The WAITING ROOM => GENERAL KNEE QUESTIONS and comments (good for new threads) => Topic started by: calum1980 on July 10, 2005, 06:16:16 PM

Title: 6 times in 3 years. I need help
Post by: calum1980 on July 10, 2005, 06:16:16 PM
I know this post goes on for a really long time but please read it all. I've had to give the history of the injury over a three year period so it's not really that long.I'm using the emergency section because I dont know what else to do. I'll try to explain as well as I can. It started about three years ago. I was in a club, very drunk. The next thing I know there was an intense pain in my knee. I don't know what I did but I had to hold on to someone to get home. I couldn't walk. The next day I was in serious pain. I couldn't bend or straighten my leg. I couldn't walk. I didn't want to see my doctor. They are a husband and wife double act. The most incompetant people I have ever met. I'm not the only one who says it. The head pharmacist over the road says so too. I waited and hoped it would get better by itself. Two weeks later and it was still the same. So I went to the doctor. She was as much use as I thought she would be. First she criticised me for not seeing her straight away then she gave me pain killers and told me to move it around a bit. Would she have been any more help if I had gone to see her sooner? I doubt it. I waited for over a year for for my knee to get better. It never went back to normal though it did get a lot better than it was. Just as I was becoming more confident that it was getting better, it happened again. I was in a club again, dancing (I know, there's a pattern here). Suddenly, it just snapped. It was the most violent feeling inside my knee. It felt like my leg had broken in half and all the tissue had torn apart. I landed on the floor and after a few seconds I knew it wasn't broken, but the same thing had happened again. I got up and hobbled to a seat. It wasn't as bad as the first time (it never has been). But it was still bad. I still didn't want to go to my doctor. They hadn't been any use before so what use would they be this time. It happened three more times before I went back to the doctor. That was about two months ago now. Stupidly, I waited before seeing him (the husband this time). The swelling had gone down and I had regained most of the movement back in my leg (I've never had full movement since it first started), so it wouldn't even look like there was a problem on the outside. But I didn't care. I wanted somebody to take notice of the problem, and accept that this is a long term injury. He couldn't understand why I hadn't been to see him every time this had happened. I held back from telling him it was because he and his wife were completely useless. I explained what had happened and he didn't understand anything I said. He kept saying "I don't understand what you mean. You'll have to explain it better". I don't know how much better I can explain it. I'm not a doctor or a knee expert. He said that he couldn't see anything wrong. Well of course not. The swelling had gone down. The fact that it had happened five times in three years just wasn't important to him, and neither was the fact that I don't have full movement of my leg, or that it just keeps happening every couple of months. He prescribed some painkillers again (are they capable of doing anything else) and sent me for blood tests for arthritis, which it isn't and I never thought it would be. He told me to come back in three weeks. I did, and that was last week. Once again he told me there wasn't anything he could do because he couldn't see a problem. I once again pointed out the inability to move my leg as fully as my other leg, and he said that because it wasn't as bad as other people he had seen there wasn't any reason to do anything about it. Since when do you treat people based on other peoples injuries. He tried to give me anti-inflammatory's. I told him I could'nt take them because I have problems with my stomach and they cause a reaction. This seemed like an alien concept to him. He said I was refusing the treatment he was offering. I'm not going to take something that is going to cause me pain. I left, frustrated with everything that had happened. Two days ago it happened again. It's not as bad as it usually is, unfortunately (I know that sounds like a strange thing to say but if it was badly swollen and I couldn't move it then they would have to take me seriously. I've had the weekend to think about it and I know I will have to go to the doctor again, but I'm sure nothing will be done. At least if I go it will be written in my medical records if nothing else. I know I can't give much information about the injury itself but I really hope someone can help. Maybe someone knows what this sounds like and/or what can be done to fix it. If it helps, I'm not an old man with dodgy joints. I'm 25 and I don't do sports. Please help. I'm absolutely desperate.
Title: Re: 6 times in 3 years. I need help
Post by: stgiles16 on July 10, 2005, 06:23:04 PM
Can you not see a different group of doctors? I am assuming that you live in the UK and I am unfamiliar with NHS but can you not get a referral to an OS? Even the quacks could do that for you. If you cant see another group of drs, try being more forceful with these two and pressure them to give you a referral to an OS.
Good luck

Just a question here,,,,, do you think that your kneecap may be dislocating?
Title: Re: 6 times in 3 years. I need help
Post by: rozzzie on July 10, 2005, 07:51:50 PM
Go see the Dr with it swollen and with it unable to straighten and bend, that should make them take notice.  Maybe they'll give you a referral to an OS.  Like Missy said maybe your kneecap or the meniscus getting caught.  There are so many things that it could be that you need to see and OS that specializes in Knees. 

