Jacqueline

Brief Outline:

After her GP put in a referral, Jacqueline waited for 16 months before seeing a knee specialist. Drawing on her hip replacement experiences, Jacqueline had an idea of what recovery from surgery would be like. Jacqueline’s surgery took place five months after her orthopaedic appointment. She is pleased to no longer have knee pain.

Background:

Jacqueline is retired and previously worked in office accounts. She is widowed and has three children. She lives in a family garden annex. Her ethnicity is White British.

More about me...

Jacqueline had pain in her right knee from arthritis, which sometimes woke her up at night. Arthritis also affects her shoulder, ankle, and hands, and she described the finger joints as “swollen and the knuckle parts out of shape”. Her previous GP thought she might have rheumatoid arthritis, but this did not show up in test results. Jacqueline also has psoriasis and recently heard for the first time about psoriatic arthritis. Jacqueline had a transient ischemic attack (TIA or mini stroke) in 2015; since then, she has used a walking stick. She takes a blood thinning tablet, and also medication for high blood pressure. Jacqueline had her left hip joint replaced and then again two years later, as it “gave me a lot of problems” and dislocated three times which was “absolutely excruciating”. She was surprised when the surgeon told her the first hip replacement had “worn out in two years” because “it’s supposed to last at least ten years”. Since her second hip replacement, “touch wood, it has been fine”.

 

When having knee problems, Jacqueline tried to stay active, doing her own housework, shopping and gardening, but her knee was very painful. She took paracetamol every day and has a morphine patch which she was originally prescribed about eight years ago for arthritis in the other parts of her body. Jacqueline says it was “a choice between [requesting surgery for] my knee or my shoulder; although my shoulder has been ongoing longer, I thought if it was better to have my knee done because I need to walk”. She explained that mobility was important and in particular that she didn’t want to “end up in a care home […] unless it’s absolutely necessary”. Previously, Jacqueline considered having a shoulder operation but decided against it as she was then a carer for her husband.

 

The problems with Jacqueline’s right knee began with “just the occasional twinge”, but gradually became worse. She visited her GP in 2020, at the very beginning of the Covid-19 pandemic, when her knee was quite swollen. Her GP put in a referral for her to see knee specialists “because you don’t know how long it’s going to take to get it done”. Jacqueline is glad her GP did this, as her knee problems became worse over the 16 months that she waited for her referral appointment. At the time of the first interview, Jacqueline had an appointment to see a surgeon later that day: “I shall be glad when someone’s looked at my knee and perhaps will do something about it”.

 

Jacqueline didn’t think that her other health conditions or medications would “cause any problems” in terms of being recommended for knee surgery, because she had them when her hip was replaced twice. Drawing on her experiences of hip surgery, Jacqueline knew it would “be a bit painful for a little while afterwards” but felt this would be “worth it if the pain goes eventually”. Her daughter helped with shopping when she had her hip replacements, and Jacqueline said this would also be the case as she recovered from knee surgery. She was “amazed” at how quickly “they get you out of bed” after a hip replacement and thinks this is “good because it gets you moving again”; she’s “assuming that it will be something the same” with a knee replacement.

 

Jacqueline hoped that she would be offered surgery and that afterwards she would be pain-free and could “enjoy life a bit more”. She explained, “when you reach 84 you can, you wonder how much more you’ve got left […] If you go on to live longer, you want to be able to enjoy it”. Jacqueline thought that the combination of her painful right knee and her left hip replacement meant she was “probably not walking properly”, and hoped that once “the knee’s done, the odd twinge I get from the hip will disappear because hopefully I’ll be walking right”.

 

At Jacqueline’s appointment, the specialist confirmed that her knee would qualify for surgery. She found the doctor to be “very nice”, and she felt “relief” that she may be in less pain soon. Once she was on the surgery list, Jacqueline received a phone call that she had the option to have the surgery done six weeks later at a private hospital on the NHS. Taking into account the possibility of “having to wait a lot longer and the pain getting worse”, she chose to take the offer.

