Victoria

Age at interview: 78

Brief Outline:

Victoria has been experiencing pain in her right knee for around two years. She previously had a partial knee replacement on her left knee. She hopes that the surgery will improve her knee so that she can get “a little bit more of my old life back”. At her appointment, Victoria was told she will need a total joint replacement and sent for more imaging. She is currently waiting on a scheduled surgery date.

Background:

Victoria is a retired landlady. She is divorced, and has three adult children plus a grandchild and great grandchildren. Her ethnicity is White British.

More about me...

Victoria had a partial joint replacement on her left knee about six years ago which has been “very good”. She currently experiences problems with her right knee, which swells up and gets very hot. She uses pillows to raise the knee up whenever she can, and uses painkiller tablets and gel. Victoria is retired now but thinks that her knee problems are related to working as landlady and cook, and being on her feet all day. She also has recurring bronchitis as a result of secondhand smoke in the pub she owned, and has inhalers to help with this. She takes chemotherapy tablets and, because bone weakness is a side effect, a medication to help strengthen her bones. She also takes aspirin to prevent blood clots, after having clots develop during two of her pregnancies and when she had a hysterectomy. Victoria also takes a medication for high blood pressure.

Around the beginning of the Covid-19 pandemic, Victoria’s right knee started “playing up”. Her knee gave way whilst she was getting something out of the freezer, and she was in “absolute agony for weeks”. It was soon after this that she was diagnosed with breast cancer, and she had surgery. She stayed with her daughter to recover, who noticed that she was really struggling with her leg. Victoria saw her doctor and had a corticosteroid injection into the joint, but this made “no difference”. She was then sent to see a physiotherapist, who told her that she probably needed knee surgery.

Before attending the appointment, Victoria thought that her right knee might need a total replacement because the pain covers the whole area; in contrast, the pain was only “at the side” for her left knee which had a partial joint replacement. She explained, “I’m hoping it’s not [a total knee replacement], but I think it might be” and that she would “go with whatever” the surgeon says. Victoria tries not to think about risks related to the surgery and is focused instead on things getting better.

Victoria’s appointments to discuss knee surgery was during a surge in the Covid-19 cases which caused the hospital to be on a “skeleton crew”. She was struck by how empty the hospital was and was told that she was “lucky to get in”. The surgeon thought a total replacement would be necessary and referred her on for MRI imaging. Victoria feels “totally confident” in her surgeon’s ability, and found him to be “very caring”. Victoria has another appointment coming up, at which she hopes will receive a surgery date.

At the moment, Victoria is doing her best to keep busy and active. Her knee pain has been getting worse with time, making it necessary to take rest breaks during activities like gardening. She now uses a walking stick to get around outside of the house. Victoria hopes that having knee surgery will allow her to “get a little bit back to normal”. She provides care to her sister and grandchildren, which she hopes to be able to carry on with.

Victoria worries that her right knee problems are contributing to issues with her hip and her other knee. She has also been having issues with cataracts, which makes her worried that she will no longer be able to drive. Victoria hopes that she will have her knee done soon, though she expects that things may move slowly because of the Covid-19 delays. Despite the risk of Covid-19 and personal history with blood clotting issues, Victoria feels that knee surgery is the best option for her and is “determined” to pursue it. She plans on speaking with her doctor about blood clotting and what can be done to lower the risk. While Victoria has heard of others having mixed success with knee replacements, she “will definitely risk it” and try to set herself up for a good outcome with physiotherapy.

Victoria has had a “bad year”, with her cancer diagnosis and the Covid-19 pandemic, and feels that she has “aged a lot”. She hopes that the surgery will help her regain her use of her leg so that she can “feel better” and get “a little bit more of my old life back”. She plans to stay with her daughter for a few days to help her recover after the knee surgery but “once I can get up my stairs, I want to be back in my own bed”.

Victoria’s knee problems started suddenly when she was getting something out of the freezer.

The other one only started a couple of years ago in March. As I say, I was getting something out the freezer and it was as if my knee went the other way. I was in absolute agony for weeks, but we, we went into Covid about two days’ later. And like the doctor did see me and they give me cortisone but it didn't make no difference. And of course, with the Covid, they weren’t doing anything like knees and everything.

Obviously as lockdowns have lifted what’s been the impact for you of your knee problems?

