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TKR Cyclist - Managing My Recovery

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patbike. Knee replacement is a major surgery. The body uses so much energy to heal that there is not a lot left for anything else. Also, yes, the meds, lack of sleep, etc.. do cause the funk. All the things you are experiencing is just what we all have gone through during recovery.

Pain meds can cause sleeplessness. Not being able to get comfortable at night also just exacerbates the issue. Being unable to do what we want to, as soon as we want to, the pain, the meds, the energy drain from the massive healing..all this leads up to the blues.

Lots of us have loss of appetite during recovery.. I know I did and lost 10 pounds the first three weeks. It makes sense that the body is burning calories during recovery..the body is using all its resources to heal. When you take into consideration the damage the body sustains having those new knees installed, it's no wonder..the bones have been cut off, kneecap moved and put back on, bones drilled, implant hammered into the bones..multi layers of internal sutures..

Yes, being tired is par for the course. I know most of us were wiped out just taking a shower and had to lay down.

My sleep patterns were a mess for months. I slept in 15 minute increments around the clock. The most I slept at one time was an hour!

Everything you are experiencing Is exactly what everyone experiences. Please go to the library section here on the forum. There are articles that help explain the sleeplessness, and the energy drain.

Hang in there my friend. It does get better. And any night you can't sleep, just come here to the forum.there is always someone here for you to chat with. And we all understand the TKR blues firsthand dear one. :friends:
 
:iagree: It's your body taking over! Relax, watch telly, take it easy.
 
It just seems like such a battle. An internal war that no one else sees and understands. Thank god for this site and the support from others fighting the same battle. Sorry, just venting. Everyday brings a new challenge.
 
Best way to sum me up fot the last week is that at night I'm too uncomfortable to sleep much and during the day I don't have pain but I'm often tired and feeling in a funk with low appetite.

I lay down last night around 8:30 and realized that even with icing I was gonna have another uncomfortable night.
So at 9:00 I took my hydrocodone which I hadn't taken for four days and by 9:30 I felt very comfortable and knew I was going to have a good nights sleep. About that time my wife came to bed and started playing on-line bridge with me kibitzing. I was in a great mood and we had fun talking about cards and the accomplishments of the day. Well it was the best I have felt in days. I got my computer going as well and played a little bridge and checked out BoneSmart.
I felt so good I didnt want to go to sleep so i stayed awake enjoying my self until about 1:00 when I took more meds and turned off the computer and fell right asleep. This AM I feel very good even though I only slept abot 5 or 6 hours.
I don't have that funky feeling and my knee is quite comfortable as I lie in bed typing this. My wife is awake too and we are chatting again about stuff mainly to do with horses for my daughters carriage driving and the new care giver we hired yesterday for her.

Bottom line I feel mucccchhhhhh bettttteeerrrrrr.

Watch out world I'm back.
 
Greeeeeaaaat! Look after that knee and cut it some slack. It's healing steadily I'm sure. :)
 
saultlooser
By the way sault, I bought a four pack of the 30 gram protein shake. It tastes ok when cold and its great if you need to quickly put something in your stomach when you take ibuprofen. Which reminds me, I'm gonna measure my knee to see if the Ibuprof is reducing the swelling.
 
Great, let me know about the ibuprofen because I plan on asking my OS on Wednesday if I can switch from tramadol to ibuprofen.
 
saultlooser
Josephine

I just measured and both my knee across the middle of the knee cap is down about 2 inches from surgery and about a half inch in the last 4 or 5 days. The area just above my knee at the narrowest point is also down although a little less than above. Not sure if it is the ibuprofen but I'm gonna keep taking it for a while. I had some pre-op arthritis swelling in the area above the knee for the last 10 years and I'm hoping that will go away as well. I think I'll ask the experst about that. (Josephine, any expierence with pre-op permanent swelling caused by knee arthritis and whether it goes away once the arthritis is removed?)

The only reason I'm a little skeptical about the ibuprofen is that I had to ask my os for it. So if it is so effective why didn't he recommend it originally? I didn't give the tramadol a chance and I am now using ibuprofen for any discomfort in the day but there really isn't much if any. Night is a different story and that is where I brought the big guns out again.
 
Actually, Ibuprofen is not that effective at pain relief. It may do well for inflammation, but Tylenol is actually a much better pain reliever.

Proper pain relief is vital during recovery.
 
I'm sure you are right, I don't think it is doing much pain wise either and hope it just helps with the swelling.
If I do get day time discomfort (which really is not a current issue - knock on wood) I'll dig out the Tylenol.
 
Swelling is a manifestation of pain so don't go telling me you don't have any pain, certainly not at 4 weeks! You may be rid of the pre-op bone-on-bone pain but there are many different types that come after surgery such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness. All these need medicating else you will never get on top of the swelling. The reason surgeons don't prescribe NSAIDs, specially in the early days, is because of this very thing. They're ineffective and the swelling is a manifestation of pain.

Having beaten that one to death, I will go further to say that Tylenol is not going to be much good right now either. Perhaps you would be kind enough to remind me if there is some good reason why you are not taking something stronger like Tramadol ...
 
