TKR Right TKR June 2, 2025

[DiannesNewKnee]

Last night was absolutely brutal. I have no idea why. I tried to sleep at 10 and my knee was in so much pain I couldn’t get comfortable. I tried changing positions, icing and elevating and nothing seemed to help. I’m not taking the max dose of the narcotic but if I do I’ll run out when I still need it, so I’m rationing. I did a lot of walking at 3 am and that did seem to calm things down. I’ll keep that in mind if this happens again.

Has this happened to anyone else? Any advice? Thank you!

I feel much better today so phew.

 

[Flashcat]

I’m so sorry about last night! Glad you’re feeling better today though!

 

[Jamie]

Nighttime is always the worst time for your knee. It’s the end of the day and your body is tired from the day. Then add on the periods of virtually no activity while lying in bed and you can frequently get pain.

What are you taking for pain and on what schedule? Unless your surgeon has told you there will be no more prescription pain medication, you should be able to get a refill if you still need it. You want to call to check several days before you are due to run out. Doctors typically prescribe a week or 10 days worth of pills and then make you come back to tell them you still need pain control at that level, so don’t be afraid to tell him that you’re needing to take more than just the minimum at some times. If you can work it out to get a bedtime full dose of your prescription pain med, this should help you get through this period.

You are very, very early in this healing process, so what you’re experiencing is very normal.

I can offer more guidance when I know exactly what you’re taking for pain and when.

 

[eaglemom]

I'm sorry you've hit a rough patch. Night time is the worst for reasons listed above. Since you indicated walking around helped, I'm wondering if you have a muscle relaxant to take. Knee pain is one thing and muscle pain is another. When it hurt, it hurts, I realize. But the more information you can give us on the type of pain the better we can help you. Also the better you can inform your surgeon.

 

[benne68]

I did a lot of walking at 3 am and that did seem to calm things down

That also worked for me. When my knee just would keep me awake -- or wake me up in the middle of the night -- I'd get up and walk back and forth in the hallway a few times. I don't know why, but the walking does seem to help.

It will get better; it just takes time.

Sending hugs

 

[Jamie]

I used to ride my stationary bike at 3am most mornings with both my knees. This can really help.

 

[Layla]

Good Morning Dianne,
I am really sorry you were dealing with such pain the other night. I understand your fear of running out of meds with no replacement, but that's no reason to suffer now. The goal is to regain function not suffer through this. You should not be in unmanaged pain just to stretch a prescription. Let them know ahead of time that you're following dosing instructions, but you're afraid you'll run out and still be in pain, then ask - what are your options for adjusting or refilling the prescription.

Remember that as pain increases, movement usually decreases, slowing your recovery. You need to remain comfortably mobile, so it's best to know your options, so you can go to Pain B if need be.
I hope today is a good day and you have a peaceful week of healing.
@DiannesNewKnee

 

[benne68]

How are you feeling, @DiannesNewKnee, now that a few more days have passed? Give us an update when you have a chance.

 

[DiannesNewKnee]

Nighttime is always the worst time for your knee. It’s the end of the day and your body is tired from the day. Then add on the periods of virtually no activity while lying in bed and you can frequently get pain.

What are you taking for pain and on what schedule? Unless your surgeon has told you there will be no more prescription pain medication, you should be able to get a refill if you still need it. You want to call to check several days before you are due to run out. Doctors typically prescribe a week or 10 days worth of pills and then make you come back to tell them you still need pain control at that level, so don’t be afraid to tell him that you’re needing to take more than just the minimum at some times. If you can work it out to get a bedtime full dose of your prescription pain med, this should help you get through this period.

You are very, very early in this healing process, so what you’re experiencing is very normal.

I can offer more guidance when I know exactly what you’re taking for pain and when.

Hi. That night, I don’t think it was an issue with the pain medication because I’ve been really careful to take it on schedule. The first week the pain was pretty intense even when I took the max. They did call in more, but I don’t need the max dose anymore. I think it was an off night.

I’m glad to hear it’s normal to have a bad night. Not fun. Since that night I’ve gradually been feeling better. Thank you for your response!

 

[DiannesNewKnee]

I'm sorry you've hit a rough patch. Night time is the worst for reasons listed above. Since you indicated walking around helped, I'm wondering if you have a muscle relaxant to take. Knee pain is one thing and muscle pain is another. When it hurt, it hurts, I realize. But the more information you can give us on the type of pain the better we can help you. Also the better you can inform your surgeon.

It’s been better since that night. One night I slept eight hours. It wasn’t consecutive hours because I would wake up, move around a bit, take my pain medication, and then eventually go back to sleep. The total was eight hours though. I felt really good in the morning.

 

[DiannesNewKnee]

I did a lot of walking at 3 am and that did seem to calm things down

That also worked for me. When my knee just would keep me awake -- or wake me up in the middle of the night -- I'd get up and walk back and forth in the hallway a few times. I don't know why, but the walking does seem to help.

It will get better; it just takes time.

Sending hugs

Sending hugs back!

 

[DiannesNewKnee]

Good Morning Dianne,
I am really sorry you were dealing with such pain the other night. I understand your fear of running out of meds with no replacement, but that's no reason to suffer now. The goal is to regain function not suffer through this. You should not be in unmanaged pain just to stretch a prescription. Let them know ahead of time that you're following dosing instructions, but you're afraid you'll run out and still be in pain, then ask - what are your options for adjusting or refilling the prescription.

