13/02/2025
Knees.
Knees…those bendy knobbly hinge joints of which we have two, and some of us may have even entered into competitions…
Now, the knee joint is a synovial joint …this meaning it is made of a cavity in one bone that another bone fits into …to aid the lovely gliding motion between the two bones, slippery hyaline cartilage covers the ends the bones… and all is further lubricated by synovial fluid..
This is all as it should be ….how it was designed…how we were initially made… but a life of being ambulatory, the 80’s and 90’s spent impossibly high heels….and maybe having an over active penchant for delicious high calorific foods… have meant that my knees are worn out…
The correct medical terminology being “osteoarthritis”
laymen’s term “wear and tear”
And ….
in actuality my knees are “buggered”
It was on my agenda to get some treatment for my painful restrictive joints…. I still had dance moves within me that needed to be appreciated.
So after spending our morning in the stifling dry streets of Margoa, buying all things glittery, we decided to take a tuk tuk to the hospital that we knew so well….Victor Hospital.
We had spent a frightening 5 days here 2 years ago when Meesh was unlucky to get a DVT. I never wrote about this at the time.. but maybe now the trauma has faded, I will….lets see…
Anyways…..
We alighted the rickety old tuk tuk, all shaken but not too stirred and headed towards the main entrance. This was to be a fact finding visit, to see what was available and what we had to do to make arrangements for appointments etc.
We spoke with the two guards who were milling around at the bottom of the large winding open slope that led to all departments .
Explaining about a desire to have better knees, I asked them what direction should I go to seek assistance with this ….
I thought I had done a pretty good job of describing what it was I was after …. But as they directed me straight to Accident and Emergency I questioned my communication skills…….
As we walked into the surprisingly airy A&E reception, Michelle and myself instantaneously said “Winston”…. The last time we were here we both witnessed the very probable and untimely demise of a man called Winston… but more of that on another day dear reader….
I asked the receptionist about where I should go to have my knee-needs sorted… she told me to go into the A&E department itself…
So…. As its India… why not…
Somewhat bemused,my travel companion and I walked through the swing doors now being held open by a smiling guard…
Inside everything was comfortingly calm, no urgency, no repetitive shouting of “Winston”, no sight of CPR being performed on a moving trolley, by a lithe female doctor who was on the trolley with the patient, whilst being almost cheered on by a large crowd of onlookers….. no none of this time … so we hardly recognise the place…
The sight of two bewildered tourists caused 4 members of staff to approach us in a friendly helpful way. I took the time to explain to very handsome older man, what it was we were trying to achieve. He nodded most reassuringly and took charge of the situation. He instructed one of the younger female members of staff as to what to do…..
So within minutes of piling out of the faded yellow and green tuk tuk, we had our own “hospital assistant”
We were led up to the outpatients department. We were assisted in completing a registration form, and we paid the fee of £6.50 to secure us an immediate appointment with the orthopaedic consultant.
We were taken to a small waiting area, where the large ceiling fans made it an ok place to be. A tiny pretty nurse, called us over in turn by name. Here in the middle of the waiting area where lots of beautiful brown people sat in plastic chairs paying no particular attention to us, we were weighed and blood pressure was taken.
Michelle was also going to be seeing the orthopaedic surgeon as she was wanting her hips checked…. One of which was as she was born with, ……. the other bionic!
Soon I was called into the consultants room….. of course both of us got up to go in….
Buy one, get one free
The Ant and Dec of Goa…
Dr Pawan Rajurkar looked semi delighted, semi nervous as we both bowled in amidst a flurry of shopping bags, big earrings and two very messy top buns!
“ oh,” he exclaimed “ you have both come in together”
He started to shuffle the files trying to understand who was who and what was what….
It was ok…. We sat down and launched in with what we were all about.
Dr Rajurkar was a lovely affable man, who soon melted into our banter. He regained control of his own consulting room and began asking me all the relevant questions about my knees.
Enquires made, examinations competed and discussions had the decision was made for me to have X-rays of both knees, then two injections into both knees one of steroid and one of hyaluronic acid.
Meesh was to have an MRI of her hips to see what the current state of play was. Could it be all those years of fabulous moves on the dance floor had made those hips impossibly sexy?
We left the consulting room together, and promptly went our own separate ways…. With cheery bursts of
“Good luck friend”
and
“I’m sure we will find each other later”
We sashayed down the corridors, jewellery glinting, and colours flashing, channelling Kate Moss and her mate Naomi…..
