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TKR Tough Going <

It took me 3 years to fully recover from tibial plateau fracture. The adhesions along IT band were awful nothing helped much with pain other than ice & stretching the calf muscles. It was a slow uphill climb but improvements did come as I continued to push myself.
 
@foodiex2, I am so sorry to hear about your difficulties with narcotic medications. Everyone is do different with regard to meds. I am very thankful that my pain management physician, OS, PCP and Rheumatologist all collaborate to find the best course of action for me. I hope you can find the right "cocktail" if you will, that works for you.
 
@foodiex2 josephine has a chart for pain meds. Tramadol isn't a narcotic and used with the correct dose of Tylenol has helped those with med problems. At the time that I took tramadol I didn't know it should be used with Tylenol so it did nothing for me. If you start a post-op thread a moderator will see it and will probably have better advice than me.
 
@KarriB- can you point me to the chart for pain Meds Jo has ? I did a search but did not find the Tylenol with Tramadol .
 
@spinnerdiva try going to the library tab, then library index. Not sure that's where I read about tramadol with Tylenol, but I know I read it somewhere with the exact mg of Tylenol.
 
Changing topics here, is there a forum or thread for bone smarties with rheumatoid or psoriatic arthritis or ankylosing Spondylitis? I have an unspecified autoimmune arthritis and I would like to understand how this challenge might affect my recovery according to the bone smart philosophy, @Josephine ? I have been reading lots of threads this morning and I am learning so much! I feel the black cloud of discouragement leaving. I wanted to go to worship this morning, but it seems the Lord wanted to encourage me in this way today. I'm right where I am supposed to be at this moment and I am finally hopeful and convinced that my recovery is going as it should, now that I will eschew everything which has previously set me back.
 
@MimiMimi during my recovery I found myself in a pattern of meditation like no other time. I wasn't able to attend church for over two months, but I worshipped like never before.
 
I've got a question. I just cancelled 2 out of my three scheduled PT appointments for this week! I already feel empowered! I will continue to do gentle essential exercises at home this week. Now, for my question. I have a follow up appointment with my OS a week from today. My ROM is still not what I know he would like for it to be. The idea that I am going to go in there and have him threaten me, once again, with a MUA is causing me great anxiety. Should I cancel and reschedule that appointment for a few weeks later? What would you do if you were me?
 
I would go and see the OS. It is important to get the X-rays done and see how the knee is doing.

Remember---he can threaten you with an MUA all he wants---but it is your body and your knee---and nobody can do anything to you without your permission.
 
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I can see how the xrays, etc, would be important. I am just anxious about the MUA conversation. I don't want to antagonize him. I have also heard that he "doesn't like to see his patients on walkers after two weeks"......well, he's not going to "like" seeing me for at least two reasons.

TKR, Sept 29, 2015
 
I agree with Tim (referee 54). Go to your appointment and have the X-Rays.

If your surgeon threatens you with an MUA, just calmly tell him you don't want it yet and would like more time, to see how you progress without it. He can't force you to do it. He might express his displeasure, but it's your knee, not his.
Can you take someone with you, to act as your support person? Clue them up about how you want them to support you.

It's only just over a month since your surgery and there's no need to rush to get ROM. There's no "window of opportunity" and ROM can continue to improve for a year or more after surgery.
Myth busting: the "window of opportunity" in TKR
It's never too late to get more ROM!
It's worth the wait for ROM
 
OK, that makes sense. It's my choice. I just wish I could present him with a scholarly article !


TKR Sept 29, 2015
 
There really isn't any point in trying to debate with your surgeon. He will have formed his opinions and you won't change his mind, even if you do find scholarly articles.

Your best approach is to remain calm and to tell him something like "I appreciate your advice, but it's my knee and I'd like the opportunity to try waiting longer before I consider a MUA."
 
In my experience as a health educator,
( my former life in which I advocated for evidence based practice and helped to shape policy in the hospital setting) a reasonable physician is more likely to consider the road less travelled when an academic, peer reviewed study could support it. Otherwise they are likely to view it as voodoo. It would be great to be able to open him up to the bone smart way.
TKR, Sept 29, 2015
 
@MimiMimi i have heard that Mayo is now advocating non-aggressive or NO pt, but I can't find the article again. My mother's friend had her knee done at the Mayo and had no pt ordered at all. My OS did a fellowship at Mayo and ordered non-aggressive pt for me until week 12 or 13.
 
Take some deep breaths. I am sure your OS has seen the different recovery rates among patients. If he cannot respect your desire to go slow then it's his problem not yours.

If he is egotistical he may not be receptive to more education about alternative theory on PT. But if he is caring he would at least give you an open ear.
 
@MimiMimi I had my knee done at Mayo. OS was not aggressive about anything but pain control. My PT home session today was great, her mantra was the BS mantra.
Told me I would do more damage "working hard" and just wanted me to do heel slides, walk in the house and ankle rotations.
When I was in nursing school we were taught to never "threaten" anything because pt. could sue. My instructors example was when a nurse says "if you don't pee I am going to have to put the catheter back in" Big no-no, absolutely and always non threatening behavior. Your OS can carry on all he wants but it is your body, your knee, your recovery.
 
My surgeon also embraces the gentle approach to recovery. He does not allow any formal PT at all for at least 4 weeks after a knee replacement.
All his patients do well and he does very few MUAs - none at all for the past 2 years.
 
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