6:00 AM Day 2 Post-Op
The CPM (continuous passive motion machine) finally arrived last evening so the nurses hooked me up to it for 3 hours each leg overnight.
Sort of like CPAP for your knee
It SLOWLY flexes and extends the knee to help increase the ROM gently and with no effort on the part of the patient -- except some inconvenience for the patient and caregiver(s).
Anyone doing CPAP will immediately recognize the trade-offs that are inherent in this type of equipment, especially the idea of having it "in bed with you", even though they are completely different treatment modalities, i.e., bending your knee vs. breathing for you.
Of course, what does CPAP do? It expands your lungs and effectively "operates your breathing" (a bit anyway.)
The CPM was actually pretty comfortable.
Typically they start the machine a 0 degrees extension and 60 degrees or so flexion, allowing the patient to operate a remove (corded) control to increase, decrease, stop, start, or otherwise adjut the machine.
We started at 0 to 60.
Now for the good news:
Almost immediately I decided that my knee could do a lot more so I cranked that baby up to -10 to 120 degrees, a 130 degree ROM.
Now to be clear, it doesn't PULL your need down fully so the -10 is more permissive than mandatory so my knee wasn't hyper-extending, and probably wasn't even going all the way to 0 (except may on the right where the extension was already at 5 degrees.)
We kept the "foot pressers" (air booties designed to press and release your feet to improve blood return and reduce the chance of blood clots) and the Polar Care cold therapy (ice water circulation right on the knees in place of ice packs) connecting and operating also.
Category TMI: You pretty much need to commit to using an in bed urinal (or catheter) but I have discovered that for males this is actually quite convenient and beats getting up at night for the bathroom -- my wife seems to indicate this isn't as convenient for females. YMMV
Medical literature is unclear about whether the CPM is actually cost effective, but my surgeon says that every patient who chooses to USE IT finds it to have an ANALGESIC effect which improves pain control and reduces stiffness.
This is different from CPAP where the effectiveness of the treatment is well documented, but similar in the sense of there are likely a LOT of people who just don't go to the trouble to use this inconvenient piece of hardware (in the bed or on the couch etc.)
My first impression is that I LOVE IT and will gladly deal with the inconvenience for 2-6 weeks (I think the rental period is 6 weeks on insurance and at this rate by 2 weeks I may not needed it any longer.)
I liked it enough on this first use that I went to Amazon to price one for purchase.
My guess was a few hundred bucks, maybe $400 to $600, but NO, they cost a few THOUSAND dollars, perhaps $2000 to $5000 (new but discounted from sources like Amazon.) Go figure.
The darn things cost more than a CPAP machine, or at best are similarly priced.
I am starting to ENJOY the hospital even. Might stop trying to escape and figure out how to STAY LONGER (at leas over in the inpatient rehab area here -- they have a POOL.)
It will be a whole lot easier to have a caregiver fetch ice, fill the cold therapy machines (I now have a separate machine for each leg), hook and unhook the tubes, and do similar setup on the CPM.
My wife isn't going to be able to keep up with all this work as much as would be useful for the rehab of the knees, and the CPM is a bit heavy for here to move and maneuver.
Even with all the walking I did yesterday and the CPM on for 6 hours last night, I am essentially pain free while lying in bed, but I did start taking 1 of 2 allowed Oxy (Percocet) by the clock to prepare for the in site Exparel to wear off sometime between today and probably Friday.
The max/approved dose for Exparel is "per person" so with 2 knees the surgeon splits the dose you would receive in a single surgical site .