More Knees Things
30/06/24 14:49
Been having problems with my knees for over a year now. I didn’t realise it was that long until I noticed when I had the X-ray done on my left knee (May last year—where does the time go when it’s not around here?). In January I had a week when I needed a walking stick—which thankfully so far has not reoccured. And on Friday I had my first "musculoskeletal" appointment at Fazakerley Hospital: I think this is basically a physio but with a more complicated spelling.
It was a good appointment—if taking about having osteoarthritis is ever a good thing. He showed the X-ray of my knee and pointed out the smaller gap between the bones. Ho hum. He showed me a few exercises to do to build strength in the legs. There is a slight weakness in my left leg but after walking funny for a year that would seem inevitable. But doing these exercises—with one of those resistance band thingymewhatsits—three or four days a week should help the upper leg strength and hips a fair bit and help in reducing the weakness and the pain in the knee joints.
He said a couple of things which helped: I’m apparently “high functioning”. Or perhaps I misheard and I’m just functioning and he thought I was a bit high at the time. He also said my weight was fine and I didn’t need to lose any. Huzzah—he’s on my Christmas card list! I guess lugging casks of beer around has helped on some of the fitness side. It was good that all we talked about was exercises and there was no need to talk in any seriousness about the dreaded knee replacement options. All good.
Trying to show me a page on the computer with the exercises on he found that the pages were “still” not accessible as someone in accounts hasn’t paid for the software/website. So he ended up trying to write them down (not ideal, sometimes a picture really is worth a thousand words). I should be able to remember them and I guess I’ll be able to find a webpage showing these same exercises too.
He didn’t notice my posterior dislocated shoulder and was quite surprised at that. He gave me a good exercise to help with that in addition to the ones for the legs. I’ve got a second appointment in six weeks or so, let’s see if I can keep up with the exercises. In the meantime if you see me crouching or slightly bent of legs in a shop, at a bar or a bus stop be assured I am just exercising—probably.
It was a good appointment—if taking about having osteoarthritis is ever a good thing. He showed the X-ray of my knee and pointed out the smaller gap between the bones. Ho hum. He showed me a few exercises to do to build strength in the legs. There is a slight weakness in my left leg but after walking funny for a year that would seem inevitable. But doing these exercises—with one of those resistance band thingymewhatsits—three or four days a week should help the upper leg strength and hips a fair bit and help in reducing the weakness and the pain in the knee joints.
He said a couple of things which helped: I’m apparently “high functioning”. Or perhaps I misheard and I’m just functioning and he thought I was a bit high at the time. He also said my weight was fine and I didn’t need to lose any. Huzzah—he’s on my Christmas card list! I guess lugging casks of beer around has helped on some of the fitness side. It was good that all we talked about was exercises and there was no need to talk in any seriousness about the dreaded knee replacement options. All good.
Trying to show me a page on the computer with the exercises on he found that the pages were “still” not accessible as someone in accounts hasn’t paid for the software/website. So he ended up trying to write them down (not ideal, sometimes a picture really is worth a thousand words). I should be able to remember them and I guess I’ll be able to find a webpage showing these same exercises too.
He didn’t notice my posterior dislocated shoulder and was quite surprised at that. He gave me a good exercise to help with that in addition to the ones for the legs. I’ve got a second appointment in six weeks or so, let’s see if I can keep up with the exercises. In the meantime if you see me crouching or slightly bent of legs in a shop, at a bar or a bus stop be assured I am just exercising—probably.
Comments
Not The Best Knees-Up
13/01/24 11:07
This has not been the best week off in some ways, but hopefully—slowly—things will be moving the right way from here on in. I’ve had a swollen knee for a few weeks now, which has got progressively worse and more painful. Have been in for several tests. A month or so before Christmas I had my second hydrocortisone injection (for the year) in my left knee. At the same time they syringed a fair bit of fluid out. I then went for blood tests to a phlebotomy centre around the same time. It was good to get done. But not long later and my knee became worse than it’s ever been-particularly in the last couple of weeks.
