Knee – not fallen off yet, but tempted to cut it off

I have now seen four physiotherapist about my stupid runner’s knee (aka tracking problems of the patella femoral joint); two at the expensive private practise that I’ve been going to since July and two at the NHS referred place.

Up until the second visit to the NHS physio place there hadn’t been a great deal of varying opinion on the cause of the problem or the treatment. The two private chaps had recommended a series of stretches, the little woman I saw at the first NHS appointment hadn’t added to or disagreed with this but had expressed her preference was for concentrated massages of the leg generally.

knee

(Photo from bthcc)

This was despite all of them identifying the VMO muscle group as being weak. VMO being short for Vastus Medialis, basically inside quad muscle.

Then I saw the other chap at the NHS centre, he certainly didn’t think massages or stretches would sort it. He favoured the building up other muscles to balance it out approach, something the private physio hadn’t been open to even when I had specifically asked.

I had started to get the impression that the private physio centre had stagnated in terms of what they were recommending and that it felt more like monitor now rather than striving for more improvement. So I was a little excited about having something else to do!

knee xray

(Photo from wadhurst-physio)

So I tried these exercises and developed a most fantastic pain on (in?) my median ligament – which is a bit pesky. Now I am not sure what to do and my physio, who seemed so super at the first appointment, is now being a bit wishy-washy; apparently I can massage the knee myself to take an edge off – because I wouldn’t have thought about that on my own!

My sibling found their visits to a physio unfulfilling and I am starting to understand this viewpoint. My knee seems to have plateaued and I don’t get the impression that any of these nice expensive people actually know what to do to fix it.

I may go back to random internet searches to see what those suggest doing! I might even include the word “knee” in some of those searches.

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Blood donation – feeding vampires and aiding data protection breaches

I have given blood a couple of times in the past despite my veins having a tendency to hide – I am a slightly weird blood type so get badgered a fair bit, but my sibling is a weirder blood type and is invited to any and all blood drives within a 50 mile radius of home!

I had declined to provide the Blood People with my email or phone number as I didn’t see a need to share that information. However at my last session the Blood People insisted that they needed my phone number in case of a problem, they promised it would only be used for that purpose.

blood donation

(Photo from Wikipedia)

A dizzy/nausea spell just as I finished dripping into the tube at my last visit was met by hysteria from the people staffing the blood drive – oddly enough I didn’t want 7 people crowding around me and holding me down when all I wanted was to sit up slowly and have some space! That didn’t make me want to go back there and the venue close to work is a stinky old gymnasium.

Combined with a medical event (or two) meant I didn’t go for a few months and in that time the Blood People sent an endless string of letters wanting blood, which was really off-putting – it made me wonder if they were desperate for blood as they were feeding vampires and the vampires were getting hungry.

I rang up the Blood People and asked nicely to be taken off the contact list but explained that I was happy to remain on the register – the idea being that I could ring up when it suited me to find an appointment.

Let the Right One In

(Still from ‘Let The Right One In’)

The following week I started getting text messages; these varied from the vague “we have invited you to a donation session taking place today” to the slightly broken English of “We have space at session in your area”.

It seems a bit sinister and unhelpful that they wouldn’t tell me where the donation session actually was but were sure that it was in my area, plus the minor issue that I had not given them my contact information for this purpose – which is technically a data protection issue.

So I ring up and spoke to the Blood Thieves again, they admitted that none of their staff should have said the mobile number would only be used for emergencies as there was no way to mark this on the system!

This all means that I now don’t trust the Blood Thieves and think I may have to stop being nice to them. If nothing else because it is only a matter of time before the latest IPhone wants a DNA sample to unlock the screen!

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Patella femoral Joint VS the NHS via my doctor’s attic

After 11 weeks since my doctor filled in a form to refer me for NHS physiotherapy on my stupid runner’s knee (aka tracking problems of the patella femoral joint) and 11 week of me hearing nothing I thought I would ring my doctor to get a bit more information about what is happening.

The phone number was engaged to the point where even their holding queue system wasn’t answering! After ringing back five times I finally got through to a holding queue, they don’t have holding music as that would require a licence so it is silence punctuated every few minutes by a computerised woman’s voice saying “you are still queuing”.

