Alice

Age at interview: 62

Brief Outline: Alice started having knee pain around 1994. She had partial knee replacement surgery in 2014. She was wary of the benefits of the operation at first, but is doing well now and has seen ‘clear improvement’.

Background: Alice in a research officer. She is divorced and has 2 adult children. Ethnic background / nationality: White British.

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Around 1994 Alice started having pain in her right knee when cycling. Over time the pain worsened in both her knees and began to affect her mobility. This in turn affected her social life, often making her feel isolated and worn down. The constant pain also impacted on her sleep. She sometimes felt ‘useless’, ‘ miserable’ or a ‘fraud’ when colleagues did tasks for her that she couldn’t manage, although many of her friends and colleagues were very understanding and supportive. The pain also prevented her from doing things such as playing with her grandchildren. Alice was living with other conditions such as spinal stenosis, an abnormal narrowing (stenosis) of the spinal canal that may occur in any of the regions of the spine.

Over the years Alice’s GP prescribed a range of painkillers but the knee pain continued to worsen, prompting her to seek further medical attention. She felt that her GP was reluctant to refer her but she was eventually x-rayed. These showed that she had moderate to severe arthritis in both knees. 

Within a few months of the diagnosis, Alice had partial knee replacement surgery to her right knee, in June 2014. She describes her experience in hospital as being mixed – twelve hours after the operation felt like a ‘night out of hell’ as the pain she had after the spine block (anaesthetic) was ‘horrible’. However, Alice was happy with the care she was given and the hospital environment felt safe. The health professionals were also attentive and ‘helpful’. 

Alice was still recovering from her surgery at the time of interview. At first she’d felt ‘miserable’ and cut off from the support in hospital, and later felt run down after overexerting herself. She felt wary of the benefits of the operation early into her recovery but is doing well now and feels that there is ‘clear improvement’. She hopes to have her left knee operated on soon, and recommends partial knee replacement to others in a similar situation. She advises that people stick to the exercises they are advised to do and not to be disheartened with the initial pain – the worst of it is only temporary.

The TEPI videos were good, short and informative but Alice had looked at the hospital website before. The videos didn’t tell her anything new.

What did you think of the videos that you were shown?

I thought they were good. But I had already read a lot of stuff on the website, hospital website, so there wasn’t much about the actual surgery that was new to me or about what the condition of what arthritis is etcetera. I think the questions I asked were fairly practical ones about, you know, ‘cos they said about what to expect after as well. But I don’t remember. I thought it was a good video, not too long, quite informative, but there wasn’t a huge amount in there that I didn’t know already.

If Alice has knee surgery again, she’d take more clothes in case she stays longer than expected and shoes she can slip on easily before exercising.

They [doctors] said before the surgery that you go, I think they even said, “Most people go home the next day, but it’s between 1 and 4 nights and bring enough stuff to stay overnight one night, and then get other people to bring stuff in for you if you need more.” And I wished they hadn’t said that because nobody that I saw went home the next day. And there was no way I could have gone home the next day, and the other person who had a knee, there was no way she could have gone home the next day. And what with all that bedpan wetting yourself, I mean with the spinal block I did wet myself ‘cos I didn’t know what was going on down there. And I was cold and then I’d be covered in sweat, so I mean the second morning they said, “Oh a shower.” Oh wonderful, wonderful you know. But I really could have done with more clothes with me.

And no, I mean I went home after four nights and that seemed, and there was no way I would have gone home before that. And in fact it just changed on that fourth day that I thought, that it suddenly seemed like a possibility whereas up to that time I wouldn’t have considered it.

So I wish I’d taken more stuff in. The other thing was the shoes, they said, “Bring sensible shoes so that you can do your exercises.” Well I mean I don’t wear heels so I thought well what are sensible shoes? I thought ones that are going to slip off aren’t sensible so I took a pair of gym shoes, and they said, “Well you can’t get those on yourself can you?” And I thought well no of course I can’t. But so they got me a pair of slipper socks, they were seen to be giving out slipper socks but I think, I mean what you needed was shoes that you could slip your feet into but weren’t going to slip off your feet once you’d got them in. They wouldn’t let you walk around in bare feet and so I mean next time there are things that I have learnt from this time that I would do differently. Try and figure out some shoes that I can slip on but that are going to stay on. And take more clothes.

The anaesthetist advised against surgery because of Alice’s cold. She arrived at the hospital at 7am, left at 8am and went back to work.

I had something like a week and a half between my, or two and a half weeks, I don’t remember, between my holiday and the surgery date, and I got a cold. And you have to phone the hospital up the day before you have your surgery and I phoned them up, and I said, “Well I’m okay for it, but I’ve got a cold.” And she said, “Oh well I can’t make a decision about that, I’ll put you through to the ward.” So she put me through and I got a nurse who said, “Well take two paracetamol.” 

And I thought, “ that’s a funny bit of advice, ’cos I’m actually telling you, not for advice about what to do with a cold but does it matter whether I’ve got a cold? ’Cos they hadn’t said anything about if you’re not well, nothing at all, but I thought perhaps being unwell is significant if you’re having surgery. I don’t know. 

So I went in the next morning, you have to be there at 7 o’clock having starved yourself, and my daughter came and so we both got up at the crack of dawn. And I saw a nurse and I said, “I’ve got a cold.” And she said, “Oh right. Well tell the doctor.” So I saw the pharmacist and I said, “I’ve got a cold.” She said, “Right well tell the doctor.” So I saw the doctor and I said, “I’ve got a cold.” And he said, “Oh right. Well I think it’s important that we do the surgery today because you don’t want to put it off, but you must tell the anaesthetist.” And I finally, the anaesthetist was the last person I saw, I said, “I’ve got a cold.” And he said, “Well you’ve got to go home then.” 

And then he said, “Well did you tell anybody?” And I told everybody, and I thought, you know, if he was going to say that before, I mean they’d known he was going to say that, then why did I have to go in? But I don’t know whether it was just him that was going to say, “No, you’re not having the surgery.” Or whether it was all anaesthetists, you know, or whether a different one would have said something different. So it was a bit silly ’cos I’d even got arrows drawn on my leg by that time and I was in a gown. I was first on the list. I was all ready. And I had to go home again. So I was out again by 8 o’clock. So I had to go back to work as well having said goodbye to everybody.