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Violent Butterflies

Discussion in 'Knee Replacement Pre-Op Area' started by Pheebs52, May 18, 2017.

  1. Pheebs52

    Pheebs52
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    Hi Smarties, I'm scheduled for a new knee this coming Monday and today the anxiety level is 10 on the Richter Scale; ugh! It's totally self-induced by having made the huge mistake of watching a horrid YouTube vid in which some man thought it would be helpful (?) to show his first outpatient PT session. As the therapist was apparently leaning on his knee and trying to press his leg flat, I thought his eyes would fall out of his head. If only I could somehow erase this torture session from my memory banks; good grief!

    "Kicking my butt with good leg" and staying away from YouTube......
     
  2. dmetz

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    Try to remember every knee is different and so are the Physical therapist! Just stay calm and follow the bonesmart guidelines! The people on this site are the best! And will support you through your recovery!

    Sent from my SAMSUNG-SM-G900A using Tapatalk
     
  3. Pheebs52

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    Thanks Dmetz, I needed that reminder. NOBODY is going to do that to my knee; eeek! I'm doing my best to chill out by just being a Busy-Bee today, attempting to get my house in order for next week. I wish I could go for a long walk to burn off this excess adrenaline, but the knee won't allow it; pfft!
     
  4. SuperSnapper

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    When I saw my physio for the first time, I told her that I did not intend to do anything that would cause pain. She laughed and said that was fine. I only saw her twice, she never touched my knee just asked me to show her what I could do, watched me walk and gave me a few ideas. She was lovely and after the second visit told me that as my ROM was brilliant, it was a waste of money me going again. I think it's important to set guidelines for your PT before you start any sessions.
     
  5. SusieShoes

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    Bring the guidelines with you so you can visit them for inspiration. Save favorite recovery threads, passages, or posts. Most of all, let only your own voice inside your head. You're taking on an important project.

    My surgery was on a Wednesday. On Monday I was confident and cool. On Tuesday I turned into a swamp of fear and doubt. I think all of us are susceptible to that.

    You did the most critical work by choosing a surgeon you trust. A hospital. A care team. On Monday you give them permission to make a great change to your body.

    It's scary to hand control over. All I needed to do was ask myself if I trusted my team. I did.

    Oh, and remember always that you don't have to go along with every therapist or exercise. Just today I asked an aggressive therapist is there wasn't a "gentler" way to do those hamstring stretches they all seem to love. Turns out there is!
     
  6. Jaycey

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    Please do not think this is the norm! PT should never hurt and certainly should not be violent.

    Read this thread BoneSmart philosophy for sensible post op therapy and memorise it. You are the customer and you should say NO! if there is anything that is uncomfortable. Excessive PT only causes more swelling and pain.

    You don't need to go there @Pheebs52 ! BTW - you might want to avoid YouTube for now. It does not help calm the nerves pre-op.
     
  7. Celle

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    Most PTs will not do painful things to you. If they do, say STOP!
    Remember that it is your knee and you have the absolute right to say what will happen to it, so set your rules with the PT right from the start.

    For reference, here are the BoneSmart guidelines - we're trying not to call them "mantras" any more:

    Knee Recovery: The Guidelines
    1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
    2. Control discomfort:
    rest
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork.
    3. Do what you want to do BUT
    a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
    b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​
    4. PT or exercise can be useful BUT take note of these
    5. Here is a week-by-week guide for Activity progression for TKRs

    I've also added the Recovery reading list for you:

    The Recovery articles:
    The importance of managing pain after a TKR and the pain chart
    Swollen and stiff knee: what causes it?

    Energy drain for TKRs
    Elevation is the key

    Ice to control pain and swelling
    Heel slides and how to do them properly

    Chart representation of TKR recovery
    Healing: how long does it take?

    Post op blues is a reality - be prepared for it
    Sleep deprivation is pretty much inevitable - but what causes it?

