Please tell me what to say to the GP in my appointment

[Journeyintomelody]

Posting here for traffic as I really need some help.

Hurt my knee mid November. It started gradually when running. I treated at home ice, compression, elevation, ibuprofen - all the usual stuff. Got worse so saw a GP. She diagnosed it as Chondromalacia patellae after examining for approx 3 seconds and quite honestly I'm not convinced. It has now become so bad I can barely put weight on my foot. Taking 400 ibuprofen every 4hours and it's doing nothing.

I have underlying health conditions. A couple of years ago I fractured my pelvis (no trauma) and it took 6 months for an x-ray because noone took me seriously.
Last appointment GP said if it was anything serious I wouldn't be able to walk into the surgery... I do have a Very high pain threshold - I spent 6 months walking around with a fractured pelvis.
I'm a single mum with a very mobile 9 month old and I'm really struggling. I don't know what to do or what to say for her to listen. Also starting to feel some pain in my other knee 😭
I have an appointment with the GP today at 3pm.

Please help. What should I say?

You need to ask to be referred for an MRI, annoyingly they'll book an Xray first but really it's an MRI you need.

where in the knee is it sore? You might want to look up meniscus tear or MCL to see if it sounds similar

Often it could just be physio you need. I had knee pain for ages it got so bad. But turns out it was muscle imbalance, which could make sense with your previous pelvis issues.
But yeah you need to get them to xray mri to rule out anything

Thank you. I thought I needed a scan but wasn't sure which one. It's deep in the knee (front, and bottom), hard to pinpoint exactly. As it's got worse I'm also feeling it in the back of my knee (like a band around the knee) and feeling numbness in my lower shin.

Ask for a hospital referral. Say it's definitely getting worse, not better, and the pain has become totally unmanageable. Hopefully they'll give you some codeine or something for the pain for now as well. Ibuprofen gel is good for joint pain. I've got osteoporosis and the hospital hadn't even followed it up. I need to get onto them.

I hope you get the treatment you need soon.

There are plenty of places in the pelvis where you can walk on a fracture, if it's in a non weight bearing area. Maybe that's why you could walk? My mate broke it in two places but it didn't affect movement at all.

I had massive hip pain. Had mris and all sorts. About 3 years of back and forth.

still no further forward. Booked a private osteo and my pelvis was out of kilter.

four sessions later. All good. I have a ‘top up’ every year or so.

if you can go see an osteo or similar. You’ll likely get further than with the gp

That's a fair point with the pelvis. In general I do have a high pain threshold and so tend to downplay things. I know it's my own fault, when I see a doctor I go all quiet and shy and act like nothings wrong (so I don't blame them at all!).
I got slammed with a rifle once, thought I'd got a nice bruise, actually broke 2 ribs 😅

@Journeyintomelody now is the time to start telling them it really hurts! I'm pathetic and whenever there's anything wrong I always say my pain is a 10. It's only genuinely been a 10 once when I broke my hip so now I'm a bit more realistic with my scores! I hope you get it sorted x

Be factual: you struggle to weight bear at all.
Make notes of how & when the pain affects you, including how you've had to adapt around it. Think carefully because when one has high pain threshold/is used to pain, it's easy to overlook adaptations and how frequent / bad the pain is.
Remind, factually, that you are good at coping with pain (ref fractured pelvis) - say good at coping with pain rather than 'high pain threshold', because doctors hear that a lot.

What was the mechanism of injury? If it was something sudden then mention this as it supports the need for an xray or scan. It the pain developed gradually, it's more likely that you need to see a physiotherapist (and they can request imaging if they think it's needed).

When the doctor gives a diagnosis, ask about other possibilities and what the recovery time is...When should you come back if it doesn't improve? What will next steps be?

Amazing advice. Thank you so much. Really appreciated.

This is a good point - it's like doctors only taking depression seriously if you cry!

You need to be really honest and stick to the facts IME - I have ongoing back issues and had real issues with one GP - requested to see someone else in the end who was lovely and got me an MRI referral which I'm now waiting for.