I had a message from the doctor’s before Christmas to arrange an appointment with a GP to discuss the test findings and have been trying ever since to get one. And failing—miserably. They ask me to make an appointment, but you can’t make one in advance, you can only make one ‘on the day’. It’s crazy you can’t even get one for five or ten days (or whatever) hence. I’m sure there’s a perfectly good reason for it. But… meh. So I’ve been calling around 8am for weeks to get the same message, ‘Sorry, all the appointments for today have been taken.’ They only give the appointments at 8am. By 8:10: they’re all gone. It’s like trying to get a Glastonbury ticket. But with a less enticing ticket.
So what a week this has been. I’ve taken it off to relax and hopefully let the leg recover—at least a little. I had hoped I’d get out and about on a train somewhere during the week if my leg did improve. And so what have this week’s highlights been? Well, in order of occurrence (if not importance, or excitement):
1. Buying and receiving my first ever walking stick on Monday. They don’t half take the pressure of your knee when you use one. I got a foldable one so I can take it around with me in my constant rucksack companion should I decide I need it after not initially requiring it on any given day (very Boy Scout of me. Dib dib dib.).
2. Actually getting a GP appointment on Wednesday (thanks to a cancellation from somebody; and me no doubt sounding thoroughly despondent when I was originally given the, ‘all the appointments for the day had gone’. The call back was much appreciated.).
3. Finding out from the GP that I’m suffering from gout. May sound weird, but I’m genuinely made up with that.
4. Paying for an Annual Prescription Certificate so I won’t have to suffer the monthly charges as painfully now that I’m on more tablets.
5. Picking up my prescription on Thursday—and getting some tablets down me within the hour!
It’s more than annoying, of course, that I could have been given that prescription before Xmas, had I been able to meet my GP initially about the blood (and fluid off-the-knee) results, and then maybe I’d not have suffered with my knee anything like as much as I have since (and may not have needed to buy and use a walking stick). I’ve never needed a walking stick before this current issue and it’s been difficult to go through first needing and then using it. Getting on and off buses is a painful and sometimes slow and risky affair.
But hell, we are where we are, and I’m made up with the gout diagnosis: as it is at least treatable. Clearly with my MS there was some worry (however misplaced), and this was compounded by the osteoarthritis in my knee only recently identified. The dreaded thought of a knee replacement… please, no.
Gout and osteoarthritis is a wicked combination. For osteoarthritis you are told to exercise the joint and for the gout you are told to rest it. So whatever you do/don’t do it is simultaneously wrong & right. It’s an unsolvable conundrum. But while the arthritis won’t get better and can’t be treated (other than painkillers if particularly bad) at least the gout can. Which is why I’m happy about the current prognosis.
I’m finally on some pills. And I can only hope that they do their stuff relatively quickly. It’d be great not to need the new walking stick (however happy I am with its purchase). The treatment should eventually result in a reduction in the fluid around the knee and then I’ll be bounding up the stairs in no time (rather than worrying about negotiating them). Hope Springs Eternal and all that. Onwards and Upwards (not painfully downwards!).
I had a message from the doctor’s before Christmas to arrange an appointment with a GP to discuss the test findings and have been trying ever since to get one. And failing—miserably. They ask me to make an appointment, but you can’t make one in advance, you can only make one ‘on the day’. It’s crazy you can’t even get one for five or ten days (or whatever) hence. I’m sure there’s a perfectly good reason for it. But… meh. So I’ve been calling around 8am for weeks to get the same message, ‘Sorry, all the appointments for today have been taken.’ They only give the appointments at 8am. By 8:10: they’re all gone. It’s like trying to get a Glastonbury ticket. But with a less enticing ticket.
