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Bilateral TKR Got out of surgery at about 5pm 6/4/2013

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harplayer said:
I am the BoneSmartie whose PT told me to do squats/deep knee bends during my session today...all I can say is OUCH! I did some as requested...they were very shallow...very slow...and 7 hours later...I am still achey...even with pain meds...so..please listen to your knees! This PT is very obsessed with the possibility of the development of adhesions..so he is very aggressive with me...and I am attempting to reign him in. Will I develop adhesions if I don't push through the pain as my PT suggests??
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AAAAAAAAAAAAAAarrrrrrrrrghhhhhhh NO. Lock him up
gazelle7777 said:
s...is it normal to be able to do deep knee bends on the 9th day?
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No

Gordon Bennett what are these people thinking? It's impossible using either polite or profane language so say NO strongly enough.


Do not push through pain! It never helps and will have no effect on whether or not adhesions develop.


The purpose of ROM exercises is to increase - duh! - range of movement. It is NOT training, which is what a knee bend is. I can imagine little worse than putting that level of force - your body weight - through damaged knees.

See my link (below) or any of the others in the library about flexion and extension exercises which don't use force.
 
Thank you Roy, Diva and Referee!! I will REFUSE these knee bends!!
 
Harplayer - that is a really good question and I'd like to know the answer since i develop keloids (excess scar tissue) and am concerned when i have my RTKR in December. I hope you feel better soon!

Hugs,
Denise
 
denpucc said:
I'd like to know the answer since i develop keloids (excess scar tissue)
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Keloids, as what I understand, are on the outside of the incision on the skin. Adhesions---if one gets them---are a reaction to surgery inside of the surgical area after the sugeon closes the wound.

Some people get adhesions---i did---it is important to understand that most people do not get them.
 
Day 10

Today is probably the worse day so far. No sleep last nite, up and down constantly. My pain pills just did not kick in. My knees are so stiff and achy. This morning I felt terrible. Got up around 9 and sat up in a chair, waiting for 10 am for my next pain pill. I need to get cleaned up to go to my post op appointment. Are their important questions I should ask? Should I ask for stronger pain meds? Is it normal to feel so bad 10 days after surgery? As I am tired, that is all for now. Will try to update later.... :gaah:
 
gazelle7777 said:
Are their important questions I should ask? Should I ask for stronger pain meds? Is it normal to feel so bad 10 days after surgery?
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I did not feel at all nice after surgery---for about two weeks---but I did have pain meds that worked. I would tell you this---if you are in pain, and your pain meds are not doing the job, you need to talk to your OS or your GP and get something that does work---there is no reason for you to be hurting when so much can be done for you.

I believe if you can get the pain meds taken care of, your sleep issues should subside.
 
harplayer I agree that some people are predisposed to adhesions. Also, I had six previous surgeries on my left knee which also predisposed me to adhesions. I did have a spacer that was a little too small. My doc and I both felt that the slight movement from that added to the adhesion problem.

But, this is what my doc said to me in a firm voice: Do Not overexercise an inflamed and hot knee. If your knee is swollen--do NOT do anything to make it more swollen. The first job of pt in the first month is to help you get rid of the swelling. You should not do anything to increase the swelling---that includes, doing too much (in or out of pt), standing for more that 10 min. walking too much,--forget shopping for now., and, in my case, riding my bike too much in the beginning.

Now, if you are not predisposed to adhesions, they will not form--but, if you have had prior surgeries on that knee--why take any chances? Just take it easy the first month---you will get rom---more rom than you will get on a swollen knee.
 
Yes good advice not to over work a swollen and painful knee. In th booklet I got from the hospital here in Sweden it says that the main priority for the first 6 weeks is to do gentle stretches and gently build up an ROM - strength training should only be done if it causes no swelling and pain and should be cut out immediately if pain/swelling develops. So take it easy and forget about the aggressive PT as it will just delay progress

It also sounds like you need to get your pain meds reassessed if they are not doing the job
 
Something about strength training that needs to be discussed:

In developing strength in a muscle, it is important to work the muscle through the entire range of motion. If you are not doing this, you are not strengthening the entire muscle.

When you think about it, how can one correctly strengthen the muscle when one cannot utilize the muscle's full range of motion? If you do not have the ROM necessary to strengthen the muscle appropriately, then one must wait until the ROM is attained so the strengthening can take place throughout the entire muscle.

Gently work on the ROM---the strength can only be gained when the ROM is there.
 
Wow...such wonderful information and encouragement! :happydance: my PT comes tomorrow at 9:30...I will continue to educate him :groan:

:thankyou: everyone!
 
Dear Gazelle...
I hope your appointment went well today. Please let us know how you are doing...were you able to get better pain management??
:sleep: hope you get good rest tonight!
:console2:
 
Think about it---when one correctly lifts weights---the full range of motion is stressed. To do anything less is not strengthening the entire muscle---and why bother?

In order to strengthen the entire muscles you have to have ROM. Why try to strengthen, say, only 10%-15% of the muscle?
 
Good point Tim. When I think back to the early days of my recovery, I remember my at home and PT putting a rolled up towel under the back of my ankle. He said it would help straighten my knee. However, my quads were totally "asleep" and not functioning at all, and this simple exercise was excruciating for me. He wanted me to stay like that for 5 min. but I could not take the pain it caused. Now this was when I had a knee infection and my entire leg and knee was twice normal size. Also the heat in my knee could melt ice in minutes! It did nothing but cause pain that I did not need on top of everything else. My point being, we must be our own advocates when it comes to PT and pain. All of this occurred before I found Bonesmart!

My quads did not start to function for 3 months. I feel that most of the PT I had up to that point was useless. I could barely do heel slides and could only lift my leg with assistance. Yet I went 3 days a week. Once my quads fired up and worked I had 3 more months of PT that helped. My ROM is not great, flexion of 115! It took me 6 months to get to an extension of 0. I truly feel that this was caused by too much PT early in my recovery.:sad:
 
UPDATE..... Well my post op visit was not to helpful. I brought up trying something else for some of the pain that current meds were not helping. She just said I could take 3 pills instead of two pills prior to PT. that they really did not find the other drugs any more effective...I am not a good patient advocate for myself..and feel it hard to speak up as well as I could have. I did get my stitches out and it feels good to have them out. I just hope as days go on I will find the pain is less and less.

My warfarin levels are still too low, so I will have to take a higher dose until my levels get to where they are suppose to be.

Tonight I feel pretty comfortable, so I hope it is a better night for sleep(what is that?..)

Good night all! :zzz:
 
JUst be careful---a lot of foods interact with warfarin and it is very unstable. So, you can go from too little to too much very quickly. If you increase your dose, you need to be checked again to make sure it is not too much.
 
skigirl said:
JUst be careful---a lot of foods interact with warfarin and it is very unstable. So, you can go from too little to too much very quickly. If you increase your dose, you need to be checked again to make sure it is not too much.
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Hello Skigirl! Thank you for posting. I am going in every five days to check my levels during the time I am on it. It was not my choice for blood thinners....but what my Dr. Likes to use. There are pros and cons on all of them from what I have read. My normal diet(before surgery) was very vit. k rich as I really am having a hard time eating healthy without my greens!
 
It is okay to eat greens as long as you eat the same amount every day.
 
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