TKR Left TKR on 6/21/2022

CarolineNC

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Hello!
Left TKR - outpatient surgery, home same day. Looking forward to hearing how others are doing. I find it hard to sleep at night- it is hard to find a comfortable position. That and I’m confused as to how to work our pain meds. I’m currently off all but Tylenol- but off the meds my range of motion is cut in half it feels like. i’m dreading PT tomorrow!! other than that I’m amazed at where i am. I can walk without a cane but carry it most times. How is everyone else doing ?? Wishing everyone well.

PS: Not sure how to get this to post within the June 2022 Group
 

Jockette

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Hi and Welcome!

Not sure how to get this to post within the June 2022 Group
The Monthly team thread is reserved for surgery date information, and so members can see who else has surgery the same month. We prefer all other comments and discussion to take place in a pre op or recovery thread, such as this one. Enjoy interacting with others who are on the same journey, here in this thread. :flwrysmile:

Sleep is difficult for all of us in the early days. We have an article about it in our recovery guidelines.

Don’t do anything in PT tomorrow that causes pain. You have the right to control the session. Painful PT is not necessary in order to have a good outcome.

The most effective way to take Tylenol is 2 x 500 mg tablets every 6 hours, to a total of 4,000 mg (4 doses) in 24 hours. You need to take it regularly, to keep up the levels in your bloodstream. If you just take the odd dose now and then, it's far less effective.

Check all other medications you're taking, to make sure there is no Tylenol/Acetaminophen/Paracetamol in them. If there is, scale back one or two of your regular Tylenol doses, so you stay within that safe 24 hour limit of 4,000 mg.
 

Jockette

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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.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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. At week 4 and after you should 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.
 
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CarolineNC

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Thank you! i have stayed consistent with the Tyelenol jyst as you described. was thinking if adding ibuprofen. Will try to reach my doctors office also. Seems strange they leave it to us to figure out. Maybe we can take some prior to PT

Thanks also for all of the info - will read.
 

sistersinhim

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It's best if you don't take pain meds before PT. You want to be able to feel the pain. When it hurts, your knee is telling you it's not ready for that movement. To keep on doing it will just cause more pain and swelling, which is a setback in your recovery. Gentle stretches and bends without pain is all your knee needs to recover.

By the way, which knee did you have replaced?
 

InkedMarie

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Sleep can be so hard. I take 400mg of Magnesium at bedtime and it has really helped. I have trouble falling asleep but once I do, I’m out for 5-7 hours without waking.

Sleep however and whenever you can. If you’re tired, take a nap. I’m almost eleven weeks and my last nap was a couple weeks ago but I’m sure I’m not done with them!

Marie
 
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CarolineNC

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Thanks for your reply. Another sleepless night last night. i was in tears this morning which is very unlike me. I did soldier through PT this morning. Reminding myself i’m only two weeks post op. i also have reached out to my Ortho to see if i could use some pain meds sometimes or what they suggest. Thanks for sharing your tip for Magnesium - which kind of Mag do you take - i gather there are three main kinds- thanks again!!!
 

InkedMarie

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@CarolineNC this is the magnesium I use.
Marie
A74DAD6A-3A94-4C2E-A968-E9FFF87915DB.jpeg
 

ChrisF

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Hello!
Left TKR - outpatient surgery, home same day. Looking forward to hearing how others are doing. I find it hard to sleep at night- it is hard to find a comfortable position. That and I’m confused as to how to work our pain meds. I’m currently off all but Tylenol- but off the meds my range of motion is cut in half it feels like. i’m dreading PT tomorrow!! other than that I’m amazed at where i am. I can walk without a cane but carry it most times. How is everyone else doing ?? Wishing everyone well.

PS: Not sure how to get this to post within the June 2022 Group
Hello,
I had my LTKR the same day as you although I had two nights in hospital because I just couldn’t manage the stairs well enough until the second day also I simply wasn’t ready.
My main problem, like you, is not being able to sleep it’s awful. I fall asleep no problem but wake constantly due to the cramping feeling which runs from my buttock to ankle, and have to move position, stretch, walk, massage anything to alleviate the discomfort. I find a magnesium spray helps (I already had this in as It helps with Restless Leg Syndrome which I sometimes suffer from) as well as taking a Neuro Night Complex containing Magnesium Vit B12 & Botanicals - to be honest I’ll throw anything at it to see if it helps. My hospital helpline suggested I take morphine solution which I did for 2 nights and which helped me to have 2 hours solid sleep but I dont want to continue with that.
Anyway I just wanted to check in with you to see how you are doing now as we are both 3 week yesterday. I have my first PT appointment today but I’m not going to be pushed into doing more than I’m ready to do, I’m following the BoneSmart philosophy.
I still use my crutches to walk, my leg feels far too weak to trust without their support.
It sounds as though you’re doing really well, I hope it continues.
 
