
I get asked a lot of questions about physiotherapy assessment. What do we do at my clinic? How do I assess? How do I teach assessing?
In my previous blog A Different Perspective On Your Physiotherapy Assessment, I mentioned that the first and most important thing is to have a safe, quiet environment that builds a connection and trust. If you don't feel that with your physiotherapist, you're not going to want to proceed to any kind of medicine or treatment and your outcome won't be as successful. There won't be that connection.
To recap, the most important thing for the patient is that the physiotherapist has created a sacred space, a quiet office, where the phones are switched off, the computer is not a distraction, and you eyeball each other to get that connection. And then your physiotherapist listens to your story. And how you describe what's going on with you. And then, in that moment of connection, your physiotherapist can get glimpses of the real authentic self behind the story, who you really are.
Once your physiotherapist glimpses the story of the problem, he or she can start to elicit some background which is past medical history. So we'll ask questions like the health of your family to see if there are relevant genetic links. We may also explore your beliefs and values and more about your family so we'll know how difficult it is for you to attend and for you to have the necessary treatment. We may touch on your past experiences of treatment because if you've been scared or let down previously, you're going to have very different expectations. We need to address that head-on.
And then, of course, my favourite four keys questions (see my first book ‘The Four Keys To Health’ available on Amazon), which looks into your mindset, lifestyle, fitness and what you eat. All these help us assess how well your immune system is working, and your general health, which helps refine our treatment prescription.
That, in a nutshell, is the first part of the physiotherapy assessment.
In my next blog ‘The Subjective Physiotherapy Assessment – Part 2’ I will continue on this journey of helping you understand how to really get the most out of this process.
In the meantime, if you are in pain right now and you feel confident we can help, then why not call now. Erica, Jean and Charlotte will be happy to help.
Physiotherapy Treatment For Vertigo Caused By BPPV
Vertigo is a problem that affects around half the population at some point in their lives and is more common as we get older. Fortunately, the symptoms usually only last for a few seconds to a minute or so, but the symptoms are very unpleasant including:
• Nausea and vomiting
• A sense of rotating
• Inability to stand or walk
What Causes Vertigo
It is widely accepted as the most common cause of vertigo is BPPV (Benign Paroxysmal Positional Vertigo) and this is linked to the 3 semi-circular canals in the inner ear. The role of these canals is to sense the position of the head in the 3 axes of up /down, right / left, forward/ backwards. If any incorrect signals occur, the brain doesn’t know where your head is and gets confused.
Faulty signals are caused by very small chalk crystals becoming loose and getting into the semi-circular canals. These loose crystals then move in the canals, stimulating faulty signals.
The types of movement which most frequently initiate a vertigo attack are rolling over in bed, getting out of bed, sitting up after lying flat or looking up or down.
Left untreated, vertigo will usually resolve itself but may take several months. Fortunately, treatment is fairly simple and painless and typically no more than 3 specialised Physiotherapy treatments are needed over a couple of weeks.
David Paling, a senior physiotherapist and our clinical lead can diagnose and treat BPPV.
If you or someone you know is suffering from vertigo, then physiotherapy treatment with us should seriously be considered.
Call the clinic now on 01889 881488 and ask for an assessment with David.
With the daily media bombardment about COVID, it is no wonder that fear is generally growing. Fear of the social impact of another lockdown, fear of the uncertainty of our livelihoods and even fear of our very existence. Staffordshire has announced that it will go to Tier 2 at midnight on Friday and this will inevitably raise the fear factor higher.
Mental health has taken a back step with this pandemic and never before in my working life has there been so much anxiety, loneliness and grief hidden away in society.
Your pain, whether physical, mental or both, isn’t going to disappear and many of you are going to need a lot of help in the coming months. Increasingly, we are being asked to help guide people through these difficult times both mentally and spiritually, the latter problems only serving to multiply the actual physical pain.
We Are Staying Open
We know that stress lowers our immunity and raises our sensitivity to pain. Gold standard trials have also proven a relationship between lifestyle stressors and white cell count. What this means is that stress, if left untreated, will slow down your ability to heal, plus worsen your response to pain, inflammation and disease. Yet psychosocial pain is, I believe, wrongly still an afterthought in western medicine, even though more often than not, it holds the key to hidden trauma and deep emotional stress.
