TKR Kneeophyte’s Left TKR

[Layla]

I've been declaring nightfall a bit on the early side so I can justify sock removal

I don't blame you.

I fantasized about burning compression stockings also. They're awful. They do their job, but you don't miss them one little bit. Have a nice weekend, Kneeophyte!

 

[sistersinhim]

Not all doctors are requiring those torturous things anymore. Mine didn't, never after 12 knee surgeries did I have to wear them. At least your time is getting closer to getting rid of them!

 

[Kneeophyte]

@sistersinhim : Yes, I've wondered what fraction of doctors insist that using compression stockings is important. Both my sister and my sister-in-law had knee replacements in 2025 and neither of their surgeons recommended they wear them

I think my surgeon is a maximalist, he seems to have an unusually long list of what he wants his patients to do. But when I've wondered whether something is really necessary, my home physical therapist has been quick to remind me that my surgeon does more knee replacements than nearly anyone else in California AND has that he has an exceptional record of success with patients following his protocols.

Can't argue with that, but it doesn’t stop me from questioning some of what he recommends.

 

[Layla]

I think my surgeon is a maximalist, he seems to have an unusually long list of what he wants his patients to do.

I can relate, mine was the same. I followed what he advised, begrudgingly, because I felt if I didn't and something went wrong, I'd want to kick myself.
I will add that in the years I've been with BoneSmart, the wearing compression stockings has been on the decline. Hopefully you'll be able to give the socks "the old heave-ho" after your post op in Wednesday.
Good Luck!

 

[Kneeophyte]

Yesterday was Day 13 and I had my first post-op check up with a physician’s assistant on the surgeon’s team. Despite the detailed “after-visit-summary”, that exam was actually very brief. Mainly, the physician’s assistant fussed because he measured my flexion as 95 degrees when he wanted it to be about 110 degrees.

Between all I’ve learned from BoneSmart and from Knee #1’s recovery, I don’t find 95 degrees at 13 days terribly alarming. One goal I do have is to make enough progress to get off Tylenol 3 (a codeine acetaminophen combination) so I can be driving when my Good Spouse has rotator cuff repair surgery on Nov 25.

I’ll continue working with my physical therapist, I find him heaps more thorough and helpful than the physician’s assistant I saw yesterday. But I’d love comments (especially on reaching my goal) from this forum as well!

 

[mendogal]

You're great at under two weeks!

My surgeon - a maximalist but was strict that in the early weeks Less is Better! - had a goal of 90 degrees at three weeks.

We have had plenty of BoneSmarties take way longer and did just fine!

 

[Layla]

Glad you're feeling optimistic and not pressured by unrealistic goals and timelines. Keep doing what you're doing...you'll get to where you want to be.
Have a great Friday and weekend!
@Kneeophyte

 

[Kneeophyte]

I’ve never done this before, but I emailed the physician’s assistant I saw for my 2-weeks post-TKR visit, asking him to correct the after-visit summary. The summary stated I denied a list of issues (things like digestive problems, nausea, dizziness, etc.). But in fact, he never asked me about any of those issues during the visit and I HAD experienced several of those problems.

I’m sure of this because my Good Spouse was present during the exam and driving home, we’d discussed how we were surprised that I wasn’t asked about those types of problems. My physical therapist asks those questions every single visit.

Maybe the physician’s assistant was just having an off day, who knows? I’ll be curious to see how he responds. No matter what, the summary shouldn’t contain patient statements that the patient never made.

 

[Jamie]

Good for you! A person must advocate for themselves and double check each visit’s documentation these days. It was also good your hubby was with you to back you up.

 

[Layla]

Great you had that extra set of ears along with you in your husband so you aren't doubting yourself.
Hopefully it's not a habit of this PA to just check boxes when in a hurry.
With any luck he is reminded of the importance of documenting these details, slows his roll a bit and takes more time for accurate record keeping. Have a great week!
@Kneeophyte

 

[Kneeophyte]

Re. the Physician's Assistant whose after-visit summary claimed I'd denied experiencing certain problems when that wasn't true (he hadn't asked me and I'd had some of the problems): I emailed him without copying others, hoping he'd simply apologize and make the correction (hopefully also resolving to do a better job during future patient exams).

