Knee injury and NHS

A snowHead

I ruptured my ACL in Breckenridge last year and after advice from my consultant opted to not have the reconstruction (I am 60) but to build the muscles up in my leg and get an Ossur brace to ski with.
Just back from another trip to Breck and had no problems with my knee and the best 9 days skiing of my life.
However this is not really about me, our friends came with us on this trip and on the penultimate day Deborah had a bad fall dismounting a lift and as her skis didn't detach she badly hurt both knees resulting in an evacuation from the mountain and treatment at the Breck clinic.
They are not sure exactly what she has done but braced one leg and told her to see her doctor as soon as she returned to arrange an MRI scan (by the way her insurers after seeing the x Ray arranged business class seats and private transfers to Denver and from Heathrow to Burnley).
The problem is that she is still in considerable pain but her doctor is not interested in her x Ray and says that her treatment has to start with a new NHS x ray before she can have an MRI scan.
As I had private health I had an MRI pretty immediately after I got back followed by pretty intensive physio which helped hugely with my torn medial ligament and I was told by my Physiotherapist that it was important to begin treatment as soon as possible to prevent scar tissue developing.
As she is on a waiting list now and a long way from an MRI does anyone have any advice as to how she may be able to short circuit the situation particularly as she already has the x Rays.
Thanks

A snowHead

@Steve.S, find it odd they won't accept the X-rays. Why subject someone to an un-necessary X-ray?

Well, the person's real but it's just a made up name, see?

When I did my knee I had to have a referral from my GP to satisfy the insurance, I then went straight to the private chap in halifax and had CT scan within 3 days, the private surgeon then said it would be better to see him via the NHS as his " tool kit" was in Huddersfield and he could do a better job. And he did... (Turned out he's a damn good knee surgeon.. Mr Chackrabati ) NHS should sort the knee out straight away..

You need to Login to know who's really who.

@Steve.S, You can pay to see an NHS specialist for a consultation, then transfer to their NHS list apparently. I've read of a few people circumventing long lists that way. Same goes for the MRI, prices vary from facility to facility.

Anyway, snowHeads is much more fun if you do.

@Steve.S, has she been to her GP or to A&E on her return? Hubby was advised to go to A&E for the fastest referral. It might be better if she went to A&E with her x-rays.

You'll need to Register first of course.

She could ask her GP to refer her to a specialist and then pay to see the specialist privately, which will save a lot of time and not cost much at all compared to a ski holiday in Breckenridge. He or she will almost certainly want to get their own X ray done (mine did) but so what, if it gets the diagnosis and treatment under way.

Then you can post your own questions or snow reports...

@Steve.S, A&E - they should have a knee clinic (according to my physio, but maybe not everywhere) but will certainly have a fracture clinic. My GP wasn't in the least bit interested in the X-ray, all I wanted was to get onto the surgeons list (I had already had surgery in Austria) for the follow up treatment. I insisted on a home visit as I was unable to get out of the house at that point. The GP came out, was only interested in the paperwork, sent it to the hospital the same day, I got a cancellation to see the consultant within a couple of days. If I had been able to get to A&E I would have likely done that as GPs in the surgery are (in my opinion) not best placed to deal with accidents and specialist diagnosis.

After all it is free

@Steve.S, when I was in agony with my locked knee (having been sent home from A&E and told goto my GP in a weeks time....but two weeks was the first available appointment!) I paid to see a doctor privately, he ordere an MRI and gave me the results all before I managed to see my GP, that cost me ~£500 (you tend to get special rates if you let them know you are self funding), well worth every penny, as they also tipped me off about "choose and book" which I used to get seen much sooner, and meant I could be referred straight to a consultant who then scheduled my knee op.

When I injured my knee in 2010 the (scottish) NHS were excellent.
MRI was arranged within 2 weeks and the twice weekly sports physio for 4 months played a big part in my rehab.
Far too many people moan about the NHS without realising how lucky we are in this country.

*Ski* the Net with snowHeads

snowHeads are a friendly bunch.

