Raven Hill Certified Hand Therapy Occupational Therapy Downeast Maine 04605

Frequently asked questions about therapy at Raven Hill Integrated Therapies, LLC

One important reason to come to Raven Hill Integrated Therapies for treatment is to have questions about your condition answered. There are at least as many important questions to ask as there are patients. There are some questions that seem to come up frequently that many prospective patients would like to have answered early. Below are some questions we often hear.

Feel free to call with questions at any time. Calls will be returned as soon as possible, usually within 1-2 hours and almost always on the same business day. There is no charge for calling.

1. Why should I see an occupational therapist for my hand, wrist, shoulder or elbow pain?

2. Why should I see a Certified Hand Therapist (CHT)?

3. Is therapy expensive? How much can I expect to have to pay for my treatment?

4. Can you just tell me what exercises to do so that I don't have to come in for treatment? (Can't I just squeeze a tennis ball or something)?

5. Which insurance plans does Raven Hill Integrated Therapies accept for payment?

6. I fell recently and experienced pain and swelling in my hand, elbow or shoulder, along with some swelling. I went to the emergency room and they said I have no broken bones. Does that mean that if I just take it easy that I'll be OK?

7. Is therapy painful?

8. How soon after my surgery or injury should I come in for treatment?

9. Should I wait for my swelling to come down before I come in for treatment?

10. When I went to see my family physician (or orthopedic surgeon, neurologist, rheumatologist or other specialist) he or she didn't say anything about going to therapy. Does that mean I shouldn't consider it?

11. If a therapist can't cure my condition, why should I bother with therapy? What difference could it possibly make to me?

12. What's the difference between occupational and physical therapy?

13. I don't live in Maine, but spend most of my summers there. I got hurt (or got ill) at home in another state, and started therapy there, but would like to come to Maine for the summer and not miss my vacation. Can Raven Hill Integrated Therapies take up where the other therapist leaves off, or do I have to start all over again?

14. How will my physician or surgeon know what happens to me in therapy, and find out how I'm doing?

15. The place I seem to have the most difficulty with my hand, arm or shoulder is at work (or at home, or when I play a particular sport, or when handwriting at school, etc.). Can I be seen at my place of work (or at home, school or some other location)?

16. I'm an occupational or physical therapist in a generalist practice in another part of rural Maine, and I have a patient with an upper quadrant condition that is difficult for me to identify and establish a treatment plan for on my own. Can Raven Hill Integrated Therapies help me with my patient?

1. Why should I see an occupational therapist for my hand, wrist, shoulder or elbow pain?

Occupational therapy is about getting people back into the activities that are important to them as rapidly as possible, with a minimum of pain and with the best possible functional outcome. Pain keeps people from moving normally. Before a painful condition develops, people are able to move efficiently and easily to complete their activities of daily living. A normal level of activity keeps us healthy, and can help us to recover from illness or injury with the greatest speed. After pain develops, a person's movement becomes less efficient, and sometimes clumsy, just to avoid pain. This slows recovery from illness or injury, forces the body out of balance, creates additional difficulties with daily living, and potential for new injuries. To Top

2. Why should I see a Certified Hand Therapist (CHT)?

A CHT is an occupational or physical therapist who has voluntarily undergone advanced education and training to become designated as a specialist in this demanding field of rehabilitation, usually at considerable personal expense. Certification requires the therapist to have been in clinical practice for at least five years, to have amassed at least 4,000 hours of direct hand treatment experience, and to successfully pass a very challenging written examination. To maintain certification requires continuing education in this area of practice, usually at significant expense, ensuring that the CHT is up to date on all developments and advancements in the rehabilitation of the upper quadrant of the body. Raven Hill Integrated Therapies provides the only certified hand therapy in Hancock, Waldo and Washington counties. Certified hand therapy costs the patient or insurance company no more than therapy that is not certified, and frequently costs less, because the patient typically spends less time in treatment to achieve the same or better results. To Top

3. Is therapy expensive?

How much can I expect to have to pay for my treatment? One of the problems with our health care system is that people can feel they are writing a blank check when they are forced to enter the health care network. Raven Hill Integrated Therapies thinks that you should be provided with the information you need to make decisions managing your own health. Today this means that financial as well as health considerations must be part of the decision-making process. As a patient you are also a consumer. You have a right to get an intelligent estimate of how much treatment will cost you (and your insurance company, if you are lucky enough to have one). While each case is uniquet, at Raven Hill Integrated Therapies you will be able to get a reasonable estimate of how long you will be in treatment, what methods will be used to treat you, and what your treatment will cost. If treatment cost is the major consideration for you, we will work with you to develop the best treatment plan that your circumstances can afford. We would much rather help you by providing treatment you can afford, than have you go without any treatment. To Top

4. Can you just tell me what exercises to do so that I don't have to come in for treatment? (Can't I just squeeze a tennis ball or something)?

