Pain after knee surgery
August 12, 2013 5:22 PM Subscribe
Pain relief question for elderly parent.
My 81 year old mom had a partial knee replacement about a month ago and she is still experiencing pain from it. Some of it seems to be nerve pain, some is muscle pain in the thigh, and now she is getting pain in the joint, with what she describes as stabbing pains. She doesn't want to take pain medication since she is also having digestive issues. Other than putting ice on the knee or a heating pad on the thigh, is there anything she can do to help relieve the pain? It's bringing her down, and I hate to see her like this.
My 81 year old mom had a partial knee replacement about a month ago and she is still experiencing pain from it. Some of it seems to be nerve pain, some is muscle pain in the thigh, and now she is getting pain in the joint, with what she describes as stabbing pains. She doesn't want to take pain medication since she is also having digestive issues. Other than putting ice on the knee or a heating pad on the thigh, is there anything she can do to help relieve the pain? It's bringing her down, and I hate to see her like this.
My dad is younger than your mom and had whole knee replacement but - he's experiencing pain from the surrounding muscles and ligaments from how long he favored the knee. Is she still in PT? What does the Physical Therapist say about this? B/c the PT should surely have an opinion / know about this / be helping. My dad is for SURE still in physical therapy - in person with the therapist and on his own.
posted by Medieval Maven at 6:32 PM on August 12, 2013 [1 favorite]
posted by Medieval Maven at 6:32 PM on August 12, 2013 [1 favorite]
I have 2 total artificial hip joints (ball and socket), but my knees are original. I'm concerned about the "stabbing" pains you describe - sharp pains in a repaired joint can be an indication of trouble, and I hope she's following up with her orthopedic surgeon, and making mention of this.
As for the pain meds, a lot of older folks have trouble taking opiates, because of digestive issues, but it is better to add additional fiber, and even laxatives to their regimen, if that will deal with the digestive issues, than to be in pain, and be unduly tense trying to protect themselves against further pain, and also be missing sleep. But it may take some experimentation, with the permission of her doctor, to get to an optimum dosage and schedule of pain medication, that least disrupts her digestion, while offering the most relief from pain.
But again, with many doctors, she needs to inform her doctor of her levels of discomfort, and ask for help, to get help. That includes explicitly describing the pain, its frequency, and the effect it is having on her life (can't sleep, can't rest easily, can't do rehabilitation, can't cook, etc.) Without specifics, either from her or someone who is familiar with her, and her daily regimen and needs, many doctors will have trouble getting the right medications and dosages to her, to alleviate the bulk of her discomfort.
Beyond medicinal approaches, I found that some basic conscious breathing exercises, like Dr. Andrew Weil describes, were more effective than I imagined they would be, in helping me to relax through aching kinds of pain, as I went through rehabilitation. And by learning to relax in response to pain, I found that I was wasting a lot less energy on trying to tense up to protect myself from additional pain, and also that I wasn't creating new sites of muscular discomfort through remaining unduly tense. Other people report the same kinds of relief from meditation, reading, doing art or knitting, or even singing or doing gentle exercise with other parts of the body. I think anything that provides some focus for your mind, as you try to relax your body and perhaps project some energy that would otherwise go into muscle tension, helps.
posted by paulsc at 6:34 PM on August 12, 2013 [2 favorites]
As for the pain meds, a lot of older folks have trouble taking opiates, because of digestive issues, but it is better to add additional fiber, and even laxatives to their regimen, if that will deal with the digestive issues, than to be in pain, and be unduly tense trying to protect themselves against further pain, and also be missing sleep. But it may take some experimentation, with the permission of her doctor, to get to an optimum dosage and schedule of pain medication, that least disrupts her digestion, while offering the most relief from pain.
But again, with many doctors, she needs to inform her doctor of her levels of discomfort, and ask for help, to get help. That includes explicitly describing the pain, its frequency, and the effect it is having on her life (can't sleep, can't rest easily, can't do rehabilitation, can't cook, etc.) Without specifics, either from her or someone who is familiar with her, and her daily regimen and needs, many doctors will have trouble getting the right medications and dosages to her, to alleviate the bulk of her discomfort.