At this clinic, we have long recognised the importance of looking at the whole person, rather than just the location of pain. That’s why, even though I am highly qualified in western medical techniques, I have written 5 books on a more holistic approach. In my first book, The 4 Keys To Health, I introduced a simple traffic light scoring system which encompassed the psychosocial factors that affect our health and which can cause so much of our pain.
Our goal is thus to help people in all aspects of their health and never before in my lifetime has there been such an urgent need for this approach. Beyond treating your pain, we wish to get you to as close optimum health as possible to help protect your immune system.
That’s why at the clinic we love to build a relationship with our clients to prescribe a tailor-made treatment plan, working out the best way to help with the mind set and adding in massage, and technology such as laser, shockwave, deep oscillation, acupuncture and IMS dry needling.
Keeping Abreast Of Research
We are constantly monitoring recent research to find new techniques to help. As an example, a recent Harvard trial successfully used electroacupuncture to improve survivability in COVID infected mice. This is highly relevant research, as in some cases it has been shown that it is the human bodies over response to COVID infection which has caused excessive inflammation [cytokine storm], leading in some cases to death. The research findings are significant. Electroacupuncture treatment before the cytokine storm increased survivability by a factor of four, from 20% to 80%. When applied after the cytokine storm, survivability increased by three-fold, from 20% to 60%. Both are huge benefits and it emphasises the benefit of preventative treatment.
As a result of our integrative approach to treatment, combining orthodox western medicine with alternative, we routinely carry out electroacupuncture here.
For those of you who need our help, we are open and will continue to be open unless forced to close by government ruling.
None of us know how long this pandemic is going to last, but the expectation is that it’s going to be a long time. If the availability of treatment is shut off there is going to be a drastic rise in pain and suffering. We have already seen this in the lockdown with patients begging us to see them. That’s why I believe it is so important that we stay open in the coming months.
Our patients are so grateful that we are here now to help them with their pain, pain they suffered for months without any help during lockdown. They have bombarded us with thanks. We will continue to stay open and help you unless and until the government dictates otherwise. Sadly, the chances are there will be few, if any, alternatives for you.
Control Your Stress Now And Improve Your Resistance To Disease
While the government is correct to react to rises in cases, we each need to keep in perspective what the tier trigger points represent, so that we can keep better control of our stress. Tier 2 is triggered at 100 per 100,000 population. Put another way, on average you would need to get close to 1000 people before you are likely to be near a COVID positive risk. How likely, if you are careful, are you to interface closely with 1000 people, especially in these troubled times? Maintain social distancing and always wear a mask to reduce your chances of infection further.
What does this tell us? Mix only with people you are reasonably sure act sensibly and act sensibly yourself. Nothing is guaranteed in life, but by acting sensibly and taking all possible precautions, you can use your own positive response to improve your health.
COVID-19 has had a dramatic affect on all our lives and not surprisingly at Nicky Snazell Clinic as well. Our foremost concern is the safety of patients and staff and we strive to stay fully up to date with the almost daily changes and wherever possible keep ahead of the curve. More on that later.
Even if you are an existing patient, but definitely if you are a new patient, we will take you through a screening process to make sure it is safe and justified for you to come in for treatment. There will be quite a few questions, and we ask you to bear with us on this as it’s all in our best interests. For sure, the questions asked will constantly change in line with latest guidelines. Where the risk is deemed higher, then a more detailed assessment will be needed with a physiotherapist, before treatment can be authorised.
Please note that in cases where you may need to be accompanied, then that person also has to pass screening to be allowed on site.
Changes At The Clinic
All of our 13,000 plus patients will know that our aim has always been to create a welcoming, peaceful and relaxing environment from the moment you walk in the door. Well that of course, to an extent, went out the door when we adjusted rapidly to the pandemic. Our waiting room has been effectively closed and patients are now asked to wait in their cars until their allotted start time. At that point they should come in alone with a face mask on, use the readily available hand sanitiser and their therapist, wearing full PPE, will take them to the treatment room.
At the end of the appointment the therapist will, if necessary, book a follow-on appointment and we then ask that you go to reception, where we have installed protective screens, to pay in advance for the next appointment. To speed this process, we now only take payment by card and by touch whenever possible. Where a payment requires a pin, the terminal is sanitised after use.
