Hi Paul, I’m so sorry for your pain. This is not my area of expertise as far as your medical issues, but I do have a friend that was in severe pain for two years. She went to a special program at Stanford for pain management using a mental process instead of drugs. Check to see if this info might help. https://stanfordhealthcare.org/medical-clinics/pain-management/programs-services.html

I applaud your efforts to be present and loving to your wife and girls. Don’t worry about shielding them from your condition, but I agree it is protective to cry in private. They love you. They want 5he best for you. Please do not lose hope. Try (if possible) to compartmentalize the pain so you can free up a space for hope. All is not lost.

I do know many people with your problems but none with all of them! I can’t even imagine. Again this is not my expertise, but these questions come to mind: Have you asked about a nerve block? Have you had spine surgery? Stenosis, herniated disks and spurs can be greatly improved. Have your doctors tried a Medral does pack (short dose steroids)? Do you take supplements? Ask your doctor if high dose vitamins d3 would help/be safe. Also for your knees ask about synovisc injections. Arthroscopic surgery can help a lot to delay replacement.

Sending you a gentle hug and best wishes for healing.