Ann
Ann had a total knee replacement on her left side in 2008, and a partial knee replacement on her right in 2015. Her right knee became very sore and swollen after a sudden change in direction. She has been told it is a soft tissue injury and that surgery is not required.
Ann is a retired nurse. She is widowed, and has two adult daughters, 2 granddaughters and 3 grandsons. Her ethnicity is White British.
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Ann had a total knee replacement on her left side in 2008. She was very happy with the results after the surgery but thinks she overdid it and developed neuropathic pain. Ann also had a partial knee replacement on her right side in 2015. After a sudden change in direction, she heard a ‘twoo’ sound from her right knee and thought that a ligament had torn; the knee then stayed very sore and swollen. Her GP referred her to see the surgeon who had fitted the partial knee replacement.
Ann describes herself as healthy but with sensitivities to medication. She is allergic to morphine, and finds some other pain-relief (like paracetamol) isn’t strong enough. She takes pregabalin for the neuropathic pain in her left knee. For several months after injuring her right knee, she also took naproxen. However, the naproxen upset her stomach so she took it sparingly and also had reflux medication. Ann finds it helps to use a TENS machine everyday on her knee. She takes lithium for biopolar disorder, which has required medication for her thyroid and caused weight gain.
Before going to the appointment with the surgeon, Ann was unsure what to expect. She wondered if she might need surgery to replace the partial joint or fit a total knee replacement, and had concerns about developing more neuropathic pain. She expected the appointment would be with the surgeon who had previously operated on her. She had a good rapport with this surgeon, and her background as a theatre nurse also helped.
Ann’s appointment to assess her knee was with a different specialist than she had expected. She “wasn’t enamoured” with this specialist and felt that she was being talked to like a child. She was meant to have an MRI scan, but couldn’t because the machine was broken. She had to go back about a month later and this time she saw the surgeon she had originally expected to see. The surgeon told her that her knee problem was to do with the soft tissue, which would heal with time. However, Ann had previously had an MRI scan and recalled the radiographer talking about something having “broken off” in her knee. She wondered what the radiographer had been talking about, but didn’t ask because the surgeon seemed to be in a hurry. There was no mention of physiotherapy, but the surgeon said she would need to come back in about 9 months for a review. Ann wonders whether there might have been more treatment options for her knee if she had been seen by specialists sooner, whereas now she has to wait for it to heal naturally.
Soon after the appointment, Ann heard about lidocaine patches through a friend and requested these from her GP. She stopped taking naproxen and the patches work well. She is able to move around her house, and uses mobility aids (like a walking stick and walker trolley) when going outside. She has an automatic car and mobility scooter, so she can get into town. Whatever happens next with her knee problems, Ann thinks she will still need to use her mobility scooter. She worries about her weight and the risk of diabetes as she is unable to exercise. Ann has recently hired a cleaner because she is no longer able to manage household tasks on her own. She enjoys gardening and attending dog shows; Ann can still garden, but it takes longer and she needs to have rests as she goes.
An automatic car and mobility scooter helped Ann to stay active.
An automatic car and mobility scooter helped Ann to stay active.
And I’m a bit insecure so I walk around with a walking stick and if I go outside, I take the, what I call the trolley. So that I can walk and then sit down, walk and sit down. Well, the walking stick I bought myself, and the trolley I got from the physio department.
I’ve got an automatic car. And so, I don’t have to clutch, I just have to brake, and that’s my right leg, which is the partial knee.
And then I’ve got a mobility scooter. ‘Cos I can’t walk the distance. So that keeps me active, I can slip off into town. Drive into town, go to the car park and offload my, my scooter and I’ll go into town. I used to be able to go and, with my scooter. Sit on the scooter and watch the rings performing and stuff like that, but they’re restricting now, no visitors. Which is I find very, you know, I used to enjoy the weekends because I’d get out in the fresh air and watch, watch the dogs and watch my daughter judging if she’s judging, or, or if she’s competing, and, yeah.
Ann’s knee pain is caused by soft tissue injury and not due to osteoarthritis which the surgeon said would heal on its own in time. She has started using a pain relief patch.
Ann’s knee pain is caused by soft tissue injury and not due to osteoarthritis which the surgeon said would heal on its own in time. She has started using a pain relief patch.
And when I saw him, he just said, “Oh well it’s soft tissue injury and, and there’s nothing much that we can do. It’s just a question of it healing on its own.”
And I went, “Oh great.” “And it’s going to take a year."
Meanwhile the pain doesn’t stop. But I have got a patch. It’s a lignocaine patch which helps numb the nerves. He didn’t mention anything about surgical intervention. He just said, “Soft tissue’s gonna take a year.” In other words, it’s a slow process and you’ve just got to have patience.
Yeah, and it sounds like it was through your friend that you knew about the pain relief patches.
Yeah.
It wasn’t sort of suggested?
Yes, it was, it was just, I was having, I went to have coffee with her and she said, “Oh my carer’s been on leave, can I ask you to put this patch on my back?” So, I said, “Yeah, no problem.” And so, I put it on her back and I said, “What is this?” And she brought me the pamphlet and I read it and I thought, “Oh, this could do with me.”
And so, I sent a message to the surgery, and she didn’t even discuss it with me, she just prescribed it, and I’ve been on it ever since. I think I’m onto my fourth box now.