Peter

Age at interview: 66

Brief Outline:

Peter started having pain in his knees around 2002, but was reluctant to have surgery because of the time he’d need off work. He had partial knee replacement surgery in 2014 after he retired and is now considering having his other knee done.

Background:

Peter is married and a self-employed plumber. Ethnic background / nationality: White British

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Peter started having pain in his knees around 2002. He was working as a plumber and often kneeling on his knees because of his job. He visited his GP, who prescribed painkillers, and also had cortisone injections in his knees. Peter had several injections over the years but felt that they didn’t help.

Eventually, Peter was advised to have surgery. However, he was reluctant to be off work for the length of time needed to recover from the operation, so decided to wait until retirement. When he did retire, Peter went back to his GP who referred him to a specialist. At the hospital, tests confirmed that Peter had osteoarthritis and was eligible for partial knee replacement surgery. Tests also showed that he had high blood pressure and a heart murmur. Peter’s operation was delayed until his blood pressure was reduced, which was done fairly quickly with tablets prescribed by his GP.

Peter had surgery to his left knee and was discharged from hospital the day after the operation. At home, he was in extreme pain. The paracetamol that he had been given did not alleviate the pain. Peter called the hospital and was told that he should also take codeine, which had been prescribed to him by his GP. Peter had not been told this when he was discharged from hospital and felt strongly that he should have been given this information before he left. 
 
At the time of interview, about three weeks after surgery, Peter could walk, go up and down the stairs, drive short distances and was not in much pain, though still needed painkillers. He hoped to go back to work part-time, and was thinking about whether to have his right knee operated on. Peter was concerned that having his other knee done might make it too painful to kneel down and so impossible to work.

The TEPI videos are a good idea but watching them should be a personal choice. Peter read what he thought was relevant and felt completely prepared for surgery.

The video that you watched, did you feel that’s a good idea?

Yeah, yeah, I felt it was a very good idea.

So if people were going in for different types of operations?

Yeah, I think they should be given the choice of, you know, of being told what the video contains. And then their choice as to whether they want to view it or not. Because some people are a bit squeamish about that sort of thing. Personally I’m not because I’ve worked for so many years in hospitals, right from an apprentice. I started my apprenticeship in [hospital name] in London and I’ve been in and around hospitals most of my life. That makes me a little bit easier with seeing things like that. Other people might not like it. It’s got to be a, you know, personal choice.

Would you have liked any leaflets to take home with the information?

We were given loads and loads of leaflets. I did try to sit down and read most of them, but in some cases it’s gone in one ear and out the other. I mean I’ve read them and digested them and, over the time now it’s, you know, I’ve probably forgotten what they said. Well, if I, you know, being honest about it, I’ve concentrated on reading things that I felt was for my benefit, you know, and my knee rather than other people’s.

So before you went in for the operation, did you feel that you were prepared for it?

Yeah, oh, yeah, I was hundred per cent up for it, yeah, absolutely. I think you’ve got to go in there with a very, very, you got to be focused. You got to want it and you got to be prepared for it.

Peter was in a lot of pain for about 2 days and couldn’t sleep. He wasn’t told when he left hospital that he should be taking codeine as well as paracetamol.

I left hospital on the Tuesday and I had, on the Tuesday night I slept here and I had a terrible night, really, really bad night. I had, I was up in the night because I couldn’t sleep with the pain. I sat down here in this chair about from 3 o’clock onwards. Couldn’t, I think probably exhaustion got me off to sleep eventually here in the chair, just sitting in the chair with my knee up on the cushion there. And when my wife came down and we discussed the bad night that I had, we decided it was time to start talking to somebody and find out why. And that was when we found out about the problem with the pills.

Because, what had you been sent home with?

I’d been sent home with paracetamol. And that was it. That was all I was sent home with was paracetamol. I think everybody else was sent home with paracetamol plus something to go alongside it. And in most cases I think it was probably codeine. Because it wasn’t until we rung up we found out that I should have been told to be using my own painkillers alongside the paracetamol. And once we started doing, once we started sorting that out with some help from the GP, then we got the pain under control. But it still took another 24 hours before all the medication kicked in. So I’d spent really one night and one day in a lot of pain. I mean on a 1 to 10, it was 12. It was really, really bad.

Did you speak to the GP as well or he-?

Oh, yeah, yeah, yes, we spoke to the GP as well. Because I was under some medication for other things and we had to make sure that everything was okay with the GP for me to take these extra tablets. So once we got that sorted out with the hospital and the GP, things started to ease off. But, as I say, it, by that time, by the time we’d got it, [clears throat] by the time we’d got it sorted out, we’re looking at probably late afternoon on the Wednesday. And it was still painful through the Wednesday night into the Thursday. And by the, we’d got halfway through the Thursday, everything was kicking in and the pain was easing off. But those first 24, 36 hours, really bad, really, really bad.

But what they, what somebody should have told me was that the pills that I had of my own would take over and do the job that the hospital should have given me. In other words they should have given me codeine, I think it was, and paracetamol. And I had co-codeine of my own, which was prescribed by my GP. And they should have said, “Carry on taking your pills and we won’t need to give you ours.” But they didn’t tell me that.

So until we got that sorted out, once we got that sorted out, the pain, we got the pain under control and it’s been pretty successful up to, you know, up to now. We’re now three, just three weeks after the op. I’m up and about, no sticks, up and down the stairs, out for nice walks with the dog, and everything seems to be going well now. 

Peter delayed having surgery until he retired because of the time he’d need to take off work. He’s been taking painkillers for a long time and plans to wean himself off.