 

medical files

(Photo from HowStuffWorks)

It might be my imagination but she sounds rather put out that I am still on the line after 20 minutes.

After a few more minutes of silence I get through to a real person, she is helpful and explains to me that the referral forms are still in the practise!

The process is the practise puts all the referral forms in a room in date order and once a month the NHS Trust tells the Practise how many referrals they can send. At which point the Practise goes to the pile and takes the oldest forms off the pile and refers those.

So technically I have not yet been referred, the nice lady explains that it is at least three months until you get to the top of the pile!

attic

(Photo from The Sunday Times)

She couldn’t tell me where I was in the pile – because at my doctor’s they put the forms in the attic which only the Practise Manager has a key to and the Practise Manager is on holiday for a couple of weeks.

So if I am very lucky I might be in October’s referrals allowance, or November’s or the attic may have eaten the forms. It might be that I’ve seen too many horror movies but nothing good is ever hiding in the attic…

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Little tips that would have made my first trimester much easier

Some women seem to breeze through pregnancy without a care in the world and certainly not with any pesky bodily-discomfort. These women must be humanoid robots, they certainly aren’t ‘normal’.

I had a few challenges in my first trimester, had I known a few of the below things in advance then life would have been easier, less painful and perhaps even less stressful!

I’m jotting these down for myself mostly, but if they help anyone else then that would be fab.

stepford wives

Cramps and pain relief:

Cramps, abdominal pain and discomfort in the stomach region are often described as “normal” and the general impression that doctors and the internet give is that they are a bit like period pain, a mild pest but nothing dire.

My cramps so much worse than anything I’ve ever felt before. They reduced me to tears and rendered it so I couldn’t move for a good 20 minutes.

Paracetamol does take an edge off and is ok to take in pregnancy.

But do not take nurofen or anything with ibuprofen in – these increase the chances of miscarriage and abnormalities to the baby/fetus/whatever you wish to call it at this stage.

Churning stomach and feeling sick:

Often lumped under the term Morning Sickness this really isn’t an accurate term. Feeling constantly sick and with a constantly churning stomach is more accurate.

I was advised the peppermint tea would help, it didn’t.

poison teacup

(Photo from etsy)

However Gaviscon does take an edge off and is safe to use.

Eating plain foods seemed to help and small portions of carbs on a regular basis.

Sometimes you will feel that someone has hooked up an air hose to your stomach, you will feel bloated and full of air- air which wants to come out with a burp or through breaking wind. You may feel mortified but there is nothing you can do – except find a quiet corner if you feel the air might escape soon!

Smells aggravate the sickness -I found that avoiding putting on perfume helped a lot. Although this didn’t protect me from the smell of other people! The smell of cooking food was always bad.
baby air hose

(Source unknown as it is all over the internet to the point where I sort of want to slap her)

Tired and Emotional:

Feeling stupidly tired and flat-out exhausted is normal for the first trimester, it is also miserable.

Randomly feeling sad or angry also seemed to be par for the course, listening to music was a way of trying to level out but this wasn’t always reliable. Sometimes going on a crying jag for an hour was going to happen whether I wanted to or not

Adding to the fun was bloating of the stomach, there doesn’t seem to be a way around this but it really doesn’t make you feel good about yourself. If your partner has any sense they will pay you lots of complements and generally try to be helpful – they have to develop a thick-skin as sometimes nothing they will do will be right!

national geographic hot air balloon ice

(Photo from National Geographic)

Medical staff:

Appointment times are more advisory than fixed – make sure you have a book, some water and a small piece of comfort food.

Unless you are very lucky you will find that the medical staff that you encounter will have a tendency to see you as a number. You will spend a lot of time waiting around; this can be very stressful but is a good time to practise deep calming breathes.

I am a bit ashamed to admit to this, but having waited 90 minutes after my appointment time to have a scan that revealed absolutely nothing the staff wanted me to join the ten people queue to get processed back into the department so I could to get a blood test.