Guess I'll give it a few more days and if he still hasn't made the change or otherwise responded, I'll file an official correction request. I believe US regulations require medical practices to respond to requests like that within 60 days.

On the recovery side, my knee seems like it turned a corner (can I say that?) this weekend and became much less stiff. I'm at Day 19 and there seems to be no problem flexing it to reach 116 degrees. That means I can start tapering off Tylenol3 (acetaminophen and codeine), I'm happy about that!

 

[Jamie]

Great news about your knee. Disappointing about your PA, though. I’m glad you’re going to follow through with a complaint if things aren’t fixed. You should have had a response the next day.

 

[Layla]

Sounds like you're doing well, Kneeophyte! I hope it continues. Keep doing what you're doing, slow and easy.
It's still very early days.

As for the PA, it was very thoughtful of you to reach out to the PA, privately. You could try following up by asking him to confirm that he received your message since you haven't noticed any change in the notes summarizing your recent appointment. I'd ask for a response by the end of the day on whether he received your email because you want to ensure that your records are corrected / accurate, or you plan to contact the OS to make sure this is addressed promptly.

Good Luck! Have a great Wednesday.
@Kneeophyte

 

[Kneeophyte]

This morning, I checked once again and the untrue statement had vanished from the after-visit "Progress Notes". I haven't heard anything from the Physician's Assistant so far. He's supposed to do a check-in phone call sometime in the coming days and I'm curious whether he'll mention it.

Regardless, I'm glad to have an accurate progress report. And I hope being asked for the correction will remind this PA to actually ask people about common issues (digestive problems, nausea, dizziness, etc.).

 

[Kneeophyte]

Have you run across this campaign - https://march2amillion.com/ - to have patients recover from joint replacements while minimizing use of opioids?

I’m a bit surprised that my surgeon is publicizing his support. He tends to recommend a longer list of medications than most. And he pushes his knee patients to reach rather aggressive range of motion targets (e.g. 0 to 110 degrees by Week 2), making it clear the medications may be essential to accomplish those targets.

 

[Jamie]

No, I hadn’t heard of this campaign. There really isn’t a lot of information out on their website about the “why” and “how” behind it, so I’m neutral about the effort at this point. I did see some mention about the doctor who is behind it stressing the subvastus (side of the knee) approach, so this may make it possible for less pain after surgery. The idea is to only use 10 or less opiate pills after suregery. That’s basically a couple of days. I guess we’ll see how it goes. But I do hope surgeons don’t try to guilt people into this if they really have pain. After all, vast numbers of patients who recover from joint replacements are not the problem with the opioid crisis. Most use the pills as long as they need them for pain, taper off, and then go on with their lives.

 

[Layla]

Kneeophyte, It's great to read that the PA corrected his errors on your medical records, but kind of odd he didn't acknowledge it in some way. Hopefully he does next time you speak. If it were me, while I wouldn't want to humiliate him, I feel I would bring it up, if he doesn't, when he checks up on you within a few days. Consider mentioning the incident and the correction letting him know how much you value having accurate records. He should at least acknowledge his mistake, offering an apology and reassurance it won't happen again. Hopefully that's his plan.
Wishing you a nice weekend!
@Kneeophyte

 

[Kneeophyte]

It’s been almost a month since my TKR. After tapering down, yesterday was my first day totally off Tylenol 3 (acetaminophen and codeine) and just using over-the-counter medications (ibuprofen, acetaminophen, aspirin). Tylenol 3 makes me drowsy, so without it, falling asleep and staying asleep were both challenging last night. But even so, I’m glad to be moving on.

 

[Jamie]

This a big step forward. Your system will get back in rhythm soon.

 

[benne68]

Good for you. As Jamie says, your body will readjust.

In the meantime, stay on a regular schedule with your other pain relief medications. Give yourself a couple of weeks before you try to step down anything else.