Wishing you lots of Luck!

Title: Re: 6 times in 3 years. I need help
Post by: calum1980 on July 10, 2005, 07:58:03 PM
I'm almost certain it's not the kneecap dislocating. It kind of feels like the whole joint coming out of place and everything tearing round the back. As for getting a referral I should be more forceful but they are such arrogant people and they talk down to me. I'm also worried that if I do get a referral and then they don't find anything then everyone will think I'm just wasting their time. Maybe I shouldnt assume that all doctors are as useless as the ones I've got but it's just difficult after everything I've put up with from them. As for getting a new doctor, the area I live in is really crowded and and no doctors are taking on new patients.
Title: reply to Rozzie
Post by: calum1980 on July 10, 2005, 08:09:43 PM
You'd think that would work but that was how it was when I first went and I just got painkillers. When it went again on Friday I actually hoped that it would swell up really badly so they would take notice but it didn't happen so now I'm nervous about seeing them again and being thought of as a time waster
Title: Re: 6 times in 3 years. I need help
Post by: Heather M. on July 10, 2005, 10:48:05 PM
You are wasting your time, unfortunately.  General Practitioners or GP's are not qualified or competent to treat knee issues.

To me, it sounds like you are subluxing your kneecap--slight dislocations.  These are extremely painful and can drop you to the floor.  You must see an orthopedic surgeon who specializes in knees and patello-femoral syndrome (PFS) to find out if this is what you have.  Essentially, this is the result of poor knee mechanics, where the kneecap is tilted or slightly out of position.  Then, under stress, it moves further out of position, which stresses and damages the soft tissue, ligaments, tendons and even meniscus.  That's actually another possibility--that you have a torn meniscus, and a bit of it is lodging in the joint occasionally and causing this extreme pain and inability to bend/straighten.  Then, with time and movement, the torn bit returns to its normal position...this can fool an inexperienced doctor into thinking nothing is wrong.  A condition which acts similarly would be a loose body, where a piece of cartilage or bone can actually move around in the joint and lock things up, causing agony when it jams the mechanics up.  An x-ray can usually see these if they are made of bone, otherwise an MRI is required.

So based on your symptoms, I would investigate PFS/mal-tracking/subluxations. loose body/chondral defect and also a meniscal tear.  Here are some great pages to do research; if you have to, print out the articles and bring them to the incompetent doctors.  But don't be a victim of the system--fight for your care and go over the head of your GP's if you must, as they are not trained to rule out knee problems!  Overview of PFS Damaged articular cartilage, which can lead to loose bodies  Meniscal injuries  Read the steps going down the left part of the page, from basic knee anatomy to meniscus to problems with the patella (which would be considered PFS)

There have been others suffering from dealing with the NHS who have managed to get the treatment they need, so don't continue to accept this level of treatment.  A GP is fine for triage, as long as he/she understands that they don't have the training to rule out orthopedic problems.  Their job is to try the basics (RICE--rest, ice, compression, elevation) and then refer the patient on for appropriate care.  Unfortunately, the job of those in the NHS is to ration healthcare, as there is not enough to go around.  So the squeaky wheel gets the grease, and all those other trite cliches.  Fight for your knee, as if the problems continue you can begin to experience serious disability!

Title: reply to Heather M
Post by: calum1980 on July 10, 2005, 11:32:27 PM
Thanks for that post. I'll get on with reading those articles. It also gives me a bit more confidence about demanding a referral.
Title: Re: 6 times in 3 years. I need help
Post by: blackbeltgirl on July 11, 2005, 02:24:59 PM
I also don't know much about the health care system in the UK, but can't you go to the emergency room?  As soon as it happens, head to the ER, and have someone there check it out.  At the very least, they may be more than willing to give you the referral to the OS.