So what a week this has been. I’ve taken it off to relax and hopefully let the leg recover—at least a little. I had hoped I’d get out and about on a train somewhere during the week if my leg did improve. And so what have this week’s highlights been? Well, in order of occurrence (if not importance, or excitement):
1. Buying and receiving my first ever walking stick on Monday. They don’t half take the pressure of your knee when you use one. I got a foldable one so I can take it around with me in my constant rucksack companion should I decide I need it after not initially requiring it on any given day (very Boy Scout of me. Dib dib dib.).
2. Actually getting a GP appointment on Wednesday (thanks to a cancellation from somebody; and me no doubt sounding thoroughly despondent when I was originally given the, ‘all the appointments for the day had gone’. The call back was much appreciated.).
3. Finding out from the GP that I’m suffering from gout. May sound weird, but I’m genuinely made up with that.
4. Paying for an Annual Prescription Certificate so I won’t have to suffer the monthly charges as painfully now that I’m on more tablets.
5. Picking up my prescription on Thursday—and getting some tablets down me within the hour!
It’s more than annoying, of course, that I could have been given that prescription before Xmas, had I been able to meet my GP initially about the blood (and fluid off-the-knee) results, and then maybe I’d not have suffered with my knee anything like as much as I have since (and may not have needed to buy and use a walking stick). I’ve never needed a walking stick before this current issue and it’s been difficult to go through first needing and then using it. Getting on and off buses is a painful and sometimes slow and risky affair.
But hell, we are where we are, and I’m made up with the gout diagnosis: as it is at least treatable. Clearly with my MS there was some worry (however misplaced), and this was compounded by the osteoarthritis in my knee only recently identified. The dreaded thought of a knee replacement… please, no.
Gout and osteoarthritis is a wicked combination. For osteoarthritis you are told to exercise the joint and for the gout you are told to rest it. So whatever you do/don’t do it is simultaneously wrong & right. It’s an unsolvable conundrum. But while the arthritis won’t get better and can’t be treated (other than painkillers if particularly bad) at least the gout can. Which is why I’m happy about the current prognosis.
I’m finally on some pills. And I can only hope that they do their stuff relatively quickly. It’d be great not to need the new walking stick (however happy I am with its purchase). The treatment should eventually result in a reduction in the fluid around the knee and then I’ll be bounding up the stairs in no time (rather than worrying about negotiating them). Hope Springs Eternal and all that. Onwards and Upwards (not painfully downwards!).
Arthritis Jab, Taps, and Communication
20/11/23 10:10
Early in the year I discovered I had Arthritis. It wasn't exactly difficult. I mean out of nowhere I suddenly began to have very sore knees—and pretty swollen too. The way it came on suddenly I found strange. The GP had a look at them and sent me for X-rays to confirm: it did. In May I went into the GP and discussed and then hydrocortisone was offered to me, which I took on the spot. The jab was put into my knee, where the injection gets put in behind the patella. Didn't hurt much at all at the time ('just a sharp scratch') and didn't really hurt later either (despite being told 'I'd probably be swearing about it later'). Recently the pain in the left knee in particular had got really bad again. After weeks of struggling up stairs and walking like an old man I returned to the practice at the weekend in the hope I'd get another injection.
It was a different GP this time and as we walked in I got told there would be two student nurses in with us. Eek! I signed some paperwork to say I was happy to get an injection. The GP seemed a little reticent about giving cortisone in general, he suggested that damage to the knees can result from the wear and tear in the joint after using them—'Sometimes a new knee may be better.' Eek (again). I'm not really a fan of surgery in general and a new knee sounds like not a good thing at all. I mean I'd only had ONE injection to that point. It seems a big jump to surgery from that. Mind you with my knees everything seems like a big jump. Anyway, he said the waiting list to see someone from orthopaedics is long and suggested that if I was in for another jab again (which I guess is quite probable) he'd put me forward to orthopaedics at that point—therefore with the waiting list being that long (i'd probably still not see them by then) best go on the list now. I agreed to that.
