Wellness

[Kachina624]

I can't help but wonder if the problem isn't fear of prescribing but rather reluctance to do the paperwork involved which is extensive for both patient and doctor. 

[chrystaltree]

Due to your husband's age, the surgeon is just afraid to give your husband pain medication that will work.  Your husband won't get a good result from the surgery if he can't do the required rehab.  Ask the doctor for a referral to a Pain Control specialist.  

[hckynutjohn]

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@chiclet wrote:

This seems to be a common surgery and I thought I would tell about my husbands surgery just to maybe help someone else.  He had it 10/7/21.  He went home within a few hours and was walking with a walker.  He used that for about 8 days and was driving withing 4 weeks (had right knee done).  Scar is about 10 or 12 inches long. 

He is 75 with diabetes and lung problems and overweight but he went through it fairly easily.  The other knee is just as bad so dreading another surgery.  The biggest problem is the pain.  The doctor said they have to give you half of what they would have done a few years ago. 

He has been going to rehab and that really gets the pain stirred up and he has very little pain meds now.  He does not want to continue rehab because of the pain it causes.  He is now looking for some alternative like a brace for his other leg. 

It infuriates me that people like him have to suffer for the opioid crisis.  Senior citizens who have a lot of medical problems and pain will spend their last few years suffering for something they did not cause.

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[hckynutjohn]

@JasoninBoston 

How or why ANY doctor would tell a patient "it's the most painful whatever", escapes me. Has that doctor had a TKR/Spinal Fusion/Cervical Reconstruction Surgeries? I am guessing, no!

And a PT telling you that they "passed out" watching the TKR procedure? CRAZY!! My good friend is a Sports Medicine Certified Orthopedic Surgeon, and does ONLY Hip and Knee Repairs and Replacements!

Prior to him doing the Left TKR on my wife, he asked me, privately, if I wanted to watch a video of a TKR. He knew I like watching all procedures, especially those being done on me, and while they are being done.

I watched it, but I did so when my wife was off Pet Sitting. Unlike me, she doesn't want to watch any medical procedures, just not her thing. To me it is intriguing what a doctor is able to do, at times with little space, to do so. For me it adds another element of my knowledge of the human Physical Anatomy, and Physiologic Function, which has always been an interest for me.

While I have not had a TKR, I have been through many rehabs of most areas of my body, including Patella Tendinitis, which was not a painless Rehab. Years ago when an ACL Surgery took athletes a year to recover? It wasn't because of the surgery itself, it was from the subsequent "Tendinitis" not the repair.

Won't go into Pain Levels with you, everyone is different when it comes to their tolerance of pain. Back to my main point! A Doctor or PT gauging pain by what they hear/heard or saw?  Not Doctors or PT that I would want doing anything to this beat up old body, nor would I recommend them to anyone.

Sorry Jason, I ain't buying what they are selling, and for several reasons.

hckynut 🥅🏒

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[RedTop]

@chiclet 

I've had both knees replaced and am very familiar with the issues you are bringing to light.   

I did in fact receive more pain meds thru my recovery process after my first surgery than with my second.   However, I also had an epidural with my second surgery and my pain was on a lesser level than with the first procedure.   I did not take all of the pain medication prescribed to me after my 2nd surgery in 2017, even when my incision above the knee, split wide open at week 2, and took nearly 4 months to close on its own.

The issue your husband is dealing with is multi level.   The doctors hands are tied as to how much pain medication they can prescribe; they are under scrutiny from state and federal government.   Insurance reviewers are auditing medical office records, and doctors reimbursement is being tied to how well they meet patient care protocols.  Nothing stands out more in those reviews than over prescribing pain meds.

Another issue to be considered here is age, and the fact your husband is diabetic.   If he is taking gabapentin for neuropathy pain, he is already on a pain medication.   Your husband should ask if that dosage can be increased, or ask about prescription strength Motrin.   There are likely more options to be considered for pain relief than narcotic meds.  

