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Author Topic: TKR Right knee 4 weeks post op no sleep  (Read 6172 times)

Offline Tagranor84

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TKR Right knee 4 weeks post op no sleep
« on: July 30, 2011, 01:48:48 AM »
Hi All

I am 46 and 4 weeks post op for r knee TKR. Single mum with two boys 13 and 11 (11 year old has Aspergers)  Haven't slept properly since op and it's getting worse.

I take slow release morphine at night and codeine based pain mess during day. At night I just can't sleep pain is horrific as soon as I lie down my knee just burns, I ice it but the burning doesn't go away. Wound is not red so I presume no infection.

What can I do to ease the burning and get some sleep. I am so low right now I keep a smile ony face nut when I'm alone I cry much. I spend many hours alone I try to do exercises but my knee just won't bend past 75 degrees. Sorry to go on but I'm just not coping with the pain, frustration and lack of sleep.

Anyone got any advice to help. Thank you. Julie - Sydney
Left knee 2 x key hole clear ups, 1 x lateral release 1 x Patella Femoral Replacement 2004
Right knee repair bucket handle tear July 2008
Right knee TKR July 2011
Right Knee MUA August 2011

Offline annie5970

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #1 on: July 30, 2011, 01:01:52 PM »
Hi Sydney,

I had a left knee TKR one week ago, and in addition to the pain meds, I was prescribed a mild muscle relaxer, which I have found to be a really good adjunct to my medications, and it helps me tremendously with sleep. A mild sleeping pill was tried while I was in the hospital, but it was ineffective. Once the muscle relaxer was added, the muscle spasms around my knee lessened, and it relaxed me enough to get some sleep. It seems to also make the pain meds work a bit better. Maybe this is something you could try to get some sleep at night. We need to sleep to heal, and getting enough sleep when the pain is so bad is difficult. I am on flexeril as a muscle relaxer, and, for me, it has been extremely helpful. Maybe you could ask your ortho, or your primary physician if this could be added to your post-op medications?

I am hoping you get some rest, and begin feeling better soon.

Annie
Jan 09-Surgery for torn mensicus/synovitis
Nov 09-Scope-Extensive Synovitis/Plica Removal
Apr 10-LR-Scar Tissue Removal
Apr 10-Hematoma Evacuated
July 10-MUA
Oct 10-Scope/Synovitis/Extensive Scar Tissue/Chondromalacia/Maltracking
Nov 10-TTO/Scar Tissue Removal
Knee Aspirated 20 Times
July 11-LK TKR

Offline Skinnycatz

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #2 on: July 30, 2011, 08:58:53 PM »
In my opinion, you need an ice machine at night, one that you can run continuously ALL night.  Some call it a "polar pack".  You can rent this machine for a few weeks.  For me, I could not sleep without it!  I only needed pain meds at night.  I also had PT come to the house for the first three weeks, then outpatient PT after that (3 times a week for three months).  I sure hope you are going to PT!  Without that, it is much harder to gain ROM.  PT also has ways to break up the scar tissue so the pain lessens. 

Elevating your leg with pillows will also help.  Make sure your leg remains straight so you don't lose extension.  A graduating stack of pillows works the best.

Good luck! 

Francine
Diagnosis: CMP, torn lateral meniscus.
Meniscus trimming, chrondroplasty 2/14/03.
Meniscus trimming (lateral again) chrondoplasty 8/3/07
Grade III/IV Chrondomalacia kneecap
Meniscus trimming (tear in front of lateral) 4/18/08
Left TKR 7/15/10

Offline Tagranor84

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #3 on: July 31, 2011, 01:22:31 AM »
Thank you for responding Annie and Francine.

I will speak to doctor about muscle relaxant this week I really need the sleep. I am going to pt twice a week but bend is just not happening. I go for two walks everyday and try to do pt home exercises as best I can. Feel very frustrated. I'm going to try find the polar pack on web today and c if I can get hold of one.

Thanks for the suggestions I will let u know how I go.

