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TKR Graduated!

I was ignorant when I started PT, he was in charge. I had more than 90 degrees flexion the day of surgery for my first walk. I honestly do not beleive he has helped me, I made no ROM (126/6) progress after 4 weeks. We finally got to no pain, but that seemed to be frustrating to him. I just am blessed with fast healing and a great OS. I was driving to work (with permission) after 2 weeks without cane or crutches, before I started PT. I feel a little guilty reading the issues folks here have, but I am very happy working pt on my own.
 
@jmdearras the good thing is that in everyones story there is somthing to learn. Good to see that despite your PT you have done well and continue to do so. Best wishes for that continued pain free improvement. See that you re west and just down the road from me....
 
Hi there, my OS said my Attune "sports" knee would max out at 137 flex. I believe him. And I am glad to know it because that way I won't shoot for 140 flex. Now I range between 125 and 130.

Also you sound like you are doing great for about 6 weeks. Congratulations!
 
after a week of mild, casual exercise (and a lot of walking), my wife measured my flexion at 129, up from 126 after PT. her measurements matched the PT ones, so I am confident i added 3 degrees in a week, after no gain in 4 weeks of PT!
 
so I am confident i added 3 degrees in a week, after no gain in 4 weeks of PT!
Hooray! No Pt = improvement, again. After leaving PT 3 weeks ago and ignoring all artificial exercise (that is anything unrelated to normal living activities) I am now able to walk downstairs like a grownup. I have been working full time, preparing meals, cleaning house and caring for my elderly parent. That's plenty o' exercise for anyone. I have no measuring tool but that is surely evidence that my flex has improved. Add to that the when lying down I can get the back of my knee to touch the bed and there you have it.
 
@gaelan01 This is an excellent comment and I think you have put your finger on something very important. My PT has been honest with me about how PTs are more or less graded on whether their patients met certain objectives in a certain amount of time. He has to write up my progress not only to his own organization's management but also to my surgeons. He (this particular PT) didn't feel that there was pressure on him but then he's sort of at the top of his group of peers and can shrug off that pressure ... lots of other PTs may not feel that way.

There must be a way to get out of this trap. Some kind of discussion with management perhaps that will result in not penalizing the PT for things that are really out of their control (and our of OUR control, as we all know too well.) At the very least it wouldn't hurt to bring the "grading system" out in the open. Your question about "who do they really work for" is perfect.

I suspect the whole health care system in the USA is riddled with this issue, in many forms and in all corners of the industry from inpatient to outpatient to pharmacy.
 
It could be insurance looks for numeric progress to keep a provider in system.
 
Pre and post-op
[Bonesmart.org] Graduated!
[Bonesmart.org] Graduated!
[Bonesmart.org] Graduated!
[Bonesmart.org] Graduated!
 
I had a discussion today with my PT about numbers vs motion. He said it is all about insurance for them. No improvement in numbers, insurance says you aren't progressing and they no longer authorize payment for PT!
 
Now a lot makes sense! No wonder he was so desperate to get a number change the last day! what a horrible system.
 
I am really enjoying this group, and have learned a lot. But one thing stands out to me. My surgical experience seems different. simplier, than most. X-Ray, no mri. OS never discussed the type of TKR, I did not know there were choices He did ask me my goals. Pre-op, I washed 3 days with special scrub soap. Surgery was epidural and nerve block, with IV drugs to sedate me and make me sleep. Early in surgery, it was obvious my sleep apnea was an issue, so they woke me for the rest of the surgery it was their first choice, intubation was next :(. Boy, was it noisy! hammers, saws, etc. I felt nothing, they could as well been working on someone else! I heard the staple gun, and the anesthesiologist told me they were closing the wound. I was wheeled into recovery where I was to stay until I could push and pull with both feet. Odd, not being able to move them, but had a nice conversation with the nurse until I could.

I was then wheeled to my room. OT came shortly afterward, and had me walk with a walker. She was surprised my leg folded to past 90 degrees when i sat on the edge of the bed.

My only meds were percocet for pain, and aspirin for clots. no leg machines, no anticoagulant shots, etc.
I used a walker 1.5 days in the hospital, arm crutches 3 days, and a cane one day. Off percocet in 5 days (long story), changed to tylenol. I was driving to work 14 days out. Doing great!

Then I started PT. :(
 
@analysta I would agree that numbers whether artificial or true permiate the system and form the basis of progress which can be used to justify or support actions. While changing the system will take some time in the interim the best guard for the individual patient is to be as informed as possible and have the gumption to just say "no" when a course of action is not in our best interest.
@jmdearras love the x rays. Like many things the bell curve applies with quick and straight forward surgery/recovery on the left and complications on the far right and speaks to the fact that individual results vary by person. Your experience has been tremendous and like the guy with the bktr on youtube running around his driveway 12 days post surgery something to aspire to. Continued good fortune with your recover and in a PT free environment.
 
OK, I am going to find out how badly I abused my knee today in the morning, I guess. My son and grandson came to the state fair and we went there to see them and the fair. (they live across state from us) I ended up walking about 5 miles per my fitbit, which is over twice my best previous day for the past couple of years and 3 times my post-op best. I'm home, now, and both my legs are so tired I can hardly walk. However, the knee is not swollen or in pain. I hope I just got my muscles REALLY tired!
:tiredwheel:
 
Ice and elevate when you get home! Hope you're not too sore maƱana!
 

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