Title: Went back to the doctor
Post by: calum1980 on July 12, 2005, 05:12:26 PM
I went to doctor again today. I hate him so much. I showed him how much movement I have in my leg. I can get it just past 90 degrees. Bear in mind with my other leg I can touch my arse with my foot, which I showed him. He said that it was a normal level of movement and he couldn't see anything wrong. He said we can't all be aerobics instructors. What a w*nker! I don't want to be an f***ing aerobics instructor, I just want my knee to be fixed. I don't care how much movement I have. The fact that this has happened 6 times is the problem. I demanded a referral which he said he would do but he also said he would note that he couldn't see a problem, which means I will be put at the bottom of the list again and again while more "serious" injuries go ahead of me. With the state of the NHS I'll be lucky if I get seen within 5 years.
Title: Re: 6 times in 3 years. I need help
Post by: Nettan on July 12, 2005, 05:16:35 PM
Are there any backways you can take f.i. see a private doc ?

Hugs nettan  8)
Title: Re: 6 times in 3 years. I need help
Post by: calum1980 on July 12, 2005, 07:25:44 PM
going private would cost more money than I ever expect to have, unfortunately. I'll just have to wait for the referral, which I think is only to see someone who will test how much movement I have, so I'm sure I will be told once again that they can't see what the problem is. They don't seem to understand this isn't about movent, but a recurring injury that I just want someone to stop it from happening again. Or at least cut it off above the knee. That would stop it. And that's how frustrated I'm feeling right now. >:(
Title: Re: 6 times in 3 years. I need help
Post by: rozzzie on July 12, 2005, 08:18:27 PM
If you haven't seen anyone and this happens again go stright to A&E.  If a DR sees it just after it happens and you will see someone and probably get a referal.  I don't want you to have to go through that again but if it happens, go directly to A&E.

Wishing you  GOOD  KNEE  DAYS !  

Title: Re: 6 times in 3 years. I need help
Post by: donna27 on July 14, 2005, 12:51:19 AM
I'd just like to say to you, Callum, that I completely understand what you are going through right now. 10 years ago, when I was 13, I had an extremely painful event like your initial injury. It took my G.P about 3 years to refer me to an OS, and even then, believe it or not, I was given an x-ray and told that there was nothing wrong with my knee! Years later, with injuries to myself from the 'falls' and 'locking' (including a fractured ankle and a fractured thumb!) I was refferred to a different OS (who was too busy too see me, so I saw a physiotherapist instead) who both ended up diagnosing an ACL tear and medial meniscus tear with an MRI scan. I have now had operations for both and are recovering, slowly.

I now have very little faith in the NHS and cannot help being totally paranoid about any treatment I receive. Hell, it is our bodies were talking about here!

I would definately advise you to go to A + E if it happens again. Although I used to go every time my knee locked, especially in the beginning, and all that happened was painkillers and x-ray, but you might get lucky! It's so frustrating how the level of care in some areas of the UK can be dated and even negligent.

Try and get your GP to refer you to a physio in the meantime? There are tests they could do that could make an assumed diagnosis, or at least give you some educated advice - just keep going to that doctor and he'll have to take notice. What person, never mind doctor, would suggest that there's nothing wrong with a knee that causes you so much pain and instability???

Good luck with the doctor and your knee - keep us posted on how things go,

Donna x

Title: update
Post by: calum1980 on July 15, 2005, 04:46:28 PM
Yesterday, even though I had left it almost a week since the last injury, I decided to go to the Accident and Emergency department to see if I could get any extra help. When I saw the doctor, she was very understanding, moved my leg about, and said she could feel something crunching, which is more than my own doctor has been able to do in 3 years. She also said (as I had already realised) that if this was happening to me at my age then it would just get even worse when I got older. She said she would write to my doctor to get him to refer me to an orthopaedic surgeon. I know my doctor said he would refer me to someone, but I have no idea who. He just mumbled something at me but it certainly didn't sound like "Orthopaedic Sugeon". Maybe one day something will actually be done.
Title: Re: 6 times in 3 years. I need help
Post by: lumpy36 on July 16, 2005, 02:40:00 AM
Hi m8

I'm really sorry to hear about the problems you're having with your GP.

I am an aerobics instructor and after waiting 18 months for a referral was told by the consultant that the best thing I could do
was stop what i did and maybe take up gentle cycling. Well, thanks very much for the complete indifference.

It seems that the only way to make progress with the NHS is to either play the benefits system or be completely incapacitated.

