The Royal National Hospital for Rheumatic Diseases
The CRPS and Complex Cancer Late Effects inpatient rehabilitation programme lasts for two weeks and follows structured group-based sessions, but also enables you to work with our therapists regarding your individual needs and personal goals.
During your outpatient assessments with the team, you may have been taught some techniques/exercises or agreed some initial goals. It is important that you regularly practice these and try to achieve set goals before you begin the programme. It is also a good idea to think about what goals you would like to work on during your stay.
Approximately 6-8 people usually attend the programme – sometimes these are all people with CRPS, but at other times the group may be a mix of people with CRPS or Complex Cancer Late Effects. Sessions can start from 8.30am and run until 4.30pm, Monday to Friday only. On the first day, nursing and medical staff will complete your admission details with you. There will also be a group welcome session in the afternoon, so that you can be formally introduced to each other and we can give you more information about the programme.
During your stay you will attend sessions of physiotherapy, occupational therapy, and hydrotherapy (where appropriate).
Each session lasts approximately 20-45 minutes. The number and duration of sessions is flexible and depends on your needs. Your daily timetable will be displayed on the noticeboard next to the therapy area.
Our physiotherapists will work towards re-educating normal movement of your whole body as well as your affected limb. The physiotherapy you receive during your stay may seem different to what you have previously experienced and some of the treatments may seem unusual. We use these treatments to target unhelpful changes which occur in your musculoskeletal system and nervous system caused by pain and your condition. Physiotherapy usually includes land and water-based (hydrotherapy) treatments.
Our occupational therapists will ask you to think about the impact that your condition has had on your life, especially on those activities that mean the most to you. This may include coping at work or with household tasks, managing your personal care, improving your sleep, or continuing to enjoy leisure activities. Treatments are varied, but may include techniques such as desensitisation, mirror visual feedback and pacing.
Other group sessions are run during the stay and cover issues that are relevant to most people with CRPS or Complex Cancer Late Effects. These can include topics such as pain medications, communicating with others, coping with low mood and anxiety, relaxation and mindfulness, or managing setbacks.
You will have the opportunity to ask any questions during these sessions. We also have a psychologist as a key member of the team, who is trained to listen and discuss with you aspects of your life that may be overwhelming and affecting your rehabilitation.
Although you will be provided with accommodation on a hospital ward, there is no specific medical input on this rehabilitation programme. Like the therapists, the nurses encourage independence but are happy to assist you as your needs require. It is likely that you will remain responsible for administering your own medication.
The CRPS and Complex Cancer Late Effects team includes a mix of clinical, research and administration staff. The programme itself is mainly run by the four therapists (Keri, Charlie, Emma and Alice), but you are likely to meet or hear from most of us at some point in your journey as a Bath patient.
We are a friendly and approachable team, so please do ask any questions or come to us with any worries – we will do our best to help.
Back row, left to right
Sharon Grieve (Research Nurse),Dr Jenny Lewis (Senior Clinical Research Occupational Therapist),Alice Trent (Senior Occupational Therapist),Keri Johnson (Physiotherapy Clinical Specialist),Lisa Buckle (Research Administrator)
Front row, left to right
Janice Goodway (Senior Clinical Administrator),
Dr Jane Hall (Senior Clinical Research Physiotherapist),
Lindsay Davies (PA to Professor McCabe)
You will be allocated a bed on the general rheumatology ward for the duration of your stay, here at the RNHRD in Bath. Male and female wards are separate, as are toilet and washing facilities.
A locker will be provided. Meals take place in the patient dining room at dedicated times – breakfast is usually approximately 7am, lunch 12noon, and evening meal 5.30pm. Meals are pre-ordered the day before.
Please be aware that there may be other patients on the ward who are not participating in the programme. There may also be noise due to the busy ward environment and our hospital being located in the city centre.
Therapy sessions are mostly held in the CRPS therapy department or the hydrotherapy department. Outside of session times, you are free to leave the hospital premises and explore the city. However, it’s important to note that the hospital doors are locked at 9.30pm. There are no therapy sessions at the weekend, so you have the choice of either staying in Bath or going home. If you choose to go home, then it is your responsibility to make your own travel arrangements and to ensure that you return in good time to resume the second week of the programme.
The hospital is a smoke free environment. You will be unable to smoke cigarettes or e-cigarettes on the premises during your stay.
If you should become unwell during your stay with us, you may be asked to return home. This is important for infection control and the protection of all patients and staff. Arrangements would then be made for you to return and complete the programme at another time.
We all understand what a big decision coming onto the programme can be. By this point, you will most likely have been living with CRPS or Complex Cancer Late Effects for some time and you have probably tried a number of different treatments to try and manage your pain. It takes courage and determination to try something new.
It can be scary leaving the comfort and familiarity of your own home to come into hospital. Staying on a hospital ward can feel strange and unsettling, hearing all the unfamiliar sounds and sharing your space with others. Being out of your comfort zone like this can make you feel vulnerable and anxious, and it can take a few days to settle in to the new environment.
These are all normal responses to being in a strange environment. We encourage you to give things a chance. We will be teaching you everything we know about your condition and how to manage it, so try to use this time to focus on yourself and your ongoing rehabilitation.
“I needn’t have worried about using cutlery, cutting food and eating in front of others. Meal times were protected, with lots of assistance, and everyone (staff and patients) were very helpful and understanding”.
“I was feeling that I didn’t deserve to be there as others may be much worse than me – this was quickly dispelled”.
“I was concerned that staff would touch my CRPS hand. They promised they wouldn’t and kept that promise!”
We hope you will enjoy taking part in all of the sessions on the programme and will continue the strategies when you return home.
People that get the most of it are those that make a commitment to changing their behaviour in the long-term. Living with long-term pain is complex and there are no simple solutions - working towards your goals takes time and perseverance.
“Being able to speak to the other patients with CRPS has helped me so much, as I now do not feel I am the only person with it”.
“All the staff have been excellent, extremely knowledgeable and friendly (easy to talk to), as well as always being there to help”.
“As a result of the programme I have found a little bit of me again”.
“I have learnt new skills to manage my condition and feel more confident with my ability to explain to others”.