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Wednesday, November 9, 2011

110 degrees and counting

My recovery from my second total knee replacement is similar to that of the first, but also different. According to all of the therapists I have seen (and that's a lot), every knee is different, even on the same person. In fact, some people who go for both knees at the same time (a concept I find nuts) usually have different experiences with each knee, one doing better than the other. Even at the same time, with the same treatment exactly.

In the case of this knee, my right, I am having more pain now than I was at five weeks with the left knee. It isn't unusual, but it has been dissatisfying for me. I find myself wondering what I should have done differently, which is an exercise in futility. I am here now and the best thing is to go forward and to expect a good outcome. Which I do, honestly, down the line. I have been a little discouraged about not making much progress in the flex and extension departments.

Today, though, after focusing more the last two days on elevating and icing, as well as on some specific flex exercises, more than before, I reached 110 degrees flex. A solid 110. I had been stuck at about 104 so this really charges me. I feel more capable and energized. I just need to keep up the good work and hope I see the same results with the extension on Friday.

Tentatively I am scheduled to go for outpatient therapy starting next week, but if I don't feel ready for it I can keep the home therapy going longer. I am beginning to understand the advantages of each:

Home therapy: One therapist focuses entirely on me. No distractions. I get from 45 minutes to an hour (even more today, as it happened) of undivided attention. I also don't have to find a ride. The therapy comes to me.

Outpatient therapy: Appointment times may be more consistent, but this varies with the therapist, of course. There is a lot of equipment available which I do not have at home. I feel more capable because I am outside of my house.

Clearly, the disadvantages fall from a comparison of the two: with home therapy I sometimes have to make more appointment changes, based often on traffic, for example, or longer stays with the previous patient than anticipated. I also have to use what equipment I have at home, which is limited. I would love to be able to use a bike of some sort. And those stim machines available in PT offices can be helpful, although I have now learned of home "tens units" that are really inexpensive and yet effective for pain relief. Different focus, though.

With outpatient therapy the biggest disadvantage is the need for the therapist to work with more than one patient at a time. So I get stuck on a machine and left until he or she returns to me. I keep feeling I could do this sort of thing at home or at the gym. The actual time spent with specialized therapy - like "mobes" and "stims" is rather small, it seems, in comparison to home therapy.

Outpatient therapy, though, is a sign of progress. So I welcome it. I also don't need to vacuum before my appointment.

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