Expanding appointments

 

Expanding appointments

It is a week of time-gobbling appointments. Monday’s dental appointment was three times as long as expected. I had to have three (or four, I lost count) anaesthetic injections. And to think, Vishal was contemplating not using any injections at all! Enough of that.

On Tuesday we had to go to a hospital a few miles away for a cholesterol blood test. I don’t know why. Perhaps the powers that be, who have little notion how to organise things, thought it would be a sensible idea to centralise things.

We duly turned up well before the appointed time, and booked in. No problems there. My blood was taken and then it was Barry’s turn. He’s supposed to have blood tests every few months. He reappeared very quickly, looking thunderous. The doctor’s notes were missing, so the phlebotomist couldn’t take a sample. However, all he needed to do was ‘phone our medical practice and get a doctor to authorise the blood-letting. Then the phlebotomist told him he could bang on the door, and he would be relieved of the requisite syringeful of blood. Annoying, but simple.

He rang the GP practice. He was number nine in the queue. Fifty minutes later he was able to speak to a long-suffering receptionist. She then had to consult a doctor. In another ten minutes, a doctor was available to speak to the phlebotomist, and the sample was taken.

Today will be spent making ‘phone calls and composing emails and letters to Wes Streeting (Secretary of State for Health and Social Care) local MPs, the CEO of the hospital, the CEO of the Foundation Trust, our medical practice, and anyone else we discover who should be made further aware of the inadequacy of the system.

Patients – we, the public – are being expected to take on more and more of the organisation of our medical treatment. We must make the appointments, chase the results, organise ongoing treatment if required. Many of us are perfectly capable of doing that, but there are many more who experience great difficulty.

People who are already feeling unwell can quickly be defeated by a system that appears designed to confuse. They don’t or can’t persevere, miss appointments, and become seriously ill. By the time they finally come to the attention of the medical profession, they may be much sicker than they would have been had they been seen in a timely fashion.

In short, the appalling IT system is completely inadequate and deteriorating all the time. Everyone agrees, from consultants to clinicians to nurses to receptionists, that the system is broken and needs urgent repair. There is huge frustration across the medical profession because a wildly inadequate system is putting people’s lives at risk.

Tomorrow, Barry has an appointment at another hospital for an MRI scan.

Fingers crossed!

Have you?

 

Have you?

                                            Image courtesy Wikimedia Commons

What a sad, small life it has become when our time is taken up with booking appointments and attending them. Not really, because we have lots of interests and not enough time to pursue them all.

Howsomever, (which I had never realised was a ‘proper’ word, and have just discovered is archaic, a bit like me) a few weeks ago we were ‘invited’ to book appointments for annual jabs, or are they six-monthly now? Anyway, being obedient little citizens, we proceeded to thread our way through the booking system and nabbed a couple of spots in early October. Yes, the site informed us that all was in order, or alles in ordnung, as Barry says, proving he still remembers some German. Job done, sit back and relax!

At the end of last week, we received another invitation from the NHS to book appointments for annual jabs! Cue double-takes and murmurs of disbelief, as we didn’t wish to be doubly jabbed! On checking, we discovered that our appointments had not been registered or noted or whatever is supposed to happen to them. That’s not strictly true, for when the very pleasant and helpful lady Barry had contacted checked a little lot deeper, she discovered that mine had been recorded, but Barry’s hadn’t. Hey ho!

Barry and the lady had a most enjoyable conversation and gentle rant about the failings of the NHS administration and the inability of the left hand to even acknowledge the existence of the right hand.

We often experience a sense of déjà vu and I’m afraid it is rearing its head in my blog, for which, apologies.

So, have you, and if you haven’t, why haven’t you? My children (odd to call them that when they’re mature adults) pay for their jabs, though one son-in-law doesn’t pay because he’s asthmatic. I don’t think middle daughter will have the jabs – she responds very poorly to them, and they make her quite ill. It’s a toss-up – have the jab and feel lousy for a few days, or contract the illness and feel lousy for a few days.

