Need input / opinions about PT

[Dedicated_Dad]

I never seem to be able to write a post that's not a book-full. I am sorry, but can't see how I can make it any shorter... Input appreciated...

I have been going to a different PT since my revision.

On my first visit, when we got to the point where he wanted to "stretch" my knee, in flexion -- I resisted. Going back to 2002, having the PT bend my knee until I scream has never worked for me. Lots of pain, no benefit at all - in fact I tended to actually LOSE range of motion, not to mention the fact that it would cause the knee to "flare" and thus reduce my activity even further.

In 2002 I was prescribed a broken link removed: https://www.jointactivesystems.com/downloads/JAS_knee_flex_english_instructions.pdfand painlessly restores range of motion in a few months. After my TKA in March I got it again, and made decent progress to 120 degrees in a few months.

The new PT got sort of poopy about it - "if you don't trust my judgement, then maybe I'm not the right person to..." I gave in and let him do his thing, but asked him to - once he saw it was not helping - let me do it "my way." When he saw my ROM was not increasing he upped my visits from 2 to 3x per week, which made my knee flare even worse and actually made my ROM go backwards.

A few weeks ago he offered to let me try it "my way" but if I was not making progress we'd go back to their yanking method.

It took 7-10 days for the knee to settle down so I could actually work the JAS. Over the next ~week or I gained about a degree per day WHEN MEASURED IN A SEATED POSITION.

He insists to measure the same way he always stretched it - with me on my stomach on the table, knee bent, pulling my foot up toward my head with a strap. In this position I see no improvement, though in seated position it steadily improving.

It finally clicked that the real difference is in "seated" position hips are bent, while on my stomach hips are straight. The JAS stretches the joint capsule, but does not stretch the long quad-muscle that runs from the pelvis down over the top of the knee.

They insist this "stomach" position is "the ONLY one that matters", that the only MEASUREMENT that matters is the one they take when I walk in the door - that "if I'm not carrying it over from visit to visit then it is irrelevant."

For clarity, now the only acceptable measure of progress is measured on arrival, in the aforementioned position. Nothing else matters.

On PT days, I get up, make and eat breakfast, take a shower and get dressed, then get in the car and drive for 30-40 minutes to get to the PT office. By the time I walk in the door I am all stiffened up - it's about the worst possible time to measure my ROM ability.

Today he really leaned on me - he wants to go back to him pulling on it. He agreed that it hadn't worked before, but claimed "what you're doing isn't working either." Actually it IS working, just not in their pet position...

I pointed out that it's not hard for THEM to jam it just a little more and get one more degree - they're not the ones who have to feel the pain, not just while it's happening but from a flared-up knee, but pain that lasts for days and ultimately never stops.

The reality is that their stretching - like I tried to tell him on day 1 - causes my knee to flare up and hurt all the time. As a result, I leave PT and go home to my bed/ice and usually spend the next day also in bed with the ice, eating pain pills, trying to get it to settle down. I struggle to make myself even go, especially on Monday when I've had the weekend to settle it down a bit...

Further, I honestly don't see the importance in this "supine" position. In real life we sit, we kneel, maybe we lean back on our haunches, or squat, but hips are always bent.

I don't need to be able to lay on my stomach and touch my heel to my rear-end. The only real-world position where this would matter is if I were on my knees and leaning backward to touch the back of my head to the floor.

What's the point - especially when it causes me so much pain? It seems to me that they're concerned with showing "progress" in their records. If I let them jam on it, of course they can squeeze out one more degree each visit - THEY aren't the ones who have to live with the pain!! I'd happily comply if I thought there was any benefit - but I just don't see it.

I also asked - IF I let them yank on it, are we going to measure my progress in the EXACT same way? "well, we may push on it a bit to see if we can get it to go just a little further..."

Then we're comparing apples and oranges.

If I am going to suffer all of this pain, then I need to know that there's really improvement. You've set the standard of success - as I described above - for JAS, why does it change if I let YOU stretch me?

