Very poorly friend

I have no suggestions but didn’t want to read and run

She is lucky to have a good friend like you along with a supportive daughter I think you all need a (((hug)))

What a sad situation. I wish I had some helpful ideas, but I can only send my fervent wishes that she finds the help she needs.

Her daughter needs to contact Adult Social Services asap, as that’s not mentioned I’m assuming it hasn’t been done. A social worker should help.

I am so sorry to hear of your friend’s situation. I wonder if the surgeon would be willing to operate if she completely understood and accepted the risk that she might not survive? I assume the operation would be a TKR? Being in so much pain, maybe she would take that risk as living with so much pain is not an acceptable alternative?

She is blessed to have a friend like you. As Jaxjacky has suggested, her daughter needs to contact the SS asap . Good luck to your friend ..

I'm really sorry to hear this. Could she not have morphine IV? I know they can give it to people in palliative care

lots of love it is such an awful thing to witness

GSM I agree. I know someone in a similar but not quite so bad position. He can hardly move and is in great pain most of the time which morphine does not fully relieve but the consultant won’t do a hip operation as he may not survive. They are having meetings at the moment to discuss taking the risk. He doesn’t want to take more morphine as it zonks you out. This is a dilemma for so many.

A small point but taking paracetamol regularly helps with the morphine.
Surely this lady would qualify for continuing care.??
What about a referral to pain management specialist?
And definitely SS.
I think now she's in a private care home they think they can now quietly ignore her.

Many thanks to all of you for taking the time to reply. I should have said that her daughter works for Social Services, so all avenues there have been thoroughly assessed, but to no avail. I absolutely agree with GSM, if it was me I’d take the risk of not surviving the surgery as her quality of life now is zero.

I think she certainly needs TKR. I wonder if there’s less risk if it could be done with an epidural rather than GA.

I suppose intravenous morphine would help, but I think that’s only used in palliative care.

The hospital couldn’t get rid of her quickly enough, I do understand that she needs the sort of care that a general hospital doesn’t offer, and beds are precious. She is currently being cared for well but I worry that she’ll just stay in her room as it’s just too painful to leave, and she unsurprisingly doesn’t feel very sociable!

I think you’re right Loopyloo. It’s a sad state of affairs when people are left to suffer. Taking paracetamol alongside morphine does make a difference. I had to take it after shoulder surgery and it worked.
What a good friend you are Bazza. 💐

I wish I had an answer. I suppose that if she's currently well looked after that's good. If she doesn't feel like socialising that's fair enough and understandable poor soul. What will happen when the money runs out though? That's when SS will really have to sharpen their pencils.

I wonder if the surgeon would be willing to operate if she completely understood and accepted the risk that she might not survive?

What does she think about this and what does her daughter think?
If it was me (or, indeed, my mum) I would maybe consider this.
Can the daughter ask the consultant to speak to them?

Interesting that two medics are unable to help. It's possible that there aspects of her medical condition that you are unaware of. I certainly know of people of much greater age who have had joint replacements.

It’s very useful her daughter knows the system, (if there is one), but in a way that’s pretty discouraging that her mum, your friend, seems to have been parked in an expensive care home, possibly with nothing further planned.
As for friends who drift away. … it happened to us, something I just was not expecting at all.

I forgot to say that she does take paracetamol with the morphine, and ibuprofen but nothing helps the pain. The main worry about the possible surgery is the fact that she has virtually no immune system and had sepsis a while ago from an undiagnosed water infection.

She’s on a waiting list 🙄 for the pain clinic.

She has been somewhat unwilling to risk the surgery up until now, but given how much worse she is I think she will change her mind, and her daughter, who is just lovely by the way, will support her decision.

Thanks again for all your posts.

My husband lay in excruciating pain for days after a hip replacement (he had secondary sarcoma). I was told he was not a priority for the pain team. He died before becoming a priority. He was in his 50s.
If your friend does decide and manages to get an operation I'd make very sure what provision is for pain control post-op. He had been in constant pain pre-op but the post-op pain was off any definable scale. It was truly horrific.

That’s a terrible experience for you both OldFrill. I must admit to not having thought of post op pain, and I don’t think she has either. I just thought, stupidly I now realise, that surgery would be the answer. It’s certainly a consideration.

What a tragic tale. Prompt referral to a pain clinic seems called for, but I’m afraid there is no easy answer as there are unknown variables.

How kind of you to be such a support to both your friend and her daughter. 💐

I think there comes a point when nhs doctors are not willing to offer treatments that will almost certainly not work.

The pain clinic seems the best option, so perhaps she could pay for that privately?

The pain management consultant at the Royal Surrey County Hospital in Guildford is a very pleasant, kind Italian lady called Dr Daniela Tonucci. She is available to be seen privately. As far as I know her PA can be contacted at the Nuffield Hospital, next door to the RSCH, on (01483) 555816.

I feel so sorry for your friend. I wonder if part of her pain relief could go down the route of including an anti-depressant such as amitryptyline. It is slow to take effect but can benefit some people.

It does sound as if a knee replacement operation is the only way to get your friend mobile again.

One thing to note about the operation is that generally now joint replacements are not done under a general anaesthetic but with a spinal block along with sedation which means the patient is completely unaware of the surgery but recovers much more quickly.

It’s still major surgery of course but there must be many benefits as it seems to be done this way more widely now.

Your poor friend. She’s no age is she to be so completely incapacitated so I do hope something can be done for her soon.

she should be supplied with continence products so that she does not wet her clothing.
her whole situation needs to be assessed and dealt with as best possible in the circumstances.
has she had a care needs assessment by social services, then there will need to be a financial assessment.
it may be a case of managing the debilitating symptoms rather than any realistic prospect of cure.
if she has widespread osteo and rheumatoid arthritis, the problem will not be limited to one knee; she may have to accept a loss of mobility.
in the right situation, with the right support, that is not necessarily a disaster.

post op tkr pain is indescribable - I ended up using the sleeping pill zopiclone - my gp said "you cant use a sleeping pill as pain relief" I told him that if I was asleep I was not in pain - it at least meant I got some relief. IV paracetemol in the hospital was really good but by mouth not so effective. Used alongside ibuprofen was helpful. Morphine gave me the worst constipation you can imagine. When anyone tells you that any pain is manageable with the correct help they are in fairyland.

I’m just so sorry and do hope she gets some help and things improve. I just don’t know what to say and send you all a big hug x