There are currently two common strains of Covid, Nimbus and Stratus, the majority of reported cases being the latter. As ever, if you are suffering from any respiratory illness, be selfish and keep it to yourself.

Now, wasn’t that a cheerful read?

Sunday afternoon alert

 

Sunday afternoon alert

3:01

The 3:00 pm alert sounded at 3:01! It didn’t last long and was reasonably loud, but could easily have been missed if we hadn’t been near our ‘phones.

Obviously, in a real emergency, the alarm would have continued to sound – well, one assumes that would be the case!

In life, we assume a lot – too much, probably.

For example, NHS blood tests are regularly conducted for all sorts of reasons. Three years ago, Barry had a routine blood test and was told, ‘We’ll contact you to let you know the results.’

To clarify matters, he asked if he should call, and was assured that he would be informed. ‘We’re very busy,’ they said. Time went on and life intruded. No-one called and thoughts of blood test results receded into the background.

Anyway, to cut a long and tedious story short, it transpired that Barry’s kidneys were showing signs of damage. That was apparent from the blood test in 2022, but no-one told him. Had he known, he would have adjusted his diet accordingly. Fortunately, we eat a largely salad-based diet, but there are some things he shouldn’t eat or should limit, like tomatoes, dried fruit, avocado, wholewheat bread, brown rice, dairy milk, olives, apricots, and potatoes, among other things.

Adjustments are now being made, too late to undo any damage done in the last three years, but enough to prevent further deterioration.

The lesson we have taken from this is to follow up every test, even if rigorously assured that we will be informed of results. In other words, we have to be ‘squeaky wheels.’

On advice, Barry takes his blood pressure every Monday and sends the results to the organisation that requested them. Recently, he discovered that the results are in a vacuum somewhere, his medical practice having no knowledge of them.

Again and again, this pattern is repeated. There seems to be no connection between one department and another, and if there’s a crossover between NHS and private medicine, life becomes even more disorganised.

Individually, administrative and medical staff are good – diligent and dedicated to their excellent work - but they agree that the system is broken and urgently needs overhauling.

Questions are answered and problems resolved eventually, but it all takes too long. I think the answer is to always carry a sharp stick and poke the sleeping beast that is reputed to be the envy of the world. Not everyone has the time or the capacity or determination to ask the right questions, or move to ‘the next level.’

A different visit

 

A different visit

My appointment was for 11:15. I arrived early, booked in, and sat down. Almost immediately my name was called, and I was optimistic that the whole event would soon be completed. After the vision test, and eye pressure check, stinging drops were applied, and I was directed elsewhere.

Along with several others, I sat and waited, and after some time someone official appeared, full of apologies for the delays we were experiencing – too many patients, too few staff, immediate referrals appearing, and so on and so forth. We murmured our thanks for the update.

Anyway, what should have taken a short time – fifteen minutes or so – extended to three hours. Meanwhile, Barry was waiting in the car, listening to a book about Rommel – he had a pet fox, did you know?

Now we’re at home again and Barry, not known for his patience, is trying to self-refer for a hearing test. He is not having much success and is ranting about the poor IT. This is a common complaint and tries my tolerance. It tries his even more. He spent his working life developing large IT systems and knows they should be debugged before being rolled out. The NHS is particularly bad in its operation.

I have been telling him for some time that his hearing is not as good as it used to be. It is quite difficult to converse with him sometimes because he often gives the impression that he hasn’t heard, or, worse, is ignoring me, when he is simply thinking about his answer or something else entirely.

 However, he didn’t ignore me when I pointed out his less than perfect hearing, but neither did he decide to do anything about it, until one of his electronic devices (his ear buds) alerted him to the fact that his hearing is not as acute as it should be. Now, research is ongoing into hearing aids – reviews, reports, problems and so on and so forth . . . and booking a hearing test.

