TKR Dewey Did It...#1 AND #2

[Lagrange]

I was lucky. My therapist knew not to push. I worked to the point that I felt I was challenging myself but not to the point of pain. Maybe you need to either get a new therapist or just tell her your plan.

 

[kneeper]

Hi Dewey--just catching up on your thread. Sounds like you've had a tough time with nausea. Have you tried icing just before and just after trying the exercises? My guess is yes. I would just keep working on it. Things are not dire re: your ROM.

 

[bottomshollow]

Notice that this says nothing about pain! Your PT is wrong about getting the numbers NOW. As long as you continue to bend and stretch just to discomfort, things will slowly, but surely, get better bit by bit. So what if it takes a month to get where she wants you in a week---you'll still get there.

If you allow her to push you into pain----your knee is going to rebel by swelling and hurting even more and making bending and straightening impossible. What good is that, for Pete's sake? And then, you'll have to wait for the swelling to go down to get started on the exercises again. A vicious cycle, if you're not adamant about doing it the BoneSmart way.

This is your knee and your recovery----take charge---and do it your way!!!!

 

[Dewey]

Hello, again...

I'm just going to again try to get some opinions on my pain control and ROM. I am just about two weeks out now, and I'm only taking Tylenol #3 for pain. Stronger medications caused terrible nausea, and I'm allergic to all NSAIDS. I am tolerating the Tylenol 3 so far, and they are keeping the pain manageable while sitting, sleeping, and light exercises. I can tell, though, that I'm not able to bend as far as I could while taking the stronger meds. I'm getting worried about all the hard work that I have yet to do. Pain is not my friend, and I have a hard time making myself hurt!!

I'm just wondering if you all think I will be able to do this with the minimal pain control of only Tylenol #3?

 

[MyKneesAreCooked]

I'm at about the same point you are and I'm cutting back on the narcotics. I do find that I do a better pt session if I'm using the drugs. That isn't as much a hard and fast rule the further I get away from the surgery. I definitely think that even if the PT didn't hurt, it fatigues my legs. That fatigue has become pain as the muscles cooled off for a few of my sessions. I'm ok with a little pain as long as its not causing swelling and setting back the recovery. I haven't had any swelling that wasn't fixed by a little rest and ice.

I have my first follow-up with my surgeon this Wednesday. I would guess that he's going to downgrade the drugs that i take. Though I'm naturally not sure of that.

 

[Dewey]

I'm still looking for some medication advice.....

I know I'm not supposed to begin a new thread, but it seems like I'm not getting many people to read and respond to my question here.

I just need some reassurance that I'm not jeopardizing my progress by not taking the stronger narcotic medications. Can I actually increase my ROM slowly while only taking Tylenol #3? I can push to discomfort, but PAIN is out of the question for me with this medication. I try, but I just can't do it! I'm just so worried that I'm hurting my chances of a complete recovery.

Can anyone help?

 

[referee54]

Dewey---I will tag Josephine and see what she has to say---she is the expert in this area. Josephine

We will do our absolute utmost to get you help in this area!

 

[referee54]

I can tell, though, that I'm not able to bend as far as I could while taking the stronger meds. I'm getting worried about all the hard work that I have yet to do. Pain is not my friend, and I have a hard time making myself hurt!!

I would like to say this---if you are working hard, you are working too hard. Take it easy and do not attempt to rush things---listen to the knee and let the knee dictate what yo can and cannot do. Trying to rush the ROM may be counterproductive and you may anger the knee; trust me, I did it a few times and had to learn not to push or rush things.

I was lucky in that my PT's knew just how far to go---there were two sets; one set worked on joint replacements, while the other set of PT's worked on the more "athletic" type of injuries. You cannot rush recovery and you should not be hurting...only to the point of discomfort.

 

[referee54]

I can tell the PT that comes to my home doesn't think I'm working hard enough on it, and she tries hard to push, push, push. She tells me I must get those numbers NOW or it may not come!

Hogwash---there is no "window" for ROM---and it can be gained up to a year---and beyond. The notion that "if you do not work hard now you will never get ROM" is not at all true. Take it gently!

Please remember that the PT works for you. She should not be telling you that ROM may not come, as there are many members of the forum family here who can validate the notions that ROM can take quite some time to gain---but it does come!

Do not let that PT hurt you, please.

 

[Josephine]

I am tolerating the Tylenol 3 so far, and they are keeping the pain manageable while sitting, sleeping, and light exercises. I can tell, though, that I'm not able to bend as far as I could while taking the stronger meds. I'm getting worried about all the hard work that I have yet to do.

Honey, you are only 2 weeks out and that is much too early to be fretting about ROM. If T3 is all you can tolerate, that's perfectly fine. Just do gentle exercises and rest, elevate and ice lots in between times. You'll still get there. There is no need for 'hard work' in this at all. Once the pain and swelling are under control - by whatever means you can achieve it - you will find the ROM is all there, just waiting for the chance to show itself. Somehow people have the idea that their knee is stiff and they have to get it working. That's not the case. Remember this article? Swollen and stiff knee: what causes it?. This is the only reason you can't bed it much yet.

I can tell the PT that comes to my home doesn't think I'm working hard enough on it, and she tries hard to push, push, push. She tells me I must get those numbers NOW or it may not come! I know BoneSmarties know differently, but it's hard for me not to worry about it. So far.....I'm only at 70 and 12 for straightness. Is that terrible? Should I be worried??