I may have politely turned around and said in a clear but distressed tone of voice “no, it is ok, I’ve had enough, and I am going home.”  At which point I may have been dealt with very quickly and was done in around 5 minutes – although I stress that I inconvenienced no one else by doing this and I really was planning to walk out.

duck crossing the road

Last but not least:

In the event that something does go wrong, and you tried your best, then it isn’t your fault, sometimes things just don’t work out.

Talking to someone might help, my preference is someone who doesn’t know me and who I don’t have to worry about interacting with again.

Set some time aside to get your head straight and to put yourself first. Your partner may want to do the same for themself too.

Then find a way to face the world together and carry on going.

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Blood sucking butterflies – give them blood, all your blood

Medical confusion about my exact condition continues to reign supreme. After three (censored) tests, three blood tests and a scan the NHS are still very unsure exactly what is going on; however they do know that they want more blood and another scan.

The only conclusions to date seem to be that my veins hide when threatened with a needle and I bruise a lot.

blood test

On the second test I resembled a pin cushion, it took them five goes and two butterflies to get more than a couple of drops of blood.

In this context a butterfly isn’t a pretty winged insect, it is a needle which is designed for pesky little veins that don’t want to co-operate. It gets shoved into you at a shallow angle and when it enters the vein it flashes blood to show the person wielding the needle that they have managed to hit a vein.

butterfly

(photo from Flickr)

The bruising on the back of my hands hurts more than expected when I type and I am grateful that watching ‘Trainspotting’ at an impressionable age (and keeping my eyes open when I got my tongue pierced) means that I now refuse to watch needles going anywhere near me.

kitty peeking

(Photo from attackofthecute)

On the one occasion so far that it wasn’t a battle to get blood out of me the medical staff took way too much, she then asked if I wanted some back… which sounds amusing until they say it to you!

I’ve donated blood a few times before without any problem, but looking at my arms at the moment that isn’t going to be an option for several months even if I wanted to! But at some point the NHS might be able to work out what to do next!

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The NHS *does* have death panels, the A&E department

Sometimes being in a certain predicament unexpectedly is annoying and inconvenient enough in its own right to make anyone grumpy. When the so-called –professionals have no answers and no compassion it is even worse.

For example, if you were feeling very off for a few days and then had terrible pain – enough to go to Accident and Emergency at 2am in total panic. You’d hope and expect that Accident and Emergency (henceforth A&E) would treat you like a person and talk to you. You would be wrong.

Ambulances

(Photo from The Guardian)

These are some tips that I discovered first hand:

  • It isn’t helpful if the initial desk staff are dismissive.
  • It isn’t helpful to leave the person for 30 minutes scared and in pain in the initial waiting area along with a couple of rowdy drunks.
  • It is helpful for the triage nurse to be kind – but being competent too would be nice.
  • It isn’t helpful to be left for another hour sitting in a second waiting area after being told that the next trolley in room B is for you – with no trolley appearing for a very long time.
  • You think of your cave and penguins – just like in ‘Fight Club’, you smile at the thought and get glared at by the staff.

Fight Club Slide

  • It really isn’t helpful for the trolley to finally appear and someone else to get it.
  •  You do feel sorry for that someone when their intimate infection is discussed at very loud volume and in great details.
  •  You then get taken back to be triage nurse and told they’ve detected X condition, the triage nurse then looks blank as you ask “so how does that explain what I am experiencing?” They say that you need to talk to the doctor.

nhs death panel

(Photo from an NHS death panel trust)

  • You think of the self-help meetings in ‘Fight Club’ and gain greater understanding of why these people cling to each other – dealing with the doctors leave you so bruised and fragile that you want someone who understands, who listens and who has empathy.
  • You watch the nursing staff write out the wrong prescription – making it worse by writing in her own name, you wonder how many overdoses these people have given patients.
  • You wait another 30 minutes and decide you are leaving – you find someone to tell as the staff have been bitching when people have got up and just left (or possibly wandered away to die).
  • They then find a doctor, the doctor is apparently 12 and is a prat who doesn’t relate the situation to condition X and ignores perfectly reasonable questions.
  • The prat says to go home, take some of your own painkillers and go see your normal doctor in the morning.

paul phillips

(Photo from Paul Phillips)

It is now 4am, you are still in pain and you feel like you’ve wasted two hours of your life. You are tired, concerned, grumpy and have no ***king answers at all – in fact you possibly have less answers than before you went in.

