Physical therapist helps spot life-threatening condition, saves patient’s life

Physical Therapist Erika Sandell-Savor, DPT, knew something wasn’t right.

Her patient, 66-year-old Richard Thurn, had come in for physical therapy after surgery to repair a torn rotator cuff. His shoulder recovery was going smoothly. But during one of their appointments, Thurn – an otherwise healthy retired nurse anesthetist – told Sandell-Savor that he hadn’t been feeling well.

“He explained that he had been having a feeling of heaviness in his chest, along with fatigue and flu-like symptoms,” Sandell-Savor said.

Sandell-Savor, who works at M Health Fairview Rehabilitation Services – Arbor Lakes, likes getting to know her patients while she helps them recover from surgery, an illness, or injury. She knows that overall health is a web made up of many complex factors. By asking comprehensive questions, Sandell-Savor can identify emerging problems – even if they are not musculoskeletal in nature.

Her detailed approach may have saved Thurn’s life.

After listening to Thurn explain his symptoms, Sandell-Savor asked whether he had received COVID-19 test. Thurn had gotten three – including one five days prior – and they were all negative. Thurn’s primary care physician ordered a chest X-ray to rule out some other concerning diagnoses, but those test results were clear, too. Finally, his physician suggested a CT scan – a test that can find problems with blood flow among other issues.

Thurn and his wife canceled a planned trip to Hawaii, because of Richard’s symptoms in addition to coronavirus-related travel concerns. When he came back for his next physical therapy appointment one week later, Sandell-Savor asked Thurn how he was feeling and whether he had gotten the CT scan his doctor had ordered. Thurn said he was feeling OK, but that he had coughed up blood and had discomfort when he coughed or sneezed.

Alarm bells went off in Sandell-Savor’s mind. “Something wasn’t adding up for me,” she said.

Although his vital signs were fine, Sandell-Savor was now concerned that Thurn’s symptoms might be caused by a pulmonary embolism (PE). A pulmonary embolism is a life-threatening condition that happens when a blood clot elsewhere in the body breaks off and travels to the blood vessels in the lungs, becoming lodged there. If left untreated, it has a mortality rate as high as 30 percent.

“Although I’ve never seen a PE as a result of a blood clot after shoulder surgery, there is always a risk of one developing. A CT scan is the gold standard for detecting a pulmonary embolism, and I urged Richard in the strongest possible terms to get scanned right away,” Sandell-Savor said.

Thurn considered Sandell-Savor’s advice along with the advice of his wife, who is an OB/GYN nurse practitioner, and his daughter, who is also a nurse. He decided to get a scan. As it turned out, Thurn didn’t have a pulmonary embolism. He had many of them.

“As someone who had a career in healthcare, I always associated blood clots with redness and swelling, and I always associated PEs with chest pain and trouble breathing,” Thurn said. “I didn’t have any of that, and as a result, I discounted my symptoms.”

Fortunately, Thurn’s PEs were caught in time and his doctor gave him a blood-thinning medication. When he came in for his next weekly appointment, Thurn shared the story with Sandell-Savor.

He told her: “You’re one of the reasons I’m sitting here today.” If Thurn had gotten on that plane to Hawaii, the pressurized cabin likely could have caused a potentially fatal embolism.

Although much of their medical training is focused on musculoskeletal issues, physical therapists like Sandell-Savor are skilled at recognizing “red flags” and refer patients for additional evaluation or emergency care in life-threatening situations.

“Physical therapists have the education and background to help figure things out when something is not right. We’re constantly trying to piece the puzzle together in order to help patients,” Sandell-Savor said. “Taking a detailed history is so crucial, because patients give you so many indicators. Being able to ask the right questions, and really listen to the answers, is a key step in creating effective treatment plans.”

Thurn appreciated Sandell-Savor’s keen attention.

“Erika always wanted to know exactly how I was feeling. Her insightful questioning and caring attitude went above and beyond,” he said. “She asks questions in a way that gets to the truth, and she doesn’t let things go until she has a satisfactory answer to her question.”

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