Eleanor
Eleanor saw her GP about osteoarthritis in her left knee a year ago when she was “in real agony with it and I could hardly walk”. Going into her appointment to discuss possible knee surgery, she hoped that knee replacement would get her back to being able to get around and to care for her husband without pain. Eleanor had a total knee replacement three months later, which she feels has given her a “new lease on life”.
Eleanor is married and has four children. She is a retired clinic manager for a community dental service. Her ethnicity is White British.
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Eleanor has osteoarthritis in both of her knees and hands. Her knee problems have been getting worse over time, and she has ‘flare-ups’. Though her left knee was worst, both knees were painful when she walked and sometimes gave way or became swollen, though she had always managed to keep her balance and avoid falling. Eleanor takes medication for high blood pressure and a statin but generally considers herself “quite healthy”.
Living with knee pain made day-to-day activities like driving and pushing her husband’s wheelchair difficult for Eleanor. At times, she became tearful thinking about how much the pain impacted on her life. While her children have been supportive, she found the toll on her life to be a big shock: “I never thought it would come to that because I’m not that old, I’m only 72, and just this year has made me feel old which I don’t like”. Family events like Christmas needed to be adapted as she could no longer stand up for extended periods of time to cook. Eleanor was also unable to play with and look after her grandchildren as much as she would have liked to.
Eleanor first saw her GP about her knee problems a year ago when she was “in real agony with it and I could hardly walk”. She’s since been back a few times. Her doctor said to take paracetamol and then later she was prescribed codeine. At times, Eleanor felt she had to “push” to get information and more help with her knee problems. At one point she was “almost coming to the end of my tether”, but her GP recognised this when Eleanor cried in the surgery.
At a following GP appointment, a referral was made to a specialist knee service and Eleanor was prescribed amitriptyline to help in the meantime. She then had some X-rays taken, and Eleanor was called over the phone by a physiotherapist about three months later. The physiotherapist suggested some simple exercises for her to do but said that they couldn’t see her in person, which was quite disappointing. A letter then came through the post with an appointment date to see the surgeon, and Eleanor was surprised to get this appointment so quickly.
Going into her appointment to discuss options with the surgeon, Eleanor had hoped to get some information about her options and reassurance that she wouldn’t have to “go on like this forever”. She also wanted to find out more about the anaesthetics; as she had heard that sometimes the surgery can be done with local, rather than general, anaesthetic which was her preference. Eleanor also wanted to know how long she would be “off my feet” after the operation. This was important so that she could make alternative caring arrangements for her husband. Eleanor wasn’t sure how long the waiting list might be for surgery, and had been open to considering private treatment in the event of a long wait.
Eleanor had known for a while that she might need knee joint replacement surgery. She ultimately felt it was the surgeon’s decision and that she would “put my trust” in them. She also accounted for what her family and GP thought, with everyone seeming supportive of going ahead with surgery. Eleanor hoped that joint replacement surgery would let her get back to doing the things she used to do and “be almost normal again”. She wanted to walk and be “running around after my grandchildren”, and not be in “such awful pain”. She knew that the surgery might not “work” but was “prepared to take that kind of chance to get back to some kind of normal life again”.
In Eleanor’s appointment with the knee surgeons, she was shown her X-ray scans and asked if she wished to proceed with surgery. She felt very sure about moving forwards based on the amount of pain she was living with. The doctor talked her through the risks from the anaesthetic, which she found frightening but considered to be necessary information. Eleanor’s surgery went forwards three months later, which she considered quite fast. On the day of the operations, her tests all came back clear, and she took her blood pressure tablets as usual. She had local anaesthetic but also fell asleep, waking up again once the surgery was over. She feels that her surgeon was “brilliant” and that the healthcare team all explained things very well.
Eleanor’s recovery went smoothly and she was pleased with the care she received. She needed to stay at the hospital for an extra night as she was feeling faint, but left the next day after “having a rest”. The remainder of her recovery was at home with the help of her daughters and son who helped care for her and her husband. Eleanor felt that the process of having the staples taken out of her knee at home by a nurse was “worse than even having the operation”. She briefly used the crutches and Zimmer frame provided by the hospital, but stopped shortly after as she didn’t want to rely on them. The pain and swelling from the surgery eased off after about a month, and Eleanor has since stopped taking daily painkillers. She attended several physiotherapy appointments, and continues to do the exercises at home. At her follow-up with the surgeon, he seemed “quite happy with everything” and was impressed by how much her gait had improved. She still has some numbness down one side of the knee, which the doctor told her was to be expected and could take around a year to resolve.
