Can I have access to an NHS stroke cln NHS stroke clinicians diagnostics process of my condition ?

[RogerHarris]

Just as the title says really. No I don’t want my medical records, but a description of the actual diagnostic rationale used by the clinician which they may not write down.

 

I was admitted in late November 2012 A + E by NHS direct for a supposed transient Ischemic Attack or mini-stroke (temporary). I was taking dizzy spells, after my right arm and face would go numb, but I thought it was stress due to numbness going away after an hour. The fact stroke is a major killer for those in my family for those 10 years older than me, and they also started with mini-strokes many years previously did not help my outlook…but I am healthier than them, no smoking, overweight or drink. Health nut and former national athlete in fact ! And a bit hypochondriac, so I tend to tell myself I am just having a worry attack.

 

Anyway fast forward 8 weeks to now. The CT scan in A + E showed no major bleed (it’s a very rough scan that’s all it can do). I was released for follow up to NHS stroke clinic for observation. They made me an appointment for an MRi. I was still getting the attacks every day or other day though, but going through all this changed my perspective. Every time an attack is over I felt glad to be here. I took a new job delivering catalogues which gave me mild exercise and got me fresh air. If I had an attack I just sat in the car for an hour till it was over. Sometimes though I would be so exhausted I had to go home for a lie down. Still I thought it was some type of super panic attack. (paradoxically I am studying neuroscience at University) and know there is something called functional Disassociation which can make you lose control of limbs…shell shock they used to call it). They can tell if you have it from fMRI now.

 

I got a letter 6 weeks ago, my GP telling to come in, that the hospital results from my admission had said my cholesterol was very high for an under 50 year old. Ak ! I wanted my problem to be psychological of course !. I realized the low carb diet to treat my IBS most of 2012 was basically all eggs and chicken protein with the boiled chicken juices as soup. it had fixed my IBS but shot up my cholesterol.

 

OK so cholesterol blocks up the arteries including cerebral as we know so I had to take it serious. I went on cholesterol clearing super-diet, and noticed the attacks were becoming less and less frequent as I changed to this very healthy, diet, Got to see my six pack for the first time in years also ! In medicine though correlation is not causation.

 

My problem now is my stroke consultant got me back in for an MRi, and it was all clear for major stroke damage. No surprise there, it was always transient 15 minute blockages, which don’t show up as damage on MRi. So she cleared me from her patients list, even though I am still having transient attacks. You can only find if transient attacks are occurring from other tests they did not order called MRA (it images blood vessels) and neck artery examinations. Not sure why these were not ordered, but my clinician sent a letter saying “I did not have symptoms consistent with a stroke event”… “I am clearing you from my patient list..you can consult your GP”

 

The problem is the NHS works well if you about to kick the bucket, but if you are in pre or mid stages of a problem suffering ill health they don’t want to spend resources on delving in to every aspect of you till the problem gets life threatening and so put you back out the system in a half messed up state to see if you return or not (its how NHS managers allocate resources).

 

OK so I am not about to drop dead, which is nice to know, but I am still having major health problems. So I need further diagnostics, and clarification from this clinician to make the next clinical decisions (my GP is nice guy but not much use).. Because if there was “no stroke event”…what is it ? Psychological, Epilepsy.. Strange if high cholesterol caused those… OK I don’t want to get into medical diagnostics here. I think its mild neuro-vascular with the symptoms, family history, lack of tests to rule out all vascular problems and the high cholesterol I had.

 

So how/can I get access to my stroke clinicians differential diagnostic process of my problem. With my knowledge of neuroscience I can pick out any problems. I do not mean just the records but the process she does not write, i.e. those describing her differential diagnostic procedures. I am suspicious she has made an error and I am having minor stroke or mini-stroke events, because she cant actually tell if I am having mini-strokes or not with the tests carried out so far. The problem is the decision making process, they don’t actually write it down, and the medical records just describe final opinions and tests.

 

Is there some method by which I legally can force her to describe her diagnostic procedures, i.e. how she has come to the conclusion I am suffering from no neuro-vascular problems at all ?

[reallymadwoman]

Have you spoken to your GP - they may be able to help. Alternatively you could contact PALS.

[RogerHarris]

thanks, GP no use.. not into questioning medical decisions by his superiors.

 

PALS looks interesting but it not for scotland.. If anybody knows a scottish equivalent. I can try NHS direct again.

[Nystagmite]

Speak to another GP?

[reallymadwoman]

You are entitled to a second opinion and your GP should help arrange this.