Question about knee replacement surgery

svengandhi

Well-Known Member
My H is in desperate need of a knee replacement. Today, he canceled his appointment with the surgeon for the third time. He finally confessed to me that he is terrified of having the surgery because he is afraid of taking pain medications. His dad was an alcoholic, his mom was addicted to "mother's little helpers" in the 60's and still takes tylenol codeine like tic tacs, his sister is multiply substance abusive. His mom's brother became addicted to pain pills after knee replacement surgery, a cousin on his dad's side was a heroin addict and was on methadone for 35 years till she died in her early 60's. H doesn't take pain medications. I don't really understand it, but I know addiction can be familial. I've had babies and surgery and took oxycodone, percocet, darvon, etc. with no issues but H was almost in tears at the mere thought of a Tylenol 3. I accept that his fear is rational to him and that it is preventing him from life improving surgery.

My question is - is knee replacement possible without opiates for pain relief? H can barely walk and he is in excruciating pain much of the time. Since he won't take pain medications, he spends much of his time on the couch (he works from home as an attorney). I truly believe that his quality of life would greatly improve if he had the surgery.

Thanks for any help you can offer.
 

Tanya M

Living with an attitude of gratitude
Staff member
It's good that he's aware of the potential problem. My first suggestion is that he talk with his Dr. and surgeon about what other options there are.

I also know there are alternatives that some Dr.'s may not favor because it's not "western medicine"

Here is just one link I found when I Googled "manage surgery pain without medication"

http://orthoinfo.aaos.org/topic.cfm?topic=A00649

Let us know how things turn out.
 

Origami

Active Member
My husband had knee replacement surgery about 8 years ago. I don't remember the specific pain medication he used, but it might have been Vicodin. I agree with Tanya's idea for him to discuss the issue with his surgeon, since he or she should have a good idea of what's available or necessary for pain management.

I can say that my husband's quality of life has improved tremendously since the surgery. Before, he could barely walk up stairs through the pain (and we live on a third-floor walkup), and he was very unstable and "wobbly" when he had to walk for any length of time. Now he can walk normally without pain. The recovery period is rough, with some painful physical therapy, but I think worth it in the long run.
 

Ironbutterfly

If focused on a single leaf you won't see the tree
Husband has had two total knees and pain was pretty bad for couple of weeks. He did take pain medicine. It was best thing he ever did- for quality of life. He needs to discuss with Dr about his history and his fears and best possible options to minimize addiction post-surgery.
 

Californiablonde

Well-Known Member
My ex boyfriend had hip replacement surgery and didn't take pain medications at all. The doctor gave him a prescription, but he refused to fill it. He took high doses of Ibuprofen instead. We lived together during his surgery, and while I was around him he didn't complain of pain at all. So it can be done. I agree with Tanya's suggestion to talk to the doctor and see what other options there are. Good luck to him.
 

susiestar

Roll With It
More and more doctors are aware of addiction risks and work with patients to manage the risk of addiction & post surgical pain, esp now that we know there is a genetic component to addiction. I think an appointment with a pain management specialist to discuss how to manage the pain after surgery while minimizing the addiction risk would be a very good thing. I know my PM doctor has seen a few patients to discuss this (waiting room chatting with several)

I can say that of the over 15 family friends and relatives who have had knee replacements, every single one of them would have done it years earlier if they had known the difference it would make and how easy the recovery was compared to life before the operation.

I am not sure I would speak with an addiction therapist about this though.. I thought about suggesting that, but the ones I have met have alll been totally against taking pain medications for any reason, incl post surgery pain mgmt. I think that a good pain mgmt doctor and the surgeon would be the best ones to talk to.

It also might help to offer to dispense any medications he needs post surgery so that he will not have a bottle of the pain medications under his control. that might give him some comfort by knowing that he can only have the amount the doctor prescribes and he cannot get into trouble by taking too much. This isn't just good at reassuring him that there are some limits, but also it keeps him from taking medications too soon due to being foggy/out-of-it after surgery.

One way to help manage pain with no addiction risk is to use lidocaine patches (brand name lidoderm). These patches are put in areas that are in pain and they help amazingly. They cannot be put over incisions/wounds, but they can be put almost anywhere else. You wear them for 12 hours on and 12 hours off, but they are amazing. They can even be cut into any shape you need. I find that rounding the corners helps them stay on much better.

There are also gels that can be used to help. Most are NSAIDS like ibuprofen but are much stronger. One relative used these t manage the pain after she got out of the hospital. It worked for her.

Finally, please reassure your husband that family history and risks are not destiny.. He has had multiple occasions to be addicted t things in his life and he has stayed away due to his CHOICES. He can choose to fix his knee and not get into addiction if he wants. in my opinion being aware of the danger up front is at least half of the battle.
 

donna723

Well-Known Member
I had shoulder replacement surgery last year and that's as bad if not worse than knee replacement. I was on the really heavy duty stuff for months and had no problem tapering off of it as the pain eased up. I got down to just one after PT and one at bedtime and soon was able to do without those either. And I come from a very long line of alcoholics and serious substance abusers. And the orthopedic surgeon who did my surgery was telling me about about having both of his knees replaced and how well he was doing!
 
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