Making decisions about knee replacement as an older person with multiple conditions

Marjorie’s knee pain also affects her hip and back.

In the last week really. I’ve noticed I can’t walk very far at all. I usually, used to go out with my husband with the dog, can’t even go round our local village rec now without taking painkillers. It’s affecting my hip and my back as well. Because my left legs taking the, my weight, you know, it’s taking all the pressure of walking. And it’s very, it’s, if I sit wrong or if I sleep and I move, it wakes me up. And sometimes I, it makes me shout out if I move quickly and don’t think about my knee first before I move. If I turn and twist or something.

Jan has to rest often when doing jobs about the house.

And the arthritis has stopped me getting into little jobs that would take me mind off it. You can’t, I can’t start a big job because I can’t see them through, ‘cos me arthritis won’t let me.

See what I mean? [Laughs] Now hanging out the washing takes like an hour whereas it used to take me ten minutes, fifteen minutes, I can take up to an hour now to do it because the shoulders don’t work like they should do. So, hanging and so pegging it up.

And the knee will only let me stand on it for so long before I have to sit down. So, I have to hang up a few things and then come in and sit down and then go back and hang up some more.

Derek was hesitant about taking painkillers because he already took other medications.

I don’t like taking, cos I take so many pills generally for my heart, I don’t like taking painkillers, however you know I do. When things are a little bit worse than normal.

Sometimes, certainly at night, sometimes I wake up and take a couple of paracetamols. But to be perfectly honest with you, they don’t, paracetamols now don’t seem to have much effect. I haven’t been down to the doctor to take stronger ones because with all the pills I am taking, you know, [laugh] I don’t want to start going down the road of taking strong painkillers unless of course, I’m advised to.

Recent steroid injections have not helped with Ged’s knee.

On this occasion now, with my right knee, the first one the doctor gave me it didn’t do anything, any, it didn’t do anything at all. I think I’ve had, I think I’ve had three altogether. And no, they haven’t done anything at all. Steroid injections in my leg. But it did initially, years back because I suppose years ago, my knee wasn’t in such a bad state that it is now. And the steroid injection helped. As your knee gets worse, it degenerates and what have you, so on and so forth, steroid injections don’t work.

Because of Tina’s heart condition, the surgery was scheduled at a hospital with an intensive care unit.

He wrote the letter very much along the lines what he’d said at the appointment said, obviously that the age, the heart experience and other conditions obviously do slightly increase the risk, the normal risk that there is with any operation, some phrase like that.

But the consultant for that then sent me for an MRI scan as well as another echo-cardiogram, and he then wrote a letter saying that you know it was okay for me to have the operation, but it still was the case, it had to be somewhere where there was ICU and an HDU because of I do still have the moderate level of leak from the mitral valve.

Mahinder weighed up the pros and cons of knee surgery, and decided keeping mobile was key.

I delayed my operation for a long time because I wanted to avoid any surgical procedures—because I didn’t want to put my heart at risk, you see, yeah, but then my mobility got so bad that, you know, not been able to go out would have been another-, because that would have made my heart worse [chuckles].

You know what I mean? Yeah, so that, yeah, you’ve got to sort of weigh up, you know, the pros and cons and I said, “Look now you see, if I’m sort of-,” you know, I said, “if I can’t go out, if I am very weak, and something like that,”  and it and I could have an operation which will give my mobility back.

Although Marjorie’s replaced knee is still slightly swollen six months later, she says it is “a really good strong knee.”

Yes, she gave me loads of exercises which I did, and it’s paid no- dividends now because I’m, it’s a really strong good knee, I’m totally okay with it, you know.

The knee is still slightly bigger than my other knee which I fully expected, you know, it’s only six months ago, and that will take another year I should think to get settled back down to the other, to the right size, but it’s fine. I’m very happy with it.

Toby’s replaced knee is much improved but he still has stiffness in the joint six months later.

Oh, it’s just stiffens up a bit, you know, in the morning when you get up, or if you get up at night, it’s best to sort of stand up and then flex it a bit. Because it stiffens up, and I think that’s what it’s all about for the year, it’s like I imagine it’s the muscles and everything just really stabilising their self.

I mean at the moment now I can walk around perfectly normal, but if you sit down for a while it stiffens up and if you lie down for a while it stiffens up.

Dorothy feels much more optimistic since having her knee replaced.

Oh, no, I feel much more positive.

Because before I went in, I was getting quite depressed because I thought, as I said, I don't like painkillers, and the pain was so bad I thought, you know, where’s this all going to lead, if I don't want to take painkillers and this pain is so bad, or I-, and I'm moving less and less, I can't walk as far, I was getting quite down.

So now, no, no, I'm much more optimistic about the future, whatever future I've got, I mean you have to be realistic I suppose when you get to 85. But it’s-, no, it’s made a real difference to my life,—

Good.

—and my mood I suppose.

Derek can walk further and can be more spontaneous since his knee replacement.

Oh, most definitely. I’ve been able to walk a lot, lot further, yes most definitely. Up, uphill is a still a bit still a bit of a bind, but no most generally I have been able to walk a lot further and also you know to stand, whereas, whereas I couldn’t really stand before now most certainly I can. As I say I try and do a little exercise, if I’m standing around for some time so whereas I would have to think about going for a little walk I now just don’t, don’t think about it, I just, we just go for a walk now.