I know it's hard to have confidence that these things will come when the PT is drip feeding you with negativity. But you must believe that her way is the BAD way. You don't need her, she is not helping you. You can manage without her. She has it all wrong anyway with that 'window of opportunity' garbage! The numbers will come. They definitely won't come now because a) you are only 2 weeks out b) you are all swelled up and c) you have inadequate pain management.

I might even go so far as to say fire her and do it all on your own but you probably won't care much for that idea. But you can complain to her manager and say you want somebody who will be more gentle with you given that you have such a major problem with pain meds. They must listen to you as you are paying them for their services which makes you in charge not them! Be assertive and insist on having someone kinder.
You might like to read the potted version of my recovery to see how little exercising I did! Knee recovery - UK style

 

[referee54]

Thank you!! Thank you !!

 

[Dewey]

Thank you....thank you.....thank you! I so appreciate your help and encouragement!

I really, really want this to work, and I want to have a great outcome. I don't want to do anything that will cause that not to happen. I've been feeling like I've been TOO easy on my new knee and causing the bend to get even harder. My therapist tries to make me believe that it must happen now.....She wants me to be over 90 by Friday! I'm only at 70 so far!

I've learned lots and lots here, and I'm going to try to calm down, go easy, and just let it happen! I will work with my PT, but I will not let her push to get those numbers that she wants! Thanks for telling me that is OK!

I continue to be thankful that I found this site! Thanks so much!

 

[referee54]

and I'm going to try to calm down, go easy, and just let it happen!

There you go! That is a great idea! Recovery is something that really does happen. It is not all about working hard, attacking PT (while some of wanted to attack the PT!!! ), or about having a tremendous work ethic. Patience is the key and gently work the knee. Try not to worry about things (I know that that is difficult because of all of the down time)---and just let recovery happen.

 

[Toothfairy]

Hi Dewey,
Sounds like you are doing amazingly well. It's such a short time since you had your surgery and you need to be resting and letting your leg heal. No need to worry about proving anything and reaching magic numbers dictated by your physio. You are an individual and will heal and improve at your own rate. As the others say pushing will actually cause swelling and hold your recovery back. Listen to the bonesmart words of wisdom and you will be achieving great things before you know it.
Listen to your knee and take it gently.
Take care, sending healing hugs and calming thoughts,
Toothfairy x

 

[Lagrange]

My sister gained 12 degrees of ROM just by living a normal life after PT. it was because after a number of months all the swelling went away and her knee could bend better.
I intend to give my knees a year before I expect the most.

 

[Titianlady]

My sister gained 12 degrees of ROM just by living a normal life after PT. it was because after a number of months all the swelling went away and her knee could bend better.
I intend to give my knees a year before I expect the most.

Now THAT'S the right attitude!! We say it over and over again, a swollen knee will not bend. You've got the formula down!!! BRAVO!!

 

[Titianlady]

You, know, I had a PT that recited the BoneSmart mantra to me from the first day he came to my home 3 days after I was home from the hospital. No pain equals more gain, never pushed my knee, gave fabulous massages etc., BUT still spouted that same ' window of opportunity' line. He told me that he wanted me to 120 degrees bend by 4 weeks because if not, the adhesions or scar tissue would set like cement!! I could hardly believe it!!

I was at 120 before the 4 weeks with no problem at all, and this was before I found Bonesmart. Once I started to get the real story here, I was appalled that even good PT's still scare the pants off patients by telling them they will have knees that won't bend if they don't get to a particular number in 4 weeks!!

I wonder if they really believe this, or are told they have to say this to motivate us to get that knee bending. Even that makes no sense because my PT was the one to tell me a swollen knee won't bend!!! It's enough to make one crazy.

Thank goodness for BoneSmart!!

 

[kneeper]

Yes, don't be a lump but don't push yourself so hard you have lots of pain. If tylenol 3 is what you can tolerate, then work with it. Finding the right combination of exercise and rest --and rest is an important component--can be a bit trial and error. YOu are very early on and seem to actually be doing pretty well. Fooey on your PT for scaring you.

 

[Jamie]

Dewey, I'm also going to encourage you to go slow and definitely NOT allow that therapist to push you before your knee is ready. Recovery takes time and she is so wrong, wrong about you only have a set amount of time to gain ROM. We have members add to their ROM numbers a year or more out from surgery with just everyday activity and gentle stretches on a regular basis. This was how my recovery went, so I know it's true!

Are you icing like crazy when you're not up and around? You know, ice is VERY good at relieving pain. I even kept ice on my knee all through the night. Just be sure there is a towel or something between the ice source and your skin so you don't get freezer burn. And don't let your therapist tell you that you should only ice 20 minutes at a time. That might be true for an injury, but it does not apply to a joint replacement recovery.

 

[Josephine]

Dewey, how are you doing? I've been worrying about you and would like to hear from you. I think about everybody has chimed in on this but I just want to emphasis that this IS the better way. It has been shown without doubt that hot, angry tissues form adhesions much more readily so making them hot and angry is definitely not the way to go! BTW, did I tell you that in the UK the "bonesmart way" has been the usual for years and provided the format for it? And that we have a significantly lower incidence of MUAs than in the States therefore proving that it works?