TKR Tawinoh on the other side, its turning into a nightmare
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Jozilla
supremo
I had some painkillers in my pocketbook which i could keep or I definitely would have had some stashed in my makeup bag or suitcase. I didn't have to use them luckily but I was not sure how pain management would be. My hospital does not use pca pumps nor morphine for joint replacement surgery and I was very nervous about so many people complaining of the pain. I will do the same the next time I have surgery too!
RTKR - 9th December, 2013
RTKR - 9th December, 2013
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tawinoh
junior member
Hi everyone, sorry once again for not keeping up with my posts, I'm either sleeping, in pain, doing PT, or laughing with my friend who's staying with me. But everything is going smoothly except for the Pharmacy giving my friend problems when she went to pick up my Percocet today. I take 2 pills every 4 hours around the clock, my doctor and nurse is fine with that and know that's what I'm taking. Well I called my doctor today to get a refill because I will be out of my pills by tomorrow, he gave me the refill, my friend took it to the Pharmacy and they refused to fill it at first because they say I'm taking too many. My friend raised a fit that I'm sure wasn't a pretty scene and they refilled my prescription. Do they have the right to refuse a refill? Am I taking too many Percocet? I'm not even 2 weeks out and I feel taking them every 4 hours has managed my pain, I can't imagine taking less right now. Although today is the first day that I haven't been in as much pain, so is it time to cut back? I just figured if my doctor ok's it then whats the problem, I'm sure if he thought I was taking too many then he wouldn't have given me a refill. I do plan on cutting back when I'm sure the pain is getting better.
On a happier note my recovery is going great, I have the sweetest PT who is very gentle with me and stops when I say so. I'm having problems with ROM, its 72 right now. Flex is -4. I'm still walking with a Walker but PT said we will switch to a Cane next week. PT had me walk up and down my flight of stairs here in my house today and I had no problems, so she said I can use my stairs now. The last few days I started having pain around my knee that felt like a toothache that would start around 4 in the afternoon and wouldn't let up til the next morning. But today I didn't have that pain at all. Strange. I rest alot, keep my leg elevated and iced. I stopped using the CPM machine which caused me too much pain but still do my PT exercises. My PT is pleased with my progress and says I'm doing great. The Nurse is coming Tuesday to take out my stapes, she said that will make me feel even better. So that's an update on my progress as of now.
On a happier note my recovery is going great, I have the sweetest PT who is very gentle with me and stops when I say so. I'm having problems with ROM, its 72 right now. Flex is -4. I'm still walking with a Walker but PT said we will switch to a Cane next week. PT had me walk up and down my flight of stairs here in my house today and I had no problems, so she said I can use my stairs now. The last few days I started having pain around my knee that felt like a toothache that would start around 4 in the afternoon and wouldn't let up til the next morning. But today I didn't have that pain at all. Strange. I rest alot, keep my leg elevated and iced. I stopped using the CPM machine which caused me too much pain but still do my PT exercises. My PT is pleased with my progress and says I'm doing great. The Nurse is coming Tuesday to take out my stapes, she said that will make me feel even better. So that's an update on my progress as of now.
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tawinoh
junior member
@maryo52 So sorry to hear you went through the 'torture chamber' experience too. I still have my right knee to do in 6 months and the worst thing I dread is the Hospital stay, that was pure torture. I'd love to have it as same day surgery. The first 2 days in the hospital weren't bad because I was on a nerve block and the CPM machine actually felt good. But once that block was taken out the CPM was pure torture and it caused me to not be able to take PT and my pain was out of control. I never wanted to get out of a place as bad as I did that Hospital. The last day I was there my pain was so out of control and I was so mad and miserable that I told the PT lady that after this I would never go to another hospital again even if I was having a heart attack!!! She tried to be sweet and smooth it over but I was just in too much pain and I felt I was going to have a nervous breakdown if I didn't get out of there. Its pretty sad that you can take better care of yourself after major surgery than a Hospital can.
Josephine
NURSE DIRECTOR EMERITA
Me too. Jo!
They have a right to be cautious and check it out but they shouldn't actually refuse without speaking to the doctor first.
Of course you're not! You are taking exactly what you need and exactly what the doctor has prescribed!
Absolutely not! Don't let ONE over cautious pharmacist let you start questioning yourself and your doctor. You are doing things correctly.
Exactly!