Eleanor currently feels that it’s “all going very well” despite some minor discomfort in her joints. She is impressed that she is able to walk further and kneel comfortably. She now feels that she has a “new lease on life” and appreciates that she is able to go out with her husband and grandchildren more. While moving her husband’s wheelchair was painful before, she is now able to manoeuvre it “automatically”. Eleanor is hopeful that she won’t need to think about surgery on her right knee for the next few years as it currently isn’t bad enough to warrant seeing a doctor.
Looking back, Eleanor feels that the outcome of surgery is even better than she had expected. She finds that not being in pain “just lifts something from your head”. Eleanor is relieved that she’s “got some life back”, particularly as she had been worried about becoming housebound. To others considering knee replacement surgery, Eleanor recommends going ahead with the procedure and chatting to people who have gone through it. Before the operation, she had spoken to a friend who reassured her it would be okay whilst being honest about the bad parts, which she valued highly. Eleanor also had leaflets and a DVD about knee surgery provided by the hospital which she found helpful.
Eleanor felt old having knee problems. Her reliance on others had increased and she was upset thinking about how things have changed.
Eleanor felt old having knee problems. Her reliance on others had increased and she was upset thinking about how things have changed.
Yeah, oh, the impact -, I really don’t have much quality of life at the minute because I can’t get out. I’ve got young grandchildren who I look after and they’re always wanting me to lots of things with them, you know, three-year-olds, four-year-olds like you to run about after them and I just find that now I can’t do it.
You know, and even down to this Christmas, it’s the first Christmas that I haven’t held Christmas day in my home because I can’t stand to cook up for a long time. So fortunately, my daughter is having me for Christmas day at her home but I feel that has impacted on my life as well because I’m not used to others-, I was always used to entertaining the whole family, you know, and I’m just not able to do that this year.
It definitely has had a mental health effect on me, you know. I find myself in tears quite a bit thinking about it, ‘oh gosh, is this what my life’s all about now’, you know, and that’s not good.
My children are very good, you know, and get me along and take me out and things like that but I never thought it would come to that because I’m not that old, I’m only 72, you know, so. And just this year has made me feel old which I don’t like, you know.
Eleanor talked to her family and her GP about her decision. When the surgeon said she could have knee replacement surgery, she knew straight away she would have it done.
Eleanor talked to her family and her GP about her decision. When the surgeon said she could have knee replacement surgery, she knew straight away she would have it done.
Oh, I knew right away I would have to, it was the only way, and then when he said how bad it looked on the X-ray and so on. He says, “I know you're in a lot of pain, we'll get this done if you're happy with that?” And I said yes, I definitely was; I wanted the pain away.
Which has happened, so it really has.
I wondered as well: in addition to talking to the surgeon, was there anybody else that you talked to that sort of informed your decision to go ahead with the surgery?
Well, obviously just family really, and what they thought about it, and they were all for it because they knew what I'd been like. And my doctor at the surgery, you know, because she was good. So yeah, I talked to her about it and she just said, you know, “Do it, just go ahead and do it.” So yeah, it was sort of the doctor and family; that was it.
Eleanor had an epidural in her spine and a sedative injection into a vein in the back of her hand which made her feel “woozy” during her operation.
Eleanor had an epidural in her spine and a sedative injection into a vein in the back of her hand which made her feel “woozy” during her operation.
Yeah, they go through all the usual risks about anaesthetic, because I had a spinal, like an epidural into my spine and because they tell you about all the risk with that, you know, anything, which scares [chuckles] the hell out of you because they tell you could be paralyzed or anything.
But that’s - you know - they have to go through all that; they have to tell you all that. But honestly, that as well was amazing. I hardly felt that because they put like a little anaesthetic in beforehand, before I had the spinal and I didn't really feel much of it at all.
And then during the operation they said to me, “Do you want to listen to some music?” So, because I had ear buds in, I said, “Oh yeah, yeah, I'll listen to the music.” He said, “I'm just giving you a little anaesthetic into your hand, it won’t knock you out but it will make you feel a bit woozy.”
Well, it did perfectly knock me out: I went to sleep, so I didn't hear much of my music and the next thing, he woke me up and says, “It’s done!”
Wow, goodness.
So, [chuckles] so that was quite a - if you have to say it - a good experience, you know? Because I was a bit worried because you don't get - it’s not a general anaesthetic - so you can more or less see what’s going on. They put a sheet in front, and he’s behind the sheet, but I thought, ‘oh, I don't want to hear noises and things,’ but I didn't, because I was so woozy, I think I went to sleep.
Yeah, wow, gosh.
So...
When you came back from the anaesthetic, how were you after that?
I was fine, yes, they watched me for a while and then took me back to the ward and I was okay.
