When you are as passionate about climbing as Meg Coyne, the sport forms the central crux of your life. In her case, climbing was something she competed in as a youth athlete, developed as a professional career as both coach and team manager, and which has formed a key part of her social life.
"The people you climb and train with occupy a large part of your life," she says. Add to that the complexity and eternal problem-solving nature of climbing and it's a sport, she says, "that's a forever project to a lot of people."
But an unexpected medical condition put her climbing future in jeopardy. It also highlighted to her the importance of open communication and trust when it came to working with her primary care provider to safeguard and improve her health on terms that drew on her own values and priorities.
Five years ago, while she was vacuuming her car, one of her limbs went from climbing ally to obstacle in a matter of seconds. Her right arm turned purple and swelled full of blood to the point it was three inches larger than her left arm. It wasn't the result of a climbing injury, but rather a condition called venous thoracic outlet syndrome, where a vein that runs from the neck to the armpit is pinched between the collar bone and the first rib. While it didn't remove climbing from her reach, it changed to some degree how she climbed and how she participated socially in the climbing partnerships at the heart of so much of her life.
In 2019, Meg moved to Salt Lake City to join USA Climbing as the national team's manager and coach. Her condition worsened in early 2020. She lost all dexterity in her right hand, unable to use a pen or do a quick drawing. She went to see a primary care provider about her right arm. The provider thought that Jordan Knox, MD, a University of Utah Health primary care provider and sports medicine specialist, would be a better fit for her needs.
"It was like being set-up on a blind date by someone who knows both of us," Knox says with a laugh.
What Meg appreciated was how quickly he put her at ease when she visited his clinic at U of U Health's Sugar House Health Center. "He acted like a person and allowed me to do the same, making me comfortable enough to ask questions." He asked her about her life and shared a little about his. Meg talked about her passion for climbing and the fundamental role it plays in both her professional and personal life.
"It's very hard to be a patient," Knox says, "and put your trust in someone who you hope not only has your best interests in mind but actually knows what your best interests are. It can be helpful for patients to take stock of their day-to-day long-term goals and values so they can share them with their provider."
In Knox, she found an advocate in medicine, someone who could run point on her case, particularly when it became apparent surgery was necessary. Having been healthy and active most of her life, surgery was a troubling prospect. Knox was akin to her medical representative on her case, helping communicate with specialists about issues he knew to be of concern to her. He describes his role as "a quarterback position," working with specialists, coordinating some of that care, while also being able to address options offered by specialist providers in a personalized way that reflected Meg's values and priorities.
The relationship became particularly beneficial when what was expected to be an hour operation in August 2020 turned into six hours and resulted in a more complex and challenging recovery than initially thought. Because of how well Knox and Meg communicated, she says she didn't feel the regret she might have had when she found that the operation had left her temporarily unable to lift her right hand above her head. Through Knox, her health care team had a clear idea of what she was and wasn't willing and able to do for her recovery and how important it was for her to be allowed to climb. By December 2020, she was climbing an indoor wall at the Front Climbing Club. "The more I move, the more I can feel my ability coming back," she says.
Knox has some advice for patients seeking a primary care provider or hoping to drill down into the kind of relationship they want with a provider:
- Recognize you may need several visits to feel things out and see if the provider is a good fit and someone who you feel will listen to your concerns.
- Consider what's important to you about your life and your health. Are you trying to avoid needing medications? Do you need to stay functional no matter the risks? How important is it to know what is causing a symptom, rather than simply making it better?
- Think of your provider as a sounding board, where you can get another perspective on your experience of health or symptoms, no matter how silly or complex you might think your questions are.
- Recognize that there are some limitations to the relationship. Only the patient can truly address their own health care habits. No one can care more about a patient's health than the patient themself.