@tawinoh Considering the speed bumps you've hit so far (what doesn't kill you makes you stronger - ??), you might get in with your PCP (soon) just to review your health and situation but mostly for pain management. Our PCPs know us and don't flinch when prescribing narcotics whereas orthos I think have come under a lot of pressure to limit their narcotic prescribing. I mean, when they look at old ladies sideways when that refill for percocet is requested, they obviously don't get it. But we do. You, my dear, know when you need a pain pill, and you need the amount to make you comfortable at a frequency that doesn't leave you with gaps of pain. I took my percocet every 4 hours. An alarm at night woke me for the 2 a.m. dose. Some people need more; some need less (or none). Your recovery is unique to you and no one can argue with what you need.
I have been in roles in hospitals where I've observed the many ways "professionals" brush off a patient's needs or dismiss their symptoms or behavior. I became an RN in my late 50s and have managed to work (very part time) without being in a hospital setting. If the PT observed you out of your mind with pain, her responsibility was to stop and go report this situation to someone who would address it.
I have been in roles in hospitals where I've observed the many ways "professionals" brush off a patient's needs or dismiss their symptoms or behavior. I became an RN in my late 50s and have managed to work (very part time) without being in a hospital setting. If the PT observed you out of your mind with pain, her responsibility was to stop and go report this situation to someone who would address it.
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tawinoh
junior member
I am 2 weeks and 2 days out now and making progress everyday. The Nurse took the Staples out Tuesday, I was so scared it was really going to hurt but it wasn't bad at all, only a couple of them kind of stung. The incision looks good and is healing nicely. I took a shower today without assistance, I had a friend standing by but I didn't need any help. I'm walking with a Cane now and sometimes I can walk without anything. I seem to get stronger by the day. I'm still on Percocet every 4 hours and most of the time I have minimal pain. The only time I seem to have pain and a lot of stiffness is when I have to get up to use the bathroom during the night and right when I first get up in the morning. After I get up and going then I'm fine. My stomach is still kind of messed up, I've lost 10 pounds so my stomach has shrunk a little bit but I still have a big appetite, I guess I over eat at times then I'm miserable with cramps and some nausea. Have to stop eating so much or start eating smaller more frequent meals. But all in all I'm very happy with my progress so far.
bottomshollow
Former BoneSmart staff member
Take care and keep us posted. We care.
hopefaith
post-grad
Maryo52, I so get what you are saying about ortho's being under more scrutiny about narcotic Rx.s I am about to run out of my short acting meds and I am very worried that the PA will not prescribe anymore after this next one or even this request. It is very sad that they decide when a person shouldn't have pain or "need" them anymore. I am also an RN and I have seen the things you describe. Brushing off patients needs, minimizing pain. It truly is a travesty. I was treated badly by an OS, (NOT mine) in the hospital about my pain med. needs.
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tawinoh
junior member
Well I was going to change my Title but the nightmare continues!
I am 1 month out as of today. I went for my 1st post-op appointment with my OS and he is not happy with my bend, it is 90, and is already talking MUA!!!! He is giving me 2 weeks!!!
I have had a difficult recovery because I was on aspirin twice a day as a blood thinner and it made me sick as a dog, it was like having the flu everyday. I would get up in the mornings and feel good, do all my exercises and I had in-home PT in the mornings. Then I would eat lunch and take that aspirin and that was it, I was in bed sick as dog. Then after I ate dinner I would take the second one and and it would get worse. I wasn't able to do my exercises more than once a day and I feel that set me back in my recovery. Thank goodness my OS told me I could go off the aspirin yesterday and today I feel great! But now since he is only giving me 2 weeks to get good bend he has given my PT instructions to be very aggressive on flexion which meant she was going to force it. Up until that she had always been very gentle with me and not forced me to do anything that caused pain. She said she would have to force it and I would have to progress or my Insurance wouldn't pay for her to keep coming.
Other than the bend I am doing great (in my opinion) I rarely have to use my cane to walk, I can go up and down stairs, I have minimal pain but am still on pain meds. Today the 'head' PT came for a visit and actually scolded me like a little child and gave me all kinds of orders to do this and do that and I HAD to progress.
I am so discouraged, frustrated, aggravated and about ready to tell them all where they can go!! I have done the best that I could, I am still healing and in my mind I'm progressing, maybe not in flexion but I feel in time it will get there. Why can't they have patience and let it heal and progress on its own???? Oh and the 'head' PT also told me that I no longer needed icing....can you believe that??
I am 1 month out as of today. I went for my 1st post-op appointment with my OS and he is not happy with my bend, it is 90, and is already talking MUA!!!! He is giving me 2 weeks!!!
