Knee Replacement: Insomnia post-surgery

@matildaschmidt I too welcome you to Connect.
I have had two TKRs and both were different. I have heard that even when both knees are done at the same time by the same doctor, there can be differences post-surgery.
I know doctors are very reluctant to prescribe pain medications these days, have you had anything? I have read that ibuprofen is just about as effective as the various opioids. If your doctor will not prescribe pain medication can you at least get a prescription for something that will help you to sleep? I had a similar problem because I cannot take ibuprofen, just acetaminophen, and that is not a huge help at all. I did have a very small prescription for a pain med that lasted a couple of weeks and that did help.
I hope you are able to catch up on your sleep during the day, being sleepless is not good and I believe lack of sleep hinders healing too.
JK

Try a firm body pillow to put your whole leg on. I have had 2 TKR and was able to get comfortable and sleep. Advil PM also helps. Love my knees.

Hi @amytro
Like you, I'm 5 weeks post 2nd knee replacement and suffering from insomnia, extreme fatigue, weight loss and nausea. I had none of these 3 years ago when I had my first knee replaced. I was on Xarelto for 30 days to prevent blood clots forming and stopped my opiod pain meds 12 days after surgery. I couldn't handle the constipation and weird feelings. I do feel depressed because I wish I had more strength. Anxiety used to be a problem but years of therapy helped with that. 5 years ago I was diagnosed with bladder cancer and had chemo followed by bladder removal and have been doing well.. All my CT scans have been negative and I felt great except for my knee. Not a fan of doing it the second time but I figured I survived the cancer surgery and first knee a year later without major difficulty. Now, I'm struggling with my PT exercises because I'm so tired. Surgeon said he doesn't prescribe for insomnia. My PCP was reluctant to prescribe but gave me a small script of Trazadone to try. It hasn't done much, nor the melatonin I'm taking. Food doesn't interest me like it did before and strong smells and tastes can make me nauseous. My surgeon's PA thinks I will turn the corner around 6 weeks post surgery when most of the pain passes. We'll see as that's only a week away. 1-2 hours sleep per night is all I can manage. Sleep is needed to heal properly and have energy to exercise. So, yes, I'm fatigued and somewhat depressed. Hopefully it will improve soon. Trazadone is also an anti-depressant so maybe I haven't given it enough time to build up in my system yet?

Hello @cmar, welcome to Connect. I am glad you found the post by @amytro to be helpful given your similar experiences. I wonder if you might have seen an earlier comment on this discussion by @jellycats who offered some additional suggestions for dealing with insomnia post TKR? You mentioned being too tired for your PT, so if you’re comfortable sharing, how are things progressing with your therapy in light of your lack of sleep?

I have had 2 TKR. Both were basically not bad experiences and not too painful ( except 1.5 yrs. later I realize the 2nd leg may have some nerve damage?). I just want to mention a simple thing that worked for me re sleeping the first 2 or 3 months. I never had terrible pain; but at night while sleeping my leg would ache. So I started sitting in a comfortable living chair (not even a recliner), putting my leg up, and watching TV. I would sleep half the night that way. Actually, it was great! I could doze on and off, being distracted by TV, my leg was up on hassock, I could put ice pack on knee; I had basically no pain. It was being in a SITTING position with TV distraction that was the key. LAYING in bed was more of a problem. Strangely I became so used to this that I often do it now if sleep is an issue. Sounds so simple, I know - but it helped me. I hope it can possibly help you as well.

I had my left Knee replaced 5 weeks ago. I just wish they would of discussed all these post up symptoms, before the surgery. My goodness, I became so irritable, depressed and crying all the time. I also have had insomnia issues too. What helped me was, acknowledging what was causing it, accepting it and knowing that it all will eventually pass. I believe anyone does better knowing what to expect, beforehand. Not wondering, what is happening to them, causing the symptoms to worsen and becoming so afraid. Just like the huge bruise on my thigh. We were so scared when we seen it, not knowing what caused it, not knowing that this was normal. Doctors need to be more informative and listen more to their patients. Hang in there everybody, as this too will pass!

Hi @kizzie48, Welcome to Mayo Clinic Connect. One thing I think we all learn from Connect that may also help you is that the more we know about our health conditions, the better we can advocate for ourselves and hopefully have a positive outcome for any future treatments. I'm about a year and half out from my right knee replacement and even though I did a lot of research and talked with my surgeon and care team before and after the replacement, I struggled some the first few weeks. I thought I should have been further along after 3 or 4 weeks that I was and found out in no uncertain terms from the surgeon on my follow up that I was not doing enough icing and elevating of the leg. I was doing all of the rehab exercises and thought I was elevating and icing enough until we had that conversation.

What is giving you the most trouble now with the left knee replacement?

Thanks. Hope you are doing better. My knee is great and I working through the rest. Take care.

It is my right iliotibial band and right hip. I working through it day by day.

Please everyone advocate for yourself. If your pain continues for a long time you can get a second opinion at a different orthopedic clinic. Sometimes it helps to have different doctors look at your problem. I have told my story on this site before but if you have not read it I will tell you my experience. Finally after 17 months of terrible pain with a few hours of sleep at night I found an orthopedic surgeon who listened to me. Come to find out I had a rare 'extra' bone in my knee called a fabella. I had a brilliant doctor who was able to remove this bone and it really helped me significantly. I still have knee problems but I am able to sleep at night.
I have had other health issues in my life that I had to fight to get recognized. This is difficult but you have a right to fight to get an answer. I really sympathize with all of you who suffer in pain and do not get enough sleep. I understand how awful that can be. When we have never had a knee replacement before it is so hard to know if what we are going through is normal. I kick myself for putting up with such unbearable pain for so long. The pain was so bad that when pulling myself out of bed I put all of the pressure on my spine and ended up with a spinal fracture.

I wish you all can find a solution to your pain and remember that it wouldn't hurt to get a second opinion.

katrina123