So tired after total knee replacement

Hi, Pam...

I am 7 weeks post-op for bilateral knee replacement (btkr) and am extremely tired by 3PM and am forced to nap.  Since I am usually active with a full time job, this is just hard for me to deal with.  I cut back on my pain meds as they weren't working anyway and am still nauseous from them.  I know that anesthesia takes a long time to leave your system...someone on this blog said "for every 1-1/2 hours of anesthesia you need 1 month to get your stamina back."  OMG. That means I had 2 + 2 hours of anesthesia on both knees....I'll be exhausted for the next 3 months???  Does anyone else here know if that's true?

I found this on another surgical site:

"I'm not an anesthesiologist, but I remember looking into this at one point... there isn't one answer to the question of how long general anesthetic agents hang around in the body.

First, there are lots of different agents used for general anesthesia, and each one has its own unique pharmacology and pharmacokinetics. Most surgeries involve the use of at least two of them in combination (an induction agent and then the "main" anesthesia). 

Some agents are inhaled, and of those, some are eliminated very rapidly once the mask is removed - they are essentially exhaled unchanged. However, some are metabolized, and cleared by the liver and/or kidneys depending on how the liver processes that particular substance. Similarly, with the injectable agents, they may be eliminated by being broken down into smaller molecules or passed whole in the urine... most involve some combination of both. The health of the individual's liver and kidneys will affect the elimination time.

Another factor with some of the anesthetic agents is how long the patient was under anesthesia. The longer the surgery, the more likely that some of the agent has passed through the circulatory system and entered the fat cells, where it's harder to eliminate from.

I've seen widely varying values for a few of the more commonly used agents... most seem to hover around the five to seven day time period. However, Propofol in particular (commonly used as an induction agent) is longer lived in the body, and even Versed has been detectable in urine up to 10 days after a procedure in which it was used.

Three weeks seems hard to believe (unless the patient was in an ICU under anesthesia for days). However, the reason they say it stays for months in the hair, is that some drugs can break down into products that can end up being incorporated into the hair as it comes out of the follicles for the first several days after surgery... and that hair stays around until it's cut off. Same deal with finger- and toenails.

I hope this helps... I searched for quite a long time at one point and couldn't find any one source that summed it all up in a nice neat table, or any one statement of what the magic number of days was."

"

Not uncommon.  For me, and many others, being tired is part of the process.  You are healing from some pretty massive surgery, dealing with pain, interrupted sleep, drug side effects, discomfort, and probably some small amount of depression.  All of these suck up energy.   So goes the mantra:  Medicate, movement, elevate, ice, and REST!  This will probably consume most of your life for a while.

Good luck, be well,  REST!

Hi Pam, this is my 2nd Knee replacement as I developed an infections after 15 years with my 1st implant. Any infection in our body is a total disaster for us. They had to remove the implant, put in an antibiotic spaces for 8 weeks then do the total knee replacement. I am 2 weeks out of post op now. No energy this time, I need to nap all the time and rarely sleep through the night without waking up 6-8 times. Im off all pain meds except for Aleve and night time Aleve pm or Tynol Pm only works for a few hours. My Dr suggested sitting outside in the direct sunlight, no sun glasses, no hat for 15 min a day. It produces a hormone called melatonin. This hormone is responsible for helping a person feel sleepy and tired. Direct Sunlight also produces an increase in the brain’s release of a hormone called serotonin. This is associated with boosting mood and helping a person feel calm and focused. SInce I have made it a point to sit outside in the sun each day, I do have the ability to fall asleep more quickly and stay aslepp for at least 3 hours. Well it's a start. My Dr also asked me to drink way more water than I have been to cleanse all the medications and tonixs out of my system. Not such an easy trick to drink 8-9 bottles of 16.9oz water each day.

I go back to work in 13 days where I normaly work 12-14 hour days and walk 5-7 miles a day. I am a little scared that I will not be ready to step back into my game. Hearing al the other comments really helps me to not feel so broken and alone. Thank you all. God Bless.

afger 2 and a half months, still feeling tired even after a few jobs around the house or a short walk.  

It was very helpful to read all of these posts.  I thought I was not bouncing back as quick as I should since I am still tired and am just entering the 7th week.  Working part time and wondering if it was going to get better.  Now I see I am not alone and it will get better.  Can't wait until I can get through a day without wanting a nap. 

Active 55yo total knee week 4. I was wondering why I am so tired now I know thanks for the support

I just had a partial knee replacement 3 weeks ago.  The surgery went well and I was back to work in 2 weeks.  I am usually a go getter and bounce back from surgery, but I am feeling so tired.  I want to thank everyone for their feedback because now I know it is normal.  I do not sleep well at night r/t burning in the knee area.  Did anyone else feel this too?

Had TKR on 13th Feb and I'm all over the place with pain etc.

I haven't managed it very well but this business of being told to keep on top of the pain has not suited me because all this medication is either going to damage my kidneys or turn me into a drug addict.

God knows why it has to be so painful?

I feel like I've been in a torture cell these last six weeks.

I'm a 68 year old woman

Hi, all. Seven weeks PO right TKR. Frustrated with sudden fatigue. Frustrates my husband too as I've always been such a "doer". Glad I'm not alone and feel more "normal". Poor sleep has got to be a big part of it. I've got that crazy incision line pain handled though and that has helped Big Time. Yep, elevate, ice, drug before bed. But I discovered a trick from a YouTube: Wrap the knee with clingy plastic wrap. I used dressings at first to keep it dry. Then I changed it up to a elastic "Ace" bandage to eleminate the sweating of plastic wrap. It seems the constant pressure and protection from sheets and PJ's friction really helps with the electric painful jolts of nerve healing. Still awake a lot flopping positions. Getting better but still need that one hour nap. Wish I discovered this with my partial left knee two years ago.