TKR too soon for MUA?

[russny]

I thought I’d lose most of summer to MUA plus recovery so yes, am very grateful because I already miissed Spring, my favorite season,

 

[russny]

Agreed. Carpe diem.

 

[EalingGran]

Another option: a friend of mine used a rocking chair and found that she got the same effect by keeping her feet flat on the floor and rocking gently back and forth.

I had a rocking stool/ rocking chair combo left over from when my daughter was nursing. It was lovely for resting my leg on and really helped ROM
It's the sort of thing might be available second hand as a lot of people may not keep it longer term

 

[russny]

Today I met with doc re MUA. He walked in with a scowl, visibly angry. He for the first time raised his voice at me, interrupted me and tried to railroad me into getting an MUA. He said manipulations don’t work three months out because they won’t be able to bend the knee. (I haven’t seen any study that claims this.) That my knee will never bend more than it does today. (It’s swollen right now by an inch, still recovering from very aggressive PT last week, so am confident it will continue to improve if I avoid aggressive therapy.) That PTs always see a vast improvement with MUAs. (I’ve seen patients complaining online who are in misery not just days but months after MUA. I also saw the PT’s Reddit post complain that in more than a decade of doing KTR with more than 1,000 patients, he’s disgusted to see patients suffer painful MUAs only to eke out a net “measely” increase of only 10 points.”)

Doc said “no pain no gain. I try not to be too firm with patients but you’re one of those people that like it’s just every time I talk to you you seem not to get it so I’m trying to explain to you this that this is an important thing we do. A manipulation where your knee doesn’t bend and you’re coming up with a lot of reasons not to do it and kicking the can down the road.”

He said I had to decide then and there before leaving. I said, “I’m not going to decide now. I will go home, call my brother, and then decide.” The doctor answered “you can go to the lobby, call right now, and then we can schedule it for Wednesday.” I felt coerced and like he was treating me like a five year old, it was humiliating, but managed to politely but firmly say, “No, I’m going to go home, take a breath, and call. After that, I will call today to let you know what I’ve decided.”

I’m the kind of person whose impulse is to say no when someone pushes me. He did at times act more conciliatory, treat me with some respect, behave more reasonably. In other words, was more professional.
That said, there was just too much coercion, interruptions, threats. At first I thought that he just believes the stuff he says. But today I wondered about his honesty because he was just too glib, refusing to acknowledge any downside to an MUA. I was told all I’d have to do for a couple of days is pop pain pills. (Though pain pills make me too dizzy to get up.) Do PT. Was assured that, though I have no help and 28 stairs, would be able take care of myself. Sigh.

 

[russny]

Am mighty bitter about PT driving down ROM from 65 to 52 (supine position) and ROM from 70 to 59 (seated position) in a single session last Wednesday. It just made the surgeon feel more vindicated.

 

[Jockette]

Wow. I’m so sorry your doctor spoke to you like that.

With my 7 years of experience with joint replacement, if a doctor ever speaks to me like that in the future, it would be the end of our relationship.

 

[EalingGran]

Efficacy of manipulation under anesthesia beyond three months following total knee arthroplasty

Stiffness after total knee arthroplasty (TKA) is often treated with manipulation under anesthesia (MUA) to improve range of motion (ROM). However, many authors recommend against MUA beyond 3 months after TKA. This study investigates the timing of MUA ...

www.ncbi.nlm.nih.gov

Here is a reference to a 2019 paper that shows that MUA can be done after 3 months if needed.
This suggests it is possible to wait until swelling and inflammation has gone down and then decide about MUA if stiffness persists.

 

[russny]

I appreciate the support. I said I would call with a decision today but I just now sent an email instead.

Am not in the mood to hear his staff yell at and berate me yet again. A Google reviewer liked the doctor but say the staff was a "nightmare." Having been on the receiving end for weeks, I now get it.

