There are three things that distinguish me from the ‘typical’ knee replacement patient:
- I’m far too young. At a slightly less than sprightly 52, I am 18 years below the average age for a knee replacement patient. Apart from the embarrassing fact that I appear to be falling apart rather earlier than most people, I have to consider the fact that I may need a revision procedure before I even reach the age at which most people have their first, or primary, knee replacement. Is it really necessary or are there other options available?
- I will be having the procedure in a private hospital. I am lucky that I am part of the company medical scheme and can go privately. The quality of surgery and care will be no better than I would get in the NHS, it simply means that I probably won’t have to wait as long. However, I am not sure that I really want a room to myself. I was rather looking forward to airing my grumbles and groans with others who would understand and provide me with the sympathy which has, to date, been noticeably lacking in some quarters. Medical insurance can also result in some unpleasant surprises: understand the detail! More of which later.
- Ironically. I am a senior member of the team that has been responsible for delivering major elements of the the National Joint Registry (NJR) since 2006. The NJR (www.njrcentre.org.uk) is a huge database of hip, knee, ankle, shoulder, and elbow replacements in England, Wales, and Northern Ireland and provides a mountain of information . I have tried to convince the team, who have all (with a couple of notable exceptions) been to watch joint replacements, that someone in the team has to experience joint replacement from the patient’s perspective in order to bring a greater understanding to the work we do. The response has been a few requests for tickets to come and watch. My role also means that I spend a considerable amount of time working with senior consultant orthopaedic surgeons (the President of the British Orthopaedic Society and the President of the British Association for Surgery of the Knee amongst them) and implant manufacturers. As a result of my contacts and my work, I am probably more informed than most knee patients.
So, if I am too young, why am I going ahead? The obvious answer is that it hurts. A lot. Not only is it affecting my work (I am home based but can’t travel and the pain relief makes me even more dozy than usual) but the Unfeeling One at home is getting less sympathetic (if this were possible) to my grumbling and groaning. I must admit she does look tired most mornings but I can’t think why. She’s not the one in pain, after all, I am. The spare bedroom has even been mentioned and I suspect that it won’t be her moving into it.
A surgeon once told me that I would know the moment when I needed to get my knee replaced. He was right. It was the day I took one of my mum’s walking sticks because I needed support. Mum had her hips replaced ages ago and doesn’t really need the sticks any more. Going out to the Flower Club can’t require that much effort, after all. It also made me realise that I could no longer pursue my hobby of gliding. I suspect that a passenger would be rather unnerved by their instructor hobbling out to the aircraft with the aid of a stick and then having to sit there, strapped in and wearing a parachute, as said instructor was helped into the back seat. All the Unfeeling One could bring herself to say when I announced my decision was ‘How Soon?’. The fact that I had just returned home at the end of a long and tiring day at the airfield might have had something to do with her obvious lack of interest.
The other reason for getting a total knee replacement (TKR, to those in the know) at such a relatively young age is that I have no other option. All three bits, or compartments, of my left knee are in various states of serious disrepair, so other procedures such as uni-compartmental knee replacement or patello-femoral joint replacement are out. In a former life, I worked for Her Majesty and my job entailed a lot of running in big, black boots, generally carrying weight on my back. The post-operative advice following each successive arthroscopy was ‘Build up the quad muscles and carry on’. I was eventually advised (by an RAF surgeon, ironically) to stop playing all forms of sport, and, if I had to run, I was only to run in straight lines. I was 34. As a result of all the surgery (and I vaguely recall a couple of arthroscopies on my right knee, which is worrying), there is nothing left to repair. The surgeon who is undertaking my TKR carried out a final arthroscopy last year but all it could really do was provide some immediate relief and delay the inevitable. It also caused some issues with my medical insurance.
That’s all for now, The next blog will discuss the need to understand your medical insurance policy so you don’t get hit unexpectedly in the pocket as I did. I will also outline what information there is to help you make your choice of surgeon and, to be honest, there isn’t that much. There seems to be an increasing trend amongst patients to choose the implant over the surgeon. I chose the surgeon. Kneedyman.