The Answer: You have two issues with regard to pain: one immediately after surgery while in hospital and another when you go home. While most surgeons write a prescription for pain medication after surgery, I would advise you to use your appointment with your anesthesiologist to see what can also be done about pain control after you leave hospital. Oftentimes, patients are sent home with a one-size-fits-all pain plan that may work for most but certainly not all. Ideally, you want something more personalized.

“Patients list pain control after surgery as one of their major concerns” said Dr. Colin McCartney, staff anesthesiologist and director of anesthesia research at Sunnybrook Health Sciences Centre. “And some patients are very reluctant to take medications after discharge and would rather suffer pain and limitation of activity instead.”

Severe postoperative pain can cause an increase in blood pressure and heart rate and it may decrease ability to breath deeply and cough leading to greater risk of cardiac problems and chest infection after surgery. And because poor pain control inhibits movement, those with limited mobility are predisposed to other risks such as blood clots, according to Dr. McCartney, who is also a pain specialist.

“There is evidence that those patients who suffer severe pain immediately after surgery are at greater risk of suffering chronic pain months or years afterward,” he said.

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I was about nine years old, decked out in my Sunday best, preparing with the rest of my grade school choir to belt out some holiday songs for the packed house of anxious and proud parents attending the Christmas concert. A quiet hush washed over the audience as we took our place on the risers and the lights dimmed. As our music teacher took her place in front of us and got ready to cue the first line of Silent Night, you could hear the proverbial pin drop. The only sound that broke it was the cracking joints of middle-aged parents bending down to capture the moment on film.

Don’t ask me why I remember that, but I do. It was simply gross to me at the time. Today, as life has a cruel way of doing, things have come full circle. My joints are increasingly verbal. And while (knock on wood) they are still functioning well, I realize that I’m smack in the middle of a demographic that is increasingly indicated for joint replacement surgery. Dr. Jeffrey Gollish, a top orthopedic surgeon at the Holland Centre says, we’re seeing a real shift in who is going under the knife. Those aged 55 used to be the exception. Today, they make up nearly a third of patients getting new parts, so to speak.

Part of the change comes from advances to the joint replacement components, with most functioning better and lasting 15 years or more the Holland Centre has also advanced the understanding of when surgery is needed, knowing that the lower people start out on the functional scale, the worse they fare even after surgery. So when your midlife crisis collides with joint replacement surgery, please don’t feel alone.

I know that crackling joints don’t mean surgery is in the cards, but a decline in your daily functioning certainly warrants an assessment. So does an increasing reliance on pain relieving medications. As one of the largest hip and knee replacement centres in Canada, the Holland recently won an award for their model of care, which cuts down on wait times and streams patients into the level of care they need: surgery, physiotherapy or otherwise.

Get more information about the Holland Centre’s programs and services, no matter how old or young you are.

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