 

Jacqueline went in for surgery around five months after the appointment. She had a health checkup, and discussed the potential risks of the surgery with her surgeon and anaesthetist. Her past TIA and blood pressure problems were discussed but were not considered an issue. The surgery went smoothly, though Jacqueline needed to take iron tablets afterwards when it was identified that she had postoperative anaemia. Before leaving the hospital, she saw a physiotherapist and was given a booklet of exercises to do regularly. Jacqueline was sent home from hospital the day after her surgery. This seemed “far too quick” to her and she thinks another night of resting would have been helpful.

 

Jacqueline’s recovery has gone well and she is able to “do everything now that was painful to do before”. She was struck by the pain being so much worse in comparison to a hip replacement, though she considers this temporary discomfort to have been worthwhile. She’s also found that low mood has been less of an issue since the knee surgery because, “when you get rid of some pain out of your body, that does help a bit”. Jacqueline still deals with pain in her shoulders and hand from arthritis, but is now pain-free in her replaced knee and hip. As she had expected before the operation, Jacqueline still using her walking stick because her balance is not as good as it was before since having the TIA. Overall, she finds being free from pain to be a “blessing”. Her message to others with knee pain is “don’t dilly dally around, just go and have it done”.

Jacqueline took paracetamol every four hours and wore a morphine patch to manage the pain from her long-term shoulder osteoarthritis. This also helped with her knee pain before knee surgery.

Jacqueline took paracetamol every four hours and wore a morphine patch to manage the pain from her long-term shoulder osteoarthritis. This also helped with her knee pain before knee surgery.

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I do take paracetamol every four hours. I have got a morphine patch - I can’t think what it’s called now, got a special name - which I change every seven days. That has been going on a long time I must admit ,‘cause I’ve got arthritis in my hands and my shoulder, my right shoulder.

As I say, things just wear out. So, they did prescribe a morphine patch for that. That’s been quite some time ago. I can’t remember the exact date. But it has been at least six, eight years, I would think. Yes, about eight years ago.

So that is, you know, not just for my knee, but for my shoulder as well, which really needs doing. But it was a choice between my knee or my shoulder; although my shoulder has been ongoing longer.

I thought it was better to have my knee done because I need to walk.

Jacqueline chose to have her knee operated on before her shoulder. She hoped it would improve her mobility and prevent her going into a care home.

Jacqueline chose to have her knee operated on before her shoulder. She hoped it would improve her mobility and prevent her going into a care home.

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I really want something done, so that I can get I suppose life back to something like normality again and not be in pain because it does restrict you. Obviously, if you’re in pain, you, there’s certain things which you can’t do.

So, I’m hoping that afterwards I will be able to do things again. I can’t do long distance walking which I used to be able to do before.

It’s being able to do them and enjoy them a bit more as well, isn’t it?

Well, that’s right. It’s to enjoy life a bit more, isn’t it? It’s when you reach 84, you wonder how much more you’ve got left. I mean I know in this day and age people live a lot, lot longer. My brother-in-law’s 96 this year. So, people are living longer. So, if you go on to live longer, you want to be able to enjoy it.

Jacqueline had her hip replaced twice when she had her other health conditions and felt confident that the first few days of recovery from knee replacement would be similar to her hip replacements.

Jacqueline had her hip replaced twice when she had her other health conditions and felt confident that the first few days of recovery from knee replacement would be similar to her hip replacements.

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Having had my hip replaced, obviously, I know what it’s like afterwards. It was painful. And we’re assuming it will be something like that again.

I remember the following morning when I woke up, I was in a lot of pain from my hip and they gave me some morphine then which I must admit it did wonders. So, I’m thinking it may well be the same, you know, the same type of thing that I will probably wake up the next morning and think oh golly, it’s horrible, my knee hurts again. And hopefully they will give me something to put it right.

But after that first dose, they were very good actually and they did -. I mean they get you out of bed very quickly, which amazed me. But I think it’s good because it gets you moving again.

So, I’m assuming that it will be something the same.

When Jacqueline was offered the choice to have knee surgery at a private hospital, paid for the NHS, she decided to take it. She was told there was a 6 week wait.

When Jacqueline was offered the choice to have knee surgery at a private hospital, paid for the NHS, she decided to take it. She was told there was a 6 week wait.