Eleanor’s knee was very painful for the first few weeks following her total knee replacement surgery, especially in bed but improved after about a month.
Eleanor’s knee was very painful for the first few weeks following her total knee replacement surgery, especially in bed but improved after about a month.
I think it will probably be about a month afterward, because obviously, you know, with the healing and everything, that’s always very painful and I remember the first few weeks being very uncomfortable in bed because I couldn't-, I didn't know where to put my leg, you know, to get it comfortable and so on.
But I suppose after about a month I knew that things were better because the pain was starting to ease off and I could move my leg better, so I suppose it took about a month, yeah.
At her follow up with the surgeon, Eleanor saw the x-rays of her knee before and after replacement surgery. She asked him about the numbness down one side of her leg.
At her follow up with the surgeon, Eleanor saw the x-rays of her knee before and after replacement surgery. She asked him about the numbness down one side of her leg.
It’s absolutely fine. I've been to see the consultant and he’s discharged me because he’s pleased with it all: it’s weight-bearing and I can more or less twist it anyway. The only problem that I have with it is it’s numb down one side, but when I said that to the consultant, he said that this could take about a year to right itself.
But it’s a strange feeling, you know, down one side being numb? But apart from that it’s all going very well.
And it was the last appointment, as I said this to you before, he showed me the X-rays of my knee before and after, and it’s amazing, I don't know how I even walked on it: I'd hardly any cartilage or anything left, and it was just amazing to see the difference from one to the other, you know, how that has improved.
Oh, that’s brilliant.
So that was interesting as well, so he really kept me in the loop, he explained all the way along what was happening, yeah.
The last time I saw [the surgeon], he discharged me and said unless I wanted to, he was quite happy with everything, and I feel fine, so I don't need to see him at the minute, you know, everything’s gone well.
Eleanor was unable to walk to the end of the street before. Now she goes for walks most days to keep her knee moving.
Eleanor was unable to walk to the end of the street before. Now she goes for walks most days to keep her knee moving.
Oh yes, yes, much better, I can actually kneel on the floor and actually get up, because I never could before, it used to take ages to try and, you know, get the knee sorted to get up off the floor and now I can do that, and I'm walking more on it as well, I'm trying to go out for walks most days just to keep it going, you know?
Which is great because it used to be I couldn't walk to the end of the street, the pain was so bad, you know? So that’s certainly changed.
That’s brilliant. And I know that you said last time, you've got young grandchildren, don't you? So, sort of getting—
Yes.
—down on the floor and being able to play it must be really lovely?
Ahh, it is, it is, it’s so funny because the little one, she’s just four, and she’ll say to me, “Grandma, I don't have to lift you up anymore,” because she used to give me a hand, you know, [chuckles] to, lift me up, so—
So sweet.
So yes, that is much better. I feel like I've got a bit of life back again, you know?
That’s so good to hear; brilliant.
Yeah.
And how has the rest of your health been since we spoke it-, the first time, so about nine months ago?
Oh, fine, fine, you know, now that the knee and all’s done: I've got a new lease of life so everything, touchwood, has all gone fine.
A friend’s experience of knee surgery helped Eleanor to be aware that there could be temporary complications afterwards.
A friend’s experience of knee surgery helped Eleanor to be aware that there could be temporary complications afterwards.
Yes, I had one friend who’d had it done a couple of years ago, so I spoke to her about it as well, and she sort of reassured me, though she unfortunately was a bit worse than me because she had actually developed an infection in the knee.
So, she said, “I'm going to tell you that because I'm not going to keep anything back.” She said, “that only happens, you know, one in-,” I don't know, “I was just very unfortunate,” she said, “that that happened to me.”
So, I was aware that things like this could happen, but it really didn't put me off because again she said once that was all over, she said she’s had a new lease of life as well. So that helped, yeah.
And I was glad that she hadn’t pulled any punches that she told me what could happen.
Eleanor’s surgeon gave her a video to watch before her operation which helped her to decide to have knee replacement surgery.
Eleanor’s surgeon gave her a video to watch before her operation which helped her to decide to have knee replacement surgery.
He gave me loads of leaflets and actually, he gave a little video as well to watch about what happens and that was really good, so I watched that beforehand. Obviously, they didn't go into the whole operation, but that was just to tell you what happens and about other people having it done; it was very interesting.
There was a woman in it who was in the same situation as me because I could see it from when she was told she was going to have the operation, till afterwards, and she was walking up steps, you know? Stone steps near where she lived, and I thought, ‘oh, I'd just love to be able to do that.’ Because I could never do that, and she was practically running up these steps, and that was after she’d had the operation done.
So, when I saw that I thought, ‘I’m definitely going for this, you know, I want to be able to run up stone steps.’