The Knee Replacement, Part 2

I did not intend for this to be a two-parter, but I left out a really important point, and then I keep remembering more. Oddly, forgetfulness is part of why this was an issue for us. I sat in on all of Mom's appointments, because she often tends to forget key details (well, my sisters and I debate whether it is forgetting or not catching in the first place, but that's a whole other issue), and we felt we needed a second pair of ears.

Your parent may have a fantastic memory and a firm grasp of details, but they are older, they are getting a lot of information, and it is even more personal for them, where even a close, loving relative may be able to be more impartial. Again, there are just more emotions tied up in all of this than you would expect. Maybe it's because getting a joint replacement tends to mean they're old, they are doing it because they are experiencing chronic pain, and the path out of that pain involves more pain, money, and some risk. It's a lot for one person.

I will give one example. I wrote yesterday about how my mother does not have great range of motion, and her therapist was goading her about it. Naturally, we brought it up on a follow-up visit to see where we should be, and if we should be doing anything differently.

That was where we found out that the surgery does not tend to increase range of motion, but we discussed that Mom was able to do what she wanted for the most part that way. She's probably not going to hop on a bike any time soon, but she can drive and walk and do things around the house and yard. So, the Physician's Assistant said we had three options. First, since Mom was pretty happy, we could do nothing, and leave it as it was. Second, we could switch to outpatient therapy and see if they could accomplish more that way. They have more equipment there, which allows more options, and also that meant Mom was going back to Randy at Aloha Physical Therapy, whom she liked, and not dealing with the visiting therapist anymore, whom she did not like. (Physical therapists seem to often have a bit of a complex about not being doctors, and can be a little overbearing as a way of compensating. At least I assumed that's what was going on when she was talking about how she knows more than doctors about these things.) Anyway, we decided to go with outpatient therapy.

The third option was that Mom could go back into the hospital, go under anesthesia again, and they could try bending her knee to break up some of the scar tissue. If we were going to go that route, we would need to do it soon, because the longer you put it off the harder the scar tissue becomes, and that increases the risk of causing damage to the bones while doing it.

At the office, we agreed to go with outpatient therapy, got an order written for it, as well as a new prescription for drugs to assist with the extra therapy sessions. However, the thought of going back into the hospital freaked Mom out so badly that she did not remember anything else that was said in that conversation. Sure, she participated in it, but only on the service. On the inside she was remember how woozy she had been, and being away from home, and cold, and every thing that was bad about the experience (just for being at the hospital--they were good to her and did a good job). Fortunately, I had pieces of paper that proved we had chosen another option, so she had to believe me.

I think I am closer to actually done now, but the range of motion issue makes another point. When you have flexibility, it is important to keep it. If you start experiencing joint pain, don't stop moving just so you don't feel it. You will probably still feel it, and then you can lose the ability to move. In retrospect, she should have done the surgery much sooner. We have a tendency to play through the pain and just keep going however you can manage, and there are good things about it, but sometimes you need to be smart about it too.
I do want her to start tai chi after we get the other surgery out of the way, and maybe even if she can't build much flexibility up for her knees, it can help keep those hips and shoulders limber. It's nice that the replacements are available, but better not to need them.

To be fair, I don't know that she could have afforded the surgery before she got on Medicare, via Humana. I have to give high praise to them. Mom is getting the best care of her life now, and I really appreciate that.

It's also worth mentioning that the way we managed home care was that Julie worked from home for several weeks. Mom was able to walk right away, but slowly, and it helped to have someone there for some waiting on her, but also to be able to attend to the dogs. They complicate everything.

20 minutes walking outside
1 Nephi 22 - 2 Nephi 5