Now he tells me I have the right to refuse, but if I am not willing to follow his instructions then he will have to note in my records that I am not compliant with their instructions. This feels like blackmail - he knows I am fighting with my disability insurance company, and they constantly review my records.

I spoke to another PT today - she always measures ROM in a seated position, she doesn't want to undercut someone else, but doesn't understand their insistence on this measurement since it is not in any way related to real-world functionality. She said if the patient is in pain the day after then she needs to back off.

I've about decided to switch to this other PT. I need some advice, here. I find it hard to accept something that hurts me so bad and has never - with 3 different PT's so far - done me any good. The previous PTs accepted the JAS and agreed that I made good progress with it.

Lastly, there's another point I think is important: They're telling me that my clunks because the muscles -- especially quads - are too weak, too loose. I have a significant "extension lag - my quads cannot contract short enough to keep knee locked straight while I do a straight-leg raise.

How does stretching my quad in this way benefit either of these? Seems to me it would be COUNTER to what I need to do...

The "flare" caused by their stretching makes my pain constant. With all my problems, I feel like I should work on strength and gait, and be able to exercise daily even if it meant ignoring ROM altogether for now.

If I can get the strength up, and the clunk stopped, then I'd have no pain and could then tolerate the ROM work! As it is, the flex-stretching keeps me flared and pain limits everything else.

Am I out of line? Is there any benefit to being able to touch my heel to the my rear while laying on my stomach? Is there any functional reason for this?

DD

 

[Linda2]

I think you need a different PT--maybe even at a completely different place. Where I had PT, they are much more hands on than many places. My therapist would put pressure on all the tight structures to help them loosen. While it sometimes hurt, it was the "good" kind of hurt, if you know what I mean. While they did stretch my leg in the way that you described, with me flat on my stomach, it never hurt or caused any problems. When it comes to measuring, they always did it with me on my back, pulling up my own leg on it's own. They said the other measurement is always less and, like you said, not functionally important. Seeing that my range is 140 degrees flexion and 0 degrees extension, I have to believe they know what they're doing. I don't know a therapist in the place that would hurt a patient like you describe. If it hurts too much, they find it counterproductive. I always looked forward to PT; it made me feel better.

My leg clunks, but there is no pain at all associated with the clunking. While I can believe that my quads are not yet strong enough, the pain that you feel on every step just doesn't seem normal. What does the OS say about it?

 

[JackieS]

My PT would take two measurements - active and passive. One was with me on my back bending the knee on my own as much as I could. The other was with me on my stomach with him forcing it as much as I could take. He always stopped when I told him to, but that was painful each and every time. But the pain stopped once he stopped and I generally felt much better leaving PT each session than I did when I went in.

My OS measured it with me on my back. I felt best in a chair doing the bend, but no one has measured it that way for any of my knee surgeries. I don't think it's a matter of "pet position" - probably more of a standard. You probably should change PTs, but I don't know if you'll find one who will do everything the way you want them to. I haven't encountered anyone who measures the bend sitting and the figures probably differ from either stomach or back as it's easier to do in the chair.

I don't think you should ignore trying to improve your ROM. If you do, there are increased chances of scar tissue building up. I know I started my ROM work behind time due to both a DVT and Baker's Cyst on the back of my knee and it was a struggle to get it to snuff.

--Jackie

 

[Simon]

Dad

Good PT is critical to recovery and even more so for those of us that have had problems with the TRK surgery or have had past surgeries. A physical therapist is just like any other health professional and you have to find one that you are comfortable with and have confidence in. Given that this PT and you have a clear difference of opinion and the PT is not listening to you regarding pain and problems, it is clearly time to switch. I don't think you will improve if you continue with the current one because you don't trust him and therefore it will be hard for you do to what he ask as well as probably tensing up just thinking about going there.

