The Unexpected Phone Call

Recently, I went in for a series of routine and preventative screenings and tests. I had to have the tests performed adaptively, where  I was seated in a chair versus standing to have the tests performed.  As I entered the room, I informed Kate, the medical technician, that I would need to have the tests performed while I was seated.

I was nervous.  I was looking for a hesitant or perplexed expression from the medical professional that can sometimes mean “I don’t know what to do here”.  I did not see that look.

Kate had introduced herself.  She clearly explained the purpose of the screenings and tests, what would happen, and what I needed to do.  Kate was efficient and assisted me to get the tests done; assisting me to find ways  to maintain proper alignment and body position in the machines.

The tests concluded and I was almost giddy with relief.  I thought,  “Good, this is over.”  I was not expecting the phone call that indicated an anomaly had been found.

“Good Afternoon Ms. Wiley”.  The woman said.  “I am calling about your screening.  We need you to come back in for additional testing.”

One of the first questions I asked, was “Could the results be wrong because I was seated when the test was performed?” The medical professional assured me that the test results were accurate and repeated that I needed to be seen for follow-up testing.

I went to the hospital for the follow-up tests.   It felt like I was part of an assembly-line.  The first step was a review of my information, patient records, and insurance.  Once the in-take was complete, I was shuffled into another room so that the initial screening test could be re-done.  After that test was complete, I was shuffled into two additional rooms so that more pictures and imaging could be taken using different machines.

I laid on the metal tables with sweaty palms, feeling cold, and exposed.

The three waiting rooms I was ushered into during this process were awkwardly silent.  Several people were seated in rows of chairs.  The only sound was the occasional rustle of an old magazine.  Most people were playing games or reading something on their cell phone.  Some people I knew were there for their first visit.  Others I knew were having additional tests or were waiting for the results like me.

When my name was called, I was shuffled into a final room where I would get my test results.  I heard people talking about what they were going to order for lunch.

I remember thinking, “My life is potentially about to change and people are deciding what kind of pizza to order…”  I jumped when the door opened a final time.   The medical professional came in with my test results.

The follow-up tests came back negative.

I heard the word “negative” and I felt myself exhale.  No one wants to get the unexpected phone call that something is wrong.  No one wants to have to go for follow up screenings and tests.

Coming out of the experience, I am thankful for Kate, the medical technician, who initially engaged with me and walked me through the  diagnostic testing purpose and processes.  During the follow-up at the hospital, I felt increasingly exposed and shuffled.

Sensitivity, empathy, and purposefully engaging a person, sharing information, and preparing them for what is next, becomes even more critical and important during follow-up diagnostic procedures.  People’s lives are frequently impacted and changed in some way.

I certainly hope that when that unexpected phone call comes again for me, I see and interact with more “Kate’s” and experience less of the assembly-line and shuffle.

Burnout for People with Disabilities in Athletics

Burnout is a subject that has been widely researched in the Health, Sports, and Fitness disciplines. Studies show links between burnout and musculoskeletal diseases including chronic neck and back pain and osteoarthritis for women and cardiovascular disease in men. [i]

Literature I have reviewed on this topic discusses the effects of burnout on professionals including Doctors, Nurses, Physical and Occupational Therapists, Coaches, and a range of other Health and Fitness Professionals. Literature also emphasizes the impact of burnout on families and caregivers.

While research has proven that participation in physical activity and leisure reduces depression, and anxiety; improves mood; and supports social interaction for people with and without disabilities, [ii] I did not find the concept of burnout for people with disabilities who are engaged in athletics widely covered in available research.

I read an article called Understanding Athletic Burnout: Coaches Perspectives, which described the signs of burnout for both amateur and professional athletes. Identified signs of burnout included: a lack of interest in athletic activities; the idea of ‘going through the motions’ without being fully committed to a defined set of goals and tasks; and a general lack of progression toward envisioned goals. [iii]

Athletic burnout is defined as “a psychological, emotional, and physical withdrawal or devaluation from a previously pursued and enjoyed activity as a result of excessive stress.” [iv] When burnout manifests, a person who was actively engaged in a sport or a training program withdraws. They become dissatisfied and listless. The person may also exhibit irritable behavior.

Over the last several years of implementing my fitness and walking program, I’ve had times where I have just gone through the motions. I felt extreme frustration, felt discouraged, and even cynical. I lacked physical and mental motivation. I was not invested in moving forward with my efforts to walk device-free. Research indicates that signs of burnout tend to appear when an individual feels a loss of choice and ownership in their program. Burnout also appears when a person is plateauing in their program. [v] When thoughts like “What is the point? Why am I am doing this?” cross my mind, it is a signal that I have likely hit a plateau in the developed program; I am feeling bored, “fed up”, or just physically or mentally exhausted.

Thomas Raedeke and his colleagues suggest using training methods like periodization and cross-training; which uses several methods to train or combines exercises, to combat burnout. [vi] They suggest implementing a variety of training formats and breaking away from established fitness routines to fight burnout.

While the referenced training strategies in the Understanding Athletic Burnout: Coaches Perspectives article have proven effective for athletes without disabilities in managing burnout, recognizing the signs and characteristics of burnout for people with disabilities engaged in athletics is an area that needs further study.

As an athlete and a person with a disability, I have exhibited the documented signs of burnout over time. I have displayed some of the highlighted characteristics including dissatisfaction, listlessness, and irritability.  After reviewing the research on burnout, I am more conscious about past experiences I had and didn’t understand or was not aware of at the time. I wonder, how many Health and Fitness Professionals working with me would be able to recognize signs of burnout that I might show? Would they know how to support me to combat my experiences of burnout?

I know that I will be more alert to the potential of burnout as I progress in my fitness and walking program. Health and Fitness professionals need to be mindful of the fact that burnout can and does happen to people with disabilities engaged in athletics. They need to be attentive to the potential signs of burnout to be able to intervene more quickly.

People with disabilities engaged in athletics also need to be educated about the signs of burnout out how to prevent it.

[i] Perceptions of wellness and burnout among certified athletic trainers: sex differences. Keith E. Naugle, Linda S. Behar-Horenstein, Virginia J. Dodd, Mark D. Tillman, and Paul A. Borsa. Journal of Athletic Training. 48.3 (May-June 2013) p424.

[ii] Haworth, J. T., & Veal, A. J. (Eds.). (2004). Work and Leisure. New York: Routledge.

[iii] Raedeke, Thomas D.; Kevin Lunney,; Kirk Venables. “Understanding athlete burnout: coach perspectives.(Statistical Data Included).” Journal of Sport Behavior. University of South Alabama. 2002.

[iv] Raedeke, Thomas D.; Kevin Lunney,; Kirk Venables. “Understanding athlete burnout: coach perspectives. (Statistical Data Included).” Journal of Sport Behavior. University of South Alabama. 2002.

[v] Raedeke, Thomas D.; Kevin Lunney,; Kirk Venables. “Understanding athlete burnout: coach perspectives. (Statistical Data Included).” Journal of Sport Behavior. University of South Alabama. 2002.

[vi] Raedeke, Thomas D.; Kevin Lunney,; Kirk Venables,. “Understanding athlete burnout: coach perspectives. (Statistical Data Included).” Journal of Sport Behavior. University of South Alabama. 2002.

This article was originally published in the “Endless CapABILITIES Blog”, and National Center on Health, Physical Activity and Disability, sponsored by The National Center on Health, Physical Activity and Disability ( NCHPAD is part of the UAB/Lakeshore Research Collaborative and supported by Grant/Cooperative Agreement Number U59DD000906 from the Centers for Disease Control and Prevention (CDC).