I have had a difficult recovery because I was on aspirin twice a day as a blood thinner and it made me sick as a dog, it was like having the flu everyday. I would get up in the mornings and feel good, do all my exercises and I had in-home PT in the mornings. Then I would eat lunch and take that aspirin and that was it, I was in bed sick as dog. Then after I ate dinner I would take the second one and and it would get worse. I wasn't able to do my exercises more than once a day and I feel that set me back in my recovery. Thank goodness my OS told me I could go off the aspirin yesterday and today I feel great! But now since he is only giving me 2 weeks to get good bend he has given my PT instructions to be very aggressive on flexion which meant she was going to force it. Up until that she had always been very gentle with me and not forced me to do anything that caused pain. She said she would have to force it and I would have to progress or my Insurance wouldn't pay for her to keep coming.
Other than the bend I am doing great (in my opinion) I rarely have to use my cane to walk, I can go up and down stairs, I have minimal pain but am still on pain meds. Today the 'head' PT came for a visit and actually scolded me like a little child and gave me all kinds of orders to do this and do that and I HAD to progress.
I am so discouraged, frustrated, aggravated and about ready to tell them all where they can go!! I have done the best that I could, I am still healing and in my mind I'm progressing, maybe not in flexion but I feel in time it will get there. Why can't they have patience and let it heal and progress on its own???? Oh and the 'head' PT also told me that I no longer needed icing....can you believe that??
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90 degrees is wonderful after one month, some surgeons do not expect 90 degrees until 6 weeks or even later.
Sounds like the plan they have for you is only going to irritate and inflame your tissues, causing you to slide backwards with increased pain, inflammation, and loss of ROM. You are still in the angry tissue range, and best you do your own rehab, rest, ice, elevate, and medicate on schedule. So called health care professionals should not be scolding you and treating you like a child. Time to cancel all your appointments.
As for the MUA it is still way to early, and un necessary 90 degrees is fantastic ROM at one month. Tell him no, you are going to wait.
You have great ROM
You rarely use a cane
You have little pain
You can go up and down stairs independently
This is fantastic progress, many of us would kill to have that kind of mobility and ROM this early.
Go back and read the posts skigirl left you in post #14
Here are some articles for you to read:
https://bonesmart.org/forum/threads/mua-the-ineffectiveness-of-early-mua-jbjs.13786/
https://bonesmart.org/forum/threads/myth-busting-the-window-of-opportunity-in-tkr.6895/
https://bonesmart.org/forum/threads/rom-its-worth-the-wait-for-rom.10703/
https://bonesmart.org/forum/threads/rom-range-of-motion-information.3730/
It may be time for you to take over your Rehab, you are doing great, do not let these people set you back.
Sounds like the plan they have for you is only going to irritate and inflame your tissues, causing you to slide backwards with increased pain, inflammation, and loss of ROM. You are still in the angry tissue range, and best you do your own rehab, rest, ice, elevate, and medicate on schedule. So called health care professionals should not be scolding you and treating you like a child. Time to cancel all your appointments.
As for the MUA it is still way to early, and un necessary 90 degrees is fantastic ROM at one month. Tell him no, you are going to wait.
You have great ROM
You rarely use a cane
You have little pain
You can go up and down stairs independently
This is fantastic progress, many of us would kill to have that kind of mobility and ROM this early.
Go back and read the posts skigirl left you in post #14
Here are some articles for you to read:
https://bonesmart.org/forum/threads/mua-the-ineffectiveness-of-early-mua-jbjs.13786/
https://bonesmart.org/forum/threads/myth-busting-the-window-of-opportunity-in-tkr.6895/
https://bonesmart.org/forum/threads/rom-its-worth-the-wait-for-rom.10703/
https://bonesmart.org/forum/threads/rom-range-of-motion-information.3730/
It may be time for you to take over your Rehab, you are doing great, do not let these people set you back.
Oh no! You're going to have to be strong and speak up to protect your knee. Take someone with you as a support person, so that they can speak up too, if you are not being listened to.
Aggressive physiotherapy, too much physiotherapy and trying to force your knee will do more harm than good. You can't make your knee bend faster by doing those things. All you'll do is irritate those poor healing tissues and make them angry, resulting in more pain and swelling.
Continue to be kind to your knee, lots of rest, ice, elevating, only gentle exercises (and not too many of them.)
There's no need to try frantically to improve your bend, in order to please your surgeon. If you don't get what he wants by 2 weeks' time - too bad! You're only 4 weeks from surgery and 90 degrees isn't too bad. It will continue to improve, as long as you don't upset your knee.
There's no rush to have an MUA. Maybe you've been told that there is a "window of opportunity" within which it needs to be done. That's bunkum! If it's really needed, a MUA can be done much later and it will be more effective then, too.
Whatever your OS and the PTs say, ask for more time, and keep doing things the BoneSmart way. He can't do a MUA without your consent anyway, so tell him what you want. Take that support person with you to the appointment and tell him/him what you want to say, and why. That way you'll have someone to back you up.