Beyond medicinal approaches, I found that some basic conscious breathing exercises, like Dr. Andrew Weil describes, were more effective than I imagined they would be, in helping me to relax through aching kinds of pain, as I went through rehabilitation. And by learning to relax in response to pain, I found that I was wasting a lot less energy on trying to tense up to protect myself from additional pain, and also that I wasn't creating new sites of muscular discomfort through remaining unduly tense. Other people report the same kinds of relief from meditation, reading, doing art or knitting, or even singing or doing gentle exercise with other parts of the body. I think anything that provides some focus for your mind, as you try to relax your body and perhaps project some energy that would otherwise go into muscle tension, helps.
posted by paulsc at 6:34 PM on August 12, 2013 [2 favorites]
Response by poster: Yes, medical marijuana is an option where I live. I'm surprised I didn't think of it. Might help with the digestion problems also.
Yes, she is still in PT. But she does need to be more open with both her therapist and her doctor. She's of the old Yankee "stiff upper lip" variety, and it is hard to break through that.
Thanks, paulsc, for the heads up on the stabbing pain. I will definitely be keeping an eye on that.
Thanks everyone for all your suggestions.
posted by jenh526 at 7:10 PM on August 12, 2013
Yes, she is still in PT. But she does need to be more open with both her therapist and her doctor. She's of the old Yankee "stiff upper lip" variety, and it is hard to break through that.
Thanks, paulsc, for the heads up on the stabbing pain. I will definitely be keeping an eye on that.
Thanks everyone for all your suggestions.
posted by jenh526 at 7:10 PM on August 12, 2013
One other nearly sub-conscious behavior I've seen from folks in near constant pain, that really messes with digestion, is repetitively swallowing small gulps of air. It sounds strange, but some people comfort themselves by doing this, without even being aware that they are doing it. Much of the swallowed air is soon burped out, giving them some episodic "relief" that they can paradoxically enjoy/control, even if they are not aware they are doing it. But some of the extra air can work its way past the duodenal valve at the bottom of the stomach, along with liquid stomach contents, and add to gas formed in digestion, to produce discomfort and flatulence, that are then blamed on medications.
My Dad did this, for a long time, in a hospitalization that eventually resulted in abdominal surgeries. Apparently, nobody noticed it for several weeks during his convalesence as he continued to have excessive gas and digestive problems, until I happened to see him doing it, and mentioned it to him, and to his nurses. Once he was aware of it, a few further reminders were sufficient to get him to stop it, in the main, and with that cessation came much better digestion and sleep within a few days.
posted by paulsc at 7:27 PM on August 12, 2013 [2 favorites]
My Dad did this, for a long time, in a hospitalization that eventually resulted in abdominal surgeries. Apparently, nobody noticed it for several weeks during his convalesence as he continued to have excessive gas and digestive problems, until I happened to see him doing it, and mentioned it to him, and to his nurses. Once he was aware of it, a few further reminders were sufficient to get him to stop it, in the main, and with that cessation came much better digestion and sleep within a few days.
posted by paulsc at 7:27 PM on August 12, 2013 [2 favorites]
I'm surprised no one has mentioned acupuncture, which is supposed to often work very well for pain relief (and to my mind at least seems much more appealing than using either marijuana or pharmaceuticals). I imagine this could also improve your mom's digestion and over-all health as well.
In addition either a good Ayurvedic practitioner or TCM practitioner could help immensely with pain and digestive issues (whatever those digestive issues might be-- no need to have it be simple or a specific diagnosis like IBS). Triphala is an ayurvedic herb you may want to look into for the digestive issues.
I also agree that breathwork and learning to release tension from the body as much and as often as possible is crucial. If you go on Amazon there are a lot of CDs to choose from with great ratings, some aimed specifically on how to deal with pain, some more for over all "relaxation", though I imagine you really learn the same things. These could be found by searching for things like "meditation for pain", "guided imagery for pain", etc.
posted by Blitz at 7:08 PM on August 14, 2013
In addition either a good Ayurvedic practitioner or TCM practitioner could help immensely with pain and digestive issues (whatever those digestive issues might be-- no need to have it be simple or a specific diagnosis like IBS). Triphala is an ayurvedic herb you may want to look into for the digestive issues.
I also agree that breathwork and learning to release tension from the body as much and as often as possible is crucial. If you go on Amazon there are a lot of CDs to choose from with great ratings, some aimed specifically on how to deal with pain, some more for over all "relaxation", though I imagine you really learn the same things. These could be found by searching for things like "meditation for pain", "guided imagery for pain", etc.
posted by Blitz at 7:08 PM on August 14, 2013
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posted by st looney up the cream bun and jam at 5:53 PM on August 12, 2013 [1 favorite]