Before the doctor sees Sven, he looks over his X-rays and referral from primary care, so he has a picture of what Sven is experiencing before their first meeting. The X-ray images, together with the patient's complaints and background, help determine whether surgical treatment is suitable.
In the consulting room, Sven describes his problems, including his pain and how much it affects everyday life. The doctor asks questions about the patient's exercise habits. Sven describes the physiotherapist’s treatment he has received, and mentions that he performs these exercises regularly. Beyond these exercises, Sven does not pursue any other specific physical activities.
The doctor asks Sven to lie down, and performs a knee examination by feeling, stretching and bending the knee. Sven informs the doctor about how the knee feels during the examination - if, when and where it hurts. The doctor also listens to Sven’s heart and lungs and takes his blood pressure. Sven's blood pressure is a little high. The doctor recommends that he visit his primary care clinic to get it checked, to ensure it doesn’t complicate future surgery if needed.
The doctor asks Sven about his wishes and expectations for treatment. Sven wishes to undergo surgery, as his knee problems have become so severe that his quality of life has deteriorated. The doctor agrees that surgery would be appropriate. However, there is a long waiting time in queue for surgery. Sven’s BMI is also on the verge of being too high to be offered surgery, which can make it difficult for Sven to use his 90-day healthcare guarantee, as private clinics often have a slightly lower maximum limit for BMI than the public hospitals. High BMI sometimes prevents approval for surgery because it is a risk factor for complications. This risk assessment is done based on national guidelines for evidence-based practice, and through consultations between the orthopedic specialist and other doctors involved in the operation, e.g. the anesthesiologist. In Svens’s case, the doctor recommends that he continue his physiotherapy, and suggests water gymnastics and cycling as other gentle forms of exercise that may be suitable for management of osteoarthritis during the waiting time for surgery.
When the doctor’s visit is done, Sven sees a nurse who gives him more information about the surgery and its waiting time. A surgery coordinator will inform him about clinics where he might be able to use his 90-day healthcare guarantee, even if it can be difficult in his case. When the visit ends, Sven is also told to get back in touch if his condition changes while he is in queue, e.g. if his problems subside, get worse, or if he experiences any other health concern that is important to look into before surgery.
Sven is looking forward to his surgery and expects it to go well, as he has previously heard about the treatment’s successes. He looks forward to not having to deal with pain everyday, although it may take a while before he receives his time for surgery.
Now Sven waits in queue for surgery. In the meantime, he will continue to exercise and try the other activities the doctor recommended, which may help with weight loss, leading to a lowered BMI.
