TKR Toni Lee Recovery Thread

[tlfiore]

You're at 6.5 weeks post-op and your flexion is barely 100º...maybe 101º

The majority of OSs would like 90 degrees at 6 weeks and you are 10 degrees better than that! Your doctor is being unreasonable.

I DO NOT WANT A MUA under any circumstances. I'm afraid if I decline the MUA, I'll end up with a permanent horrible contracture.

You are the boss, not your doctor. You are doing amazingly for 6 weeks out. Don't let him depress you. He needs to go to recovery training school for a knee replacement. Where you are today is not where your knee is going to end up. All your knee needs is time and your doctor needs to have more patience.

Thank you for being so supportive!

 

[flacie1]

OMG!!! I am so sorry your OS is pushing for MUA. I am in disbelief. I barely got to 100 degrees at therapy today and my PT hasn’t said anything about MUA. In the beginning it was mentioned because I was on the border of regressing but now all my therapists say I’m doing well. Don’t stress and don’t let your OS force you to do something you don’t want. I think you’re doing great, much better than me in some areas.

 

[Jockette]

I agree with all the others! Your knee is coming along fine. I would not agree to an MUA with a bend of 100.

And, just so you know, my ROM improved after my one year anniversary AND after my second anniversary. You’re going to be fine.

 

[Jockette]

Here’s how things went for TortiTabby:

At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!"

 

[InkedMarie]

Just say no!

 

[caredFL]

So sorry you are dealing with this....it just amazes me how different the OS can be with recovery process. At 5.5 weeks I had my follow-up and was 98 with good extension and my OS was pleased. He is more concerned with extension as he says the flex will come. Now at 7.5 weeks I am at 107 and I'm quite pleased with that and do not see my OS again until Feb. No way in hell would I agree to an MUA as long as I am progressing no matter how slow.

 

[flacie1]

@tlfiore How are you doing? Haven’t seen you post lately and I’ve been wondering how you are doing.

 

[tlfiore]

@flacie1 you are too kind to check in on me. I've wanted to post an update for a while but just haven't done so. I have followed your updates and progress. Uggghhhhhh...this is difficult flake, isn't it?

Needless to say, I've been an emotional WRECK. I've been up, down 'n all around. But I think I have made a relatively firm decision.

Long 'n short is apparently my PT had some email correspondences with my OS and my current 105º active flexion is not adequate. I have about 115º passive (assisted) flexion and I'm about 9.5 weeks out.

In ALL OTHER AREAS, I'm showing improvement, albeit slowly. I'm walking 90% of the time unassisted by a cane, my pain is less with only Aleve 220 mg q 12 hrs. I'm tolerating ADLs and household chores better and I'm sleeping more restfully throughout the night. I am running more errands and even though my OS hasn't officially "cleared" me to do so, I'm driving myself to PT and around my little town (locally...no more than a mile). I bought a home recumbent bike and I easily complete 10-15 minutes twice daily on the bike. I'm able to walk Ernie further. My gait is improving day by day.

I am scheduled to see my OS on Tuesday, the 7th of January. Unless I'm missing something, I will refuse any plans for a MUA. Additionally, I'm willing to self-pay for non-invasive tests that may/may not show the presence of adhesions (I don't think such text exists). Finally, I'm leaning towards seeing a Physiotherapist, one who specializes in breaking up adhesions following a TKR via manipulation & massage.

I am fearful of going against the "grain" of the strict medical model my OS obviously adheres to. But I do not think I am a candidate for a MUA and I have to go into my visit Tuesday prepared to think alternatives.

I know others here on BoneSmart will provide input and advice. I am tired of feeling "bullied" into meeting standards that seem set by Insurance Standards, payment issues, statistical analysis, quality improvement programs, surgical outcomes and other things unrelated to patient care & patient satisfaction.

I'm told, "Well you need 120º flexion to get up from a seat, including a toilet seat, blah, blah." Well, I'm doing that now. Why not ask me if I am satisfied thus far with my recovery and outcome?