Julie
Left knee 2 x key hole clear ups, 1 x lateral release 1 x Patella Femoral Replacement 2004
Right knee repair bucket handle tear July 2008
Right knee TKR July 2011
Right Knee MUA August 2011

Offline Tagranor84

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #4 on: August 01, 2011, 09:02:18 AM »
Hi

Just a catch up went to PT today he wants me to go back to surgeon over continuing problems.

Surgeon believes there maybe a scar tissue issue so I'm off to see him tomorrow to figure this out. Spoke to PT about polar pack he hadn't heard of one must be called something else in Australia. CPM machines can only hired privately and are very expensive. So tonight I'm stuck with frozen bags of peas and another sleepless night. Can only hope my surgeon can put me on the right track when I see him.

Julie
Left knee 2 x key hole clear ups, 1 x lateral release 1 x Patella Femoral Replacement 2004
Right knee repair bucket handle tear July 2008
Right knee TKR July 2011
Right Knee MUA August 2011

Offline mlbbarry

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #5 on: August 02, 2011, 05:25:20 AM »
I agree with skinnycatz the ice water machine was key at night, and used it all night long, plus sleeping pill perhaps. 

How long are you walking?  I don't remember doing that at four weeks, I did enough of that with my daily routine.  Maybe work on your exercises a bit more and relax with the walking, just a thought, maybe someone else has some input there.  Also you mentioned trying to do lunges on your porch ???, I think this was in my thread.  Dang girl at 4 weeks that would really hurt, did the P.T. Guy give you that exercise?

One more thought, twice a week doesn't seem like enough to me ??? What do you guys think?

Sorry if I am way off on things only my suggestions, as you really sound down and wish I could help :'(

Monica
88' torn ACL, MCL, LCL repair
92' clean up
95' clean up
96' lateral release
99' meniscus repair, and clean up
2004 meniscus repair, & failed micro fracture attempt
2010 April, arthritis clean up and meniscus repair, poor outcome.
2010 Nov. 8th tkr left knee

Offline Tagranor84

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #6 on: August 02, 2011, 07:45:29 AM »
Hi Monica

My walks are shirt two or three blocks and back mainly to prevent me going stir crazy, I found walking with a cane easy weight bearing has never been a huge problem it hurts a bit but a jaunt to get a good take away coffee stops me from going insane.

PT visits must be a premium in Sydney I have never been offered more than twice a week and I have to arrange transport to and from out patient department they expect me to complete exercises at home. The lunge was suggested by PT. I have to use front door step as it us the only proper step I have I simply put my bad knee on step and push forward as if I was going to climb it. I think this was recommended as after procedure femoral block damaged some nerves when I had an ultra sound they found out I had a femoral hernia so my exercises have to be designed around that plus the loss if feeling in leg causing some problems with my quad movement.

I saw my surgeon today and I hVe to go back in hospital on Monday to have a knee manipulation done under a general, he believes I have a scar tissue problem which is hindering the ROM today I could only get about 60-65 in docs rooms so I'm off to hospital again.

I ask about ice machines but they don't deem to be readily available in Sydney will try another search on web tonight to see if I can track one down.

Thanks for responding I have read your boRd with great interest it is nice to know I am not alone

Julie
Left knee 2 x key hole clear ups, 1 x lateral release 1 x Patella Femoral Replacement 2004
Right knee repair bucket handle tear July 2008
Right knee TKR July 2011
Right Knee MUA August 2011

Offline mlbbarry

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #7 on: August 02, 2011, 07:57:55 AM »
Ice water machine is on eBay.  They have many brands search under, Polar bear, ice therapy etc... I would have it shipped overnight if possible and have it on while in the hospital.  With a MUA they should be using a cpm machine right?? Otherwise it will possibly happen again I would think.

Good luck, wish I had the MUA procedure earlier, a lot of people have great success afterwards.
88' torn ACL, MCL, LCL repair
92' clean up
95' clean up
96' lateral release
99' meniscus repair, and clean up
2004 meniscus repair, & failed micro fracture attempt
2010 April, arthritis clean up and meniscus repair, poor outcome.
2010 Nov. 8th tkr left knee

Offline Tagranor84

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #8 on: August 02, 2011, 11:13:58 PM »
Checked eBay only ice machines are in the US. doesn't seem to be a big thing in Australia. I found one site with a polar bear cub going to call them today.