Something doesn't quite add up here. If her insurers were prepared to pay out on the basis of the X-ray (and presumably a letter from tbe clinic), then presumably it must be possible to see something on the x-ray which indicates an injury. An MRI might enable a more accurate diagnosis but surely the original clinic who did both a X-ray and a physical examination must have had some idea as to what the injury is. Did the clinic write a letter to the insurers? Did she see it? It might be worth asking the insurance company for a copy of everything they have in the hope that there might be some clues as to what the injury is.

snow reports

@Steve.S, and as a matter of fact (given their great treatment of your friend) who is the insurer?

You know it makes sense.

Thanks everyone.

I think that the A&E advice is probably best as she is in considerable pain and given that the Breck clinic is dealing with knee injuries all day long (as I can testify) then any X-rays they have taken should be of a good enough standard for someone in A&E to take a view (their was some mention of a possible small fracture by the clinic hence the advice to see her doctor as soon as she returned).

Her insurer was Tesco's who I have to say were fantastic with several calls to check that all arrangements were in place and to check how she was getting on.

Contrast this with my experience last year when all I had from my insurer was 6 months later a debt collector on behalf of the clinic in Breck chasing me for payment of the bill which had not been settled, no phone calls, nothing, I had to just make the best of it which was not easy given the nature of the injury, the fact that I cannot use my left arm (which they knew) and that I had to drive from London to Burnley with my leg in a brace.

I just assumed that this was as expected, I will certainly be asking them why there was such a contrast in service.

Otherwise you'll just go on seeing the one name:

A snowHead

A snowHead

^ try using the health service in other nations ?
suddenly the NHS, as a free service, seems pretty damn good Wink

if you hurt your knee then almost always the first course of action in short term is physio ?
in many ways the results of any MRI scan are irrelevant.
even if you eventually need operated on then the physio will significantly reduce you recovery time and is not wasted time.
surgery is intrusive and best avoided if possible (though obviously depends on each case)

when I badly seriously my PCL in 2010 I (wrongly) thought that my knee would need to be reconstructed.
at that time I couldn't walk or do any sport.
however I followed the doctors advice and after 6-12 months physio / hard gym work my knee was back to normal.
NHS signed me up to UK wide gym referral scheme which allowed me to use council gyms for £1 a session during rehab.
as mentioned above MRI scans aren't always conclusive either (still don't actually know if I ruptured or tore mine).

Well, the person's real but it's just a made up name, see?

@Haggis_Trap, ok but it sounds like OP's friend is being told she has to have a SECOND set of X rays before she can get treatment and no mention of physio course prescribed so, while it's great that you got a terrific service from the NHS, it's not really relevant…?! OP's friend probably shouldn't be too concerned about not having an MRI right now, but should be concerned about not having any treatment offered until she has a second set of unnecessary X rays...

You need to Login to know who's really who.

perhaps, being a qualified doctor, he had good professional reason to think that a 2nd x-ray is required ?
so might as get the ball rolling and get it done.
rather than assuming it is not required (physio and mri dont help broken bones)

of course service in the NHS is variable - they are a massive organisation.
but generally I think they do a great job at providing free health care to the nation ?

Anyway, snowHeads is much more fun if you do.

You'll need to Register first of course.

When I did my medial collateral, the French doctor in La Clusaz was most unsympathetic. He kept calling me an English Sissy for wincing when he was pulling my leg about. To be fair, I had noticed the rugby literature in his waiting room and gloated mercilessly about England stuffing France in the six nations. He did a great diagnosis though and I was very pleased. I did get a hefty bill though which I thought my EU healthcard thingy would pay for. Fortunately, my insurance paid but would I have been out of pocket if they hadn't?

Then you can post your own questions or snow reports...

@cameronphillips2000, you could have claimed some of it back on the EHIC.

After all it is free

Getting physio prescribed on the NHS is a bit of a lottery. When I went to my GP with a knee problem she got a student with her to do the examination, had the girl talk her through it, and discussed the findings - so I got a ringside seat at a very useful and informative session. She said there was some muscle wastage, "prescribed" physio as a first step but told me frankly it would take ages and suggested I see somebody privately to get some exercises to do, which I did.

There's never enough physio time on NHS - a session costs around £50 and you don't need that many if you take the instructions on board and do the exercises conscientiously.

