Lack of communication?

After my total knee replacement, I had two weeks of in-home therapy; then I was sent to a therapy center, where I was truly challenged for awhile.  On my second visit there, I asked my therapist, Micah, if I should continue doing the exercises I had been doing at home.  
"Only if they challenge you," he replied.  
Well, compared to what he was making me do, those old exercises were pretty darned easy, so I took that as permission to stop them.  
I had my last session with Micah on Monday.  He had me choose a "graduation gift"; I selected a T-shirt with plenty of advertisement for them, and was on my way.  At no time did he instruct me in exercises to continue at home.  
I saw Dr. Strong today.  My X-rays looked great, she said.  She noticed that my knee was swollen and I told her it had been that way for three days, probably because I'd been going on forty-minute walks with Cliff.  She suggested taking Ibuprofin and said maybe I should skip the walk for a couple of days, and then start out with a twenty-minute walk and work up slowly.  
I could see she was about done with me, so I asked her two questions.  
First, is it OK if I kneel on the new knee?  Most people say you are not supposed to get down on your knees after this surgery.  
Surprise, surprise.  She said as long as I let myself down easily and didn't fall down on the kneecap, it was fine.  Hard surfaces might not be so great without a cushion, but outside, for instance on grass or soil, would be fine.  If you fall down hard on the kneecap, it could break, she told me.  
Question number two:  Are there any exercises I should continue to do at home?  
"Didn't the therapist show you what you are supposed to do at home?"  
She actually seemed a little angry, so rather than say, "No," I said, "Oh, well I can do all that stuff they had me doing there".  
I liked my therapist and didn't want to get him in trouble.  
"OK, then continue with those," she said.  
So here's where people fall through the cracks.  If I had not asked, nobody had told me to continue doing exercises and I would have assumed I was through.  Dr. Strong figured the therapist had taken care of the situation, and I guess Micah thought the doctor would instruct me.  
So I got home and found a website with several post-TKR exercises, some of which are supposed to be continued for six months.  
And they wonder why people don't follow through on these things!  
I have to thank a Blogger and Facebook friend for mentioning to me yesterday that I would still have to do therapy at home; thanks, Deb!  If not for you, I wouldn't have quizzed the doctor about it and would have paid the price on down the road.  

Therapy. Ugh.

I knew therapy wasn't going to be a walk in the park; I had been warned.  I also know that if you don't do the therapy, the artificial knee will never do the job it's supposed to do.  So, five times a day, I deliberately hurt myself.  At first I timed the hydrocodone in such a way that it helped me through, although I will tell you that therapy was far from pain-free even with such help.  Now I've really let up on the pain meds; most of the time I only take one every six hours.  However, when I get a call from the therapist notifying me he (or she) is coming, I take an extra one.  Those therapists are heartless!  

This is my first exercise, in which I tighten up the thigh and try to put the back of my knee against the bed as firmly as possible.  I do it 20 times, holding for a count of five.  It is a lot more painful than it looks; I've made a lot of progress, though.

This is a leg raise I do with the new knee.  I do this twenty times.  For some reason, the first time always feels like I can't possibly do it, but then the other 19 come fairly easily.

    This one isn't so bad until the therapist comes; when he's here, he pushes down on the ankle while I'm trying to lift it, to give more resistance.  

This is my most dreaded exercise:  I slide my heel up as far as I possibly can, fifteen times.  Then I take a few deep breaths and do it another fifteen times; then I do it yet a third set of fifteen.  When the therapist is here, he measures to see if I'm bending the knee further than last session.  

  This one, my last exercise, is a piece of cake, and I'm getting my foot higher each day.  Again, when the therapist is here, he pushes down on the leg as I lift it, making it much more difficult.  


Since I have to go through this routine five times daily, I usually get started early, sometimes by five A.M.  I'm a morning person.  I always hope to have done all five sessions by 2 P.M., and what a relief it is to have that chore done for the day.


Cliff and I figure this artificial knee must really be strong, to be able to take all this punishment!