TKR Sleep

[Kneelady]

Hi
I’m six weeks post TKR scar healed well and PT was going well but now unable to sleep at night for more than an hour due to pain and discomfort
No position in bed comfortable
Unable to continue NSAID’s due to gastric problems

 

[FourCats]

For the first few months I had trouble sleeping so took every opportunity to nap throughout the day. If I was in my chair icing and felt drowsy, I didn’t fight it. You’re early in your recovery and rest is so important for the healing process so let yourself relax and your body will find ways to sleep. Have you tried any meditation or listening to gentle instrumental music?

 

[Pumpkin]

@Kneelady
Welcome to BoneSmart, glad you joined us!!!

Difficulty sleeping is common after joint replacement. Has anyone suggested Tylenol instead of NSAIDS's?
Be sure to read the sleep deprivation article in the guidelines below.

Please post your surgery date, a moderator will add it to your signature for you. Thanks!

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

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:

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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

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

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Activity Progression for TKR's​

6. Access these pages on the website

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Oral And Intravenous Pain Medications​

Wound Closure​

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.

OneStep information

 

[EalingGran]

Hi
I’m six weeks post TKR scar healed well and PT was going well but now unable to sleep at night for more than an hour due to pain and discomfort
No position in bed comfortable
Unable to continue NSAID’s due to gastric problems

This was/is definitely my experience too.
It is only now at 10 weeks post PKR that I am getting spells of 5-6 hours sleep at a time and even that is with some medication.
I got a month's worth of zopiclone from my GP which did help. GPs are reluctant to prescribe z drugs due to dependency risk- but they were fine about a one off prescription for post operation insomnia. I split the 7.5mg and found the half dose worked just as well for me. I also didn't take it every night. I also used valerian ( marketed as herbal nytol in the UK) and a sedative antihistamine ( Nytol in UK) some nights.
The difficulty sleeping is horrible. I also still use my cryo- cuff at night. I don't wrap it round the knee at night but fill it and rest the cool part on my knee once I am in position. I also then use a hot water bottle ( with cover) on my upper body, plus layer of night clothes to avoid feeling too cold generally. I would refill the sleeve when I woke. If the barrel is filled with ice it will last all night.
As for NSAIDs. I take naproxen. Do you take omeprazole for the gastric side effects? I now just take one naproxen in the morning with food and omeprazole an hour before. I take paracetamol ( I think it is called Tylenol in US)at night

 

[thneed]

Do you have a recliner you can sleep in? Or even just a way to prop yourself up with a bunch of pillows or something? I didn't sleep well with my first TKR because I had to sleep on my back (side-sleeping was way too painful for a long time) and I slept in my bed. But with the second one I had the brilliant idea of trying to sleep in my recliner and it made all the difference in the world, at least for me. I still was on my back so my knee felt okay, but I wasn't so flat that I snored myself awake or had back issues.

 

[sistersinhim]

I’m six weeks post TKR scar healed well and PT was going well but now unable to sleep at night for more than an hour due to pain and discomfort

Increased pain is usually a sign that you are doing too much during the day. Being only 6 weeks out, your knee is still a tiny baby and needs the TLC that a baby needs. Doing all these exercises that cause pain means that your knee isn't healed enough to do these yet. This is keeping your knee inflamed and painful. Your bend will come naturally when your healing increases and your swelling goes down. A swollen knee can't bend well because the fluid is in the way and can't be compressed.

I'm one of those who never took formal PT. Due to birth defects, I've had 12 knee surgeries, 2 of them kneecap removals, and 1 TKR. Even after those I never took formal PT. But, I didn't just sit around and do nothing, I used my knee as it was intended to be used by walking around to take care of my daily needs along with the necessary house and yard work. As I healed I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increasing pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do. Doing too much too soon causes setbacks because your knee has to heal from the inflammation caused by the too-soon exercises before it can get back to its normal, after-surgery healing.

 

[sistersinhim]

@Kneelady, please give us the exact date of your surgery and which knee it was. A moderator will add it to your signature for you.

 

[Kneelady]

Left Knee Surgery was 24/11/2022
Thanks

 

[Layla]

Happy Two Month Anniversary!
Hope your recovery is going well. Please let us know how you’re doing when you have the time.
Happy 2023! I hope it’s a great year for you.
@Kneelady

 

[Kneelady]

Thanks on holiday at the moment knee still a little stiff but walking 3-4 miles a day!! Hydro therapy helping with range of movement and weekly physio as well. Sleep still eludes me

 

[Candyapple]

I had the same issue, tho I wasn't in pain. I just couldn't sleep over 3 hours. I was so sleep deprived I was barely coherent. I tried pain meds, gabapentin, xanax, muscle relaxers, cbd gummies, medical marijuana gummies, and ambien. Nothing helped. Every doctor said give it time, but thats hard to do when youre barely functional. In time, i was able to sleep 4-5 hours, then about a month later, around the 16 week point, I miraculously started sleeping normally. Hopefully you will too, in time. As for stomach issues from nsaids, I was there too. The surgeon prescribed prilosec from the day of surgery, but it didnt help. I went to my gastro doc. He prescribed 1-2 mo of prilosec, followed by a month of zantac 360, both of which had worked for me in the past. It took time, but it did work. I know saying to give it time probably isnt what you wanted to hear, but it does help.

 

[Layla]

I hope you're enjoying your holiday! Glad to read you're doing well.

Consider Magnesium for sleep, if you haven't already. I'll leave a little info below. Hopefully your sleep regulates soon, Kneelady.

Magnesium supports the following:
Bone health
Healthy blood sugar
Cardiovascular health
Muscle relaxation and nerves
Promotes healthy sleep (falling asleep and staying asleep)

An article on Magnesium -
https://bonesmart.org/forum/threads/magnesium-is-a-star.20301/
@Kneelady

 

[LD of Michigan]

@Kneelady
So glad to hear about your TKR recovery progress I look forward to more walking as time goes by.
Sleep is inconsistent for me too ...... Getting up to early after what sleep I get overnight.

I need to remember I am on a 'medical' from work. Yet 'work' wake-up habits persist.