Given the problems I had with PT in the past, I investigated the PT's before surgery. This is a small area and there are really only 2 options. The main one which is part of the hospital or an independent PT. As soon as I walked into the hospital one I had a bad feeling, it reminded me of what I had seen in the past a kind of assembly line mentality with lots of PT aids. i also found out you don't always get the same PT. The independent one had excellent reviews and talking with him, I knew it was someone i could work with. I checked with the PCP (who is also part of the hospital system) and she agreed with my thinking.

I have a wonderful PT and because of him I avoided a MUA and after 5 months we made great progress even though for the first month we got almost no where but he kept working on it. He says I frustrate him because I won't till him if he is hurting me so he just keeps asking if things are ok. He
listens to what I say and if I say something like my hips are sore, he investigates and adjust things accordingly.

If measuring ROM lying on the stomach was the norm, I would flunk. In one of my early surgeries, the OS had to make a decision about how to do something as one way would keep the bend sitting and going back would be the same but less than it would be if he sacrificed the ROM going back. We went with the latter and so no matter what my leg does not bend back very far. We have been working with this as the position you described is very good for stretching out the quads and hamstrings.

My experience with 9 previous surgeries as ROM was always measured sitting. The reason is that is the position you need most for doing everyday activities like getting up from a chair, stair climbing etc. As you said there is no need to have your heel touch your butt.

Go with your gut and change. you don't need any more problems and you need someone who understands you are not the normally case and is welling to work with you not against you.

Good luck.

Simon

 

[Dedicated_Dad]

I appreciate the input.

I am a complicated case - I know that. The clunking makes me not want to walk, which makes it harder to strengthen the muscles, which (they claim) prolongs the clunking. I'd LOVE to walk, but it just hurts too darn much. Still, generally, I do my exercises at home... ONce they get my testosterone straight I expect my muscles will respond...

Don't forget too that I am using the JAS device and my SEATED ROM is slowly but steadily improving.

I let them yank on me for ~6 weeks and didn't gain any ROM, seated or supine. I've averaged a degree a day seated since they stopped yanking and I started using my JAS. There's no point in doing the JAS if they're going to yank on me - the yanking causes it to flare and the gentle JAS thing just won't work.

DD

One more thought: I went to this PT because they had a bunch of exercise equiment and I need to get my whole body in shape at this point - I've lost over 30 pounds of muscle since march. I told them this in the beginning. Every time I bring it up now I get "not now - we need to focus on the knee." Then why did I change?

The other one I talked to today is a friend of the family. I didn't go to her because they have no exercise eq... I found today they're moving 1/1/09 into a new facility with aquatic therapy and a full gym/health club in addition to the PT practice. Gym is $55/month or free for PT patients.

I think I am changing.

There's another guy @ PT - young (~50) and struggling. I have had to leave and go outside because it makes me ill to hear him groan and cry when they are yanking on him. I've been around a lot with this leg and it always hurts but I've never had them push as hard as these people do, and never had it flare me up and KEEP IT flared up the way they do. If I go in and my knee is visibly swollen, tell them they hurt me the last time and I spent the intervening day in bed, I expect they'd ease up a bit, but they'll push until they get a degree or few more than they had last time, no matter how much you scream.

I'm sorry to be gross, but I've had a lot of PT and never before have I blown snot on a pillow while someone was stretching my leg... It just seems like it's way too much.

The more I think, the more convinced I am becoming that I need to change. I just don't think we can reconcile their methods and my pain.

Again - after my accident in '02 I got nowhere until I started using the slow and easy JAS method. I got 120 after my TKA with my JAS, no PT-yanking. When I started with these folks in October they yanked for 6 weeks - no improvement - but I've gotten ~10 degrees (seated) in 10 days since I started the JAS. They say I've gotten nothing because their supine position is the only one that counts, and that only when I walk through the door. If I could cut my drive in half I bed I'd get 10 more degrees just because it would have less time to lock up while I am in the car.

I need to move.

