Trouble sleeping after TKR: What helped you sleep?

Hi @mom4twins4me, welcome to Mayo Clinic Connect. You'll notice that I moved your message to this existing discussion called "Trouble sleeping after TKR." I did this because I thought you'd appreciate some of the tips members like @10nsmom @sleepy0 @debbbraw @u13496 @ellerbracke @johnbishop and others have shared with each other and to get responses about your situation where your sleep is interrupted around 4am from stiffness and pain.

Do you get any stiffness and pain during the day or is it only caused by the lack of movement? What do you do at 4am to relieve the pain?

Good evening @mom4twins4me, I would like to add my welcome to Connect. You are very brave. I only know one other person who has been awakened by pain and discomfort at 4:00 a.m. after just one TKR. And that would be me. You on the other hand have two knees to take care of. I talked with my surgeon about the night pain and he acknowledged that it happens. Mine always began around 4:00 a.m. The trick is to have whatever medication you need or other treatment devices, placed at the head of your bed so you don't have to get up and walk around. My surgeon gave me Ambien and I hated it. I quit cold turkey and called my to tell him that we needed to find another option. Well, after a while with consistent sleep habits, it just went away. We call that taking a "poof" as in "Poof, go away....you are gone."

My real comfort was Miss Roxie, who got up to go outside and then came back and planted her self right alongside me. I don't know why but that really helped. Of course, so did the medical cannabis tincture. I added this picture because it shows you how she can take a pillow and twist it about until it becomes a bed. Sometimes when she would come back inside to find me still in bed, she just looked at me with a sense of almost disgust....like....what are you doing still in bed? She was my constant companion through all the surgeries. I couldn't have done it without her.

I also learned about fascia. The tightened fascia around the surgical area becomes layered and restricted. With gentle and soothing pressure, an MFR therapist can separate the layers and release the restrictions. If you have not tried MFR therapy, you may wish to give it a try. Here is the link to the website.
https://myofascialrelease.com/
If you are already awake with no chance of going back to sleep you may profit from doing the "legs up the wall" yoga pose. If you are interested there are images on youtube or just google it.

And I will say goodnight with one of my very favorite Roxie images. Sleep well. Let me know if there are any other tidbits of my experience you might like to share.

May you be free of suffering and the causes of suffering.

Chris

Hi @mom4twins4me, I am a little over a year out from my right knee replacement in April 2019. I had some pain with the knee for the first month or so. I think partially because I am a side sleeper and when my side would ache a little during the night I would roll over and that caused some problems for me. One thing the care team suggested to me was to add a pillow under the mattress at the bottom of the bed to raise it a little to help keep the leg a little higher. I also use a small pillow in between my knees and that helped the most I think.

My first follow up meeting with my surgeon when I wasn't doing really as good as expected, he chastised me for not following his instructions which he repeated to me again - ice and elevate, ice and elevate, ice and elevate. He did say it with a grin and in all fairness I thought I was icing the knee often and elevating it during the day...just not enough according to him so I picked it up and did it multiple times during the day which seemed to help a lot for me.

Did you receive any suggestions from your surgeon or care team?

@mom4twins4me I am sorry to hear of your nighttime pain. You were very brave to have bilateral TKRs. I have had two TKRs but at different times.
I don't recall having your problem. I did find when I tried to fall asleep that I was more conscious of the pain than I was during the day so I took tramadol before bed. Initially I had an opioid also but the doctor only prescribed them for a very brief time. Has your doctor prescribed anything?

@artscaping Roxie looks so much like the Cavalier we had. Does she have the typical Blenheim lozenge on top of her head? They have the sweetest dispositions which is why we chose that breed. My son and daughter were young and there was a constant stream of friends coming and going so I wanted a very non-threatening dog. The worst she would do was to lick a person to death. I had to have her put to sleep in 2006 when she was 14 years old, old for a Cavalier.
JK

Thanks for your reply.. I too am a side sleeper & I think that's it! LOL. I have pillows all over the bed. Plus when I go to my side I feel each I pound knee coming with me.:) Each day gets better.. I am the queen of ice & cant wait to get back on the golf course.. I walked one hole yesterday.. I was very stiff so got on the bike when I got home.. then ice.

Hi there:) Yes.. I am stiff during the day but I just read a great response to me , I think from John? He is a mentor & he said he is also side sleeper.. that's the problem.. LOL. Each day is better.. If, I would just stay on my back & not drag these I pound knees around, I would probably sleep thru it! 🙂 I'm the queen of ice & bike & rest..

Thanks for the imput.. I came home with an opioid & tramadol but got rid of them after three days @ home.. I didn't like the side affects & the possible addiction. I wasn't sure I would be able to do it but mind over matter.. I took the Tylenol PM which helped me sleep. I take two of those @ night & that carries me thru. I need to stay sleeping on my back with the pillow between the knees. I am a side sleeper. 🙂

Thank you for that informative post & that beautiful picture of Roxie. 🙂 I forgot to tell everyone my other problem sleeping @ night.. I have two of my fur babies that like to lay between the legs! LOL..Cats. Very good info you gave me. My physical therapist told me to massage these knees.. I do not want scar tissue building back up.. I too have my tylenol above my bed if I need it.. I feel very blessed to be walking & have walked one hole of my golf course yesterday.. Its coming just slower than I want.. 🙂

Thanks for your help, Colleen. Hoping to find someone else that had a bilateral ? Do you think I was the only crazy one? LOL. Both of my knees were severe with bone on bone & I'm 69 years old.. so, when the doctor asked me if I wanted to wait. I said " Wait for what"? I didn't have a good leg..

@mom4twins4me, Good afternoon, I am just checking in on your nights. Have you found something that lets you sleep on through that 4:00 a.m. awakening with pain? I liked your response......." wait for what?"

Be free of suffering and the causes of suffering.
Chris