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

After a month I had to go back to the [hospital] for them to check it. The physio looked at it and she said, “Oh yeah, not too bad at all. I don’t even want to see you again.”

Then after that it was, God when was it now? Perhaps it was six weeks I had to go back to the consultant.  I went in there on this one stick and she put me in a room, put me on a bed.

She said, "can you bend your knee?" And I bent my knee. And she said, “Oh that’s very good.”

And you know she put, measured the knee bend to see if everything was okay. Checked it, looked at the scars and she said, “Yeah, you’ve done, we don’t want to see you again.”

But when I got the pamphlet with all the stuff in it, she did say to me, “You’ll be under us for six months.”

So that was then six sessions, six weeks, and she signed me off on the fifth week because with the exercises I’d been doing at home my knee was as good as it could possibly be.

It had gone well beyond 90 degrees, and I could do all the exercises and walk without crutches and all that kind of thing. And then of course roundabout the same time I had the post-op session with the people in [hospital] surgeons.

And they said exactly the same, he walked in the door, checked my knee and he said, “Stand up, do this, do that.” He said, “It doesn’t get any better than that.” And he just signed me off as well.

So, you know I guess it went quite well really.

And that, I have a feeling it’s all about listening to what they say to you.

 I would say yes, the pain has gone and I can walk, but the leg doesn’t seem, - that pamphlet that I had it said it could take over a year to get your knee back to normal.

Which I’ve accepted that’s my-  But the knee, okay I can bend it, I can do what I want with it but it doesn’t seem like my leg. It’s hard to explain but like it feels hard, the muscles and all that feel hard.

And when I went back to the consultant, no the after a month of the operation, I had - my thighs ached, they really, really were painful.

And when I said to the consultant she said, “Well what they do, they put a tournet over the top of your leg” on an air,  to stop the blood from flowing.

Now they put that [on] tight and that’s what stops - so they can do the operation - and of course she said, “All your muscles now are back as they should do, so they’ve got to get used to the other way of doing it.”

It’s absolutely fine. I've been to see the consultant and he’s discharged me because he’s pleased with it all: it’s weight-bearing and I can more or less twist it anyway. The only problem that I have with it is it’s numb down one side, but when I said that to the consultant, he said that this could take about a year to right itself.

But it’s a strange feeling, you know, down one side being numb? But apart from that it’s all going very well.

And it was the last appointment, as I said this to you before, he showed me the X-rays of my knee before and after, and it’s amazing, I don't know how I even walked on it: I'd hardly any cartilage or anything left, and it was just amazing to see the difference from one to the other, you know, how that has improved.

Oh, that’s brilliant.

So that was interesting as well, so he really kept me in the loop, he explained all the way along what was happening, yeah.

The last time I saw [the surgeon], he discharged me and said unless I wanted to, he was quite happy with everything, and I feel fine, so I don't need to see him at the minute, you know, everything’s gone well.

Yes, I did, yes, she gave me loads of exercises which I did, and it’s paid dividends now because I’m, it’s a really strong good knee, I’m totally okay with it, you know.

It doesn’t actually feel like I’ve had an operation on there at all. It’s just like well you know it’s really settled in very well.

I had crutches which I’ve still got here. I ought to take them back. Yeah again, I can’t really remember but four to six weeks and I was fine, you know. I felt fine so I didn’t need them after that.

I walk and yeah, I’m not actually doing the physio things to be honest, but I do quite a lot of walking. I’ve got a little dog - I take him out most days with my husband. You know so I don’t feel I’ve got a problem with it at all.

You know my leg’s the same size as my other leg, you know it’s - 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.

So how do you feel about the impact of the surgery?

Well, where I was so nervous, and you do meet people that have had- you know they haven’t been too happy or something’s happened with their operation, I was, I was nervous, but I’m thrilled with it.

Being able to walk, I hadn’t realised, I knew I was in pain but you know when you haven’t got it, it makes such a big difference to your life.

Can I ask a bit more about what has changed, so sort of pain and what you’re able to do?

Well, I’m able to walk.  I wasn’t really, I was having to work out how far everything was, you know from parking my car, could I go there? Could I get there? And then have to come home. I mean now I don’t have to think that; I can just act like other people.

So, it’s brilliant.

And is it completely pain free or do you have some pain still?

Well sometimes I just get like, oh yes, my knee hurts a little bit, but I mean it, no, literally it’s fantastic. Really fantastic.

I’m so pleased to hear that.

Yeah, it’s wonderful and I’ve lost some weight, cos I’m able to move and I’ve gone back to Nordic walking, so it’s brilliant.

Well, I was able to walk from, you know, about three days after, four days after the op I could walk with crutches, and that just gradually improved quite quickly really. I think by end of June, beginning of July, I was walking quite unaided.

In fact, the six weeks after the op, you know, I was back driving again.

I'm able now to walk up and down the stairs normally, whereas previous to it all, I had to go down the stairs one at a time and hang onto the rail, but now I can go up and down stairs without holding on at all, so, it’s improved greatly.

Well, it’s as I expected it to be.

I haven’t fully got full use as I-, you know, I can bend my knee and both upright, but with my right knee it’s not a pain at all, it’s like the skin of my knee feels tight,—that’s all, you know, and I shall have to-, yeah, I can get down and put my shoes on, and all right now, and bend down and do that, and get up again without, you know, struggling.

So, I suppose it could say that it’s exceeded my expectations at the moment.

I can see I’m improving all the time.