In the end I had a consultation privately - it cost £ 150.00 - but was worth it just to find out what was wrong with the knee and what my options were.

I'd suggest the same course of action and then, when a bit more information is available, camp at the doctors surgery until a proper referral is made for you. Its an awful way to have to do things but if you want people to actually take notice of a serious and debiltating injury it seems to be the only way.

Good luck.


Title: Re: 6 times in 3 years. I need help
Post by: stgiles16 on July 16, 2005, 03:08:19 AM
After being a member of this site for around a year or so,,,, I am so thankful that we in the US do not live in a country with socialized medicine. My heart goes out to you guys in the UK and Canada. when I see a post about it taking months just to get an MRI or an appt with an OS, it upsets me so. I continually complain about my stinky insurance but at least when I needed my MRIs and surgeries , it only took a week or so. I hope that you both feel better soon and that the NHS doesnt delay your treatment too long.

good luck
Title: Re: 6 times in 3 years. I need help
Post by: calum1980 on July 16, 2005, 06:02:05 PM
I just want to say thanks to everyone who has posted on here and to the people who will post on here in the future. It means a lot to have support from people who have been through similar things and who have mostly received bad treatment from various doctors. It has given me the confidence to demand more from them, rather than go away and shut up. It's a shame those doctors don't get to see this bulletin board and see the problems they have caused for people. Severe recurring injuries are one thing, but when you get mistreated, misdiagnosed, ignored and insulted by the person or people you desperately need help from, then that causes a whole set of other problems, physical, mental and emotional. Without their incompetence and arrogance this board probably wouldn't exist. So I would also like to thank the people who started this site. It really is helping. I just hope I get proper treatment soon.
Title: update
Post by: calum1980 on July 30, 2005, 07:52:49 PM
I mentioned that the last time I saw my own doctor I managed to get him to refer me to someone, but I couldn't tell who because he just mumbled something at me. Yesterday I got a letter from the hospital saying I had been referred to a physiotherapist and the waiting list was currently 8 weeks. As much as I am sure physiotherapy will help get movement back in my leg, it isn't going to stop the injury from happening again. I have to hope that he gets the letter from the other doctor I saw, who said she would get him to refer me to an orthopaedic surgeon. And I have to hope that he acts on it and not just decide that he's already referred me to someone else so he won't have to bother. Isn't the NHS wonderful?
Title: Re: 6 times in 3 years. I need help
Post by: rozzzie on July 30, 2005, 08:00:25 PM
Good Luck with Physio.  The physio could ask you DR to refer you to and OS, that might help get the referral.

Title: Re: 6 times in 3 years. I need help
Post by: silva on August 02, 2005, 09:53:29 PM
Hi Callum
You are haviing problems.. even with NHS things are not working. You  should have gome tp a&e each time, and they can refer you to O.S in their hospital,. do try digging you heels in and being more assertive, but politely.  Ny daughter has had  really bad problems with her knee, because they did not deal with it correctly in the first instance, also because you was not a sports person they thought  would not be too much trouble.  however things got worse, they referred her to ROH in London, they did a full scan, found she had a crushed pinal cord, which demanded instant attention, so the knee hjad to wait,  and she has now had 4 ops, we do hope this time will be ok, but you do have to  check out the surgeons, also do what somebnody else said, go for a prival consultantion which is about £150, then get put oin the NH list. also try you GP's and tell them uyou want referals and scans and now. The qualityy of life is bad and uyou are not preparted to be side railed anymore. be firm but nice.
good luck. Silva
Title: Re: 6 times in 3 years. I need help
Post by: Natalie.D on August 03, 2005, 02:09:58 PM
Hi Callum

I really feel for you, I too know what its like to get caught up in the NHS nightmare.  I agree with what a lot of people here have said about going to A&E next time this happens (I too think it sounds like subluxations/dislocations), I think you may have more of a chance of actually getting something done there.  Also I wanted to ask, can you not see another doctor within your GPs practise?  The practise I go to I can see whatever doctor I want even though I'm registered with a particular one as usually mine is fully booked for weeks!

