Joint Replacement Surgery - Pain Management Following Surgery
Narrator: When Sauk Prairie Healthcare Memorial Joint Replacement Center changed their program a few years ago, one of the major innovations involved pain management. Yet, despite the success of the program, don't expect anyone around here to deny how you'll feel after surgery.
Sarah Cook, RN: You are going to have pain.
Dr. Michael Lamson: With knee replacement, it's probably one of the more painful surgeries we perform.
Kathy Straub, PT: Pain is a normal part of the recovery.
Dr. Matthew Hebert: You will have pain. There's no way around it; you'll have pain after having a joint replacement.
Narrator: As strange as it may sound, being up front about post-surgery pain is a key part of the pain management program. The philosophy here is simple: The better educated the patient, the more successful the outcome. That's why pain is discussed at the joint replacement class at least two weeks before surgery.
Cook: This is where they establish your pain control.
Dr. William Niedermeir: People handle pain very differently. Some people don't require much in the way of pain medicine, some people can't get enough pain medicine. But, I think the concept that it won't hurt at all is wrong.
Dr. Lamson: That's an important thing to realize too before you go in, because if you wake up from the surgery and you have pain that you weren't expecting, it's going to be a tough recovery for you. Fortunately though, we're very aggressive with the pain control, and that's been another huge part of this whole process. Now patients actually see an anesthesiologist a week before the surgery to get a plan in place, and we do very progressive things to try to treat the pain.
Curtis Johnson, CRNA: We see the patients weeks ahead of time, and it gives us an opportunity to design an anesthetic for them specifically for their particular needs that works very well with what's going to happen to them after surgery.
Dr. Hebert: There's no way to eliminate pain after joint replacement surgery, so we try to manage your pain so that it's reasonable, you can participate with the exercises without being in excruciating pain. There are several things that we do. It starts with the anesthesia, and they're very innovative in the techniques that they use. One is what's called a femoral block, which is a block of the nerve in front of the leg. We keep that going for 48 hours afterwards through a small catheter that's inserted along the nerve, and what that does is really blocks a lot of the pain that people will have. What it allows us to do is reduce the amount of narcotic pain medications that we have to use, which can cause a lot of nausea, their sickness... People just don't feel good when they're taking high doses of narcotics.
Dr. Diana Kruse: Orthopedic surgery is a little different than other surgical disciplines in the sense that it takes a little longer to get to where you're going to be considered 100 percent healed, and so one has to have patience and realize there's going to be some soft tissue discomfort involved along the way as you're exercising.
Cook: It's a pain that's different. Arthritic pain is not going to get better; this is a surgery pain that will get better with time.
Narrator: Yes, the muscles around your new joint will hurt after surgery. Dan Weaver's knee joint pain became so severe, he had two knee replacements at the same time. But, the pain of watching life from the sidelines became impossible to bear.
Dan Weaver: Before when I went in, I was in so much pain that the next morning when I woke up, you've got muscle pain, but there was no joint pain. And that was completely different for me. I could not believe it. The first time I stood up and stood on them and took those first steps, it was like, "Wow, they don't crack." I don't hear crunching anymore. They don't hurt. The joints don't hurt anymore. If you look at it as far as when you go into the operation to what it is afterward, to me it was extremely tolerable because the pain I was living with on a daily basis was 10 times worse than it was afterwards.