TKR & the affects on psychological health

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One subject we haven't touched on yet is the impact TKR has on our mental health.

It can take away, even if temporarily, our independence & our dignity!

I must admit to feeling that I was a burden to my husband in the first month, probably, after TKR. I feel that for most women, who have worked all their lives, cared for the home & family, the robbing of independence is up there with the pain in making this recovery hard (dignity goes when you have babies!!). Yes it IS usually temporary but can last for a long time as we have heard. Post op depression is real, but tends to be pushed to one side. Should we be given more information & help to deal with the issues depression brings? In none of the literature I was given did it mention how I may FEEL in myself after TKR. Should it have been?

That isn't to say men don't find this hard too, but given the role women have in the home, as generally speaking the main carer for the family, it is hard to accept the role reversal.

Do you think women are more prone to feeling like this or are men, who are the 'hunter gatherers' usually hard at work all week, the ones who are more affected due to being unable to escape the home for the office?

Has this affected you? Or do you think it nonsense?

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  • Posted

    This is such a good point Marilyn!!!!!  It does affect people in so many ways!  And something should be included in info from hospitals.  Personally it was the opposite for me!  This was the light at the end of the tunnel and my husband had been doing his absolute best to make life as easy as possible for me for so many years because of the knee pain, that now was the beginning of my chance to do all these things myself again!  Everything from the moment I went into hospital was positive and I found each little progress absolutely exhilarating - my spirits were higher than they'd been for years!  Of course, the fact I'd not got pain, and was making progress faster than anyone expected, also added to this.  My husband was my slave for the first few weeks, but as soon as I got down to one stick, at around three weeks, then I could make HIM that first cup of tea and things progressed so well from there!  I think the effect mentally will depend very much on level of pain, sleep, and how frustrating the recovery is, as well as basic attitude - if you tend to be a positive or negative person.  But yes, some will be affected more than others and it certainly is a reality for some!  I felt permanently tired before I went in for my op and really looked forward to a rest (don't know why I was so tired, but struggling to walk seemed to take it out of me, as well as exercising!) but from the moment of the op, and resting after it, I had more energy than I'd had for ages.  I was never tired from the moment I came home - never slept during the day at all, but I was sleeping at night better with only one knee hurting (the unoperated one!) so maybe that was relevant too!  So for me, it was ALL positive!!!!!  But I know we're all going to be SO different in this!

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    • Posted

      Oh yes I was so glad to be out of pain in that knee!

      What I found hard was having to rely on someone else, I've always been so independent even with arthritis I have always tried to do the things I always have!

      I suppose it's about identity as well. I've always been the coper, the carer, I found being cared for difficult.

      Suffering depression already didn't help I suppose. I think that as I have been through quite a bit since 2013 I had 5 operations before the TKR.

      Also I was the one who had to be strong when I was diagnosed with cancer, my husband went to pieces. I HAD to be strong, it didn't really hit me until a year later summer if last year!!

      But, having read of some people's hard recoveries after TKR when I didn't really & truly have it that bad I just wondered if the hospitals should be doing more to warn us of the psychological effects of TKR?

      XX

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    • Posted

      I THINK this aspect was something that got me very positive - I'd felt as though I'd depended on my husband for so long that I looked forward to being able to do more after the knee ops, so that was opposite for me really.  Ah, so it was the opposite with the cancer too! 

      I think you're right, and they could at least point out that some people do get down with it, so prepare to plan things you like doing that you CAN do when recovering etc., just to try and turn it round a bit.

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  • Posted

    Hi Marilyn!

    Interesting topic to discuss!😊

    I didn't get any information about mental issues in the pre-op meeting we went to prior to surgery. Discussion was on the physical aspects of the surgery, recovery, etc.

    I've had two C-Sections and a Myomectomy (removal of a fibroid). Each of those were abdominal surgeries which bring their own special kinds of "fun"😱 but are VERY, VERY different than TKR surgery and it's aftermath!

    For me personally, I was in so much pain prior to knee replacement surgery, I actually began to think that AMPUTATION would have been better than keeping my damaged knees IF no other remedy was available! ( I had gone through all the steps the insurance companies require-- Physical Therapy sessions, cortisone shots, seeing a Rheumatologist and getting extensive blood testing then medication (which caused stomach issues and the beginning of an ulcer.) 😬 I became DISGUSTED, so I quit going to doctors for FOUR YEARS! Sudden excruciating pain that felt like a sword going through the back of my left knee and out the kneecap forced me back in to see my doctor.

