Scared of pain in PT

Posted by babette @babette, Aug 22, 2018

I’m starting outpatient PT next week … I’ll be 5 weeks out from a R TKR. Until now I’ve had gentle PT at home and I’m concerned about more aggressive PT being painful. I’m also concerned about it creating more inflammation and, in my case, scar tissue. Reasonable fear? Words of wisdom/encouragement most welcome!

@fjkphx

Thanks John. I'm still at 90 two weeks out. I want to feel pleased but I don't think my PT is! Knee is swollen and my hope is that I will improve when that subsides.

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ice 20 min. on, 20 min. off. leg raised above heart Ice really helped me.

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@mari

Good Luck with all. I had PRP + cells but for Bone on Bone – it was not expected to help. after couple of weeks, got rejuvenated, better balance, strength, lively – my former self. Dr. says he heard that b4.

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Kidsincollege That procedure sounds great Im just now starting to have pain but i n my right knee so far putting a brace on it for a day helps yes let us know how your procedure comes out and if they ins.pays for it

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@grandmar

@kidsincollege
Good Morning!
Sounds like to you found a very inventive doctor. I love docs like this….ones who are not surgery happy.
The only thing I want to suggest is to make sure your medical insurance will cover the procedures he does since they are out of the ordinary.
He might be covered by your insurance, but it might be for only the conventional treatments.
Good luck and let us know how these treatments go since many of us have knee issues.

Have a pain-free day!
Ronnie (GRANDMAr)

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My insurance is going to cover this procedure. I checked on that before ever agreeing to having it done. I did do stem cell replacement in St. Louis, at Bluetail Medical Group. It was not covered by insurance and was $2,000.00. However it worked and kept me out of pain for two years.

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@kidsincollege

My insurance is going to cover this procedure. I checked on that before ever agreeing to having it done. I did do stem cell replacement in St. Louis, at Bluetail Medical Group. It was not covered by insurance and was $2,000.00. However it worked and kept me out of pain for two years.

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Kidsincollege thats great may I ask what kind of ins. do you have?

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@kidsincollege

I went to my new ortho doctor last Tuesday totally convinced he was going to tell me I was going to have to have a total knew replacement as soon as he could schedule the surgery. To my surprise and delight he said he had several different procedure he wanted to preform on my knee before we get even close to the TKR. We discussed the various procedure he does and he is going to do a Platelet-rich Plasma (PRP) Treatment.You take a person’s (mine) blood, you spin it down, you concentrate the platelets, and you inject that in my knee with my own platelets in a concentrated form, his then activates growth factors and stem cells to help repair the tissue, if possible, calm osteoarthritic symptoms and decrease inflammation. I am excited and anxious to have this procedure and pray for the very best results.
@babette My doctor did go over some of the other methods he could try if this might not work and what he would do when I do get to the point when I will have to have a TKR. He said that once he gets the whole surgery done he does a Knee Nerve block on the knee he has done the TKR on, while the patient is still under Anesthesia..He does this to cut down on the discomfort and fear that his patient's have about their rehab. They are very worried about what they are to do for pain treatment and management and the nerve block in the knee will drastically cut down on the discomfort and fear that his patient's have about their rehab. He said that these blocks typically contain an anesthetic with a known duration of relief. He just calmly said, why have your patient hurt when there is a simple resolve that will help them to recover easier and with less pain. He did stress that the rehab was the most important part of this surgery. If you don't do all of your rehab the way your PT tells you, you will end up walking with a limp, develop back pain and a plethora of other symptoms your don't want. You want to have this surgery to get better and get it over with and gone, no to create another issue. He is a younger doctor and says that is the way he was taught in med school to do this surgery. I like this idea! Perhaps you should ask him about the Nerve Block? If he won't do it you might could find a Pain Specialist that will do it for you after your surgery. I have them in my neck and they do work wonders. Sorry, if this is way to much info but I do hope that all will go as smoothly as possible for you. More than 600,000 knee replacements are performed each year in the United States. If all those people can make it through everything, I have no doubt that you will do great. I will put you on my prayer list and pray for things to go as well as possible for you, dear. Try to remember when you feel overwhelmed-stop-inhale a lone breath though your nose and slowly release it by slowly blowing out your mouth. Goggle some "self relaxation" practice what they suggest. God Bless YOu. (Keep us updates, please.)

