Deborah Warren was a senior Physiotherapist.
How were you first introduced to new patients?
Probably it depended if they, I think in the office they probably sorted out what requests were, maybe a doctor requesting hydro, probably then would be sort of put on the hydro list, but they would actually be assessed before they had any treatment. All patients were assessed and I think this is, probably they have bigger assessments now than probably what we did then, but you assessed whether they were actually suitable, whether they had any open wounds, sores, whatever, heart trouble, chest trouble, if they were scared stiff of water and they’d been asked for physio, well you’d try and coax them in there but if they wouldn’t, I mean you wouldn’t push anyone that way. A lot of people had never worn a bathing costume so they’d never been into swimming pools, so there was always that element of apprehension, you know, sort of what was going to happen. But I think if you showed them so they – and they were talking to other people in the, when they came in as well – but if you showed them what went on, that they weren’t left alone at all, someone always greeted them when they went down the ramp, they were walked in with someone and they got used to it probably just a short time, the first time, and came out and some of them really loved it after that, [laughing] you know, you couldn’t get them away from it almost. So it was the initial examination really; you examined the part you… you listened to them. And that was, you know, you had to make time to listen to what someone had got to say because often they just told the doctor something and there wasn’t time and he said oh yes, you’ve got osteoarthritis in your back and that’s it. If you can hear all their problems you sort of gain something, they could talk to you and say well, it isn’t only my back, my shoulders hurt as well. So often you could give them a bit of treatment for that as well, you weren’t sort of tied down to just doing the back. You know, they’d probably got arthritis all over the place, but you’d treat, you wouldn’t sort of give them everything they wanted but you could, with a little bit of modification you could say well, you can have three hot packs, would you like them on your shoulder this week and we’ll do your back, and that’s fine, you know, you could modify the treatments. But you had to be careful initially, you had to find out what they could do, how much movement they’d got, so you actually put all this down, what they said or how they’d injured themselves, if they’d had any treatment before. I wouldn’t treat anyone if they were having treatment, particularly physio, if they were going to other places while they were here. I’d say you choose one or the other, because it’s not fair to you and it’s not fair to us to be treating you because we won’t know whether our treatment’s helping you or whether it’s the other person’s treatment. You know, if they were going to an osteopath or private somewhere else, you know, you really wanted to know, keep it to one thing.
And how long would an average course of treatment last?
Well, this is where I suppose it wasn’t cost effective. Used to be six weeks, so if you were coming three times a week I suppose you could probably get a maximum of eighteen treatments. Twice a week, twelve. And I think it was basically twelve in the pool, that was sort of the standard.
[T]hey [patients] could either be taken in on what we called a stretcher, which was like a deckchair on wheels, or a smaller chair which was sort of the chair that the ambulance men use, they could be taken on a little one just to the water’s edge and walk in. Or on the stretcher one they actually were pushed right into the water and then floated off by a member of staff and then taken to – they had stretchers in the pool...they were literally canvas stretchers that were actually hooked on to the rail of the pool and they had a sort of a base at the bottom, so that rested on the pool bottom, and so they sloped down so that the person could rest their head on a pillow but a lot of their body could lie in the water, or they could float on to the surface of the water and they could hold on to the side so they felt quite safe and then the member of staff would put them through a series of exercises.
You did sort of electrical stimulation. You could do… some of them were multi-purpose things, you could choose your current or whatever you wanted, the mode of what you wanted to do. The one we probably used most was a sort of stimulation if you wanted to stimulate muscles of the feet probably, that was one of the most ones, when you did a footbath with electrodes so that you actually – for example, if you were doing fallen arches you could actually re-educate them. If people hadn’t got the idea how to do the exercise you wanted you could actually help them to re-educate that sort of exercise so you would put a couple of electrodes in and [laughs] – sounds awful doesn’t it? So you’d stimulate if, you know, you knew where the motor point was in your nerves then you could actually try and stimulate the nerves or a group of muscles. And so if it was a foot, if you’d dropped the arch like that, you could actually put two electrodes in and you’d get a stimulation like that. And so the person, then you’d want them to work with that pulse and so they’d get the idea and then you could try them to get them to do it without having the pulse going through. And yes, a lot of them did it and a lot of them actually helped, they found it helped so it was one of those little treatments I would say that was quite good and probably quite a lot we did, that was probably the one we probably did mostly here. A few ionisations I think we did, but I think it was very few and far between by that time.
Did you use paraffin wax treatments?
Well, you could do, it’s rather a nice coating of warmth really, particularly feet and hands because you could get in between the fingers. Whereas if you put a hot pack between, if you’ve made a muff with a hot pack, it was only sort of, the heat was going round, so you could actually treat the whole hand as it were. Very nice prior to doing exercises, particularly wrists if you’d had a Colles’ fracture, that was quite a good one. Or rheumatoid really, you actually dipped the wrist in till you’d got a nice coating – has anyone explained this to you? We had two, usually there were two baths: a footbath and a hand bath. Hand baths were probably the ones that were mostly used. You had to test that the wax was of the right temperature, wasn’t too hot, and you got the patient to – I think they call them clients now I should think [laughs], terminology’s changed, but to me they were patients and that was it – they dipped their hand in so that they got really a nice coating, kept on dipping and drying and then dipping in again so that it really got a really, like a lovely thick glove of wax on their hand. And then they were wrapped up in, like in chip paper, for want of a better word, you wrapped in a sort of special paper so you didn’t get the grease everywhere and then they were wrapped in towels and they were taken and sat down to relax while their hands were in this lovely warm muff, or one or whatever they were doing, did one or both. And then about quarter of an hour, twenty minutes later, that was peeled off and you got a wax model of their hand virtually sometimes. And that was put aside to be reprocessed, to be cleaned, because if you were doing it for someone who was just out of plaster you would actually get a lot of skin, dead skin. But it actually made the skin rather nice, even after that, so it was part of the treatment to getting the skin condition back to what it was and you’d probably advise them to use some cream when they got home to, you know, get the condition up again. But it was rather nice, and then they’d probably go into a class or have some wrist exercises to – probably come up to physio then, they wouldn’t necessarily have to be on the hydro side although the wax baths were actually down in a little cubicle.