Doctor 00:00
Good morning. What would you like us to talk about today?
Patient 00:08
It’s my knee. It isn’t stopping me doing everything, but it feels stiff and I’ve started thinking twice about going for my usual walk.
Doctor 00:25
Tell me a bit more about the stiffness. When do you notice it most?
Patient 00:34
First thing in the morning, and when I get up after sitting for a while. Once I’m moving it feels a bit easier. The walk to the shops is all right, but I don’t always feel like walking home again.
Doctor 00:57
And how long has that been happening?
Patient 01:03
A few weeks. I can’t give you the exact day. I noticed it when I was out in the garden, getting up from the little stool I use.
Doctor 01:20
Was there a particular fall or twist, or did it come on gradually?
Patient 01:28
Gradually, I think. I haven’t fallen. I’ve just been doing less because I don’t want to make it uncomfortable.
Doctor 01:42
What would you most like to be able to do more comfortably?
Patient 01:49
My walks, really. I meet a friend on Fridays and we walk round the park. And I’d like to get back to pottering in the garden without thinking about my knee all the time.
Doctor 02:12
Those are useful things to aim for. I’d like to examine your knee now, if that’s all right. Afterwards we can talk through a plan.
Patient 02:23
Yes, that’s fine. Will I need to take my shoes off?
Doctor 02:30
Yes, please. Take your time getting onto the couch. I’ll ask you to bend and straighten your leg and tell me what feels uncomfortable.
Doctor 03:24
Thank you. You can put your shoes back on and sit down again. We’ve talked about when it feels stiff, and I’ve checked how your knee moves. I think some advice from a physiotherapist would be a useful next step.
Patient 03:45
Is that somebody I have to find myself, or do you arrange it?
Doctor 03:54
I’ll send a referral from here. The physiotherapy team will contact you to arrange an appointment. They can talk about your usual walks and gardening, and help you find movements and exercises that suit you.
Patient 04:16
I’m not very good at remembering exercises. Last time I was given a sheet, I put it somewhere safe and then couldn’t find it.
Doctor 04:28
You can tell the physiotherapist that. Ask them to write down the plan in a way that works for you. You don’t need to remember an exercise routine from today; this appointment is about agreeing the next step.
Patient 04:47
That’s a relief. How will I know when the appointment is?
Doctor 04:55
The team will contact you with the details. If you haven’t heard from them after two weeks, call this practice and ask us to check the referral.
Patient 05:12
Two weeks before I ring you. Right. And should I come back to see you as well?
Doctor 05:22
Yes. Let’s review things in about six weeks. You can book that with reception. Before then, make a few notes about what feels easier and what is still difficult. That will help us see how you’re getting on.
Patient 05:45
Would it be useful to write down how I feel after going to the shops? I sometimes forget by the time I get here.
Doctor 05:57
Yes, that would be helpful. It doesn’t need to be a long diary. A few things you notice, and any questions you want to ask, will do. If things get worse or you are worried, contact the practice sooner rather than waiting for the review.
Patient 06:23
I’d also like to ask about kneeling in the garden. It’s getting down and back up that puts me off.
Doctor 06:32
That’s a good question to take to the physiotherapist. Tell them what you normally do in the garden, so the advice fits your day.
Patient 06:47
Can I just check I’ve got it right? You’ll send the referral, I’ll ring the practice if I haven’t heard in two weeks, and I’ll book to see you in about six weeks.
Doctor 07:03
That’s right. And bring your notes about your walks and anything else you want to discuss. Is there anything about that plan you’d like me to go over again?
Patient 07:17
No, that sounds clear. I’ll write down the gardening question before I forget it. Thank you.
Doctor 07:27
You’re welcome. Reception can help you with the review appointment on your way out.