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[TKR] Rockgirl4's Recovery---already full of surprises.

Discussion in 'Knee Replacement Recovery Area' started by Rockgirl4, May 23, 2019.

  1. winemama

    winemama senior

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    @Rockgirl4 the leg straightening was crazy, lots of pain in my calf and foot almost 9 weeks to have it almost gone. Thanks for the thoughts
     
  2. Rockgirl4

    Rockgirl4 senior
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    PT Praise: Considering how many of us have bad experiences, I want to share a good one from today. My PT took measurements so she could update my surgeon before my Thursday appointment. She didn't do any measuring yesterday, as she knows the numbers mess with my head. She made sure I knew where we started 8 days ago, and how much progress we'd made in 8 days. She is super positive, then stressed to me that I AM NOT TO OBSESS about the numbers, regardless of what the surgeon says Thursday. I walked in the door 8 days ago at 60 degrees of bend, and today I walked in with 75 degrees. By the end of the appointment and no painful stretching, I had 89 degrees actively, and she helped me lift my knee a bit (she gave me leverage actually), and that was 92. She wasn't focused on what week I was at, and she's not setting unrealistic goals. She's celebrating progress! :)

    PT Praise #2: She's going to be out of town next Thurs/Fri. We didn't want to go 4-5 days between visits, so she asked if I'd see one of the other therapists. I know one of them is a "pusher," as we've talked about it before. She purposely gave me the OTHER male PT and said he'd be a better fit. I told her I have no issue with self-advocating and would remind him of NO PUSHING when we began----but in my firmness, I'd also be nice. She got a good laugh out of it and thinks we'll be fine. I bet you she even says something to him ahead of time. Luckily I've been around him enough the last few months because of my Spring ankle problem that he knows me. :)

    Some of you may not go in for stuff like this, but I do believe she's a gift from God. I didn't know if I'd ever let another PT near my knee again after my ACI recovery, but she's restored my faith that there are some kind, caring ones out there who you can trust.

    It's not fair, but I keep telling myself not to brag on her too much until this is all over and done with. It's always in the back of my mind that the ones I trusted before betrayed my trust after months of working together.
     
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    Last edited: Jun 19, 2019
  3. Celle

    Celle FORUM ADVISOR Forum Advisor

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    It's great to hear about a good PT. So many people aren't as fortunate as you are and some of their PTs do more harm than good.
     
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  4. BCSAnna

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    @Rockgirl4

    Lisa,

    Glad that you are having a positive PT experience this time around. And, I sincerely hope that continues for you.

    My experience was not so positive. The big part of the problem was, I had my surgery at Penn Medicine in Philadelphia. Which is over three hours away from my home. While in the hospital, I had nothing but the very best of experience with my PT there. However, Penn Medicine does not offer their brand of PT in my area and commuting up to Philly three times a week is out of the question. And so, I signed on to receive PT through Home Health Care at our local community hospital with the specific instructions that they were to comply with Penn Medicine's PT Exercises for TKR contained in the book. Which I gave a copy to my local PT. Penn addresses healing; range of motion ( over the course of several weeks/months) and then strength training. Using a less non-aggressive approach. My first and last session of in-home and off site PT was this past Monday. The PT did not follow Penn's PT instructions; put me through roughly 18 exercises, some of which were geared for hip replacement patients, and left me with the worst pain and swelling I have had since my surgery!:hairpulling: It has taken me the past two days to recover! Believe me, I did not travel three hours from home to have my TKR at one of the top medical facilities in the US only to have a bunch of local yokels damage all of the excellent work my OS did. And so, with my Penn Medicine PT Exercises Book; and my hubby as my coach (PT) I have decided to do my own PT. It will not be the first time, and with a left knee yet to me replaced, I am pretty sure it won't be the last!:chinstroke:

    Take care Lisa. And keep moving along that recovery road.

    Anna:flwrysmile:
     
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  5. sistersinhim

    sistersinhim FORUM ADVISOR Forum Advisor

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    I am one of those that believe God wants the best for his children. If we listen to Him the best will happen!
     
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  6. Rockgirl4

    Rockgirl4 senior
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    Today's update is more for me than anything. :) It's been 4 wks and 2 days since my right TKR. Things seem to change/improve every 2 days.

    1) Tonight I sat on the edge of my kitchen table with my legs dangling. This table is my stretching buddy and has been for years. :) It's a good way to loosen up my stiff right knee rather than sitting in a chair/couch. After a couple of minutes, I was able to cross my ankles. Just last weekend I couldn't push the right leg back with the left without lots of force. This is definite improvement as no effort was involved. I sat there comfortably!!!! :wow:

    2) Walking was smoother and quicker today without trying. Extension seems to improve by the day in tiny increments.