 

[Jockette]

You are so early in this recovery, you have lots of time for improvement.

The stress this doctor is causing you is not helping. I was always in more pain when I was upset about a situation, even a situation unrelated to my knee.

 

[russny]

Exactly. My knee even swells more.

 

[russny]

I now know who serves as the role model for his staff's behavior.

 

[Layla]

So sorry for the stress this has likely caused you. You don’t need that as you’re healing physically. Go with your gut. It’s your body, your decision to make. Take a deep breath and move forward in confidence with your decision.

Please know that we’re here for you whenever you’re in need. I hope your evening is a peaceful one.
@russny

 

[mendogal]

Just sending you a heartfelt ((hug))

 

[russny]

So when I left the hospital an Uber driver refused to let me get in the front seat, just left me.

Another Uber driver showed up, was really gracious like most of them have been, and said about the other driver, "He should be arrested." We had a lovely chat - the best part was her telling me how her dad had had knee surgery and they told him he would have to use crutches for the rest of his life. But he just kept at it, diligently exercising and taking baby steps, over a very long time, but now walks fine

So lucky I got ditched by the first guy.

 

[Elf1]

@russny it definitely sounds like there was some intervention there today to get you with the right driver. I have not had a TKR though I'm getting ready to have some arthroscopic knee procedures done on Wednesday the 12th. Luckily I have a great OS taking care of me.

I have previously had a spinal fusion and a THR. Most of the staff's that I dealt with with helpful and docs were good as well. But I will say that if any doctor, PT, or medical staffer ever talked to me like that they'd get a big old earful of exactly what I thought and I'd walk out, never to return. We should never, ever be treated that way and bullied into making a decision.

 

[russny]

It is now two weeks since the bad PT visit. Am not quite recovered to where I was before but gradual improvements daily. If I overdo it on my own at least it’s not as bad - can recover in a day or so, rather than weeks later. That said, Got scared because walk with walker a few days ago felt so rough. The pavement is full of pebbles so even with skis the walker was shaking so much my arms were sore for days after. Didn’t remember it being so bad when I had ventured out before. And that was when I hadn’t even put the skis on. Was scared thinking am I getting weaker not stronger?Is there no coming back from the bad PT visit? Even indoors It was more awkward w/walker. Then I wake up this morning and suddenly the thought arises, “Did I remember to adjust the legs to the right height after adding the skis?” Nope. Just now adjusted and the walker feels absolutely lovely now Very relieved.

 

[Jockette]

This recovery is so hard sometimes and it makes us worry so. I’m glad that adjusting your walker made a big difference for you.

I’m so sorry that you are still recovering from that bad PT visit, but that is not unusual. Hang in there and do the best you can to be patient with your poor knee, it’s doing the best it can to overcome this whole process.

 

[russny]

OS in last visit did give ok to travel as long as I take low dose aspirin. Thinking of leaving Northeast within a week to visit family down South. Can stay in ranch house w/sib, only two steps instead of 28 to get outside for walks. Pre-surgery already learned how to use free airline service that provides wheelchair along w/person to push you from curb to plane, then, on arrival, from plane to baggage claim and then rideshare/taxi - it's fantastic but remember to tip attendant. Will pay extra for plane seat w/enough leg room for knee still not at 90 degrees. Maybe should bring something to rest foot on?" "Comfort" class Uber costs extra but is good because can sit in front seat w/ample leg room so will book it for to and from airport. Nonstop flight only 2.5 hrs. Question - are these wheelchairs able to adjust the leg rest to accommodate knee that won't bend beyond 70 degrees? Pre-surgery I was able to bend to 120, so not a problem before.

 

[mendogal]

In my experience with my mom, the airport wheelchairs are totally basic with non adjustable legrests. However it may depend on the airport so it's worth calling the airport (in my experience, it's often the airport contracting with a provider, not individual airlines; again, it might vary in different places).

 

[russny]

Thanks! Will check.