A couple of months ago I had some injections in my spine; 7 around my neck and 6 in my lower back on the right hand side. These injections comprised of cortizone and local anaesthetic make the rigid muscle relax, breaking the pattern of pain messages to the brain which then stops the need for the muscle to contract. This process of spasm and pain is a vicious circle that endlessly repeats causing chronic pain. I had my injections in May and after a few days recovery I found them really effective and felt almost normal.
Then a few weeks later I started to get muscle spasm in my back but this time on the left side. It was excruciating. Every time I moved it would grip me round the middle. Like someone giving me an inappropriate hug - right round my pelvis with a tazer! It was so bad after a couple of days I gave in and asked for help. Ringing the ward where I had my treatment was supposed to be the first port of call, but as I had found out in the past their advice ranges from ring an ambulance, to call your GP with an unspoken undertone of 'for god's sake don't come back here because we don't know what we're doing'. This time I got 'ring your GP' so I did that. My GP is great, she really listens and after a half hour on the phone we came to the conclusion that my discs weren't caving in and the priority was to get the pain controlled. She prescribed something called Acupan which is another nerve blocking painkiller like the other two I have. So someone went to fetch it for me and after 24 hours I was a lot more comfortable. The other thing she advised was to call the pain clinic just to ask if this was a normal reaction. It seemed obvious that it would be but still I made the call to the pain secretary and this is where the NHS became ridiculous.
The pain clinic secretaries work on a job share basis and not your common and garden job share; instead of simply sharing the work and communicating with each other they decided to split roles. So, one works in the morning but solely on sending letters out and the other works in the afternoon solely on making appointments. Its supposed to work like his: you telephone in the afternoon and get the appointments girl, she then makes you an appointment either in clinic or on the ward, she then emails the day's appointments to the morning girl, next morning secretary no 2 checks her emails and gets the appointments diary, she then sends out letters and information. It sort of sounds like it might work, but then you realise people don't slot neatly into morning or afternoon, or even into appointments and letters. If you ring in the morning to make an appointment woe betide you - you have to ring back in the afternoon if you can or rely on afternoon girl to check her emails and make you an appointment. Or you ring in the afternoon but can never get through because everyone has clocked the system and ring all at once. I confounded the system by managing to get through on appointments afternoon but by not wanting an appointment.
I explained that I wanted to ring for some advice and explained what had happened. The girl seemed completely baffled:
'So you want an appointment?' I explained again that I just needed some advice. I thought there must be some system of getting queries to the actual doctors.
'I don't want to waste their time with an appointment if its something simple'. I told her 'What if I ring within clinic hours? Can I get a message to a doctor then?'
'No, but I can give you an appointment', she said. She was tenacious. In the end I relented because I thought if I had a fast track appointment it would be all done and sorted for my new treatment appointment in September. I just had to keep taking the Acupan and hold on till then. The appointment came through a few days later and it was for two weeks before my ward appointment. I didn't know whether to keep it or wait, but experience told me that whether you were listened to on the ward depended very much on who was dishing out the treatment. If it was the pain consultant or his registrar that was good, but if one of the anaesthetists was subbing for them they had needles in you before they said hello!
Yesterday I went for my appointment and met with the registrar and more madness ensued.
'Why are we seeing you again? You were here in May' he said
'Yes I was on the ward in May then I had some problems so i rang for some advice and the secretary kept insisting I needed an appointment'. He turned back to my notes and rustled through a few pages. He showed me a discharge notice.
'You have seen this?' He was pointing at a line on the summary that said 'assessment and treatment'. I nodded.
'And you understand this?' he asked 'it means when you come to the ward you are assessed there not in clinic'.
'I get that, but two weeks after the treatment I was really struggling and I tried to ask for advice over the phone but that wasn't possible. She kept saying I needed an appointment'.
'Here it says to ring the ward', he pointed to another line on the page. I started to get a little bit cross.
'I understand you think I have wasted your time but have you ever tried ringing the ward? I have done it twice in the last four years only be told they couldn't do anything or didn't know what to do. Once I ended up as an emergency admission in hospital and this time they told me to ring my GP. As for assessment that depends very much which consultant you get. Some of them have a needle in you before you've had chance to tell them anything. An assessment to some consists of 'did it work' as they're setting up an IV and doing the actual treatment. They're not listening.'
The registrar put down his pen and turned to face me.
'You are never, ever wasting my time. It is no problem to me that you are here, but you have come a long way. I am worried that you are telling me these things but telling them to me makes no difference. I could tell the consultant now and he would make enquiries but nothing would happen, but if you from outside makes a complaint about these things then something is done. Make a complaint. This is not good enough'.
As he started to look at my back I was completely baffled by the whole experience. They have a problem with part of their service, and instead of keeping quiet and dealing it they now want me to complain about it? This problem has cost whatever the original treatment cost, then with GP time and the costs of a new drug for 6 months. It also cost ward time on the phone, admin time on the phone, then an appointment of at least 30 minutes with a consultant where I was told the following;
- the reaction you had was completely normal and could have been solved in a phone call
He examined my back anyway and concluded that no wonder I was in pain the left side of my spine is rigid! He then told me a long involved story about a dog, some fleas and a big stick which apparently was a metaphor explaining that the right side of my back is worse and caused greater pain so when it was resolved I then felt the lesser pain in my left side. He also checked out the trapezium muscle and decided that needs work too. In 30 minutes I talked myself into 20 spine injections for next time! I could have saved hundreds if not thousands if anyone in this chain had decided to do more than the minimum requirements of their job. They were all so focused on their little bit they were missing the bigger picture.
After that it became my usual fun appointment. He was very reassuring about my pain, because sometimes its easy to think it's all in my head. He explained what my muscles were doing and seemed very positive about the results and since the injections had removed the right sided pain, it does seem likely. Then he seemed to scratch his elbow and it was bleeding. He then called a nurse and shouted that I had bitten him and needed first aid (don't think this is weird, this is normal for my clinic)! After he had first aid he reassured me that they would listen and have a proper assessment before the injections and would basically inject wherever I told them. Then he apologised for people wasting my time and handed me all my things, but wanted to keep my new tweed handbag because it was fabulous! Another day another appointment I guess.
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