That's a shame...about the 10k, but lucky you going travelling

We were in York at the weekend visiting so I couldn't go out training for too long but I ran 4 on Saturday, felt pretty good. Sunday my partner and I went out to do 12. At 5 miles I had to stop and stretch my leg, and had to repeat the stretching frequently from then on. It wasn't getting any better so we decided to cut the run short and finished with just over 9

Suffice to say that I was quite down on Sunday afternoon. I felt like I wanted to get my physio, sports masseur and acupuncturist all together in one room to pool all the knowledge they have of my injury and give me a difinitive answer to what should be done to fix it. I can't begin to say how frustrated I am with it.

I had acupuncture on Monday, he sympathised and tried a different, stronger treatment. And he suggested trying a form of acupressure massage on my next time. I'll try anything now so that should be interesting.

I have spent so much on this injury but now I'm thinking of an 'all or nothing' strategy. The acupuncture/acupressure treatments cost me £32 each, my sports massage costs £25 per half hour session, and I'm thinking of having one of each per week for 4 or 5 weeks. It'll cost me quite a bit, but if it means I can train properly for this marathon in the time I have left and ultimately run the race knowing that I have trained for it then it will be worth it.

Any thoughts?

Trinity
If you think your treatment is worth it then you should have it also if it helps put you in the right frame of mind you need for the marathon...you have done really well up to now so you should do what you feel is right for you. Cant offer any advice as such as I am still a novice but I think its great the committment you have to running in spite of your injury. Good luck with whatever you decide and keep your chin up.

Best Wishes

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NELLIE

Trinity,

You're not really getting anywhere, are you? I've had another look at your first message in this thread to remind myself of the details of your injury. You've probably researched the web no end on this, but I found this web site useful, which discusses hyaline cartilage injuries in particular:

http://www.sportsinjurybulletin.com/...e-injuries.htm

You mention seeing some physio's and the MRI scan which shows a clear tear to your hyaline cartilage. Is your injury a superficial one which is tough to heal or a deep one where surgical intervention might be the best answer? Knee injuries are very tough to diagnose even with MRI scans, and your training might not be helping the healing process much at this stage.

I admit I'm biased, but have you considered getting a referral to an orthopaedic surgeon, and discussing with him whether an arthroscopy might show up the real extent of the damage much better than an MRI scan? Having private medical insurance helps for this, but the NHS route should also work, though much slower.

The arthrosopy is just the camera part of the operation. They make a small incision (mine is about 0.75 cm long), and insert a camera to have a good look around. If there is any tidying up to do, then they make another small incision of the same size, and insert a different surgical implement, and then tidy up the offending bits of cartilage. The operation, which is done under general anaethetic, last 20-40 minutes, and you are out of hospital the same day. It's no big deal.

My injury was a large tear to the meniscal cartilage (I think the more usual area of damage), and lots of debris caused by abrasion over time. So my operation was called an arthroscopy and menoscopy. In the end the surgeon removed 15% of my total meniscus (which in my opinion is quite a lot). The surgeon's diagnosis after the op was that 'this was one operation well worth doing' as my damage was quite extensive. I saw the before and after photographs after the op, and the before shows quite a mess. I have been taking glucosamine and chondroitin ever since, and can feel the difference if I stop taking it for a few days. Hopefully, I will eventually wean myself off this supplement, but I see no reason to hurry.

I suffered with my knee for about 10 years before it finally went completely earlier this year. I was unable to do real exercise for years, and accepted a sedentary lifestyle just as the vast majority of our British population does. Now that the whole thing is behind me, I am a new person and exercise is no longer an issue. I can't begin to describe the relief I feel.

I would suggest you discuss your injury with an orthopaedic surgeon. Get a GP referral. The surgeon may well, based on your MRI scan, turn you down for an arthroscopy. But equally, he may decide to go ahead. It's well worthwhile to describe your athletic past and future ambitions to him. I suppose this all depends on how clearly your MRI scan shows up the hyaline tear, and whether it's clearly superficial, or maybe deeper.

I think (!) that many people just have the arthroscopy done, and nothing else. I say this because, on the day of my operation, the hospital insisted on calling my operation an arthroscopy only, whilst my doctor already knew (from my MRI) that a menoscopy would also be needed. So he kept adding to their records the extra 'menoscopy' word in. From that I concluded that it is not unusual to have just an arthroscopy.

Go for it, girl. Chase all the possible avenues. Sorry if I'm biased, and others on this forum may disagree with this opinion. I accept that. But I don't see why you should suffer with such an injury (stop your life as it were, as I stopped mine), when this is really a very routine operation, and hospitals conduct thousands of these every year.

