TKR Slow recovery from TKR

[westiemom]

I don't think I got the quote right - this is for Layla, who wondered why my PT was contacting my doctor. Cause when she told me to go right home and contact him (late on Friday afternoon), I said I'd wait till next week and doubted much would happen next week because of Christmas. I know at that point I told her no more PT that day so only had 1/2 hour before I quit and said no more.

I have an appointment with PT this Monday but still deciding if I'm going to go. There are about 15 PTs at this office and this is the ONLY one in our very rural area. It is connected to the hospital and all the doctors.

Today I did some heel slides and dangled my leg onto the floor and walked a lot. I'm back on the *&$* pain meds again too. They mess my memory up so bad I hate taking them.

Thanks for your answer. It's just really hard to feel good about myself right now.

Thanks everyone who has answered my questions or encouraged me. It means a lot.

 

[Layla]

I don't think I got the quote right

That's okay, sweetie. No worries.
I understand how tough this must be for you right now. You are coming along, you're healing and you will continue to gradually make progress. As you've read, recovery varies from person to person, so some will excel and others will lag behind. There are many here that have faced challenges or had slower recoveries, but still had a positive outcome. Maybe you should take Monday off giving yourself this weekend to rest and at least the first half of next week with Christmas Eve and Day allowing yourself time to collect your thoughts and not worry about getting to a PT appointment since it seems to stress you out. Remember this is a journey, not a sprint and you're really early into the process. Try to remain optimistic and know that you can do this.
Big hugs...here for you always!

 

[Layla]

Here's an explanation on the quote feature, if interested.

How to use the quote feature

BoneSmart has the ability for you to easily and quickly quote comments from another member in your post. The quote function is useful when: The message to which you wish to reply is not the last one on the thread and may not be visible to the readers You want to respond to only a portion of...

bonesmart.org

 

[Jockette]

and this is the ONLY one in our very rural area.

I’m very sorry to read this. In my little state of Delaware they are everywhere.

 

[Layla]

There are about 15 PTs at this office and this is the ONLY one in our very rural area.

Do you work with a different PT each time, or always the same one? I was assigned the same one.
If the PT you are seeing is difficult to work with, possibly switching the time of day you attend will allow for a change. There is certainly nothing wrong with requesting a change with a coordinator mentioning that you feel another approach may be a better fit for you and another's recovery goals better aligned with yours. I wouldn't share any negative experience unless it's necessary. Not every patient / PT dynamic is a perfect match. Every PT knows this and should understand if you feel a switch will make you happier.

 

[westiemom]

There are about 15 PTs at this office and this is the ONLY one in our very rural area.

Do you work with a different PT each time, or always the same one? I was assigned the same one.
If the PT you are seeing is difficult to work with, possibly switching the time of day you attend will allow for a change. There is certainly nothing wrong with requesting a change with a coordinator mentioning that you feel another approach may be a better fit for you and another's recovery goals better aligned with yours. I wouldn't share any negative experience unless it's necessary. Not every patient / PT dynamic is a perfect match. Every PT knows this and should understand if you feel a switch will make you happier.

I've bounced between 3 different therapists. They are basically the same. Sometimes I wonder if they are graded on the degree of flexion I get each visit. I'm still thinking about what I need to do about this whole situation.

 

[westiemom]

and this is the ONLY one in our very rural area.

I’m very sorry to read this. In my little state of Delaware they are everywhere.

Yeah, there are definitely disadvantages to living way out in the boonies! I love the peace and quiet and having my dogs, but there are not a lot of amenities around here.

 

[westiemom]

I don't think I got the quote right

That's okay, sweetie. No worries.
I understand how tough this must be for you right now. You are coming along, you're healing and you will continue to gradually make progress. As you've read, recovery varies from person to person, so some will excel and others will lag behind. There are many here that have faced challenges or had slower recoveries, but still had a positive outcome. Maybe you should take Monday off giving yourself this weekend to rest and at least the first half of next week with Christmas Eve and Day allowing yourself time to collect your thoughts and not worry about getting to a PT appointment since it seems to stress you out. Remember this is a journey, not a sprint and you're really early into the process. Try to remain optimistic and know that you can do this.
Big hugs...here for you always!

Thank you.

