Momentus decision: Return to work yet?

[Josephine]

Jo, the OS don't want to see the patients after they leave the OR. They feel their work is done and go get on with your life. They have never rehabed anyone, and probably never have had surgery. I had one OS tell me "I don't want to talk to these people, put them asleep, let me cut them, and send them on their way."
They don't know about anxiety and what level of endurance someone must have to return to work. You have to work with the whole forest and not just the tree.
David

And don't I know it! :th_heehee:

You know, a psychologist was once on record as saying there was very little difference in personality traits between a surgeon and a serial murderer! Makes you think! :doorscary:

 

[LinZee77]

Be that as it may, I spoke with my bosses and they expect me back next Tuesday, which I committed to. I will be renewing my FMLA when it expires, with the help of my Rheumy. This way, I can give it the old college try and if it seems too much too soon, I can at least take a day off now and then without being harrassed.

On an encouraging note, my last P/T session went very well:yes 4: She seemed to be giving me a battery of goals to meet, much like the previous post which gave a list of milestones to reach before considering returning to work, and I passed each one without much difficulty. Among these included the stationary bike 10 mins, 30 step ups, treadmill with only one hand holding on at a 1.5 rate for 10 min, waking up a flight of stairs and back down several times in a natural gait, and walking heel to toe, as quickly as I could for about 50 meters without a limping gait and without a cane. However, the caveat was that I was rather sore the next day.

I don't think that my job will require as much of sustained activity as the P/T sessions, but it still will be a long day and my work building complex is quite large to navigate even with accessable handicapped parking areas. I will just have to bring some portable ice packs and lots of advil and tylenol to get through it.

I really didn't mean to paint my OS as an unfeeling ogre, but I think his standards practice is thus: if he expects his patients to strive for independence and autonomy, it just may be a challenge at first but in the end will bring desired results of maximum healing to both mind and body for this often agonizing process of TKR recovery. I also believe that this attitude has to make for a thorough and competant surgeon, who really are quite incredibly admirable individuals, considering what they are faced with each and every day in their work.

Best to all in their recovery,

LinZ
LTKR 5/9/11
LK Arthroscope 9/16/10
RK Euflexxa injections 12/10 & 7/11

 

[Josephine]

if he expects his patients to strive for independence and autonomy, it just may be a challenge at first but in the end will bring desired results of maximum healing to both mind and body for this often agonizing process of TKR recovery. I also believe that this attitude has to make for a thorough and competant surgeon, who really are quite incredibly admirable individuals, considering what they are faced with each and every day in their work.

I think you are heroizing surgeons. They are quite often disinterested in post-op care and therefore issue edicts with little or no thought to what the patient is really going through.

And TKR recovery should never be an "agonizing process". If it is, you're not doing it right.

Sorry but them's the facts, my dear.

 

[lionsm13]

Work 1/2 days for 2 weeks and then go back full time.
You should be ready by then.

 

[LinZee77]

I think you are heroizing surgeons. They are quite often disinterested in post-op care and therefore issue edicts with little or no thought to what the patient is really going through.

And TKR recovery should never be an "agonizing process". If it is, you're not doing it right.

Sorry but them's the facts, my dear.

Jo, with all due respect., it was not that I was trying to paint surgeons as flawless, super-human idols. I was only trying to point out that we would all be in real hot water without them, even if they seem to be detached and often, as you put, disinterested in the post-op part. I think this attitude is really is just a coping mechanism that seems to put them at odds with the patient's "whole self", not just the body parts that they fixed.

Oh, come on now, I think it is safe to say that many of us would agree that TKR recovery is agony at some point (particularly the first few days to first weeks) until it is not any longer.

If I have been going about it wrong, that is a shame, because I actually admire your advice, this site, and its contributors, and feel hurt that you are projecting this on me when you really do not know me or can see in person just how far I have come. I feel that I have really made excellent progress and am just beginning to feel very at peace with the whole experience.

But que sera
best to all in their recoverym
Lin Z

LTKR 5/9/11
LK Arthroscope 9/16/10
RK Euflexxa injections 12/10 & 7/11

 

[Josephine]

Oh sorry - didn't mean to come over all bossy and that. But surgeons mostly don't care to be too involved with their patients afterwards. But I know a few who do and they make great doctors as well as great surgeons.

I was actually more thinking about the many hundreds of 'guests' who read this forum on a daily basis. No-one in their right minds would suggest there's no pain involved but it shouldn't be 'agony'. I stand by that.

