Bilateral TKR July 1 LHop - Bilateral TKR Recovery Thread

[Rob 68]

I have been experimenting with trying to sleep on my side. One of my hindrances is that I sleep with my polar ice packs on so it constricts my movements. So far I haven't found a way to sleep on my side for more than 20-30 minutes before something starts to hurt. This morning it was my hip. I vow to keep on trying though! As @kerrib said, where there is a will, there is a way!

Please, please let me know when you figure it out. I'm DYING to sleep on my side, right side to be specific, but my operated left leg keeps slipping off my right leg, which naturally triggers all kinds of alarm bells and whistles in my head. Driving me batty.

 

[KarriB]

@Rob 68 i had success sleeping on my side by throwing my unoperated left leg over my RTKR. It didn't work all night, but helped me to fall asleep. That was me sleeping on my right side with a RTKR, not sure how you'll fair on your right side with a LTKR.

 

[KYata]

Try putting a pillow between the legs. Gives TKR leg a more stable platform if it is on top and protection from pressure if it is on the bottom. I actually put a pillow crosswise so my TKR knee had just one pillow under and between it and the leg on top.

Have you tried sleeping with pillows behind you and under your legs? I found it a poor substitute for side sleeping but with all those pillows I wasn't laying flat. Apparently I need to be bent in the middle as much as on my side to sleep.

 

[MsBlue]

I have also been able to lie on my side/sleep on my side with a pillow under the top knee.

 

[Celle]

For a change of position, they turned me on to my side with a pillow between my knees while I was in the hospital.
When I got home, my husband would help me to get comfortable like that, too. No matter how often i went to sleep on my side, I always seemed to roll onto my back while I was asleep.

 

[Rob 68]

Many thanks for all the good suggestions. My primary problem is my bed; it's a adjustable one and I keep the bottom half high at night to keep my knee/leg elevated. To actually sleep on my side, I would have to lower that part of the bed significantly or suddenly turn as flexible as an uncooked pretzel. I may try a night with it lowered and see how it goes. Again, appreciate everyone's input. This is one of those minor problems we sometimes magnify a bit too much.

 

[Slainte]

You are not magnifying it a bit! Probably true that flattening out your bed might help. Sleep is so important. Your cells grow 20 percent faster when you sleep. And that means we heal faster. But the main reason I need sleep is to be able to deal with the normal frustrations of this recovery. If I am well rested, I can keep an even keel. I am sleeping pretty well thanks to the power of drugs. But long for the day when sleep will come naturally.

 

[PolarBear60]

Definitely consider lowering the bottom part of the bed to allow you to sleep comfortably on your side. At this point in your recovery, you should be able to do that just fine.

 

[LHop]

@Rob 68 I also have an adjustable bed, but I keep the bottom lowered when I sleep. I have found some success with side sleeping using the methods already suggested. With a BTKR I don't have a "good leg", but I try to swing the leg over and then I have a flat pillow I put between my legs to take some of the pressure off. I end up having to roll over and switch sides frequently, but I sleep more soundly for the times I am asleep.

 

[LHop]

I had my first full PT appointment on Friday and I really worked hard. It felt really good at the time and although I noticed I was a little stiff, I made sure to go for a short walk to keep the joints moving. Unfortunately, somewhere along the line my knees protested. They have been stiff and swollen the last two days and I have felt the need to stay off of them as much as possible. Recovery is often a three steps forward, two steps back process, but it is so frustrating when the steps back happen. I have been making such good progress and was feeling so much more "normal" and now, not so much. I was feeling so discouraged yesterday I was pretty weepy. I know I will get through this set back but

 

[Celle]

@LHop
Undoubtedly, the PT was too much for your knees, so you'll need to cut back a bit. You really don't have to work hard at Pt in order to recover. This is a situation where part of the BoneSmart recovery philosophy/mantra applies. Remember this?
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again

Don't worry - we all overdo it at times. Testing your limits is a matter of trial and error.

I had the foot of my bed elevated on bricks, so that the foot was higher than the head, but the bed itself was flat, so side sleeping was possible.

 

[kneeper]

Operated leg over the unoperated leg and on a pillow.

