Husband 3 weeks out of TKR and in to much pain to leave house

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My husband aged 58  had a TKR on 21st December, came out on the 23rd and was back in by the 26th with cellulitis. After seeming to do well on morphine when he first came out on Ocycodone, he is struggling with pain after contracting an infection and is now on codeine 60mg. He is sleeping fitfully, doesn't want to leave the house for even a short walk and spends most of the days going from bed to settee and back. Although the knee is doing well and the physios are impressed, I am just worried by how wiped out he is.  He can't face going anywhere else because he may not be able to get comfortable and alleviate the pain.  I'm not trying to take him out for dinner or anything, just a trip to the local Costa.   Am I just being unrealistic in expecting him to be able to manage more at this stage or does he need higher levels of painkillers.  His GP said he didn't want him to go back on the morphine, but I am wondering if this would significantly help him.  I hate to see him looking so grey all the time.

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  • Posted

    Barbara, I think he needs more time. I was three weeks before I went out and my son pushed me in a wheel chair. There's no way I could have walked. I had mine done on Dec 5 2014 and barely made it to my daughters for Christmas Day. I was beat beyond. Be patient, it's a very difficult time for him. 
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  • Posted

    Hi Barbara

    3 weeks is early days and he probably feels a little loss of confidence too...after the set back.  I wouldn't try and push him, he will know when he's ready.  This is a difficult time of the year to have it done...my first TKR was just before Xmas in 2912.  None of us are really prepared for the pain and difficulties.  It would be worth seeing if alternative pain meds are available, but otherwise if the consultant and physio think that physically he is doing well I wouldn't worry too much at this stage.

    Patsy

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  • Posted

    You are a little unrealistic in your time expectations. This is a major surgery even without complcations you have to give it time. The pain levels are high and take time even if the healing is text book in nature. When you realize the healing t I me to a new normal is about a year or so (yeah, I known, the surgeons didn't tell him that up front) he hasn't even been a month yet. 1st of all make sure the excercise program is being followed as prescribed and pain meds are being taken the same way, not when the pain gets so bad he is trying to catch up. Ice as often as necessary as this will keep the swelling in check. Elevate and get the leg slightly above the heart and rest every chance he gets. Sleep will be in the distance so don't be overly concerned that it isnt expected immediately. Increase fluid levels and slow down the pace. One of the biggest problems with tkr is everyone wants to rush, rush, rush to hit some kind of phantom deadline. I've been through complete rehab on my left left 5 times and everytime it's different to some degree. Don't listen to all the crap from family and friendsabout how quickly they or some persons they know bounced back. If its true 74th as t individual may be that 1 in 10000 that did it. The folks on this forum are the ones with true to life problems and what they will tell you is real not fabrication. Again, slow down on the expectations and work toward recovery. Use 6 weeks as your 1st benchmark.....then 13.....t hen 6 months. Be very concerned about the infection and how its been treated. Infection and blood clots are your 2 biggest concerns. Keep checking in and asking questions as well as keeping the group informed.
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  • Posted

    With my 1st TKR, & then the revision 10 weeks ago, I had over-whelming tiredness that wiped me out. I would never last past 9pm at night before having to give in in & go to bed - & I often fell asleep during the day too. However, this does pass by about weeks 5-6. At 10 weeks, I now go out for meals, host dinner parties again & often stay up watching films way past midnight. I would also query the pain killers. My GP was happy for me to have oxycodone on a week by week basis, the 1st time around I was on them for over 6 months because of all the problems, this time around I weaned myself off them by 5 weeks. It's a dreadfully brutal operation that I wouldn't wish on my worst enemy, so be patient with him & give him time (& pain relief!).
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  • Posted