Title: Re: 6 times in 3 years. I need help
Post by: calum1980 on August 03, 2005, 08:51:38 PM
As I mentioned before, there are only 2 doctors at the practise, him and his wife. And I don't believe she's even registered. I tried to go to another practise, but no one is taking on new patients. It's an overcrowded area, Seven people in a flat (apartment) sort of thing. My area is one of the places where they dump the countries asylum seekers, because they know people in affluent areas would complain. If you dump so many people in a poor area and no one can get a doctor, it doesn't matter because we don't count. I did go to A&E as I mentioned, and the doctor I saw treated me properly and said she would get my doctor to refer me to an OS. Whether he does that is another matter. I will probably have to go back to check. I hate having to see him. Thanks again to everyone for their support. It's very difficult not to get down about this.
Title: Re: 6 times in 3 years. I need help
Post by: shy20878 on August 04, 2005, 05:04:17 PM
Hello - I am 26 and have knee problems.  Both my knee caps are tilted towards the outside of my legs.  What you are describing sounds like your patella is subluxating.  That is when it partially dislocates.  The grinding you hear is the damaged cartilage.

About 12 years ago I twisted my body but my feet stayed planted.  I dislocated my right knee.  Since then it has gotten a lot worse.

In October 2001 I had surgery to clean up the damaged cartilage (knee cap cleanup). 

That surgery worked for a little while, but the pain got worse.  I was afraid to go to the doctor fearing I would need another operation.  So I lived with the pain until I couldn't stand it anymore.  With every step I had extreme pain, you could actually see the knee cap moving towards the outside of my leg.  If I sat on the floor and moved the knee cap it felt like it was floating in water.  I had swelling every day.  There were times when I would be walking and I would trip on nothing or I would completely fall.  Thats when I went back to the doctor.

They ordered ct scan, mri, bone scan and x-rays.  Everything but the x-ray (which showed nothing) showed that I had major damage to my knee cap.  I was scheduled for surgery to realign my knee.

In August 2004 I had the fulkerson procedure done (where they split the top of your shin, raise it and screw the tendon in place).  They also cleaned up the kneecap, drilled 15-20 holes in the knee cap to promote healing (I had worn a divit from left to right on the back of the knee cap from the sublaxations), they also did a lateral release.  After that surgery I had a 7 1/2 inch incision, 32 staples, and 2 screws in my leg.

I spent 9 weeks on crutches, 9 weeks no driving, and about 5 months in physical therapy.  The surgery was amazing!  I had no pain for the first time in 10 + years.

Then in Feb 2005 I hit my shin on the coffee table right where the screw was and I had to have surgery 1 week later since the area would not heal!  What luck huh?!

Well although the surgery worked to realign my knee I waited too long to have it done and the damage was already done.  The knee cap is now too dense to stay in place.

I am now scheduled to have the Avon Patellofemoral Arthroplasty done on Aug 18th.  The parts they are going to put on my knee last a max of 17 years.  So when I am 43 I will be looking at another procedure.  I have also caused damage to my left knee from favoring the right so much.  So I may need surgery on that one soon.

I am not telling you this story to scare you but I am telling you this because you CANNOT afford to be passive when it comes to your doctors.  Look at it this way - its your body, they are your knees, the doctors don't have to live with the pain YOU do.  Be forceful tell them to give you the referral!  Once you go to therapy do the exercises to strengthen your quad, that will help make recovery shorter.  There are exercises you can be doing now at home that will help you also.  If you like I can tell you how to do them.

For the swelling, lie on the floor, put your foot on the sofa where your rear is suppose to go and put ice on your knee.  This raises the knee above your heart and will help with the swelling.  You have got to get your knee moving - if you continue to allow it to stay straight or not bend all the way the muscles will get atrophy and you will have a longer and more painful recovery.

How far do you live from Bristow?  What are you taking for the swelling now?

What you are describing sounds a lot like what I started with.  Please feel free to keep intouch, I will help you in anyway that I possibly can. 
Title: Update
Post by: calum1980 on August 26, 2005, 01:16:44 PM
I went to the Physiotherapist today. I was really worried that, like my doctor, he would decide there was nothing wrong with me. Obviously, not everyone in the medical profession is as useless as my doctor. It has just been very difficult to believe. The therapist was amazing. He checked everything there was to check. He could feel all the clicking, cracking, jumping, muscle weakness. He even got someone else in who did something to my leg that made my knee do something I didn't even know it would do. I will now be seeing him regularly and I am going to be referred to an OS. Things are finally moving now, and even though it might take years to get things sorted, at least I know it's getting there now. I am so grateful to everyone who has posted here and been supportive. I don't think I would have demanded better treatment if it wasn't for this website. This isn't really an emergency post anymore so it should probably be moved but I don't know how to do that.
Title: Re: 6 times in 3 years. I need help
Post by: donna27 on August 26, 2005, 05:22:18 PM
That's really good Callum! It was a physiotherapist who got things going in my situation also. Hopefully you will get sorted before any other damage is done. BTW when you say your knee done something that you didn't know it would do, do you mean that your shin would pull forward from your knee?