    3) My scar is coming along nicely. I have a bit more definition around the knee itself. This means the swelling is "Oh so SLOOOOOWLY" coming down!! Most of the scabs are gone, but I'm leaving things alone for now to be safe. I see the surgeon tomorrow and will get his opinion on lotion (or not yet).

    4) Most of the calf pain and all of the bruising is gone. This happened sometime in recent days without me realizing it. I don't EVER want to experience the calf pain again. Talk about misery!! :xmark:

    5) Mornings are better when getting out of bed. I loosen up quicker than a few days ago.

    I credit a lot of this to my PT. She's been having me work on alternating bending/straightening (and repeat) with a few different types of tools/machines---using no force. Just a little pressure or resistance to help transition directions. I can tell a major difference today after doing more of that kind of thing yesterday. Even if there isn't a lot of bend in the knee yet, she said being able to transition from bent to straight more quickly will ease the stiffness/discomfort sooner.

    Let's face it---even after a simple arthroscopy, it always took me many weeks longer to get flexion and extension back and walk normally. My gait wold be atrocious for months, and it killed my back---just like it is now.:banghead: I'm not talking a week longer than most either---more like 4-6 weeks longer. After my ACI fiasco, it took 6-7 MONTHS to walk normally. She's hoping we can avoid that this time, stretch things out AROUND the knee sooner, with the goal to make walking easier now rather than later. Again, she's all about functionality, not numbers. I'm up for anything to help my poor back too.
     
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    Last edited: Jun 19, 2019
  7. Rockgirl4

    Rockgirl4 senior
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    @BCSAnna I totally feel for you with your messed up PT situation. I wouldn't want to take that chance either.:sad:

    I know MANY of us here have had horrid PT experiences in the past, and I'd never fault anyone for not going back. Unfortunately, my body has enough lower back issues (and other weird things that pop up),so I need to know the good ones from the bad. Plus, I wanted to be fair this time and give credit where due. I hope you continue to have good days ahead too.
     
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  8. Rockgirl4

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    So I had my 4 wk checkup with the surgeon yesterday. It was a doozy!!!

    1) He and his PA gave us an hour of their time. I was impressed. I saw cool x-rays of the prosthesis and had all of my 11 questions answered.:thumb: The scar looks great.

    2) BIGGEST TAKEAWAY---He and the PA are NOT happy with my PT. I've been going 3X a week for 2 hrs each time. He said cut it to 1-2X a week, for no more than an hour each time. Stick to soft-tissue work,gait work if needed, and stretching only. If they give me grief, stop going and do it at home. He knows I can do all my own strength training once we get past 3 months.

    3) The more I described PT, the more exasperated they became. :thud: I was embarrassed, as I knew better in some ways....

    What started out as gentle the first week ramped up into the uncomfortable zone this week ((raising red flags with ME before even speaking to the surgeon)). I was doing 2 periods on the bike each day, some gentle bends on a step every 3-4 hrs, and a couple sets of heel slides through the day. The knee became angrier starting Monday when we added more varieties of bending. He wants no more than ONE episode of cyclic, repeated bending every day (like 5-10 minutes on the bike), but after that there should ONLY be prolonged periods of static bending, such as sitting in a chair with my leg bent, trying to scoot it back a bit more each day, pushing myself into the "slight discomfort" zone each day (Not pain!!) to slowly achieve more flexion. It does NOT have to come all at once. (Very Bonesmart-ish!!) :) The other red flag was she asked me to do the leg press with no weight. I thought it would be easy and was wrong. As many times as I've read here that it was too early for weights, I was my own worst enemy and wanted to try (I'm a girl that loves weights---can't help it!!). I did it again Tuesday and regretted it for 2 days afterwards. I told her yesterday "No more leg press". I needed more pain meds to sleep Tues/Wed nights, and started limping Wednesday. Not good at all.

    The surgeon agreed----cut back or stop going!!

    5) Overall, my 89 degree bend is "sluggish" in his words, but he's not worried. He just prefers it comes sooner and wants to see me at 8 wks (instead of 12), to see if things have improved. I have an adhesion history, so it would be dumb to ignore it. We're also trying an oral anti-inflammatory to get the swelling down, as a) it's still significant, and b) my unusual history with inflammation concerns him. The pills have made me nauseous the last 2 days though, so I don't know if I can handle a month of this stuff. I may call back Monday and just get the topical gel. I REALLY wanted the extra "help" though, as it's benefited me in the past. Time will tell.