Then we got around to the injection. There was a lot of fluid around my knee—which he illustrated by pressing the swelling down and watching the fluid wash back in—and he suggested taking some of that out at the same time. He took out a big syringe full of fluid from my knee. It was good to do. The hydrocortisone doesn't begin to do its stuff for a while, but I was finding walking easier on the day of the injection. Think the removal of all that liquid was a damn good thing.
Maybe next time I'll get them to drain my knee instead of (rather than as well as) the injection. Or perhaps I can get a small tap installed to save going into the medical centre. We shall see.
———
Just before I was about to go I remembered that I hadn't heard from the practice since my blood tests earlier in the year. The practice asks everyone over fifty (or maybe even younger) to get an Annual Health Check, which is largely done through blood tests. I don't do it every year, but I did this one. I went for a test and a week later was asked to go again, then they asked me to go for a third one. Repeat tests over the space of a month, and I'd never been spoken to about them (i.e. whether the results had revealed a problem, or why I had to get three lots). I'd forgotten about it to be honest—so remembering at this point must have been seeing the syringe.
Thankfully it turned out to be okay. One of the tests from the first batch wasn't undertaken (maybe a lost or damaged vial; or some other lab issue). When they did do that test there was a slightly low blood result and the third one was therefore to check that out. The third one was fine.
So a) I found the reason for there being three tests and not one, and b) everything was fine. They didn't confirm the ABV though. Communication, communication.
It was a different GP this time and as we walked in I got told there would be two student nurses in with us. Eek! I signed some paperwork to say I was happy to get an injection. The GP seemed a little reticent about giving cortisone in general, he suggested that damage to the knees can result from the wear and tear in the joint after using them—'Sometimes a new knee may be better.' Eek (again). I'm not really a fan of surgery in general and a new knee sounds like not a good thing at all. I mean I'd only had ONE injection to that point. It seems a big jump to surgery from that. Mind you with my knees everything seems like a big jump. Anyway, he said the waiting list to see someone from orthopaedics is long and suggested that if I was in for another jab again (which I guess is quite probable) he'd put me forward to orthopaedics at that point—therefore with the waiting list being that long (i'd probably still not see them by then) best go on the list now. I agreed to that.
Then we got around to the injection. There was a lot of fluid around my knee—which he illustrated by pressing the swelling down and watching the fluid wash back in—and he suggested taking some of that out at the same time. He took out a big syringe full of fluid from my knee. It was good to do. The hydrocortisone doesn't begin to do its stuff for a while, but I was finding walking easier on the day of the injection. Think the removal of all that liquid was a damn good thing.
Maybe next time I'll get them to drain my knee instead of (rather than as well as) the injection. Or perhaps I can get a small tap installed to save going into the medical centre. We shall see.
———
Just before I was about to go I remembered that I hadn't heard from the practice since my blood tests earlier in the year. The practice asks everyone over fifty (or maybe even younger) to get an Annual Health Check, which is largely done through blood tests. I don't do it every year, but I did this one. I went for a test and a week later was asked to go again, then they asked me to go for a third one. Repeat tests over the space of a month, and I'd never been spoken to about them (i.e. whether the results had revealed a problem, or why I had to get three lots). I'd forgotten about it to be honest—so remembering at this point must have been seeing the syringe.
Thankfully it turned out to be okay. One of the tests from the first batch wasn't undertaken (maybe a lost or damaged vial; or some other lab issue). When they did do that test there was a slightly low blood result and the third one was therefore to check that out. The third one was fine.
So a) I found the reason for there being three tests and not one, and b) everything was fine. They didn't confirm the ABV though. Communication, communication.
Annual(ish) MS MOT
28/09/23 23:09
Every year or so I get a a meeting with my Multiple Sclerosis specialist in the—most excellent— Walton Centre and today was that day. It’s a bit of a funny one because of course you know how you think you are but there is always that element of doubt that they'll find something has changed that you haven't noticed yourself. Of course you can take the opportunity to report any changes and ask any questions.
