on emotions

[zelik]

I am a man, nine weeks post surgery for a tkr. Some days ago I used the search tool for "emotions". I found few references to the emotions that people experience in recovering from a tkr. For the most part it has been women who have described their emotional world. I believe that there is much benefit to be gained by both men and women in acknowledging the emotional elements that can accompany the major surgery that a tkr entails.

This was first brought to my attention by a counselor I saw shortly after my surgery. At the time of my surgery there were other events happening that resulted in a different kind of recovery period than I had expected. The counselor suggested strongly that I had undergone major surgery, inflicting major stress on all aspects of my body and psyche, especially when coupled with the fact that my whole routine and activity schedule was now completely different.

Missing were the activities that acted as an outlet for stress, activities that I found gratifying and from which I gained pleasure and satisfaction. Add to this the unplanned events that life brings and the natural bumps that happen in most intimate relationships, I can appreciate that my emotional world became something other than normal.

I experienced a day or two of depression about two weeks post surgery. It seemed to dissipate once I began physio. Somewhere around seven weeks I experienced some resentment that I could be called upon by others to be supportive in their challenges even though it was clear (at least to me) that I was incapacitated and dealing with my own hardship. This resentment lasted longer than the depression and, probably, still comes and goes. I assume this resentment is not necessarily present in most women who are mothers and wives with a long history of giving to others.

I am fortunate in that I have access to a skilled counselor with whom I can examine these issues and can learn more about who I am and how I am in this world.

My latest discovery addresses the pain I still experience in my knee. While it is greatly reduced it is still with me, especially at the end of the day or when I am fatigued. Tonight my knee had swelled up and I was hurting after being on it most of the day and finishing day with three hours of baking. (Not that I did such a lot, but I am slow).

I took a pain killer and was laying down icing my knee. I could still feel the pain and my wife began to converse with me about the events of the day. As we talked I could feel my fatigue and the pain. Having unsuccessfully tried to curtail the conversation, I experimented with telling myself to relax and breathe. I focused on the sensation in my knee and continued to let go of my tension.

Whether it was the medication or my relaxation technique I cant say, but in short order the pain did dissipate. Only now am I making a connection between relaxation and the reduction of pain levels. That is, the more I relax the greater chance I have of reducing my pain. The physios talk about the same phenomenon in therapy. Relax the muscle and the rom can increase.

These two aspects of recovery are little talked about. Relaxation technique and emotional expression. I would like to hear from others on these topics and your experiences, if you dont mind sharing.

 

[Texas]

Hi amd Welcome. I did have depression for awile. It did go went away. Not bad just more sad. I would think that would be normal for a man or women. I do agree my poor husband. I didnt hold anything in because I was told the same thing...Now I say sorry alot about how I was those first few weeks.lol. No he was great same as it seems your wife it. Now thats important. It does get better Im 10 1/2 weeks and it different then I was at 9. I hope you feel better soon. We are always here it you need to let go....Post anytime.....Good Luck...

 

[loggon]

Sorry to hear you have had a problem. But from reading your note,
you might want to change meds and see if that does not help your mood changes. Of course when in pain, most of us just want to be left a lone and of course the more we can relax the better. Relaxing the muscle will allow for more rom. When the muscle is tight it is difficult for it to stretch. My PT will massage the muscles to loosen them and I am able to get more rom.

You said you had baked for 3 hours? Wow I would have been in a pain also. I am at 3 months on the 27th and I could not stand or sit and bake for that long.

I do everything a little at a time and go slow. I know it takes a long time to heal from this surgery. I went to the doctor yesterday for my 3 month check up and he could not have been more pleased with my progress. I was released to return to a normal life style.

Yes I still have pain and swelling and get tired and I understand this will go on for some time. I do not have depression or mood swings thought. I have been very lucky, because I have ready post that seem to indicate the depression is common.

 

[Josephine]

Hello, zelik. And what a wonderful description of the emotional/psychological roller coaster that is the pre/post op experience! So many of them I have said on here before but not as succinctly! It is certainly well documented that excessive fear/anxiety/stress/frustration can make pain so much worse.

It's all down to the adrenaline issue. All those emotions cause a release of adrenaline which in turn blocks pain killers and inhibits the body's natural endorphins. The tension also causes the pain to escalate. Where as being relaxed, positive and calm does the total opposite.

I've frequently observed this in the recovery room and even been able to reverse the negative situation in patients by employing some very rudimentary relaxation techniques, 'talking them down' so to speak and then they relax, the pain killers get to work and their pain experience lessens dramatically. I've had some really good responses to it over the years and wish a lot more nurses would learn about it to the benefit of their patients.

