"Bleak consultation"

I left my consultation at Fulwood Hall Hospital very disheartened. I’ve had knee problems since 1981, and in the mid-90’s X-rays confirmed that I had early-onset osteoarthritis in both knees. X-rays a year ago confirmed the degeneration was by then ‘severe’. I’ve avoided having a knee replacement because of an awareness of the risks; however my knees are now both locking daily and have caused falls by giving way, as well as causing a great deal of pain and interfering with work and everyday activities and making exercise impossible.

The surgeon I met at Fulwood Hall was polite and respectful, and after looking at my X-rays from that day, which showed bone-on-bone contact in both knees, examining me and taking a brief history, they said the only effective treatment would be full knee replacements.

They said it should be possible to straighten my right knee, but apart from this one benefit concentrated exclusively on information about possible complications – continuing pain, infection to the joint, including from an infection elsewhere in the body several years later, DVT, failure of the joint and its wearing out over time with adverse links to exercise (types of exercise not specified, and I’m not overweight) etc. They also said the joint would be likely to last 10-15 years, whereas the NHS website says ‘A replacement knee usually lasts over 20 years, especially if the new knee is cared for properly and not put under too much strain’. There was no discussion of this discrepancy. There was also no discussion of the possible negative effects of waiting too long, as happened with my mother, whose knee operation was long and very complex as a result of severe degeneration and bone loss. There were significant effects on her general health, at an advanced age, of such a major operation, and she suffered a stroke a few weeks later. I felt confused by the unrelenting bleakness and very ill-equipped to make a decision. All the discussion was along the lines of ‘It’s your decision but….’

Perhaps they misread me as a litigious person, or misread my positive attitude as ignorance of or glibness about possible risks – all of which I’d researched fully. Having lived with often-severe pain so long I’m not a complainer, and perhaps their few, very ‘closed’ questions didn’t elicit the information they needed to know about the levels of pain I experience, in order to advise. Of course patients need to know of the risks, ethically as well as legally (and I knew of more than they went into, having nursed my Mum), but balance is key. There was zero optimism expressed in relation to the possible outcome in my case, and it’s hard to make a decision based on only negative information. It’s important to have some level of optimism from your surgeon, if only for the placebo effect! I felt in a fog, that perhaps there was another agenda that was hidden from me.

As I left, they suggested I use ibuprofen gel and paracetamol

I have changed to a different hospital.