TKR TKR September 10

[flsungirl]

hi everyone! First I want to say thank you for this forum, it’s been so helpful!

I had TKR on my right knee last month as outpatient surgery. The first week was great, the second week it all fell apart. I’m starting week 6 on Monday and still not sleeping. The bottom of my right foot has become numb and the outer part as well. Then the top of my foot is painful.

Starting a few days ago I noticed right hip pain that spreads medially to the groin area. I can’t get comfortable at night because of the foot and hip symptoms. Plus it makes PT difficult due to the pain. I can feel something with my hand, clicking in my right hip area as I walk.

Saw orthopedic doc on Monday and he wants to do a nerve conduction study. I haven’t heard from his office so I’m sure I’ll have to be the one to follow up with this procedure, which has been the case since surgery. But that’s a whole different story.

I just want to sleep, and I just can’t get comfy with hip and foot problems. My regular doc gave me some 6 mg Doxepin to sleep, tried it last night with good hopes...it didn’t work. I took pain meds for 2 weeks and have been on ibuprofen 800 mg 3 times daily. I’m back on gabapentin 100 mg for nerve pain 3 times daily.

I’m starting my 4 th week of outpatient PT. I’m able to get around well and driving. The problem is really not knee pain, just unable to sleep and I’m so dang tired. I know everyone heals differently, I’m just hoping this isn’t nerve related due to surgery. I’ve tried just about everything out there to sleep, I am so tired a can’t nap in the daytime anymore. Can’t wait till this is all a memory.

 

[Jockette]

Hi and Welcome to Bonesmart!

Not sleeping is a very common complaint of this recovery. I haven’t slept well for years, so it didn’t bother me in recovery, I just changed locations, looked at things on my phone or kindle until I fell asleep again.

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Knee Recovery: Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now; they are almost certainly temporary
2. Control discomfort:

rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. Here is a week-by-week guide for

Activity progression for TKRs​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?

Energy drain for TKRs
Elevation is the key

Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only
ONE Recovery Thread.
This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[flsungirl]

Thanks, I’ve read most of these and it’s what has filled in all the blanks that we’re not told about pre op. They have been extremely helpful. I am grateful for this forum

 

[Kiwigirl62]

@flsungirl , i right with you re sleeping. Been absolutely exhausted. Go to bed tired and hey presto 3 hrs later still awake. Legs very restkess when i hit the bed. Not painful though.

I trawled threads and found a thread regarfing restless legs. Last night i actually for 1st time in 4.5 weeks got more than 3-4 hrs. I still have oxycodone in cupboard that i didnt need to take so took one last night and slept 6-7 straight.

I will use maybe every 3rd night until i get 'normal' sleep as i hate medication but was so desperate -prior was just at the point where i was crying from exhastion.

Hope you find sleep....it sucks

 

[Clairebear]

I feel for you with the lack of sleep . @flsungirl, @Kiwigirl62 I too struggle to get off to sleep and then I'm very wakeful for the first couple of hours. I'm rarely asleep before 2/3am. No pain just this zappy restless feeling. I'm shattered throughout the day and try not to nap in the hope I'll sleep at night but tbh it makes no difference either way. I used to sleep so well before the op but I suppose it's all part of the healing process, or at least I hope so.

 

[flsungirl]

I toss and turn for hours when I try and sleep. I’ll be 6 weeks post op on Monday. Developed the knew symptoms with my right foot being asleep and right hip pain, that’s what really stops me from getting any sleep. I can’t have anything touching my foot while I’ll laying down or lay on my right side for long. Then my knee will kick in with all the tossing and turning I do. And I to never had difficulty sleeping prior to surgery. I know it wouldn’t seem as bad if I could sleep. I used a heating pad on the outside of my foot and hip today and actually fell asleep for about a solid hour. So ready for this to be over. Thanks ladies and I hope you’re sleeping soon!

 

[Clairebear]

@flsungirl I hope you get to the bottom of what's causing your new pain soon, I'm not medically trained but logic says the hip pain and foot numbness could be nerve pressure? I was 4 weeks post op yesterday and my main issue is the tight band feeling on the front of my knee and nerve pain on the scar. I hope you get some good quality sleep soon.

 

[Kiwigirl62]

Well i was soooo exhasted, i pulled out the big guns last night. I took 1x 5mg oxycodene (had some left as stopped these 10 days ago).

It so did the trick of relaxing legs and i got 6-7 straight......feel better today. Also cut water intake late afternoon so i wouldn't need to get through the night. Will try again in 3 days if sleeplessness still plagues me.

 

[Josephine]

I toss and turn for hours when I try and sleep.

Sleep disturbances like this are invariably due to poorly managed pain.

I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?

 

[ThumperJB]

@Kiwigirl62, so glad to hear you were finally able to get a few hours of sleep. Medicated sleep is better than none. I'm sure pain levels are inreased by lack of sleep so hopefully getting a few hours will also help manage the foot pain.