@DuckDuckG00se are you medically trained by any chance?
The pain started suddenly during a run. I stopped running completely so it could heal. At that point walking around was fine, zero pain at all. Then I started getting excruciating pain randomly (the kind that makes you throw up or shout some very choice words and cry a little) which would disappear almost as quick as it came on. Now it's constant whenever I move my knee. But not when sitting or standing.

I think you need to actively show that you are in pain when you see the GP. . Use a walking stick. Limp or hobble. Cry if you can. A stuff upper lip just gets you parked until youre really in( obvious) need.

I only know this as cope well with pain and was devastated to not be referred when i had terrible sciatica. This was because ( in my notes) the GP stated that i had normal gait. I was determined not to wreck my joints by walking as my pain would have dictated. The next time i went i took a prop walking stick and grimaced a lot -referral made and lesson learned.

Don't be brave be clear about the pain and suffering ask for a mri. Physio could help too

No, I'm not medically trained. I have had extensive first aid training (beyond the usual first aid certificate), many members of my family - and friends - are in various medical professions and I've had both serious injury and illness myself.

The mechanism of injury is important to any diagnosis and is a key factor of triage. The fact that the pain has made you want to vomit / cry / shout is important information that you should share with your doctor.

Make notes that you can refer to when you're there.

As someone who isn't medically trained, from what you've said, I'd guess it's more likely you've damaged a ligament or random and not that you've broken a bone, so a physiotherapist is probably what you need. But that doesn't mean you dont need a correct diagnosis - just remember that physios often know more about MSK issues than GPs do so don't worry that you're bring fobbed off if you're referred.

Write down everything you want to convey, the history if it, how it affects you and your life, ways it has gotten worse - get everything organised on paper so you can look at your notes and make sure you have mentioned all the important points.

Firstly don't walk into the surgery - can someone come with you? Have you got a wheelchair/stick/frame you could borrow. Sometimes GPs need to see you at your worst to do anything. A lot of GPs are absolutely clueless. Personally if I were you if you don't get a good response I'd go straight to a&e and just wait to be seen. Or a walk in that offers xrays etc. Could be osteoporosis or something like that. Needs checking properly.

This, you have to Ham it up a bit.

I already have osteoporosis (which for me is painless), lupus (can be painful), and a history of injury without trauma (ie. Broken bones getting dressed). The doctor I saw last time said, oh I think I know what this is, before she even examined my knee. (Which is why I'm skeptical). I thought the GP would have been able to see my record during the appointment. I'm not even 30 yet just blessed with some not great genes!

As you have osteoporosis then in your shoes I would definitely query the possibility of a break and request imaging.

GPs don't have time to check patient histories properly anymore, don't be afraid to remind them of anything pertinent!

Ok you have significant list of illnesses there - you need to stand your ground - insist the gp thoroughly reads your notes and also talk them through it as you do so and insist on a referral/scan etc as appropriate. Don't be dismissed, stay in your seat until action is taken. If you don't feel able to fully advocate yourself in that way please bring a suitable friend or relative with you who will insist on your behalf.

If they refuse to take you seriously, ask that they record on your notes you've requested a scan/xray based on your history of osteoporosis and that it's been refused.

I hurt my knee last year. I felt like i was not taken seriously. I even fell in front of the doctor as my knee kept giving way. I was also screaming in pain and i was told to just take paracetamol. I referred myself for physio. My physio was really abbrupt. Basically she just said that i was anxious.

I've just been diagnosed with a cruciate injury which has similar symptoms to those you describe. I was sent for an X-ray to diagnose and now I'm seeing a physio. My knee was collapsing under me too. Insist on an X-ray and say that it is affecting your mobility.

honestly, you need a referral to physiotherapy and then they will pass you onto musculoskeletal team.

Don't use 'high pain threshold' its 'high pain tolerance' but then make it clear just because you 'tolerate' it doesn't mean it doesn't hurt, and you're not going to 'perform' your pain to make it believable, they should believe you.

Tell them you want a referral, it isn't getting better, and ignoring it isn't going to help, you want treatment and answers, and if they refuse you ask them directly to write on your notes WHY they're refusing, and they put their name to it, then you make another appointment with someone else.. you also have the option of complaining.

I'm currently in limbo myself, i have got sick of my GP and booked a private physio assessment with a local sports centre to see what they say.