 

[Rowdy66]

Dad, your posts are so difficult for me to read, I cannot even begin to imagine what you are being put through. From your description of the other fellow and his groans and crys it sounds as though you all are being put on the rack. Without a doubt I would have changed PT's long ago and filed a complaint against this PT for undue pain and sufferring. They are not listening to you! I just find it unforgivable that they are so unconcerned with your pain. As for taking the ROM measurement the way they are taking it I have never heard of such a thing. I hope you change PT's and that you insist on a letter being put in this PT's file and in your medical records documenting all of what you have been through. Good luck, Rowdy

 

[referee54]

There's another guy @ PT - young (~50) and struggling. I have had to leave and go outside because it makes me ill to hear him groan and cry when they are yanking on him. I've been around a lot with this leg and it always hurts but I've never had them push as hard as these people do, and never had it flare me up and KEEP IT flared up the way they do. If I go in and my knee is visibly swollen, tell them they hurt me the last time and I spent the intervening day in bed, I expect they'd ease up a bit, but they'll push until they get a degree or few more than they had last time, no matter how much you scream.

I'm sorry to be gross, but I've had a lot of PT and never before have I blown snot on a pillow while someone was stretching my leg... It just seems like it's way too much.

I will tell you something...when the PT came to my house after my BTKR's last November, I would bite down hard on a towel so I wouldn't swear or scream at her. Yes, it hurt that badly. My dogs were penned in the kitchen so they wouldn't try to rescue me.

When I was tearing adhesions over Christmas time, It hurt like a son of a $%^$; there are no two ways around it.

I was told up front that it was going to hurt---and that if I didn't get stuff done, that I was going to be MUA---and that was something that I definitely did not want to happen.

I guess you need to find another PT and try their way. You are not happy with the way things are going with this PT group, so you need to do what you think is right and move on.

For the record, though, I have never been in so much pain---and felt like I accomplished so little, as I did when the visiting PT came twice -three times a week. It did hurt, but I did regain my life back.

TSC

 

[Josephine]

I'm with Rowdy - sounds like a torture chamber. You're in charge - get a new PT.

 

[Dedicated_Dad]

I'm with Rowdy - sounds like a torture chamber. You're in charge - get a new PT.

My mother is a bit of a nut. She refuses to do what her Doctors tell her - if she doesn't like it, or think it "makes sense" then she just won't do it. She "doctor-shops" until she finds one who will go along with her...

Truth is that I'm frankly TERRIFIED of being as nutty as she is.

I feel sure that I am in the right here, but then again, so does she... If you heard her defending herself, she's convinced she is right.

It's not like I am refusing to follow my diabetic diet/insulin plan, refusing the CPAP even though she has 100+ apnea episodes in a 5-hour sleep study, but still...

Refusing to follow something painful or harmful when it has no benefit is not the same as refusing good advice, but then that too is a matter of perspective...

Is there any benefit to this sort of "hip-straight" stretching? This is the pivotal point for me. If there's benefit I'll suck it up and take it like a man, but I just don't see it.

When my hips are bent, I am making steady progress with my knee ROM. I can't imagine anything I'd ever need to do in day-to-day life where my hips would be straight and my knee would need to bend past 90. Even kneeling, if you sit back on your heels your hips bend as the knee does.

Wrapping it up, I still have a ~10-degree "extension lag" - when I try to do a straight-leg raise, my knee will bend ~10-deg before my heel comes off the table. This is a leftover from the 6-years pre-surgery when my knee was stuck ~15 from straight - my quads can't contract far enough to keep the knee straight.

Further, they're now saying the slack in my atrophied quads is causing my clunk - that when I get the muscles back everything will tighten up and the clunk will stop.

How does stretching the quad in such a seemingly unnatural way help with any of this? Is there any clear benefit to be gained from this pain?