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Hi @kidsincollege! I was reading your post. Can I ask how bad your knee is? I was completely bone on bone in my right knee and had a total knee replacement in May. Because of being the stabilizing leg during my recovery, my left knee which was moderate, has now become severe and I am pretty much bone on bone. After having surgery in May, I am not thrilled about the idea of having the other knee done so quickly. The problem with the shots is that they will no longer help. I don't know if the treatment you are getting is even an option. I have to also agree with you on the breathing. I did a lot of deep breathing during physical therapy on my right knee. I called them my labor breaths. 🙂

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I had very little cartilage left in my knee and in one area it was bone on bone two years ago. I had stem cell replacement therapy and it worked to help my cartilage regenerate and grow. I had one booster of stem cell about 10 months after the original stem cell treatment. It worked for me and lasted for almost two years. Now my arthritis is growing faster than it ever has. The doctor didn't tell me a couple of weeks ago what degree my knee is just that he felt I had a shot with some other treatments before going the full knee replacement. I did injure it in May and it was really bad. It was swollen to 3 times the size of my regular knee, couldn't bend it and hurt worse than anything that I have had anything ever hurt. I'm sorry that the nerve blocks can't help you, they don't take all my pain away but they do greatly help with my pain. When it was hurt and "angry" so bad in May nothing was helping the inflammation or pain. A friend suggested I go to an acupuncturist that had been practicing for 35 years in the US. I did that out of the need to try anything to ease my pain. Since I had to travel from our small town to her about 100 miles, she had me have two treatments in one day9morning & afternoon) and then return for another the next day. I could tell a slight improvement after the first 2 days of treatment with my pain. After the 3rd week my knee was no longer inflamed, swelling was almost gone and the I was in discomfort not intense pain. I continued these treatments for 6 weeks. These were not covered by my insurance but it was worth every penny to get out of the intense pain and begin to be able to sleep and feel a little more normal. I am certainly not a trained medical person but I do a lot of research online and have several friends that are doctors and APRN's that I have questioned a lot. There are a lot of options to try before going straight into a complete knee replacement if you knee has some cartilage. I have other health issues and go to a Pain Interventional Center where my very favorite doctor ever, is with a Double Boarded in Diagnostic and Interventional Radiology. This doctor has been real and honest with me ever though he isn't the oertho doctor but he soes have advanced trained in Interventional Radiology. He reads all my tests! Good luck! Ask lots of question before doing anything!

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@kidsincollege

I had very little cartilage left in my knee and in one area it was bone on bone two years ago. I had stem cell replacement therapy and it worked to help my cartilage regenerate and grow. I had one booster of stem cell about 10 months after the original stem cell treatment. It worked for me and lasted for almost two years. Now my arthritis is growing faster than it ever has. The doctor didn't tell me a couple of weeks ago what degree my knee is just that he felt I had a shot with some other treatments before going the full knee replacement. I did injure it in May and it was really bad. It was swollen to 3 times the size of my regular knee, couldn't bend it and hurt worse than anything that I have had anything ever hurt. I'm sorry that the nerve blocks can't help you, they don't take all my pain away but they do greatly help with my pain. When it was hurt and "angry" so bad in May nothing was helping the inflammation or pain. A friend suggested I go to an acupuncturist that had been practicing for 35 years in the US. I did that out of the need to try anything to ease my pain. Since I had to travel from our small town to her about 100 miles, she had me have two treatments in one day9morning & afternoon) and then return for another the next day. I could tell a slight improvement after the first 2 days of treatment with my pain. After the 3rd week my knee was no longer inflamed, swelling was almost gone and the I was in discomfort not intense pain. I continued these treatments for 6 weeks. These were not covered by my insurance but it was worth every penny to get out of the intense pain and begin to be able to sleep and feel a little more normal. I am certainly not a trained medical person but I do a lot of research online and have several friends that are doctors and APRN's that I have questioned a lot. There are a lot of options to try before going straight into a complete knee replacement if you knee has some cartilage. I have other health issues and go to a Pain Interventional Center where my very favorite doctor ever, is with a Double Boarded in Diagnostic and Interventional Radiology. This doctor has been real and honest with me ever though he isn't the oertho doctor but he soes have advanced trained in Interventional Radiology. He reads all my tests! Good luck! Ask lots of question before doing anything!

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It is nice that you are able to try the other options. I have good days and bad days, Most days Alieve and Tylenol along with ice and heat help. I don't like to take pain meds unless I am recovering from surgery. I have been reading about different options for helping with pain and my insurance with only cover my PT. They will not cover the other things you suggested, which I think is ridiculous, I feel like doctors tend to give you pain medication, instead of trying some of the other options. I would love to try some of your suggestions, however, I have been out of work since May and am not getting paid, so money is really tight. I am right there with you about asking questions. I want the facts before I make any decisions. I talk with as many people as I can, My PT is very good at answering questions as well. And then people, like yourself. who have been through the same thing. Thank you for sharing. No one has ever mentioned the plasma treatment before.. I will ask about that.