Aggressive physiotherapy, too much physiotherapy and trying to force your knee will do more harm than good. You can't make your knee bend faster by doing those things. All you'll do is irritate those poor healing tissues and make them angry, resulting in more pain and swelling.
Continue to be kind to your knee, lots of rest, ice, elevating, only gentle exercises (and not too many of them.)
There's no need to try frantically to improve your bend, in order to please your surgeon. If you don't get what he wants by 2 weeks' time - too bad! You're only 4 weeks from surgery and 90 degrees isn't too bad. It will continue to improve, as long as you don't upset your knee.
There's no rush to have an MUA. Maybe you've been told that there is a "window of opportunity" within which it needs to be done. That's bunkum! If it's really needed, a MUA can be done much later and it will be more effective then, too.
Whatever your OS and the PTs say, ask for more time, and keep doing things the BoneSmart way. He can't do a MUA without your consent anyway, so tell him what you want. Take that support person with you to the appointment and tell him/him what you want to say, and why. That way you'll have someone to back you up.
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tawinoh
junior member
@Pumpkln @Celle Thanks so much for the support, I feel the same way about it as you, I feel I am doing good and progressing everyday. Even my regular PT over the last week or so said she didn't think I would need anymore PT after I saw my OS this week, that I was doing great. When she came last night after my OS appointment and I gave her the new orders from my OS I believe she was shocked. But since he has requested her to be aggressive with me her hands are tied, that's what she has to do now. I don't think I will see her again til Monday so I will see how things go this weekend, I'm so glad to have a few days break from these people to get my thoughts together and rest my knee.
I am definitely refusing the MUA in 2 weeks if he still insists on it. I don't have anyone to go with me and support me, I'm pretty much alone. My friend that promised she'd help me get through this abandoned me after the first week I was home, I've been pretty much on my own ever since. One of my friend's daughters has been coming over some and helping, but that's about it. If I have too I will continue rehab on my own at my own speed, if my OS doesn't like it....oh well....its my body, my knee.
I am definitely refusing the MUA in 2 weeks if he still insists on it. I don't have anyone to go with me and support me, I'm pretty much alone. My friend that promised she'd help me get through this abandoned me after the first week I was home, I've been pretty much on my own ever since. One of my friend's daughters has been coming over some and helping, but that's about it. If I have too I will continue rehab on my own at my own speed, if my OS doesn't like it....oh well....its my body, my knee.
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Remember it is your knee, and you have the right to refuse any and all treatments. Tell the PT NO on Monday, and she cannot touch you, regardless of what the OS has ordered.
Glad you have the weekend to read over the articles and have time to make the best decision for you and your knee.
Glad you have the weekend to read over the articles and have time to make the best decision for you and your knee.
She has to try, but you don't have to let her! It's your knee!
You and she have a couple of options here, both of which include not letting her do aggressive therapy:
- She tries to follow her orders, you refuse, and she reports that she's tried, but you were not co-operative (so what?).
- You and she agree that you will both continue with the gentle therapy, and she says nothing.
I hope your PT will feel that she can accept your wishes, because you mustn't let her harm your knee!
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tawinoh
junior member
@Celle She said if I refuse then she can't continue therapy on me, the place she works for won't let her. The 'head' PT that came to visit me today said I need outpatient PT, which is done at my OS office. He has an opt facility set up across the hall from his office. So I know not to go there, he'll for sure have them be aggressive with me. Actually my OS had the nerve to ask me yesterday if my PT was mean....I said no. I guess I should have lied and said yes...lol
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Unless you stop improving little by little I don't see why it would be necessary.
Let's ask @Josephine what she thinks of that!
I think your surgeon, while he may well be technically good, sounds like a right little Hitler - a "my way or the highway" person. There's more than one way to skin a cat and you have the right to choose, not to be bullied into having your knee hurt.
Well, to be totally subversive, let me tell you that you really don't need PT at all! You can do it all by yourself, at home.
Have a look at this:
https://bonesmart.org/forum/threads...rself-exercises-from-basic-to-advanced.14390/
And walking is the best exercise of all.
Lots of people in the UK go home with a sheet of exercises to do by themselves at home and they don't have PT at all. Guess what? They recover just fine.
Apart from the basic exercises I was shown before I left hospital, I only had 3 sessions of PT with a 2-week gap between each session. The PT never touched me, but just showed me some additional exercises each time. I had a textbook recovery, I can bend to about 125 degrees and my TKR knee is now my good knee.
I believe that @maryo52 did all her exercises without the help of PT and I know that Josephine did, too.
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