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.
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.
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.
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 ---
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.