[REVISION TKR] Story of My Knees by RestAssured: Pt 3

O.M.G.! (about the size of your leg.)

Hmmm, what does your PT say about that? I am so sorry that you are discouraged.

Sonja, Bless your heart! I am so glad to hear you are doing well! You are in my prayers!

Glad everyone is home...

Man you have waaaayyyy tooooo active a brain and body to be able to sit and be still don't you?

I don't know about the patella thing...

It has only been about two days ago that I actually was able to see mine because of all the swelling. What do you mean not going up with extension? Does it feel stuck or twisty when you straingthn your leg? What happens when you do quad sets? It seems to me that the patella would lift up with quad sets and glide with knee extensions.

I agree with BJ talk to your PT... I think you are allowed to call them even if you aren't scheduled for a few days. I'm sure they would be glad to talk to you.

I was taught to manually move the patella gently across its range when I do my scar work. Maybe they need to show you how to do this manual exercise to help keep things mobile. ( And maybe not... it might be best for them to do patella ROM at first)

Keep us posted.

Chris

Well, that's just it. Katie has labeled me as an "exercise' patient, so she has the aides work with me. She works with another patient while I am there. I had to ask her today if my foot was straight while I was walking in the anti-gravity treadmill, and she seemed put out by that. Since I went back to PT, I am no longer feeling like I am actually making any progress. When I try to push my knee to the table, one side of my knee will go down, and the inside of the patella just lies there! It is so weird, and at the same time so frustrating! i feel like i am am going backwards instead of forwards. I was in a wheelchair at rehab, a walker and zooming around on crutches and feeling great! Now, I am still on crutches and going backwards and wondering why Katie thinks that I should not be more of a priority. Yes, I guess you could say I am going into a funk and I hate feeling like this! I will be talking to Chris the head PT tomorrow, and then Katie to decide what I am going to do from here. Sorry, I just need to vent! I am so tired of looking at a leg that has a knee that won't do a leg lift, because the kneecap shifts over to the left. i can't do quad sets, because the kneecap shifts over to the left, and I can't do much of anything off of crutches because the kneecap shifts over to the left! (Yet Katie says all I need to do is strengthen the muscle on that side but she won't work with me to do it!)
Does anyone know what causes the patella to do this? Josephine, Jamie

Oh Sonja, I am so sorry that you are down in the dumps and feeling so discouraged and seeming to go backwards instead of forward... And then Katie just seeming to ditch you Hang in there!!! I am sending ((((((HUGS)))))) and I am praying for you, dear one.

I do not know at this point if Katie has ditched me or if it is because I have been classified a workout, that the whole thing has gotten out of control! I am bummed to say the least, but really I think it is with their terminology that put me in this predicament in the first place. I am not a workout, able to be with just an aide at this point, though it would be nice! That would mean that I was almost ready to be on my own and I would be ecstatic! I have been in PT for almost 2 years now, and I am ready to get this knee whipped into shape, get the muscles strengthened, and live the life that I have envisioned since the start of my jouurney! No, i am not laying this on Katie's shoulders, the head PT is the one who makes the call about who is a workout and needs an aide, and who needs more help. I will have answers after tomorrow though. I intend to talk to Chris in the morning, and Katie when she arrives at 1:00. If she wants, Valerie is every bit as capable as she is, and I will switch. Sometimes, it comes down to a misunderstanding, so I will give Katie the benefit of the doubt until after our talk! Thanks for letting me vent tonight! My husband listened to me also, even though he was tired. He thinks the way I am approaching this is a good idea.

Chris I can lightly touch my patella and it will pop, pop, pop, Popcorn anyone?

Sonja,
I am a PT, I do not move my patients on to aides, we do not even have aides. If your insurance is paying or you are paying for PT, the PT should see you, and only the PT. In limited circumstances aides are appropriate, but not for the whole session.
If you are paying to use the the PT office as a gym, then aides are OK. Stories like this make me.
Your PT should be treating you each and every visit for no less than 15 minutes, insist on it, your successful rehabilitation depends on close monitoring.
Where I live we are required to keep all aides, assistants, and students in line of sight for direct supervision, Medicare has even stricter guidelines for time spent with PT in direct care.