 

[LHop]

Still struggling. We have a loan of a stationary bike and I rode it on Sunday for a while. I am still stiff and swollen and am experiencing a lot of aches and pains I hadn't before. This is especially frustrating when I am working at cutting down my pain meds. The doctor cut me from 20 mg Oxy to 5 mg. I'm supplementing with Ibuprofin every 4 hours, but my pain is not being managed very well.

I was supposed to have an appointment with my OS for my 6 week check up on Thursday, but he had a death in his family and won't be in the office for the next two weeks. That means I'm not cleared to drive yet either.

 

[jbrooklyn]

Good day, @LHop. Sorry to hear about the pain management issue. Can you let your doc know? Going from 20 to 5 is a big reduction at once. If you think about the total dose for the day, especially. Perhaps you could be at 10 for a week or 2? Or maybe there is something better to supplement with than ibuprofen, like tramadol?

Taking it suuuuuuuper easy in PT is prob wise, even if they try to push you--they did not have BTKR, we did. You will be better able to accomplish amazing feats when you are healed further . . . being in the ODIC causes pain, swelling, stiffness--yucko. Espec when your pain meds just got cut. It will not delay your ability to do stuff if you take it easy in PT.

So stinky about having to wait 2 weeks to be cleared to drive. Grrrrr. So sorry about that! If patience is a virtue, you have a halo this week.

Do you think we have lost our buddy @iivesfam5? Boo hoo. She hasn't been here since Aug 1. (If you are listening, girl--let us know how you are.)

 

[Rob 68]

JBrook's right, @LHop; get on the phone and tell your doc the story. If the OS is out of pocket and/or uncooperative, you could try your primary physician. I didn't like taking the powerful drugs, either, but if you need them to get through some rough spots, you should be able to take them. Did you try taking 2 instead of 1? That might get you through until one of the docs comes through, and you are dealing with two knees, not one as most of us are.

 

[kneeper]

If your OS is out of town, does he have a PA who you could ask about pain control until he comes back?

 

[Celle]

The doctor cut me from 20 mg Oxy to 5 mg. I'm supplementing with Ibuprofin every 4 hours, but my pain is not being managed very well.

Some doctors will prescribe Tramadol as a step down drug from the heavy narcotics.

Or, instead of using Ibuprofen (which is primarily an anti-inflammatory and not really a good pain killer) you could try Tylenol/Acetaminophen. It's otc, so you don't need a prescription for it. The effective dose is 1,000 mg (1G) 4 times a day, to a total of 4,000 mg (4G) in 24 hours. Check to make sure that none of your other medications have Tylenol in them. If they do, you'll need to add that into your calculations of daily dosage.

 

[LHop]

@jbrooklyn Saw your last post and I'm glad you're doing so well and that the OS had such good things to say! I wish I knew what happened to our other amigo @iivesfam5

I am doing better. I had another PT appointment yesterday and although I'm sore, I think it's mostly the muscles that are protesting. They have gotten so weak over the last few years. I did tell him how much pain and swelling I had after the last session so he said he would "take it easy on me".

Regarding the pain meds @Rob 68 and @kneeper the reduction in the dosage was done by my primary. She is not a big fan of pain meds and I have had to "work" with her over the years. For instance, when I was first seeing my OS, he gave me a prescription for Tramadol 500 pills at time to take 1-2 every six hours as needed for pain. When I had to go back to my primary for a refill, she reduced to 200 pills to be taken every six hours as needed for pain, but specified that this prescription must last three months. If I took 4 pills a day, that would only last a month and a half. I'm getting by with the present prescriptions, just not pain free. @Celle I will try switching over the Tylenol to see if that makes a difference with the pain.

Thanks everyone, I don't know what I would do without this group! I tell everyone I know about this forum and how much it's helped me!

 

[Pumpkin]

You can use tramadol and tylenol together, just be sure your tramadol does not have tylenol.
You can go up to 3000 mg of tylenol a day, other sources say 4000 mg. Lower does is due to so many OTC containing hidden tylenol.

 

[kneeper]

I still say "pooh" on your PCP. This is not using narcotics for chronic pain (there I agree there can be other options) but post surgical pain (which is temporary) and you're not that far out of surgery. :( You won't be pain free, true, but it should be manageable with meds.