I did have a wait of about an hour for my X-ray.
There was an issue with the equipment ….it was misbehaving intermittently.
I chose this hiatus in proceedings to collect myself( it had been a bit of an unexpected whirlwind since arriving here, we had only come to make an appointment and now it was all happening ….. no chance for nerves to set in I guess…), drink some water, which I luckily had with me, and more interestingly take stock of all that was around me…..
Little pockets of plastic chairs sat in neat rows, all with bottoms upon them. I was the only person on her own. It’s a thing i have observed in Indian medical places …it's extremely rare for “the patient” to be alone.
A medical visit tends to be a family afffair, parents, offspring, siblings, maybe even second cousins will all be there to offer support and assistance.
I was sat amongst older sari’d ladies who held onto big bags that I just knew held copious amounts of snacks as the maternal compunction to always provide sustinence runs high here. Companiable men folk sit along side the ladies, limited chat, occasional grunt, occasional unwrapping of a food stuff.
Youths in over-tight jeans monitoring their elders when they can take their eyes off of the small electronic screens permanently in their hands…..
Although the setting was somewhat more basic, the heat somewhat more heavy the behaviours were universal to any waiting room world wide…..
As i sat waiting for my name to be called, my phone rang. It was my “drug supplier”. He had been given my details by Dr Rajurkar and it was from him that I was to buy the hyaluronic acid injections.
These were not held as routine stock here at Victor Hospital. He asked where I was and lo’ came and found me. After handing over the two boxes of pre-filled syringes, he whipped out a portable card machine and I paid him £280.00.
The time came for my photo call, The efficient busy radiographer was very good at making sure she got my “best side” if there was such a thing on these worn out old joints….
I left the X-ray room and clutching a slip of paper she had given me. She said to leave it 30 minutes, then the report would be ready and on paying at the main outpatient desk I would be given the X-rays and the report would be instantly emailed to me.
I sat patiently waiting on another a plastic chair, gazing at a lonely little cardboard star hanging from the ceiling still telling of the Christmas just gone…. It’s rhythmical fluttering from the breeze of the big fan swaying me into a lovely little soporific state….
Dozing, a voice shook me from me seated slumbers….
Meesh was alongside me… She had had an MRI and was now having a CT scan ….she didn’t really know why but as it was India was just going with it ….
We had a little catch up on what we had seen, what we had heard, and what we had experienced…. It transpired we were both concerned about a very elderly, thin lady who was accompanied by a man who we assumed was her husband… She was constantly being asked to drink liquids by various medical staff, and then being whisked off behind different doors. Her path had crossed both of ours over the hour or so we had been in various departments and independently we had both considered whether we were going to get another ‘Winston’ situation……
As Meesh disappeared around one corner, I wondered off with my X-ray in hand back down to A&E as this is where the procedure was going to be done.
I sauntered in like an old hand, I knew how those doors swung……
I spoke with the first medical person I saw, explained that I was waiting for Dr Rajurkar… he showed me to yet anther plastic seat.
I sat with my back to where Winston we believe met his maker….te flashbacks still being strong.
The kindly gentleman came back over to me and explained that there had been some mix up in communication, …… I was in the wrong place. I should have gone to the Operating Theatre……
Now my heart rate went up a notch……
He told me how to get there so off I went, somewhat hesitantly….
I climbed back up the wide sweeping slope… two floors this time…
Read the big wooden signs and found my way easily to the OT department.
The doors were very official with very strict instruction not to enter. I found a seat outside and sat amongst 4 or 5 others waiting….
After 10 minutes or so of waiting and wondering what my fate was to be, a man in scrubs appears at the door and calls out for me….. well it sounded like Emma ….and no one else moved so I got up and out of my seat …prepared to take my chances…..
Once inside the big heavy prohibited doors, I was asked to take my trainers and socks off….. and leave in a pile with several others. I did as asked and then duly followed the man to my destiny.
Taken into a large airy light room, I noticed two curtained areas sectioned off. I was welcomed to the one in the corner and instructed to climb onto the bed. I eyed the bed, thought of my knees, but still made the attempt……. The young male nurse watched , nodded and dropped the bed lower for me…. Knowingly dignified.
