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TKR Help please for one week out Right TKR

Reh3

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I had my total right knee replacement on September 15 tomorrow is a week. And I’m trying to gauge where I should be for a week. I know it’s different for for everyone and I also have to watch out that my physical therapist doesn’t try to kill me. She already gave me the spiel if you work hard now in the beginning and do all these things I have you doing then recovery will be that much better.
Today I’m feeling wiped out sleeping on and off during the day and pain in my knee And especially in my upper thigh..
Even though I’m taking pain medications as prescribed and maybe even a little more. I’m also very itchy. Just wondering if anybody had any advice for me in this lonely post Covid New World. Thank you! Robin
 

Gramalita98

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The first two weeks were horrible for me especially at night. I really couldn’t keep ahead of the pain because I was afraid to take too much norco 10/325 I know now that when I get the other knee done I will increase my meds or at least take them way ahead of time. I’m at week 5and sleep has been an ongoing issue. This seems to be very common with most of the threads I have read. It seems like every weird pain shows up at night. Last night I took a norco and muscle relaxer because I was having a throbbing pain all day and evening that would come every few minutes and last about 15 seconds and it was the first time that I only woke up 1 time and was able to fall back asleep until 5:45. Needless to say I was very surprised and grateful. I know not to hold my breath though. I saw my OS today and he said I was doing great and I should put a salonpas patch on each side of my knee at bedtime. I have a hard time keeping them on and wonder if anyone has any suggestions.
 

Celle

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Hello @Reh3 - and :welome: to recovery.

Yes, I'm afraid that poor sleep at night is common after this surgery.

Pain at night is often the result of two things - doing too much during the daytime, and not taking enough pain relief when you go to bed at night. The fact that you had a better night after taking a Norco and a muscle relaxer indicates that was a good thing to do.

Do be careful with your daytime activity and your PT. At only a week after this major surgery, your knee doesn't need much exercise at all - just enough to keep it moving gently.
Activity progression for TKRs

Your PT therapist is wrong. You don't have to work hard, and pushing through the pain is only going to keep your knee swollen and inflamed. The poor thing isn't lazy or unfit - it's wounded and it needs time and gentle treatment, so it can heal.

You are allowed to say how much exercise you will do, because it's your knee, not your therapist's. Your therapist has to respect your wishes.
Saying no to therapy - am I allowed to?
 

Celle

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Here are our recovery guidelines, to help you - lots of helpful articles:

Knee Recovery: The 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
ice
take your pain meds by prescription schedule (not when pain starts!)​

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

5. Try to follow this

6. Access to these pages on the website

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.
 

Gramalita98

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I had my total right knee replacement on September 15 tomorrow is a week. And I’m trying to gauge where I should be for a week. I know it’s different for for everyone and I also have to watch out that my physical therapist doesn’t try to kill me. She already gave me the spiel if you work hard now in the beginning and do all these things I have you doing then recovery will be that much better.
Today I’m feeling wiped out sleeping on and off during the day and pain in my knee And especially in my upper thigh..
Even though I’m taking pain medications as prescribed and maybe even a little more. I’m also very itchy. Just wondering if anybody had any advice for me in this lonely post Covid New World. Thank you! Robin
I forgot to mention that when I first started taking norco I was very itchy on my neck and head but as I go used to it it went away. Hang in there!
 
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Reh3

Reh3

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Thank you for your comments and help. What about these tight compression stockings and the ace bandage wrap. I was told to wear them both during the day but leave the ace bandage on at night is that what you recommend also? It keeps falling off. Is this what I’m supposed to look like, this black and blue all the way down to my heel ?Thank you, Robin
 

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Gramalita98

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The compression stockings they had on me in the hospital and sent me home with were too big In the thigh and would just hang down. I got re measured when I went for staple removal and went down a size. They fit better but kept rolling down in the thigh area and kind of acted as a tourniquet. The swelling never really went down while wearing them. I wore them for almost 5 weeks during the day not the 6-8 weeks they told me too. I’m not sure but I would assume your bruising is pretty normal. Some days my bruising looks darker than other days. Take care..
 

