TKR Struggling through recovery<

[kneeper]

At first I only slept about 3-4 hours when I went to bed. I'd get up for a while--maybe an hour or two but then was able to get back to sleep a a couple of hours more. And/or I'd take a morning nap. And an afternoon nap...

 

[Beckadeez]

Naps are essential, I fully believe.

 

[pamwmsn]

@Beckadeez I have tried melatonin but it doesnt work for me

 

[Josephine]

restless legs severely affecting sleep?

Restless legs following knee replacement surgery

Would it hurt to start iron tablets to see if it helps?

It won't! Read the article!

Here y'go then!

It would be very helpful if you would answer each one individually - numbered as I have done - in as much detail as you can then I'll come back as see where you are ....

1. what are your pain levels right now? (remember the 1-10 scale: 1 = no pain and 10 = the worst you can imagine. And don't forget to factor in other forms of pain such as soreness, burning, stabbing, throbbing, aching, swelling and stiffness).

2. what pain medications have you been prescribed, how much are you taking (in mg please) and how often?

3. how swollen is your leg compared to these?

4. what is your ROM - that's flexion (bend) and extension (straightness)

5. are you icing your knee at all? If so, how often and for how long?

6. are you elevating your leg. If so how often and for how long?

7. what is your activity level? What do you do in the way of housework, cooking, cleaning, shopping, etc., and

8. are you doing any exercises at home? If so what and how often?
This is the most crucial question so please help me by using the format I have left as an example
(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each
etc., etc.

Anything done at PT
- how many times a week
- enter exercise by name then number of repetitions of each
etc., etc.

 

[Beckadeez]

@Beckadeez I have tried melatonin but it doesnt work for me

I’m sorry. I’d ask your doctor for something, then.

 

[pamwmsn]

@Josephine

1. Overall pain level 3

2. I’m taking Advil 600 mg or Tylenol 1500 mg as needed. Advil at night

3. Swelling is moderate

4. ROM is 132 and 0, about a week ago

5. Usually ice once during the day for 30 min and also use ice during the night in desperation with rls.
6. Elevate most of the day and at night.
7. A little cooking at times - have to stop and lie down to regroup. Clothes washing. A little dusting. Grocery store wipes me out

8. Very little exercise at home. Short walk at night with dog. Want to join our neighborhood pool when the water warms up.

Physical therapy 2-3 times a week. Stationary bike - 15 min. Elliptical - 6-7 min. Calf stretches (2 different kinds) - 2 sets-3o sec each. Balance board - 2 sets of 20. Thigh stretch - 4 sets-30 sec each. Leg press - 2 sets of 10. Leg curl - 2 sets of 10. Leg extensions - 2 sets of 10.

 

[pamwmsn]

@Laurenkate
I’ve tried everything to sleep on my side but it doesn’t work. It hurts. I have to try and sleep flat on my back with my leg on a pillow. Miserable!
Anyone have any ideas or tricks?

 

[Jockette]

@Laurenkate

Are you elevating your leg on more than just that one pillow?

My hospital sent me home with a foam elevating wedge. I found it to be much better than a pillow. I still use it but now I put both legs up on it, because I’ve come to like elevating both legs over night, and, I have low back issues, so I could never sleep on my back if my body was level.

 

[Beckadeez]

Is it incision pain or general surgical pain? I’ve read that some people put plastic wrap on their incision at night, so that the sheets don’t rub it. If it’s surgical pain, I’d try a pillow or wedge between your knees. It worked for me.

 

[Josephine]

Physical therapy 2-3 times a week. Stationary bike - 15 min. Elliptical - 6-7 min. Calf stretches (2 different kinds) - 2 sets-3o sec each. Balance board - 2 sets of 20. Thigh stretch - 4 sets-30 sec each. Leg press - 2 sets of 10. Leg curl - 2 sets of 10. Leg extensions - 2 sets of 10.

@pamwmsn I did ask this

(which means please make a list and not an essay!)

Exercises done at home
- how many sessions you do each day
- enter exercise by name then number of repetitions of each

 

[Laurenkate]

@Laurenkate
I’ve tried everything to sleep on my side but it doesn’t work. It hurts. I have to try and sleep flat on my back with my leg on a pillow. Miserable!
Anyone have any ideas or tricks?