 

[maumeefootball]

Z

What a great post. I am also male and have experienced many of the same emotions you described. I have had both knees replaced 10 weeks apart and some of the same problems cropped up both times. I can remember breaking down a couple of times within the first two weeks. That period seemed to be a living hell both physically and emotionally whaich i am sure go hand in hand. Another emotion that I experience happens when you start to feel better and want to do something other then PT and icing. You try and go out to dinner and half way through the meal you are shot. That gets depressing for me.

Another reaction that interests me is how people close to you respond. The first replacement I seemed to get help and empathy from those close to me. The second one was more like oh no I'm not going to put up with that again. Even my dogs responded that way. They kind of gave me the come on get up and walk us look.

Don Green ltkr 3/18/09 rtkr 5/26/09

 

[Texas]

Zelik I hope you are doing better today...........Keep your head up my friend......We have all been there...Post anytime............

 

[JudyS]

WElcome and awesome post Zelik

I have been on an emotional roller coaster for a while now. I agree having favorite activities taken away is very depressing. And as Josephine pointed out the whole adreneline /hormone issue. I have hypopituitarism, the master gland of hormones is not producing what it should. I am on a lot of replacement therapy which gets out of range quite easily, so my own personal roller coaster of emotions too.
I have always been an advid exercisor, mostly a mountain trail runner and am still coping with the loss of running after hip replacement.
As you can see from my signature I've had a kind of surgery marathon going on with ups and downs emotionally for sure.
After the back surgery , I , who consider myself very strong, broke down with heavy sobs in the hospital. I was too embarrassed to have my teenage kids see me this way and first sent them off to dinner. Then I totally lost it.

I took up hiking to try to replace running. The knee surgery in Dec had me sidelined for 5 months. My doc gave me to OK to start, I was thrilled, 2 weeks into it and some great strength training for my spine and hips and I had an eye hemorrhage. So no strenouous activity allowed indefinately. Now at my visit to the hip/knee surgeon last week, he noted my hip/quad muscles are really weak and causing problems.
So yes, I an an emotional mess!!!!!!!
I am also put on prednisone for a rheumatic inflammatory condition which has effected all my other hormone replacement levels so I am in a constant state of trying to regulate my body. I have not given up hiking, I just pray it does not effect my eye. I don't think I could survive without it , it gives me such peace and hapiness.
One minute I am very happy , on top of the world, the next in tears.

Even as a caregiver I have really resented my family at times in all my recovery. I try to do everything myself, but really needed help and got very little. As someone else wrote, they seem to be tired of me recovering and needing help. As now with the eye, which is so priceless, I can't seem to get the lifting grocery help or understanding that I really am not supposed to be doing these things. Some days the restentment is worse than others.

This is getting way too long and unorganized. glad you posted. i understand.
judy

 

[Linda2]

Thank you for your insights, Zelick. Even after 11 months, my new knee hurts sometimes, but I have my soon-to-be-replaced knee reminding me of the vast differences in the kind of pain it is. Of course it is saddening to have a joint replaced. As great as our new knees are, the are not as great as the original issue was in it's prime. I think this kind of surgery makes us confront issue of aging and mortality, and we don't really like to do that.

I don't know that we mothers are immune to the resentment you mentioned. We might just be more accustomed to having our needs met last, if at all, so we soldier through as we have always done. And we complain to our friends in here!

Another interesting phenomena with this surgery is that it has become so common that people (patients, families, friends and others) forget what a major deal it is. That's what is great about this forum. We know that, common or not, it is still a big d#*n deal, and we commiserate and celebrate with each other. In two weeks I will do this for the second time, and while I might be a bit less anxious, I am downhearted a bit because I know what I will need to endure and overcome. I am, however, more determined to move through it than to live with the limitations I have now.

 

[skigirl]

Interesting--I am a female at 6 weeks post op and the thing that I resent the most is people calling me up to discuss this surgery. I am a wife and mother, but I still resent them calling me---even one woman who launched into her knee history dispite several attempts to interrupt her--I finally hung up.

I am frustrated that I can't do things to make myself feel better---like hike or bike. Yesterday I went to the grocery store for an hour and my knee swelled, I had to ice the damn thing for about an hour. Then, because I was lying down, I fell asleep. Woke up went down to my studio for a few hours--then back to icing the stupid knee. Another day bites the dust with little or nothing to show for it.

This week I did go back to yoga--and it did help me to relax, and being in a class with other people made me feel less like a recluse. I have spent six weeks in my house basically and I have major cabin fever.

I am going to go to Pilates too since I feel like my muscles are wasting on my body. I swim for 30 min most days--but I am such a terrible swimmer---mostly I just flail around. Pt for 2 hours 3 times a week. water aerobics twice a week.