    CONFESSIONAL----- I admit I fell into the PT trap. Yes, I was in control and there was no pushing/forcing, but I didn't totally follow my gut and stick to my guns when certain "things" were suggested this week. :sorry:I'm sure it's the people-pleaser in me. Now I'm nervous about the conversation Monday, as I will change the plan or stop going. I don't WANT to stop going though, as the hand's-on, soft tissue massage has really made my thigh/calf feel better. It's going to be interesting to say "Yeah, you did wonders for my gait and muscles, but you REALLY ticked off the joint!!!!" I'll find better words, as she's a great person and is just doing what she was taught. We are responsible for our behavior and have to own it.

    However, in my defense, I wish someone had explained about the REPETITIVE bending cycles causing inflammation/swelling. All I'd ever read/understood was that FORCEFUL bending was bad. Oh well!! I can still hear all of the "I told you so" 's ---:rotfl: No words necessary, as I'm still kicking my own butt over it all.

    Lastly, I ended up sleeping 12 hrs last night---10 pm to 10 am. I needed it after the marathon day of PT and the surgeon's appointment. It was 2 hrs of PT, 2 hrs at home, a one hour drive to the Dr, over 2.5 hrs at the Dr, then a 90 minutes drive home in rush hour. No wonder I was tired. :sleeep:
     
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    Last edited: Jun 22, 2019
  9. dogwalker2

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    So sorry to hear about your mum xxx you are right, something so awful makes you appreciate each day. It's also great that you know your body so well, we are all so different and one size does NOT fit all for sure. Sounds like you gave a great regime going that is really working for you, well done. Hope your son is over his strep throat - so horrid when they are in pain
     
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  10. dogwalker2

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    Sorry, my computer was slow to update so have only just seen your post re appointment update. don't beat yourself up about repetition or worry too much about the conversation on Monday. Stick to the main message line and it will work out just fine, I can tell you are a natural diplomat x So glad you had all your questions answered and got to see come great xrays☺ Sounds like you are doing really well to me. Take care and remember to listen to what your own body is trying to tell you.☺
     
  11. BCSAnna

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    @Rockgirl4

    Hi Lisa,

    As one who was kicking their own behind earlier this week, over my own stupidity in allowing a PT to go too far, I can truly empathize with you. Please don't beat herself up over this. Like you, it took me two days; upping my pain medicines; and plenty of icing to get my knee back to where it was before PT. After that God awful assault on my poor baby knee, who at the time was just 5 days old, I called it quits on doing "professional PT.":no-fin:

    Since then, my hubby went to a local medical supply store and purchased a goniometer, for measuring my ROM; a TENS unit; and a hand held massager.

    Since beginning our own, "self administered PT," gentle and pain-free, my ROM was measured late yesterday, as extension = 0 degrees; flexion = 100. I also transitioned from my walker to my cane
    last night. Not too bad for a 9 day old baby knee!:curtsey:

    Lisa, as long as you are highly motivated and self disciplined, you can do your own "self administered" PT.

    At any rate, I sincerely wish you the very best of recoveries regardless of which form of PT you chose to pursue. We all must do what is best for each of us as an individual and hope that we all end up with the very best recovery we can achieve.:dancy:

    Anna:flwrysmile:
     
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  12. TimeBuster

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    Excellent advice from your medical team. IMHO going to physical therapy no more than twice a week is sufficient. Our knees and muscles need time to recuperate between PT sessions if not we defeat the whole purpose of going to PT. What's best for our knees is a careful balance between exercise and recovery. Our goal is to exercise enough to stimulate gains in our fitness level and to then back off and let our body adapt to the gains.

    I have been following your story and I think you've done a fabulous job orchestrating your recovery. I understand you feeling apprehensive about having a conversation with your PT on Monday but remember you're in charge and if your physical therapist can't get on board or get their feelings hurt it might be that you need a different physical therapist, not that you need to stop physical therapy altogether.
     
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  13. Celle

    Celle FORUM ADVISOR Forum Advisor

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    I love your surgeon, @Rockgirl4 . His advice is so similar to what we advise - he must be a Bonesmartie.
    My surgeon is, too.
    I think we're very lucky to have surgeons who think like that.
     
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  14. Rockgirl4

    Rockgirl4 senior
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    @Celle I agree. The entire time he was in the room, it was all I could do not to ask him "Hey, by the way, do you know about this website called Bonesmart?"