Some conditions don't require a great deal of attention from a therapist in order for the patient to have a good outcome. In such cases educating the patient in how to manage his or her own condition is the emphasis of the treatment plan, and the patient can be coached more than treated. With a trustworthy, independent patient, coaching can be infrequent. At times coaching can be conducted over the telephone at no charge. Other cases require daily treatment, and interventions that are complex, technical and expensive. If we think that you need to come in for treatment because you won't be able to manage well on you own, we will tell you. Either way, our ethics ensure that the patient receives only needed treatment without our "padding the bill." To Top

5. Which insurance plans does Raven Hill Integrated Therapies accept for payment?

Please call to confirm which insurances we accept. We are involved with the credentialing process with a number of common carriers and will have the most updated information over the phone. To Top

6. I fell recently and experienced pain and swelling in my hand, elbow or shoulder, along with some swelling. I went to the emergency room and they said I have no broken bones. Does that mean that if I just take it easy that I'll be OK?

It might, but we have seen a significant number of patients who had so-called soft tissue injuries that don't show up on radiographs (X-rays). They experience weeks or months of pain and loss of hand and/or arm function. When they are finally referred to therapy they sometimes experience stiffness, swelling and pain that are not readily correctable. At other times very few treatments are needed to help them be fully functional again, but they have in the meantime experienced long-term interruptions to their activities of daily living that they could have avoided entirely. The key here is to listen to your body, and see your physician. If you are not getting better, ask to see an occupational therapist. To Top

7. Is therapy painful?

It can be, but usually does not have to be excessively uncomfortable. At Raven Hill Integrated Therapies we have found that "no pain no gain" is a greatly over-rated philosophical approach to therapy and athletic training. We find functional activities to be the key to an optimal treatment plan. It's your body, you are in control of it, and your pain will be respected. We will not push you beyond your limits, and you are the one who gets to say what and where those limits are. We also know that not all pain is physical; in all too many cases we have had patients who are survivors of domestic abuse or other personal violence, either recent or in the distant past, and we know the critical importance of respecting not only your physical limits, but also your emotional ones. To Top

8. How soon after my surgery or injury should I come in for treatment?

The rule-of-thumb (sorry; I could not resist the pun) is that the earlier therapy is begun, the better the outcome for the patient. In some cases this means as early as the day after surgery. One of the reasons to be treated by a Certified Hand Therapist (CHT) is that they are specifically trained and experienced in early, safe intervention. Early intervention can in some cases return a person to full functional ability and independence much faster than the more conservative, "wait and see" approach of old. In those cases where the therapist knows that the patient has been referred too early for an active program to be safely implemented, the therapist can be trusted to delay treatment appropriately. While there are still physicians, physician assistants or nurse practitioners who are reluctant to send a patient to therapy within the first few days following an injury, the modern trend is otherwise, and knowledgeable professionals tend to make early referrals to therapy. The informed patient/consumer will ask to be referred to a qualified therapist for early intervention. To Top

9. Should I wait for my swelling to come down before I come in for treatment?

No. Swelling inhibits normal movement, can increase pain, and when prolonged can compromise the body's lymphatic system, causing it to be vulnerable to conditions (e.g.; infections) that can be avoided with early intervention. The techniques employed by the therapist to reduce swelling are gentle and include massage, ultrasound, electrical stimulation, light exercise and pressure wrapping. In addition, other techniques are taught to the patient to use independently. Healing accelerates when normal joint movement is restored. To Top

10. When I went to see my family physician (or orthopedic surgeon, neurologist, rheumatologist or other specialist) he or she didn't say anything about going to therapy. Does that mean I shouldn't consider it?

