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TKR Not sleeping.

Aweescott

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Had opp 13 th April, managing walking with walker, doing exorcises but not sure how much. Knee stiff, not sleeping well. Came off day med on Tuesday want to get off night one on Friday. Pain not bad during day but aiking at night.
 

sistersinhim

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Welcome to Bonesmart, @Aweescott! Did you have a total knee replacement? Which knee was it?

It's pretty early to be coming off of your pain meds. It sounds like you need them at night still. Also, nighttime pain is an indication that you are doing too much during the day. I suggest you cut back on your activities.

Each person is different as is their recovery. Most find that the Bonesmart approach works best for them, but others find that a more aggressive therapy helps them more. It's your recovery and your choice on how you recover. As you read more on other members' recovery threads, you’ll get a better perspective of what to expect. The following are our basic guidelines and should help get you started.

Knee Recovery: The Guidelines

1. Don’t worry: Your body will heal all by itself. Relax and let it. Don't try and hurry it, don’t worry about any symptoms now; they are almost certainly only temporary.
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when the pain starts!)​
3. Do what you want to do BUT...
a. If it hurts, don't do it, and don't allow anyone to hurt you.
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again for a few weeks.
4. PT or exercise can be useful BUT take note of these
5. Here is a week-by-week guide for Activity progression for TKRs


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 a 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 history before providing advice.
 

Sara61

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Unless the pain meds are causing you a allergy, I certainly wouldn't consider coming off them until you really don't need them, I took mine for a good month or two, did me no harm and I was able to sleep better and also it took the edge of any painful movements. .at this early stage plenty of rest, your body (not only your knee) needs to heal, if you look after it well in the early stages it will look after you well after, time is the essence in my opinion at least it worked wonders for my knee in 2019 - best thing I ever did and all I can say is roll on knee number 2 xx
 

Merymete

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I agree with Sara61, it is way early to be coming off pain meds especially if you are not sleeping. Sleep is so important to recovery in my opinion. If you are not comfortable with (I presume) opioids, can you take anything else for sleep? Melatonin? Talk to your doctor maybe?
 
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Aweescott

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Hi thank you all very much for your reply, I am still taking Celebrex. I must be lucky as my pain isn't bad the only thing I have is the joint feels stiff and thick. The specialist said it will be a while before it feels better. I think some of the problem is because I used to sleep on my side and have to sleep on my back. Managing exercises as he has given me only a few. Small floor exercise bike leg slides and a stretch and some walking. Luckily didn't have a great deal of swelling. Thank you all very much xx
 

Jaycey

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my pain isn't bad the only thing I have is the joint feels stiff and thick
This is internal swelling. Ice like crazy! Reducing this swelling will help increase your ROM.
 

Jamie

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Jaycey is right. That tightness is usually a sign of swelling within the knee compartment itself. It's a very compact area and it doesn't take much fluid to cause a tight feeling and even pain. Icing and elevating your let so that your toes are above your nose is the best remedy. You'll also want to continue some gentle bends and stretches along with short (5-10 minutes) walks around the house.

You are very early in this recovery process. Some type of stiffness in the joint can continue off and on for quite a while as your body adjusts to your new joint.
 

Tykey

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I have trouble sleeping at the best of times. It was even worse when I was in recovery from both my tkrs.
In the wee small hours, I think I saw every episode of Dr Phil and Judge Judy (plus many uk programmes on Youtube). I often had to get out of bed and cook some food for me, nearly always steamed puddings and custard.

I've often tried relaxation techniques, some work, some don't, but I found this podcast which takes us to many wonderful places. Often, I've no idea how the stories end, because I've rarely stay awake long enough to find out. The ones on this link are free. The best one for me is when I walked in the forest.

 

Tykey

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You'll have to bear with me for a while on this thread!
The reason we can't sleep is that our minds keep churning away in the background and winding us up. We worry, we imagine all things which might happen, so we get all het up. Its no wonder we can't sleep.
I've spent years trying to calm my mind,, without success!!
But I have been introduced to a new way of looking at it which is proving brilliant, for me, anyway.
Daft as it might appear on the surface, it simplifies all the psychological jargon and describes our subconscious as a naughty chimp in our thoughts. Once we control this naughty chimp and make it settle down, we become far calmer, and my chimps and I all go off to a good solid sleep together.
I reckon I had a whole troop of chimps in there, chattering away and having a high old time with a tea party.
I'm not an expert or a messiah, just a plain old Yorkshireman who is now sleeping like a top.
If you want to explore this a bit more, have a look at this clip, about what is called the Chimp Paradox.

 

Sisterpat

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I’ll have a look at those podcasts as well, thanks!
 

Emelbee21

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I have struggled with insomnia since my surgery on 04.01 I didn’t sleep well at all for the first 2 weeks and then it got better and I still have some nights when I can’t sleep. I started taking my pain medicine before bed and not drinking caffeine late at night and it has gotten better. My doctor did tell me I was ok to take Melatonin but I never did. Hope you get better!!
 

LM90

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I had my surgery not long ago and still got sleep problems, I feel you... Stay strong!
 

BBCG

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I’ll have to explore the podcasts, too, Tykey; they sound interesting, and the chimp analogy is a good one!

During the recovery from knee #1 back in 2016, sleeplessness was a huge issue for me. I was also taking opioids as well, unlike this time when I refused them and have been only using Tylenol (acetaminophen) and Tramadol.
Gradually back then I learned to put those hours to some use and it’s how I first found Bonesmart! So, that was a great find, I dare say!

In the intervening years, I have fewer reasons to let sleeplessness at night annoy me, if I have something enjoyable to do whilst awake. I keep a book by my bed, I check out how everyone on Bonesmart is doing (even when I’m not in prep or recovery mode), make task lists, research information I need to present to someone, etc.

I do go to bed earlier so as to make the task easier in the long run, I do take a 5 mg Melatonin melt-under-tongue tablet, and an herb tincture that has sleep-aiding herbal plants in it.

The other thing I found to deal with the inevitable sleepiness is to assume I’ll rest sometime during the day, perhaps in my recliner, perhaps back here in my bedroom..

I just decided to take more time in the bedroom for sleep, and assume I’ll have some awake hours and spend them pleasantly...
 

Tykey

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Great comments BBCG.
One of the main reasons for not sleeping is worrying about not sleeping, then we get in a vicious circle. If we REALLY can't sleep, do something enjoyable while we are awake. We are also programmed to think that the time between (say) 11pm and 7am is for sleep, and think something is wrong if we are awake. Many animals normally sleep during the day, don't they:tada:
I totally recommend getting up and eating jam roly poly and custard - natures own melatonin.
 
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Aweescott

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Hi not having much luck, been feeling cold, have another blanket on bed and a dressing gown, is this normal? 24 days since surgery. Has anyone else had this?
 

Jaycey

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Sounds like you might be coming down with something. Low grade fevers are pretty normal just post op. But you are 24 days out. You might want to check in with your family doctor.
 

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