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May. 9th, 2009 04:20 pmSome of you have seen from my Facebook that my appointment yesterday went quite well.
It was at Spire Murrayfield private hospital (near the zoo), with an orthopaedic surgeon who just happens to also be the head of the NHS orthopaedics department at the Royal Infirmary, and has written textbooks on orthopaedic surgery. My GP recommended him as someone who is very good with knees.
He was *much* nicer than the other guy, and patient with all my questions (of which I had brought in a list). He did a brief physical assessment and looked at my X Ray and MRI reports, and I asked him if the fallen swollen arch in the left foot was a factor, if the PCOS was a factor, if the bruised tendon was important. My impression was that he'd seen lots of knees like mine and it wasn't a big deal, and none of these things were particularly important. Apparently it's likely I had some misalignment for a while, but the injury suddenly kicked it off or something.
He told me he would do pretty much exactly the same surgery (lateral release) as the last guy, only he would check for damaged cartilage under the kneecap and if it was bad he'd open up the knee and resurface it, but going from the MRI results there's actually only a very small amount of cartilage damage and that's not what's causing pain. Apparently the lateral release is successful in 70% of patients, and never makes it worse, so I guess 70% of people go back to normal lives whereas 30% only have limited improvement, which seems better than nothing. Assuming I will be one of those 70%, the surgery is only keyhole (unless they open the knee up for cartilage resurfacing) so I won't be in a cast or anything, it would take a couple of months to recover from the surgery, three more before I am totally without pain, and then 6 months before I can do sports, which sounds like a bloody good deal to me given the last guy seemed convinced I'd be in pain for the rest of my life. And for now I can return to the gym and do all my exercises without worrying about damaging myself irreperably, so it's basically however much I can handle (although I'll check this with my physio too as the ortho seemed slightly less confident with that assessment).
To have the surgery done privately would apparently cost ~2,500 quid, and his waiting list is a mere 4 weeks. The cost, although still a lot of money, is considerably less than I was expecting, and to have it done that quickly would be worth it to me. I don't have that kind of money, so it would be coming from a savings account my dad set up for family emergencies, and I'm *hoping* there's enough in there to cover it or I'm going to have to come up with some epic money-making schemes. Because I'm going to need someone to look after me right after the arthroscopy, my mum had been planning to come over, and we were hoping it would be done before she goes back to work in August. With the NHS waiting times that would be seriously unlikely and she'd been considering leaving her job to come over if it came to that. So to have it done in the summer when she's already here would be a huuuuuuuuuuge bonus. Only thing is we certainly don't have enough to cover private physio so I was worried that by opting for private surgery I would be waiving my right to NHS physio.
So I went home to look up the rules about getting private surgery and then NHS physio and came across the Department of Health's "Guidance on NHS patients who wish to pay for additional private treatment" which seems to suggest they're not allowed to deny me NHS treatment if I opt for private treatment elsewhere. So I called Edinburgh's Citizens Advice Bureau who didn't pick up, and then NHS 24 who told me as long as my GP is happy to refer me for private surgery I can still have NHS physio.
I do have this remaining worry that maybe they've still not got the right thing, because everyone seems so dismissive about it, and I don't think they realise how limited I am or how much pain a small amount of walking will cause. If it is such a small thing, why do I have so much pain? And it seems so clear to me that the foot is a factor, but everyone I've mentioned it to has just ignored it. I'll bring it up with my GP on Monday and see what she says (along with asking her to write a letter saying I'm not fit for work yet, asking her what she thinks about doing the surgery privately and physio on the NHS, and getting her to refill my painkillers).
It was at Spire Murrayfield private hospital (near the zoo), with an orthopaedic surgeon who just happens to also be the head of the NHS orthopaedics department at the Royal Infirmary, and has written textbooks on orthopaedic surgery. My GP recommended him as someone who is very good with knees.
He was *much* nicer than the other guy, and patient with all my questions (of which I had brought in a list). He did a brief physical assessment and looked at my X Ray and MRI reports, and I asked him if the fallen swollen arch in the left foot was a factor, if the PCOS was a factor, if the bruised tendon was important. My impression was that he'd seen lots of knees like mine and it wasn't a big deal, and none of these things were particularly important. Apparently it's likely I had some misalignment for a while, but the injury suddenly kicked it off or something.
He told me he would do pretty much exactly the same surgery (lateral release) as the last guy, only he would check for damaged cartilage under the kneecap and if it was bad he'd open up the knee and resurface it, but going from the MRI results there's actually only a very small amount of cartilage damage and that's not what's causing pain. Apparently the lateral release is successful in 70% of patients, and never makes it worse, so I guess 70% of people go back to normal lives whereas 30% only have limited improvement, which seems better than nothing. Assuming I will be one of those 70%, the surgery is only keyhole (unless they open the knee up for cartilage resurfacing) so I won't be in a cast or anything, it would take a couple of months to recover from the surgery, three more before I am totally without pain, and then 6 months before I can do sports, which sounds like a bloody good deal to me given the last guy seemed convinced I'd be in pain for the rest of my life. And for now I can return to the gym and do all my exercises without worrying about damaging myself irreperably, so it's basically however much I can handle (although I'll check this with my physio too as the ortho seemed slightly less confident with that assessment).
To have the surgery done privately would apparently cost ~2,500 quid, and his waiting list is a mere 4 weeks. The cost, although still a lot of money, is considerably less than I was expecting, and to have it done that quickly would be worth it to me. I don't have that kind of money, so it would be coming from a savings account my dad set up for family emergencies, and I'm *hoping* there's enough in there to cover it or I'm going to have to come up with some epic money-making schemes. Because I'm going to need someone to look after me right after the arthroscopy, my mum had been planning to come over, and we were hoping it would be done before she goes back to work in August. With the NHS waiting times that would be seriously unlikely and she'd been considering leaving her job to come over if it came to that. So to have it done in the summer when she's already here would be a huuuuuuuuuuge bonus. Only thing is we certainly don't have enough to cover private physio so I was worried that by opting for private surgery I would be waiving my right to NHS physio.
So I went home to look up the rules about getting private surgery and then NHS physio and came across the Department of Health's "Guidance on NHS patients who wish to pay for additional private treatment" which seems to suggest they're not allowed to deny me NHS treatment if I opt for private treatment elsewhere. So I called Edinburgh's Citizens Advice Bureau who didn't pick up, and then NHS 24 who told me as long as my GP is happy to refer me for private surgery I can still have NHS physio.
I do have this remaining worry that maybe they've still not got the right thing, because everyone seems so dismissive about it, and I don't think they realise how limited I am or how much pain a small amount of walking will cause. If it is such a small thing, why do I have so much pain? And it seems so clear to me that the foot is a factor, but everyone I've mentioned it to has just ignored it. I'll bring it up with my GP on Monday and see what she says (along with asking her to write a letter saying I'm not fit for work yet, asking her what she thinks about doing the surgery privately and physio on the NHS, and getting her to refill my painkillers).