[Danielle46]

My husband had total knee replacement last year.  Yes, it was painful.  Doctor allowed him to remain on the strong painkillers for 10 days and that's it.  After that, he used extra strength Tylenol.  Do you really want your husband to become addicted to pain killers?  This is the reason.  All of us can become addicted that's how bad these meds are.  My husband delt with it.  Your husband's preexisting conditions could also have something to do with it,  My husband is like an athlete, very lean and fit,  no preexisting conditions and in his 60's.  He dealt with the pain and is as good as new now.  By the way, he had hip replacement surgery on the other side 3 years earlier.   Just as painful, strong med only permitted for the first week, went through PT etc.  He needs to ask his doctor what other options are available, like icing the need.  I think my husband did that at the doctor's recommendation.  You can overdo it, so he needs to ask the doctor.  By the way, my bus was given an epidural at the time of the surgery and he had no pain for the first 5 days.

[vsm]

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@KailaS wrote:

   I had total knee replacement of the right knee on August 16 of this year.  I came home alone in an ambulance transport and was alone ( except for my cat) since my return home.  ( I do have a stair lift, so handling steps was/is doable.) I am 74 with cancer and diabetes. I was driving at 3.5 weeks.  A difference is that I rehabbed at home by myself with something called a RomTech.  Medicare paid for 20 days of the device. It was painful, but I pushed myself daily to complete five sessions. Being by myself was a great motivator. My angles for extension and bend back after the RomTech were great. I refused opioids and took only Meloxicam.  I elevated and iced my knee every time I could. I really felt I had done everything I could. I was not someone who was " happy" to have the surgery. 
   I must admit that after at-home rehab, I went to PT for five final sessions.  That was painful, but I really was feeling okay-- even though I had more pain than I expected.
     After rehab and  PT I discovered that sleeping was awful because of pain, getting up and down still is a challenge, getting up and down curbs still hurts, and carrying anything slightly heavy ( like my 11 pound cat) is hard.

    I have to keep moving to avoid getting really stiff.  Yes, my other knee and right hip are screaming.  I just passed three months and I have felt finally a little less pain, but this was a hard surgery for me.  I just went back on Meloxicam and have tried to walk every day, but going more than about two blocks still hurts. 

     I try to avoid pain pills, but that is me.  But I feel awful for your husband. We should have what we need to handle pain. Thankfully, your husband has you. But keep him moving and icing. Do not let him give up.  Maybe an anti- inflammatory or something else will ease his pain.  His doctor should know how he feels.  

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@KailaS   You are one tough cookie, going through this by yourself, forgoing the opiods for meloxicam, and relying on your own inner resources to stay motivated. I admire your grit and wish I had more of it myself!  (I've been delaying TKRs for years.)

[hckynutjohn]

@vsm 

"I've been delaying TKRs for years"!  Why? 

My wife was the same. When we talked about it my question was always something like this. "You know you are bone on bone, and also that this condition will not change. You are now ** years old and healthy. Do you think this surgery will be better when you are ** plus 10, and maybe not as healthy"?

For those that don't mind having limitations on their mobility, along with being almost constantly in pain? Hey, it's your body! I personally want to get whatever source is causing me to be less mobile, and in pain, fixed yesterday. But that's just me,

hckynut 

[KailaS]

@Danielle46 

I also had an epidural, but the " no pain" phase lasted until the middle of day 2.  But at least I had that.

[chiclet]

My husband talked to the doctor about a brace for the second leg and he said that would be useless and scheduled him for the second knee on 12/28. ( Brace won't bring in any money for the surgeon).  I have been married to this man for 30 years and it has been non stop surgeries.  He has had two or three neck surgeries, rotator cuff, and so many others I cannot even remember.  He is a gold mine for the orthopedics.  At least with this surgery he knows what it is like going in so he will have to deal with it....The surgeon told him to just stop rehab on this knee since he will start over again after the next surgery.  He has been walking fine since day one and has 100% extension but the rehab place says Medicare will pay for 20 visits.  It is not like he is going back to work as an active person climbing ladders etc.  All he will do when this over is walk around walmart or other grocery store and go to a restaurant.  I think rehab should be tailored for the age of the person and what they will need to do afterward.  A younger person doing an active job would need to get back to a better level than a 75 year old man who is 100 lbs overweight with so many other medical problems.