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Ice has been a great help for me too. I'm with you about the narcotic pain meds. I do my very best to not take them except for extreme cases.It is crazy that your insurance will only cover your PT. You know you can call them and challenge their decision to not cover some of the procedures that you may need. I've found that insurance first answer for any type of procedure is "No, declines." Do your homework and know you history and why the doctor feels it is necessary for you to have a procedure they are denying. Ask you doctor's office to appeal their opinion. Take it as far as it will go. My experience is that the first person you talk to is the low person on the list of being able to change to cover procedures. Ask for a supervisor if you don't get any luck with the person you are talking to. Plead you case that you need to have this/these procedures covered to be able to keep you out of pain and from having to have another knee replacement surgery. Mention to them that wouldn't it be better for them to allow/approve an outpatient procedure than cover the cost of surgery and weeks and weeks of PT. You will be amazed at how you can get the insurance company to change and approve something that had denied earlier. It doesn't always work, but it is worth spending the time on the phone and talking to try! Have you thought about trying to get another opinion from another doctor about options for you? I have an Interventional Radiologist (Interventional radiologists perform a broad range of procedures.) that I go to for other health issues and he has been amazing to tell me about options. He now only does pain management, without pain meds, and is a wealth of knowledge. I'm so sorry that you have been out of work and without pay! That is really tough. May God watch over you on your journey!

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@kidsincollege

I had very little cartilage left in my knee and in one area it was bone on bone two years ago. I had stem cell replacement therapy and it worked to help my cartilage regenerate and grow. I had one booster of stem cell about 10 months after the original stem cell treatment. It worked for me and lasted for almost two years. Now my arthritis is growing faster than it ever has. The doctor didn't tell me a couple of weeks ago what degree my knee is just that he felt I had a shot with some other treatments before going the full knee replacement. I did injure it in May and it was really bad. It was swollen to 3 times the size of my regular knee, couldn't bend it and hurt worse than anything that I have had anything ever hurt. I'm sorry that the nerve blocks can't help you, they don't take all my pain away but they do greatly help with my pain. When it was hurt and "angry" so bad in May nothing was helping the inflammation or pain. A friend suggested I go to an acupuncturist that had been practicing for 35 years in the US. I did that out of the need to try anything to ease my pain. Since I had to travel from our small town to her about 100 miles, she had me have two treatments in one day9morning & afternoon) and then return for another the next day. I could tell a slight improvement after the first 2 days of treatment with my pain. After the 3rd week my knee was no longer inflamed, swelling was almost gone and the I was in discomfort not intense pain. I continued these treatments for 6 weeks. These were not covered by my insurance but it was worth every penny to get out of the intense pain and begin to be able to sleep and feel a little more normal. I am certainly not a trained medical person but I do a lot of research online and have several friends that are doctors and APRN's that I have questioned a lot. There are a lot of options to try before going straight into a complete knee replacement if you knee has some cartilage. I have other health issues and go to a Pain Interventional Center where my very favorite doctor ever, is with a Double Boarded in Diagnostic and Interventional Radiology. This doctor has been real and honest with me ever though he isn't the oertho doctor but he soes have advanced trained in Interventional Radiology. He reads all my tests! Good luck! Ask lots of question before doing anything!

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Kidsincollege thanks for information For my inflammation I use Tumeric 400 mg everyday when bad I,ll also drink ginger Tumeric tea from Trader-Joe's it really helps I,ve told alot of people about this.My Left thumb lasted 5yrs after Dr.injected it My right one is still o.k just had it done last year,now that Dr refuses to inject my left thumb. Going to an orthopedic Dr Till then
I wear a brace on it .So far a brace helps my knee I only wear it when needed.The knee isnt in need now its my thu mbs but thanks for information on stem cells

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@lioness

Kidsincollege thanks for information For my inflammation I use Tumeric 400 mg everyday when bad I,ll also drink ginger Tumeric tea from Trader-Joe's it really helps I,ve told alot of people about this.My Left thumb lasted 5yrs after Dr.injected it My right one is still o.k just had it done last year,now that Dr refuses to inject my left thumb. Going to an orthopedic Dr Till then
I wear a brace on it .So far a brace helps my knee I only wear it when needed.The knee isnt in need now its my thu mbs but thanks for information on stem cells

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@lioness While we are talking about supplements: after doing some research I started taking tart cherry extract. It's hard to know if it's helping because I take conventional anti-inflammatories as well. This is what I take: https://www.amazon.com/gp/product/B00TP54IFO/ref=oh_aui_detailpage_o07_s00?ie=UTF8&psc=1

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@babette

@lioness While we are talking about supplements: after doing some research I started taking tart cherry extract. It's hard to know if it's helping because I take conventional anti-inflammatories as well. This is what I take: https://www.amazon.com/gp/product/B00TP54IFO/ref=oh_aui_detailpage_o07_s00?ie=UTF8&psc=1

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Babette I,ve heard of tart cherries let me know if it works Right now I take Tumeric 400 mg everyday seems to work also drink ginger,-Tumeric tea its good for inflammation and works for me.

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@lioness

Babette I,ve heard of tart cherries let me know if it works Right now I take Tumeric 400 mg everyday seems to work also drink ginger,-Tumeric tea its good for inflammation and works for me.

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Yes, turmeric is excellent. I don't know if taking it along with tart cherry is a good plan, though! Must do a little more research.

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@babette

Yes, turmeric is excellent. I don't know if taking it along with tart cherry is a good plan, though! Must do a little more research.

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Babette I do research everything also I like a website http://www.ncih.nih.com but there are others also

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