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Tired and tired of the pain

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Susie Mac

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Feb 4, 2009
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First off I am soo happy I found this site. I am 6 weeks and 4 days post op bilateral TKR. I live alone, I have 2 sets of stairs in my house (15 steps each), and I have a full time job and a business to run; let’s just say I’m struggling a little (ok, A LOT!!). I can straighten my legs to 100% my range of motion is 122 degrees today (PT). My problem is the pain, not sleeping at night and the tiredness. I would like to get off of the meds but I just crumble when the pain comes on. How long does it take for bone to heal normally? I’m not sleeping well at night and when I try to do what I need to do (work) I hit what I call the brick wall. If I don’t get home and get to bed ASAP I’m in real trouble. I don’t know when this is going to happen from day to day so it’s hard to determine how to pace myself. I wish I had the luxury to take more time off but it’s not going to happen. Any suggestions are greatly appreciated!! I would like to know a time frame (average) when I should expect to start gaining more energy? How long before I see a significant reduction in the pain? Thank you!
 
Hi Susie Mac
WElcome from a hippy, so I won't be too helpful with your questions., More knees around than hips, so yu should get help.
I do know that 6 weeks is very early especially as you did both knees. Being exhausted is totally normal at this point too. Sorry you had to return to work so soon. Others have done that as well. I got fired during my hip event so I got to take all the time in the world off.

Welcome and I'm sure others will respond
Judy
 
Welcome Susie Mac,

I don't think there is a time frame really since everyone recovers differently. On the forum there are heaps of stories from different people. Your Flexion and Extension are great for where you are, and I think you are very strong to have had both done at once. Best wishes for your recovery.

Chris :)
 
Same here, 3 months TKR. Sleep was difficult for quite awhile for me. I as well own my own business and needed to take some time to reflect on what this was causing. The lack of sleep was incredible. Once you have sleep issues it's difficult to get that clock back. So I took 2 sleeping pills (over the counter) for about a week at night. It really did help (although I woke up with what felt like a hangover) and finally was able to reset that internal sleep clock.

Also finding that position that is just right. The new knee made me look for a new sleep position. My right knee, (my sleep position is roll on the left and put a small (thin) pillow between the knees (so they don't knock) and pull the right leg up (towards the chest) a bit. That took a while to figure out. Now when I cannot sleep I find my sleep position and it works.

Good luck and keep the faith, supposedly it gets better..... and eventually BOOM you forgot you had knee replacement (I am waiting for that day).
 
Have you tried melatonin to help you get a full night's sleep? I, too wake up with pain and discomfort but sometimes, a sleep aid can get me through that. Then, at least you're well rested!
 
Your extension and flexion are great for such a short time recovery. I wish I had some good news about sleep, it effects some people more than others. I am ten weeks out and just starting to get a good nights sleep. The only way I was able to get any sleep early on was as follows. I told my family not to wake me if they found me asleep no matter where or what time it was. I have trouble getting comfortable in bed. Most nights I start out in bed but end up moving to the couch or recliner whichever one I can get comfortable in. One thing I can tell you helps is an electrick heating pad I put it on my knees about 30 minutes before I go to bed. This seems to help with the pain and help me to get comfortable. I cant tell you how many times I fell asleep right there in my recliner with the heat on. As far as the pain mine went away in stages 3 weeks, 6 weeks etc. i am now at 10 weeks and only have pain during PT and every once in a while when I move or twist funny.

I am 10 weeks post BI-TKR

Max
 
Like Susie Mac, I'm glad I found this site today. This morning I cried "uncle" and told my work colleagues I was going to spend today and tomorrow at home resting. I'm 7 weeks, 2 days left TKR post op. All along I've been told I'm doing just fine with my rehab: walking on day 2; PT at home for two weeks; outpatient PT 3x pw since then; back at work part time in week 4 and full time in week 5. My ROM is 119 with -2 flexion. But like so many others on this site, I'm tired, I hurt (hip and glut pains this morning sent me for the hot pad and a day of rest), and I'm frustrated that recovery is so slow. I get it that this is a long term project and I need to adjust my usual go-flat-out approach to getting things done; I'm working on it. So, just a thank you, to contributors to this site who have given me helpful ideas about refining my expectations, putting some of the aches and pains into perspective, and managing the transition from vicodin (ES 7.5/750 mg) to an over-the-counter effective pain manager. Maggie Sue.
 
