Michael X
Michael has problems with his left knee. He thinks this may be causing or adding to pain in other parts of his body, including his hip, back, and ankles. Michael was offered knee surgery at a private hospital, but became ineligible when diagnosed with kidney cancer. He is due to have his right kidney removed in a few weeks, after which he hopes to have his left knee replaced.
Michael X is a retired security guard. He is married and has children, grandchildren and great grandchildren. His ethnicity is White British.
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Michael has problems with his left knee, which is “bent, just like a banana” and pointing “outwards”. He thinks his job as a bricklayer contributed to “wear and tear” of his joints. Michael also has back problems, with five damaged vertebrae in his lower back, and spondylitis at the top of his neck. He wears a brace around his waist when gardening. At one point, Michael was hoping to have surgery on his spine but was declined the surgery. He also has a condition called monoclonal gammopathy of undetermined significance (MGUS), which he has regular monitoring for as it is linked with a higher risk of a particular type of cancer. Michael takes medication for high blood pressure and, because he previously had a stomach ulcer, he’s cautious about taking pain killers which might interact with his other medications or affect his stomach.
Michael thinks his knee problems are causing or adding to pain in other parts of his body: “the [left] knee is perhaps the main one, but that’s sending up to the hip and then it’s making me walk funny and that’s pulling the spine”. He’s noticed that his foot has turned in and he’s “walking on the side of my foot […] my shoes are wearing on the outside”. He can feel his knee “grinding, bone on bone” and gets cramp in his toes. Michael’s knee sometimes ‘gives out’ and he’s had a few falls. He struggles to walk far, as both his knee and back ache, and he uses a walking stick. He’s noticed the knee problems becoming worse in the last two years. He would like to be more active and has young grandchildren and great grandchildren but currently “can’t get down and play”.
Michael has seen his GP about his knee problems for a few years. He’s had a few steroid injections and was referred to see a physiotherapist about 18 months ago. After a few sessions, the physiotherapist gave Michael two options for next steps: a knee brace, or knee surgery. Michael thinks that his appointment was delayed by Covid-19 and its impacts on health services and that, if he is offered surgery, there would be a wait for this too.
At his appointment, the surgeon told Michael that his knee is “definitely gone” and would require surgery. The surgeon was also aware of problems Michael has been having with his hip and said that he was also eligible to have his hip replaced. Michael believes that “it all goes down to the knee” and that replacing the knee might in turn help his hip. Other health issues, like Michael’s MGUS, were mentioned but not flagged as especially risky. Michael was put on the waiting list for surgery, and was later informed that he could have the surgery at a private hospital under the NHS.
Whilst waiting for a surgery date, Michael sought medical advice for issues with his bowels. A scan of his internal organs showed a tumour in one of his kidneys. This had previously been detected a few years ago but it had not been followed up by the medical team. Michael feels “annoyed” that this was overlooked and is very aware that “the cancer could’ve grown faster and I could’ve been gone by now”. He is due to have surgery in a few weeks to remove his right kidney.
Because of his recent kidney cancer diagnosis, Michael was no longer eligible for surgery at a private hospital. He was taken off the private hospital’s list and put back onto the list for his original hospital. Michael felt a “bit disappointed” by this change and the delay it will probably cause to his knee surgery. As of now, Michael has waited about nine months for knee surgery, and thinks he will be waiting for up to another nine months. He is unsure if the kidney removal could cause any problems for a knee operation or his recovery afterwards.
Michael’s knee has continued to worsen since his appointment with the knee surgeon. He manages the pain with paracetamol, and now uses a knee brace from time to time. Michael now feels less able to do activities like gardening and walking, and reflects that “you get a bit down with it”. Until he can have his kidney removed, Michael thinks he’s “just got to carry on”.
Michael has some friends and family members who have had knee surgery before. He has also looked online for information about the operation, and read about research for new treatments in the newspaper. He knows that knee surgery is not always successful and “you might still have a little bit of pain” but hopes this would be “better than what it is at the moment”. Michael has had previous operations and had no issues with anaesthetic before, including having his appendix removed as a toddler, an operation to clear a blockage in his heart, and an operation on blood vessels near his bowel. Michael doesn’t know if his back will improve or not after having his knee replaced. He would be interested in having another scan done on his spine, to see how it has changed over time.
Michael X thinks his job as a bricklayer contributed to “wear and tear” of his joints.
Michael X thinks his job as a bricklayer contributed to “wear and tear” of his joints.
Yeah, I’m getting pain in my right one as well. You know, I think it’s wear and tear. ‘Cos my job, my main job was in the construction industry. And I was a bricklayer.
Oh yeah.
And when you’re bricklaying, you swivel all the time, if you know what I mean. You pick up your brick and you swivel to the wall, and that wears your joints. I’m almost sure it does.
Yes, yeah. Yeah, very hard work.
Yes. And the left leg which is gone is the one I used to rely on because I’m right-handed. And that’s the one you swivel on more than anything.
The pain in Michael X's spine also affected his walking.
The pain in Michael X's spine also affected his walking.
Well, I can’t walk very far, simple as that. ‘Cos it’s not only the knee that aches, it is my spine, my spine sort of, you know gives up and I’ve got a lot of pain. I can’t walk without a walking stick. I’ve got to have a walking stick as an aid.
My knee or my leg at the moment is bent, just like a banana.
Oh gosh.
My knee's gone outwards and I’m walking on the side of my foot.
Gosh. Must be very painful.
It is. It is. It makes your ankle ache as well, sort of thing, you know.
And I’ve noticed all my shoes are wearing on the outside [laughs].
Oh, sort of from the way that you’re having to walk? Yes.
Yeah, yeah, yeah. ‘Cos it makes you, makes your foot turn in as well.
The knee is perhaps the main one, but that’s sending up to the hip and then it’s making me walk funny and that’s pulling the spine I think as well.
‘Cos if I, if I go in the garden and I usually go in in the morning and do like a couple of hours work, it’s really painful right up through.
Michael X took an ibuprofen in the morning to help with stiffness. He didn’t like taking more because he was already taking medication for high blood pressure and his back.
Michael X took an ibuprofen in the morning to help with stiffness. He didn’t like taking more because he was already taking medication for high blood pressure and his back.
Well, I don’t like taking painkillers, to be honest. I’ve had two injections in my knee and that sort of lasts for a little while, but not very long. The last injection he gave me, he gave me a little bit extra and that did last a little bit longer. But the pain is back again now. When I wake up first thing in the morning, I’m very, very stiff sort of thing and it takes me a long time to get going. And I do take an ibuprofen.
Just to get the pain in the-, get me a bit of relief sort of thing.
Yeah, I don’t like taking too much, ‘cos I take quite a lot of medication for other things.
Do you mind me asking if…?
Kind of, I’ve got a high disc hernia and then I’ve got blood pressure. So, I take tablets for that and so I don’t wanna mess up too much, if you know what I mean.
Is that something that your GP’s talked about as well, about sort of interactions between medicines and-?
Yes. Yeah, I’ve talked to the doctor and he said that ibuprofen is all right so long as I don’t take too many. So, if I just take one with a meal, you know, my breakfast, that’s all right.
Because I did, years back, have a duodenal ulcer in my stomach.