    Well I can see everyone is reassuring you that to feel how your husband does is pretty normal at the three week stage.  I remember being pretty hysterical at the idea of having to go out to the hospital  at around week three to see the surgeon . .Tiredness is terrible at this stage, and sleep is incredibly elusive.  If he is on codeine, he may very well have the added discomfort of constipation.  In reply to your question 'am I being unrealistic in expecting him to be able to manage more at this stage' the answer, I'm afraid, is that most certainly you are.  While it is NOT a good idea for him to resort to the bed for hours at a time, and movement and exercise are essential for recovery, feeling that someone is expecting more of you than you can manage is counter productive.  Help and encouragement, yes. . even a little push in the right direction.....but at the moment, it is very normal for him to feel totally wiped out by this gruelling operation.  I was on tramadol . .better than codeine I think.  doctors are so stupid sometimes. they just don't seem to realise how debilitating pain is, and  are so convinced that we shall all end up as addicts if we avail ourselves of the excellent painkillers on the market.  I often wonder why they think anyone bothered to invent them . . there are few things in life more painful that a TKR!  Provided he does persevere with the exercises, at around six weeks he is likely to experience an improvememnt . . but believe me, it will be many months before he begins to think about anything other than his knee!
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  • Posted

    Hi Barbara,

    I would have to say he definitely needs more time!  I am also 58 and starting my 4th week of rehab and other than taking a ride with my husband, I haven't left the house!  I had no other complications, as he has, and I still have only gone from bed to recliner, other than stopping to exercise.  My doc requires I stay on a walker for 6 weeks and I probably won't leave the house until then because of that!  I think he's overly cautious, but he says if I do what he says, I will have great results!  This is my second knee replacement.  First done in September.  Both have been similar other than now I feel like I have been house bound, except for a couple short weeks between, and I'm really anxious to be done with this! Be supportive and let him progress in his own time.  Make sure he sticks to the exercises because they are soooo important!  I recommend riding a stationary bike.  My first knee is great!  Take care and keep us informed.

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  • Posted

    Hi Barbara!

    So sorry to hear that your husband suffered some complications following his surgery!

    You mentioned that he had an infection but didn't say what was being done to get rid of the infection. As many on this site have said, infection is a very real possibility following surgery and can sidetrack all progress untilnitvis under control and eliminated.

    Please let us know about his infection and how that is being handled. In my opinion the infection needs to be eliminated so the body can heal and your husband can have the strength to recover from the surgery.

    Pain medication is important, but ELIMINATING the infection will allow his body to naturally recover, and he will be able to focus on his recovery progress.

    Please keep us up on how he is doing!

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  • Posted

    Barbara, everyone here is correct.  This operation, although common, is far more painful and grueling than they lead you to believe beforehand.  I had left TKR on 11/30/15 and for the first two weeks I literally had to take a nap after walking to the bathroom and back to the recliner, or after an in-home rehab session.  Even now at 5 weeks I am wiped by 8:00 pm, and I am having a really good recovery (I am told).  Give it time, it takes way longer to recover than you might think and don't let anyone else's stories of no-pain recovery and other blah blah steer you wrong.  For anyone who thinks this is an easy operation, I highly recommend you watch a You-tube video of an actual TKR operation.  Saws, hammers, drills,rods, bone pieces flying everywhere, not to mention the strain on muscles, ligaments, tendons, etc., all of which need to heal.
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  • Posted

    Hi Barbara, Cellulitis at the best of times is extremely painful and has to be treated with care.  Having said that, your husband does need to get out of the "I can't do" frame of mind.  I know that sounds harsh, but we have all been there.  Some worse than others.  He needs to start thinking about what he must do and then follow up with he can do.... He may feel as if he has a mountain to climb.  Yes, he does, but it is do-able.  If he does not start thinking positively now, it will be all the more harder in the long run.  He does need to buck up a little.  There is only so much you, as his support, can do.  But he does have to do the donkey work and fight his depression, the feeling of never getting better and also the feeling of "you don't know what I am feeling" attitude.  Spring is on its way, a time for fresh, positive thoughts.  He can do it. You are doing just fine, if he needs painkillers, I am sure he does! then he needs to take them, none of this "I am strong, I don't need to". He does, and if he is depressed, some anti-depressants as well.    The main thing. He needs to start moving. By all means be supportive, but do not make yourself unwell
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  • Posted

