Pete
After previously having a total joint replacement of his left knee, Pete’s right knee then began causing him pain. After a surgeon confirmed that Pete needed right knee surgery, he had another total replacement. Whilst his procedure went well, Pete’s recovery was made more difficult by other health issues, including a bowel obstruction, Covid-19, and pneumonia.
Pete is married, with children and grandchildren. He is a retired practicing accountant. His ethnicity is White British.
More about me...
Pete had a total knee replacement in his left knee in 2014. There were complications after the surgery, due to a sudden drop in his sodium levels. Pete ended up in hospital as an emergency where he stayed for five weeks. He and the surgeon think this was his body responding to all the medical trauma and surgeries he had been through in a short period of time. Several years later, Pete developed pain, swelling, and limited mobility in his right knee. To cope with this, Pete took paracetamol four or five times a day for his knee pain and also used kinesiology tape, ibuprofen gel, and a walking stick for support. Whilst he kept co-codamol on hand for especially painful days, Pete tried to avoid it because of its digestive side-effects.
Pete previously had two heart attacks, which resulted in five stents being implanted, and an aneurysm. He recently had an angioplasty procedure in both legs to improve the blood flow to his muscles. Pete also has mild COPD, which he considers just a “bit of a nuisance” in daily life. His COPD is managed with carbocisteine to break up the mucus in his lungs. In addition, Pete has macular degeneration and glaucoma, and takes MacuShield. He also takes atorvastatin, ramipril, apixaban, bisoprolol, and pantoprazone. These medications help with heart disease prevention, blood pressure and protecting his stomach.
When the problems particularly in his left knee first began, Pete had an MRI scan to see whether his spine could be causing the pain in his legs. The scan showed some signs of degeneration, which resulted in Pete being given a nerve injection. This helped with the pain in his back, but not in his legs, which led his doctor to believe that his problems were also vascular. An X-ray scan showed that Pete’s knee was nearly bone-on-bone and that part of the knee had dislodged, which suggests that a lot of the pain is joint-related. Pete tried steroid injections into his left knee joint but found these did not work for very long and he then had his knee replaced. However, because of the severity shown on the X-ray, his GP did not think a steroid injection would be much help for his right knee.
Pete’s history of heart and vascular problems, and the medications he takes, sometimes affected previous operations and treatments for other health concerns. For example, his left knee replacement surgery was delayed because, following a heart procedure, he needed to take a clopidogrel for a full year before going under a general anaesthetic. For more minor concerns like a hernia which is not causing any problems, Pete was advised to avoid surgery altogether.
After a referral from his GP, Pete saw a surgeon who confirmed that he needed a joint replacement of his right knee. The surgeon talked about some risks of the procedure, and Pete felt the risk of death was a “fact of life”. He explained that he was willing to take on a “fair degree of risk” to be able to walk comfortably again. The surgeon said there were two options and Pete opted for a total replacement because he knew a partial replacement might mean an additional surgery later anyway. Pete also has friends who have had negative experiences of partial knee replacements. Pete was told to expect at least a nine month wait for a surgery date, so he was surprised to receive an appointment for surgery after four months. At Pete’s pre-operative assessment, he was told they would be closely monitoring his sodium levels to avoid the complications from his previous replacement.
Pete’s right knee replacement surgery went smoothly, although his discharge from hospital was delayed slightly due to a missing sodium value in his bloodwork records. Pete’s recovery was hindered by having other health problems soon after. Eight days after his knee procedure, Pete had emergency surgery for a bowel obstruction. He then had two subsequent visits to A&E for low blood pressure and pneumonia. More recently, Pete also had Covid-19, which was made more serious by his COPD. Pete feels these issues have affected his recovery because his focus was on other aspects of his health and he wasn’t able to do the full range of his rehabilitation exercises at this time.
Nevertheless, Pete had three sessions of physiotherapy at the hospital and saw a consultant physiotherapist for a follow-up appointment, who confirmed that his knee was recovering nicely. Pete was initially using Nordic sticks when walking but he is now walking without them. He tries to be active every day, either by walking with his wife or a local walking group, or by doing activities around the house like cleaning the car or mowing the lawn. Pete has not taken any pain relief for his knees since three weeks after surgery. He is looking forward to taking some summer holidays, which were limited by his knee pain this time last year. When asked his advice for anyone considering knee surgery, he says to “go for it”.
Pete took daily paracetamol for his knee pain which did not manage his pain but was reluctant to take co-codamol because of the side effects. He had also steroid injections.
