Whatever it takes

December 3rd is the International Day for Disabled Persons. We celebrate the working lives of three physios. Daloni Carlisle finds out more

World-class act

Lynne Burton (right) is a world-class athlete. When she's not globetrotting with the GB squad, she's a physiotherapist at Bromley's Marjorie McClure School for children with special needs. Oh, and I nearly forgot, she's a wheelchair user. Lynne's sport is archery. 'It's brilliant,' she says. 'I can compete on an equal footing with able bodied people.' In October this year she took part in the paralympic archery world championships in Korea. When Lynne came into physiotherapy she was able-bodied but as her training progressed she became seriously unwell with an autoimmune liver disease, and by the time she qualified in 1998 she was in hospital more than she was out. Two liver transplants resulted in an aortic aneurism and it was during an operation to repair this that her spinal cord was damaged. 'I can walk with splints but I fall over a lot,' she says. 'I consider myself a full-time wheelchair user.' Her first job was at Broomwell hospital in Essex where she worked in outpatients. Then two years ago she got her 'dream job' at the school. 'Of course there are things I cannot do,' she says. 'I cannot get a child into a hoist by myself.' The government's Access to work scheme pays for an assistant to work alongside her, acting as her arms and legs. 'They become an extension of you,' she says. The school has likewise been willing to make adaptations to help her work. Lynne's disability has positive aspects in relation to her work. She recalls a comment made to a colleague when she was new at the school. 'An eight-year-old girl said: "It's a good idea that she's come to work here. She understands what it's like being in a chair all day".' She adds ruefully: 'I have had a year's neurophysiotherapy and there is nothing like that to give you insight.' She recently started wheelchair skills classes for children at the school. 'No one taught me how to use a wheelchair,' she points out. Lynne is big on the functional side of things. Could she have trained in a wheelchair? 'No, I don't think I could. You would have to be exceptionally bloody minded to do it. There's one girl, 16 with cerebral palsy, who told me she'd always wanted to be a nursery assistant but assumed she couldn't do it. She said seeing me working as a physio has made her re-evaluate and now she's going to go for it.'

Life is for doing

Sheila North (above right) didn't realise for a long time that she was disabled, despite being diagnosed with two major chronic illnesses.  'It never dawned on me,' she says. 'I never thought of myself as disabled...' Sheila qualified 30 years ago in Nottingham and worked in the NHS until she had children. Two years after returning to work as an occupational physiotherapist at Rolls Royce Aerospace, her handwriting started to deteriorate and she developed a droop in her right arm. 'I thought it was atypical multiple sclerosis,' she says. 'I was diagnosed with Parkinson's disease.' It was a horrendous shock; she was only 42. Then a year later she was also diagnosed with coeliac disease, meaning she had to go on to a gluten-free diet. Her Parkinson's disease progressed slowly and Sheila was able to adapt her practice, using professional advice to encourage self-care. 'There are always things you are better at,' she says. 'I never did much manipulation because I am five foot one and don't have the upper body strength. It was not a big thing to adapt my practice.' However, as the tremor became worse, accessing computer notes and using a mouse became more difficult and eventually she left full-time employment. Which was a shame, she says in retrospect. 'I didn't know about Access to work. It's possible they could have provided some voice recognition software or some computer hardware to make the mouse easier to use. I could have coped in another role.' She has not put her feet up. She works part-time doing physiotherapy assessments for Access to work, is a volunteer tutor on the Expert patients programme, and runs exercise sessions for local Parkinson's disease groups. She also sits on the CSP's equalities committee, where she is the only member with a physical disability. She is glad the committee exists, but feels the CSP overall struggles with disability awareness.  She does see the world changing, though. 'Ten to 20 years ago, if you were disabled you didn't work. Now you see really quite severely disabled people in the workplace. My brother is in hospital and his OT has cerebral palsy. He is perfectly able and capable.' Next year she will become a retired member, giving up her physiotherapy practice altogether, despite being only 53. 'I'm not sad about it now, no,' she says. 'Life is for doing stuff and there are things I want to do while I can.' FURTHER INFO The Chartered Society of Physiotherapy has a tradition of being open to people with disabilities. The UK is one of a handful of countries where people with a visual impairment can train and register as physios, and the Society employs an officer to support visually impaired students. Guidelines for education of partially sighted physios are undergoing review. Disabled people also have representation through the disabilities network and the equality and diversity group. For details contact Monika Held, tel 020 7306 6682, email heldm@csp.org.uk or register for the disability network at the iCSP website www.interactivecsp.org.uk Accentuating the positive Frances Milne (left) was born profoundly deaf and rather than learn sign language, her mother taught her to talk and to rely on lip reading. This, she says, has been crucial to her successfully training, and then working as a physiotherapist for nearly 25 years now. As she puts it:  'I am sure it must be easier for an "oral" deaf person to be able to take up physio than one whose first or only language is sign language.' Frances qualified in 1983 at Aberdeen School of Physiotherapy: she was the first deaf student the school had taken. 'The lecturers were very deaf aware and being a small class size made it easier to communicate,' she says. She later studied management studies at the Open University. 'Most of my career was in chest physiotherapy, first chronic chest conditions then surgical/intensive care. This was where I had one advantage: I could lip-read patients with tracheostomies and endotracheal tubes.'  She is now a specialist community physiotherapist in the community older people's team, working within a health and social care team in Glasgow. Being deaf has meant some adaptations to her practice. Frances has elected not to use an electronic stethoscope, relying instead on her hands and her experience. She uses a mirror to lip read when she has to treat a patient from behind, and even does chest percussion from the front of the patient. She says:  'I am fortunate that I am able to lip read well and have good speech, so I am able to gain a good rapport in most situations. Where I can't, I bring in an interpreter.' That doesn't solve the problem of not being able to lip read and write at the same time, however. There are other limitations.  She can't use a telephone, so uses email, text messaging or the Royal National Institute for the Deaf's Typetalk. Taking part in team meetings can be challenging, and she avoids group sessions with patients. Even so, carers or family members are often present at treatment sessions. 'It's taken me a while to gain the confidence to say that I am deaf, depend on lip reading, and could people speak one at a time, facing me, without their back to the light.' She'd go so far as to say she has some advantages. 'People can become hard of hearing or deaf as they age. Many elderly people are very appreciative of my understanding of their needs and frustrations.' There's one problem even someone as resourceful and determined as Frances has not managed to solve: door entry systems at patient's homes. If any readers have ideas do let us know.
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Daloni Carlisle

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