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New - knee surgury, sleeping on back
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Peter_C Offline

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Post: #11
RE: New - knee surgury, sleeping on back
Again speak to either your Ortho or PT doc, but a 'muscle stim' unit helped me greatly with my hip replacement, did not think to try it with the knee. Some Docs say to only use them 20 minutes at a time, and some will say use them as long as you hurt. I used mine a good 4-6 hours at a time for 3-4 weeks (daily). Simple units that use recharge-able batteries can be had for around $100 bucks or so - it's the 'reusable' pads that can add up - helps to keep them in the fridge.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
06-10-2014 11:40 PM
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DocWils Offline

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Post: #12
RE: New - knee surgury, sleeping on back
Alas, since you are not my patient and the rules here forbid it, I cannot give you my set of exercises for the knee, post replacement (your physio will do that eventually anyway) but for now, put a soft pillow under the knee to give it support at night, and keep your ankle and foot well exercised and mobile. As soon as you can stop pain-killers, do so. While tramadol will certainly stop pain, opiates as a whole will cause respiratory irregularity when sleeping, and have other side effects that you may prefer not to have (severe constipation comes to mind). NSAIDs can cause stomach distress and bleeding, but will not impact on your sleep pattern. So if you take NSAIDs (Naproxen, Olfen, etc) take them with a PPI to counter the negative effects (Omeprazol, etc) or take them with Diovol.

Until you can sleep on your side (and when you do, use the pillow to cushion one knee from the other), raise your chest and head a bit with pillows or some other method, so you are not flat on your back for the night. This will help to mitigate any positional apnoea. Do not prop up only your head, this will tilt you chin forward and constrict your airway, you have to raise both head and chest.
06-11-2014 06:23 AM
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ThatOtherGuy Offline

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Post: #13
RE: New - knee surgury, sleeping on back
I have a complete knee reconstruction last year so can really sympathise with your plight, sleeping with a full knee brace is the pits. Support with pillows etc is the go, anything to make it more comfortable. I had to stay away from the opiates as I react very badly to them, Morphine, Codeine, Tramal, Tramadol, Oxycontin, Endone and all the other various names they come with. The Pain team at the hospital ended prescribing me with Buprenorphine sublingual tablets and PCA Fentanyl in hospital. I ditched the Fentanyl very quickly, but it took nearly 9 months to quit the Buprenorphine, its a drug you need to wean off gradually because of some of the side benefits such as being a mild anti-depressant. It was good though as it dealt with pain very well for me without many of the other bad side effects that opiate based medicines have on me.

Good luck with the recovery and listen to your physiotherapist. I did lots of water based physio after the reconstruction and achieved some excellent results that have my surgeon ecstatic. My philosophy in my recovery was to be like an arrow. An arrow has a purpose, but to achieve its purpose it must first be drawn backwards in the bow before being launched forward to its goal. Some days you are drawn backward, some days you launch forward. In the end you will reach your goal.
06-11-2014 06:53 AM
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Peter_C Offline

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Post: #14
RE: New - knee surgury, sleeping on back
(06-11-2014 06:53 AM)ThatOtherGuy Wrote:  Good luck with the recovery and listen to your physiotherapist. I did lots of water based physio after the reconstruction and achieved some excellent results that have my surgeon ecstatic. My philosophy in my recovery was to be like an arrow. An arrow has a purpose, but to achieve its purpose it must first be drawn backwards in the bow before being launched forward to its goal. Some days you are drawn backward, some days you launch forward. In the end you will reach your goal.

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*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
06-11-2014 11:07 AM
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Clay L Offline

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Post: #15
RE: New - knee surgury, sleeping on back
I had a hip replacement that precluded me from sleeping on my right side for a couple of weeks and I used a pillow between my legs - it helped me sleep on my left side.
I was completely off the pain meds in two weeks. The surgeon had me take oxycontin at night for two full weeks to make sure I got some sleep but I didn't really need it the last few nights. He was fully aware that I had sleep apnea.
06-11-2014 04:22 PM
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Peter_C Offline

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Post: #16
RE: New - knee surgury, sleeping on back
opioid pain meds and OSA do not mix well. Depends on many details I for one am not qualified to determine. I am in Pain MGNT, and have been taking pain meds daily for multiple years, and my sleep doc is less-than-thrilled to say the least.

I also wear a recording Oximeter with a alarm set to go off at an O2 of 75 - which will wake my wife at least if not me. Quality of life vs the very real risk of me forgetting to breathe. But, my heart issues are now both better and stable (which is not yet the case for the OP).

I have huge empathy for the OP, and wish/hope he voices his pain and concerns to all of his doctors, and so kind of answer is soon coming.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
06-11-2014 04:57 PM
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APAAW Offline

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Post: #17
RE: New - knee surgury, sleeping on back
(06-11-2014 06:23 AM)DocWils Wrote:  Alas, since you are not my patient and the rules here forbid it, I cannot give you my set of exercises for the knee, post replacement...

Would there be knee exercises appropriate for a general public otherwise? I get the occasional knee pain - and I would prefer to avoid having to complain to my physician about my knees, unlike everything else... Smile
06-11-2014 08:50 PM
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gingigingi13 Offline

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Post: #18
RE: New - knee surgury, sleeping on back
Hi All,
Well I went to the pulmonologist. He is ordering an oximetry recording and after he makes sure that my congestive heart failure is totally cleared up, I will probably have another sleep study. From there, he will decide. He thinks I would probably do better with an apap. More to come. Thanks for everyone's support and help.
06-11-2014 09:16 PM
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DocWils Offline

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Post: #19
RE: New - knee surgury, sleeping on back
(06-11-2014 08:50 PM)APAAW Wrote:  Would there be knee exercises appropriate for a general public otherwise? I get the occasional knee pain - and I would prefer to avoid having to complain to my physician about my knees, unlike everything else... Smile

Look a the general chain of weight bearing, from foot to lower back, abs, and balance them out so that the they are well strengthened and stable. Often the ankle or the lower back and abs can unbalance the knee by placing too great load on them. At the same time the most common problem for knees is an imbalance between the quad muscles, the inside or outside muscles pulling too much and turning the knee can off its centre as the knee flexes. Try Googling "chondromalacia exercises" and you will find charts of exercise for not just the knee, but the back and ankle, all of which can help.
(This post was last modified: 06-12-2014 05:14 AM by DocWils.)
06-12-2014 05:12 AM
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DocWils Offline

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Post: #20
RE: New - knee surgury, sleeping on back
(06-11-2014 09:16 PM)gingigingi13 Wrote:  Hi All,
Well I went to the pulmonologist. He is ordering an oximetry recording and after he makes sure that my congestive heart failure is totally cleared up, I will probably have another sleep study. From there, he will decide. He thinks I would probably do better with an apap. More to come. Thanks for everyone's support and help.


Good luck, and I think you are taking the right course of action.
06-12-2014 05:13 AM
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