On the bright side you know now that A&E is useless and staffed by a-holes.

You also know that they could have very easily killed you through incompetence. You celebrate your escape by visiting your normal doctor at a civilised time.

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Cooking my knee will fix it? Why a diathermy machine is my new best friend

As my patella femoral joint pain continues my physiotherapist starts getting desperate. Let’s call him Bob.

According to Bob it shouldn’t hurt this much – however the swelling and clicking when he manipulates that leg speak for themselves, as do my frantic squeaking noises when it all gets too much.

So Bob pulled out the big guns – or at least the machine that looks like 1940 Soviet-era space technology, a diathermy machine.

Untitled

Basically a diathermy machine uses high-frequency electromagnetic currents to electrically induced heat, with this heat then relaxing the muscles and attempting to reduce the under knee pain.

It can do other things too, for example it can coagulate bleeding vessels and cut through tissue! This is called electrosurgery or electrocautery. Apparently Great Ormond Street Hospital (GOSH) use these functions.

My physio, ‘Bob’, was telling me that about 40 years ago when this technology was being fine-tuned there were instances where people had body parts effectively cooked – as it wasn’t understood at the time that too much heat was bad. He says that now this isn’t a problem.

slot

I do hope that Bob is correct it now being safe, I rather hope that he is wrong about people being cooked!

The internet tells me that there have been reported instances of flash fires in operating theatres – something to do with the combination of heat, chemical flash points and lots of oxygen from the anaesthetic equipment.

So far I haven’t been cooked, set fire to or even felt that much heat from the machine. It has however reduced some of a swelling and pain – for a day or so, which makes this machine almost worth a £1 per minute I am paying!

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Dinosaurs had knee pain – but not the same knee pain as me

Contrary to some peoples’ opinion the British NHS isn’t all an evil death panel. However sometimes it can be a little bit like something broken that has been ‘fixed’ with duct tape – you can still see the break and piling tape on it just isn’t going to make it ok.

Having hated my old doctor – he didn’t believe in illness, I swapped to a new one. His opinion on my knee was similar to the previous chap, “it’s a strain, rest it.”

As my knee wasn’t agonising every single day – although more often than not it didn’t feel ‘right’, so this let’s stick tape on it approach sort of worked for a while. The system for making appointments for doctors in my town is you phone up in the morning to get an appointment that day. You can’t get future appointments; you just ring up and hope you were one of the first to call.

fixed

This means there is never a waiting list for the doctor to be judged on – but it does mean you might not get an appointment despite ringing on multiple days in a row.

One day I woke up very cranky as my knee was excruciating, I couldn’t get a doctor’s appointment and fuelled by happy burning anger I made an appointment with a private physiotherapist.

The private physio was expensive, but they could tell me what the problem was within 10 minute – as I had guessed I have a very very grumpy patella femoral joint with added pain! They even seem to have a plan – it does mean coming back weekly and spending £1 per minute or their expertise, but if it gets me a working knee it is money well spent!
allosaurus

However I did end up wondering what exactly I’ve been paying taxes for – so I went to my doctor anyway, got to see the locum and squealed like a stuck piggy (which wasn’t hard with them poking my knee).

They are now going to refer me to an NHS physiotherapist, although they couldn’t give me a wait time – they warned it wouldn’t be short and they can only allow a max of 6 (six) appointments when I do get to see the physio.

What they could do was give me a print out of exercises to try at home; the most appropriate thing they could find on their fancy computer system was on Osteoarthritis (OA) which is also known as degenerative arthritis.

No one thinks that I have this condition or that my problems are linked to it in any way– not even the Doctor who handed me the printout. However the internet tells me that OA has been reported in fossils of the large carnivorous dinosaur Allosaurus, so that is kind of cool. (Apparently pages 337 to 363 in ‘Mesozoic Vertebrate Life’, edited by D. H Tanke and K. Carpenter (Indiana University Press).

The moral of the story is dinosaurs had horrible knee pain too and that I should make more decisions when angry.

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