So when you first started having pain, did you take painkillers or did you –

Yes, I’ve been taking painkillers for probably the best part of that 10 years. 

Painkillers that you bought over the counter?

No, no. Painkillers that were prescribed by my GP. That’s my next, probably my next big problem is, is obviously they were fairly heavy-duty painkillers and at some stage I’ve got to get off of them. 

Can you remember the name of those painkillers?

Yeah, I’m on co-codamol and tramadol.

And you’ve been on that for..?

A long time.

A long time, yes.

So it’s quite possible that, to a certain extent, I suppose I’m addicted to them. So that will be the next big problem is getting off of them. Because I don’t want to be addicted to anything, not, certainly not them. So, yes, they were doing a fantastic job because they’ve kept the pain away. They’ve allowed me to carry on working up until my retirement, which was last year. And although my working day was probably shortened a little bit, at least I’ve been able to earn a living. You know, being self-employed, I need to work.

So you took, through the GP you were prescribed these. Can you remember for how long? For the whole of the 10 years or were they, was it just paracetamol to start with?

No, I think it might have been, it might have been something milder to start with. But, you know, we’ve progressed. And I’m not blaming the GP in any way, shape or form. It was probably me saying that I don’t want to go in for the op. Because I knew that if I’d gone in for an operation, I would have been in a situation where I would have, if both knees were done separately, one after the other, I could have been off work for, I don’t know, 8, 9 months. That’s a long time if you’re self-employed. And, you know, customers will wait a short period of time if they want you to do the work. But you can’t expect people to hang around when they’ve, when they want things done, you can’t expect them to hang around for 9 months. So I’d be losing, not only losing the work but losing the customers as well. So I made a decision there and then that I would not have new knees until such time as I got to retirement age.

If Peter can’t kneel, he can’t work. He wonders if he should wait until he has completely retired before he has his other knee replaced.

The main question that I’ve had all the way through is, “Can I kneel on them afterwards? Can I kneel on my knees afterwards?” And, to be honest, no one’s given me a definite yes or no. I think probably the surgeon got the closest in. And he said, “Well, medically speaking” and I think this is how it was put to me that, “Medically speaking, there is no reason why you shouldn’t. But…” And the ‘but’ is ‘everybody is an individual’. It will affect different people in different ways. How much you need to kneel down. How much you don’t need to kneel down. Whether it will cause you pain. Whether it won’t. It’s got, it’s an individual thing.

And that’s something that I’ve got to sort out for myself as and when I feel well enough and confident enough to kneel down on them. And obviously not on a hard floor. On a nice cushion or on a rubber pad, which is what I carry now anyway. But obviously, you know, being a little bit more careful to kneel on something soft. But again it’s something that I’ve got to try for myself when I feel ready.

That’s the bit that really worried me. The fact that, because of my profe-, of my occupation, if I can’t kneel down, I can’t work. And there’s people telling me, “Oh, no, you can’t kneel down on them. Oh, no, no, it’d be too painful.” And that sort of thing was putting me off all the time. That’s the sort of thing was making me think, “Well, do I really want to go through with it or do I stay on the pills? At least while I’m on the pills I can still kneel down.”

And even now I’ve got one knee done and I’m still thinking to myself, “Well.” That’s still at the back of my mind. Okay, I’ve still got one knee that I can kneel down on at the moment. If I go straight from having the left knee done, which has been done, and then go straight in and have the right one done, I’m not going to know until it’s too late. So do I put the right one off or do I go ahead? 

And that is what’s on my mind at the moment. Do I go back to work and struggle with one knee that I can kneel down on? Because the pain is not that much from there at the moment. Or do I throw caution to the wind and get both of them done and hope that I can kneel down on them afterwards? That’s the decision I’ve got to make.

Hearing that he had high blood pressure was disappointing. Peter’s GP prescribed tablets and his blood pressure went back to normal.

Went up for the pre-op, and a good system going. Went to see all the different people in turn, and one of the last bits was blood pressure test. And that was when it was found that I had high blood pressure, which was a bit of a bombshell really. But, you know, being self-employed and pressures of work etc., I suppose it, and my lifestyle, I don’t eat a lot of green stuff. So then it was just a case of getting the blood pressure under control, which my GP done quite well. Had a bit of a murmur on the heart, but that turned out to be, I think they said it was just hardening of the arteries, age as well. But they didn’t seem to worry too much about that.

Peter recommends listening to the doctor’s advice. If exercising feels painful, try it again later. Professionals should make sure patients leave with the correct medications.

If somebody has had the operation, is there any advice or tips you would give in terms of recovery?

Yeah. “Do as you’re told. Absolutely, do as you’re told. If you have been told to do certain exercises at certain times, do ‘em.” If you don’t, you’ll finish up with a seized-up knee and… If you do as you’re told, you can move at the right time, you can move your knee, you know. Most of the time the exercises, they state quite clearly, “If it starts to hurt, stop.” Fine, fine. Do the exercises. If it starts to hurt, stop. Leave it for tomorrow. But at least you would have done some. The more you do, the better it’s gonna be.

And is there any message that you would like to give to health professionals at all?

Possibly the only thing I would say would be, “Make sure that when that patient leaves hospital that patient has got quite clearly and categorically all the necessary pills and information that they need written down. Not just ‘take once’ on the side of a box.” But they’ve got to have, they’ve got to know exactly ’cos their mind is possibly elsewhere, wanting to get out to see somebody or to do something. “Make sure that they’ve got the information that they need.” And, you know, other than that, that’s it. Because I’m really, really happy with the way I was treated in hospital. More than happy. You know, they really looked after me.