the over zealous pt

I have decided that even worse than the non-compliant pt is the over zealous pt! I have a patient at the moment who is only 4 / 52 post major joint replacement and has decided he no longer needs to stick to the surgeons post op precautions. He never reports any pain and thinks he is completely fine. He basically told me on my initial Ax that he feels its time to push on, he wants help to do it properly but if I didn’t help him he would move on with his programme anyway! I have done education +++ I have explained healing times, insurance companies and why you cant drive, the possibility of dislocation etc. He says he understands it but then says things like “you have to understand I am a lot younger and I need a higher level of function for my job so I can’t wait”. I got the feeling he had no respect for me and considered my education irrelevant.

The only thing that has actually helped is I got him in a hydro class and really pushed the strength and high level balance within the limits of his post op orders. By the end of the class he seemed to understand he can still do high level strengthening within the restricted range, he was feeling a little pain and could appreciate that he had worked hard and achieved a fair bit without having to push through the surgeon’s restrictions. It worked quite well too because the water prevented him from taking to much weight through the limb or being at risk of a fall. I felt like I was back in control of the Rx session and he was actually listening to me. I think, I hope, now he will take my advice regarding post-op orders a little more seriously too.