To have opted for conservative treatment not surgery?

[growingsidewaysnotup]

I’m just looking for some opinions here as between this, a potential new job, and day to day life, my head is a scrambled mess.

I have recently been diagnosed with a painful but not critical knee injury. This injury is very hard to treat via physio, it has a poor outcome.

I really do not want surgery. I don’t particularly have the time for it this year, nor do I have the energy for the (intense) rehab after.

The physio said she understands this, in my shoes she’d be hearing for surgery but she can see why I’d want to opt for conservative treatment.

My partner, family and colleagues all think I’m being silly. They think that given the long term impact on my life and the pain I’m in, I should have opted for surgery. I do have to admit that after a couple of weeks of physio and being back to normal exercise levels, it does seem to be getting worse and not better.

Am I being silly? Should I just bite the bullet and get my name on the list? As this is a soft tissue injury the waiting list for surgery isn’t actually that long at my hospital (the consultants take on extra lists to do these - confirmed by a family member who works in the team), so id be looking at a 12-16 week wait.

I just need some clarity because my life is incredibly hectic at the moment and I can’t see the wood from the trees.

There will never be a good time for surgery,get your name on the list.

It’s your body, your choice but personally I’d go for the surgery. Long term it should save you time as the pain you’re in and the constant physio will end up sapping more of your time and energy than an intense period of surgery and recuperation, I’d have thought.

I might be biased in that I had surgery recently (not orthopaedic) and I was really anxious about it having had a horrible experience with a minor op many years ago. But anaesthetics and care have come in so much since then that it was far less bad an experience than I thought it would be and the long term effects have been more than worth it. But that was a very different surgery and I’m a different person so take it for what it’s worth.

I do appreciate that but between things I have planned (deposits etc paid so they can’t be cancelled) and a potential new job, this year just isn’t the right time at all.

apparently I’d be likely to be seen in April for the surgery.

I’m just really, really reluctant because I have a huge trip planned in August. I’m not just worried about recovery, but insurance, and everything like that. Also, being stuck in a foreign country in pain and unable to get any help sounds horrendous. I’m due to do 25,000 steps a day

Getting your name on the list, and actually having the surgery are two surprisingly separate decisions.

Often with waiting lists you can give them dates that you’re not available. You get a warning that that will delay the surgery.

You’d usually get an appointment to discuss the options prior to actually being booked for surgery.

So there’s a slow moving but still gradually heading that direction option - rather than next 12 weeks or never.

Put your name on the waiting list for surgery.It doesn't mean you're then committed to that, and you can remove your name if or when you want.

This way you keep all options open and time to think.

From how I understand it I can opt to go on at any time, and I have a follow up in about 3 months

But if things are getting worse anyway - would you actually be able to keep up with that due to the pain your feeling without the surgery?

As has been said, get to see the consultant, get the actual timings and see from there. 25k steps on a dodgy knee that needs surgery sounds like it’s going to be very challenging.

If it were me I would opt to go on the list now, as that will also bring forward any discussions with medical professionals that you would have before the operation; these would further help you to decide.

Unless it's private you could be waiting a year or so for the surgery.

I spent 3 years on crutches waiting for knee surgery, I had 'plica' catching in the joint and the pain was horrendous. The delay made things much worse and I ended up with the fat pad also being removed. I had a 2 year old, a divorce, a new job goodness knows what going on and it still made a lot of difference.

Isn't that holiday going to impossible with the injury you have? If you have the surgery you may be fit enough to go in August if you don't you will probably never be fit enough. If it gets worse while you are there you will be in exactly the position you don't want to be in, and you have to declare pre-existing conditions for insurance anyway.

You could book the surgery, there may be a cancellation to get it done earlier and if it really looks impossible closer to the date cancel, someone will be delighted to get a cancellation, not too close to the date to waste the slot though.

The way I see it, you can have 12-16 weeks of struggle, then surgery, then rehab, or 1-2 years (however long you put it off for) of struggle, then surgery, then rehab.

No. I can function day to day and even run, it’s just painful. The physio has confirmed that nothing I will do can make it worse, and that it’s likely unable to heal by itself. My insurance are aware as it stands

Have the surgery. My dad is suffering terribly with his knees and can’t have surgery due to other health needs and it’s really affected his quality of life at times.

Can this condition get worse over time?

I think so. I did it last summer and coped, it’s just painful

I’ll be honest as well, I’m a huge baby. I don’t think I’d cope with the recovery, which can be brutal.

I'd go conservative. I was told a gynae surgery would massively improve my quality of life, it did not. I ended up needing 3 further surgeries.

I will never have elective surgery again unless I break a leg or something. Elective means you can choose.

I'd go hell for leather over the physio. Swimming, daily physio, discipline, footwear change, look after hips and feet too. Look at how you sleep, book regular physio massages.

I think this is a lesson. You need to prioritise and value yourself.

A few years back I broke both shoulders within 2 years.

The first time I had surgery for plate and pins and my god it was so painful, it was 4 years back but I will never forget it. The second time, they suggested the surgery again and I begged them to go down the conservative route with slings and physio. Fortunately I was able to do this. However, if the doctors had said the surgery was the only way to treat it effectively I'd have gone with it.

If it's the only way to treat your knee you may have to bite the bullet, but I totally understand your reluctance.

I’m just not sure that surgery is the option for me right now. It would mean cancelling a lot of things I have planned that bring me so much joy to do.

I’ve had both knees replaced and both the surgery and recovery are brutal, but, I’m no longer in the pain I used to be in. Sounds like your surgery is different, but it doesn’t sound like the pain will make your trip in August much fun.

Can you go on the list and then ask to be considered for any cancellation that pops up. Get it over with and give yourself a bit more recovery time before your big trip.

But if the condition is getting worse, even with the conservative treatment, you have no guarantee that you'll be able to do the things you have planned. Yes, at the moment you could (albeit in pain the whole time which sounds soul suckingly dreadful) but you don't know how you'll be in 5-6 months. What happens if you go on the trip & it suddenly gets worse?

Also I don't know the specifics of your condition but is there a chance that in day to day life you're compensating on the other leg/knee therefore putting more strain on that one? What happens if you injure the other leg?

Surely it'd be better to bite the bullet, put the work in and have peace of mind knowing that even if it takes time, you'll be able to function without constant pain?

If there is no guarantee that the conservative treatment will work and your condition continues to deteriorate then it is a given that your quality of live and ability to do what you currently do will be adversely impacted.

You should also do some research about the impact of chronic pain on your mental health and well being - a key contributor to developing depression over a period of time. You should also consider the impact of your chronic pain will have on your family / DH. Again research will show that it has a detrimental impact on relationships over a period of time - no matter how supportive they appear to be outwardly , it’s hard living with someone suffering chronic pain. Is this something else you want to add to your list of issues for this year ?

By continuing to exercise on your painful leg by default you are putting stress on your body as it will try to make adjustments to reduce impact / pain on the affected area which over time will cause other issues , be that in your other knee / spine / pelvis / ankles / neck and then you will have another issue to deal with.

I get you aren’t keen on surgery and you want to protect the deposits on your holiday but what happens if you have a breakdown on your holiday ? Will your insurance cover an existing condition ? But in your position even if it doesn’t feel like the right time with everything else going on at the moment I would seriously think about the longer term implications for your mental health, physical health and your relationship and decide if there are work trading for surgery and extensive and intensive physio. It sounds like the intensive physio won’t be a problem for you as you are continuing to push through with your running and exercise and won’t it be better to elect having the surgery at a time which broadly works for you rather than a physical breakdown which means you can’t do what you currently do and it becomes an emergency.