    Many thanks to everyone who has replied to me, it's really helpful to be given information from other people who have been through the operation.  To those who asked about the infection, it was cleared up with intravenous fluoxicillin in hospital and he has just finished an oral course at home so I don't think it's a problem but God knows what the antibiotics have done to his stomach.  I will encourage him to ask his doctor about tramadol rather than codeine as he was on this before the operation and tolerates it much better.  Thank you again for all your replies it is so heartwarming to know there are so many of you out there giving support to us. I really appreciate it and will let you all know how he goes on. 
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    • Posted

      Please remember there are other strong painkillers out there, other than Tramadol.  Yes they all belong to the opiate family, but might be easier for him to take.  If he feels that one particular drug does not agree with him,  must say so and try something else.
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    • Posted

      Barbara, I am on oxycodone and tramadol.  I take one oxy before bed and maybe two tramadols each day for pain.  The tramadol is not a listed narcotic so the docs seem to be fine with prescribing extras when you run out.
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    • Posted

      SO HAPPY to hear that his infection is cleared up now! You MAY want to check his temperature several times a day for awhile just to keep on top of anything that MAY return!

      Everyone reacts differently to various pain medications. I, personally, have much trouble with ANYTHING narcotic. Tramadol gave me flu symptoms without the fever. I finally just got off all except Ibuprofen. Sometimes pain medication side effects are worse than the actual pain. Very strange!

      Moving and exercising helps pain management for me. I had my first TKR in June and my second in October. Stretching is something I do continuously throughout the day and even at night in bed. Keeping a positive attitude gets the endorphins flowing which actually help reduce pain.

      Men often have a lower tolerance for pain than women. We women soldier through and compartmentalize pain. Men often have a much harder time redirecting their focus. Maybe if your husband could get moving more he might be better able to focus on something else and help himself redirect focus away from his pain. Just a thought...

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    • Posted

      Thanks Cheryl.  I don't think my expectations where helped by my sister who is a GP. Her mother in law had a TKR last year and all we heard was how she sailed through it coming home on paracetemol and ibuprofen and no real problems at all.  I am starting to realise that either my sisters mother in law wasn't being straight with her about the pain she was in (quite probable) or  she's unique. 
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    • Posted

      Proably in the "unique" class!!

      I had a friend who kept reminding me that her mother had both knees done at once & sailed through it (also in the unique class)!

      Mine turned out to be one of the ones that needed re-doing, & despite always being made of strong stuff (I encouraged my husband to give up work when he was diagnosed with MS at 40, & I took two jobs on) - I couldn't believe how much pain I was in. To be reminded constantly how well other folk are doing is a right pain in the neck!

      I would have buckled under the strain if it wasn't for this forum, & communicating with other folk going through this ordeal.

      Don't get me wrong - I'm sailing through this revision - but I will never forget the year of pain after the misaligned TKR & being told by family & friends I wasn't excercising enough & to pull myself together.

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    • Posted

      You do always hear of these cases.  there must be a few. when I was suffering in hospital, with cisttis and anaemia to add to my probems, and a foot which wouldn't move, another old lady of 80 had the same op, and went home on day three without crutches, walking out on her own.  so yes, there are these weird people around, but they are not, i am sure , the norm, and nobody should be made to feel they are nferior because they have not had this incredible luck!

       

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    • Posted

      I'm sure that didn't help. She's unique I'd say. We all have to listen to how good so and so is etc, and I felt that I must not be doing hard enough work. But on the forum I read and finally got it, that everybody is different and I was normal. Lol. Give you man all the time he needs. Never mind others. Your sister didn't have it done, so she can't understand. Good for her mother in law. 

       

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    • Posted

      My friend's husband had his TKR the day after I came out from having my opened up again.  He said that he couldn't believe how I coped with both of mine (done separately) on my own.  He has done really well with his, but the man in the bed next to him has had a terrible time, with excess swelling, stiffness and excessive pain.

      We are all different!

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