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[TKR] Sleep - where are you? Please come back.

Discussion in 'Knee Replacement Recovery Area' started by JDP, Aug 26, 2017.

  1. JDP

    JDP
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    Good Morning all,

    Another sleepless night for this previous champion of a sleeper, is allowing me to start my own recovery thread.
    I cannot thank you all enough for this amazing information. As with most things, you have to experience it to truly understand the TKR post-op course. You have made me realize I am not losing my mind and what I am feeling physically and emotionally is common. What a relief!
    I do have a couple of questions that I hope to post tomorrow - 9 days after my first TKR.
     
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  2. Celle

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    Welcome to recovery, Dawn!

    Here is your post-op information and reading:
    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
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork.
    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. 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.
     
  3. JDP

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    Thank you Celle.
    I appreciate reading many of the posts and hopefully chatting with others for encoragement and to be able to respond in kind.
    I am desperate from the lack of sleep, inactivity, and painkiller fog. I have a 16 year old son who is a great helper and a man in my life who has moved in temporarily and is providing amazing help. I am also blessed with friends who help and visit but I am finding it more and more difficult to socialize which I know is very important
    Any thoughts? Similar experiences?
    Thank you very much.
     
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  4. SusieShoes

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    It feels good to socialize, for sure! I took a couple weeks, three maybe, before I joined my next door neighbor for coffee and cake. I walked over with my walker. :happydance: It felt normal, except for the walker. Little victories make all the difference. Just be patient with yourself, because your energy will be low for a while, and your knee is going to need lots of rest and TLC.
     
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  5. newlybionic

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    For the first few weeks I didn't feel like socializing at all. Between lack of sleep, pain meds and just sheer exhaustion I preferred to be able to just fall asleep anytime and anywhere I could. Once past the initial phase I started to socialize more and got out of the house.
     
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  6. gertie

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    @JDP Socializing helps the spirit for sure but I find I don't have much stamina. So far (I'm in week 3.5 of a TKR), friends have come to me and I don't hesitate to kick them out when I start to fade which is often after an hour--just can't engage and make conversation any longer. This is only partly because of the pain meds, I think. I had a THR last fall and took no narcotics during recovery--remarkably little pain--but I still had the energy drain big time.
     
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  7. imjustme62

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    The pain medication held me back from being social. It messed with my moods BIG time! After 2 weeks I was off of Narco totally as I couldn’t deal with the way it was making me feel. Plus the fact the RX was wrong and I was taking too much and couldn’t refill it! :loll::loll:

    I’ll be at 7 weeks this week on Wednesday. It DOES get better I promise you! I thought I would never make progress, but it WILL happen. You have to be patient and always listen to your knee.:flwrysmile:

    Everyone here gave me such awesome information and I’m so glad I found a place to chat and express what was happening to those who know what I’m talking about and understand this whole crazy process.:loveshwr:

    Hang in there and take care of yourselves! There is hope, so don’t give up!:ok::SUNsmile::happydance:
     
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  8. kneeper

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    I started by socializing in short bursts. Sometimes a friend would drop by with lunch or dinner for me or do a quick errand like bringing me bread or something I was out of, and stop to chat for maybe 15 minutes. That was just fine for both of us.
     
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  9. KarriB

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    I did a lot of napping during that first month because I was too tired to hold a conversation. Like you, sleep was elusive so I found it important to nap often through the day, even though I have never been a napper. When friends did stop by I stayed in my elevated position, chatted a short while and usually they left after a half hour or so.
     
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  10. OJ2

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    I find everything to be exhausting. I enjoy dropping off to sleep when I need to, and hubby allows me that privilege. He is enough socializing for me right now. I even found the inhome therapist to be exhausting me with all his chatter, and he was only there for about 20 minutes each time.
     
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  11. Celle

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    I frequently often fell asleep while people were visiting me. Your body takes the rest that it needs to.
     
  12. sistersinhim

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    I didn't want to socialize either for the first month. I slept fitfully at night, so napped mornings, afternoons and after dinners. This left very little time to be a host. Everyone understood and let me get the rest I needed.
     
  13. JDP

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    Thank you everyone.
    Your comments and advice have really helped.
    Because I am single, have no family nearby, and my son is too young to drive independently, I can't function without my friends' support, so that means more socializing than I feel up to some days, but it is worth the effort because of the wonderful friends I have.
    This has been much more of an adjustment than I ever imagined and I am so scared.
    I've gone from being a teenager's taxi, fridge filling Mom working in a high demanding professional career with travel; teaching fitness; sports; working out; being very social, etc .......... to this.
    With the insomnia, blues, painkiller fog, and being housebound (physio starts tomorrow so at least I get out) I feel like I am a different person. Although this is only Day 10, it feels like 100.
    Any words of wisdom, advice, and encouragement are welcome. I know many of you have been through these feelings and adjustments.
    PS I have 8 weeks off and now I am questioning if that is enough.
     