Remember that as pain increases, movement usually decreases, slowing your recovery. You need to remain comfortably mobile, so it's best to know your options, so you can go to Pain B if need be.
I hope today is a good day and you have a peaceful week of healing.
@DiannesNewKnee

You’re completely right. I couple of days ago I was feeling nauseous because of the narcotics, so I tried to cut back a lot. I didn’t feel horrible, but when the physical therapist came, he said that I wasn’t moving like I was 2 days ago, and that cutting back that much would slow down my recovery. So I called the surgeon and got nausea medication to go with the narcotic so I can take it regularly. Now I’m taking one of the narcotic every 6 hours, which is way less than I could be taking it, but it does the trick with the pain. I’m also taking other non narcotic pain medications twice a day that seem to help also. Thank you Layla

 

[DiannesNewKnee]

How are you feeling, @DiannesNewKnee, now that a few more days have passed? Give us an update when you have a chance.

It’s more manageable now, thank you for asking. This feels like a big balancing act. I have PT exercises to do, but if I do them 3 times a day like they say I should, it spikes the pain and swelling to the point where I can’t do much the next day. So I have been doing the exercises , but I’m gentle with myself and not pushing too hard. Then I have a RomTech bike that I love, and it helps the pain, but if it ride it too often it does the opposite. Then there is the pain medication and trying to manage that. This is definitely a complicated balancing act! Oh, and the icing and elevating

 

[Jamie]

Doing the exercises three times a day is usually too much for most people. I’ve had therapists confess that they tell patients to do that much because they believe people don’t do them at all or very little and if they say three times, maybe they will do them once or twice.

It’s actually better to have a little rest between the exercises routines. If you attend therapy three times a week, for example, on the days in between only do gentle bends and stretches and maybe 5-10 minutes on a bike or peddler that day. Let your activities of daily living be your exercise on those “rest” days. Then you could do the exercises once over the weekend. Most people tend to underestimate how much activity they do with just moving about the house, going on an errand, or doing some minor household chores. If you have a pet, there is activity associated with that. ANY movement is therapy when you are recovering from joint replacement surgery.

Listen to your body’s signals and it will tell you when you’re doing too much. If you feel tired or have pain, that’s the signal to take a day or two of rest. On those days the gentle bends and stretches will be adequate to keep things loose.

It is a balancing act in the early weeks, but you’ll get through this. You’re doing fine!

 

[sistersinhim]

when the physical therapist came, he said that I wasn’t moving like I was 2 days ago, and that cutting back that much would slow down my recovery.

That's just not true. Recovery is based on time, not exercises. Everyone heals at a different speed, and your recovery is unique to you. You can not speed it up by doing many exercises and activities, but you can sure slow it down by doing too much too soon. Doing too much for your knee's healing stage will actually cause more inflammation, which causes more pain and swelling. Like Jamie said, listen to your knee!

 

[Layla]

Good Morning Dianne,
I just want to say that you're doing well, even if it doesn't always feel that way. Recovery can be confusing, especially when you're getting different messages from those you want to trust. There is your surgeon, your PT, well meaning loved ones and us (people who've been through it before). Each has value to offer, but you are the one living in your body and your body has it's own pace and own way of healing. Each recovery is unique. It's easy to feel uncertain, but what matters most is to tune into what your body is telling you. You're not doing anything wrong by slowing down, or adjusting your healing protocol. Be gentle with yourself. While the BoneSmart philosophy successfully works for many, there will be exceptions, the key is to find what works best for you.

Have a lovely Sunday and know that we're here for you always!
@DiannesNewKnee

 

[DiannesNewKnee]

Guessing you have a memory of the lack of energy from your PKR five years ago.

I remember my first post op shower and felt like I could take a nap afterward from sheer exhaustion.
Think of what a massive, although controlled, assault the TKR was on your body. Blood loss, anesthesia, tissue damage and inflammation. Then there's the pain, possibly lack of sleep and mental stress that goes along with it all. Our body's energy supply isn't limitless. So when we're in healing mode after major surgery
our energy will be used for healing first, not leaving a great reserve for all the other activity of daily life. It is completely normal to feel tired for quite some time. How long....most likely relates to your body's rate of healing. Making our best effort to get adequate rest / sleep is beneficial since our body does the best repair work while we're sleeping. Also, prioritize nutrition and protein along with remaining adequately hydrated. Protein aids in the repair of tissues, strengthens our immune system, supports bone and joint healing and gives us energy.
So protein UP A great Saturday to you, Dianne!
@DiannesNewKnee

It’s good to be reminded about how much stress this surgery is on your body. The last few times I’ve gone upstairs to take a shower haven’t been nearly as exhausting as before, but then I add something else that wears me out. All I can say is, I’m really glad I’m a teacher and have the summer off to recover. No way I could go back to work in a month.

 

[Jamie]

Now you know why we advise people not to plan to return to work for 10-12 weeks at the soonest. Some people do it and are okay, but it is really common that fatigue lasts for quite a while after surgery. I’m glad you have time this summer to recovery on your body’s schedule.

 

[DiannesNewKnee]

A little update. Yesterday I went to my 2 week post op appointment, and today was my first PT appointment outside my home. This has been a very different experience than my left knee. I’m two weeks out and with a little stretching I’m at 0 degrees so I can flatten my leg out. My bend is at 108º. Also I can lift my leg up pretty well. The PT said I’m doing great.

My left knee took a lot longer but it’s a completely functional knee. It can bend just like a natural knee and is strong. My right knee might end up being a shorter recovery time, but I’m getting to the same place regardless of how long it takes.

I’m way kinder with myself this time around, and I think that’s helping.

 

[Layla]

Being more kind / gentle with yourself means understanding that progress isn't linear. You will have good days, and not so good days. Understanding this and giving your body the space it needs to heal is the ticket!
You're doing great, Dianne!
@DiannesNewKnee