 

[sistersinhim]

I suggest you quite all PT and exercises. They are doing you no good at all. I'm one of those who never took formal PT or did any knee exercises. Due to birth defects, I've had 12 knee surgeries, 2 of them kneecap removals, and 1 TKR. Even after those, I never took formal PT. But, I didn't just sit around and do nothing, I used my knee as it was intended to be used by walking around to take care of my daily needs along with the necessary house and yard work. As I healed, I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increasing pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do. Doing too much too soon causes setbacks because your knee has to heal from the inflammation caused by the exercises before it can get back to its normal, after-surgery healing.

 

[westiemom]

I suggest you quit all PT and exercises. They are doing you no good at all. I'm one of those who never took formal PT or did any knee exercises. Due to birth defects, I've had 12 knee surgeries, 2 of them kneecap removals, and 1 TKR. Even after those, I never took formal PT. But, I didn't just sit around and do nothing, I used my knee as it was intended to be used by walking around to take care of my daily needs along with the necessary house and yard work. As I healed, I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increasing pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do. Doing too much too soon causes setbacks because your knee has to heal from the inflammation caused by the exercises before it can get back to its normal, after-surgery healing.

My DH called Monday morning and cancelled all my PT appointments thru the holidays. Boy, did that set everyone crazy! Apparently the PT called my surgeon because about an hour after that, the surgeon's office called and wanted to move my appointment up to 12/30 (versus my scheduled 1/15 appointment). I wouldn't even answer the phone - DH answered it. (I've said before that for some reason this doctor just scares me to death). DH told the doctor's office that we would just keep our 1/15 appointment and no thanks to coming in sooner. I cannot believe how panic-y everyone is. I have felt so relieved this week knowing I don't have to go to PT and get measured and find out I'm doing worse or better.

I am doing some exercises but not to any extreme. I am doing a lot of daily living things and moving around quite a bit. I do exercises every other day to the point of discomfort but not to the point of needing opioid pain pills. My leg is still moderately swollen (based upon pictures I found on BoneSmart.)

Thanks again for all the encouragement, and hoping everyone had a fabulous Christmas!

 

[Layla]

My leg is still moderately swollen (based upon pictures I found on BoneSmart.)

Continue to ice and elevate for the swelling, if you're not already. It should help. I'm happy to read you're taking a break from PT and will be curious to see how you're feeling in another week to two. Please keep us posted.
Best Wishes!

 

[Jockette]

Good for you and DH for taking charge of your recovery! I’m glad he’s so supportive! You’ll do fine with your daily activities, which I call “natural PT.”

Remember, people are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Thanks again for all the encouragement and hoping everyone had a fabulous Christmas!

My daughter and her family have been at my house since Tuesday afternoon and we had a nice, quiet-ish Christmas Day. (As quiet as one can with 3 kids ages 11-15 and a yellow lab!) She made home made cinnamon buns for breakfast and mid day we took a walk through a local park. It was a very nice day.

I hope you enjoyed your Christmas, too.

 

[sistersinhim]

I think you'll find that your knee will improve with your gentle movements! Taking care of your own recovery is the best for the vast majority of people.

 

[westiemom]

My leg is still moderately swollen (based upon pictures I found on BoneSmart.)

Continue to ice and elevate for the swelling, if you're not already. It should help. I'm happy to read you're taking a break from PT and will be curious to see how you're feeling in another week to two. Please keep us posted.
Best Wishes!

I'm still icing and elevating every day. I rest a lot too. It's amazing to me how tired I get just doing my stuff around the house. Of course, I'm not sure if the tiredness is from my congestive heart failure though. I just take naps as needed. Will be nice when I can sleep the whole night thru too.

 

[DiannesNewKnee]

I felt just like you did after my surgery. When I went to my 6 weeks post op the physician’s assistant told me I wasn’t where I needed to be with my ROM and that they might need to do an additional surgery. I had read a lot on here and decided to take things slowly. My knee improved gradually and now my ROM is the same as my other knee. It’s 4 years after surgery and my new knee is awesome. Please don’t be so hard on yourself. I remember feeling at first that I made a mistake getting my knee done and feeling like it would never heal. It did heal and everything is fine. Now I need to do my right knee soon and hopefully I will be more realistic about the healing process.

