Hi everyone---I took a break from the Internet yesterday. I'm just updating after my first Outpatient PT appointment.
Let's get the emotional junk out of the way-
I was worried for nothing. I'd worked with this PT in Feb/March for an ankle problem and liked her. I "interviewed" her for my TKR recovery and loved her PT philosophy. She's not a "cranker," she completely understands my "PT PTSD" from the ACI recovery, and she never did anything to make me distrust her. Twice, she commented on how guarded/tense I was, just sitting there. She wasn't offended but made a point to get me to relax my leg/hip as much as I could. She was very empathetic and understanding of the weirdness known as "Lisa's knee."
Now for the physical...
1) As soon as I walked in, she said "Whoa--that's one angry knee!"
Lots of swelling, lots of peeling skin from the fracture blisters. She agreed major swelling is my biggest problem right now.
2) In her 15+ years of practice and as a certified Ortho PT specialist, she'd never seen a fracture blister from joint replacement---only from broken bones due to traumatic injury.
After the eval and discussion of my "severe inflammatory reaction" to the surgery, she asked if I'd had a valid inflammatory arthritis diagnosis (as that would help explain things) and what the surgeon thought when he saw the knee post-op. I told her I hadn't seen him yet---she was surprised. I then explained my last 6 yrs of bi-yearly exams with a Rheumatologist, no definitive diagnosis, some random joint swelling of the wrist, a "tennis elbow" flare with no direct cause/repetitive trauma---she suggested I discuss the knee recovery in gross detail at my next Rheumatology appointment, as this TKR recovery seems to be a another puzzle piece. My Rheumatologist still suspects Psoriatic Arthritis, as I get very small, thin plaques on my hips/torso/scalp.....my Dermatologist says it's not enough to biopsy though, so that's that--no concrete answers yet. Just lots of suspicion.....
3) Flexion was 60 when I got there, 78 when I left. Lots of soft tissue massage. Calf and thigh were hard as rock. IT Band super tight----no surprises from any of this.
4) At the top point of my last heel slide, as she was measuring, she saw "blanching" of the skin----she reiterated swelling is impeding this bend. The knee is just FULL!!!! She's asking me to do 10-15 heel slides every waking hour, and once a day to try and force the bend "a little bit" further. Not to the point of pain, just reasonable discomfort and trying to maintain each daily gain (or to just not go backwards either!). I
think today is better than yesterday morning.
5) Best part of the visit----my extension was +3 when I walked in the door. She was impressed. After the massage and light stretching, it was +1. As she had me move to a different part of the clinic, one of the other PTs said
"Wow---that's some magical extension!!!" They both complimented my heel-toe walking and my speed with the walker (not on purpose). She said I should take heart we have no need to worry about extension.
6) She said don't bother buying a cane as I'd only need it a day or two. By the end of the 2 hrs, I was walking slowly/carefully without the walker. I had to wake up a few balancing muscles first, as I'd been shifting all of my weight to the left knee for 3 wks. It was much easier than expected. We walked a short loop around the clinic with my hands hovering above hers, in case I lost my balance. I'm to go without it at home unless I need it in the night/morning after sleeping and am extra stiff/tired. I'm to use it for outside the home and around people until my balance improves. The walking adds to my soreness though, so it's going to be awhile before I want to walk a lot or do too much around the house. I don't know how some of you walk so much this early on. I am in awe!!! My knee would look like a watermelon and hurt like
.
7. In a nutshell, I'm glad I went and KNOW I need what this PT can offer me. I'm glad I set the tone though and was my own biggest advocate. I still worry at times, wondering is she's going to do a 180 on me and start pushing me to achieve numbers, but I need to give her the benefit of the doubt for now and not punish her prematurely for the PTs of my past.
8) My mood was much improved today. I didn't feel as trapped and immobile once I knew the walker wasn't a 24/7 necessity, and I know I might be driving in 2-3 wks. I may not WANT to go anywhere, but knowing I CAN is huge!
I celebrated with french fries, a Dr. Pepper, and a 3 hr nap. I was mentally and physically exhausted.