Also yesterday I had my appointment with the osteopath. To be honest in view of my suffering at the hand of the physiotherapist on Wednesday, I was dreading the encounter . And yes there was a lot of pain involved. The difference was that my pain responses were incorporated into the assessment of my condition, rather than being seen as being what needed intervention. The conclusion was that the muscles of my lower back were so inflamed and so liable to go into spasm, that he could not do what was needed without inflicting unacceptable levels of pain, and so he recommended that I go straight away to the ambulatorio.
Here, a couple of digressions. The ambulatorio is the emergency ambulance station, and it is located alongside the health centre in Nerja. In addition to the paramedics there is always at least one emergency doctor in attendance. You walk in, explain your problem and you will be seen by the appropriate professional, in my case a doctor who examined my back, immediately called in one of the paramedics to administer cortisone injections into the affected muscles, and then sent me by wheelchair next door for X-rays. These showed problems with my two lowest lumbar vertebrae (L4/L5 for the technically minded). Another injection followed, a cocktail of pain killers, prescriptions for a course of tramadol and diazepam, a report for my doctor and instructions to her for daily injections over the coming week. A visit which took only three hours, largely because the doctor had to leap into an ambulance and go out on an emergency call. Today I am already well on the way to recovery, with no need to head for A & E, nor to seek an emergency appointment with my own doctor.
I later had time to compare this service with what would have happened if I still lived in the UK. The local NHS Trust has just announced the closure of two walk-in centres originally opened to relieve the pressure on the local A & E Dept. Cuts to their budget mean a counterproductive saving has to be made, with no thought for the needs of the patient.
The second digression relates to the osteopath. I trained as a psychologist and worked for many years in the fields of psychotherapy and hypnotherapy. People sometimes asked me which school of therapy I subscribed to. I told them that I thought of myself as eclectic; that is to say I read widely on the basis that no one had a monopoly on truth, and so my task was to nick the good bits from wherever I found them. But also I needed to be aware of when the client's problem fell outside my competence. So I was pleased rather than disappointed when my osteopath was honest and confident enough to say, "I can't help you with this. You need chemical intervention to resolve the immediate problem. He apologized for charging his full fee while not able to do more than examine me. As I shall tell him when I return for him to treat the underlying cause of this flare up, I value treatment by its quality, not by the quantity. He knew his limitations, knew where I needed to go, and sent me off in the right direction. I couldn't have asked for more than that.
If you're one of my local readers, I'm talking about Mark Shurey who works two days a week at Fisioterapia Holandesa in c/ Almirante Ferrandiz, Nerja.