DD

 

[ship4]

DD,
My advice? Get yourself a used total gym on Craigslist for about $150 and work on those quads doing exercises from the book.
Work at the exercises in the book, and slowly but surely you will strengthen the quad and the clunk will go away. My PT told me when the quad is firing at 100% the clunk is gone. Mine "clunks" occasionally. This is how I know I am not ready as yet to get back on my downhill skis.
Best,
Crystal

 

[JackieS]

It sounds like repeated quad sets may help you. In the end, you're going to obviously want as much bend in the knee as you can get. True, getting there is probably the most painful part of the TKR recovery ordeal. But I'd worry about that extension number just as much. I found that quad sets (on your back in bed repeatedly tightening and relaxing the quads) helped me get to 0. Since your extension wasn't good going into this, it may never be perfect. But, from what I've read, the closer you are to zero, the less likely you'll limp.

You're really probably going to have to switch your PT. I remember my PT telling me how each knee replacement is a partnership between the orthropedic surgeon, the physical therapist, and the patient. Each has to uphold their part of the partnership or it just won't work out well. It sounds like you not only don't like his methods, but he doesn't seem too thrilled with you either. It would be best to start anew, probably somewhere entirely removed from that particular PT. Go in with the idea of talking, but also be willing to compromise and realize that it is a hard recovery and there will be pain. You can't go into it telling them how to do the job they've been trained to do, but they should also listen to you and know the limits of what you can handle.

Another suggestion would be to do things which might keep your mind occupied and off of your knee. I found that when I was over-analyzing things (I had some surgical complications), I became more depressed. The more depressed I became, the more my knee hurt me. It was a vicious cycle. I managed to get beyond it and part of it was to stop struggling with my recovery. I did my exercises daily, but didn't push myself to tears. It was slow and steady. Each day I thought of something I could do that I couldn't do before.

Now at six months, I still have my clunks. I still have a weak quad (it was cut). I still occasionally lurch forward unexpectedly -- and, no -- not from drinking! I know I still have a ways to go, but I'm doing whatever it takes. Hang in there. And get a different PT to start off that partnership!

--Jackie

 

[Josephine]

I see an awful lot of "shoulds" and "oughts" in your posts, Dad. But bottom line is, are YOU satisfied with what you've achieved thus far? I can tell you, patients in the UK don't have anwhere near as much PT as you do over there and their results are just fine and dandy.

 

[Rowdy66]

Jo, I was so glad to see your comment about the amount of PT we have here in comparison to the UK. I had four or five weeks of PT (going once or twice a week) after my first knee scope. Only had to go to have the drain removed and go a couple of times after the second knee was scoped. I only had three PT sessions (once a week for three weeks) after my BTKR in May and I have done really well. I was able to do at home on my own the exercises that I needed to do and was at normal ROM and extention by week six when I was released by the OS. My OS was aware and in agreement that I was doing fine on my own, in fact he seemed very pleased that I didn't need to have further PT. Having someone come to my house was something my OS didn't even have in the game plan. I remember being amazed that others have posted about two or three weeks of inhome PT and remember seeing at least one post where the PT came to their house to check it out prior to surgery. I was given a list of suggestions on how best to set up my home for after I returned from surgery, i.e., putting away throw rugs and other common sense suggestions. I am not criticising anyone's having more PT than I did, please do not think that, we all do what we think we need to do and I realize I have been extremely fortunate in that I had no complications and recovered very quickly from the surgery. Rowdy

 

[Rowdy66]

