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Janice

Age at interview: 52
Brief Outline: Janice had partial knee replacement surgery in May 2014. She found it challenging to do her exercises regularly but is happy with her recovery and said the benefits of surgery were ‘brilliant’.
Background: Janice is an admin assistant. She is married and has 4 adult children. Ethnic background / nationality: White British.

More about me...

Janice started having pain in her left knee, which got progressively worse over a couple of years. She was initially given anti-inflammatory painkillers but, when the pain increased, she was referred to hospital and had an arthroscopy in 2001. Arthroscopy is a type of keyhole surgery used both to diagnose and treat problems with joints. Because Janice has Factor V Leiden, a blood clotting disorder, she had complications after the arthroscopy (deep vein thrombosis), which made recovery difficult. Janice feels that the arthroscopy made little difference to her knee. The pain had only begun to settle in her left knee when, in 2004, she noticed a similar pain in her right knee, which quickly got worse by 2005-2006. 

In 2009, unable to cope with the pain any longer, Janice had an arthroscopy on her right knee, which showed that she had severe arthritis. She was advised to have knee replacement surgery. Janice delayed having surgery because she felt uneasy about having it so young, at the age of 49. In 2012-2013, though, the pain became ‘unbearable’. She was walking very badly with pain in both knees, and daily activities such as getting in and out of the car and household chores became very difficult. Janice was referred to hospital and was prescribed strong painkillers by her doctor in 2013. 

In May 2014 Janice had partial knee replacement surgery, and although she felt uncomfortable using a bedpan, she was pleased with the care she was given and said that the health professionals were ‘lovely’. After the operation she felt that the physiotherapist gave adequate information but she has struggled to keep doing her exercises regularly. Janice feels that physiotherapy sessions and checkups after surgery would have helped her keep to a routine. She felt uncomfortable injecting herself with medication to prevent blood clotting, though is happy with her recovery so far. 

Six weeks into recovery Janice said that the benefits of her surgery are ‘brilliant’ – she still has some twinges but is more comfortable walking than before the operation. She recommends partial knee replacement to others in a similar situation and says that people should not worry about having it too young. Janice feels that it is better to get the doctor’s advice sooner rather than putting up with unnecessary pain.
 

Janice felt a bit tearful after surgery and having to use a bedpan came as a ‘big shock’. It was fine after the first time, and the physio got her up the next day.

Janice felt a bit tearful after surgery and having to use a bedpan came as a ‘big shock’. It was fine after the first time, and the physio got her up the next day.

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My big shock for me was not being able to get up to go to the loo and that you’d have to use a bedpan. Which was quite a thought for me. I wished I’d known that before. It wouldn’t have made me not want to have it done, but I’d have been less sort of like, perhaps, because you can be a bit tearful perhaps after an operation and a bit low. That just compounded that feeling for a moment. I thought, “Oh, gosh, I’ve got to go on a bedpan.” But once you’ve done it once, you’re fine. And you know you can’t get up till the next day, and so that’s where you are. Then the next day you’re got up by your physio.
 

Janice was shocked to learn that she’d have to inject herself every day at home. She hated having the injections and dreaded doing them in the evenings.

Janice was shocked to learn that she’d have to inject herself every day at home. She hated having the injections and dreaded doing them in the evenings.

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The big problem for me then was having to inject with the anticoagulant drug. It’s not heparin. I’ve forgotten what it’s called now. And I think all knee patients now have to have that for two weeks afterwards, which you have to do at home. Which also surprised me. On the day of my surgery the doctor said that I’d have to have that every day. And I was quite shocked. I thought it was a thing I’d have to have done once a week at the doctor’s surgery and I wouldn’t have to do it myself. But I didn’t find out until like the eleventh hour that you do that yourself. So they have to show you how to do that. Which was a bit of a pain. I didn’t enjoy doing that every day for six weeks. And I had to do it for six weeks because of my Leiden Factor V. I think generally if it’s just an ordinary situation, it’s just for two weeks. So it’s not so bad.