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Was it a letter, or they might have phoned up to say would I be willing to go elsewhere, to a private hospital? Which they naturally pay for, because the waiting list is so long, obviously due to Covid. They couldn't give me a date as to when it would be done at the hospital, and so I went to a private hospital in another city.

Well I obviously discussed it with my daughter because she would be the one that was going to look after me afterwards. In fact I asked her when this letter or phone call came to say would I be willing to go to another hospital -  I did have to ask her first because she would be the person that was going to take me, and she just said, “Well, go wherever it is, you know, I will take you.” So to go ahead and not just wait for the [other hospital] to do it.

They were very good there. I suppose I was very lucky that they chose me to go, you know. This little private hospital because a lot of people are waiting longer. Mind you it was my choice that I went there; I could have had it done at the [other hospital] but it would have been a much longer wait.

I think time was the factor you know, that having to wait a lot longer and the pain getting worse, and who knows, if I had to wait another couple of years how much worse it would have been.

Jacqueline found the bending and stretching of her knee during recovery particularly painful, but thought it was worth it to be able to walk properly.

Jacqueline found the bending and stretching of her knee during recovery particularly painful, but thought it was worth it to be able to walk properly.

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It was good actually, and I must admit I recovered very quickly. I'm not saying it wasn’t painful, because it was, but you know, pain fades. You do the exercises and stretches whatever it has to do, and as long as you do them, you recover quickly.

I know because a friend of mine didn't do all the exercises and didn't persevere with them and she can’t get her leg straight.

I think that was the most painful part, is getting your leg straight properly you know? Being able to bend it back the full- I think is it- is it 90 degrees? Something like that, that you have to get your leg? It’s that stretching part of bending your knee so much and pulling it back to this- to that degree, that was the painful part.

But that’s all part and parcel of you being able to walk properly afterwards.

Jacqueline’s knee cap was “a little bit sore” several months after knee replacement surgery but she no longer had joint pain.

Jacqueline’s knee cap was “a little bit sore” several months after knee replacement surgery but she no longer had joint pain.

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It’s still a little bit sore in places, but it’s healed up beautifully, the scar is fading now. It’s still a little bit sore, perhaps over the knee cap but, you know, it’s fine, it’s working, and there’s no pain there apart from a soreness pain rather than a joint pain.

It’s only in just one place where - well, it’s right over the knee cap - and I suppose it’s getting stretched a bit more, isn't it?

It’s not pain as to the rubbing inside, you know, of the inside of the knee, it’s just a little painful where I think one of the staples was, but it’s probably, as I say, it’s right over the knee, patella part of your knee, there, and it’s probably because it was- looking down at it now - it is a little bit- the actual scar itself is probably a little bit brighter there, you know? So perhaps it’s just taking that little bit longer to heal underneath; I don’t know.

So, it’s just- it’s not a knee joint pain, it’s just like a skin pain.

Jacqueline’s mobility is much better. She can carry out everyday activities which previously would have been painful to do.

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Jacqueline’s mobility is much better. She can carry out everyday activities which previously would have been painful to do.

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I can do everything, because I live by myself so I do everything, my home - the housework, the shopping and things like that, gardening, so I can do everything now that possibly would have - was painful to do before.

I suppose walking is one thing. I can, you know, walk- I do walk a lot, so walking is easier now because you don’t get that pain inside. I think possibly my mobility’s a lot better now it has been done. Well, it’s got to be, hasn’t it, after it’s done? But yes, I feel fine now after it, and that it is fine.

Jacqueline has a friend who had knee surgery on both her knees and “she’s over the moon” because she’s pain free.

Jacqueline has a friend who had knee surgery on both her knees and “she’s over the moon” because she’s pain free.

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I have got a friend who's had both her knees done. And she’s absolutely over the moon, ‘cause she’s pain free [laughs].

You know, and she said it is painful after, I did see her afterwards and she said it’s painful, you know, immediately afterwards. But, you know, you expect that when you’ve had-. ‘Cause it’s quite a lengthy scar and, when I had my hip done, it’s quite a lengthy scar and it’s bound to be sore.

But the actual knee itself, the joint itself wasn’t sore, it was actually more the operation site itself rather than the knee.

She’s, she’s over the moon [laughs]. She’s pain free. So, she’s had both, she’s had both of hers done.