Because of my stupid knee, I can't work this summer---I am a hiking guide--and so I have lost my support system and friends.
Every now and then someone calls me and asks with great pity, How are you doing---and it is all I can do to speak to them.

You are right--my life as I knew it is completely gone. I don't believe that this thing will ever work right---I think it will always swell and cause pain. It clicks and clanks too---yesterday someone actually heard it when I walked by and said, "What was that?" I almost died--and fled the scene of the coffee shop.

I feel like I am 13 again---my emotions are all over the place. I am finally doing strengthing in pt, but still my body looks funny---my muscles are no longer tight, they hang on me. I cry, I stamp my feet, I throw things---yesterday my husband put six cardboard boxes in the garage and gave me a baseball bat---I beat them to smithereens!!! The most fun I have had since this surgery!!!

 

[Judles]

Zelik! I admire your honesty! It is refreshing to hear what is going on in a "man's" head! Too often, I just think we are so focused on our recovery, that if we don't meet our own expectations. We can have feelings of depression....not only letting ourselves down, but those around us, and especially the ones we love the most! After all, they're the ones we want to depend on the most! So, if something doesn't meet up to our expectations, they're the first ones we tend to lash out at! You are miles ahead of the game because you can not only talk about this, but that you can seek the help you need! Who wouldn't be upset, if after so many months, the pain and swelling is STILL there! We understand, but so many outsiders think "times up, he should be feeling BETTER already!! The physical part will resolve, the psyche is a lot more delicate! You STILL need time to heal....on all these different levels! Whether it manifests into outward anger or introspection, you must acknowledge your feelings! Now that you are expressing yourself, you are that much closer to achieving your goal! Don't be so tough on yourself! Just realize not everyone "gets it!". Think of all the positives! You WILL be on your way to recovery....just take it on your own terms and be true to yourself! It WILL get better!!! No time limits!

 

[maumeefootball]

Since we seem to be on a good topic that I haven't seen discussed much on the forum I would like to add another knee replacement moan. No matter where you go there seems to be a person or two who I call the toppers. Actually got this from a Dilbert cartoon. You know the type ,here you are limping around in pain recovering from having your knee replaced and someone has to point out how much worse their knee is then yours. Even though they may have never had surgery of any kind. I don't mean to discount their pain but come on we just had our knees hacked open with a knife then someone sawed out a joint and hammered a metal one in it's place. Please don't tell me how bad your grade one ACL sprain is and how much it affects you. let alone the fact that most of us have been suffering through years of pain prior to getting to the replacement. Feels good to get that one off my chest.

Don Green

 

[Judles]

I TOTALLY agree, Don! I know SO many "toppers"! They really ARE annoying!!!

 

[Josephine]

True - oh so true! And trust me, it's even worse when you're a nurse!

 

[Judles]

Ha! I BET, Jo!!!

 

[brs0660]

I too have struggled with post op depression. Between a very understanding family, a great counselor and some good drugs..things look a little better.

I am a wife and mother (two grown kids) and have always been the caregiver. Having this surgery put me in a quite new position of having to be the person who was receiving the care. I am very independent and having someone help me in and out of bed, up from chairs and to the bathroom was more than my pysche could handle. Having to be chauffered around every where sometimes much longer than I could handle.

Then there was to whole issue of almost constant pain and discomfort. Having birthed two babies with no anesthesia was a cake walk compared to this. What I did learn was that the wonderful pain medications have the side effects of irritability, insomnia and mood shifts. :rant:

And then for me there was this ultimate fear of infection (I am a microbiologist my profession). I know about the ugly germs that lie in hiding waiting for an opportunity to sneak out and set up housekeepping.:pnc:

All this said my lessons learned...
1. I have learned how to be a better caretaker of both myself and others
2. I have learned that meltdowns can be expected when out bodies go through such major surgery.
3. There is a definite downside to being too independent...we need to give others the opportunity to return the care we have given to them
4. Lastly, those ugly germs are around everywhere...good wound care, good handwashing go a long way to prevent infection.

Thanks for posting :thmb:

 

[trish.tx]

Welcome Zelik

Wow you described perfectly alot of how I have been feeling, I know about 2 weeks after surgery I would cry over anything this surely ticked off my husband, I believe it was a combination of surgery and coming off a pain killer I had before my surgery. I am not having crying jags no more, BUT my sister was here to help me and she commented about wow normally your phone is ringing off the wall where are your friends when you need them hmmmmmmmm good question, I know they have familys and lives ect but it is nice to hear a friendly voice say hi how are you they dont have to do anything. Just care Someone said people forget this is major surgery and I believe that this is true. Thanks for stating what I have been feeling. I hope your feeling better now and like someone suggested too made a change of drugs would help. Take care and god bless.

