TKR TKR @ 6 months.

[BCMR20]

I’m now just over 8 weeks post op and the new knee is doing remarkable. Over doing it will most certainly cause some discomfort by way of aches and swelling but even that is getting less and less. I’m not ready to walk and play an 18 hole golf course but I can hit balls and certainly getting 6000-7000 steps in a day.
Here’s my one concern. My sleeping habits haven’t gone back to normal. I’m still having such a difficult time falling asleep. I’ve tried melatonin, valerium, antihistamine sleeping pills, a glass of milk, a shot of whiskey late ate nite, zzzquil, nothing works except the lazy few nites I had a left prescription for Atavan 1 mg pill. I had them to ease so very stressful situations in my life. Well at 3 am I tried one and I slept til almost 10.
The next night I used one at 1 am and it also worked. I don’t want to get hooked on Ativan for sleeping. It seems it’s the only thing that is working for me. Has anyone else used this or how long can this sleep issue last. Does it typically go away in 8-10 weeks or is this something I might deal with for months.
It’s tough dealing with this amount of lack of sleep. At some point it catches up to you and I feel almost unfunctionable. Thx all for listening.

 

[Jockette]

Maybe this will help you understand the sleep problem better:

Sleep deprivation is pretty much inevitable - but what causes it?

Time and again members complain about not being able to sleep and after a while, that it gets to making them feel frustrated, despairing, depressed and even ill. I thought perhaps a short treatise on the reasons for disturbance of sleep patterns was long overdue. It won't help you to sleep but...

bonesmart.org

 

[FleuveStone]

I agree @BCMR20 , problems with sleeping have been one of the hardest things for me too. I'm just over 2 months post surgery and just the last few weeks have had occasional 'good" (okay half decent) sleeps. I'm trying to be patient with it, try different things and wait it out, but that's not always easy, especially when I doze off at dinner or afterwards.

I track my sleeping with a relatively cheap Samsung smart watch . It's supposed to show your different phases of sleep though I'm not sure how it does it or how accurate it is. But I believe it can show trends over time, and also how different interventions, eg sleeping pills, herbs, etc. affect quality of sleep, not just quantity.

I'm no expert, but my experience is that rx sleep meds can interfere with deep sleep and REM. Having said all that, I do a lot of reading on my Kindle at night on a dark setting. If I drop off and drop it in the floor, I know I'm at the stage where it will be easy enough to get back to sleep!

Meanwhile I just expect to rest as much as possible and if sleep comes, that's icing on the cake.

Take care, it sounds like you're doing quite well!

 

[mendogal]

The best way to avoid a medication dependency with an "as needed" med is to not use it on consecutive days. Two reasons: so the blood levels can go down to zero and you avoid creating a pattern.
I know sleep deprivation is miserable (I had it for long weeks with both my TKRs) but if you can space the Ativan out maybe every third night?
And on other days focus on naps, creating nighttime environments as dim and physically comfortable as possible, seeing if a white noise or nocturnal sounds app helps...
If you haven't tried combining valerian plus melatonin plus low lighting, it's the one thing that helped me.

 

[Layla]

Hi BCMR20,
Happy Two Month Anniversary!

Pillows help me get comfortable in bed, making it easier to drift off.
Make up the bed with your most comfortable bedding / blankets along with a few extra bed pillows of different degrees of firmness. Try to block out the light if it's daytime. Minimize noise unless you feel listening to calming relaxation music, a fan, or white noise may help lull you to sleep. Make sure the room temperature is not too hot or too cold. Try to disconnect from the devices at least an hour before the targeted nap or bed time, so it's easier to wind down.

Consider Magnesium -
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/

I hope you’re able to get some restorative rest this week.
@BCMR20

 

[BCMR20]

Still having plenty of sleep issues except when I’ve been really active and then I seem to get a reasonable sleep. Not as good as it used to be but better than since surgery. I’m just over 12 weeks now and the knee is doing ok. Lots of ROM and it only seems to get sore when I use it a lot. Magic number seems to be about 7000-8000 steps. But here’s a question. Most mornings there is some stiffness and swelling that sets in very quickly after I first get up. The stiffness seems to ease with usage but the swelling keeps increasing most of the day.
I do think I maybe over using the knee at 3 months and if that’s the case please give me input. As I’ve said before I am pretty active and probably need to slow it down a bit. Also I find riding my exercise bike for about 15/minutes with very little resistance can cause more swelling and an achy knee.

 

[Layla]

Hello and Happy Three Month Anniversary!

