Wednesday 18 February 2015

Into the unknown, an everyday story of ordinary arthroscopy.

A third year of knee injury well under way, and there was still no hint of a date for an op' from the NHS.  It has been a good few years since we've had a winter like this one with snow on the hills and long periods of settled weather, missing out was more than I could bear.  I decided enough was enough and I raided my retirement savings to fund arthroscopy for medial meniscus tears myself.  Once I had made this commitment I felt deep regret at not having done so back in June when my injury was finally diagnosed after engaging the services of Nuffield Health.

Two weeks later I was standing apprehensively outside the Nuffield hospital in Clayton at seven thirty on a gorgeous crisp morning, with a few essentials in my ancient Hot Ice rucksack.  I was soon in my room, processed, then on a trolley headed for the anaesthetist with an arrow drawn on my left leg.  The anaesthetist stuck a tap in the back of my hand then plumbed me in to the sleepy stuff.  He warned me of a slight sensation of cold and told me to think of somewhere I liked to be.  Of course I imagined myself running, peacefully, effortlessly through a quiet, misty, frosted landscape, a smile came over my face and I drifted into unconsciousness.

Above:  Frosty early morning scene, a few weeks ago on my local route.  It was a scene like this one that I drifted into as I drifted out of consciousness.

I came to a while later, I felt as if I had woken from a nap, but was rather more refreshed than I would be from a natural sleep.  I was not at all hazy and knew instantly where I was and was rather relieved to note that I could feel my leg and that there was no sensation of pain.

I was soon back in my room and was at last allowed to eat, the sandwich I was given didn't touch the sides.  The consultant visited me and told me that the procedure had gone satisfactorily.  He showed me a photo of the inside of my knee in which the debris that he had removed could be seen.  He also pointed out the arthritis to the surfaces of the knee joint which he said was no more than was to be expected at my age and that it was was OK "considering what you do".

I was then visited by a physio' who asked me to perform a few simple movements.  She said that I would be given a sheet with the exercises on it then told me her department would be in touch in a few days.  She left and I started to do a few of the leg raises while I waited for my 'discharge papers'.  I had been advised to take it easy so I stopped after 70 straight leg raises, about half the number I would repeat for several sets ordinarily.

The nurses brought my 'Going Home' pack (including a video of the op), took the tap out of my hand and gave me instructions on managing dressings and so on.  I then phoned my lift, dressed and went to sit outside in the winter sun while I waited.  I read my book and did a few more leg raises, only about thirty this time due to the extra weight of my boots.  I got out the pack I had been given to check what other exercises I should be doing.  I read that I should do five leg raises, five times a day, oops!! 

Later that day the knee was still pain free and my mobility was restricted only by the bulk of the dressings.  This surprised me, I had expected swelling and pain.  I took it easy, just watching films and the like, but could stand up long enough to prepare a meal and manage stairs with ease (though one at a time in descent on my very steep Victorian stairs).  Later, as I undressed at bedtime, I realised that I was still wearing the electrodes they had attached at the hospital.

I was very impressed by the efficiency of Nuffield's organisation and care up until I was discharged from the hospital.  Getting a physio' appointment was another matter.  I was not contacted within the specified time or within the next week.  I phoned as I had been advised to do in that eventuality.

I was answered by a machine that instructed me to phone an 0845 number to make an appointment.  The mention of 0845 makes my blood, and that of all right thinking people, boil, there was worse to come when I rang the number.  After an automatic prelude, routing and call queue with awful electronic music, I was connected to the appointments operator.  This operator advised me that they could not make appointments for post op' physio', this needed to be arranged with the hospital.  He connected me to the hospital.  The hospital front desk answered, I stated my business.  The receptionist advised me that they could not make appointments at the front desk and put me through to the physiotherapy department.  I was answered by the machine telling me that to make an appointment I had to phone the 0845 number!

It took me most of the morning to break this loop of organisational incompetence.  No email address is given on the Nuffield web site and no one answers the 'Contact Us' message service (they still haven't two days later).  Eventually I got the hospital front desk to email the physio' dept. and ask them to ring me at work on my mobile. 

After this frustrating day I visited my mother in the evening.  She told me that mail for me had been delivered to her address that day,.. curious.  I opened the letter, it was from the NHS inviting me to attend an appointment on the previous Wednesday!  The letter had been sent with an incomplete (wrong) address.  That they had sent the letter to my mother's address (almost) instead of the one that I registered with the NHS twenty odd years ago and to which they have sent all previous correspondence for the last two decades, beggars belief.  I was speechless.

I wrote back politely and explained that I would be unable to keep an appointment for the previous Wednesday, that they had sent the letter to the wrong address and that it was not necessary to make another appointment as I had now decided to fund my operation myself.  I asked that they correct their records and confirm that they had done so.  I am still wound up about this two days later, a two year wait for this nonsense.

The dressings are now off my knee and the incisions are pretty much healed.  The knee is creaky though it allows day to day use, it doesn't hurt unless stressed.  It feels pretty much like it did, during 'so-so' phases, before the op'.  I hope that this is due to residual swelling from the surgery and that it will pass.  I suppose only time will tell, from what I have heard I should be able to run on it in another ten days.  Here's hoping, I need some stress relief urgently.

Thanks to the team at Clayton on the day, the two nurses and the anaesthetist were kind, caring, reassuring and efficient without ever being patronising, well done boys.  Thanks also to my sister Sandi for getting up at 05:30 to get me there on time and for getting me home afterwards.  For the team - an everyday story of ordinary arthroscopy, for me -  a singular day of extraordinary  importance.