Josephine
Well everyday can be different but lets take today. I had none to minimal discomfort this AM. I have done one round of stretching and strengthening exercises, I have iced and elevated twice and finally took a tylenol an hour ago because I had sort of that very mild discomfort around 3:30 PM that make you want to keep moving your leg around plus I am now icing again as I type . At this moment I don't notice anything. However by 9:00 tonight when I lie down I plan to take my hydrocodone because based on experience theire is more discomfort when lying in bed and it keeps me from sleeping. I expect to take more hydrocodoe around 1:00AM as well. It worked great last night and I am having
a really nice day overall. I agree the tylenol doesn't really seem to do much so perhaps it is the ice and the general activity that is eliminating (or getting my mind off )the minor discomfort during the day. I tried tramadol briefly the other night and it had no effect at making me comfortable in bed so I reverted to the hydrocodone.

Back to my question regarding the swelling that existed pre op that is located above the knee area where the thigh meets the kneecap. That swelling popped up about 10 years ago and has stayed static in size (I think)even though my knee condition has deteriorated significantly over that time and my pain has gotten worse but the swelling has not gotten worse just stayed the same. I'm understanding now that the swelling was caused by the knee pain which eventually led me to get the TKR. of course I currently have some new swelling related to the pain of the surgery.

So is it reasonable to assume that the old pre-op swelling will resolve once I am totally "pain free".
 
I had another great night last night and even woke up once on my stomach. That is a post op first, not sure why it happened but I guess master knee sent out a roll over signal to the rest of my body and voila!

saultlooser



Sault if you look at Josephine and Titian Lady above you will see what experienced folks are saying about Tylenol and ibuprophen which to summarize is that they are for minor discomfort at best and may not give much relief at all for TKR patients, at least in the early weeks.

For now I don't have a real pain issue during the day and am getting by with the occasional
Tylenol or Ibuprophen even though I have to agree with Titianlady and Josephine that they don't do much.


Better for me is ice and movement and mental diversion. Night time I need the meds and I will not be in a hurry to get rid of them for now. Originally I thought they were making me feel funky during the day but now I think the funk was more from lack of sleep and a little low energy. I have no funky feeling right now and I have been back on the night time hydrocodone for 2 nights now. My appetite is still suppressed but i am eating well enough.

Just got back from Mondays PT and had a good BoneSmart session. My Rom had made a good jump as of last
Friday but was the same this AM as Friday. They measure at the beginning of the session. With massage and stretching and general warming up it improved a little during the session.

My scar which was glued goes right down my old scar and is looking fairly well healed.

Today I'm happy with what is going on.
 
Way to go! Sounds like a great night, can't believe you woke up on your stomach. I'm not doing so well today. Can barely eat and drink. When taking my tramadol, even they really hurt going down. Tried eating chicken soup and threw up twice. Trying to keep my head up but I will be seeing my OS on Wednesday and will need to discuss med alternative. I will try and stick to protein drinks between now and then. Oh we'll, at least my ROM was at 100 with the PT this morning.
 
patbike said:
Anyone have idea as to how long the discomfort at night will probably last with a single tkr.
Click to expand...
I had sleep issues for about four weeks---it was not that I was actually in pain---it was more like that I could not get comfortable. In fact, I would wander around the house at night, going from room to room looking for a place where I finally could sleep.

I finally gave in and took my OS's prescription for Ambien---that did the trick.
 
sault, good for your rom news. I was out today and i noticed that in the afternoon I was starting to get that old funky feeling but as I analyzed it, it seemed more like a mild nausea. I might try some anti nausea med tomorrow to see if that cures the nausea and the funky feeling. the old afternoon discomfort had started up as well just when I said this AM that i wasn't noticing it that much anymore. Oh well, I think I am pretty much along for the ride on this recovery thing and other than doing my exercises I will just have to wait and see what Mr. knee springs on me next.
 
Good morning Patbike,
Yes, we are at the knees mercy. I am having serious issues with nausea. I know the tramadol is making me sick to the point tat yesterday, I could not eat or drink. When I did attempt soup, I was in severe abdominal pain. When taking the tramadol, I have severe pain, like I can feel them traveling to my stomach. My daughter is a doctor and she suspects I am suffering from gastritis caused by the meds and I am now taking Zantac and liquid gaviscon. I think I will try like you, to take extra strength Tylenol and really cut back on the tramadol. If I'm not able to eat and drink today, I will be calling my doc.
 
saultlooser
My med history is that I only took tramadol one night hoping at the time it would be a natural down grade from the Vicodin I was taking. Well it did absolutely nothing so I then (its a little fuzzy) took ibuprofen and Tylenol for a couple of nights and I was miserable. Now for the last two nights I have been back on Vicodin and I can sleep and don't feel as tired/funky during the day but I do feel nausea /funky and am thinking of taking a zofran (anti-nausea pill) today if it persists. I am only using the Vicodin at night although I may use one in the day if the discomfort gets to be too much. sometimes I have zero pain and sometimes I have around a 3 and every thing in between. It seems to start out at nothing and then gradually become uncomfortable in the afternoon.

At this time I'm not too concerned about continuing Vicodin for a few weeks or so.

By the way I wouldn't expect too much relief from Tylenol or ibuprofen (see josephine and titianlady comments above)

I do like Blue Bunny ice cream with chocolate sauce and angel food cake :)
 
It is now 4 weeks and 3 days and I decided to try my bike out so after a test ride in the driveway I drove to the bike path and I went for a slow and easy 2 mile ride without much problem . I was pleased to know that I can do it which was one of my goals. My rom is just good enough to easily get the pedals around but I will still will need to improve'

My PT was good today and my extension is now about 4 % from flat unassisted and two degrees with gentle pressure. I think the reason it improved is that the swelling behind my knee has gone down a lot in the several days. And why did the swelling improve behind the knee. I think because of gentle stretching , icing and elevation.(where I have heard that before)
 
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