 

[Texas]

So strange you bring that up. There are a few people that do that to me. One certain person no matter what I say about my knee there head is worse or the toe or the ankle..Ahhhh...Glad Im not the only one...lol...Thanks for that. Actually since I had the surgery seems like some only some people dont bother...I guess I didnt loose anything anyway, but it hurts a lil....

 

[Motherofmany]

Well said everyone. I think the loss of independence and the need to be taken care of when I am used to doing it was hard on me. I don't know if resentment is the correct term. Maybe more like I felt like a failure. So many depend on me. It was difficult for them to see me incapacitated. It was painful to watch. I didn't even want my small children 12 and under to come see me at the hospital. It was scary for them to see me like that. I remember the look on her face of shock, the first time my 10 year old saw my knee. She was afraid.

Even when I finally came home. I stupidly stepped up with the operated leg when coming in the steps. My precious children were hiding to surprise me and ended up cowaring in fear when they heard me wail out in severe pain. When all my weight was placed on that leg, I knew what a level 15 was in pain. As I heard them weeping, my heart broke. They had written me poems and songs and even made me a banner to welcome me home and I had ruined it with my stupidity. My husband quickly got me seated so I could regain composure and I bravely tried to accept their priceless gifts. When it became obvious I couldn't handle anymore, my friend and husband shoed the children away by saying Momma needs to rest now.

I felt horrible for exposing my children to this kind of raw pain. I had always been strong and felt so weak now.

Even yesterday, my 23 year old son said, "Mom - I thought this was supposed to improve things. Dad said it would be a few weeks and you would be so much better that before." My heart broke once again, as I felt like a failure to my family.

We honestly believed I would be better in a few weeks. This bionic knee has yet to be so great. My family looks at me with love, yet pity and that I can't stand. For so long they wouldn't let me do anything. I felt useless. I remember committing to my 16 year old daughter a short while after surgery "This is your Mother, the slug!" That's what I felt like, a slug.

As I have posted before, I know my value is not in what I do, but who I am. I have had to remind myself of that. My husband has been wonderful to tell me all that I do, even when resting, elevating and icing. My daughter says "Mom you still command, even from bed." Don't know if I like that or not, makes me sound bosy!

I have found it to be a mental battle at times, and not have a pity party of what I can't do, but rejoice in the small victories! I need to focus on the solution, not the problem. God is still God, He has never changed, only my circumstances. He is still working on me!

Just my late night ponderings on the subject.

Blessings,

 

[zelik]

This is Zelik, again, and thank you all for sharing your emotional experiences, as well as the physical ones. Let me first say, I am doing quite well, on all levels. I find that I am probably in the middle of the pack with regards to getting back to what used to be normal. Last week in pt I saw another guy doing the stationary bike with what looked like a 140 degree bend. I asked him how long since his tkr. He said FOUR WEEKS. (Yes, I am shouting). I couldnt believe it. This was his last day in physio. His friend finally told me he heals abnormally quickly so I felt better. But the experience made me realize everybody is different and like most times in life I am somewhere in the middle. That is just fine with me.

One thing that strikes me in all of our stories is how this operation has taken most, if not all, of us out of our usual roles and comfort zones. I think this can be of great benefit to us if we can accept the reality of it all and not fight against it. Undoubtedly, easier for some than for others. If mothertomany doesnt mind my two cents worth, my thinking is it is a wonderful learning opportunity for your kids to see you vulnerable as long as they get an explanation that this condition is temporary (so they dont worry), they can help out (which gives them a sense of power and acccomplishment), you may be a parent but you suffer pain as well, unlike superman/woman, and that as great a mom as you are and accomplished as you are, you also have down times. After all, their parent is a real human not bionic, if you catch my drift.

I remember being about fifteen and had gone to a drive-in movie with my dad. We went to the concession stand and I went to the gent's room while my dad ordered the food. I came back and when I saw him in the crowd everyone was taller than he was. Until that evening I thought my dad was the biggest and strongest person in the whole world. I think I got a dose of reality then and learned that he was still great and strong even if he was not the biggest.

I highly recommend two books that focus on the self and changes that we can experience when undergoing medical transformations. One is called Kitchen Table Wisdom by Dr. Rachel Remen. The other is When The Body Says No by Dr. Gabor Mate (there is a stroke over the E in Mate, he is Hungarian by birth but now lives in Vancouver).

I wish you all a full and speedy recovery.

zel

 

[Texas]

Rose you said it I felt bad as well my daughter really didnt like it. Son either but he helped her no way. After a few weeks she would barely come near me. I asked her what was wrong. I thought she was being nasty and not wanting to help me. She said no she couldnt take me crying or hurting because she couldnt stop it so I guess, I didnt think it would have that impact on the kids..They are much happier now..Glad I wasnt alone either then. Pretty good thread I like it....