I lay back….. not wanting to think of England…
The smiling face of Dr Rajurkar appeared around the curtain. I could tell by the atmosphere around me he was revered. He seemed to have quite a brusque tone with his colleagues.
Maybe a man with many patients but not much patience……?
Dr Rajurkar was now getting gowned up….
This was getting serious…..
I was expecting needles but was he about too turn around with a scalpel??
Then I recalled Indians love a bit of drama, love a bit of a performance especially when it comes to all things health related.
If anyone you remotely love or even just like goes to hospital, you all go, and you all camp out with the patient, just in case…. That’s what you do if you are Indian. If you get a cough or a chill, you go to the doctor and get an injection…
Indeed when Dr Rajurkar discussed my X-ray results with me he told me I had the knees of someone 10 years older than my real age and indeed I was osteoporotic….. surgery for my knees was only 2 years away….
I disagreed with all of that ….Dr Rajurkar wasn’t to know I was a chiropractor and could read the X-ray just as well as him……
I don’t think it is done with any malice or negligence ….. they just like to over dramatise….
Anyways in the pursuit of pain free walking and maybe even jigging I was prepared to trust this big brown handsome man…..
I was on my back, both knees were bent and had been painted in the very dark iodine solution …that antiseptic solution that has been used pre-operatively for some time 100 years now to disinfect and sanitise skin before breaking its surface with surgical tools…
I’m still hoping at this point the only tool to break my skin is a hypodermic……
Dr Rajurkar, all clad from head to toe in a papery material of mushy pea green approaches latex covered hands held aloft and asks “ are you nervous”
Hmmm…….
Well I wasn't …..but the course of events have gone down a whole different path than i was expecting…
I had only popped in for a quote…….
The experienced surgeon detected a flicker of apprehension that swept across my face …. He told the young female nurse to get a pulse meter on my finger. She snapped to it quickly… he wasn’t a man to keep waiting.
Right knee was first to be done. Clever well trained experienced fingers prodded into the painful area where the decreased medial joint space existed. I confirmed that he was in the right spot with a little controlled whelp ….
Ok, so Dr Rajurkar was going to be kind….he was going to put one cannula in and use that one portal for both syringes.
Needle goes in…… reasonable….. don’t even grimace…
He pushes the large syringe of hyaluronic acid in first. I feel pressure, discomfort. He checks I’m ok …
I reassure him that I am.
Next the smaller syringe of steroid. This elicits a bigger pressure feeling but still bearable…..
me, Dr R, his two assistants we are all doing ok…..
With both drugs in, the cannula is removed and Dr Rajurkar gently moves my knee around to distribute the magic fluids…..
The improvement was instant!!
If I hadn’t felt it myself I wouldn’t have believed
I had absolutely no pain in that knee and could lay it flat on the bed ….something I couldn’t do before …..
How is that ?
Who was this man?
Was he married?
He moved to my left side.. my brown knee raised and ready…expectant….
Cannula goes in…..
ooh that stung a bit
I flinch
He checks if I’m ok ….
Yes its fine i say…
He starts to slowly push in the hyaluronic acid ….
I begin to make all sorts of noises….
Eyes tightly shut … someone holds my hand
I think it’s the nurse …
It could have been Winston from the other side from all i know..
This was painful….
He tells me to breath…
He was right, I had forgotten this vital action…
I breathe
He primes the steroid..
It goes in…..
I start singing my own version of opera
I didn’t know I could make such notes, my vocal range exceeded anything i had achieved in the shower at home…..
The hand holder was squeezing tightly and Dr R was telling me it was nearly over ..
I’m still performing a personalised aria ….sounds from a full three octave range are ringing out in that makeshift cubicle …
And as he pulled the cannula out, I delivered my vocal finale…..
What a performance from both of us…
I dared to open my eyes……
A crowd had gathered at the bottom of the bed and round to the right side of me….
Various humans, maybe hospital staff, maybe relatives of other patients , who knew…..but there were now an extra 7 people in our cubicle, the curtain having been fully pulled to one side to accommodate everyone…..
Just when thought my moment had come ….and i was to become the next Jane McDonald….
Just when I was ready to receive my applause……
When in my head I was calling “Hello Wembley” into my microphone
Dr R bought me cashing back down to earth……
“ They have all come to see what the fuss was about”
Lyric of the day “dreaming of the things she never got to do , all those dreams that never came true”
