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[TKR] Hello everyone

Tykey

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Great story to hear. These little victories keep happening, sometimes they happen when we don't even realise it's happened.
 
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ouchstl

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First outpatient PT today was far easier than what the home PT lady wanted to subject me to. Only one exercise: Lying flat and tensing the quad muscles in order to retrain them to start working in harmony to lift the straightened leg up. Did it many times, and she also massaged the entire area, including quad muscle quite vigorously. She gently moved the knee cap around, searching for sticking points and not finding much. She did straighten the leg 100% and managed to be quite gentle, seeing no reason why full ROM could not be gained in time. She repeated many times that the first order of business was retraining and strengthening the quad muscle.

The knee was protesting quite loudly by the time she put the cold water machine on, but it was manageable. As with last week, I left a message with doctor's office concerning pain med refill in the AM and heard nothing back. This strikes me as quite unprofessional and I'm debating having another outfit check their work or at least answer my questions promptly and thoroughly.
 

Celle

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I'm glad things are going well.

She gently moved the knee cap around, searching for sticking points and not finding much.
It's not a good idea to let her do that. Mobilizing the kneecap isn't necessary. It will mobilize itself, as your knee heals.
 
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ouchstl

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Had nearly a week long delay in getting back to PT. My instructions were simply to practice tightening the quad muscle in anticipation of lifting/ extending the leg - which I could not do without a cheater cord at that point. Lo and behold, at some point I regained the ability to exactly that and was a bit exited to show off my newly rediscovered ability. You'd think that would be worth something, right?

Wrong...dead wrong. Had a substitute PT ROM Nazi and she was clearly not impressed with the degrees. Always the degrees! Never mind that sitting flex was closing in on 100%; I was still far away from where she thought I should be in other positions. So she attempted to get me there manually and yet again I had to bluntly remind her who exactly is in charge of this particular recovery. It is so unnecessarily awkward...that silence that envelopes after their "29 years of experience" is trumped by simple bodily possession. It is 9/10ths of the law after all...as they say.

Fortunately, I don't see this specific young lady and her 29 years on the remainder of the schedule. But I'm quite sure she left some nasty notes for the others to view. Translated simply and concisely; they should read DO. NOT. PUSH.
 

luvcats

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Well done to keep your "NO" handy. How unfortunate that your sensible, gentle PT wasn't available.
 

Rather

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Good for you in sticking to NO. Years of experience in not listening to patients may deliver a paycheck, but they don't always equate with doing what is correct for you.
 

kneeper

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These PTs annoy me with their scare talk and pressure tactics.
You're less than a month out and have 100 degrees of bend? I'd have been overjoyed with that. It took me 6 weeks to get to 90. (Though I gained more after that. 6 weeks is about when the swelling finally started to visibly go down, and lo and behold the bend increased quite nicely.)
 

sistersinhim

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If she got her training 29 years ago, then that explains why she's so far behind in the proper way to rehab a joint replacement! She needs new training. You for you sticking to your "No!"!
 

marieltha

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Loved your “simple bodily possession.”

I’ve had some very positive PT experiences in the now distant past, mostly due to my insurance’s requirement (was working then—pre Medicare) that I be treated by only a fully licensed therapist (no aides, trainees, interns), that it should be the same therapist for continuity, unless I requested a change. Only one time did anyone “other than” get substituted (last minute? someone out sick? Blah blah), and my insurance not only did not pay for the session, they followed up with the owner to ensure I was not billed!
Usually, I was treated by an owner, almost always someone with a PhD in PT.

My present OS does not send his patients for PT unless they absolutely will not do the exercises he assigns.

Glad you held firm. Do not be afraid to request continuity
 
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ouchstl

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Wow...just wow. The PTs are just incredibly stubborn. Had one with my regular person last Friday and she made me want to push myself. It was the first session of PT this entire go around that ever earned me a compliment...as in "I'm very happy with what I saw today." It cost me a weekend of stiffness, but I'm a month post op this week and figured I could push it a little.

Then a sub today and he was hell bent on establishing dominance. Forcefully straightening the joint and putting his hand under my knee and on top of the bed and exclaiming "we should not be able to slip our hand in there - see how flat the other one is?" "You mean the one that wasn't operated on," I clarified? He didn't care for that.

Then he went the other way until I said "stop" with my hand raised. It felt like a corner of my knee cap was going to snap right off. He looked irritated and said we need to do better. I fixed my gaze upon him and spoke very slowly (my daughter said this still shows up in her nightmares from time to time, she's in her early 30's): "Please let go of my leg." As I got up off the bed he actually pointed his finger at me and said, with a red face, I needed to tell him sooner when the pain was increasing. I grabbed my cane and slowly walked away without another word. We nearly made a full session based on time; based on pain we did a session and a half. I'm not allowing any more subs.

I just don't get it. You would think they have access to even more information than we do - yet all they care about is a few degrees within a certain time. Has to be a financial thing, as in we need to demonstrate our willingness to push them or the surgeons will not recommend them any more. I can't imagine the surgeon I've used four times now would be on board with this. However I intend to clarify when I see him this week.

Standing strong...and sometimes without my cane.
 

sistersinhim

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Good for you taking control of your session. It is so strange that even in the same office, the therapy can be different by different PTs. It makes no sense.
 
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ouchstl

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Regular PT gal today. Two full revolutions on an exercise bike after many attempts immediately prior. Went right up to the brink and had to back down numerous times; just needed to ease into it and increase pain and squeamy meamy tolerance a little more each attempt. And then - over and through. She considered it a major accomplishment, roughly equal to a full buck's worth of flex.

One month follow up with surgeon tomorrow - I was sorely in need of something positive to report. You know...to keep all those threats of MUA at bay. people.
 

mainegirl1

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They cannot do an MUA on you without your consent. It is barbaric to even threaten! My OS never insisted on certain flexion. He was more concerned with extension and had me sit on sofa with foot on ottoman with no support underneath several times a day to improve extension. It did not happen. He did not get upset.
When I had the hip replaced on the same leg.. the extension happened with the realigned hip.

Good on the bike though expect that there will be harder days when you can't do a revolution now and then. And close your ears if they get upset at that.
 

kneeper

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Full revolution! Score!:egypdance: It really is a milestone. Congrats.
 

luvcats

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Full revolutions already is a great milestone! I hope your surgeon visit goes well.
 
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ouchstl

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So a full revolution on a bike is roughly 100 degrees of flex. Cold, I can do 90 with mild to moderate discomfort/pain. Getting the full revolution yesterday set me back as far as general comfort with nominal movement, but everything is settling back down. I just sat on my chair and made sure I could still do 90 easily enough.

Would you believe the surgeon is insinuating 120? One. Freaking. Twenty! At four weeks! When I set that on the goniometer it seems like my knee will split apart before I even hold close to the knee for comparison.

I use the word "insinuating" carefully as it's hard to pin them down. They are careful to give lip service to the extent that everyone is different - all the while making a point to say that most people are beyond where you are. At one point he stated he is not necessarily disappointed with 90 degrees at one month.

:gaah:

Sometimes I suspect they are merely trying to get you to think "90 degrees, hmpff! I'll give you 105.

I'm really thankful I found this forum this time around.
 

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