    There are also some cautionary articles here
    Myth busting: no pain, no gain
    Myth busting: the "window of opportunity" in TKR
    Myth busting: on getting addicted to pain meds

    We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
    .
     
  8. Pheebs52

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    I'm so grateful to all of you for responding! I just re-read the BoneSmart guidelines for sensible PT and couldn't help but notice the following: Patient given a towel to bite down on! Egads, this is exactly what happened in that dreadful video I saw and can't get out of my head. I feel like I have PTSD after viewing.:yikes:

    I love the idea of bringing the BoneSmart guidelines with me, so thanks so much for that tip! My forces are scattered right now so I can't think of every single detail. I know all of you can relate well to that scenario.:rolleyes:

    SusieShoes, I can't help but feel there's always a more gentle way of achieving good results and I will be firm in demanding such. :tantrum2:

    My adrenaline seems to have run it's course for now, I have stayed off YouTube, accomplished many practical tasks around the house and since my knee is now screaming, am now settled down with a good book and some ice packs.

    I did have one, hopefully minor concern today unrelated to the video and perhaps someone here can enlighten me. I had a torn meniscus and arthroscopic surgery on this knee on March 30th. I hope this won't negatively impact my recovery after the TKR? Perhaps what I am saying is I can't tell if the knee has fully recovered from that procedure because it still feels lousy due to the OA. I also have a Bakers cyst that the surgeon hopes will resolve on it's own eventually, post TKR. It's not huge, but it is uncomfortable. Any insights on either of these issues?
     
  9. Celle

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    I don't think the arthroscopy will have much impact on your recovery from the TKR. Even if it slows you down for a week or two, this is a year-long recovery period, so a short difference isn't really important.

    Some people do still have discomfort from the Baker's Cyst for a while, but it should eventually settle down.

    Have you read this article?
    Baker's cysts and other knee bursae
     
  10. KarriB

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    My dad and best friend had a PT push down on their knee. When I went to the same group I watched their hands like a hawk to be sure no one touched or pushed on my knee. I didn't know about BoneSmart, but I didn't want the pain. If you go to PT have a talk when they're doing the assessment. Tell them exactly what you will and won't do, as well as what they'll be allowed to do.

    I saw a different PT group after my second surgery and they were wonderful! There were lots of knee, hip and shoulders there and from what I saw no one was in pain. Just be clear about your expectations.
     
  11. Pheebs52

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    Celle, great point on recovery time. Another week or two is definitely nothing in the grand scheme, eh? I'll just have to cross my fingers and hope for the best with the cyst.

    KarrieB, I will remember this advice for my initial PT evaluation.:) *Must tie string around finger*
     
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  12. Jennszoo

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    For extension/flexion, my Pt uses a machine called a Genuease? (I think) that I strap my leg into and crank a handle and the machine extends my leg and I hold it for 20 secs and then I crabk it the other way and it flexes. When I first went for my pre-op and saw a pt on it, I was terrified. But I've since used it every visit and I love it. It's totally in my control. I crank it slowly, I get to a spot that feels like a good stretch, a bit of discomfort but not pain and i hold. I've even been known to add some additional hamstring stretch during extension by leaning forward.

    All that to say, sometimes things look scarier from the outside. But also, there are other options to a PT manually stretching us. Other than the painful estim to wake my quad (which I consented to), my PT has not hurt me. And my area is hardly progressive, everyone I know who's had a TKR had an aggressive PT and my OS is a proponent of aggressive PT. Lol. So I felt like the odds were stacked against me, except I was armed with The BS mantra and knowledge.
     
  13. Pheebs52

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    Oh Jennszoo, that last sentence just says it all, hahaha! Thanks for your informative and humorous reply!
     
  14. SusieShoes

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    My OS too is a believer in aggressive PT, though aggressive gentle PT. He sets goals. Because I met his week 1 goals out of the gate, we haven't locked horns. A good PT confident in their skills will work with you and you boundaries.
     
