It is nearly the end of November 2017 and I have been back to my GP to talk about my knee again. It hurts, and it has been hurting for more than 23 years.
The first mention of my left knee problems in my medical record are for 1994 when I had an Arthroscopy in Stafford Hospital. It was performed by a Mr Travlos. I never did know what he did while he poked around inside my knee, but it was the beginning of a story that has continued to the present day.
This arthroscopy, a quite minor surgical procedure, must have been preceded by a visit to my GP to complain of stiffness and pain in my knee, and I no longer remember when the problem actually began. I ivaguely recall having physiotherapy in Witney where I lived before moving to Staffordshire in 1993, so that might be closer to the beginning of the saga.
Anyway, the 1994 arthroscopy was a success and I was happy with my knee for some time, but it was just the first of the warning signs about being affected by osteoarthritis.
Over the next two decades the knee issue returned and increased in severity, but by now I had been officially told of my arthritic tendencies and suffered various joint pains around my body. Neck, elbow, wrists, thumbs and both knees were now making my life difficult, and I was using painkillers on a regular basis. It was mainly Paracetamol but sometimes I used Ibrufen, but this anti-inflammatory pill affected a stomach condition I have.
Anyway, the next landmark was in 2012 when our GP decided I should see a consultant about a possible hernia. Although they did find a small hernia in my groin, the medical guru was less than impressed. My pain was suspected to be more of an orthopaedic nature and after a few more weeks of waiting I arrived in the consultation room of a Mr Collier in Cannock Hospital. Over the coming nine months I had multiple x-rays, an MRI scan, another arthroscopy, and various pain killing injections in my knee and also my hip. The outcome was that little could be done about the knee, but there was a twist to the story, as I needed a hip replacement.
Before Mr Collier had a chance to warm up his scalpel, Deb and I moved to new home in Herefordshire.
I had no idea that the medical authorities don’t believe, or trust the findings of their peers in other authorities. The findings of Mr Collier in Staffordshire were totally ignored, and my new consultant in Herefordshire (Mr Oakley) began the diagnosis from scratch.
I had more x-rays, and the knee and hip were declared to be perfectly healthy. Only after much pleading, I was given a further pain killing injection, which led to a hip replacement over a year later.
The knee was forgotten by the medical profession, and even I pushed it to the back of my mind while I dealt with the after effects of the hip replacement.
With my hip issues fixed, I began to be aware of my knee pain again, but also that original pain in my groin. I returned to my GP at the end of 2014 to talk about my issues again.
In terms of my knee, I came up against a wall of doubt based on Mr Oakley’s conclusions from the x-ray. It didn’t show any obvious issues, so my pain killers were notched up to full strength does of co-codamol.
…they were not really touching the pain.
The groin on the other hand did get some interest, and after several months I saw a surgeon who suspected I had an abdominal wall which needed a bit of extra support. In early January 2016 He inserted a quite large area of mesh over the affected area.
My groin now felt far more comfortable, but during 2016 my knee gradually became worse. My GP did eventually give me a pain killing injection, but this only gave a short period of relief.
The pain meant I had to give up dancing. Working in the garden was reduced to short spells to avoid long periods of near agony. Walking was still possible but not very far, before I required hours of rest to make the pain subside to acceptable.
So what symptoms was my knee giving me?
- The left knee was swollen compared to the right one. This was not obvious but indicated that something was not quite right.
- I had stiffness in the joint that made me want to rub it, but I couldn’t find the spot to rub.
- The knee joint ached all the time. I had become tolerant of this over the years, but if I relaxed, or kept my knee in the same position for a period, the ache would get worse, or at least more noticeable.
- There was pain at the top of the knee virtually all the time.
- When I knelt there was excruciating pain at the front, and the joint was very stiff.
- I tended to groan every time I sat down or stood up. Each time I rolled over, or simply moved in bed made the knee hurt, and this meant sleeping became very difficult.
- The same pain made going up or down stairs very painful.
In May 2017 my GP relented and sent me for an x-ray. Once again the results didn’t give him any sign of a problem.
