Injection for knee pain

[fedupworking]

Hi I have bee suffering with knee pain now for a few years, attended hospital appointment last week where the consultant told me it was arthritis and he would try an injection before considering a knee replacement. He then went on to tell me he would bring me into theater in a few weeks to have this done, this I didn't expect and thought if that was what was to be done I'd have it done there and then.
My problem is I am TERRIFIED of anesthetics and avoid them at all cost, I'm assuming this is a cortisone injection but may be wrong, I'm on the verge of cancelling and suffering the pain, I've already had to give me job up because of this problem with my knee and I know it won't get any better by leaving it how can I get over my fear of anesthetics and do I really need to have one

[InPursuitOfOblivion]

Hi fedup,
I work in anaesthetics and I would say most patients are terrified of anaesthetics. Much more afraid of the the anaesthetic then the surgery even!
What is it specifically that you are afraid of?
Depending on that, there are lots of things we can do to help.

The other thing is, although I can't be sure, I think you are right that it is a cortisone injection you will be receiving but we don't anaesthetise patients for that procedure.

[fedupworking]

Hi and thank you for your reply, I've been terrified all my life of them, think it may have something to do with being born with a cleft palate and having surgery many times when I was young,anesthetic by the old method of rubber mask over your face, I would do anything to avoid surgery because of this.

[Matildathecat]

Hi fed up,

I have arthritis in my knee quite badly and have been told I really need a replacement. However, I have injections which are very helpful. So much so that for now I'm pretty much pain free knee wise.

I have something called Ostenil which is not a steroid but a synthetic version of synovial fluid that lubricates the joint. It is injected into the space under the patella once a week for three weeks. It ranges from very uncomfortable to barely even sore having the injections. The Specialist physio does it and it's no big deal.

Problem is, Ostenil has fallen out of favour and now I have to fight for it even though I definitely helps me.

The surgeons would rather do major surgery on a young(ish) person [confused) than do the injections that help.

Ah well, lucky the physio agrees with me.

Sorry, re your question, it doesn't hurt much and might help a lot.

[fedupworking]

Hi do you have the injections in theater ? I can't get my head round this as I've a few friends who have had the same thing done but all that their GP's surgery or out patients, think I'm panicking because I'm going to theater to have it done and never heard of it being done this way

[InPursuitOfOblivion]

Oh you are certainly not alone when it comes to 'previous crap anaesthetic experience induced fear'!
Luckily we have come a long, long way since those days. Most anaesthetics are not given via mask anymore (except in paediatrics) but rather an injection directly into a vein via a cannula.
In the case of knee replacement though, you don't even have to go to sleep. You can have an injection in the back that will numb you from the waist down. (Spinal anaesthetic) this can be done with or without sedation.
Or you can have just the one leg numbed from the groin downwards. This is achieved by injecting local anaesthetic around the nerves. (Regional block) again this can be done with or without sedation and has the added bonus of providing post op pain relief for up to 8 hours.
Not every anaesthetist can perform this type of block though. It is more commonly performed in dedicated orthopaedic hospitals but is gaining popularity in general hospitals.
Before the surgery you can request to have counselling specifically for your anaesthetic fear or even hypnosis.
On the day you can be given sedatives on the ward before you are bought to theatre.
Again I do not believe you will be receiving any form of anaesthesia for these injections. It is most likely just hospital policy that you must be treated in theatre not out patients.
Call the surgeon and ask him directly though. Don't feel you are being a nuisance or bothering him, it is his job to explain procedures to patients and to answer any questions they have.

[flow4]

fedup, the consultant will have a secretary, and you can phone up and ask. If you don't get a clear answer, you can phone PALS, and they'll help you get the answer you need. :)

[fedupworking]

Thank you so much for all the information, I feel such an idiot being so scared. I have put op's off before because of this fear but really need to do something about the pain in my knee as it is holding me back from doing things in my life that I want to do, I will give the consultant's secretary a ring tomorrow and see what I can find out, and as you say it possibly could be a case of them doing it in theater for hygiene reasons Thanks again as I do appreciate knowing I'm not the only person with this fear

[flow4]

No, you're definitely not alone. I'm on the list for a hip replacement and I'm terrified... I'm just dealing with it by not thinking about it!

[fedupworking]

Thanks everyone , I had a phone call this morning from the consultants secretary asking if I could confirm that I was attending the appointment next week, I asked what the procedure would be, she must have heard the relief in my voice when she said my knee would be frozen as she asked if I was okay with that, I blurted out " OH YES DELIGHTED " she started to laugh and said why is that so I explained how I felt and she said never feel like that always speak us about any fears you have.
Now I just have to keep calm and get it over with and hope that I will be pain free at least for a while. once again THANKS EVERYONE

[flow4]

Glad you've got that sorted, fedup. Good luck with it! :)