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TKR Sleepless and exhausted

Knitting Queen

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Hello everyone,
I had TKR on 22nd November 2019., so just over nine weeks now after surgery.
I am so happy to have found this forum and hear the experience of others., and maybe realise that I am not alone in my daily and nightly struggle with sleep..
I sleep for maybe one hour then awake for another, this goes on all night. I can't get into a comfortable position and I start every day completely exhausted. I find the daily exercise routine a huge challenge but try my best. .
I was advised to stop HRT prior to surgery so I'm wondering if this is adding to my problem as I was taking it for a few years, I haven't taken it since.
I'm just wondering if anybody else had sleep problems like me and how did they cope and can I hope for a return to normal sleep ever again.
Thank you.
 

Celle

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Hello @Knitting Queen - and :welome:

Which knee did you have replaced? If you tell us that, I'll add it to your signature.

I'm afraid that sleep disturbance seems to bean inevitable part of this recovery. Try to make up for loss of sleep at night by taking daytime naps. Sleep where you can, when you can, and how you can.

The exhaustion is also part of recovery. Most of your body's energy is being directed towards healing your knee and there isn't much left for anything else.

Don't wear yourself out doing exercises. All the exercise your nee needs during early recovery is the use it gets during your activities of daily living. Time, healing, and a decrease in swelling will all help your knee to regain its Range of Motion (ROM).

Here's the post-op advice we give to everyone, together with some informative articles that explain about sleeplessness, energy drain, and exercise advice;

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. 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.
 

kneeper

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I'm sorry your "sleep installments" are so short. I started with about 2 hours at a time. I'd say by 8 weeks I was getting 4 hour installments. It really varies by person. It's very frustrating, I know. Are you able to nap at all?
Wishing you some more :sleeep:
 

Sara61

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I totally empathize with you, there is nothing more exhausting as not getting enough sleep, :mcoffee:I'm like you, I struggled most nights - thankfully DH moved into the spare bedroom and I was able to read bonesmart/read a book, play games etc without disturbing anyone. I think you will find once your days get more active (the odd walks, a few light exercises etc) eventually you will sleep better. I'm now nearly at 4 months, I sleep most of the night but still use a pillow in between my knees and spend the night intermittently moving it from side to side much to DH annoyance as he decided to resume his place in the bedroom :yikes:.. I would give my right arm for a full night undisturbed sleep and to be able to wake up in the morning without the feeling that either the bend or stretch isn't an issue - but I'm following several posts and know that eventually this will be a reality x
So don't give up hope, you will get there soon. Sending sleepy vibes your way :sleep:
 
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Knitting Queen

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So lovely to hear from you and thank you for your kind words and support..
Didn't realise how difficult it would be to try and put myself back together after the surgery..
So good to know I'm not the only one. I wil try to stop obsessing about it , and like you I'm lucky enough to have a spare room and it's great to have found Bonesmart...
I will let you know if there is any improvement.
Thank you...
 

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I’m a few days behind you in recovery. I’m doing okay with sleep, and I am counting my blessings about that.

What has helped me a bunch is listening to audiobooks and lectures from The Great Courses series. I just put in my headphones, lie back, and learn about physics or the about presidencies of Roosevelt and Taft, or listen to a cozy mystery or some old classic I could never take time to focus on before or whatever.

I always have to listen to a chapter or section several time to actually grasp it all because I often fall asleep while it’s playing. But, when I’m not sleeping, who cares how long it takes to get through a chapter or a section? Even if I don’t fall asleep, I feel like it’s time well spent.
 

Tykey

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You are quite normal, welcome to the club!

The more we worry about not sleeping, the more trouble we have sleeping!
It was earphones and YouTube for me. Old BBC radio programs did it for me, especially the dramas.
I also found myself feeling hungry, so I didn't fight it, I just got up and ate even more jam Roly poly and custard!

You could always pick up your knitting
 

sondrals

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I think I finally got back to “normal” sleeping at about three months, then I ran out and had my other knee done! Lol so I’m back to not sleeping well, so i take sleep when I can get it. I’m back to work but for some reason I sleep best when I go back to bed in the mornings. Even yesterday, because it’s the weekend, I went back to bed and slept almost 4 hours. Even with that I was so ready for bed by 8-9pm last night.
 

loneshark64

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I am there too. It’s been a week and a half and sounds like it will be a while. Dull ache and having to sleep on my back. Last night I did a little better as I was able to lay on my side for a while with the surgery leg on top more or less straight on a piloow over the other leg. I couldn’t really sleep this way but I did it for a few minutes a couple times when I woke up and it eased up my back and leg and then I went on my back and slept again for a while. Fits and starts.
 

Lindylee

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Sleeplessness does seem to affect the majority. As others have said, try not to stress over it, just accept it and find something to do. Last time I did a couple of online courses and a silly game on the iPad in between reading. This year it's online jigsaw puzzles, family history and reading.