As far as sleep, great news that it's improving. Here are a few ideas that may benefit you -
Pillows really help me get comfortable in bed, making it easier to drift off.
I suggest making up the bed with your most comfortable bedding / blankets along with a few extra bed pillows of different degrees of firmness. Try to block out the light if it's daytime. Minimize noise unless you feel listening to calming relaxation music, a fan, or white noise may help lull you to sleep. Make sure the room temperature is not too hot or too cold. Try to disconnect from the devices at least an hour before the targeted nap or bed time, so it's easier to wind down. Limit caffeine throughout the day and consider natural sleep aids such as Valerian, Chamomile or, Magnesium, my personal favorite, which can assist in muscle relaxation and nerves and promote healthy sleep (falling asleep and staying asleep)

Stiffness and swelling - if you're no longer icing and elevating, it's not too late, you may find relief through both.
Listen to your body and if you notice a negative effect from the exercise bike, step away from it for a time and see if you notice a difference. Possibly the activities of daily living coupled with an easy walk outdoors taking in the sunshine, fresh air and sights and sounds of nature might be enough for you at this point?
May be worth a try.
@BCMR20

 

[mendogal]

Yes, stiffness in the morning that lessens is usual, while increasing swelling is a definite message.

What I have observed among our members is that somewhere around 3 - 4 months folks are naturally increasing their activity while at the same time neglecting to elevate and ice.

Yeah, I was among them! It's natural!

My suggestions are
1) reduce some of your daily activities - for instance, if daily 15 minutes on the bike is too much, try 10 minutes (and maybe just every other day for a week). Increases should be in very small time or distance increments.

2) make time to lie down and elevate "toes above nose" with ice for 45 minutes two to three times a day. People often think "Really!?!?" but consider you're only 25% into your year long recovery and heed your body's clear message.

 

[BCMR20]

Thought I’d share a bit of “I should have known better”. I was out volunteering my time at the local curling club and helping setting up for the upcoming season. One of the jobs that needed doing was washing the floors with a mop. I thought I can do that and I spent about 1 1/2 hours mopping. Now it’s about 14 weeks after surgery so recovery is going well but I had no idea mopping with one of those larger commercial mops could put lots of stress on my new knee and the attached muscles around it. I think the motion of back and forth and the twisting on the right knee. Well I’m paying the price yesterday and today with a bunch of aching not at the knee but just a little below it at the upper calf area close to the knee. Ouch. How quickly we can forget it’s a year of recovery. Lesson learned until next time. Lol. “Posted for all of us go getters.”

 

[Layla]

Thanks for sharing your cautionary tale of how one can easily land in the ODIC (Over Did It Club) when you least expect it. I am sorry your generous volunteer efforts now have you struggling with discomfort and pain. Hopefully a few days of ice and rest and you'll be back to where you were before you picked up the mop.
Lots of comfort to you, BCMR20.
@BCMR20

 

[sistersinhim]

Also I find riding my exercise bike for about 15/minutes with very little resistance can cause more swelling and an achy knee.

This is your knee telling you that it's a no-no right now. You will have a lot less pain and swelling if you listen to and watch your knee's reaction to things you are doing. I found this out early in my numerous knee surgeries. I was alone during the majority of my 12 knee surgeries, and learned in my first knee surgery that less is better. Even though I had to take care of my house, yard, cats, and me, I would do as little as possible and rest, ice, and elevate as much as I could. Experience is the best teacher, and I learned early how to let my knees recover themselves gently and naturally.

 

[BCMR20]

I’m looking for some input on where should most TKR be at after 6 months. I’m having some issues with stiffness after driving for an hour or two and first thing in the morning. Also my knee can ache enough from just sitting down and watching TV for an hour or two or for that matter just standing in one spot and talking to someone one. It’s Easier to walk than stand still. I’m getting a good amount of walking in daily. Around 4000-5000 steps a day plus the regular around the house routines that are normal. When I have my pedometer on it adds another 1500 or so steps. The achyness at the end of the day and the stiffness are bothersome and I hope they will go away over time. Is this normal? My ROM is good and I have no issues there. I know the recovery is a year long time frame it seems to have slowed way down in recent weeks.

 

[Jockette]

All that is very normal, I felt the same way at 6 months! Hang in there, it will continue to improve.

By the way, I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you.

Many members bookmark their thread in their computer browser, so they can find it when they log on.
How can I find my threads and posts?

How can I find my threads and posts?

There are a couple of ways you can find categories of threads on the forum. You are able to use links in the main forum toolbars at the top of the screen to quickly access certain types of threads: your own threads, threads with your posts in them, and watched threads. You can also use links...

bonesmart.org

Best wishes on your continuing recovery!

 

[EalingGran]

All sounds pretty normal to me. I was active walking plenty from early on but would get stiff and achey later in the day at your stage. I found a rocking stool for watching TV was a godsend. Mine was left over from a rocking nursing chair/ stool set my daughter had. You might find one cheaply on eBay.
Standing was much harder than walking. I could easily do 10,000 steps/ day but struggled standing to cook or go round an exhibition.

 

[mendogal]

I too found it necessary to get up a couple of times during the average 2 hour movie and take a short walk as well as alternate periods of leg up/leg down. Very normal and expected!

 

[sistersinhim]

Remember, at 6 months, you are only halfway through this healing process. You'll have good days and bad days. As time goes on and your healing continues, you'll have more good days with less stiffness. Then before you know it, you'll be having many more good days!