The problem, and it is a valid one, is that he likes to pin everything down so there are no misunderstandings, but in the process ties everyone up in knots with the details.

 Some would call it nit-picking! I don’t because I know he is seeking answers. Most people are extremely helpful, but occasionally, for after all, people are only human, a little irritation creeps in. The most accommodating people are those who understand the questions and can answer them fully and succinctly.

Update: He now has an appointment to see a doctor – that in itself is a minor miracle! – on 2^nd July, despite the fact that, and I quote, ‘Individuals over 55 can access free NHS hearing aids and related services through a self-referral pathway for age-relate hearing loss, meaning they don’t need a GP referral if they meet specific criteria.’

Maybe they just want to ascertain that it’s not something else that’s creating the problem. He’s quite sure the hearing discrepancy in his left ear is from his time as a soldier, shooting his rifle left-handed.

 I suggested that he will probably not opt for free hearing aids. I know him well and he will want need something he can fine-tune. He says he would use NHS aids as spares.

We shall see.

Update on the sickly one

 

Update on the sickly one

In an emergency, the NHS is unbeatable. Wednesday 31st July was an interesting day. 

After we agreed it was time for him to consult the professionals, Barry filled in an online triage form in the morning, then ‘phoned 111 for advice. That prompted someone to call him and question him further, and then someone else called immediately to make an appointment for him at the Urgent Care clinic, where the doctor there referred him to the hospital. 

At A&E he was seen at once, admitted, scanned, x-rayed,  and put on intravenous antibiotics and a saline drip in the Acute Medical Unit. This all happened within four hours, from triage to hospital admission.

He had pneumonia, which I had suspected from the occasionally crackling lungs and wheeziness of the preceding two nights, but the diagnosis of sepsis came as a complete shock. The doctor we spoke to thought that he’d had an initial viral infection and then developed a bacterial infection on top. He was monitored thoroughly and had two Covid tests, which proved inconclusive. (The Covid ward at this particular hospital is still maintained as a separate ward and currently has twenty patients in it. Lung infections are also very common at present.) 

Anyway, there he had to stay until the tests were repeated and found satisfactory. He’s a good patient, asks lots of questions so that he’s completely aware of his condition, and follows instructions carefully. He was full of praise for the staff and as anxious to leave them as they were to see him go. Hospitals are hotbeds (!) of infection. He was not discharged until he was taken off intravenous antibiotics and given two lots of tablets, to be taken at different intervals.

  He came home on Friday, feeling as if he’d been away for a month. On Tuesday, he had another blood test at the hospital. Two days later he had an appointment with the local GP practice to follow up the possible skin cancer they noticed (!) and will have another x-ray in a few weeks’ time and further blood tests as he is slightly anaemic. He has always taken good care of himself and is very fit, so this episode has been a shocking wake-up call.

When we think of hospitals, we think of doctors and nurses administering advice and medication. What we often don’t consider are all the other things that have to be dealt with. The cleaners clean the floors, unobtrusively. Porters cheerfully transport non-ambulant patients at all times of day or night. Trolleys are wheeled round at regular intervals with tea, coffee, cordials, water. Food is brought, and in this hospital it was excellent – freshly cooked and nicely presented. Fresh hospital gowns are provided daily and tests are conducted quickly and courteously. Temperature, blood pressure and blood tests are taken through the night and analysed promptly to inform the attending doctors of the state of play.

Some of the patients are not at all appreciative. They complain all the time, and ‘please’ and ‘thank you’ are rarely on their lips. One man with dementia was very distressed and so someone sat with him all night to try and calm him. Another young man caused a disturbance and the police were called to attend to him. A third man swore loudly and frequently and threateningly. During this, the staff were calm, efficient, and cheerful. Many, in fact, probably most, of them are not British, but hail from South East Asia, are poorly paid and save to send money home to their families.

We take our hats off to them and wish them better pay and conditions.