Welcome to new forum members Maggiesue and Susie Mac! Glad you found us. It sounds as if you both are doing very well in recovery and I congratulate you for your hard work and progress. The only advice I might offer is that you REALLY listen to your body. You have gone through major surgery - a huge trauma that your body must now recover from. Yes, you can push yourself and go to work when you are exhausted, but that will actually make your full recovery slower. If your body tells you that you need to rest, try to get things arranged so that you can do that. Is working from home an option?

Many of us experience sleep problems at about the stage you are in recovery. It's normal and it does get better.

Maggiesue, it sounds to me like it is too early for you to try and get off your pain pills. It will help if you can establish a schedule for taking them and then stick to the schedule. If you wait until you feel the pain, it takes much longer and is more difficult for your body to recover once you finally take the meds. Here's a chart that shows what I'm talking about:

[Bonesmart.org] Tired and tired of the pain
 
Welcome to Bonesmart, Susie Mac! So sorry to hear how much you're in pain! You've really have to look back first to realize how far you've come so far! Runnin a business in these really tough and difficult times can drive anyone to endure sleepless nights,I'd venture a guess that every one of us, whether we've had hip or knee issues, have had our share of sleepless nights. The positions we've had to get ourselves in, alone, could fill a book, I'm sure!
What we all must learn, is to keep ahead of the pain,,,,anticipate it, and prepare for it! There are some wonderful pain killers out there,,,(no!!! I'm certainly NOT a druggie!!!) And you should take full advantage of them while you're still in your early stages of recuperation! I also find that having a sense of humor and the amazingly wonderful support you'll get here will make a world of difference to you! Best of good luck ! Things will get better!!!
 
You have returned to work far too early! TKRs need at least 8 if not 12 weeks in order to recoupe properly.

Okay - what to do about it?

First thing, pain management. What is you taking in the way of pain meds? And how much, how often? You are at the peak period for post op pain and it must be controlled.

Second, are you using ice and elevation to help? This is almost as important as pain meds. And elevation is not just putting your foot on a footstool, it's raising it up until your heel is above the level of your behind! It's the only way you get gravity to work in your favour and reduce the swelling>pain. How often do you use ice? 10 minutes 2-3 times a day is not worth the effort!
You needs to use it lots and for long periods.

Finally, you must realise that you've had a major, major op and healing needs a lot of rest even though, contradictorily, you need the PT to help get back into trim. But healing takes lots of energy. Pain soaks up lots of energy. PT expends lots of energy. But you only has so much energy to go around. So you have to shelve your frustration and prioritise the use of your reserves.

So
1. manage pain
2. rest to enable healing
3. then do some PT.

Finally, you need to stop setting yourself such high goals. You have 6-10 weeks more of basic healing. Keep a daily journal because often we don't realise how far we've come unless we have a record of it.
 
Thanks, Josephine, Jamie, and others for replies: I'm the newcomer who is 7 wks and 2 days out from LTKR. My Cryo/Cuff is my best friend. I ice 4+ times per day for 20 mins a time; until 10 days ago it was 8+ times because I needed it throughout the night. I will wear my Ted stocking until if falls apart because it feels better on than off during the day. I elevate once a day on Pillow Mt. (meets your requirements, Josephine), and try to keep my feet up at least to hip level at other times. I sleep at night, but in bouts of 2-4 hours; finding comfortable sleeping positions using pillows has been essential (as others have suggested). Meds: I'm taking 600 mg of Ibuprofen total each day over regular intervals (more in morning and work hours) and Vicodin (1 for sleep and 1 if it seems a more painful day). My OS renewed my Vicodin prescription 2 weeks ago, but with no refills. Essentially, he's prescribed pain meds only until I see him next week. I plan to talk about pain management and appropriate mix of meds. Any further suggestions of changes that I should make in my pain management and of questions that I should ask my OS next week? Maggie Sue
 
