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Physical Rehabilitation

Physical rehabilitation includes many services designed to help you function as normally as possible. Services are provided under the direction of a physiatrist (a doctor who specializes in rehabilitation medicine) and are carried out by physical and occupational therapists, speech pathologists, rehabilitation counselors, and social workers. You may need one or more of these services depending on the nature of your disability. You can receive rehabilitation in the hospital as an inpatient or outpatient or in your own home.

No one likes the idea of a temporary or permanent disability. Sometimes people will have to think hard about agreeing to have treatment that may significantly alter their ability to function. An amputation is one example. But the trade-off, in many cases, is life. The availability of rehabilitation makes the decision to accept aggressive treatment much easier.

1. Physical therapy to reduce edema (swelling) in your arm following a mastectomy or to regain strength following major surgery.

2. Occupational therapy to increase the strength and coordination of your body or to reevaluate your ability to return to your daily activities.

3. Speech therapy to help you regain your ability to communicate following a laryngectomy.

4. Rehabilitation counseling to help you deal with the emotional impact of your disability.

5. Wigs and prostheses if your illness has resulted in hair loss or loss of a body part.

1. Your doctor will refer you to a rehabilitation center or to a community health agency that provides these services. The rehabilitation specialists will then evaluate you to determine how they can help. Without your doctor's referral, your insurance may not cover the cost of these services.

2. Sometimes doctors don't mention rehabilitation since they may not think about the changes in your life that cancer has produced. If your doctor does not bring up the subject, ask for a referral, or at least for an evaluation, so you can be sure you are not missing out on services that could help you to continue enjoying your life.

3. wRehabilitation services should be provided by licensed physical and occupational therapists and speech pathologists, along with doctors who are board-certified in rehabilitation medicine. Counseling services should be provided by specially trained rehabilitation counselors, social workers, or psychologists. Inpatient services are provided in specialty rehabilitation hospitals or rehabilitation units within a teaching or community hospital. These services are also provided to outpatients who go to these facilities. Physical, occupational, and speech therapy can also be provided in the home through a home-health-care agency, which also provides skilled nursing services.

4. Rehabilitation services may also be available through private practitioners. If you use a private practitioner, he or she may not necessarily qualify for reimbursement from your insurance company. Ask your doctor, nurse, or social worker for information about what is available in your community.

• Not all insurance companies pay for rehabilitation, so it's important to check your benefits. Sometimes the Office of Vocational Rehabilitation in Pennsylvania will pay for these services if they will result in your ability to return to work or to independent homemaking. Ask your hospital social worker for help if you are having trouble getting the services covered by insurance. Other resources may be available to pay for rehabilitation services.

• Remember that after any major change in your body, such as the loss of physical energy, or a body part, you will probably experience a period of sadness. This is normal and natural. You will need to adjust to a new image of yourself, and feelings of sadness are part of your adjustment.

• If you are having trouble adjusting to the physical changes your cancer treatment has caused, consider seeing a professional counselor. He or she can help you reevaluate who you are as a person despite the differences you feel as a result of cancer treatment. A support group may also be helpful. You and your family deserve to enjoy the benefits of your cure or long-term control. Don't let emotional stress rob you and them of the joy of your recovery.

• The American Cancer Society sponsors several rehabilitation programs. Examples are "Reach to Recovery" for women with breast cancer and visitation programs for people with ostomies or laryngectomies. Call your local ACS for more information.

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