Dad: I have to ask, why do you care what anyone else thinks about this PT? While we can sympathize and offer advice it is you, ultimately, who is the one who is going to have to make the decision if you are satisfied or not. All we can do is support you in your decisions. Normally it has been my experience that when a person asks my advice it is after they have made their own decision and they just want to be reassured that others would have done the same thing. Without a doubt if I were as unsatisfied as you have described yourself being I would have already changed PT's and there would already be documentation in my medical records and in the PT's personnel files that stated very clearly my reasons for the change, I wouldn't care one bit what anyone else thought about it. I do not mean to sound unsupportive or unkind and I totally sympathize with all the difficulties you have had. You sound very unsatisfied with the progress you are making as you have repeated several times about your ROM and inability to gain normal extention. You know Crystal made an excellent suggestion for strengthening your quads so you can eliminate the clunk. Buy a total gym and work on your quads. I was told by the ortho doctors at a major hosptial in the midwest when I was 40 that I would be in a wheelchair for the rest of my life, there was nothing more they could do for me. I was so angry and that anger made me determined to prove them wrong. I found a PT who would work with me and within six weeks of really painful work I was able to walk and I am still walking. The therapist who helped me explained to me that my pain was just that, MY PAIN. I had to decide how I was going to live with it. Was I going to manage it or was it going to manage me and my life. I chose to manage the pain and sometimes that means you do indeed have to suck up a certain amount of pain. However, the amount of pain you suck up has to be up to you, no one can tell you how much is enough and how much is too much. At times I thought this PT was the devil himself but hiis tenacity and constantly challenging me to push harder was what spurred me on to accomplish what I needed to accomplish. I really hope you find relief and that you find someone to work with who can get you to the place where you can once again live you life fully. Good luck, Rowdy

 

[Linda2]

PT is a very individual thing. In the U.S. it depends on the patient, the surgeon, and the insurance benefits. Many patients receive no PT at all once the leave the hospital on the third or fourth days. Their surgeons don't believe it's necessary. My surgeon is one of those who thinks you can do it on your own. I happen to think PT is essential, and I'm lucky to have insurance that pays for much of it. Therefore, I asked him to send me anyway, and he did. I'm a firm believer that good physical therapy keeps one from developing bad compensations for injuries, which I have a tendency to do if left to my own devices. It take much less therapy to avoid them than to correct them.

 

[Josephine]

Jo, I was so glad to see your comment about the amount of PT we have here in comparison to the UK. I had four or five weeks of PT (going once or twice a week) after my first knee scope.

You had how much?

I had NONE!! Not a single session! After about 4 weeks, I called in on them on my way off duty because I was worried about the pain I was getting at each step and she told me my gait was totally wrong. I was bending my knee as I put the foot forward and down. When I adjusted that, the pain was no more! It was a miracle! I was CURED!!

Never thought of having pt after the op - nobody here gets it.

 

[Simon]

Dad

I really don't think at this point it is about the pain as it is clear you will go with the pain if it is necessary. I think the problem is no confidence in the Physical Therapist and so you will be questioning everything they do. If I was you, I would find a new physical therapist that you can work with, then the exercise pain will be acceptable.

I can remember after my 1st knee surgery (when I was in the 20's) that when I started PT I kept telling them something was wrong and the knee did not feel right. They kept saying, it was muscle soreness from being in a straight leg cast for 7 weeks. I said no, I played sports long enough to know muscle soreness from this type of pain. Well, I let them keep on bending and pushing it and at the start of the third week when the swelling was about twice that of when we started, they decided I had better have it checked by the OS. The OS took x-rays but did not see anything but he said the x-rays would not pick up soft tissue problems (this was way before MRI) and he wanted to do a scope. Well that scope ended up being a complete surgery as it seems the patella tendon had become caught under the pilca. Now if it had not swollen so much and I had let then continue, the patella tendon might have ruptured.

When the cast was being changed after the 2nd surgery, the tech closed the door and said the problem is that the PT practice (they were part of the OS practice) had alot of PT aids and not enough PT to oversee things and the aids just follow the protocol no matter what. He then gave me the name of a private physical therapist and that made all the difference. This PT was aware that the other knee was a problem as well and adjusted physical therapy program to make sure we did not make that one worse. With him, I had a real partnership and it worked.

You know your body better than anyone and you have to find someone that will respect that and work with you and is willing to clear explain his plan and is willing to adjust as ncecessary.

You don't have a straight forward TKR and you need a PT that is smart enough to come up with a program to meet your needs.

All of us spent time picking a OS and picking a PT is no different.

Simon

 

[Dedicated_Dad]

Sorry - I missed that there was "page 2" until now...