Maggiesue, everyone is different in recovery and pain management is definitely an individual thing. You are taking much less than I was at your point, but you have to determine if it's working for you or not. Just be sure you are not in pain during the day or night. If you are, then you need to discuss that with your surgeon and if that is not successful, discuss it with your primary doctor. Proper pain management is critical to recovery from this surgery. Without it you cannot rest or do your PT properly. Congratulations on making such a close friendship with your Cryo/Cuff - a VERY GOOD THING!!
 
Hi and welcome Maggiesue! I echo what everybody else has said about pain management...make sure you're getting enough! Don't try to be stoic and cut down too quickly.

I can now compare two different OS's and pain management methods, and even though I LOVE my second OS (RTKR last week) and he had fabulous hospital pain protocols, he's still a bit unrealistic about how much and how long the pain lasts. The OS for my LTKR (last April) had one response: "It shouldn't hurt that much."

So my solution has been to talk to my GP and she's willing to make sure I get enough of whatever I need AND she's willing to experiment to find out what works. On my first TKR, I made the mistake of thinking I should be off pain meds in a couple of weeks, and it wasn't until I found this group of folks that I began to understand what a TKR really entails and--most important--recovery takes a LOOOONNNNNNGGGGG time, to everyone's frustration.

It really does take about a year for things to start feeling normal! Hard to admit, but true for many of us. I'm at about 10 months now for my LTKR and it really feels like part of me and I now can trust it completely. The down side of having done this before is that I know how frustrating recovery can be, especially the tired part. Gawd I hated that!

Hang in there, take plenty of pain meds on a regular schedule, keep your icy friend around, and whine when you need to.

Weezy
 
Although I do not run my own business, I do work full time and I remember those brick walls well. I would just get so tired that I had no choice but to come home and go to bed! It's gotten much better - I'm at almost 6 mo post op. I still have "tired" days and I had to learn the hard way about overdoing it too soon (see some of my whiney other posts). Jo's three points of advice are my absolute creed now. Don't shirk on any of it. You don't win awards for putting up with pain and you need to be good to yourself. I was so worried about work, etc., and you know what? It all works out and the world won't come to an end if you treat yourself a little better. Trust me when I tell you that I wanted it all back immediately. And this has been the toughest lesson I've had to learn. Hang in there!
 
I am taking oxycontin 10 mg 1 in the day 2 at night and Dilaudid 2 mg every 4 hrs for pain. I do not have the swelling or as bad as some do. I live in the mountains of Colorado so it's plenty cold. Weather storms are interesting. Pain really fluctuates with the weather.

I had to return to work because I do not have enough sick time accrued. I'm 43 with many years left to work. I had the surgery because I needed it and the circumstances of my situation were ideal at this time to have it. A little history, I have had 7 total knee surgeries; 3 ACL’s and 4 scopes for various reasons. I guess I was expecting to bounce back as I did from the other surgeries; fairly quickly. I am thankful that there were no complications from my surgery and I have no infection. All in all I'm doing well, but wanted to know how long it would take to recover. I was not prepared for how tired I would feel at this point. I was not like this a few weeks back.

I have to say this is a fantastic site and everyone has been wonderful!! Thank you so much for all of the great information. Bless all of you!!

Susie Mac
 
I had a bilateral TKR in November of 07. I was away from school until after Christmas, and the big issues for me was A) tearing adhsions, and B) lack of sleep. finally took Ambien to get the sleep I needed...it is normal to have sleep troubles---evrybody that I know who had a TKR saidthe same thing...just hang in there, and do not be afraid to take some sleep meds to get your sleep schedule back on track.

I was on Oxy codone as well---I tried to take some vicoen, but it was like eating M%M's---just didn't work. Hang in there, there will be much, much better times ahead.

Tim C.
 
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