Oh, I couldn't sleep on my side for months after surgery. Still have to sleep with the pillow between my legs. It took a while but finally found the combination of pillows which made sleeping on my back with an elevated leg more comfortable. This sounds strange but I didn't know what to do with my arms so tucking pillows in on each side helped sleeping on my back. My husband said planning D Day was probably less complicated than arranging the pillows on the bed every night.

 

[Jockette]

My husband said planning D Day was probably less complicated than arranging the pillows on the bed every night.

Whatever it takes!

 

[pamwmsn]

@Josephine
8. Short walk with dog.
Mild stretching.

PT 2-3 times a weeks.
Stationary bike 15 min
Elliptical 6 min
Calf stretches 4 sets 30 sec each
Balance board 2 sets of 20
Thigh stretch 4 sets 30 sec each
Leg press 2 sets of 10
Leg curl 2 sets of 10
Leg extensions 2 sets of 10

 

[SusieShoes]

Sleeping on my back, legs up on a foam wedge, did the trick for me. It was the only position in which my knees didn’t hurt, so the only way I could sleep. I’m normally a side-sleeper. It was around six months after surgery before I could sleep on my side again. Whatever it takes, indeed!

 

[Josephine]

1. Overall pain level 3

3. Swelling is moderate

If your swelling is moderate then your pain score must be more than 3

2. I’m taking Advil 600 mg or Tylenol 1500 mg as needed. Advil at night

I think you should quit the 'as needed' philosophy. I suggest you take Tylenol 1,000mg 4 times a day instead. Forget the Advil - ibuprofen really isn't that good a pain killer anyway.

4. ROM is 132 and 0, about a week ago

Actually, that's pretty good!

5. Usually ice once during the day for 30 min

You accomplish little or nothing in 30 minutes. Ice for at least 40-60mins and more than 4 times a day.

6. Elevate most of the day and at night.

Well okay but are you elevating properly? Like I;ve suggested in here? Elevation: the do's and dont's

7. A little cooking at times - have to stop and lie down to regroup. Clothes washing. A little dusting. Grocery store wipes me out

Then maybe you are doing too much for you right now. Read this again and see what's suggested Activity progression for TKRs


PT 2-3 times a weeks
Stationary bike 15 min - that's okay provided you're using zero resistance
Elliptical 6 min - that's not a good machine to use even at 8 weeks. Much too demanding
Calf stretches 4 sets 30 sec each - okay but that's rather a lot.
Balance board 2 sets of 20 - I've never been a fan of the balance board. You can achieve as much by walking
Thigh stretch 4 sets 30 sec each - okay
Leg press 2 sets of 10 - NO leg press, NO weights, NO gym machines, VERY bad!
Leg curl 2 sets of 10 - here again, NO weights, NO gym machines, VERY bad!
Leg extensions 2 sets of 10 - why are you doing these? You said your extension is zero so there is no reason for you to do these.

I recommend you stop doing exercises altogether because your ROM is so good. And it's probably these exercises that are making you feel wiped out. You are doing too much.

 

[pamwmsn]

After 2 nights of very little sleep, last night I took 2 Tylenol PMs before bedtime. Shortly after settling into bed the restless legs started. I tried ice, stretching, everything I could think of but did not sleep at all. After taking care of my dog this morning I did sleep for 2 hours. I feel absolutely miserable today and don’t know what I’ll do if I don’t get some sleep tonight. I started taking iron supplements today for restless legs syndrome and pray that will help. Also, ordered a foam wedge to elevate my leg at night instead of using just a pillow.

 

[Celle]

Pam, Are you taking naps during the daytime, to make up for not sleeping well at night? Do take those naps. It just doesn't work if you try to stay awake during the daytime, in the hopes that you'll sleep better at night.

Sleeplessness is part of recovery for almost all of us:
Sleep deprivation is pretty much inevitable - but what causes it?
Worrying about it just makes the problem worse. It will get better in its own sweet time.

Meanwhile, sleep where you can, when you can, and how you can. All those naps add up to the hours of sleep that you need.

 

[pamwmsn]

@Josephine, @Celle
Thank you so much for your advice and caring.
Also, @Josephine, I had weaned myself off of Gabapentin but was thinking today about going back on it for the RLS. I do believe it has worsened since I stopped taking the Gaba.

 

[Josephine]

I think you should discuss this with your GP. Your leg needs to be examined by a doctor before that kind of decision can be made.

 

[MaryMC]

Have you ever tried magnesium?