So, I, when my sort of swelling will go, although I’m not in pain. I sleep well, you know, there hasn’t been any pain or anything like that, but on the whole, yeah, or now when I’m sort of I will do a little bit, I could feel a little bit of pain in my knee.

But listen, some of it could be age related as well, you know? So you know, you can’t just blame that. So yeah, I’m hoping that it-  but I’m sort of almost there and I’m hoping that I’ll continue, you know, so, more like that.

I don't know how much of the bend I’m going to get, but we’ve got quite a - going to go all the way back or not - but of course when I go and see a consultant in a month, a couple of months, he or she will look and then they’ll know [chuckles] how-, or what the state, and how much you can achieve.

But really what I’ve achieved is good mobility.

Good, and it’s better than it was before?

Oh yes, definitely.

Definitely, oh definitely yeah, I’ve got-, yeah, I feel revitalised really, yeah.  I can-, I’m almost at a point when I don’t have to use a walking stick either.

I can walk without it; I often walk without walking stick, and I can get on the bus and all that sort of thing, yeah.

So you know at point of getting my normal mobility again.

Well, you know I still, I can’t sort of completely bend my knee, but you know it’s still, I feel it is getting better and betterer, if I put it that way and I was told it’d be two or three years before it actually returns to bang on normal.

Which you know, which is fine. But now I can’t bend my knee as far back as yeah as my left one, and I don’t expect to but yeah, I can certainly bend it back far more than I could’ve done two or three months ago. So if you like every month that goes past so, I can, it’s getting easier, let me put it that way.

The first I would say week, week and a half, was two arm crutches, which then reduced to one [crutch] after about a week and a half, just moving around the house. If I went outside, I still took both.

I would say at about four weeks I could move around the house perfectly well without, and I went to a walking stick just outside then.

At six weeks, when I went for my six-weeks check-up, I gave the crutches back to the hospital and I used a walking stick probably till three months, just for balance, especially if I was outside the house, not inside the house, but outside.

I would say I've probably got 95% of usage, and I don't think it’s going to improve from that; I think this is it.

The only thing I don't like doing now is going down stairs. I don't mind going up, but I don't like coming down, but I do feel that might be as much the problem of the other knee being a bit dodgy and not necessarily the fault of the operated knee.

The physiotherapist came out and that was-, after three weeks, that was the first time I’d seen any exercises to do.

So, I was doing the exercises and then various things happened. Then they had the rehab and they walked me out the house and round to there, but with my heart condition I was getting a bit out of breath, but no one’s doing anything about that, anyway, but I was taking furosemide for a while.

Anyway, then I had-, my legs killed me, so they changed the medication. So, I had a Longtec for 12 hours and I had-, I could have up to four five milligrams of Shortec in between if and when the pain reared its head.

So, I had agony from the knee down on one-, both knees, from your knees down once, and then I got over that, and then - the knees-, at the back of my legs were killing me and I didn’t know where to put myself.

Anyway the physiotherapist came and the GP told me I should walk up and down and do more exercises. The physiotherapist came and said because you had 30% weight on your knees and 60% on your frame, and you moved over to 30% on the frame and 60% on your knee, you’ve actually done too much on your knees, it was too much, so you’ve got to rest your knees and just go slowly at it, so that improved.

And then my anxiety state came back and I can’t get anything out the GP for that, and then I had-, as I said I had low-, very low blood pressure. They told me to drink loads of water, and when I went to the hospital to the acute triage on Wednesday of last week, they told me that was utterly wrong and because that’s why I’ve got such a-, out of breath, it’s because I had too much liquid, too much water.

So, I might have to take water tablets at a higher strength, or more often. And water tablets, I can only explain to you that if you take the water tablet in the morning, I can’t even get as far as the front door without wanting to go loo, so it’s terrible. And when I came back from triage on Wednesday, they made me take one in triage and I had to stop four times in the 11 miles back from the hospital to my house, so, it was a nightmare to say the least.

I’ve now got legs that ache because of course they’re swollen, and so we’re trying to get it down so I’m under the acute triage and I go back there on Thursday.

I am walking better and I am-, I can walk out to the front of my house, but I haven’t started to drive because I don’t want to drive while I’ve got these particular-, what they called, you know, these particular drugs, these opiates?

So, my sister, if I’ve got to go anywhere, she takes me. Her employer has been brilliant, and for the first few weeks I was home, she was home altogether, she’s been going back to work mornings only and she works from home in the afternoons, and she’s doing that and she’s going to do that-, she’s put in for her retirement, which will be [in] April.

But she’s been absolutely marvellous, because there are nights when I don’t sleep, I can’t get comfortable, my legs are like-, oh, they’re fidgety, they just won’t calm down and every now and again I get so anxiety status I just can’t lay down and sleep, whatever. Because it’s just-, I just-, oh, my brain does overtime.

When I think I’m getting better, something else comes along and throws me off beam.

I think it’s slower because I anticipated being in and out of this in eight weeks, and it didn’t happen, and if I’d have known that it was going to be triple whatever they call it, then I would have known I would have been longer.

The physiotherapist tells me, “Well, everybody’s different,” and, you know, so on? Yeah, accepted, but I think that people ought to have been a bit more realistic. I just felt that I was abandoned by the NHS because the physiotherapist didn’t come, the so-called urgent community response when you come home didn’t exist, it weren’t there.

I know they’re in difficulties, and I know they’re under pressure, but if you come out of hospital-, you know, my sister, if she hadn’t been working for [a hospice] - what about those other people?

I mean she works for [a hospice] so the nurses helped her move the lounge around and get the bed ready and put everything in place.