I'll hold off on Tylenol unless I feel discomfort/pain.
At 5 weeks, you should still be on a fairly regular regimen of pain meds. So I recommend Tylenol 3-4 times a day. Prophylaxis is the word! There is a lot of pain we can get which is low grade meaning it's grumbling along in the background. This can cause problems without us even being aware of it. The evidence of this is swelling, stiffness or generally being uncomfortable. Don't ignore those.
k, last time, you sure I should stop going to PT?
No pain, more gain!
Absolutely! Remember, many of us did no exercising whatsoever - not even so much as a single heel slide and got rattling good outcomes!
Anyone see any issues that I cover my incision with gauze
For what reason, may I ask? I've worked with surgeons who did major surgery like heart transplants and similar and never ever put dressings on their wounds, not even so much as a spray of plastic skin! Their reasoning was that "God's good air" was better for wound healing and in 99.9% of cases, it was! Mind, I wouldn't recommend that for a new TKR or THR wound but at 8 weeks, it will do it good to be exposed to air!
but advise improperly on PT?!
They do it because it was the norm between 1970 and the present. At that time, they too agonised over the horrors of adhesions, which were a lot more common in those days for various reasons - the surgery took longer - 3-4 hours sometimes - they made huge incisions (14-18" long!) and were very rough with the tissues during the surgery all of which contributed to the development of adhesions - and almost every other patient had to have an MUA in those days.
So now the teaching is to make smaller incisions, be gentle with the tissues, be more stringent with haemostasis (stopping bleeding) and washing the wound with cooling, cleansing saline with a kind of power wash and as a result we don't get adhesions and wounds heal more quickly. But they still cling to the old notions.
I recently engaged a professor friend of mine (young and a knee surgeon) in an email discussion about this and he recoiled in horror when I told him I was advocating no exercises. He said 'but this is what we've been taught for donkey's years' and I pointed out that that was the point - 'donkey's years'! Things have changed a lot and (this was the seminal comment that changed his mind) "we have to stop brutalizing these patients in the mistaken notion that it's necessary to get good ROM". So now he's looking into getting funding to do a research project on it! I am so delighted!
I believe that some surgeons are afraid that their patients will do nothing at all and not move due to the pain.
Exactly so, Granny!
I don't think it's all about the money.
Also very true - which is why we don't tend to do it that much in the UK!
United States