Pete took daily paracetamol for his knee pain which did not manage his pain but was reluctant to take co-codamol because of the side effects. He had also steroid injections.
Pete: Fortunately I’ve not experienced a lot of pain with it during the night.
Wife: It was- that in that way, it’s different to the left leg—
Pete: Yes.
Wife: —because you were in a lot of pain at night.
Pete: Yeah, I was.
Wife: You have been in pain sometimes, but it’s basically standing and walking on it, isn’t it?
Pete: Yeah. But, you know, it- I am taking regular paracetamol, you see, I take two at breakfast, one at lunchtime, one at suppertime and quite often one or two at night. You know, which is within the permitted dosage, but I mean I am fairly well paracetamolled [laughs].
And do you find that paracetamol’s enough to manage the pain or is it still quite obviously there in difficult at times?
Wife: It doesn’t really help you because—
Pete: Not a great deal. I mean but I’m a bit reluctant to go onto the co-codamol because if I do that, I get terribly constipated.
And other than pain relief, are there any other options in terms of treatments that you're aware of or have tried in the past, either for your left knee, before you had the replacement, or for your right knee?
Pete: Well, what I did for my left knee: I had two injections, what they called?
Wife: Yes, steroid injections, yeah—
Pete: Steroid injections. The first one lasted, ooh three or four months, and then it got bad again, and the second one- and it was absolute agony when it was being administered, because it was being done by a trainee doctor and it lasted all of a week or two [laughs].
Pete had low sodium levels after a previous knee replacement surgery. His sodium levels were closely monitored for his second knee replacement surgery.
Pete had low sodium levels after a previous knee replacement surgery. His sodium levels were closely monitored for his second knee replacement surgery.
And following on from that, there were some quite serious complications, not because of the knee operation, but when I went through the follow-up appointment with [knee surgeon], I think he allowed me half an hour, and we spent about seven minutes talking about my knee, and 23 minutes talking about the fact that I had a sudden serious drop in my sodium level and ended up in hospital for five weeks.
And the low sodium was obviously because of that experience where they monitored it pretty closely this time, and yes, I did go through a period when it did drop quite low, but nowhere near as low as it did on the previous occasion.
Pete, who has heart and vascular problems, says he would be guided by the consultant when making a decision about surgery. He was prepared to take some risk to have his mobility improve.
Pete, who has heart and vascular problems, says he would be guided by the consultant when making a decision about surgery. He was prepared to take some risk to have his mobility improve.
I’d be very guided by what the consultant says, you know, the likelihood of it being successful.
What the risks are going to be, and I mean [sighs] I suppose I’m prepared to undergo a fair degree of risk to try and get myself more mobile, to be honest.
Could you say a bit more about that? I suppose I’m just interested in, in what you mean by what level of risk would you be prepared to, to go under to have the outcome that you hope for?
Well, I think if, you know, a really qualified consultant said ‘not on your nelly’, I wouldn't [laughs].
But if- I mean every operation you have, they always tell you that there’s a possibility you could die, isn’t there?
You know, the- I mean that’s a fact of life, whatever procedure you have there are certain risks. So yeah, I think I would be very much guided by what the consultant advised and said. I mean obviously one’s very anxious about going in for any operation, but yeah, I think that the quality of life, you know, it’s deteriorating badly and it’s not much fun.
Pete had bowel obstruction surgery and pneumonia in the weeks following knee replacement surgery and says, “I’ve been convalescing for everything else except my knee.”
Pete had bowel obstruction surgery and pneumonia in the weeks following knee replacement surgery and says, “I’ve been convalescing for everything else except my knee.”
I can’t bend it back quite as far as I can my left, but other than that I’ve got no pain, and it’s, it’s fine.
Good.
So that operation was , you know a hundred percent really.
Brilliant, brilliant.
But the trouble was that only eight days after that operation, which was obviously under general anaesthetic, I then had a bowel obstruction, and was rushed into hospital again, only eight days later, and had to have general anaesthetic again where some scar tissue from a 2009 hernia operation had strangulated the small intestine.
No.
So that, that was quite, you know, a nasty little operation that.
So that I think caused my body to suffer from a bit of trauma to be honest, because following on from that I was then rushed into hospital twice by ambulance en-route to A&E, once with extremely low blood pressure, and then other one was
Wife: [in background] pneumonia.
Pneumonia. Yeah, I was diagnosed with pneumonia the week after that.
Oh no.
So, you know I’ve been rather sort of convalescing for everything else except my knee since then.