I don't get it.

Flacie, what are your thoughts? I look forward to hearing from you. I am so happy your recovery is going so well.

 

[Jockette]

In ALL OTHER AREAS, I'm showing improvement, albeit slowly.

This is what counts the most. All those things you listed are wonderful milestones. These are the types of things my PT looked for and happily discharged me at just under 8 weeks post op.

ROM of 105-115 is very fine for your stage of recovery. There are no adhesions with those numbers.

If it was me I’d stop the formal PT and continue healing on your own, things will continue to improve as you heal. You still have a ways to go, and you’ll get there in time. You are not having a slow recovery, you are having a normal recovery. I will never understand PTs and surgeons who push (literally and figuratively) for a one size fits all recovery according to their opinion. Our knee doesn’t care about their opinion, only it’s own.

Stop going to these negative influences, they are not helping you. You are coming along fine, and deep down you know that.

 

[Macknit]

@tlfiore whew, I haven't had time until this weekend to catch up on everyone. I'm so sad to hear the bullying that you have been through. I honestly think this is an injustice of western medicine. I do understand your education and career formed you, but this isn't a rebellion you are launching... it is just plain sticking up for yourself. I hit 112 degrees at about 8 weeks and stalled there for quite a few weeks. Right when I started back to work full time....(Hmmm there's a pattern here!)

When I saw my OS, just before my 12 week point and he said, "Oh, you're doing great! My calibrated eye-ball says 120 and you will just continue to improve." Now this is a guy who was military trained, (you know all the macho "no pain, no gain" propaganda that those guys have to deal with), then he became head of Ortho at one of the bases, and 15 years ago he landed here and everyone who I've met has praised both his technical skills and his approach with patients. He gets it, just like Bone Smart!!!

I'm not telling you this to make you feel bad about your OS, rather to let you know that there are probably 10s of thousands of Orthopedic Surgeons out there, who do understand the gentle approach. Please stick up for yourself on Tuesday and know that this site isn't misleading any of us!! You are not a rabble-rouser, but a human being who feels pain and knows when to speak up to heal properly!!!

My positive thoughts will be with you on Tuesday!

 

[flacie1]

@tlfiore you are doing so much better than I am with your flexion I’m shocked your OS is talking MUA. My flexion is at 95 unassisted. I’m very interested in the physiotherapy you are thinking of trying. Whenever I massage my incision it feels so much better. I see my OS this Tuesday also and I don’t have any therapy scheduled and I’d prefer to not go anymore.

I took Blue out for walk today, trying to get back to that I miss it and I know Blue does too. Thankfully I had my son with me, I stumbled and almost fell. I wrenched my knee pretty good so now here I sit on the couch with my ice machine. I hope I didn’t do any damage.

 

[tlfiore]

Thank you everyone for your kind words and encouragement. It's amazing how everything everyone states makes so much sense. Then, I think about these ridiculous OS and PT goals & measurements and it discourages me...makes me angry, actually.

Jockette thank you for always offering so much wisdom and understanding. Given so many factors that include my upbringing, my respect for authority, my people-pleasing dysfunction and all the rest, it is extremely difficult for me to say "no" to people and go against the "grain," or the SOP. I've always had a hard time sticking up for myself and speaking up, especially towards authoritative folks. I get SO SO SO tired of hearing, "Well, you are a Nurse Practitioner and you all are the worst, you make the worst patients...you are your own worst enemy...too much knowledge is a dangerous thing...stop reading medical abstracts & outcomes, you're too anxious, blah, blah, blah."

Macknit thanks again for always taking the time to respond. Sounds like you are doing very well and the "fit" between you and your OS is remarkable and positive. It means a lot to me for you to keep me in your heart on Tuesday.