I hated it, I absolutely hated the thought. How people that are diabetic have to do that every day for life must be quite a thought. You take it in the e-, I was taking mine every evening. Now whether that’s relative to when you have your surgery and they give it you, I don’t know. For me, I would have preferred to have done it every morning. Because like you’d get up and you’d do it and it’s done. It was almost like once you’re, because you’ve been asleep all night and you’re not thinking about it. So you get up and you just think about it and you do it. So you haven’t got to think...

For me, I hated doing it so much that come teatime I was thinking, “Oh, I’ve got to do that injection later. I hate the thought of that.” And I almost sort of thought like, “Oh, I’m not going to go to bed. Because if I go to bed, I’ve got to do my injection before I go to bed.” Silly, it sounds silly, but I didn’t want to have to do that. And it’s not for the fact that it actually always hurt, because they show you how to do it. And you, apparently you can do it in your leg, but it’s absorbed better and quicker if you do it in your tummy.
 

Janice struggled to motivate herself once she was mobile. An exercise video would have made her feel that someone was doing the exercises with her.

Janice struggled to motivate herself once she was mobile. An exercise video would have made her feel that someone was doing the exercises with her.

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You mentioned you’ve been doing your exercises, but in a way you’ve had to motivate yourself to do that?

I’ve had to really motivate myself to do that. I find, especially now at six weeks on and you can do really all the things, I can do all the things that I could do before. And so then your day becomes busy. You know, you start doing your jobs, you start working. And the only thing I haven’t done is the hoovering because that’s not, I don’t, that I can feel is uncomfortable. And so then you think, you get up and rather than doing your exercises you think, “Oh, well, I’ll just put some washing on. I’ll just peg some washing out.” 

Before you know, it’s lunchtime; you haven’t done them. And I’m still struggling to motivate myself to do the exercises actually. And we have got a friend who’s a physio, who just come in to see me the other day. It’s the first time she’d been in to see me since my operation. But she did just say, “Well, you know, you must do this and you must do that. And you’ll benefit more if you do.” So, yes.

So you had a little booklet with the exercises. Would it have been helpful to have them on video or anything else?

Oh, yes. Now that would have been good. I would have liked that actually. If you could have, it’s, yes, if you could put something on and do it with them, I think that that would motivate you more I think. It’s as if there’s someone doing it with you. Yes, that’s a good idea. I hadn’t thought of that. It’s quite a lonely thing. You know, you’ve got to get on the floor or on your bed or whatever and, you know, do these exercises. 
 

It’s a shame not to have physio after surgery. Having a specific time to exercise would help, including drop-in or group classes for knee surgery patients.

It’s a shame not to have physio after surgery. Having a specific time to exercise would help, including drop-in or group classes for knee surgery patients.

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The only thing I think is a shame is that once you’re discharged you don’t get any physio. And I know it’s difficult because they’re busy. But I almost feel it would be easier for me because I know I’m a bit perhaps younger than people that might have it done if they’re older. But if you could go once a week even just to see a physio, it makes you feel more that you must do your exercises. Because you’re left to your own devices really. And that makes you a little bit more, “I must get on and do that or else they’ll know I’m not doing it.” But that would be my only thing as a follow-up thing. I would have liked to have seen someone rather than just be left for six weeks before you go back and see the doctor and presumably be discharged at that point.

You mentioned it would have been nice to go for physiotherapy once a week.

Yes, yes, yes. It’s like anything, isn’t it really? If you go to a fitness class and you’ve got a specific time when you’ve got, you, you go, you do make time for it. When you’re left to your own devices, you think you’ll do it, do it later. And later comes and you don’t do it. So a video would perhaps help. Or I think they did say you could go in for drop-in, you could drop in at the physio at the hospital. But I think you had to ring first. It wasn’t something you could just go and do. So I do understand though that they’re pushed up there and they can’t see everybody that has, you know, joint surgery on a weekly or daily basis at all. But actually I wondered whether it would be possible, if they could do group classes.

The physios?

Yes. So like if every day there was a group class and they could see however many people they’ve got room for that have all had knee surgery. And you can all go along at the same time.
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