 

[benne68]

Hi @DiannesNewKnee and welcome back! Glad to read that your 4-year-old knee is doing well. How about posting an update in your recovery thread so other can see your full story? You can find it here https://bonesmart.org/forum/threads/new-here.61122/

 

[westiemom]

Could you change my title to 9 weeks After - considering MUA

Is that too long? If so, please shorten it so it reflects where I am now. Thanks

 

[Jamie]

Don't be in a hurry to have an MUA. If you've had a lot of swelling and your therapy has consisted of exercises that were painful, it is more likely that inflammation and swelling is holding you back. You'll have a better idea if that's the case after this resting period. Just be sure to do some walking around the house every couple of hours along with some gentle bends and stretches throughout the day and evening to keep your knee moving.

I'm glad you're standing up for yourself with your surgeon and therapy. Not everyone heals at the same rate. We see it time and time again with our BoneSmarties like @DiannesNewKnee posted above. No one knows your body better than you, so have faith in your gut feelings about what is beneficial and what is not in terms of activity and exercises. It's never good to try and work through pain.

 

[Jamie]

I see you live in the beautiful Top of the Rock area in Taney County. I'm in Kansas City, but VERY familiar with Table Rock Lake and Branson. How far are you from Branson? Would it be possible to find a therapist there to see? I have a good friend who had two successful knee replacements and I could check with her about who she saw. She lives on Indian Point at Table Rock Lake.

What is the hospital that your surgeon is connected to?

A little bit more information on the things you're being told by your therapists....

After Wednesday,s PT appointment, I was back on Oxycodone cause of the pain. I will do my exercises at home today. I found out that (because I am on Medicare), if I don't show improvement every time, if it looks like I am plateauing then Medicare will not pay for more PT sessions. So cynical me, I think that is why they push me so bloody hard to make the "measurement". I had 84 degree on Wed. and she wanted 85 so badly. Now I know why. This is such an American Healthcare scam.

Medicare does have a rule about patients who reach a "plateau." But this is geared more toward older people who have issues and are refusing to do any therapy to help themselves. It's not designed for individuals who had surgery and are recovering. Good therapists and surgeons understand this and know how to set periodic goals for an individual patient. Then they write up those goals to meet the Medicare requirements. For example, I've had therapy for soft tissue problems following my hip replacement two years ago. My therapist assured me all along the way that getting approval to continue was no problem. She said as long as I was willing to work on the gradual goals she set for pain improvement, balance or strength, she could get approval. I feel like you need a better therapy clinic. Maybe if you could find one and only go once a week, it could be a whole different experience for you.

I have traditional M'care with a M'care supplement. Physical Therapist is the one who told me that after 10 sessions, if I don't show improvement each time, they will not get approval for any more sessions. They want to see at least a 5 degree improvement each session.

This is just not true. It just means the clinic either doesn't know how to successfully work with Medicare or they don't want to. Either way is bad for the patient. Medicare does not set requirements like 5 degrees each session. Even the government is smart enough to know that people heal on different schedules and there is no "one size fits all."

Didn't sleep good and throbbed all night. Won't make that mistake again.

You do know that you can ice your knee through the night as well as during the day.....I used the gel packs to do just that and it really helped with both my knees. I would get up once during the night to use the bathroom and would get a new ice pack. Ice is a terrific pain reliever. Just be sure to keep the ice source wrapped in a towel so you don't burn your skin.

 

[ouchie!]

Oh westiemom I felt so sad at how you are being treated by your medical team. I’m in the UK and doctors here aren’t so obsessed with measuring ROM or doing MUAs. My doc just looked at me sitting with my leg at a right angle, no measuring. He was happy. I stopped doing PT at the hospital at 7 weeks after being made to attend a chaotic group session run by a horrendous physio who pushed down on my knee and kneaded it like a piece of dough. How I stopped myself from slapping her I will never know! I didn’t go back and nobody chased me up to attend. Since then I do PT at home most days, but I have a day or 2 off a week as advised by the Bonesmart crew. I will say my pain and swelling has certainly lessened but it’s still there if I overdo things and I’m now at 3 1/2 months post op. I still ice about 3 times a day. I want to send you a big hug and to your DH for having your back. ((( ))) xx