Flacie I'm sorry you are having a rough go of it. I am so sorry you nearly fell and wrenched your knee today...that is awful. I still use a cane when I'm out with Ernie, or I'm on uneven surfaces, or unfamiliar surfaces. Please take care and let us know how you heal. I will keep you posted about the physiotherapy. There seems to be a reputable center in Ann Arbor Michigan that provides all sorts of alternative, holistic & healing therapies.

Thank you everyone. Keep me in your thoughts come Tuesday.

 

[Jockette]

Given so many factors that include my upbringing, my respect for authority, my people-pleasing dysfunction and all the rest, it is extremely difficult for me to say "no" to people and go against the "grain," or the SOP. I've always had a hard time sticking up for myself and speaking up, especially towards authoritative folks.

I have been the same way, but I think this recovery, and how I was treated by my medical team, has pushed me over the edge and enough is enough. It’s all opinions and my opinion counts most of all, when it comes to my body!

There seems to be a reputable center in Ann Arbor Michigan that provides all sorts of alternative, holistic & healing therapies.

You really don’t need anymore outside help, you are recovering very well and doing your daily activities. The rest of your improvement will come in time. I saw a lot of improvement in my second year and even still more, now in my third. Don’t feel like you have to seek out further treatments. Time is the main thing you need now.

 

[tlfiore]

Jockette thank you again for taking the time to provide input. Yes, I'm not sure I require additional help at this point, either. I guess I'll have more information come Tuesday. I am NOT looking forward to the visit. Thanks again for everything you do for everyone.

 

[Jockette]

Remember, you are allowed to follow your instincts of common sense.
Saying no to therapy - am I allowed to?

 

[caredFL]

Have also been thinking of you. I haven't posted in a while either but really our team of OS and PT are so different. As you know I'm just a few days ahead of you and very much the same flex. I am 100 unassisted and 108 when assisted. Like you, I feel better everyday and am functioning well. My PT just told me Friday "don't worry about the number, it's function that's important and you are functioning well and have good strength at this point". Anyway, sounds like you are doing good and hoping all goes well for you at the appointment.

 

[tlfiore]

@caredFL thank you for the encouraging words. I'm glad to hear you are coming along so well. It is still striking to me how different teams of OS and PTs can be so opposing in their views, beliefs and thoughts.

One would think "definitely it is my overall functioning that matters most," right? I certainly didn't care to focus on numbers when this all began (if at al)l until my last OS visit three weeks past, during which my doctor appeared appalled my lack of post-operative flexion.

We'll see what Tuesday brings. I've been thinking about you, too. Please keep up the good work and feel well.

 

[LD of Michigan]

Yes, that sounds annoying and a bit pushy -- I'll take a hint should those sorts of dictates head my way (sheer numbers and quotas that is). If feedback (ala ones functioning) is not desired OR considered then we probably need to question the treatment. Please keep us posted. And stay strong and affirmed in what you have achieved so far~!

....I am tired of feeling "bullied" into meeting standards that seem set by Insurance Standards, payment issues, statistical analysis, quality improvement programs, surgical outcomes and other things unrelated to patient care & patient satisfaction.

I'm told, "Well you need 120º flexion to get up from a seat, including a toilet seat, blah, blah." Well, I'm doing that now. Why not ask me if I am satisfied thus far with my recovery and outcome?

 

[sistersinhim]

Be strong Tuesday and don't let your OS tell you that you aren't doing well, because you are! Those of us that have been on Bonesmart for years have seen all kinds of different recoveries and know when someone has a problem. The only problem you have is that you are being brought down by your medical care people. Your numbers are good and you are functioning great. Keep your chin up and don't be bullied or persuaded into doing something that will do you more harm than good.

I will be praying for a really good appointment for you Tuesday. Your recovery is good!

 

[Macknit]

Hi there,

I'm hoping our prayers and positive thoughts came through for you today, and that you're pleased with the outcome of your appointment!!

Your recovery has been well within the range of everything we read here! Hoping for the best!