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CarolineNC

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Hello! sorry I am so late responding but I didn’t get a notification that anybody had replied like I was in the beginning. In the end I went back on tramadolvIn the end I went back on tramadol and that was enough to allow me to sleep and to resume exercises I had tried to come off all the opioids too soon. today three weeks out 3 1/2 weeks out I’m trying to be off the tramadol and I don’t think I’m going to be successful I’m in the same situation my leg aches I can’t find a comfortable position so I may go back on it for a little while longer I’m doing pretty well overall I carry a cane but I don’t use it often I’m going to physical therapy twice a week my bending is going pretty good I’m at 110° but I need to work more on my knee straightening/flattening I hope you’re doing well I’m jealous that you got to spend a night or two in a hospital I can’t believe I had to come home the same day but all at all it has gone pretty well. Good luck with your recovery!!
 

ChrisF

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Another sleepless night for me . It’s just gone 4am and I’ve been trying to get some sleep since 10. I’ve had 10 -15mins of dozing then looking at the clock/ getting up/stretching, another few minutes dozing/changing the pillows etc. I’d even taken Morphine as my GP said to give it another go - I’ve got an appointment to have bloods done next week before seeing him, he’s suggesting Amytriptaline to calm the nerves in my leg, I’ll have to wait for another week for that though. sleeplessness is beginning to feel almost normal
I’m managing to be on my feet a lot more now and went on a short (1/2 hour) food shopping trip with my husband today but paid for it as my knee swelled up pretty badly on the way home in the car.
Ah well, keep up the good work! I’ve no idea how I’m doing with the bending to be honest as I’ve not even seen the physiotherapist yet as my appointment was cancelled. It’s rescheduled for next Tuesday. I’ll let you know then.
 
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CarolineNC

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Hi Chris F - checking in from yet another sleepless restless achy night! Any luck for you yet?

I’m off all meds now (only ibuprofen or tylenol) for about a week - but i swear i am truly suffering after my PT sessions for a day or two. I understand their reluctance to prescribe opioids but what is the right balance for being able to sleep and to keep on with exercises. ugh!! i think my next approach will be to stop trying to overachieve in my PT sessions :)

Would love suggestions for anything that could help with the constant dull ache and sleepless nights!!

I did go to a postop appt with my doctors office this past week that was enlightening. because I was knock-kneed, the hardest thing for me is straightening my leg. my bend is at 113 which I think is good and ahead of schedule maybe but flattening my knee is my hardest thing now.

The doctor’s PA shared with me (and it did ring true for me) that our body has a primal response to the surgery we had. he described it as being similar to being attacked by a bear and that our bodies are now in fight or flight mode which is why we’re not sleeping, why we’ve lost our appetite etc because we’re on high alert for what could be around the bend and that recovering from this trauma response takes time. I don’t know about you but I do have these flashes of I call it a white hot flash of fear that only lasts for a millisecond - but you feel it all the way to your toes - when you take an odd step where you think you could’ve fallen or if one of your dogs gets too close to your knee (does anyone else experience this?). this happens to me throughout the day and has for weeks. Nice to know it’s normal.

2:35 am EST….. sigh…,

Take care and good healing to all!
 

Jockette

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The doctor’s PA shared with me (and it did ring true for me) that our body has a primal response to the surgery we had. he described it as being similar to being attacked by a bear and that our bodies are now in fight or flight mode which is why we’re not sleeping, why we’ve lost our appetite etc because we’re on high alert for what could be around the bend and that recovering from this trauma response takes time.
I agree with this.

For months after my surgery I was afraid of someone bumping into me, especially in a grocery store, and a similar feeling even when I was driving. I had young grandchildren at the time and I was always very protective of my knee.
 

sistersinhim

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I don’t know about you but I do have these flashes of I call it a white hot flash of fear that only lasts for a millisecond - but you feel it all the way to your toes - when you take an odd step where you think you could’ve fallen or if one of your dogs gets too close to your knee (does anyone else experience this?).
Oh yes, the fear of someone or something bumping into my knee was always there for the first 6 months or so. That's where using a cane really helped others to notice me better and stay farther away.
 

agsmom

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Hi, I’m about a week behind you in recovery; my surgery was on 6/27. I found it very helpful to read the articles regarding pain meds and addiction. This surgery was a revision with the original surgery being 12/21. I took opiods for a full six weeks after that surgery and had no problem stopping them when the time came. I just slowly cut back until I didn’t need them anymore. This time around, I’ve cut back but I’m definitely still taking opioid pain meds. My knee and leg hurt too much without them. I feel that pain is counterproductive to recuperating so I do what I can to alleviate the pain. I’m not suggesting that you take opioids, just giving you my perspective.

I went through a two week period recently when sleep was very elusive. The last few nights I’ve been able to sleep a little better and it feels so nice! I hope your sleep gets better soon. I bought the Lounge Doctor wedge and sleep with my legs elevated on that. It is a much more comfortable position than I was able to find before I got it.
 
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CarolineNC

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Good Evening,

Thanks for your reply. i’m finally better today. have taken several naps (hallelujah). i will be asking for a refill tomorrow. in hindsight i was truly suffering post my last PT appointment for 2.5 days. i need to be able to take something for pain still when i need it.

Thanks for you insight based on experience. in hindsight i would do as you suggest - stay on opioids as prescribed for the first six weeks. my doctors office has been very hands off driving all questions and refills through a portal - plus they refill for 5 to 7 days at a time. That and you read about others who come off the pain meds after 1or 2 weeks and feel pressure.

Good luck with your revision. if you had TKR in December do you mind my asking what caused the need for a revision?

Thanks again!
 

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