Michael Y
Michael previously had partial joint replacements in both knees. Currently, his knees are painful and sometimes limit his activity levels. Michael had an appointment scheduled to see a surgeon but, after reflecting on his pain levels, chose to cancel it. He has also decided to try to cut down on the painkillers he takes.
Michael is a retired area manager for groundcare machinery. He is in a relationship, and has step children and grandchildren. His ethnicity is White English.
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Michael had been waiting for an appointment to discuss revision surgery on his knees. He previously had partial replacements on both knees. The first surgery was 20 years ago and went “okay”, but he had to go back into hospital for machine-assisted physiotherapy to help bend and straighten his leg. His second knee replacement surgery was two years ago. Michael thinks that he went back to work too quickly after both surgeries, which strained his knees and affected his recovery. In recent months, Michael has had pain in both of his knees, for example while driving and walking. He also struggles with movements like kneeling.
Michael was diagnosed with type 2 diabetes four years ago. He takes tablets for his type 2 diabetes and for high blood pressure. Recently, Michael has lost around two stone, which he hopes will help with his blood sugar and blood pressure. Michael has also noticed an improvement with less discomfort in his knee and hopes to keep losing weight in the hope this helps. For pain management of his knees, Michael had been taking tramadol and paracetamol. He also had liquid morphine on hand for bad days, but used it very rarely. Most days Michael finds that his knee pain “doesn’t impair me at all” once he’s taken painkillers and applied Voltarol gel.
Michael’s referral for a surgery consultation was put through after he brought it up in an appointment with his GP about another health concern, which involved a lump on his skin. Five weeks later, Michael received an appointment for a surgery consultation. He was unsure whether surgery would mean replacing the prosthesis with another partial joint, or putting in a total knee joint. Michael had tried steroid injections before but found they didn’t help, so he thought surgery was the only true fix for his knees in the future. However, he wondered if surgery was worth pursuing as he doesn’t have the “violent pain like I had before”. Michael thought that physiotherapy probably wouldn’t help much as he moves his knee regularly through exercise.
In the time leading up to his appointment, Michael had “doubts” about whether to pursue knee surgery. He planned to try weaning himself off of painkillers to see how his knees are before making a decision. Michael had been finding it difficult to tell whether “its old age that’s affecting everything or whether you’ve got a problem”. Based on the long waiting list for surgery, Michael thought about cancelling his appointment as he felt that others with more severe knee problems might be “more deserving” and he didn’t want to be “taking up a place” that another patient could benefit from. Michael was surprised by how quickly he had got an appointment, and worried that he would “feel a bit of a fraud” when speaking to the surgeon as he considered his knees to be painful but manageable at the moment.
As his appointment to discuss options with a knee surgeon date got closer, Michael decided to cancel his appointment. He discussed this with his partner, who backed his choice and encouraged him to try losing weight rather than going straight to surgery. Currently, Michael considers turning down the appointment to have been a “good decision” and has “not regretted” it. He feels fortunate that his current knee prosthetics have lasted longer than their intended 10 years and plans on keeping these in for the foreseeable future.
For now, his pain levels are “bearable” and he doesn’t feel held back from doing the things he wants to. Michael thinks that taking medication can become a habit rather than something that’s actually helpful, so he chose to start tapering off his pain medications. This took some getting used to but has since levelled out to a consistent low ache. Michael plans on speaking to his GP soon about cancelling his prescription for pain medications. Looking towards the future, he thinks that he’ll be “quite happy” if his knees stay as they are as he “can get about and it doesn’t impair me at all”.
After having previous partial knee replacement on both knees, Michael Y started having pain again. He wanted to reduce the painkillers he takes.
After having previous partial knee replacement on both knees, Michael Y started having pain again. He wanted to reduce the painkillers he takes.
The knees: they ache as they always have, but it’s bearable and I manage to get around and I can manage to walk as far as I want to. Although they ache, I still manage to walk, so it-, it’s not impairing me at all.
I've actually done away with all my painkillers whatsoever and I don't take anything at all.
How did you find that process of stopping the pain relief?
Yeah, that wasn't too bad, it was-, over the first couple of weeks it was, should I say, a bit challenging, but after that once you got used to the type of pain you were getting and how bad it was, it’s not a problem, it’s manageable. So no, it would have to get a lot worse than what it is.
In actual fact, as regards the ache, they're more stiff than achy, in pain, if that makes sense?
They're more, you know, you thought they're stiff, and when you bend them, you can actually feel them, but I think that’s because they're false knees and you can feel a difference in them.
I think you get into a habit, I think, of just keep taking the medication, and taking the medication, and in the end I was quite sure it wasn't working like it did in the first place, because I suppose my body got immune to it?
And so that was another reason, you know, I stopped taking it.
Michael Y felt physiotherapy is sometimes a “stalling tactic” before considering surgery. He feels walking and going up and down stairs are a better way for him to exercise his knees.
Michael Y felt physiotherapy is sometimes a “stalling tactic” before considering surgery. He feels walking and going up and down stairs are a better way for him to exercise his knees.
No, I'm a bit cynical I'm afraid where physiotherapy’s concerned.
I always think that’s just a stalling tactic, because everybody you sort of speak to that’s been to physio, doesn't seem to think it does as much good as they thought it might have done, or if any good.
And I honestly think that just generally for me, walking, and then occasionally I have a session where I go up and down the stairs, because we've got a stairs in our house, but we live downstairs rather than upstairs, our bedroom and everything’s downstairs.
So occasionally I have a session of walking up and down the stairs and making sure if I come to any stairs, that I walk up and down them properly, if that doesn't sound too cynical, whatever?