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  14. gertie

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    @JDP It is the loss of independence that has been hardest for me I think. Plus the self image that comes with creeping around on a walker, which I did for the first 10 days--ugh, instant old lady (which I of course am but don't usually feel like). And since I'm single I signed on for Meals on Wheels delivery for the first few weeks and nice as it is not to have to worry about grocery shopping and cooking, I struggle with receiving "elder services."

    I'm now on replacement #3 (1 hip and 2 knees) so I've gained a small bit of perspective. I think the thing that helps the most is reminding myself that this is temporary and making note of the small improvements as they happen (using the cane instead of a walker, using no mobility aids, cooking a meal for myself, etc.). And although socializing can be tiring, chatting with friends does remind me that there's more to my life than bad joints and helps me feel a bit more like "me."
     
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  15. gertie

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    @JDP Re: your question about time off work. The usual recommendation on here is 12 weeks off. I work in a high responsibility job that requires a lot of multi-tasking, decision making, quality control, etc. Since I've done the TKRs as a staged replacement, I've had a long time off work and am not sure when I'll have the focus and energy to go back--I need to get completely off the narcotic pain meds before I can assess that.

    With the THR last year I stayed out for about 8 weeks and then did a phased return--half time for a week or two, then three-quarters time for a week, etc.--and that worked well. However, with the THR I had minimal pain, took no narcotics, and pretty quickly got back to easy mobility--overall an easier recovery.
     
  16. JDP

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    Thank you so much Lynn. I will keep saying to myself it's temporary and count my blessings.
    Being off longer than 8 weeks has sone significant negative financial implications for me so I hope I can go back as planned. Time will tell!
     
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  17. Pheebs52

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    Hi Dawn, nice to meet you! Right now, you are still in the dreadful, first 2 weeks phase and that is the most exhausting and painful part of recovery. It doesn't get worse than this, only better! Way better! :SUNsmile: Soon, somewhere between Weeks 3 and 4, I think you'll find some improvement in pain levels and mobility. At 4 weeks post-op, I began to wean off the Rx meds because I wanted to be able to drive again. By 5 weeks, I began to drive short trips of about roughly a mile or two. Getting back behind the wheel is thrilling! It's exactly the mood booster we need after being cooped-up! Trust me, you'll feel like a teen again, lol.

    Frankly, I wasn't much of a social butterfly at all during my first month. I even told my own brother not to bother to visit, lol. He understood, as did most of my friends. Two of my friends, nurses, really understood, so they'd drop by for a quick cup of tea and some fast chat, but....that was it for me until about Week 6. We're all different and heal differently at a different pace, but there are many common threads to our recoveries as can be seen here.

    In summary, for now, just rest, ice and elevate and think of this time as nurturing yourself and your new knee. You're not being lazy, you're recovering from a very major surgery that knocks the stuffing out of all of us. It's like a very strange sabbatical where all you need to do is heal. It's a unique moment in time that will not last; promise! Soon you'll be noting some fun little victories, perhaps ditching the walker for a cane or crutches, maybe tying your own shoes, or something super exciting like emptying the dishwasher; hah! Inch by inch, the progress comes along! Hang in there!:SUNsmile:
     
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  18. kmak81230

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    :flwrysmile:Hi Dawn: I would not worry too much about 8 weeks down the road - just concentrate on resting, icing and elevating now. One week, or one day, or even one hour at a time! You are in the toughest phase of recovery - still on pain meds with all the brain fog and exhaustion that comes with that. Each week you will notice small improvements that will begin to add up. I started back to work half days in week 4, which was too soon - I had major discomfort and was unable to focus - spent all evening on the couch trying to recover. I continued half to 3/4 time through week six. But by week 8 I was back full time. I have a desk job so I think it was an easier transition back to work as standing for long periods of time would be tough I think. As Gertie said, the usual recommendation is 12 weeks but some of us don't have that luxury for lots of reasons. This recovery is a butt-kicker. For those of us who were very active prior to surgery, it is humbling indeed. Take advantage of the offers of help from friends. True friends will not care if you are not very social or need to nap in the middle of a visit or need to decline a visit. But they can be helpful for doing little chores that are too much for you at this point. You might need one of our t-shirts that says "this recovery takes a year." PS: love your avatar photo.:SUNsmile:
     
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  19. KarriB

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    I did talk to friends during the first month, but many later told me I wasn't making much sense. I stayed on pain meds for the first month.

    In most cases 12 weeks is recommended before returning to work. It was also my OS's recommendation. When I went back to teaching I went back to a phased return with 6 weeks of mornings only. I was still tired and my knee would swell while I was on it, so I spent many afternoons icing and elevating.

    Just remember that there's nothing you can do to hurry along the healing process. It takes time, patience, ice, and elevation, along with rest. Your body is working hard to heal so sleep/rest as much as possible.
     
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    Last edited: Aug 28, 2017
  20. PoetryChef

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    Hi Dawn,
    While I can offer little to you in the experience of TKR (I am scheduled for bilateral in November), I would like you to know that I wish you rest and healing. I trust what the others offer will help you through this.

    my best to you,
    Sherry
     
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