“I think it may be time to discharge ..."

By Tim McCullough, PT, DPT, AIT

Tim was second runner-up for the 2023 Best Physical Therapist Reader's Choice Award

I hope that, before you hear something similar to this, you’ve had detailed conversations with your therapist to identify your needs and potential to benefit from therapy. You and your therapist are a team and big decisions require a team effort. The circumstances that influence this decision are unique to the person and the situation. It may be time to take a break because functional progress has been difficult to achieve. Or maybe all your goals have been met, making the service unnecessary. For some readers, hearing your therapist talk about discharge can cause anxiety or worry. Others may feel a huge sigh of relief. Even so, it begs an important question. What’s next?

At a standard clinic, discharged patients are usually given a home exercise program that they should be performing regularly, encouragement to continue regular activity, and a pat on the back or a handshake just before walking out the door for the last time. This is when reality hits. You are it. There’s no therapist there to guide you or your family to complete ten repetitions over three sets of whatever exercise. There’s no pre-planned exercise routine ready for you to fall into once or multiple times a week. And there’s no one automatically there to hold you accountable.

What does this mean? You need to be proactive about managing your health, especially after discharge. Odds are very likely that you have probably heard your therapist, physician, or family emphasize this many times it’s almost sickening. The truth is that if you aren’t looking out for yourself, it’s likely that no one else is either. This becomes especially important when you leave therapy for the last time and come to the realization that your level of activity is entirely up to you. Without regular exercise or activity, you begin to lose all your progress, which can lead to also losing your freedom and independence. Without a plan in place, you can zoom downhill like Clark Griswold riding his [cooking] oil-covered sled down a hill of powdered snow.

Let’s talk about this “plan.” A plan doesn’t look the same for everyone. However, they do share the following characteristics:

1. Whatever you do should be something you enjoy. You don’t have to be smiling every time you do it, but it should be something you don’t hate and can easily repeat (or vary, if you want).

1. You need support. Whether that’s a friend who works out with you or finding a place where community exists, you need people to support and encourage you along the way. The whole “lone wolf” thing rarely works. You really are in charge of your health, but without support, taking care of yourself becomes a lower priority and can eventually fall off your routine altogether.

Just as plans look differently for everyone, so can support. And what’s cool about Turnstone is that there is so much variety in support here. Want a predictable place where you can access adaptable equipment to fit your needs? We got that. Want to find a place where you can see friendly and regular faces? Our staff is working the fitness floor and our clients are supportive, lending encouragement to friends as well as total strangers who may just be trying to build their momentum toward a healthy lifestyle. Want to find a workout buddy to push you? Our fitness staff does personal training for those who prefer one-on-one attention. Or what about finding a group to help challenge you? We have plenty of opportunities in sports and recreation and classes conducted by our fitness specialists to find individuals with similar mindsets who aren’t afraid to push you (and themselves) to their limits in order to achieve great things.

So in all this, let me be a voice of encouragement. Take your health seriously. Care for your body. Be proactive about managing your health. Engage with a community of people who care as much as you do (or should) about your own well-being. Find friends who aren’t afraid to challenge you to be the strongest and healthiest version of yourself possible. Sure, as a therapist I love to get returning patients, but, if I am being totally transparent, I love it even more when I see patients who become so excited about their own health that they hardly need me anymore or, better yet, don’t need me at all. Keeping a healthy routine can be difficult BUT it could be as easy as walking through our doors and hearing “Hello, and welcome to Turnstone.”