He decided I needed a course of physiotherapy.
The physiotherapist checked out my stiffness, movement, and flexibility. She suggested I go on a programme run by the local NHS alongside the local Leisure Centre. It is designed to give support to arthritic knee and hip sufferers to learn about their condition, as well as some physical exercises to strength the muscles in the leg and encourage greater movement.
So for eight weeks I was supposed to have an hour’s theoretical discussion session from trained physiotherapists, plus a separate hour in the gym. The theory was a little useful, but to be honest I had been hearing the information for longer than the instructor had been out of short trousers. But I am competitive and love a challenge so when it came to the gym exercises I took it very seriously.
I spoke earlier that I had become tolerant of my basic knee pain. Medical people often ask a patient to say how bad a pain is on the scale of 1 to 10. Well that basic pain is probably level 2 or 3, and if I am not thinking about it, I can almost ignore it. The true problems are when something triggers short, sharp, moments of pain that can literally be banging on the level 8 or 9 levels. These moments may last a few seconds or a few minutes, but will probably fade away after a moment or two. Also after periods of working hard or over exercise, the resulting ache or pain can be again quite high, maybe 5 or 6, and that will often continue for several hours, or even days, before it subsides to the forgettable level again.
So in the gym I walked or cycled with a smile on my face. I got my heart rate up to near the maximum figure and set myself goals of the distance I achieved or the speed I did it in. This was sport to me and my body created sufficient of whatever chemical we can produce to mask pain during competition. It didn’t really cause me any pain….at that moment.
Turning to the muscle strengthening; I thoroughly enjoyed the weight work as I curled, pushed and pressed quite reasonable amounts of weight. Again I switched into competitive mode and did as I was told without any pain…at that moment.
When I had finished the sessions I got home and quickly dropped into pain mode.
After week two I struggled for several hours to calm down the pain, but by week five it took two or three days.
I had to give up before week six as it was obvious that this exercise regime was making things worse.
It was time to stop any more of this as we were going on holiday, and I wanted to enjoy it.
When we got back I went to see my doctor again. After discussing the lack of relief he once more said that my x-ray was not giving sufficient signs that I needed a replacement joint. Instead he said I should have an MRI scan to check out soft tissue damage.
Realising I had to go down every possible avenue before I get to the consultant, I agreed.
The MRI scan would take about 4 weeks to organise, so perhaps by mid-December, and the results just before the Christmas period.
I understand the need to filter out anyone who definitely doesn’t need to see a consultant, and I also understand all the various stages of x-rays, scans, pain killing injections, and physiotherapy…
….but it is frustratingly, painfully slow.
Don’t get me wrong, I don’t blame anyone.
The NHS has been overloaded for decades, and the situation gets worse year by year. My parents’ generation saw the beginning of free health care for everyone, and it is creaking at the seams now.
Too many mistakes have been made in an effort to save money. The worst thing is certainly shutting down smaller hospitals that could be used to look after those people who are currently bed blocking the major specialised hospitals. Hence many operations cannot go ahead, and waiting lists get longer and longer.
Sadly for people like me possibly heading for a new joint, it has resulted in a combination of delaying tactics, and long waiting times between and actions.
Of course as people get older, their recovery times after surgery possibly get longer before they can go home, meaning further bed-blocking.
In other words, the system is inevitably spiralling down into longer and longer delays.
And, what about those highly specialised, and expensive, consultants and surgeons?
What are they doing while they are unable to perform their life improving operations?
Well possibly they are doing lots of less specialised operations, or more likely they are spending more time at their private clinics. Of course that means many people are turning to those same surgeons at their private hospitals for the same operations that are delayed via the NHS.
The costs of such operations are ridiculous, and simply line the pockets of share-holders in the private medical arena.
Anyway I have no intention of spending the small saving pot that I hope will maintain my darling wife into her old age. I will wait for the NHS to run out of delaying tactics and hopefully get to see a specialist in the near future.
This story will be continued very soon…I hope!