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

    You are expecting too much. The pain and the vulnerability and fear of falling at 3 weeks is incredible. We went to Walmart at 4 weeks and I held on to the grocery cart as a walker shopping the front of the store while my husband got things from the back half. Came home exhausted, iced the knee and slept. I have 7 weeks tkr on my left knee and 12 tkr on the right . It is going well except for sleeping. The right knee regressed while I was down with the left. This is a real journey and I know I need to have patience. A friend told me at a dance tonight that people either do not push enough or push too hard and either is just as bad. He is a nurse.
  • Posted

    Hi Barbara,

    I had a UKR (a partial knee replacement) on 6 Nov, sent home on 9 Nov, dressing removed on 19 Nov and my one and only physio assessment on 24 Nov and then nothing until 29 Dec when I was assessed by my Orthopaedic Consultant. Yes, I think you are quite unreasonable to expect him to be able to manage more at this stage. At 3 weeks I was still in much pain and hating what I'd had done - my dark thoughts were I wish I'd not had this done ..... and hey ...... mine was more straightforward than a TKR with no complications -  I'm 71 by the way.

    Thing to remember is that each of our body's respond so differently to different drugs, treatments, and even just plain simple healing. He will heal at the rate that his body wants him to heal at. If he is in pain stay with the pain relief, mine was Co-Codomol 30/500 and take it as prescribed - and if you think he isn't managing his exercises very well its probably because he is in pain. The thing with pain killers is not to use them as a pill in the pocket to be taken whenever pain is at its worst, but, to be taken all the time 24/7 as directed on the packet.

    This bed to settee business - crickey, all I could manage was bed to upright chair, I've only managed a settee in the last 10 days. I got out of the house as often as I felt like it mind you the weather was a big disincentive to going out but as and when .... I did on my crutches. I cancelled two christmas parties because I was in no fit state, dates were 2 and 5 Dec and the earliest outside event I went to when I actually felt like it was 19 Dec. and that was 6 weeks after surgery.I didn't start sleeping well until about the 4th week, prior to that I was sleeping 90 minutes at a time, here and there, gradually getting longer and longer as the weeks went on. The other thing that put me off about going out was that I didn't have a good bend in my knee initially and so any chairs that were too low, or that had a soft seat and which sagged caused me pain and discomfort, despite the co-codomol. If I couldn't sit in a high chair, with a reasonably solid seat there was no point in me going anywhere.

    Oldfat guy who sent you his thoughts is pretty spot on in all he says in my view. I spent alot of time icing up with ankle up high, I have a gel pack which worked and also I used a bag of frozen peas both wrapped up in a towel and applied to the knee, helps with the inflammation and swelling. And what Oldfatguy wrote about exercises is so true.

    I found I was battling uphill all the time, with exercises, with pain, with not getting the right knee bend or not getting the right degree of extension in my leg then all of a sudden, a bit at a time things started to improve, and the more they improved the further I went with exercises, and getting about. He will know when is the right time to get more active,'cos, his body will tell him.

    I saw my Orthopaedic Consultant on 29 Dec (7 and half weeks) he then told me three things .... 1) Do without crutches in the home, but use one only outside - I've in fact managed with none both inside and out; 2) I can start and drive my car again (in UK the minimum period before driving again is 6 weeks due to insurance legalities) and 3) I can return to work at the end of January 2016. I'm planning a return to work on 25th January. so, from those dates you can work out my timeline and, as I say, that was with only a UKR, and no complications.

    Hope this helps, and good luck to you both.

     

  • Posted

    Your husband is reluctant to move around because his pain is not being adequately treated!! Tell his Doctor ( who has clearly not had pain of this nature) to increase his painless thereby increasing his mobility and decreasing his risk of DVT and pneumonia. There are no awards for needless suffering.
  • Posted

    Barbara,  hi, I am 5 weeks out and just went to dinner last night out.  Within 45 minutes and was ready to go home...very uncomfortable.  Mentally I think I need to go out, but physically not there, although I can walk thru the neighborhood using my walker now.  I have gone to the grocery 2 times for short pick ups with my hubby.  I am no longer using a device of any type to walk in the house.

     

    • Posted

      Hi Pam, next time you go to a restaurant ask for either something under the table or rest your foot on another chair.  Instead of a walker, can you use crutches.  The transference of support is better.

      Mentally you are still tired because the anaesthetic is still in your system plus the stress on your system was extreme.  Sleep as much as you want, when you want. Make sure you have medication at night to help you sleep.  The more you rest, the more you are able to cope with the ups and downs that you will experience.  It is not so doom and gloom, so long as you look at your advances.  Learn to praise yourself.  5 weeks was a bit commando, but very brave.  Keep pushing yourself, but not to the point of exhaustion

    • Posted

      Thank you.  I figure being tired is a big part of the issue.  I do not sleep thru the night, however, that has improved recently.  Tylenol pm is all that.  I am managing 6 hours at a time at night now.  Actually slept 7 last night before waking up.  I do lay down to rest and elevate twice a day....sometimes I nap but not for the most part.  I forget to remind myself how well I am doing for 5 weeks out.
    • Posted

      You are very welcome.  Don't be afraid to take extra for the pain as it can be quite taxing and don't forget to pat yourself on the back regularly.

      You are doing good

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