We then ask that you leave the clinic immediately as we want to minimise time that patients are in the clinic. Please don’t think we are being rude if we don’t chat as we used to. We are minimising your time on site. We have also staggered the start times between therapists, to avoid multiple patients being on site outside of a treatment room at the same time.
All rooms are sanitised between treatments and thus treatment times will be slightly shorter. In addition, we use a spray which lasts up to 5 hours on surfaces and this is used on all common touch points every 3 hours. Thus, for example, when you open the door to come in, you can be sure that the handle and surrounding woodwork will have been sprayed and is as safe as is practical.
We understand of course that some patients will need to use the toilet and we request that if needed, you first advise us so that we can sanitise after each use. Note, however, that the toilet is also thoroughly sanitised every 3 hours with our 5 hour effective spray. Please try to avoid the need to use our facilities wherever possible.
We require that you use a face mask which covers your mouth and nose at all times while inside the clinic. All of the available scientific information supports the need to wear masks inside a building. It is important for each of us to realise that wearing a mask helps protect those around us from us. By not wearing a mask properly, this would be putting our staff at additional risk and this is not acceptable.
Patients at times have found difficulty in wearing a mask, but we politely request that you must do so for the short time on site. Bear in mind that our staff are in full PPE all day to protect you.
Patients who do not comply with this request may be refused further treatment.
We also need your help in running to time. It is vital that you have vacated the treatment room on time, leaving sufficient time for the room to be sanitised. Any overrun will mean that patients will be held in the waiting room and this is not acceptable.
Payment In Advance
We have changed our payment procedure, as we now ask for payment in full at time of booking and in 99.9% of cases this has been fully understood and accepted. On one or two occasions, however, patients have misunderstood our reasoning for this. We have made this change by necessity, as many patients leave the building immediately after their treatment and it would be totally unworkable for us to have to continuously call patients to take payment. We had to come up with a single system for all, so this change is not a reflection on any one patient.
Staying Ahead Of The Curve
Part of our role is to stay up to speed with the ongoing changes caused by our government updates, but in addition, we, and in fact all of us, can choose to operate more safely if we wish. An example would be that last night Scotland announced that most COVID-19 infections were caused by meeting people from outside our household within our homes and thus banned this. In England a more relaxed position has been taken. It is, however, up to us to decide which position is more in our best interest. If we at the clinic feel it worthwhile to use more strict guidelines to help protect all, then we reserve the right to do so.
Having lived in the USA twice, I personally check in on their news channels and in particular I look for information from Dr Anthony Fauci, who is the USA’s leading disease expert, having been advisor to the last six Presidents. He talks more openly and simply than we tend to get in the UK. He is also completely apolitical and is only interested in scientific proof. There is also a wealth of real world, scientifically based information put out by Dr Sanjay Gupta.
Yesterday Dr Gupta interviewed Dr Fauci and for those who want a better insight and understanding of where we are right now, then I recommend you watch the interview on YouTube.
For those who don’t have time to watch this, here are some snippets:
- Dr Fauci is optimistic that a vaccine may be ready for approval by November or December, based on the limited results available in the small-scale phase one and two trials. But, and this is a big but, the all important large scale phase 3 trials are double blind, placebo controlled trials and so even he has no idea what the current results are. In fact, nobody does, except one or two statisticians who see unblinded results. In simple terms, a double blind trial means that only the statisticians know who is getting the placebo and who is getting the vaccine being tested, not even the manufacturers, as the trial is conducted by an independent group. This is the gold standard for scientific testing and is not something that can be politically manipulated.
- The best advice is that we must all wear face masks if social distancing can’t be maintained.
- What we didn’t know a few months ago was that 40% to 45% of COVID positive people were asymptomatic, nor were we aware that a substantial proportion of the infections were coming from those who were without symptoms. That makes it overwhelmingly important to wear a mask.
- There is a suggestion that some of the virus droplets in the air may be light enough to hang around and circulate, thus acting as an aerosol. The facts are we don’t know yet, but in many respects, it doesn’t matter. It just emphasises the advice given: wear a mask, keep your distance, avoid crowds, wash hands regularly, ventilate rooms.
- Yes, the elderly are more at risk, but people with underlying conditions, at any age, are at risk.
The overwhelming issue is that we all need to get on with our lives while we minimise our risk during this pandemic. We believe we are taking every possible step to minimise that risk and that we have created a far safer environment than most.
Take care, be safe, think of others