TKR 6 weeks in and still not sleeping<

[Jazz1963]

I still take 60mg codeine just at night time, and this helps me sleep. I have to get up to go to the bathroom, but go straight back to sleep, last night slept from 1 am to 6 am, which was pretty good for me. Then got up at 9 am to go to bathroom again. Other than that, I’ve only taken 2 x 500mg paracetamols today. My doctor doesn’t mind me just taking codeine at night time. Might be worth trying it,

 

[Jazz1963]

I’m 7 weeks post op tomorrow btw

 

[Lucky man]

I’m at 7.5 weeks, and still struggling with sleep. I went through a period (several weeks) where I only got 2-3 hrs per night. The last couple of weeks, I’ll have one or two good days, followed by a couple of difficult ones. One other thing to try is magnesium. It’s a common deficiency, helps with muscle spasms, and can improve sleep.

 

[Josephine]

1. Level 3

Okay

2. Dihydrocodeine 30mg, 2 tabs 4 times daily
Gradually dropped off codeine till stopped at 5wks, 3 days
I still take 60mg codeine just at night time, and this helps me sleep.
Gabapentin 300mg, twice daily Gabapentin stopped at the same time
Other than that, I’ve only taken 2 x 500mg paracetamols today.

Well are you taking codeine or dihydrocodeine? There is a big difference, y'know.
But whatever it is, you are still taking it at night, right?

I think you need a better pain med regime and I suggest you take 2 paracetamol 3-4 times a day routinely.

3. swelling Slight

OKay

4 ROM flex 100 degrees, ext straight

Okay

5 icing: 20 mins every 2 hours
6. elevating: 20 mins hourly

You accomplish little or nothing in 20 minutes. Ice and elevate for at least 40-60mins and more than 4 times a day.

7. Moderate activity, pottering around house

Doing what, exactly?

20 mins walk twice daily - okay but make sure you go 10 mins there and 10 mins back!
Up and downstairs normally - jolly good!

The following are all twice daily:
Towel under heel, push back of knee down, hold 6 secs x10 - not a good idea. Besides which your ROM is actually pretty good!

On front, legs over end of bed, straighten knees, hold for 6 secs x10
Knee dips (single leg squat) x10/Step on lowest stair, lower hip x10
Bend knee up with flexed ankle x10
heel slides x10
these are all flexion exercises which you don't need

Rolled towel under knee, lift lower leg (short leg arc) hold for 6 secs x10
Lift up heels, together and alternately x10
Bridge, hold for 6 secs x10
Lying on front, bend operated knee up, help pressure with good leg, hold for 6 secs x10
you don't need these either.
Altogether these mount up to 180 reps per day which is far, FAR too much!

twice daily: Step slowly onto book with operated knee, slowly lift other leg onto book x5 - another unnecessary exercise.

So simply put, all these exercises are what is causing your sleep issues and pain. You said this

I just cannot sleep properly
Has been worse since I stopped codeine pain relief last week - I’m only taking paracetamol now.
I’ve tried late night exercises and ice packs but hasn’t helped

Disturbed sleep is a sign of inadequate pain management.
"has been worse since stopped taking codeine" means you are in pain
Never do exercises to solve problems like this. Very much the wrong thing to do. You will notice I have crossed out many of your exercises because these are unnecessary and the cause of your problems.

 

[izzyb52]

It was dihydrocodeine and I stopped taking it two weeks ago.
I take on board the suggestion of the paracetemol.
In the house, I have been doing food prep and a little cooking. Light dusting and washing/drying dishes.

I will extend the icing and elevation.
Do you have exercise suggestions in place of those you have crossed through?

 

[sistersinhim]

No exercises, just your daily activities will be all you need. These knees heal and rehab on their on if you use them the way God intended them to be used!

 

[izzyb52]

Hi. Just wondering if anyone had any thoughts about Pilates mat classes and any advice on how long it’s likely to be until I can get up from the mat? 11 weeks post op

 

[Josephine]

Try kneeling and getting up at home or on your bed. That should give you a good idea.