The only thing I had to report really was that I’d been having issues with my knees over recent months which had consequently resulted in some quite bad issues with my legs a couple of weeks ago. I was majorly incapacitated for a few days—and for a short time I was seriously worried (Google searches at that time included ‘how to walk with a cane’). But as the days after the most severe issues passed my calves and thighs both got less painful and it seemed clear that the issues I’d had with my whole legs (rather than just the knees) was a result of a long day standing up resulting in fatigue and me trying ferociously hard to remain upright and not folding in on my knees (and failing repeatedly). The strain in trying not to collapse on my arse was evidently felt in all the muscles I’d used fighting gravity (and the frequently failing had probably bruised my upper legs too). Fatigue is a common issue with MS but I hadn’t knowingly felt the effects of it before. I guess it really was a combination of my newly arthritic knees and MS (purely in terms of muscle fatigue)—and basically standing up for too long on that one day. I will definitely sit down more often when out and about from now on. That said over the last couple of weeks I’ve found when you are looking for a place to sit when you’re out it is amazing how difficult it can be to find appropriate places.
The doc confirmed it was likely to be that rather than anything directly MS related (but of course call up the Walton Centre if anything changes). And from the check up on eyes, coordination, arms and leg strength, and nerves/feeling etc he reported that everything was the same as when I first came. All in all Happy Days!
Exercises. Exercises.
Of course it means I still have my knee issues to deal with, but it is great to be pretty damn sure it is not MS related—and my meeting final notes say I have not had a 'relapse' — Huzzah! So it’ll be a case of knee and leg exercises, rest when appropriate, and pain management. Google searches over the last few weeks have involved pain management and knee exercises. The joys of getting older: you really know you’re getting older when your last search engine entry was ‘udder cream’ (thanks, Neil for that one).
Udder Cream. Really? Really!
The only thing I had to report really was that I’d been having issues with my knees over recent months which had consequently resulted in some quite bad issues with my legs a couple of weeks ago. I was majorly incapacitated for a few days—and for a short time I was seriously worried (Google searches at that time included ‘how to walk with a cane’). But as the days after the most severe issues passed my calves and thighs both got less painful and it seemed clear that the issues I’d had with my whole legs (rather than just the knees) was a result of a long day standing up resulting in fatigue and me trying ferociously hard to remain upright and not folding in on my knees (and failing repeatedly). The strain in trying not to collapse on my arse was evidently felt in all the muscles I’d used fighting gravity (and the frequently failing had probably bruised my upper legs too). Fatigue is a common issue with MS but I hadn’t knowingly felt the effects of it before. I guess it really was a combination of my newly arthritic knees and MS (purely in terms of muscle fatigue)—and basically standing up for too long on that one day. I will definitely sit down more often when out and about from now on. That said over the last couple of weeks I’ve found when you are looking for a place to sit when you’re out it is amazing how difficult it can be to find appropriate places.
The doc confirmed it was likely to be that rather than anything directly MS related (but of course call up the Walton Centre if anything changes). And from the check up on eyes, coordination, arms and leg strength, and nerves/feeling etc he reported that everything was the same as when I first came. All in all Happy Days!
Exercises. Exercises.
Of course it means I still have my knee issues to deal with, but it is great to be pretty damn sure it is not MS related—and my meeting final notes say I have not had a 'relapse' — Huzzah! So it’ll be a case of knee and leg exercises, rest when appropriate, and pain management. Google searches over the last few weeks have involved pain management and knee exercises. The joys of getting older: you really know you’re getting older when your last search engine entry was ‘udder cream’ (thanks, Neil for that one).
Udder Cream. Really? Really!
Applying for a Disability Rail Card
19/04/23 07:49
I only found out relatively recently that people with MS are entitled to apply for a disability rail card. The card entitles you (and someone travelling with you) to 1/3rd off rail fares. Of course this year I've already been to Birmingham, Lancaster, Manchester, Preston etc and would have saved a fair (fare) bit if I'd known then. Anyway, I'll no doubt be out and about on the trains again, so it was definitely worth applying now.