Thanks Karen

Although I don't think it was a clear tear. The MRI report said:

1. No meniscal, cruciate or collateral ligament abnormality is shown.
2. Normal patella tendon and quadriceps mechanism
3. Some hyaline cartilage irregularity and ulceration is shown over the lateral facet of the patella.

I don't have private medical insurance and I would have to go the NHS route. So I expect it would be about a year before I could get an appointment for an arthroscopy
But then I don't suppose there's much harm in getting on the waiting list.

To be honest... just the thought of not being able to run for a year or more scares the life out of me, especially as my partner runs too... it's a case of the physical pain of running against the emotional pain of not being able to.

This is an awkward conundrum.Run and suffer physical pain or don't run and get "depressed".

SWMBO is in the same boat as you Trinity. She has Rheumatoid Arthritis and hasn't been able to run much since doing the Keswick 1/2m in April. To make it worse I keep on running and entering races that she would have done too. It's an impossible situation to resolve unless and until you are able to accept the position you are in and maybe find some other form of activity to keep you fit whilst you recover. Easier said than done though!

I'm sure you'll come through it eventually so keep on smiling!

Yes, I agree, Steve. It's an impossible situation.

It's also when the NHS lets you down on things like this that you feel so utterly helpless. There is nothing life-threatening wrong, but it is life-reducing. So maybe, Trinity, get yourself on the waiting list. If things get worse in the meantime (and they sound pretty bad to me already), then at least you're on the list and they may up your priority. Alternatively, if things get better, you can always take yourself off the list (but I would think you'd want to keep on it as long as possible to be sure). Maybe it's not a year's wait anyway, maybe it's less... You won't know until you've gotten onto it.

As for physical pain - well, the body can take an awful lot. It was only after my operation when suddenly there was no more pain, that I realised just how long and how subtle my pain had been for the years leading upto it. We do such crazy things to our bodies, and they keep taking the pace. Emotional pain is a lot worse, but the strength to overcome it must come from within.

What exactly is rheumatoid arthritis, Steve? The only thing I think I know about it is that it can hit people fairly young. But is it life-long thereafter, and can one's diet help it at all?

Good luck Trinity.

Bl**dy NHS!! I have been reminded today of why I choose to pay for as much medical help as I can afford!!

I phoned the surgery at 8.30 this morning to get an appointment, however you're not allowed to book an appointment in advance now and can only book one for the same day.

But they don't have any appointyments left for the day and you can't get added to the list without getting past the 'triage phone call'.

I was told to wait for a doctor to phone me. I asked when that would be and she could only say 'sometime this morning'.

At 12 midday I phoned the surgery again because I hadn't received the phone call.

Apparently the doctor who was supposed to phone finishes at 11 so another doctor has to pick up the phone calls left to be made after they have finished seeing patients. I was told that someone would call me within an hour.

A GP did indeed phone within the hour but a few minutes into the call the phone went dead.
I was getting 'a little tetchy' by this time so drove down to the surgery with a copy of my MRI report.

Explained the situation as calmly as my impatience would allow (I think I did quite well actually) and said that all I needed was a referral for an arthroscopy.

Obviously I wasn't going to get past the receptionist, because otherwise she wouldn't have been doing her job... heaven forbid I ever get to see a doctor!

But she did take a photocopy of my MRI report and wrote a little note to put with it in the doctor's pigeon hole... so I should be grateful huh

Good grief!

I do feel for you Trinity, I used to be a Doctor's receptionist and take it from me it is not a job I would recommend or wish to return back to!!! Good luck I am sure the receptionist will pass your MRI report onto the relevant Doctor and hopefully someone will get back to you soon.

__________________
NELLIE

It is a lifelong illness. Fortunately SWMBO got an early diagnosis, despite the best efforts of her GP to fob her off, as we paid for a private consultation with a Rheumatologist. I could easily repeat the NHS stories given by you Trinity!

RA effects your joints and with time causes damage to your bones. 3x more women are effected than men and it can be completely debilitating.

Diet can help and SWMBO has seen a nutritionist and not only has a list of foods to avoid but also a number of pills to pop alongside those given to her by the consultant.

Roll on 2007!

Really sorry to hear bout SWMBOs illness Steve... I can only imagine how she feels

I phoned the surgery early this morning to find out if there had been any progress on the little note that was left for the doctor about my referral.

Todays receptionist knew nothing but said she would make a phone call to find out and phone me back this morning.