    I EXPECTED he would put me back on the insurance train with the next step which would be arthroscopic surgery. I was THRILLED when he leaned back in his chair and FINALLY SAID that my knees were SO BAD that I FINALLY was a candidate for KNEE REPLACEMENTS!!!😊😄😁. 👍👍

    At that point I was ALL IN! If he could have done the surgery THAT DAY I would have been ready! I had to wait three more weeks, but I was READY, for sure! I wanted those bad knees GONE!

    Recovery with my first knee was challenging because I had a lot of swelling. I prayed a lot and kept a journal. I had GREAT care during my three days in the hospital. Pain, for me, was SO MUCH LESS even with surgery than what I had been dealing with prior to surgery. At least ONE out of two knees was feeling a lot better! I scheduled my second knee's surgery three and a half months after my first surgery. It went even better than Knee #1 with almost no swelling.

    I had six months of physical therapy with my two knees. My husband came to every session with me. I had a FANTASTIC physical therapist.

    As I mentioned earlier, I was SO GLAD to get rid of my damaged knees that I was grateful for everything. I prayed all the time, and God strengthened me. I did not have any depression or sadness. My feelings were of much gratitude that I had a chance of having a normal life again.

    I've ALWAYS been pretty independent, and I must have a pretty high pain tolerance. I do most of the work around the house and before retirement taught first graders during the day and ran a reading program after school. Our two sons are now grown and married, but I did the lion's share of the child rearing as my husband was busy with HIS teaching, his band, and writing curriculum for the SEMMA Program (K-12 science program ) of NASA. As most moms, we JUST DO IT! I learned early on to take power naps!

    I have been incredibly fortunate that all has gone well for my recovery. I am quite blessed to have access to a great surgeon, innovative hospital and nurses, physical therapy, and help from my husband. My greatest strength came from PRAYER. I asked for peace and calm and courage, and I got it. I am grateful every day.

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    • Posted

      I agree with you the pain after TKR was nothing compared to the arthritis! I really think it was loss of independence that got to me!! Lol

      Luckily that only lasted probably 2 weeks, & realistically prob a couple of days! Mostly also due to my not fully 'getting' the fact that I would be so useless after the op! Introspection doesn't help! I had some sleepless nights which didn't help! I wonder, though, if some of it was due to SAD also as it was November by then. (Clocks had gone back!)

      I'm glad that you are doing well & I note how much your faith helped in your recovery. You have been through quite a lot too! You always sound a very positive person.

      Positivity, as Chris said is the key & I am usually a 'glass half full' kinda gal!!!??

      XX

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    • Posted

      Yes, I usually tally all the things that are going good FIRST. It probably comes from teaching little ones for so many years and having to look for small bits of progress to keep the children going when things seem pretty challenging to them. It can be very hard learning how to read!

      For me I was SHOCKED that my left leg (first TKR) WOULD NOT MOVE on its own after surgery. It needed to be moved BY my nurse, and kicked out like a old log when I needed to take a step to walk. I called it my TREE TRUNK FILLED WITH CEMENT!😱😬😮

      Also EVERYTHING took REALLY LONG to do! Taking care of my mom in our home for two years when she was 99 and 100 years old taught me the extreme patience required with MOVING SLOWLY. I tapped into that to help myself when I was in my TORTOISE/ SLOTH phase of recovery.

      I'm pretty stubborn (read: PERSISTENT!), so I spent a great deal of time figuring out creative ways to do things on my own. Each solution that actually WORKED was a VICTORY. My Dud Ideas were classified as Attempts Made: If at first I don't succeed, I WILL TRY AGAIN!😁 I tried to make a game of it...like I was on SURVIVOR or on some QUEST.

      Yes, my faith in God proved to be THE BEST THING EVER! He brought me calm and peace and strength. I could not have done it alone.

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    • Posted

      I like that Cheryl!  It's SO positive!  I must admit, if I can't lift my leg after the next op, I WILL be shocked!  Like you, I'm not expecting that to happen!  But I think a lot of us, over life, come across challenges where we think 'I can't do this!'  But find with perseverance, we can!  It probably sounds trivial, but my moment came when we started breeding cats and we needed to do our own website.  All I knew about computers at that point was that they plugged into a wall.  Literally.   I never used one and didn't have a clue.  Boy that was a steep learning curve, and so many times I could have jumped on it to reduce it to tiny bits and flushed it down the toilet LOL!  But I ended up with doing a wonderful website that other breeders were copying!  And then developed in photography so we were putting our kittens' pictures up every day so new owners could see them growing.  That was my moment of 'I CAN do'. 