I'm (obviously) struggling here... 9 months+ and another surgery since my TKR and I'm still crippled. 9 months of PT 2-3x per week plus exercising at home... I won't lie and say "every day" but it has been a good 3/4 of the time save the one month I took off prior to surgery on Dr's orders. My quads are still only 1/4 as strong as my "good leg." I'm in more pain, am more crippled, than I was before the TKR.

Hopefully getting the testosterone thing straight will finally help the muscles respond, but even so... I got the TKR because I was tired of being crippled. I was supposed to be able "to forget I have a knee" after 12 weeks or so. I see guys on TV running the Boston Marathon on a stump, I can't walk across my living room.

I'm just damn tired of all of it. I was 43 a couple of weeks ago. I haven't had any income since June - still fighting the disability fight to get what I paid for... I can't buy a "total gym" or anything else right now - I don't know how we're going to pay our mortgage.

I just can't believe all of this. It's honestly got me questioning my own sanity. Needless to say, I'm not getting a lot of support in my house - wife just wants my paycheck back. Teen kids just want what THEY want. Eldest is a Senior in HS -- 150+ IQ -- and is trying to pick a college, I don't even have the application fees, she has no comprehension of the situation. My income HISTORY is in the $100k range but we've always put all our $$ toward paying down debt like mortgage so have no savings - what we had saved is long gone.

She can't get scholarships because of my income history. Both girls have had to give up ballet after 11+ years because I don't have the $$ to pay for classes, shoes or transport. If I stop going to PT (or if my PT puts in their documents that I am refusing their recommendations) then my disability is gone for sure as soon as they see the docs...

Meanwhile, I'm sitting here with ice on my knee just like I always do.

I'm walking through my house today, relatives say "G*d - your doctor can't HEAR that??!!" talking about the clunking... Nope. Not with all the background noise - none of them have heard it yet. But they know what's wrong? I'm having trouble believing that.

I'm in this catch-22. Walking hurts so I don't walk - I literally CAN'T more than a couple of hundred steps in a day. Not walking keeps my muscles from building. Docs say weak muscles are the root cause of the clunking and the pain.

I'm seriously ready for them to take it off. In a year I could be running the Boston Marathon.

 

[AlaskanTKR]

Dad -
Man - I don't even know how to respond to all that you are dealing with. I am 42 and my other half is not the most supportive - but at least we don't have the financial issue - mine would like me to stay home but I can't.. I would go nuts and get totally depressed.
i am 4 months out and have finally started to feel human in the last 2 weeks. i now have hip issues - but that will be dealt with during Christmas break. we have great insurance (thank god) and double between us. i am a teacher so I can manage at work and have great teachers and kids that i work with. my school psych has already offered to pick me up on the way to school if for some reason I cant drive after break is over.
My little one is only 9 (almost 10) so we don't have the college worries. Can your kiddo get some loans - depending on majors some of them can be paid off with service in your state (our state has great loan forgiveness for teachers and medical personel). i had trouble with loans when I went to school because of my dad's salary. the other way to try to help with school is work study. I did my master's that way - i worked and tutored for the college and they paid me in credits. it was tough becuase I worked 30 hours a week in addition to school and tutoring but I wanted it bad and so I was really willing to work for it. it was nice not to have a loan at the end of my master's program.
I ahven't had nearly the trouble you have experienced, but I can relate to the ice every day. it kinda is a drag. my big push has to be in work and make it through the day. That has really helped. once my hip issue is corrected this month my plan is to really strengthen my quads and get through the pain enough to get in really good shape again. everything has gone to pot since the tkr - but I was able to get in great shape 2 years ago b4 the tkr so I know I have the drive to do it again - and I will.