Yesterday afternoon I fell asleep on the sofa for 2 hours, but then I didn't get to sleep until after 3.30 this morning and was awake by 5.30. I'm trying to keep awake today hoping I have a better night :fingersx:
 
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I am wishing you improved sleep asap. Hearing others stories lets you know you're not alone.

For sure many of us have noted changes in our sleep pattern to say the least. I sleep all of the day and place (the first 25 days or so) but it's getting more concentrated at night as it must for what I need to resume doing during the days!
 

Equinista

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My LTKR was 27th November so around the same time. I had a blissful few days during the last few weeks where I seemed to sleep 12 hours straight. The last 4 or 5 weeks have seen me a zombie unable to nap during the day or sleep at night. My whole body clock is out of whack and I am beginning to become quite upset about it. I agree that lack of activity does not help; normally I would be doing a lot of work with my horses and going for walks and the physio does not seem to cut it! Consequently once I am in bed which is so comfortable and I set the room up to be a haven I am cosy but sleep never comes. Something in my brain is just going tick tick tick and won't stop. I listen to podcasts, books and try not to get stressed but do get very frustrated. I do drop off about 4 or 5am for snatches of an hour or two hours then wake to get up around lunch time. I hate it!!!

However, it is comforting to know this is quite normal with many post op people but its a little ironic when we need sleep the most we cannot achieve it. I am hoping that when a more normal pattern of days emerges things will improve. One part of me wants to bring the horses home but I do not know how I would stand up to the work involved and another part of me says its too soon.

Rest assured you are most definitely not alone.
 

sistersinhim

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I'd say it's probably pretty early to be adding on to your workload taking care of your horses, too. Why not try increasing activities a little bit then see how you do the next day. That worked for me.
 
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Knitting Queen

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Hi everyone,
I had Right TKR on 22nd November 2019, apart from the problem I have been having with my sleep pattern ( still ongoing but getting a little better) , I'm just wondering if anybody has experienced issues with leg muscles.
I have been progressing well, so far,, my physio is very pleased with extension and flexion ect and has advised some very sensible and ' doable ' leg strengthening excersises, (quads are still a bit weak) but physio happy to discharge me at this point.
Two weeks ago, getting ready to go away for short stay in our favorite hotel, first exciting thing since the surgery! I bent my operated knee and felt a sudden ripping type sensation in my calf muscle.
The pain was awful, could not walk, was going to cancel our trip but we went anyway, luckily still had my crutches, hobbled around for 3 days until felt I could weight bear.. Even now it's sore and stiff and I'm so worried it will set me back in my knee recovery.
Going to see physio next week for review.
Has anybody else heard of anything like this. I'm thinking it's a torn /strained calf muscle and I'm wondering how long it might take to heal.
It's two weeks ago now...
Thanks.. Sorry for the short novel...!!
 

sistersinhim

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Physio is probably the last thing you need if your have a torn or strained calf muscle. I suggest you rest it as much as you can. Is icing helping?
 
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Knitting Queen

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Hi..
Thank you for replying.
Yes I have iced and I am trying to rest as much as possible.
The physio is very good and not at all pushy, always let's me set the pace .
I think I really need reassurance more than anything, particularly with my knee recovery.
Just have felt so set back in my progress ,the last 2 weeks really frightened me , as I couldn't continue my walking ect .
I think I am probably too impatient.
Thank you again for your prompt reply .
 

eliza61nyc

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Hi..
Thank you for replying.
Yes I have iced and I am trying to rest as much as possible.
The physio is very good and not at all pushy, always let's me set the pace .
I think I really need reassurance more than anything, particularly with my knee recovery.
Just have felt so set back in my progress ,the last 2 weeks really frightened me , as I couldn't continue my walking ect .
I think I am probably too impatient.
Thank you again for your prompt reply .
Hi Knitting queen,

Yep we all have had the problem with wanting to do more than we really are able to. I wouldn't worry about set backs, I think everyone has one. when I had my left tkr after about 12 weeks I somehow twisted my leg on a crack in the side walk. darn thing immediately swelled up to the point where I couldn't walk. took me almost 2 weeks to get the swelling back down. It is so frustrating.
 

Jockette

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I think I really need reassurance more than anything, particularly with my knee recovery.
These accidents happen but they do heal, but some issues take longer than others.

I had 2 major setbacks in my recovery, one at 4 months, when I would have thought I “should” be far enough along not to have a set back, and it took me a month to improve again, only to have another setback at 5 months, and it took another month. But it all did settle down eventually.
 
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Knitting Queen

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Thank you so much for your kind and reassuring comments , it means so much to know that other people have had similar experiences and have resumed the 'journey '....
I must say having this forum to turn to is certainly helping me on mine .
I hardly know anyone who has had TKR, not recently anyway , and anyone I have spoken to who has , doesn't really remember, so , I'm thinking that's reassurance in itself .
 

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