 

[flsungirl]

@Josephine, absolutely interested in your thoughts. I tried to walk today, I was doing a mile every morning and sometimes in the evening. I made it to the end of the block and had to turn around. My hip pain has increased exponentially and it is now numb at times near my right groin area. My knee pain is minimal but occasionally I’ll get a few stabbing pains that go away after a few jabs.

@Clairebear, so glad you got some sleep! I actually had about an hour nap today that felt fabulous!

@Kiwigirl62, I too have the tight band but it was getting better. I was limited on exercises this weekend due to weird hip pain. I’ve noticed the less exercise I do, the longer and tighter the band becomes. I have PT tomorrow and am calling the orthopedic doc too so I can get a handle on the hip pain and numbness. My foot seems much better today so hoping that’s over.

Hope everyone is progressing and feeling a little better. I can’t wait till it’s all over. Ive had enough new symptoms popping up and don’t want any more! Tomorrow is the beginning of week 6 post op for me. It’s got to get easier!

 

[Rhodyrhody]

Week 6 on Tuesday here. Getting better...not every single day...but the trend is definitely better.
I have the same tight band and it also seems like...the less exercise I do, the bigger and tighter it becomes.
Need to ice after exercise, but seems like ice just stiffens everything up even more.

Oh well...go calendar go!

 

[traceys]

@flsungirl @Rhodyrhody the band ...yes!! People think I’m crazy when I try to explain it but doctor said it’s inflammation under the muscles and they tighten and trap nerves. Mine are happening less and are way less severe. The elevation helps so much as does flexing knee lightly to keep fluids from pooling there.

I am sept 11 surgery so right with you. I too am having hip issues and it was determined they trapped a nerve during surgery (considering what they do while you are out no surprise) AND my hip is realigning after decades of the femur being twisted. Not sleeping just adds to the stress and anxiety.

That is a LOT of walking you are doing! Are you maybe pushing a bit much and irritating things as well?
Keep us posted and hope you get some relief!

 

[Kiwigirl62]

Theres an interesting article in the library re the tight band....it makes sense after reading it....sorry not sure how to link it.

Wearing a compression knee band helps to minimise the sensation. ...well for me to date it has

 

[alexthecat]

Here's a library article about the tight band feeling. I don't know if it's the one you were thinking of.
https://bonesmart.org/forum/threads/tight-band-feeling-across-the-front-of-my-knee.11734/

Sent from my SM-S327VL using Tapatalk

 

[flsungirl]

Woo hoo! I slept most of last night! I took aspirin and a 300 mg gabapentin before bed. My foot is just about back to normal and hip is not as bad. I have PT this morning then will come home and take 100 mg gabapentin and an aspirin. We’ll see if this lasts, please please please be over insomnia

 

[flsungirl]

@Rhodyrhody @traceys my orthopedic doc was pleased with the progress and not alarmed that I was walking too much. I’m thinking, clearly now after a full nights sleep, that my whole body is adjusting because both my knees have needed to be replaced for over 4-5 years. So everything is not used to this new way of walking. My big worry was a nerve compression or something with nerves being messed up during surgery. I’m hoping my body is on the way to total healing. I did very little this weekend due to all the hip pain and weird foot symptoms.
But this whole process has been 1 step forward then 5 steps backward, which I know has a lot to do with sleep deprivation. I hope you’re healing well and thanks for your post. Plus you and I are so close for our procedure dates!

 

[Rhodyrhody]

@flsungirl Glad you got some sleep and are able to take walks. I frequently walk around the house, but have only recently started taking longer walks outside. (5 minutes is way longer than one thinks when starting out and actually timing it). I did a couple 10 minute walks outside yesterday and my right knee was a-hurtin' after both. Felt better after ice and elevation, but I am really getting tired of.....icing.

 

[flsungirl]

@Rhodyrhody I agree with timing the walks 5-10 minutes is plenty. I was unable to do certain exercises today at PT because of my hip. After doing one of them my whole lower right side got numb but slowly the numbness decreased. Super weird feeling. My right hip is still a little numb near my right groin area. I took a gabapentin 100 mg and an aspirin when I got home and had a good 2 hour nap. Still will take any sleep I can get! I ice after exercise and walks. Don’t need it as as much as I used to. But I’m sure as writing this, I’ll need it again. Something else is sure to pop up! It always does...

Since I’ve slept a little the depression has eased along with the grumpiness. Sleep is underrated, sleep is good!

In a few months it will all be over. And I’ll be able to get some of my life back and do things I’ve missed out on due to my knees.

Hope you’re doing well today!

 

[Rhodyrhody]

Doing ok so far today. Just posted in my recovery thread that I actually walked a whole mile. Started out that I was just going to do my regular 10 minute walk but just kept going. Eventually got to a spot that I know is exactly a half mile from the house and turned it around and came back.

Glad you're getting some sleep and hope you're having a good day, too!