5 wks postop. Wake every two hrs in pain. What should I do

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I AM 5 weeks postop for total right knee. I wake up every 2 hours with pain and am not getting any quality sleep. With the new opioid laws, they want me to titrate down on the NORCO. I try, but am still in pain. what do I DO?? very frustrated!

Gail

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  • Posted

    Hi,

    Sorry to hear you're still in that much pain. I find that ordinary opioid painkillers are not very effective for me and I cant take NSAIDs but I did find that Tramadol was effective. I think it might be known as Ultram in the states? when I was I hospital was on 2x50mg 4 times daily and that helped alot. Don't know if you Dr will let you try that but fingers .

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    • Posted

      Hi,

      The Norco does work but inly for two hours. I did get a script for Tramadol for in between breakthrough pain, and was still waking every two hrs with pain. I don't know if my situation is a little different because I has valgus, Along with a torn meniscus, bone on bone, and arthritis. I'm just frustrated that i can't get more than two hrs at a time. Occasionally, like two, I was able to get three. I even wake every hr at times. i ask for refill meds and i get them, but they titrate them and i am afraid I am going run out of pain killers and then still be in pain. I haven't talked to the surgeon since the surgery, only the MA.

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    • Posted

      I was actually on Tramadol plus 2 paracetamol every 4 hrs so that might make a difference for you? Hope you get it sorted soon. Just remembered I did occasionally take an NSAID painkiller that I was prescribed for my arthritis before the ops that helped. Its one I can get away with occasionally and is called Arcoxia or Etoricoxib and is especially for arthritis type pain. Fingers for you.

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  • Posted

    Oh I remember those 2 hour wake up calls so well! I don't tolerate opioids and gave them up after the first week, but found taking 2 x 500 mg paracetemol/tylenol regularly every 6 hours plus using Voltarol at night, putting pillows under the whole of my leg from bottom to toes and wrapping my knee in clingfilm once my wound had healed and all scabs fallen off helped. How much are you doing in the day? Maybe you're overdoing things at this stage? Are you icing and elevating regularly still?

    If you're doing all that and the pain is still unbearable maybe you need to see the surgeon again. When do you have your review? I hope things improve soon for you.

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    • Posted

      i take the norco every 4 hrs, icing, and elevating all the time. I do think that FRIDAYS Physical therapy I did over do a bit, but its every night regardless of therapy or not. I try to supplement with ibuprophen and sometimes excedrin (acetaminaphen/aspirin/caffeine) and still wake every two hrs. i thought it strange that my two week postop visit was only ti get my staples removed by a Medical assistant. That's it. My next appointment is Jan. 6TH.

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    • Posted

      That sounds similar to the UK. I had my staples out at my GP Practice by the nurse and saw the surgeon at 8 weeks post op. Apart from the exercises I came out of hospital with I didn't start formal physio for 6 weeks. I attempted an exercise on my own back at 4 weeks and took a giant step backwards!

      It took a while for me to get past seeing every second hour on the clock all through the night, but the clingfilm (saranwrap I think you call it) made such a difference. It might be worth trying, but if you still have any scabs you must wrap your knee in kitchen paper towel first. I remember the bliss of sleeping through 5 hours so hope you get there soon. This recovery is a marathon that's for sure.

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  • Posted

    Im in the UK and 3 months post op. i was given sleeping pills ( Zopicone) which helped to knock me out at night. Im now on Amytriptyline which combines pain relief / sleeping aid. Not sure what the brand names are in the States? Im still taking an icepack to bed each night in a coolbag and surround myself with pillows to prop my knee into a comfortable position.

    Im afraid you will have a few more months of sleepless nights but I am seeing a small improvement each month, so am optimistic it will get better.

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  • Posted

    i am 6 weeks tomorrow from tkr of left knee. i sleep with a pillow between my legs and take tylenol at night. Also I started taking my Gabapentin at night which helps relax me because I was having restless leg. Before starting the Gabapentin back I took Zquil to help me sleep. Ice your leg before you fo to bed will also help.

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  • Posted

    It should start to get better soon. When i first went to bed i would take benadryl and it would help me sleep. I also found when the pain woke me up i would watch a tv show on my Ipad this took my mind off the pain and I would fall asleep. Or i would go sleep on the couch and put the TV on and fall asleep. Sometimes i would put my head phones on and listen to spa music to help me relax. Other times I'd get up and ice the leg...read a book. All these things helped me cope with nights.

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  • Posted

    The first 12 weeks are usually the most painful. Very few people avoid that. Therefore, everything you say is absolutely normal for the vast majority of TKR patients. You are definitely not alone.

    Talk to the doc about titrating down from the Norco to Tramadol. It is the mildest of the opioids but can still get you some relief. Remember that NSAIDS (ibuprofen) should not be taken long term due to potential stomach damage. You might try some Tylenol Arthritis Strength but you should not be on acetaminophen long term either.

    For sleep, try some of these tricks...

    Sleeping

    None of this is any fun...at all!!! However, it does ease up in time. Concentrate on your ROM right now. You would like to target a full 0 / +120 ROM at around 12 weeks. After that, you start the months-long muscle rebuild which is mandatory to walk correctly, get your balance back and be able to do stairs alternately like you used to. Yes, a typical recovery takes a full year...not many escape that path.

    The good thing is that long-term you will forget about this phase and rejoice in a pain-free knee. I'm coming up on four years soon and I can tell you that it was worth all the pain and work. I barely notice it anymore.

    Post this on your fridge...

    Reality

    Get rid of all your expectations. Time, work and patience are your tools. Take good care of yourself. Listen to the knee!!!

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  • Posted

    Hi Gail, sorry to hear your plight, i was exactly the same waking every 2 hrs . i came off the opioids pretty quick and took 2 codeine and 2 paracetamol 4 times a day spread over 24hrs. Also lots of ice packs...it really does work. i am 11 weeks in and still have sleepless nights, not with pain but a tension in my right knee area, it usually becomes comfortable again with the use of an ice pack. please dont give up as it does get better with time and patience. dont forget to do your exercises, it helps with a quicker recovery.

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