Please have your kneecap looked at soon, it needs evaluation and appropriate treatment.

Thanks Pumpkin! I had a very informative meeting with Chris this morning, and he is going to take care of the situation! I had requested Katie, and that's how I moved to a PTA and I never had minded until now. Chris will talk with her this afternoon, and if the situation is not resolved, I will move back to his schedule or Valerie's (my choice)

Sonia;
I am not trying to be mean here, but if I was working with another patient and a patient that I was not working with was demanding my attention, I might get a little upset too- both as the PT AND the patient.

Also, in your last post you said that you had requested Katie so that is why you had a PTA, but now you seem upset about having a PTA? Or am I reading that wrong?

So that sounds a little mean the way I worded it. It was not intended as mean, I meant that maybe that is why Katie seemed put out.
Sorry you have to possibly change therapists.

Coachie, first of all let me set the record straight. Chris is the Pt, Katie is the PTA, and then they have aides. Since I was "labeled" as an exercise patient, it was assumed under their new computer system that the aides were the only ones who had to work with me. Not true..... On Mondays, Wednesdays and Fridays, my schedule is set with Katie. You are correct, I requested her, and if we can get past this problem of "exercise" patient, vs patient then all will be fine. According to Chris, I wasn't supposed to know the difference, it was just the way they were coding it. Well..... somebody forgot to give Katie the memo and all I have been working with are the aides. My insurance is paying for a PT/PTA to see me for at least 30 minutes a session and I have been falling through the cracks. Coachie, I would not encroach on another patient's rights. I know that there is a certain time when the PT/PTA has the aide take over and do the icing. That is when I was talking to Katie, and I tried to wait for her yesterday to discuss this matter but it didn't work out so tomorrow we will talk before I start therapy. If she decides she has done all she can for me, then I will move on to Valerie, and I will understand. What has failed is a lack of communication on both of our parts. Katie is allowed to "double book" if she has one that is an exercise patient and one that is a patient. I have been moved to the patient side.

When I talked to Katie about if my foot was straight or not she was sitting at her desk. She wasn't working with anyone at that point.

Glad to hear you will be getting the care you need.

Thanks Chris! Right now all I am doing is sitting here crying! I hurt so bad. The knee has been acting up and I sure hope we can start making forward progress again tomorrow!

Maybe that's why I am hurting! I can't sit still. I am using my crutches though!

It's funny, before I had my knees replaced I was a couch potato! My brain was always active and kept me in trouble though!

Huge HUGS and lots of love from St. Lou to you! After reading your posts this past month I can tell that you are determined to be active and fully participating in all aspects of living. I bet you even feel better emotionally when you are moving. When other people that you count on to understand you don't it creates conflict. Good for you that you voiced your concerns and expectations re: your PT sessions.

Perhaps it would be a good idea to discuss w/ your PT the therapy goals they have for you and the goals you have for yourself. It might be enlightening to you both. For example, when do you expect to be able to transition to more weight bearing? When do they? Given everything you have gone through what do you think is reasonable for strength and stamina in one month? In 6 months?

It seems that conditioning exercises and strengthening exercises must be very carefully and slowly increased, there may be weeks where you feel that you are just spinning your wheels, however you are progressing you just cant see it. Your body will recondition just give it time. I can't even immagine the amount of muscle loss you have had over this past few years, I can't immagine the frustration and fear you have already faced but time wise you might be right in the middle of your recovery. I used to work in a rehab setting for people who had spent months in the hospital. A gauge I always used for time to recovery was to take how long the person was sick and double that for expected time to recovery. Not losing ground is progress.

I think a good cry help now and then. What you hve been through is more than I could manage without going totally bonkers. Try to get your pain under control tonight and try to sleep. Maybe tomorrow will be better.

Maybe it Is time to give traditional PT a pause? Would you like to try something new? I tried yoga once when my stress levels were very high. It didn't work for me because I couldn't become still and quiet enough but you might like it. Call around and see if there is someone near you that does adaptive yoga. If you have a stable near you that has therapy horses you might want to call them. Hippo therapy has been found to benefit core muscle strength balance and release stress.

Just some things to think about.

Chris