Celle

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What about these tight compression stockings and the ace bandage wrap. I was told to wear them both during the day but leave the ace bandage on at night is that what you recommend also? It keeps falling off. Is this what I’m supposed to look like, this black and blue all the way down to my heel ? Thank you, Robin
Hi again, @Reh3

Each surgeon has his/her own protocol for the compression stockings and ace wrap. You should ask your surgeon, not another member, whose surgeon could well have different ideas.
Other members can only tell you what they did, not what you should do.

Your bruising looks normal - amounts can vary.
Have a look at this article and its illustrations for other examples:
Bruising after surgery
 

Bob1653

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@Reh3 I am 1 week ahead of you. I had my TKR on September 8. I too have bruising from my thigh down to my ankle. Not solid, but blotches of bruises all the way down and around the back of my leg.
My knee is still very swollen and aches and very hard to move. Tomorrow is the 2 week mark, I doubt the swelling is magically going away, but I keep hoping I see some big improvements this week. My OS told me before the surgery I would be cussing him with every breath the first couple of weeks. I do feel like the swelling and soreness is starting to subside some, but not much yet. Also my thigh is not super tight and painful like it was the first week.

I actually pushed pretty hard at PT today, harder than I probably should have, and I feel I have paid the price the rest of the day. My ROM today was 101 and -2. Tonight I feel like I can't bend it at all.
I have been trying to cut back on the narcotics and only took half dosages since yesterday. Tonight I am taking the full dose and probably a Tylenol to go with it. The most I have slept since the surgery was 4.5 hours last night. The rest of the time is short cat naps throughout the day.
I haven't experienced the itchiness from the narcotics.

Good luck with recovery.
 
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Reh3

Reh3

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Hi Celle and Bob.
I got no sleep at all maybe a couple hours here and there. It is painful laying with your legs straight all night. Do you know can you sleep on your side and if it’s your right knee you had done what side can you sleep on. I’m going to take two of my oxycodone this morning to see if I can get past the pain. And Bob-if you have to be careful with those physical therapistS. Read the article here that tells you how no one should hurt you. I think there’s validity to that and the majority of the physical therapist out there have no idea about it and then they threaten you that there will be issues down the line if you don’t do it the way they want you to.

I have to get better control on my pain!
 

Jockette

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In the very early days I had trouble getting comfortable at all to sleep. What finally worked for me was to elevate my leg all night on a foam wedge the hospital sent home with me.

And, you don’t have to keep your legs 100% straight, that is very painful. A slight bend is fine for your knee and will be a bit more comfortable.
Elevation: Doing It the Right Way.
 
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Reh3

Reh3

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Here I am a day 13 of my total right knee replacement and I’m still not sleeping all wink. I called the doctors office today and they said to take two Tylenol PMs before I go to bed. What does everybody think about that? Does that work? I had my staples out yesterday it was wonderful :)
 

WhenImOld

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Hi Robin, welcome! I can't give you much info on the Tylenol PM, as I'm allergic to benadryl so I can't take it. I did take Unison, which has a different active ingredient, along with the Tylenol dosage separately. It didn't seem to help me much. It was close to 10 weeks before I slept through the night completely. Even at 15 weeks, I'd say that I still don't sleep through the night about half the days during a week.
 

nettie

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@Reh3 - Totally understand what you are saying about difficulties sleeping. I am 6 weeks out from my TKR and have had difficulty sleeping every night. BUT... there has been some improvement over time, so hang in there! Definitely take your pain medicine before bed. Don't wait for the pain to set in and then try to get rid of it. Best to be proactive with pain management, especially at night. I have also taken Melatonin on some nights and that has helped. I wake up every 1 1/2 to 2 hours and have to move around a bit, get up and walk, and then reposition myself when I get back in bed. Just this week I was finally able to lay on my side, but it's not comfortable for long. Yet I see it as progress because at least I can get on my side, even if I can't stay there for long. Good luck and hang in there!
 

Geoffa

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I have used Melatonin with success for sleeping although I found it leaves me dopey in the morning and did little for my restless leg. My OS recommended Restavit doxylamine succinate for sleep and restless leg, I am now 9 weeks and take 1/2 a 25mg nightly. No script required in Australia.
Works well and now as evening pain events are more driven by my exuberance and thus controllable hoping to wean off over the next weeks.
Hope this helps.
 

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