      As for the moving slowly - I've been doing that for so many years because each step has been hard!   I notice so much now how the operated knee is so much more stable than the unoperated knee,  It seems to take all the muscles of my whole body to tense to move the unoperated leg because the knee is so unstable.  But just maybe this week I'll get my date for the other one!:-))))))

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    • Posted

      Congratulations on sticking with your computer challenge! It can be crazy hard when we attack hard things head on, but when we master those hard things the feeling is BEAUTIFUL!😄😁?????

      We humans are strange creatures. We often let so many things get in our way. We need to take some tips from KITTIES who NEVER let any challenge stop them from their goal (usually FOOD or MORE BRUSHING TIME!😺😺wink I watch our wild birds at our feeders out front. They persist until those seeds drop from the suet then GO GET THEM! Our three crows work as a tag team to be more efficient! They DO NOT give up!

      I'm so glad that you succeeded in your website! You learned A LOT from your sweet KITTIES!😺😺😺😺😺😺😺😺😺

      I hope you get your date for #2 VERY SOON!??

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  • Posted

    Hello Marilyn,

    How I empathise with your comments. Yes I too have experienced all of your feelings.

    Having brought up a family on my own, worked full time etc, although now remarried to a lovely man, I found the lack of independence very frustrating.

    i too suffered the depression period, which none of the family understood. The comments coming back were 'I've never seen Mum like this before'. 

    I have had had two TKR This year. One in January, the other in April, as my husband is deteriorating with Parkinsons so I needed to be fit and recovered asap.

    I find that because I am on my feet and the wounds and swelling is not visible under trousers, that the family assume that I am recovered and Mum can just get on as usual

    In a way I am pleased about this as they don't have to feel responsible, but it would be so nice to occasionally be a lady of leisure.

    having said all this. 6 weeks after my second TKR I am pretty mobile, driving and well on the road to a full recovery. Take heart anyone who is still suffering, it does get so much better. 

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    • Posted

      I'm sorry to hear about your husband Jan. It must have been doubly hard after your op! I hope you are looking after yourself as much as you can.

      Yes Jan that is absolutely it!

      You look ok, the scar IS hidden & everyone else's world has moved on! Without you (for a moment). Unfortunately those that haven't gone through TKR just do not understand! I didn't! I just thought it would be like the other ops I had, a bit sore but a good rest, bit of a break then back to work. I thought I'd be back at work in 6 weeks!!! How delusional was I!!

      I just wondered about the people who are on their own! How do they cope with this esp when they feel overwhelmed?! And those that feel all alone even when they have people with them! Someone who had suffered clinical depression once said they had felt so very alone, even though there were those that cared for them around them!!

      Any anaesthetic can leave you feeling down, spinal not so much but our medics seem to like to give us opioids which are depressive! It doesn't help, & they give no guidance should we do feel overwhelmed! Something missing there!

      After all we need to look after our mental health as well as our physical health!

      XX

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    • Posted

      So sorry to hear about your hsuband Jan.  That adds a lot of stress to you, feeling that you NEED to make a fast recovery to look after your husband.  I think you need to tell your family that you could do with a bit more support sometimes?  But I'm glad your recovery has been so good!  Do take care of yourself!

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  • Posted

    That's interesting. Loss of independence is difficult, and most of us are fairly achievement orientated. Lots of the time we use our doing and busy-ness to avoid just being. But with TKR suddenly you cannot run away from yourself. Plus the physical impact which has an effect.

    So it'say big life change. Before surgery we tend to envisage life further along the road to recovery, and miss out the six to nine months spent getting there...longer of course for full recovery. That can be disappointing. But I think being able to see the experience as an opportunity is key. It may not be the opportunity we expected, but it can still produce positive change.

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    • Posted

      Interesting that Jenny.  I don't think I did miss out the original journey getting to the end.  I think I concentrated more on the first few weeks than anything else when I thought about it before the op.  To the point where I'd got stretchy joggers for initially and then suddenly realised none of my trousers or jeans were wide enough round the knees!  I hadn't thought that far ahead!  Yet I KNEW that there was going to be swelling for up to a year - just hadn't processed it in my mind.  So suddenly needed to look further ahead, but initially I'd say I very much took it day by day.  And enjoyed it.  I loved all those little signs of progress and celebrated each one.

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    • Posted

      I wonder if you and I had read up on it more Jenny.  Maybe it's left down to the patient to find all the info online, and some are better than others at doing this.  Some maybe wouldn't even think of doing it.

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