My heart goes out to you during this challenging time for everyone. the economy is a mess. fortunately living where we do - we seem a bit protected from it. Most of our jobs up here are the kind that are not affected by the economy in the lower 48 - I teach and my hubby is a miner - open pit drill and blast. this is the place to be if you can drill or blast - Good job security! His company has really good benefits and in case of an accident where he would be out of work they also have good benefits. hopefully he will always be safe. He was out once for a knee issue and they took good care of him and financially we were fine.

i know words are not enough right now for you...I hope there is someone out there that can help or at least can be supportive. As far as your wife - can she help out financially (is she already working????). Talk to your mortgage people and explain what is up - same with any creditors. talk with your kids - they are old enough to understand what is going on and how they can help. Community college is not a bad thing - The first 2 years are basic courses anyway - maybe by then things will be better and they can finish out at a bigger school. its ok. Seriously - I spent way too much on my four year degree - if I had done the first at a community college it would have saved me sooooooo much money! its time for the kids to grow up too! you can't do it all by yourself - ASK FOR HELP!!!

thinking of you and wishing I could share my or my husband's benefits.

Marianne

 

[Rowdy66]

Dad and Marianne, I knew Marianne was in her early 40"s but honest to God I had no idea with your problems you were in your early 40's as well. For some reason, I think because of the various problems you have told us about, that you were way older than what you actually are. I can remember when my own problems with my neck and back began and I was a couple of years younger than you guys and I still had two small boys at home, small to me, they were in 1st and 4th grades, and suddenly they were coming home from school and cooking and doing laundry. To say my ex was a useless lump would be giving him credit he doesn't deserve, he simply found it easier to stay away most of the time which in a way was a blessing looking back. The problems I had seemed so terrible at the time but to be quite honest I overcame them because I was able to find a really good PT and because, as my ex told everyone, I was too mean to take no for an answer. You both have problems that make what mine were seem rather insignificant. Marianne, to go through all you have gone through with your knees only to reach this point and be faced with hip surgery must just be devastating. I cannot concieve of what you must feel, just as I can't imagine what a 42 year old man must feel like to face all the problems Dad faces. I can remember when Dad first started posting. To go from expecting to recover with no problems to stating that having his leg amputated sounds like a viable solution pretty much says it all. But, I can understand how you might feel that way, at least it would be over with but I sure hope you don't do that. I can't help but believe that there is a solution to your problems. I still think you need to be carefully documenting all you are going through on a daily basis and I think you need to have a letter put in your medical records of the complaints that you have made and how each one has been responded to by the doctor, the PT and you. Having fought the good fight with disablity and won I cannot stress strongly enough the importance of documentation. Anytime you are dealing with an insurance, whether it be workmen's comp or disablity insurance, their job is to pay out as little as possible, your job is to do everything you can to make sure you get all that you are entitled to. What makes this so unfair and why so many people just give up is because at a time when all of your energy needs to be going toward your recovery you have to fight for something which by rights should be yours.

Dad, your post broke my heart. I am sure that to be unable to provide for your children what you have always been able to drives you up the wall and kids being kids don't understand much but what they want. It isn't just your children, I think it is pretty rare to find a child today that isn't that way.

It is bad enough you both have the serious health problems you have but to have spouses who are not supportive really doubles the load you are carrying. I didn't realize how much until I got rid of the ex (after 21 years) and met a man who was all the things he wasn't. Sometimes it just seems that life is stacked against us and that what is happening isn't fair, especially when you are sick or in pain or both and the world around you keeps going on, the bills keep coming and everyone keeps wanting.

I think Marianne had some great advice for you Dad, especially the community college suggestion for your daughter who is going to college next year. My son who does DNA research graduated from the University of Arizona but he got all his basic requirements through community colleges. I have heard him say on more than one occasion that as much as he has spent on his education it would have been a lot more had he not gone that route and there were, at times, professors who taught in the CC that were far better than the TA would have been at the University. So much of what the kids learn comes from TA's, the professors are far too busy publishing and staying current to actually teach, something I find really crazy.

Anyway, I hope with all my heart that you both find the strength to continue your fight for recovery. That is one thing that this forum does, one of the many things it does I should say, is it gives us a place to vent and people who are sympathetic and who care to help bolster us so that we can continue. Good luck and God bless, Rowdy