The CPM has only been used on me once at last PT session my surgeon says that I will be put in one after MUA they are still deciding if I will go home same day or stay over night so that will decide how long I am on CPM.  I am going to check if my insurance covers hire if thus so I can get one for home trouble is being a single mum at home I dont have lots of money and occupational health at hospital do not arrange hire of this or ice machines.  But I am on to it, at least I have a mission to achieve today.

I am now out if all prescription pain meds and I'm using over the counter pain tablets may have to try to get to my own doctor today to get something stronger but it is quite a walk we'll see how I go.

Thanks for advice I'll see what I can arrange today.
Julie
Left knee 2 x key hole clear ups, 1 x lateral release 1 x Patella Femoral Replacement 2004
Right knee repair bucket handle tear July 2008
Right knee TKR July 2011
Right Knee MUA August 2011

Offline Redwing

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #9 on: August 03, 2011, 09:00:05 AM »
Hi Julie.  You really must get some more prescriptive pain meds!!!  I sense you are going to need them and it is important to stay ahead of the pain.  Have you not got a friend or a relative who can help out with transport to the doc?  This is a time when you need your friends, particularly as you are a single mother.  There will come a time when you can do things for them but now you need to take advantage of any help there is.

Re CPM and ice machines:  I didn't have them either; they don't seem to be widely used in the UK either.  It is possible to get through TKR without them.  Do you have any icepacks?  They  work well.  I had two and kept one in the freezer while I used the other and when it thawed I always had a freshly frozen one.

Hope you are feeling better by the time you read this.  I can't comment on MUA, no experience of it.
2001: first referral to OS for osteoarthritis in knees after about 5 years of OA pain.  Told I was too young for knee replacement.
July 2009 Bilateral arthroscopy
Jan 2010 TKR-right knee

Offline Tagranor84

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #10 on: August 04, 2011, 04:44:52 AM »
Hi Redwing

Unfortunately my friends all work and boyfriend doesn't drive so I only get to see him at weekends, so I'm on my own. I found a bus to take me to the docs and took your advise he gave me a script for Endone a morphine based pain killer. Took one half an hour ago and already feel a little less grumpy. Long term pain makes it hard to keep smiling but I'm trying my best. I have bags of frozen peas for the knee and they work ok just don't stay frozen too long. I am OK for hospital appointments we have local community transport (actually for aged care, but seems they r OK with a 46 year old) they charge very little for a ddior to door service and as a single mum I get some home help with cleaning and washing they also take and help me with grocery shopping, so I guess I'm really lucky my ortho arranged these services for me.  ;)

I'm originally from the UK a Brummie gal now living in Sydney.
It seems that TKR patients in the US have much more available at home than we do when all this is said and done I am seriously thinking about putting together a business for equipment to assist Oz patients after TKR it seems ice machines are pretty much unheard if here and CPM machines r few and far between and very expensive to hire $145 per week, just something to think about for the future instead of my brain going mushy watching The Love Boat.

Thanks for the responses this site is keeping me positive and informed and not so much alone. Will let u know how MUA goes fingers crossed

Julie
Left knee 2 x key hole clear ups, 1 x lateral release 1 x Patella Femoral Replacement 2004
Right knee repair bucket handle tear July 2008
Right knee TKR July 2011
Right Knee MUA August 2011

Offline subwayknees

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #11 on: August 06, 2011, 08:48:27 PM »
I myself cannot drive due to knee pain and the amount of medication I must take, (morphine0  I live alone except for my son who works long hours driving a big rig truck, usually out of town. and my other children work long hours and although they do drive me once in a while I cannot rely on them all the time even though they try.