Sure, it would be good if everyone got what they need on the NHS and sure, some health professionals are much better than others. But why would somebody who can afford to go skiing in Breckenridge not take themselves off to a private physio when they are in pain?

Hi Pam.
I think it more a case of the fact that she is not sure what she has done to her knees and doesn't want to do something that could make things worse which in the circumstances is sensible particularly as she was told by the clinic to see her doctor as soon as she got home.
I think that she is going to A&E today along with her X-Rays

*Ski* the Net with snowHeads

@Steve.S, second everything that us said about seeing a good physio. Mine is £35 a session...special rate as I'm in it for the long haul.

snowHeads are a friendly bunch.

I had a dog walking knee injury, resulting in MCL damage and a tibial plateau fracture. I went to A and E straight away, and had X-rays, and was told it was just ligament damage and to go home and take painkillers (by a nurse) I could not walk out of A and E! I was contacted by my doctor 5 days later who wanted to see me. I went and was told that I had a broken leg. I was to go home, not weight it, and wait for an appointment from the fracture clinic, being told it could be up to two weeks! That would have meant that my fracture would be 3weeks old! I went to A and E and had a meltdown, they agreed that would be too long and was not right. I was given an appointment for the next clinic. More xrays, the original ones still being in the first A and E attended. I was fitted with a brace, being told it was too late to do much else, and was sent home, being told not to weight bear, lay with my leg higher than my heart, and wait for my next appointment in 8 weeks. I did have an MRI in the meantime which on the next appointment confirmed that there had been a break. More x Rays confirmed no displacement, so I was lucky. I have had physio privately from the start, my knee is improving and I am back to working on the muscle wastage and other unexpected damage ie it has affected my balance. I can cycle, hop, jump and run, very badly but was never much good at running. It has taken a long time to get where I am now. So I would not hang about, I would take matters in your own hands and go to A and E. NHS physio is like gold dust, they would have not given me anything like the sessions needed. I am an older lady, and have been concerned that what is good enough for one, may not suit all. I was a very active 61yr old, and intend to be so again. Very Happy

snow reports

@cameronphillips2000, you may find that your insurers recovered the costs from the NHS on your behalf.

£50 a session !!! It's less than £35 here.

You know it makes sense.

Otherwise you'll just go on seeing the one name:

@NickyJ, yes my first session was about £45. Usual price thereafter is £40 but I get a loyalty discount rolling eyes

@Steve.S, has she checked to see if her travel insurance includes physio? I got £500 worth

A snowHead

Well she went back to the doctors today and I believe that they have now looked at the X-Ray as she does have a fracture and has now been referred to the fracture clinic.
She is going to contact them again tomorrow and is going to pressure them for an appointment.

A snowHead

@holidayloverxx,
Thanks I will tell her to check tomorrow

Well, the person's real but it's just a made up name, see?

You need to Login to know who's really who.

X rays aren't always obvious. My X ray did not clearly show I had fractured my pelvis; the doctor in the clinic I was taken to diagnosed that by examination, told me it would be fine and gave me various drugs and a pair of crutches. I found it difficult to believe, having never had a fracture and because I thought it would be a lot more painful (it didn't hurt at all if I stayed still). The X ray I had at the NHS fracture clinic, about 5 weeks later, very clearly showed where the fractures had been, and how nicely they had healed.

Anyway, snowHeads is much more fun if you do.

@Haggis_Trap, are you sure it was a second X ray that showed the fracture and not the original one?

You'll need to Register first of course.

@Steve.S, Hope it's not too serious; best wishes for a quick recovery to her

Then you can post your own questions or snow reports...

@Haggis_Trap, the NHS ain't free, it's free a point of access, tax payers pay for it. There are countries where their citizens get equal or better service.
I've had good and terrible experiences with the NHS and some excellent experiences in Austria, where cost really aren't that high of covered with ehic.

After all it is free

I think the NHS can and does offer a great service to many; I'm just not sure that the OPs friend got one when she returned with her X-ray and was told they were of no interest.

Steve.S all the very best to your friend - I hope her leg gets fixed and this doesn't put her off skiing!

*Ski* the Net with snowHeads

@pam w,

Help!!

Knee injury and NHS

snowHeads Forum Index >>> Ski Fitness, Exercise, Injury and Rehab