TKR So Who's Anu'sKnees?

[KarriB]

I did not know about BS during my recovery, but I was determined no one would touch or hurt my leg the way they had my dad and bff. The PT told me to do half squats 2 weeks post op. I looked at her as if she had 2 heads, tried one squat and looked at her saying, "never again". I just don't like pain.

 

[Jennszoo]

I'm so glad I found BS before my surgery. Bc I heard all the same **** you posted about. Everyone saying "the most important thing is to do the PT exercises, no matter how much they hurt" and from the OS and his PA "you dobt want a MUA, so do the PT" and advice to take meds before PT and just a general peer pressure of hard core no pain, no gain attitudes.

I had so much anxiety about my knowledge of the BS way vs what seemed to be the prevailing attitude in my area. Luckily the PT affiliated with my surgeon was out of network and I lucked into a great practice close to home. Not once have they pushed me, the most work on ROM they do is this machine where I control the cranking and I report to them my max ext and Flexion. If I say I can't do x,y,z, they modify the exercise or we skip it.

So yeah, I hate it for all the TKR pts who are getting bombarded with the bad advice of painful PT bring necessary for recovery.

 

[Anu'sNees]

So what I hear from you Jennszoo is that you managed to develop a healthy relationship with your physical therapist. Good for you! I know from experience that it can be difficult to speak up. I didn't have your anxiety about PT as I didn't know there was a different way to do PT. My anxiety was solely due to fear of the "well advertised" goal of "No Pain, No Gain PT. And judging by my own experience and research before and after my TKR's, there remains a strong voice in many arenas in support of aggressive PT. Finding a way to get the Bonesmart message to more vulnerable patients who may be terrorized by an inflexible physical therapy regiment seems a fabulous goal.

 

[sistersinhim]

When it comes to faith and life I am such a toddler, always asking God "why." Why did that have to happen that way? Why do I have to go through this now (or ever)? Why can't I sit back and enjoy my TKR with my family and friends? Why? Frankly, God has never given me an answer to my "why's,"

I understand where you are coming from in your statement. Maybe God is giving you time to grow, both spiritually and emotionally. When I made my little, tiny baby steps, I'd stop and thank God for the blessing of being able to do a little bit more! Instead of asking God 'why me', ask yourself 'why not me'! That helps me to get over my frequent pity parties!

 

[Celle]

There isn't any need to allow a PT therapist to perform aggressive therapy on you. Just say NO, and if the therapist does not comply with your wishes, get off the table, walk out of the clinic, and don't go back. Take your knee away, so they can't do what you have asked them not to. It's foolish to stay and allow the wrong sort of therapy to continue.
Don't give anyone the opportunity to hurt your knee.

It is your knee and you have the absolute right to say what happens to it. You don't have to please the therapists. They have to please you.
Saying no to therapy - am I allowed to?

 

[Anu'sNees]

I think part of the problem is knowing you can say no and you must say no to protect your knee. I didn't do a good job saying no, and judging by the posts on the write-in website, this saying no is a problem for others as well. As new patients we are vulnerable, and we have heard from authorities and friends to expect very difficult PT. So we figure if we say no (when so many are saying yes), we will hurt our chances of healing properly and with respectable ROM. Still I understand it is our responsibility to say no and get off the table.

 

[Celle]

Would you allow a stranger from off the street to do things that hurt you if you could just walk away? No, of course not. Apply the same common sense to everyone.
Your PT therapists and doctors are not gods. You don't have to do or allow what they say. Remove your knee from harm.

 

[Anu'sNees]

@sistersinhim,
You point about "why not me" is one I work with time and again. What causes me to stumble there is years of abuse in childhood, and abuse in marriage. Dealing with that with the eyes of faith has been difficult, especially since the residual has been lifelong depression. But that aside, I do believe in the idea of "why not me;" I just have a hard time executing it.

 

[Jennszoo]

But Anu is right that leading up to this surgery, we are told by all the so called "experts" and many survivors of TKR that hard core PT is the one and onLy path to recovery. It will make you second guess yourself.

 

[Anu'sNees]

Ah @Celle,
Your last post is precisely where the problem is. We have been told our PTs know what their job is. We have been told to do our PT religiously. Since my PT was part of the hospital where I had my TKR, I did trust them. I had more reason to trust my first PT since a nurse at the hospital used her and recommended her. She commented on how difficult her therapy was with this PT, but she didn't warn me against her. In fact, she came to agree with the harshness of the PT; it got her back to her nursing job, which was the overall goal of the therapy. So by the time I met the PT, she was already an authority to me. And yes, I do have a skewed relationship with people I deem have some kind of authority over me. I either rebel against that authority or succumb to it, like it or not. That's my problem, but it is also the problem of many out there having TKR's. Wish it were otherwise.