But y'know, sometimes I need to vent in here as much as anyone else! Don't take it too personally.

 

[Jamie]

Lin....is there any way you could do a few half days or maybe telecommute for althernating days?

You are going to be very tired, hon.....I feel for you.

I happen to completely disagree with your surgeon's hard line approach, but that's just my opinion. I know that people who are working have to do what is necessary with their jobs. Just know that I'll be thinking of you and hoping that you get accustomed to the activity level as soon as possible.

I was impressed with the "test" your therapist gave you....and you passed. That is a good sign. Hang in there and you will get stronger as each week passes.

 

[kneesrus]

I agree with Jamie and lionsM. Give the wheel a test drive before going on the Freeway.
David

 

[lionsm13]

I think you are heroizing surgeons. They are quite often disinterested in post-op care and therefore issue edicts with little or no thought to what the patient is really going through..

No true-er words spoke there Jo.

That's what I've always said and thought, is that once they're (the OS's) done w/you they really don't want anything to do with you..

After I saw mine for the first time after the PA took out the staples. He said, "Exray's look perfect. "See you in 3 years." I'm like "that's it, and he was yep, "That's it."

When I went back to see him 4 months later and said "How come I'm not getting along as good like so many other's, and still have lot's of swellng and pain, he said, " I have no idea why you are still in the shape you're in."
Boy, if that wasn't a confidence builder?

So I do agree w/your comment about your OS being dis-interested in your post op situation, and that is the frustrating part of it, is that there is very few concrete answers to our questions, at least it has been for me anyway.

I guess that I would liked have known what I could have really been up against while I was recovering, rather than worrying and such all the time.
It was and is still spooky at times, but it appears to still be making progress which is a good thing..

However it was and has been very trying at times..and it does take it's toll on you and makes you doubt yourself as well as many other of the less-er desirable human traits.
Make no mistake about that one.

 

[LinZee77]

Well I made it through two days of work so far. Went Tuesday, then took off Wednesday b/c of the sudden need to stop taking Advil ( severe acid reflux at night). Now back again today, sans the Advils. Took two extra strength Tylenols and drove to work. Okay until about 10 AM. Had to take Nucynta for pain. Luckily it does not make my head all fuzzy like the Percocets. I took a an ice gel pack for icing, and used twice in the 8 hour stretch (was able to use the an ice box @ nurse's office, yes we have a staff nurse at my job, even a couch I can use to elevate if I want)
I have not been using my cane at all. It is really beginning to feel like MY knee and despite some stiffness and discomfort, I actually DO feel better than before the surgery!:yes 4: I have been told by many of my co-workers who saw me in my sorry state pre-op that I look transformed.
Having a day in between did help, so really all I am working this week is three days. The real test will be if I can make it through five consecutive days. Of this I am not so sure. I have been icing and resting alot when I get home, trying hard not let my knee get too mad at me.:wink1:
Note to Jamie- Thank you for your kind concern for me, but I cannot telecommute due to security reasons and the nature of my work. Because my OS did not specify part time work in his letter, only "light duty", I can only work part weeks (less than 5 days) until I can extend my FMLA which I am in the process of getting an extension on (from a different physician, the rheumatolgist). Because of the distance of my job, it doesn't make sense to work shorter days. Once I am there, I just stay the full day.
And yes, Jo, truth be known, I actually am still ticked at my OS for being such a hard a**, but I still maintain that at least he did the surgery part right, and I am thankful for that much.

best to all in their recovery,

Lin Z
LTKR 5/9/11
LK Arthroscope 9/16/10
RK Euflexxa injections 12/10 & 7/11

 

[Bees Knees]

Do you have someone to fix your dinner while you elevate,ice, and relax after work? I would come home and fall asleep for the first few weeks. I would wake up to eat dinner and then go to bed. My husband was very helpful. I can now resume my cooking duties and work.

 

[Jamie]

It sounds like you have things under control. The good news is that it will get easier as the weeks go by. I think almost everyone who starts back to work at whatever point in recovery feels the lack of stamina at the beginning. But your wonderful body will build itself up. Just keep doing what you're doing to rest when you can, take off when you need to and get as much help as possible at home. You'll make it just fine!