Ask about therapy when you talk to your physician about your condition. Many physicians are so busy that they don't take the time to think about therapy, or may simply prescribe pain or anti-inflammatory medication and hope for the best. Some adopt a "wait and see" approach, and if you come back in a few weeks to see them and are still weak, stiff and sore, then they will make a referral to therapy. Others have never worked closely with occupational therapists and don't realize all of the things we can do to assist in the patient's recovery. The patient can advocate for himself or herself by being an informed consumer. Frequently, just asking about referral to occupational therapy is enough to arrange it. Early therapy is much better than late therapy. To Top

11. If a therapist can't cure my condition, why should I bother with therapy? What difference could it possibly make to me?

Occupational Therapy strives to achieve treatment goals which improve functional independence, safety, comfort and quality of life. Occupational Therapists (OTs) often work with patients with chronic (sometimes even terminal) conditions, such as lymphedema, arthritis, Parkinson's disease, cancer, ALS and multiple sclerosis. Direct therapeutic "body work" (e.g.; exercise, massage, etc.), education for the patient and patient's family, and modifications to tools, utensils and the patient's environment are commonly used to accomplish these goals. To Top

12. What's the difference between occupational and physical therapy?

There is no well defined boundary between Occupational Therapy (OT) and Physical Therapy (PT), so it's easy to see why the public is often confused by the differences between the two professions. The fact of this "overlap" between these two health care disciplines often works to the public's advantage, as frequently both occupational and physical therapists work with a patient at the same time, and coordinate treatments closely with one another. This is most commonly seen with pediatric patients in schools, and with elderly stroke patients in hospital or home health settings. Occupational and physical therapists approach clinical problems from different perspectives, and use different thought processes to design treatment plans for persons with injuries or disabilities. Occupational therapy believes that activity is the key to health and quality of life. OTs use functional activities to treat problems as much as possible. For example, adapting a hair brush so that the patient can hold it to brush her own hair is frequently a good exercise for improvement of range of motion in the wrist and elbow. OTs also use many of the same clinical techniques to treat injuries as physical therapists, such as therapeutic exercise and wound care measures. A great deal of an OT's education is in psychology, in addition to the education in physical medicine theory and practice which they have in common with physical therapists. OTs are also expert at analyzing a patient's or client's daily activities, and finding ways to solve problems patients have with successfully and safely completing those activities. Like OT, Physical Therapy (PT) uses therapeutic exercise to improve strength, increase range of motion and reduce pain. PTs work well to help patients with back and knee problems, balance and mobility. While either an OT or a PT can be a Certified Hand Therapist (CHT), the great majority of the CHTs in America (and all of the CHTs in Maine) are OTs. This is because of the OT focus on functional activity; OTs tend to be very interested in the types of tools and utensils people use to complete daily activities, and the hands are our principle means of using tools to influence our environment. It tends to be much more difficult for a PT to specialize in hand rehabilitation. This is because they usually don't have enough upper extremity patients to allow them to specialize in this area of rehabilitation unless they are in practice in a large urban area. To Top

13. I don't live in Maine, but spend most of my summers there. I got hurt (or got ill) at home in another state, and started therapy there, but would like to come to Maine for the summer and not miss my vacation. Can Raven Hill Integrated Therapies take up where the other therapist leaves off, or do I have to start all over again?

We frequently see out-of-state referrals, especially in the summer. You can expect that we will dovetail our treatments with those of the therapist you worked with at home, and provide detailed reports of your progress to your original physician or surgeon. With your permission we will also make all of our clinical notes available to the therapist of your choice if you need to continue treatment when you return home. To Top

14. How will my physician or surgeon know what happens to me in therapy, and find out how I'm doing?

We make routine reports to your referring physician. As a matter of policy, a written progress report is made at every tenth visit, every 30 days or at the time of your discharge from treatment, whichever comes soonest. To Top

15. The place I seem to have the most difficulty with my hand, arm or shoulder is at work (or at home, or when I play a particular sport, or when handwriting at school, etc.). Can I be seen at my place of work (or at home, school or some other location)?

Yes. We find that the work place or home is frequently the ideal location in which to be engaged in therapy, as problem-solving is best carried out on site. To Top

16. I'm an occupational or physical therapist in a generalist practice in another part of rural Maine, and I have a patient with an upper quadrant condition that is difficult for me to identify and establish a treatment plan for on my own. Can Raven Hill Integrated Therapies help me with my patient?

Yes. We can provide a range of assistance, from informal peer review suggestions over the telephone at no charge, to formalized, contracted mentoring at your work location, to tutoring those who wish to challenge the Certified Hand Therapist examination. Call us to discuss your needs. To Top