 

[Anu'sNees]

I think you are right on the money, @Jennszoo! And who are we to walk into the therapy scene and claim we know more? We want to TRUST that our PT knows what s/he is doing and knows how to do it to my benefit. In our most vulnerable, we don't want to have the awesome responsibility of telling our PT what to do. Most of us didn't tell the OS what to do, and we hold the same position for the PT, wise or not.

 

[Jamie]

I believe a good part of the problem is the way medical professionals were perceived in past decades. They were "authority" figures and we poor people on the outside didn't have the knowledge or experience to do anything but follow blindly whatever was said or done.

That philosophy has gone by the wayside now. Each person is expected to be part of their medical team. We have resources that were never before available to us via the internet so that we can get educated and ask intelligent questions when working with doctors, nurses and therapists. Granted, some people prefer not to do that and that is their choice. But frankly, no one...no matter how well educated and capable they are.....knows our bodies like we do. And we are the person most invested in our own health and well-being. So our opinions and questions have value in this process.

You don't have to be rude when bringing up these controversial matters to your medical team. You ask questions. You tell them what seems to be working and what is not working. You have discussions. You are all on the same team!

Of course, there will be people out there who don't want patients to be on an equal footing. That's usually the time to thank them and go find someone else to work with. A person always, always has the right to refuse any treatment or recommendation.

 

[Anu'sNees]

I agree with all you wrote, @Jamie. It shows how well you understand the issue of patient responsibility. Many forum members have similar knowledge. The internet has changed the way we get information, as you suggest. It is available to anyone who chooses to spend time seeking it out. Choosing NOT to do so does not give us an excuse when things fall apart. As you write, there will always be people who don't want to research their medical issues, don't want to involve themselves directly in their care, and that is their right. (I think of the people who wrote about their negative experiences with PT.) Unfortunately, some pay a hefty cost for choosing to be ignorant.

Wishfully my medical team, including my physical therapists, are going to do what is right for me when I engage their service, regardless my input and participation in the process. But as you and others have kindly and patiently pointed out, I must look out for myself. In a perfect world, the PT would do exactly what my body needs, no more, no less. But this isn't a perfect world, and people like myself had better step up to the plate of responsibility whether we like it or not.

It is only through discussions like this (admittedly uncomfortable and messy at times), that we learn where our faulty thinking lies and how best to revise it. I thank the Bonesmart Forum members for their patience with me as I struggle to get my head around patient responsibility as concerns physical therapy. Of great importance, I am learning that choosing NOT to get needed information does not relieve us from the consequences of our ignorance. Thank you all for helping me to understand this better. I am a better person for the opportunity to hear other voices who have far more experience and knowledge about PT. Thank you.

 

[Anu'sNees]

@Celle,
My apologies for thinking I knew everything. The more I think I know, the more dangerous I am. It is only when I say I don't know that I am teachable. Above all, I would like to think of myself as able to learn from others.

When I fall, there are consequences. But thankfully, people can be very forgiving of knucklehead behavior. (Up to a point.) I wish I could guarantee that is the last appearance of the knucklehead. I can only hope and try to be my desirable open-minded, teachable self from here on out. Thank you for your patience.

 

[Celle]

Thanks @Anu'sNees . We all make mistakes and we're all on a learning journey.
We're here to help each other.

Josephine and Jamie have picked the staff because of their various experience in having had joint replacements, and they continue to train us.

 

[Templar1974]

I know for me, therapy was a challenge at first. The Mantras here did not mesh with the therapist agenda. I had a male in particular, hwho despite my directives and protest continued to persist with pushing me. Being limited with insurance, I found another therapist in the same practice who does listen, and never pushes me beyond anything I am comfortable with.

I am happy that I followed the advice here, and spoke up.

 

[2happy]

It's because of PT I have had a set back. I did complain, every session. Everyone kept saying 'no pain, no gain'. I was made to feel the pain was all in my head. Now that Ortho has said stop PT I am relieved, but 4 1/2 months postop with a setback of 2 months all because of PT


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[sistersinhim]

Unfortunately, you aren't the only one that has suffered through PT, and you won't be the last until all involved with the surgery will cast aside their outdated thinking and get with the new and improved program!

 

[Cratchit]

@Anu'sNees I'm coming out of retirement especially to say how much l have enjoyed reading your posts and how much l miss your updates. I hope you're alright? Recovery is a vulnerable time within which all other vulnerabilities can rear their heads. From reading your posts it sounds as though you've dealt with a heck of a lot in life and that you are one of life's overcomers. I do hope you are alright and that you can see progress in tiny steps. This TKR business ain't for the faint hearted!

 

[sandi4213]

@Anu'sNees I'm just checking in to see how you are doing. I hope you have been busy recovering, resting, elevating, icing. {hugs}