Sleeping comfortably with a new Total Knee- advice needed!

Posted by amytro @amytro, Feb 17, 2019

Does anyone have any suggestions for how to get comfortable a) while watching TV in a recliner and/or b. In bed? I have tried all of the pillow arrangements to keep my knee high above my heart (and the pillow towers tip over unfailingly!!) and not comfortable. Should I/can I bend my knee in bed to the extent possible if I'm sleeping on my side? Is this bad? I just can't sleep on my back with my leg straight out. I'm averaging 3-4 hours of sleep a night according to Fitbit. I am 9 days out from surgery. Thank you to anyone who can help with positioning.

@pthielen5923

Since movement within reason is the goal, my doctors encouraged whatever position allowed me to move. Keep knee elevated during day while sitting, but keep it flat with body at night. If you are not sleeping, you will not heal. After I weaned off the narcotics (as quickly as possible), I would use Tylenol PM to help on nights when I could not get comfortable. Btw…I weaned off narcotics by getting off during day first…the going down in strength over time at night…1 pill…1/2 pill…1/4 pill, then just tylenol. This worked for my 2 medial knee replacements, my repair of spiral fracture of the fibula and my tibial plateau fracture repair.

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@pthielen5923 – Hi Patti, Welcome to Connect! I liked your method of weaning off pain meds. Can you tell me what the difference is between plain old Tylenol and Tylenol PM. That might be the answer to my prayers! Thanks for your constructive comments.

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@debbraw

@pthielen5923 – Hi Patti, Welcome to Connect! I liked your method of weaning off pain meds. Can you tell me what the difference is between plain old Tylenol and Tylenol PM. That might be the answer to my prayers! Thanks for your constructive comments.

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PM includes antihistamine…in OTC dosage. Just took the edge off the pain. I learned this when I had the hands worked on…those are very VERY painful (LOTS of little nerves) and was in a cast with full elevation for 6-8 weeks (they take a tendon from your lower arm and create a new joint, so time in healing is a must). I was on narcotics for the entire time in cast…then weaned off. Learned from a very good doc that you can be more creative with meds as long as you are under the dosage. I got sick from anything I took at their dosage (gee…used to get high from Ipubrofen, so go figure??). So…instead of 2 percosets every 4-6 hours, I would take one every 3-4 hours…etc. I just used that same thought process as I got off them…reduce…see how you do…reduce more…etc. I hate the feeling of being on them, but they are a necessary evil in my mind, as long as my goal is to get off them all.

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@debbraw

Hi @amytro
I am 4 weeks post surgery for a left TKR. (My right was done in 2017). In terms of sleeping, it's still a little awkward for me. I sleep best if I elevate my surgery leg. My sleep preference is on my side and I'm just beginning to be able to turn on my side comfortably. I still can't stay there long.

@ellerbracke – Yes, that was me! Your memory is great. Thanks for your good wishes. I'm doing well. I had in-home PT the first 2 weeks and then started out patient PT. At last measure, I had full extension of my knee and was at 128 degrees flexion. I have been using a cane since the 2nd week. I can walk a little over 1 mile outside in my neighborhood. I take the cane, but I usually only use in on the trip home when I'm getting tired!

At this point, I'm trying to manage my pain meds. I am still taking 3 oxycodone tablets a day – 1 in the morning since I wake up stiff, 1 about dinnertime and one before bed. I feel like I need every one, but I'm going to try to cut out the dinnertime pill soon. I wish there was another option but the Extra Strength Tylenol does nothing for me and they won't let me take any NSAIDs. I had a bad reaction with some internal bleeding so I can't even take the Celebrex I was on to start with. @ellerbracke – didn't you say you got off the opiods very quickly? Do you have any secrets or tips? I have about 6 days left on my last prescription and I'd love to not need them anymore!

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Debbra: no tricks re. getting off opioids. I so far had a total of 4 surgeries for various joints, and other than the first 5 to 7 days after surgery I usually taper off rapidly. Probably a little too soon, since I end up with some bearable pain, but I want my indepence (driving!) back asap. Drove myself to outpatient PT 9 days after right shoulder repair. A little awkward hitting the turn signals and putting car in parking gear, but I was getting cabin fever. And generally speaking, most pain medications including opioids only seem to reduce pain for me, never take it away completely. And thankfully my PT people – not a single one in the group – have ever tried to painfully manipulate whatever joint had had the surgery, so I never needed to dope up before therapy. Continued success with your recovery – you are a shining example of determination (and, of course, also some luck?) with your progress.

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I think it's important to get off the opioids but I also think it's important to stay on them which trying to achieve PT goals. I know we all worry about opioid addiction, but the truth is that these drugs were created with very painful conditions like TKR in mind. I am following the dosage on the bottle and I find that without taking them, I cannot sleep, make progress at independent living, or progress in my flexion and extension. Tylenol does nothing for me. I admire people who can do with less but for those of us who cannot,I think it's important to not to feel guilty because you need the pain meds. My doctor has applied 0 pressure to get off of them. I am now at 3 weeks and 2 days post-surgery.

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@amytro

I think it's important to get off the opioids but I also think it's important to stay on them which trying to achieve PT goals. I know we all worry about opioid addiction, but the truth is that these drugs were created with very painful conditions like TKR in mind. I am following the dosage on the bottle and I find that without taking them, I cannot sleep, make progress at independent living, or progress in my flexion and extension. Tylenol does nothing for me. I admire people who can do with less but for those of us who cannot,I think it's important to not to feel guilty because you need the pain meds. My doctor has applied 0 pressure to get off of them. I am now at 3 weeks and 2 days post-surgery.

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Totally agree. Tylenol is totally useless for me, as well. Opioid addiction potential is highly overrated for acute post-surgical pain. My doctor has also been super generous with prescription for opioids after each procedure, it was always my choice not to use the full alloted amount. And still keep a few for “just in case”, and turn that “just in case” number in when I had a different surgery in subsequent years, and a new scrip. Which I also did not quite use up. I have 15 Oxycodone pills left (from 42 prescribed) that will probably mildew……. it’s the reassurance that I could take them if pain really and unexpectedly occurs. Not likely at 5 1/2 months after TKr.

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@ellerbracke

Debbra: no tricks re. getting off opioids. I so far had a total of 4 surgeries for various joints, and other than the first 5 to 7 days after surgery I usually taper off rapidly. Probably a little too soon, since I end up with some bearable pain, but I want my indepence (driving!) back asap. Drove myself to outpatient PT 9 days after right shoulder repair. A little awkward hitting the turn signals and putting car in parking gear, but I was getting cabin fever. And generally speaking, most pain medications including opioids only seem to reduce pain for me, never take it away completely. And thankfully my PT people – not a single one in the group – have ever tried to painfully manipulate whatever joint had had the surgery, so I never needed to dope up before therapy. Continued success with your recovery – you are a shining example of determination (and, of course, also some luck?) with your progress.

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@ellerbracke I was the same as you, being able to drive was a huge incentive to get off of opioids. I got off as quickly as possible. I was so sick of being house-bound.
JK

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