Lack of faith in the NHS

[alanalan864]

A few years back I had a serious Road Traffic Accident. Unable to work since.

I'm 57, and now have severe osteoarthritis in my lower back, legs, etc., a right arm which has severe limitations, and a mental condition causing a lot of stress.

After a recent move to another area, I visited my new Doctor, as the condition of my back seems to be getting worse, needing more and more pain relief.

I asked for another scan on my back, as a previous scan showed bulging of the lumber discs. I wanted to know if this bulging was getting worse

What he said to me next came as a surprise.

He asked me what I expect it to reveal, and what difference it would make in knowing, he went on to say spending £250 on a scan would be a waste of money, money better spent on people with cataracts or similar.

I was shocked at this and came away feeling the doctors have given up on me.

[honeybee13]

Hello there.

 

I would be shocked too, 57 isn't old. I don't see the doctor's logic.

 

We have some good NHS commetators here, hopefully they will spot your thread later and advise you.

 

HB

[nolegion]

I agree. That seems very dismissive of the doctor. And what cheek to 'return' the question to the patient. The clinician should explain what treatment options are available for a bulging disc causing increasing pain. I hope others with better technical knowledge than me will come along to help identify these options, but I believe surgery can be appropriate in some cases - before which, further investigation by eg. some kind of scan would no doubt be undertaken.

[think about it]

I also agree, it does seem dismissive and it's for the GP to explain why they feel a further scan is not indicated if the results won't make any difference to the treatment.

 

I can see where the GP is coming from, what differences will a worsening make to your current treatment? If you're currently on pain relief and having your symptoms managed then providing sufficient pain relief to help you on a daily basis is what's been decided and they don't need to scan for that. A bulge is a bulge, and unless your symptoms become dangerous then the treatment is largely conservative in nature - physio and pain relief.

 

However, if you'd like to stump him / her a bit then go to see them again, ask for a referral to the local specialist physiotherapist who'll assess your back and then, if needs be, refer you on to the MRI. You can also ask that you be considered for a discectomy/microdiscectomy (the surgical procedure to remove the bulged part of the disc to release the pressure on the nerve).

 

There are also several 'red flag' symptoms of lumbar disc bulges that require emergency intervention and probably an MRI on the same day via accident and emergency. It goes without saying that you should only go down this route if you find that the following list accurately describes your current symptoms:

 

Red flags that suggest cauda equina syndrome include:

• tingling or numbness between your legs and around your buttocks
  
• recent loss of bladder and/or bowel control
  
• weakness in your leg and foot
  

Red flags that suggest cancer or infection include:

• being over 50 or under 20 years of age
  
• a history of cancer
  
• symptoms of fever, chills or unexplained weight loss
  
• having had a recent bacterial infection, such as a urinary tract infection (UTI)
  
• having a history of injecting illegal drugs, such as heroin or cocaine
  
• having a condition that weakens your immune system, such as HIV
  
• a structural deformity of the spine
  

Red flags that suggest a spinal fracture include:

• sudden severe pain in the spine which is relieved by lying down
  
• recent major trauma, such as a road accident or fall from a height
  
• minor trauma, including strenuous lifting in people with osteoporosis (weakened bones)
  
• a structural deformity of the spine
  

Having one or more of these warning signs doesn't necessarily mean you have a serious condition, but it does mean a potentially more serious cause should be considered and investigated.

 

(source: http://www.nhs.uk/Conditions/Sciatica/Pages/Diagnosis.aspx )

 

Lastly, you have my express empathy - I'm currently on the waiting list for a discectomy and spend most of my time taking some very strong pain relief whilst juggling a full time job in the NHS and a young family. Good luck and I hope you get some relief from your symptoms soon.

[alanalan864]

Thank you 'all' for your comments.

I have booked another appointment with the doctor, with a view to another referral to a phisio, hopefully this with lead to a scan of some sort.

 

 

Thank you 'Think about it', for your input.

You have my sympathy for your situation. My wife was on a NHS waiting list for a discectomy back in 2012.

Back then she could hardly walk, due to the pain, and was on strong Morphine for ages. Due to the extremely long waiting list, we had to go private, [fortunately compensation from the accident, paid the £5,000 cost of the op].

Ironically the same Surgeon performed the same op, but almost immediately.

He confirmed after the op, they only just caught it in time.

I hope all goes well for you, and you don't have to wait too long.

 

 

Alan

[mr_mastiff]

Alanalan. The doctor should have ruled out that your back pain was as a result of the problem with your discs. It could be that your severe osteoarthritis may be a factor for your increased pain. I would ask for a referral to a orthopaedic consultant. Pain is natures way of telling you that something is wrong and the Doctor should not ignore an increase of symptoms.