One day I decided to call my local church and like that I received calls from a number of people willing to take me to doctor and hospital appointmnets, to shopping centers and even just for rides out in the country to get out of the house.  I might suggest you call some churches near by, even if you do not attend, I am sure they will be able to help you.  Here in the area I live near Washington D.C. it is difficult to get around without a car and not all of our metro stations are easy for someone who is handicapped to get into so a car is important.  What I do now is make a list of appointments like doctors, physial therapy etc and the secretary at the church posts them on their web site every month and I get so many calls that I have to tell people I do not need them.  I have never missed an important appointment.  Just a few day's ago I felt really depressed stuck in the house, my oldest son was on the road and would not be back for several days driving a load from Virginia to South Dakota and back.

I simply picked up the phone and asked the church secretary if she may be able to get a ride for me in the next few days to the mall to get out.  In less than an hour a local member stopped by with her father in his 80's who also wanted to get out.  We drove to the local mall had some coffee and a few hours later returned home.  It was great.  I also know of a person who called the local college and has several nursing students come to her home a few days a week to help out.

People will usually try to help someone else if they can, you just have to ask, your locals church is a good place to start and although I have started to attend once or twice a month on Sunday morning no one ever pushed me to, they were simply willing to help.  We are all on the same planet on the same journey so reach out anbd I am sure you will get some rides and make some new friends also

Offline debbieo

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #12 on: August 23, 2011, 12:38:08 AM »
Julie
How did the mua go? I hope your rom has improved.
Hope by now you are sleeping better. Not sleeping is a common occurence after a tkr. It's not just the pain. Have you tried a sleep med. I was totally totally against sleep meds untill I tried Ambiene. It was a night of pure bliss. I did not take them very long.
You've got your hands full. Be kind to yourself and don't do what you don't have tooo--most things will wait a few months. :) And hey, cry all you want to--we all have.  :'(
Wonder Woman
tkr 9.14.09  tibia fracture 04
As Lovely as Aphrodite—as Wise as Athena and the strength of Hercules—she is known only as Wonder Woman, but who she is, or whence she came, nobody knows!  
I WILL NOT BE DEFINED BY WHAT I CAN NOT DO!
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=48797.0

Offline alohaleslie

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #13 on: January 23, 2012, 04:04:25 AM »
Aloha Julie,

I am so sorry to hear you are having such a challenge with your new knee. I am 6.5 weeks post op from a right knee replacement and finally turned the corner where my surgeion told me I would be beating myself up and wishing I had never had it done. Yes, there is a lot of pain, sleeping is very painful and dfificult. I understand that can go on for 6 months or so. But you do need some sleep so you body can heal. I am receiving rehab two times a week, but I am diligent at home in doing my flexion and extension exercises several times a day. Yes, the horrific pain just plain sucks. I take a pain med an hour before I begin my exercises, then ice really well afterwards. I would suggest that you relax on too much walking and strengthening exercises until you begin to get your range of motion back. My flexion is up to 117, but gaining extension has been most difficult, which is only 8 degrees. I wish you the best in your recovery. You have a long vital life to live!!! 

Aloha Leslie :)

Offline oohyeah4

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Re: TKR Right knee 4 weeks post op no sleep
« Reply #14 on: January 23, 2012, 12:48:28 PM »
Julie, Hello, Sorry you are going thru all this pain and no sleep. I too can relate to all the hardship you are going thru. I too have a special needs child thats 12.. So thats a whole nother issue added to what we are going thru. My heart goes out to you. I am a veteran by now when it comes to T.K.R.  I had one in 2009 another  (revision) in 2010 and now a week from now have to have it all done all over again because my implant is comming loose. What I can tell you is Narcotics for me, give me "Insomnia" and I cant sleep ..what I did find to help me so much is Ice all the time...I usually would put it 30 on and 1 hour off and so forth...you might want to try (By script only) the Flector patches.. they work pretty good for me. it's only a suggestion...Hope you can find relief, Rob
« Last Edit: January 23, 2012, 12:57:01 PM by oohyeah4 »
2007-2008  (3) scopes on left knee
early 2009 (3) synvisc injections (worthless)
Oct 2009   TKR  left knee
Oct 09 - Aug 2010 endured almost 1 yr of unbearable pain
Aug26th 2010 revision on left T.K.R.
Feb 2012  complete removal of failed zimmer T.K.R. new one put in...