Meanwhile, our youngest daughter is in France on crutches. Bethan tore a ligament in her ankle just before she and her husband were due to fly. She would have preferred to abandon the holiday, but her children were excited at the prospect of going away and she didn’t want to disappoint them. In addition, her husband takes little time off and it’s important for him to have a complete break. I don’t think it’s a lot of fun for her, as her leg is very painful, but it’s probably easier than trying to entertain two very lively little boys at home.

She needs to compare notes with our son-in-law. Paul fell off a ladder and damaged his ankle badly, so he’s not very mobile. It’s not broken, but is an interesting range of colours. He’s in a lot of pain, hobbling around with the support of an elbow crutch, and fretting about the work he cannot complete at the moment. Gillian is being kept busy ‘managing’ him.

Our middle daughter, Susannah, did all the ferrying around on Wednesday and continues to do so, despite her personal problems. She keeps the rest of the family informed, so there’s no glossing over facts, even if we wanted to. Our son appeared at the hospital while we were there on Thursday and it was so good for Barry to see him and have some male conversation. Gareth worries, but not as vociferously as our daughters.

It’s good to be in contact with our family, but better when it’s in more relaxed circumstances.

It will be several weeks before we can assume that Barry is completely well again, but his habitual cheerfulness masks the fact to outsiders that he has had an enormous shock. He is very much better, but still puzzled that he succumbed to infection without much more than a cough and feeling unusually tired. 

Without the fitness trackers he wears, which record things like variable heart rate, pulse, blood pressure, stress, he would not have thought anything was amiss. Those signs, more than anything, alerted him. 

There will be no escape now from the Inquisition from our children. I have to grit my teeth when I hear, ‘I know you’re fiercely independent, but you are getting older . . .’

We have been well and truly put in our boxes, though fortunately not the final ones.

The Latest Lunacy

Complaints have been made recently about a ‘straight’ actor being cast as a ‘gay’ character. There are ‘so many gay actors, why couldn’t one of them have been offered the role?’  This is political correctness, or sensitivity, or equality, or whatever else one could call it, gone stark raving bonkers.  Using this argument, one could insist that only straight men should be cast as straight men, or train drivers as train drivers, soldiers as soldiers, paedophiles as paedophiles.

Aren’t they all actors? And isn’t the whole point of being an actor that he or she should inhabit and symbolise the character being presented?

I don’t know what letter of the alphabet represents you – there are so many nowadays – L,G,B,Q,T for example. How about adding a few more? F for Fed up, D for Disinterested, HTWIWB for Happy The Way I Was Born, GINGUITCW for Glad I’m Not Growing Up In This Confused World.

While on the subject, or one associated with it, there are people being given gender assignment or reassignment surgery on the NHS, the much loved and now elderly and creaking public service available ‘free at the point of delivery’ in the UK. I have some issues with that surgery being offered although I appreciate there is a very small minority of people truly troubled by the belief that they have been assigned the wrong sex at birth. See this fascinating TED talk by Paula Stone Williams.

However, what I really cannot stomach is the complaints that have been made by a few that they are unhappy with the results and want them reversed (!) or improved (bigger breasts, for example, because the recipient is suffering mental stress.)

I will write a post about the NHS another day.

For now, I will finish this by stating that I will never call myself ‘cis’. I am a female (and yes, I am becoming a Grumpy Old Woman, but better to be a GOW than a COW!)

From Wikipedia: Cisgender (often abbreviated to simply cis) is a term for people whose gender identity matches the sex that they were assigned at birth. Cisgender may also be defined as those who have "a gender identity or perform a gender role society considers appropriate for one's sex". It is the opposite of the term transgender.

Microfiction Monday #71

Lovely Susan from ‘Stony River’ organises and hosts this weekly meme. Thank you Susan J She provides a picture and the challenge is to create a story in 140 characters or less – including punctuation!

Click here to read more marvels of microfiction – and perhaps join in. It’s fun!