You can download and fill in a form to post if you want, but it is quick and simple online. That said be aware that the rail card website itself makes no mention of MS or other similar issues being accepted for the card. And in fact the list of things listed as accepted as proof of disability on the webpage makes it look like it just isn't. Do not be put off by this, just carry on with the application.
First things first. Before applying make sure you have a copy (a photo or pdf etc) of a letter giving your diagnosis. I just got a copy of one of the first letters I received - which was a letter from the hospital to my GP cc'd to me. And you will need a passport style photo (digitally if you're applying online - so just take a photo of a passport photo on your phone if need be).
Once you know you have a letter and a photo then just get on to the website at railcard.co.uk. You'll only have a small amount of information to fill in; the usual name, address, email et al. You'll be asked if you want a three year card (£54) or a one year card (£20) and then if you want a plastic card to be posted out, or a digital version on your phone (you can't have both). You'll be asked whether you're applying for the card for yourself or someone you know. Then you'll get to upload your document and photo.
No sign of MS on here, but don't worry
After you've filled in your details you'll be asked to select the reason for the disability and this is where it may be off putting - as you have to click on one of the long list including whether you are receiving PIP payment, receive an attendance allowance, have epilepsy, or a range of other options. As there is no simply relevant to MS click on any of these and get uploading. In my application I just clicked the first on the list PIP payment (which I don't get) and then instead of uploading a proof of PIP I uploaded my diagnosis letter.
After you've uploaded that you'll have to upload the photo and then you're pretty much there. Simple.
It says on the website that the process will take up to 5 days. In fact I applied for mine on a Sunday and received the digital card within 24 hours. Brilliant.
Whilst I wasn't challenged about the application I assume some may be depending on what you have been able to upload or whether there were any other issues with the application process. Just know that with an MS diagnosis YOU ARE entitled to get one. I suspect that it would take a single email or phone call to address any such queries. More information on travelling with MS can be found on the MS society website.
You can download and fill in a form to post if you want, but it is quick and simple online. That said be aware that the rail card website itself makes no mention of MS or other similar issues being accepted for the card. And in fact the list of things listed as accepted as proof of disability on the webpage makes it look like it just isn't. Do not be put off by this, just carry on with the application.
First things first. Before applying make sure you have a copy (a photo or pdf etc) of a letter giving your diagnosis. I just got a copy of one of the first letters I received - which was a letter from the hospital to my GP cc'd to me. And you will need a passport style photo (digitally if you're applying online - so just take a photo of a passport photo on your phone if need be).
Once you know you have a letter and a photo then just get on to the website at railcard.co.uk. You'll only have a small amount of information to fill in; the usual name, address, email et al. You'll be asked if you want a three year card (£54) or a one year card (£20) and then if you want a plastic card to be posted out, or a digital version on your phone (you can't have both). You'll be asked whether you're applying for the card for yourself or someone you know. Then you'll get to upload your document and photo.
No sign of MS on here, but don't worry
After you've filled in your details you'll be asked to select the reason for the disability and this is where it may be off putting - as you have to click on one of the long list including whether you are receiving PIP payment, receive an attendance allowance, have epilepsy, or a range of other options. As there is no simply relevant to MS click on any of these and get uploading. In my application I just clicked the first on the list PIP payment (which I don't get) and then instead of uploading a proof of PIP I uploaded my diagnosis letter.
After you've uploaded that you'll have to upload the photo and then you're pretty much there. Simple.
It says on the website that the process will take up to 5 days. In fact I applied for mine on a Sunday and received the digital card within 24 hours. Brilliant.
Whilst I wasn't challenged about the application I assume some may be depending on what you have been able to upload or whether there were any other issues with the application process. Just know that with an MS diagnosis YOU ARE entitled to get one. I suspect that it would take a single email or phone call to address any such queries. More information on travelling with MS can be found on the MS society website.