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[TKR] Thorne's recovery thread

Discussion in 'Knee Replacement Recovery Area' started by Thorne, Apr 16, 2019.

  1. Thorne

    Thorne new member
    Thread Starter

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    I am not sleeping. After reading other posts, this is not unusual , but I am very frustrated. I am 7 weeks post op and my doc is allowing me 1 Tylenol 3 a day. Unfortunately it doesn’t seem to have much effect. When will I be able to sleep normally ?

    I started a new round of physio, and one exercise they are having me do is ‘bridge’ . This is excruciating. My new physio is very gung ho ( I have been quite religious about physio up until this point)

    My ROM is 105-110 degrees depending. I am seeing him tomorrow. Should I flat out refuse to do this bridge exercise or is this expected at this point in recovery?

    Any advice is very welcome. Btw I had 2 total hip,replacements when I was 52 , and this TKR is by far the worst.
     
  2. possum65

    possum65 junior member

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    It varies from person to person as to when sleep settles back into your regular pattern. I do sympathise, I hardly slept at all for 3 weeks post surgery, and it is desperate stuff! Are you in pain at night? You might need more than Tylenol to help with that.
    Wow, bridges, really? DON'T do them, PT should not be excruciatingly painful, it will only set your healing time back.
    Just say no to this.
    I too have had full hip replacements Oct/Nov 2018, and bilateral TKR 6 weeks ago. SO much harder than the hips, I was blown away. I hope you start to sleep soon, everything will seem so much better once that happen.
     
  3. Jamie

    Jamie ADMINISTRATOR Administrator

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    Hi, Thorne and welcome to BoneSmart. I'm going to post our basic recovery articles for you to read as I think you'll find them very helpful to know what to expect in recovery and how to deal with things like an over-zealous therapist.

    Your ROM at 7 weeks is excellent and frankly I'd tell that therapist you're not doing any bridges at all. That's a strength building exercise and it's way too soon for that. You need at least 6 months of recovery under your belt before you attempt bridges and only then if you're not having significant pain or swelling in your knee. Right now you're still healing inside and you're doing yourself no favors by trying to push through a painful exercise.

    Knees generally are more difficult to recover from than hips, so your experience is very normal there. And difficulty sleeping is common as well. Are you icing your knee as much as possible? Even through the night? That can help with pain, swelling and improve sleep. Just be sure you keep a kitchen towel between your skin and the ice source so you don't damage your skin.

    Is there some medical reason your surgeon is limiting your Tylenol use? For Tylenol to be effective with a joint replacement, normally you would need to take 1000mg doses 3-4 times a day on a regular schedule. You should never take more than 4000mg in any 24 hour period. Of course, if you have any kidney problems or other medical issues that your doctor is aware of, that could be why he's limiting you. But if you have significant pain, there are many other options and you need to have a frank discussion with either your surgeon or your GP about pain management.
     
  4. Bionic

    Bionic post-grad

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    @Thorne
    I am 7 weeks post op and Friday and your ROM is making me envious. Having said that mine was 75 last week and 85 this week so it is improving.
    Those bridges just seem to be a step too far for me and I wouldn't want to be doing them. If they are causing you that much pain just say no.
     
  5. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    Hi and Welcome to Bonesmart.

    I am going to tag @Josephine
    our forum administrator and nurse director to address your concerns.

    Here are the Recovery Guidelines Jamie mentioned, each article is short but very informative. Following these guidelines will help you have a less painful recovery.

    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. At week 4 and after 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.
     
  6. donnag1108

    donnag1108 senior

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    I am sorry to hear of your sleep issues but it is common. You may be able to get some type of RX from your primary doctor for that. It may help. I was still on oxycodone at 7 weeks so if pain is the culprit, or at least part of the issue you may need stronger pain control. I really did not start sleeping much at all until week 10 after I returned to work. I guess it just goes with the territory. As far as the PT I would not do anything that was excruciating and my doctor agreed. I did not some PT but followed the bone smart way for the most part and have recovered beautifully now. I hope you get some relief soon! Hang in there it does get better. :bored:
     
  7. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     

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