Posted 8 a.m. Tuesday, Nov. 22, 2022

UW-La Crosse student Christonna Shafranski was feeling out of sorts, with chills and an aching pain in her back that wouldn't go away for two weeks. She had a hard time focusing on her studies and kept wondering what was wrong. Shafranski says a UWL physical therapy class helped her put it together that these feelings were more than typical back pain.

Shafranski learned about the red flags of infection in a UWL pathophysiology class as part of her physical therapy program curriculum. Chills, a low-grade fever, and continual back pain were actually symptoms of pyelonephritis, a kidney infection.

"I kept checking these boxes and I didn't know why," says Shafranski. "It was interesting to see how accurate those red flags are that we've learned about in class, and how it can make a difference if you pay attention to them or not."

UWL Assistant Professor Steni Sackiriyas, who teaches Pathophysiology and Pharmacology classes, wants students to understand the possible mechanism behind the development of a disease, as well as signs and symptoms. In the clinic, a PT would need to identify the disease characteristics from multiple diseases and narrow down to the one that closely stems from the patient’s current neuromusculoskeletal conditions vs. other medical conditions. If the characteristics do not fit what a physical therapist can treat, then they would be referred to appropriate healthcare providers for further examination. This must happen in a timely manner to provide safe and effective physical therapy services and other medical care, he notes.

"This is an advanced-level skill that requires multiple layers of thinking and taking timely action for collaborative care," says Sackiriyas. "I try to impart this skill to my students and encourage our students to listen to their patient’s complaints because I think it may hold a key to successful physical therapy treatment."

Sackiriyas adds that he is glad Shafranski paid close attention to the details discussed in class and she could catch her own body's signal for further medical attention. 

Pyelonephritis can become very serious if left untreated. Shafranski ended up going to urgent care. She describes the pain as being in her mid-to-low back. The pain would get intense if she was bumped or moved in certain ways such as putting on a backpack.

"It felt like I kept getting punched from the inside," she says.

Blood samples, a urine analysis and a Murphy's test determined she had pyelonephritis. Shafranski was prescribed an antibiotic and she is now feeling much better.