    I didn't, but I sure wanted to!!!:heehee:

    Not only did he come highly recommended, but he did the TKR of a friend's husband back in February. She has been keeping me up to date with her husband's wonderful recovery, knowing I would want the feedback. He didn't do any PT at all, is 50 yrs old, and already back to playing high-level weekend baseball. I told her my goals are nowhere near as lofty.:rofsign:
     
  15. Rockgirl4

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    @BCSAnna I agree, Anna. Motivation has never been a problem except for these last 6 months with my mom's passing and the rescheduled TKR hanging over my head. I truly feel past all of that though. :) I don't think I realized what the stress of all of that was doing to me until it was over.

    I mostly miss my daily stretching and am eager to see what's possible over the next 2-3 wks. As soon as I can get back to my core/back workouts, I'll feel like a new person because of better flexibility and lower back pain relief. I can do my upper body workouts easily at home too, but I'm in no hurry. I will ease into the leg/lower body stuff as my knee permits and will be walking for exercise until probably the end of August. The weights can wait for September. I'm one of those girls that need strength training to manage my weight and size (plus I love it), so I'll get there. :) It helps I have 20 yrs and 11 surgeries worth of PT knowledge to pull from. Knowing where to start and how to progress is ingrained in me after all these years.
     
  16. Rockgirl4

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    RANT TIME.......

    OK, so no offense to anyone here (especially if you're male), but the hardest part of this recovery is MENTAL.:banghead:I'm stir-crazy, I just want to drive, I'm fed up with a sorta-bending knee being that will KEEP me from driving for a few more weeks (per my Dr), then add in a husband that is clueless......just absolutely clueless. :bored:

    I was able to do SOOOOOO much more this weekend and even cooked a real, homemade dinner tonight. The last 4 days have been a night/day turnaround from the previous 4 wks. I just wanted a "Thank You," or "Wow, look at what you can do?"------ Instead, I get a babysitter who tells me I'm remembering everything wrong, and a kid who wants to know what's NEW for dinner each night!

    See, my husband is trying to help by "reminding me" of the new advice my surgeon gave me Thursday. Unfortunately, his memory keeps differing from mine. I heard 10 minutes on the bike, he heard 5. I heard 15 minutes for sitting, he heard 30. I heard heat twice a day, he heard many times a day. I'm wrong, of course, because I'm the one on Percoset, right??!! :gaah: He made me SOOOOO mad!!!!!! Next time I'm recording the :censored: appointment so I can play it all back!!!!!

    So I think this is a good time to remember those around us needing support or encouragement. Hubs knows he's in the dog house, and I plan to keep him there a bit. :no-fin:
    How hard is a simple :thankyou: or "good job".....It's not like this is our first "knee" rodeo. I've had a baby and 11 knee surgeries----yes---ELEVEN!!!! We had this same conversation 3 yrs ago after the ACI fiasco.....but yet MYYYYY memory is the compromised one!!!! Where is the "eye roll" emoji when I most need it?
     
    Last edited: Jun 24, 2019
  17. Jamie

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    Oh, @Rockgirl4.....I can't believe you passed up an opportunity like this to toot BoneSmart's horn a bit with tyour surgeon. Next time, do it!

    We can't get around to all 27,000 orthopedic surgeons in the US, so we need our members to let them know about us. You might get an eye roll look from him, but stay assertive about how much help you receive here. We need surgeons out there to realize how we can help them with their patients.
     
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  18. winemama

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    I told my OS about Bone Smart, he told me he’d never heard of it. Told him to look it up.
     
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  19. Rockgirl4

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    5 Week Update (Much More Positive Than My My Earlier Rant:whistle:)

    Things have changed drastically in the last 4 days....
    1) My leg goes from straight to bent (not past 90 though) MUCH more smoothly. I don't have to wait for it to bend every single time I sit down somewhere.
    2) My walking/gait is much improved and even more natural.
    3) I have needed a lot less pain medication and can see where in 2-3 wks I might not be taking any.
    4) I can move around for long periods while standing----cooking, laundry, basic things like going room to room for something simple---it seems to get better almost daily.
    5) The bend I DO have is more natural. I can easily sit down and not have to stretch my leg out for awhile. This seems to improve daily too.
    6) I'm mostly back in my own bed and off the couch for sleeping. I still stay up late most nights so I don't lay there with an achy knee, waiting for sleep to come. We'll see what tonight brings.

    All in all, my ONLY complaint is the knee won't bend on MY schedule. Imagine that------someone telling my body when it's supposed to do something!!!! :loll:Sounds like some PTs we dislike!!!! I promise I'm working on patience.
     
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  20. Benay

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    Those are all positive improvements - great to hear.
     
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