  15. Jennszoo

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    Yeah, I feel fortunate that I've made good progress with my ROM so I didn't have to fight much. If I was still struggling to get to 90 or something, I think it would be harder to stand my ground on the bonesmart ways vs his aggressive approach.
     
  16. Pheebs52

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    As a Newbie still stuck on the other side for a few more days, I'm probably wrong, but it seems as though reaching the holy grail of 90 degrees flexion quickly is just the luck of the draw? If so, that's a bit concerning. I've read so many posts here that seem to fall into one camp or the other; quick realization of this goal or very slow (if at all), but I have no understanding of how this occurs, given TKR is such a common surgery. Naturally, I realize swelling is the real culprit and everyone heals at their own pace, but can't help wonder if the immediate post-op care or the surgeon's skill or just a combo of the two are what results in poor flexion outcomes ?
     
  17. jaschembra

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    I layed down the law with PT on first visit - "I" will do it myself - I do not want you to touch me - if I don't continue to improve we can discuss - but for now, don't touch me".

    I have a small Bakers Cyst behind my knee and it does have fluid but my OS has said it will settle when the other swelling settles. I had one in my right knee too and when the knee was drained, the Cyst went down. I too had a scope on that right knee and said I would never do that with the left knee - I would have a TKR first! The scope was a long recovery and the OA bone on bone seemed to be worse from his clean up - pain never ended (until recovery began with my LTKR) :)

    The surgery itself is not bad, you don't feel anything until the heavy drugs and block wear off and then you just have to manage your medication to keep the discomfort at bay - you will be so happy once it's done that you will be ready to endure the long marathon of recovery and GENTLE exercise/PT
     
  18. jaschembra

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    Flex, example. I was (am) an easy sweller.
    Leaving hospital I was at 82. First full day home (day 3) I had pain and swelling and was only at 56.
    At about 2 weeks I was 95. However, at 4 weeks, I was 100, my OS mentioned the MUA and wanted to see me in 4 more weeks (he didn't know I wouldn't even consider an MUA for many months!). 8 weeks I was 115 and he was pleased... but - I'm just laying this out there for an example - it can go up and down based on pain and swelling - you cant get there any faster than your body(knee) is ready for. (And I remember being stuck at 105 for many weeks). And... don't compare. I was in tears one day at PT when I saw a knee twin walking so well and doing much better than me! Don't do that. I learned my lesson :)

    Look forward to following your journey with your new knee(s?)
     
  19. SusieShoes

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    My experience with post-op flexion is largely personal. I know only what I did or did not do, and not what others did. It would take someone far more expert in medicine and physiology to determine if anything I did had any effect on my results at all. Perhaps it's the shape of my joint. It could be genetics.

    Both my mother and my sister had an easy time achieving post-TKR goals.

    Did my eight weeks of pre-op exercises (at home, nothing intense or special) help? My legs are strong.

    Did losing 10 lbs. matter? I suspect not. Many people lose much more.

    I will venture the surgeon matters. My surgeon is sought after for his "gentle" hands and low failure rate. Maybe gentle hands mean less tissue damage and resultant swelling. But I don't know this for a fact.

    I do think being less afraid can have a good effect on tissue healing and swelling. Less stress could yield less swelling, could yield better ROM. I was not fearful going in... and received Reiki relaxation therapy the next day while Mr. Shoes tried not to roll his eyes.

    All I can really say for certain is that the morning following surgery, my flexion was close to 90. That's led to lots of medical caregivers telling me how great I'm doing. As if I had anything to do with it.

    :chinstroke:
     
  20. Pheebs52

    Pheebs52
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    Jaschembra, your knee journey sounds very similar to mine, at least so far.:smile2: Thanks for sharing your flex experience and wisdom. Thankfully, I learned not to compare myself to others when I had a THR 5 years ago. I was branded a *slow-healer* and I can't argue with that. The good news is, I also cultivated great patience, something that had always been in short supply up until then; hah! So, at least I am bringing some hard-won, personal wisdom with me on Monday and of course, all the collective brilliance found here. The members here and this site rocks!:yay:
     

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