I'm pleased that you've managed to find someone to take you serious at last,

Donna x
Title: Re: 6 times in 3 years. I need help
Post by: calum1980 on August 26, 2005, 09:15:47 PM
No, he pulled my leg to the side and rotated it in a way that I can't do myself, and then my knee started jumping around in it's socket. It's never done that before so I was quite glad they did it. Now I've been noticing things about my other knee. It has this thing that pops in and out of the outside of my left knee when I bend it and my kneecap is really crunchy. I think it's because I've been putting my weight on it for the last three years. I'll have to tell them on tuesday, but it only happens sometimes. Maybe it's happening now because they moved it around so much earlier
Title: Re: 6 times in 3 years. I need help
Post by: donna27 on August 26, 2005, 10:33:49 PM
Us kneegeeks don't have much luck with our stupid knees do we! Make sure you explain everything to your physio on Tuesday.

Keep us posted  :)
Donna x
Title: update
Post by: calum1980 on September 19, 2005, 09:05:55 PM
It's about time I told people what's going on. It's been a while. I'm doing strengthening exercises with a different physiotherapist until I see the surgeon I've been referred to, which will take a while. I've been told if I do need surgery, it's best to get my knee stronger first. As for my other knee, the thing that's jumping around is the hamstring. At least I'm being treated properly now, but I just want to see the surgeon. I don't know if the exercises are making my knee better though. I worry that it's making it worse, because it causes me pain afterwards.
Title: Re: 6 times in 3 years. I need help
Post by: donna27 on September 21, 2005, 09:51:05 PM
Hi Callum,

Nice to hear from you again! I know it's hard when your waiting for the surgeon, you just want to be told that they know what is wrong with your knee and that they're gonna' fix it! Like you say though, you are defo in good hands now in physio. You must tell your physio that you are getting pain after the classes (if you haven't already). Having strong leg muscles is always good for knees, but not if it causes harsh pain...?

My knee seems to be going backwards at the moment. I just can't get the muscle mass or strength back and it's totally unstable. I still can't jog or anything and I'm about 14 weeks post-op. I'm gonna' keep at it though.

Take care Callum,
Donna x
Title: update
Post by: calum1980 on November 19, 2005, 02:21:26 PM
It's been a while. Just to let people know what's been happening. I've been diagnosed with a torn/ruptured ACL. I will have reconstructive surgery, then about 9 months of physio until I'm fully recovered (hopefully).
Title: Re: 6 times in 3 years. I need help
Post by: donna27 on November 26, 2005, 05:32:02 PM
Hi Callum,
Glad you've finally been diagnosed! Good look for your recovery!. At least there are no probs with meniscus etc so far.
I've just started jogging - only manage about 2 mins before my knee starts to hurt but I've had serious muscle problems. Fingers,toes and knees crossed you'll have a swift and smooth recovery.
Donna x
Title: Re: 6 times in 3 years. I need help
Post by: Kayls23 on December 30, 2005, 12:41:23 AM
GPs are a load of nonsense. Unless you've got a common cold or something. When I was 12 years old I was having really, really bad pain in my right knee, the kind of pain that makes a 12 year old shut themselves up in bed and do nothing but cry. My mother took me to see the GP and she said, and continued to insist, that I had nothing wrong with me other than growing pains  ::). Fast forward three years and I'm having major surgery. It took my mother six months to convince the stupid doctor that something was wrong with me and I suspect that she only eventually referred me to a PT after being slightly intimidated by my mother one day when she insisted for the 60th time that there was nothing wrong with me.

When your knee starts to hurt again, go straight to Accident and Emergency. Exaggarate the pain if need be, but at least you should then be referred to an OS. Say that you've been having trouble with your knee for a long time, but this time the pain was near unbearable...

Anywho, good luck!
Hope the silly GPs will come to their senses!