Well I waited in all morning, just like Thursday...but no call, also just like Thursday
So once again I got in my car and went down there and asked calmly, but assertively, what was going on, because I have now wasted two whole mornings waiting for promised phone calls that never came.

Now, considering I have had physio from 2 professional physiotherapists since May, one of whom referred me for the MRI, plus sports massage, plus acupuncture and have probably spent in the region of £1000 on treatment, this apparently isn't enough evidence for the NHS.

I was told this afternoon by the receptionist (because doctors are obviously far too busy to see patients) that firstly I would have to be referred to 'knee triage' (whatever that may be!) before then seeing a physio of their choosing, who might then decide that I could have an arthroscopy

I'm sorry but I don't understand... I have spent all my money on investigating a problem that clearly the professionals can't fix permanently with manipulation, so why do I have to see more people and waste NHS money, to tell me what I already know...can't the NHS talk to private physios or something??
And they wonder why the NHS is collapsing!!!

Thanks Trinity.

The NHS is just hopeless isn't it...SWMBO was told when she went to her GP that she could go on a waiting list for a referral...2 months wait at least...may not sound that long but RA progresses quickly without treatment. When we saw the consultant privately he immediately gave her a steroid for instant relief, prescribed medication and asked " Why didn't you come to me sooner?" Moral of the story .... ignore the NHS go with gut instinct and go direct to a consultant.

NHS only interested in meeting target numbers....getting people fit and well enough to return to work seems irrelvant to GPs.

It's ridiculous that you have to spend your hard earned and then still have to go through the NHS system as you describe.

They (God knows who THEY are) say the NHS is the best in the world.....heaven knows what similar systems are like elsewhere!

I hate waiting in for calls/workmen to arrive...you just know they won't call/arrive when they say they will.

Why not write to your MP and local health authority CEO copying in the GPs surgery. Probably wouldn't get you anywhere but would at the very least put the GP on edge.

MAKES ME MAD!!!!!!!!!!

I'm sure we could rant all day Trinity!

Im sure you could.

Costs of my operation

Just so's you know - my consultant's bill for the arthroscopy and menoscopy was about £550 (that was for the operation itself). The hospital added another roughly £1000 - £1500 for the anaesthetic and the hospital room, nursing and medication for that same day. I had a number of physio sessions after the op - they came to about £200. The consultant may have put forward further bills to cover the appointments that I saw him for before and after the op, but I don't know how much they were. And then there was the cost of the MRI (again, I don't know how much).

I'm sorry I can't be more precise on these costs, as many of the bills were sent directly to BUPA (my private medical insurance company), without me getting any idea of the real costs. But I'm guessing a budget of about £2000 - £2500. That's a shed load of money.

I wish we could help you more, but I like the suggestion of kicking up a fuss with your MP and local health CEO (never heard of that role before now).

I must also add that my GP's surgery is not as awful as yours is. I can get to see my doctor relatively easily, and they have not apparently adopted this 24/48 hour rule as a rock solid policy. Some rules are meant to be broken. Continue to make a fuss.

PS - the funny thing was - my husband had managed to completely snap off the tendon across the front of this knee (his kneecap was sitting half way up his thigh) - whilst skiing - and the same consultant that 'did' him, did me nine weeks later. That total operation came to about £5000-£6000, for what was clearly much more serious surgery.

Hi, and thanks guys for all the support and encouragement...

Karen... I somehow don't think your husband saw the 'funny' side


Anyway, I have had a modicum of success at the GP health centre this afternoon. I finally got to see a real live doctor!! No, really I did!!

I went armed with the films from my MRI, plus the MRI report, plus a business card from my physio, which stated that he was a 'Member of the Organisation of Chartered Physiotherapists in Private Practice'.

I also saw a completely different GP who I had not previously seen about anything before.

He listened to me rant for a while and then sympathised, which was a good start, and calmed me slightly. I did also apologise for taking my frustrations of the health centre and NHS system out on him though.

He said that he thought my case was exeptional and that I didn't need to go through the whole process of knee triage and physio before seeing a consultant, agreeing that I had already spent money on seeing a variety of professionals so it would be a waste of valuable time.

He is going to refer me to a consultant straight away


Meanwhile, I am seeing my sports masseur and he believes there is an alignment problem, which is why I get the feeling of my knee being out of joint, but if I stop running and do a few stretches the problem disappears for a little while.

I tried running today and had to stop and stretch out after 3, then 3.8, then 4.5...when I finally gave up

I've got an acupressure treatment tomorrow and then I think I'm going to see my sports masseur twice a week for as long as I can afford it...to see if he can fix it enough for me to at least train regularly.

The marathon is 8 weeks on Sunday