Here is this week’s picture followed by my offerings.

This is one of our leading universities. Increased tuition fees allow us to offer the very best education and accommodation to our students.

(140 characters)

NHS cuts mean that some budgets will be much reduced. We don’t think the high standards of care of which we are so proud will be affected.

(138 characters)

How big?

The National Health Service (NHS) is one of the biggest organisations in the world after the People's Liberation Army of China and comparable to the Indian National Railway System. The INRS daily transports 20 million passengers and 2 million tonnes of goods.  


While not denigrating the immense good done by the NHS in emergency situations, one wonders why  £330 million were spent on management consultants in 2009, a sum almost as great as that spent on combined lung cancer and skin cancer treatment and research. 


There are certainly great savings to be made in this unwieldy service.

Castaway – doctor or vet?

I have always said that if I should ever be cast away in an inhospitable place I would hope that among my companions there would be a veterinary surgeon. In my opinion they are far better qualified to deal with day to day emergencies and of course their diagnostic skills must be infinitely superior since their patients cannot tell them what hurts where. Of course, I'd have to stand on all fours – or on my back with my legs in the air (done that, for babies, four x umpteen times!)

I don't doubt there are good doctors and bad vets – I have met examples of each. Based on our experience over many years, my trust would be more readily placed in a vet than a hospital doctor. I know at this time of year the hospitals are full of newly-trained, apprehensive doctors who are expected to put into practice what they have absorbed in six years of training. Again, some will be splendid, some adequate and some should go back to medical school.

I have no idea of the experience of the hospital staff who recently - I was going to say 'treated' but that would be inaccurate, so, who recently 'saw' my fourteen-year-old granddaughter. Kiri had hurt her ankle badly playing football (her team won the game!) My daughter took her straight to the Accident and Emergency department at Dorchester Hospital. The leg was x-rayed and no break was found. 'Someone' decided that it was a bad sprain, told her she must use it and would not give her crutches as she 'didn't need' them. Kiri could not put her weight on it and burst into tears every time she tried. Gillian, very worried, took her to their family doctor who immediately suspected ligament problems and arranged for Kiri to have some crutches.

Days passed and Kiri's ankle was very swollen; she still could not put any weight on it, the pain was intense and she was taking strong painkillers regularly. In order to straighten her foot she had to carry it over to the opposite side of her body, above her other foot and allow gravity to work on it. Gillian went back to the hospital several times without getting a satisfactory answer. Eventually, almost a week later, she was told that they 'thought' Kiri had snapped her Achilles tendon and so they put her leg in a cast. So Kiri has had many days of pain, lost many days of schooling and given her parents a few more grey hairs – and Gillian has had to overcome the attitude, so prevalent in medical and educational circles, of being an 'over-anxious mother'. I applaud her for her fortitude – my grandchildren are lucky to have her and Paul as their parents. (My son and daughter-in-law are similarly to be commended!) It is appalling that a young girl should have to endure such (lack of . . .) treatment and such pain.

We have had several animals over many years that have led active lives and suffered occasional injuries. The vets' treatment has been immediate and to the point. By way of direct comparison one of our cats damaged her leg and the consulting vet immediately diagnosed and treated cruciate ligament damage. On other occasions treatment has always been urgently applied according to need.

Perhaps the Government has set targets for the NHS that do not encompass injuries of the nature that Kiri has endured. Perhaps the emergency departments are so focussed on meeting objectives and ticking boxes that they have lost sight of their primary function – the relief of pain and distress.

My apologies – this is a very personal rant. Make no mistake – if someone is in dire need through injury, accident or chronic illness, the National Health Service is wonderful, truly – and certainly my sister, among others, would not have had the peaceful, graceful passing that she had.

For 'everyday' emergencies those of us who can afford private medical insurance are thankful – but it's WRONG. There must be a better solution. (Education is another bugbear . . . ugh . . . later!)