 

[LinZee77]

Hello all Bone Smarties
I have not been checking in for a long time, except to look at other posts now and then on my smart phone.
I am at four months post -op now, and been back at work for almost a month. Here are some stats...(if anyone really wants to know..hehe)
The first two weeks where pretty difficult, but after resting,icing and elevating I was even able to squeeze in two P/T visits AFTER work during the week and actually complete the course of P/T with successful discharge Now I can even work all day without needing another dose of pain meds (usually just tylenol or advil in the morning) until after I get home.
I also took a long weekend trip from Long Island to Boston to visit my son and his girlfriend in their new condo, took the ferry (with all the staircases!)and in their condo which also has three flights of steps. We took many hikes and even a sightsee stroll in one of the area's oldest arboretum memorial cemetaries. All pretty good, considering the pain I was dealing with both before and immediately after the surgery.
However, I am very disappointed to report that I think I have developed plantar faciitus (sp?) in my right foot from the way my gait is now after healing from the knee replacement. I was reading some of the older posts about it, and are using some of the suggested exercises, and remedies, which help at times, but the pain from this is very bothersome and just discouraging since as my operated knee gets stronger, and my overall energy level has really increased nicely, I have this one dark cloud ruining my recovery. :hissyfit:
Tuesday is when I am scheduled to see the OS for the four month post op follow up. I do plan to ask him about the heel pain. Is there anything else that I should request from him? I hope he doesn't think I am being a chronic complainer, but while this is the kind of pain that isn't quite as bad as the knee pain by a long shot, I can't just ignor it and hope it goes away on its own.
best to all in your recovery,
Lin Zee
LTKR 5/09/11
LK Arthroscope 9/16/10
RK Euflexxor injections 12/2010 & 6/2011

 

[Jamie]

Lin....you definitely need to deal with the plantar fasciitis right away. It rarely just gets better on its own.

First of all, did you purchase NEW SHOES following your surgery? You must do that because all your old ones have old wear patterns from walking the way you were before surgery.

Your orthopedic surgeon may not be the best person to talk to about this problem, but you can bring it up anyway. You really need to see a foot specialist - either a podiatrist or an ortho who specializes in foot issues.

Don't feel bad....it can be cured!!! I had the exact same thing happen after my TKR....plantar fasiitis in the opposite foot. Unfortunately, I didn't take my own good advice and let it go too long. I had to wear a brace for a couple of months to allow the torn tissue to heal again. Plus I did a ton of stretching exercises after the brace for another 6 weeks to get the ligaments back in balance. This is nothing to mess with and all your walking on your trip probably made it act up even more.

 

[LinZee77]

Lin....you definitely need to deal with the plantar fasciitis right away. It rarely just gets better on its own.

First of all, did you purchase NEW SHOES following your surgery? You must do that because all your old ones have old wear patterns from walking the way you were before surgery.

Your orthopedic surgeon may not be the best person to talk to about this problem, but you can bring it up anyway. You really need to see a foot specialist - either a podiatrist or an ortho who specializes in foot issues.

Don't feel bad....it can be cured!!! I had the exact same thing happen after my TKR....plantar fasiitis in the opposite foot. Unfortunately, I didn't take my own good advice and let it go too long. I had to wear a brace for a couple of months to allow the torn tissue to heal again. Plus I did a ton of stretching exercises after the brace for another 6 weeks to get the ligaments back in balance. This is nothing to mess with and all your walking on your trip probably made it act up even more.

Hi Jamie
I actually had been reading a thread where you gave an account of your experience with the plantar fasciitus, and started by aquiring those heel inserts (Dr Scholl's) which I can use interchangably in my various diffferent pairs of shoes that I wear to work.
Unfortunately, for me the cost to replace my entire shoe wardrobe would be astronomical! Being of the female persuasion, I have at least 20 pairs of shoes that I would be hard-pressed to just throw out.:rolleyespink: However, I will take your advice and at least buy a new pair of walking/athletic shoes because I believe it was my old Pumas sneakers that may have been the culprit when I used them for the longer hikes during my trip to Boston. I also have been doing some of the suggested stretches and exercises, along with just plain resting and icing the heel, as well.
I did see the OS today, and he gave me some literature from his database on the condition, and suggested I contact a podiatrist, and who will know just how to manipulate the facsia band when he examines me.
And to the other bone smarties and observers:
BTW the OS took xrays of my surgery knee and everything is right where it should be...so on that front I am really happy and thrilled with my new knee and have to say it was worth all of the hard work (i.e PT for 12 weeks, icing 'round the clock, recovery pain management, and most of all that time and patience. So if you are feeling alittle down, all you TKR's out there...
there truly will be a time when you do turn the corner, I promise you.:yes 4:
best all in your recovery,
Linda Z
LTKR 5/09/11
LK Arthroscope 9/6/10
RK Euflexxor injections 12/2010 & 6/2011