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[C.Ann]

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[CF'er]

I've not had surgery but I do know (or think I know) that better outcomes are achieved by doing the PT. It gets all the junk worked out of the knee and makes it stronger. It isn't the most comfortable at first but she'll be grateful in the end. At this rate she is going to end up with a walker.

 

[sugarpie]

I'm a nurse & I've worked a little bit on a rehab unit. I've never encountered anybody as young as your daughter's MIL that refused therapy. Is she getting effective pain management? Knee replacements are extremely painful & she should be medicating for the pain, especially before doing therapy. She definitely won't have as good an outcome without therapy, her range of motion will not be as good and the muscles around her knee won't be as strong.

I have seen much older, usually elderly, patients behave this way. But it's usually because they're in a great deal of pain.

I would suggest her husband call the ortho and get her an appointment to see him/her. Maybe he can talk some sense into her.

 

[lulu71]

My father (about the same age as the MIL) had knee replacement last year and I was concerned about that issue too. IIRC, they sent out a PT evaluator (no exercise done with this person) about a week after he came home from the hospital and the regular PT came about a week after that. So it was almost two weeks before he had regular PT activity on the knee. It all turned out fine and he was walking around WDW like a new man 4 months later.

 

[Jeanny]

My uncle had both knees replaced (separate operations, a few years apart). He had that machine and yes it does hurt, but it's for the best. My uncle also walked up and down his driveway to get the paper in the morning, then to get the mail in the afternoon.

She needs to keep moving and that will help with the PT.

 

[C.Ann]

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[sugarpie]

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Pain medication is Lortabs.. Don't know how effective it is, but in all honesty, she has a very low threshold for pain and tends to baby herself beyond belief.. If she has a cold, she's in bed for a week.. If she has a headache, she's in bed for a week.. If she has an ear ache - you got it - bed for a week.. And of course she runs to the doctor immediately and insists on an antibiotic if she so much as sneezes.. I think this is why her DH is so annoyed.. He's trying to be helpful and understanding, but doesn't see her doing anything to help herself..

Lortab is the usual drug for moderate to severe pain. It's a brand name for hydrocodone and it should be pretty effective. She sounds like she's got a major attitude problem. I'm sure nobody told her having a joint replaced would be easy. It's a lot of hard work, but she should have known that.

Everything will work out fine. Things have a way of working themselves out.

 

[Saphire]

It is the responsibility of the physical therapist to educate patients after knee surgery about pain, activity level, exercises to do, and most of all, to tell the patient it is not ok to "lie in bed for a week". She needs to keep moving. Leave the job up to the therapist, that is what they do.

 

[mamajoan]

The machine you are describing is called a CPM.. continuous passive motion

CPM's have been beneficial for patients who find moving their knee difficult after surgery. She was given exercises while in the hospital, such as quad sets, ankle pumps, flexion and extension of the knee.. those are all active exercises. She should have been given a written exercise sheet when she left the hospital. These should be continued as described, as should any ice packs after the exercise along with her pain medication.
The CPM has been proven to increase range of motion if used consistently.

I would venture to say that she will not follow any of the exercises as instructed. This will cause decreased range of motion, decreased strength, increased pain and a longer time to regain full strength. All in all delaying the healing process and putting the artificial knee replacement at risk.
The PT who will be doing the home health will take note and set her up on a program. It is up to her... I saw lots of patients just like her.. I also saw many who worked very hard to follow their home program.. and they were successful rehab patients.
She should be seeing the ortho soon.. he is probably quite aware of her low pain tolerance.. TKR are very painful btw.

High Five for Saphire!! right on!

 

[Breezy_Carol]

I do home PT and we are required to see any new patient within 48 hours of the referral. I don't know how lulu's father took 2 weeks to get PT.

In this area they stopped using the CPM, I am not sure why. So, I wouldn't be overly concerned about her not using it because none of my patients get it now.

If the MIL does not do her exercises she can get scar tissue in the knee and they will have to go in and do "Manipulation under anesthesia." Basically knock her out then bend the knee until the adhesions break, not something
she wants to go through.

Bottom line, it is up to her to do her exercises if she wants to recover and no one can do it for her.

 

[lulu71]

I do home PT and we are required to see any new patient within 48 hours of the referral. I don't know how lulu's father took 2 weeks to get PT.

Our area is a little short of hospitals/medical professionals right now.

 

[C.Ann]

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