Well, because of, because we’re going out more and I’ve been out in the garden and everything I do find my leg really bad, especially it bothers me at night, it, it swells and it’s hot and it swells. And I go to sleep. I put a pillow under my knee so it’s raised up all the time and I’ve got painkilling gel for it and I’ve got painkillers for it.

And do you use those regularly, so taking painkillers or using the gel or is it if it just becomes too much or something happens?

That when I use it, well, I usually use it nearly every day I would say the painkillers and the painkiller gel. If it’s not bothering me, if I’ve had like where today I’m not doing nothing, it’d probably be okay, ‘cos I’m not doing anything. But if I’ve been out shopping or somewhere or even pushing the lawnmower or doing something like that, then it’ll play up at night, ‘cos especially when I, which it seems odd, when I’m in bed, doing nothing, that all starts then for some reason, it’s I don’t know, when you get off it, it’s as if it comes to life again or something, whatever.

Does it have an impact on sleep? Getting to sleep and staying asleep?

It does. It does, yes. Some nights I can’t get to sleep. I have my leg in the bed and out the bed, along the pillow and all over the place.

Victoria’s knee bothered her at night if she had been doing more during the day.

Well, because of, because we’re going out more and I’ve been out in the garden and everything I do find my leg really bad, especially it bothers me at night, it, it swells and it’s hot and it swells. And I go to sleep. I put a pillow under my knee so it’s raised up all the time and I’ve got painkilling gel for it and I’ve got painkillers for it.

And do you use those regularly, so taking painkillers or using the gel or is it if it just becomes too much or something happens?

That when I use it, well, I usually use it nearly every day I would say the painkillers and the painkiller gel. If it’s not bothering me, if I’ve had like where today I’m not doing nothing, it’d probably be okay, ‘cos I’m not doing anything. But if I’ve been out shopping or somewhere or even pushing the lawnmower or doing something like that, then it’ll play up at night, ‘cos especially when I, which it seems odd, when I’m in bed, doing nothing, that all starts then for some reason, it’s I don’t know, when you get off it, it’s as if it comes to life again or something, whatever.

Does it have an impact on sleep? Getting to sleep and staying asleep?

It does. It does, yes. Some nights I can’t get to sleep. I have my leg in the bed and out the bed, along the pillow and all over the place.

Victoria had three steroid injections over 18 months before her knee replacement surgery. The first two worked but the last didn’t and she was referred to an orthopaedic surgeon.

Well, I had it four years ago when I had my other knee done. And, years ago, you used to be able to get it, you could get one every six months.

So, I had one in six months and it definitely helped and I had one another six months and it helped. And then the next time I had it, it didn't work, so when they done the X-ray, they seen there was no cartridge left for it to go into.

So, when the doctor said, they send me for this, I was hoping it would work, but it didn't.

As I say, then when they X-rayed it, they said, “There’s no cartridge there to put, you know.” So that’s when they said they’ll refer me to the hospital.

Victoria’s surgeon requested a scan of her knee so that he could decide about a partial or total knee replacement.

He was saying to start with, the first one, was they- in case it was full knee, and not a partial, I think he thought it was going to be a full knee, but that’s why they sent me for the MRI scan, the next scan to make sure.

Because he said we don’t want to do a half a knee and find out we needed- you know, in six months’ time or a year, you know, it would need another half, so that’s why they put-

I know when I had the other leg done, I didn’t have an MRI scan, I just had the ordinary X-rays and stuff but he said, he said to make sure that they were checking it was going to be a full knee.

Victoria was “a bit worried” about being older and that she won’t “bounce back so good” but she is determined to “get back to normal”.

Well, I’m not so worried about Covid now because I’ve had all my booster- and if you have it, well, I know with COPD it can be bad anyway, I know that, but I am a bit worried because being older and we don’t bounce back so good from things, you know, as you get older.

But no, I’ve got my determined head on I’m going to be okay, and I’m going to get back to normal, and that is it.

Victoria feels that getting her knee fixed will "feel like I'll have a little bit more of my old life back."

I find with my knees the way it is and walking with a stick, I do feel all of a sudden that I already feel it’s been a bad year with everything with Covid and cancer and everything. So, I feel like I’ve aged really bad and well, aged a lot in the last twelve months.

And I feel, you know, if I get my leg back and that it gives me a bit more, I think I’ll feel better.