1 month wait for an urgent appointment?

[elliejjtiny]

Finally got my son's appointment sorted after a lot of faff with choose and book and it's for 1 month away. I know I should probably be thankful it's not longer but he's in a lot of pain and the GP marked the referral as urgent. The school keep phoning me and saying he is in a lot of pain and needs to see someone and I just feel awful that I can't fix it for him. He is likely to be waiting another year for surgery after this appointment as well.

The Practice Nurse along with the GP did my daughters last week. No issues, no referrals required. 7 days of Antibiotics prior to the procedure to clear up the infection and then they dealt with it.

My husband had a painful ingrown toenail, which was treated at a good, qualified local podiatrist, under a local anaesthetic. A follow up appointment a week or so later and all was good! We can't remember how much it cost but it was well below £100. This is in East Yorkshire, if by some miracle you are close by!

Thank you. They won't do it under local anaesthetic for children and he has had complications from general anaesthesia before so I would rather he have it done at an nhs hospital.

I will go back to the gp and ask if he can have prescribed painkillers so he can have a dose at school as well. He isn't allowed to have over the counter medication at school so i have to time it so he has paracetamol 30 minutes before he gets up, ibuprofen with breakfast, paracetamol when he gets home, ibuprofen at tea time and then paracetamol before bed. He ends up in quite a bit of pain in the afternoon at school and a general ache at other times.

I had surgery done on my big toenails that kept on getting infected with a private podiatrist - I have medical insurance and was able to claim it back.

I think you're being a bit dramatic. This is a routine procedure. Whoever has told you this can't be done under local anaesthetic is simply wrong. A suitably qualified private podiatrist will do this under LA for a child, no problem whatsoever. If you're in London you could have an appointment on Monday afternoon. Cost is usually £365.

This really doesn't require a GA, what a waste of NHS resources. Its a simple outpatient podiatry treatment

The paediatric surgeon who did the same procedure on my older son said they don't do it under local anaesthetic on children. He was 17 so I asked if they would do it under local but she said no, it would be extremely traumatic for him so I felt guilty for even suggesting it.

They absolutely do use a local anaesthetic to young people. My daughter had it done last week at our Surgery. A waste of resources to want a hospital appointment for something so minor.

Is he soaking it every day in a bowl of salt water?

Are these prices quoted for whole nail removal? Maybe it doesn't need to be all removed and might be a lot cheaper,worth looking in to.

Unless there is a medial reason for him needing a GA- which there is for a small minority of children, LA is completely routine for this procedure and can be performed safely in a community setting. GA carries much more risk than LA, if that consultant is offering GA to all children for this procedure that is ridiculous.

Why would it be extremely traumatic? He won’t feel a thing! A hospital visit and all the bells and whistles of a GE is a far bigger deal.

Yes the surgeon gives every child under 18 a general anaesthetic.

Well, I am quite surprised to hear that for a 17 year old.

Although my 12 year old has been referred to a different dr (paediatric orthopaedics for some reason) so maybe they will do it differently.

My 12 year old is a nightmare with a GA. He has to have a sedative first and then last time he was meant to be in for day surgery and ended up being in all day the next day as well. I'd like to avoid a GA if possible.

I think the only explanation for this is that the surgeon in the hospital is seeing the most complex cases eg kids not suitable for community treatment- which is actually how it should be, in which case I can understand why 100% of the patients get GA. If they are still seeing kids with no complex sensory or medial needs and still giving GA then I can’t understand the rationale.

Can’t comment on the pathway your son is following as obviously we don’t know his full background, but if he is healthy with no additional adjustments required for neurodivergence or learning disability then I can’t understand why it needs a hospital referral and GA, if you think it’s putting him at risk then I think you should discuss your concerns.

Please don't waste a GP appointment with this. The pharmacist will put a label on some paracetamol or ibuprofen if you ask them and school should be happy with that.

It's frustrating but I don't think a month is too crazy tbh, my son needed a hearing test and was referred by the GP, took 14 months (luckily he wasn't that deaf but we didn't know that!) It's the reality of a health system for everyone and we are lucky to have it really, imagine not even knowing if you could afford the procedure. I'd focus on what you can do in the meantime, already some good suggestions;

• work with school/gp/pharmacy on how he can take pain relief at school. At 12 can he not just pop paracetamol in his school bag and take at lunch (appreciate school would say no to this, but at secondary will they even know, I'd not even discuss with them and get a 12 yr old to handle taking 2 pills at lunch quietly)
• use salt baths, cleaning etc to keep it as hygienic as possible
• look at private if possible, as if done under local that negates the issue of GA complications
• speak to the GP about any better pain relief options that might work, are there topical gels that can relief the pain too

I cannot believe an ingrowing toe nail at any age can't be done under local. My mum just had an actual knee replacement under local (tbf did sound traumatic but they hacked her knee joint out and replaced it, surely a toenail, if he just looks away, will be fine!) They put a piece of material up so you can't see what's happening. I know I had some surgery and the consultant said she prefers to only do GA because she doesn't like working with awake patients (I kid you not, she was charming) so might be more to do with the surgeons preference than any genuine issue for kids. Especially given so many people on this thread have had locals for their kids toenails- it's clearly not medically necessary.

Op, going private doesn’t necessarily mean you aren’t still in an NHS hospital.

I paid for my 1 year old to have private surgery last year and it was done in a major NHS hospital.

It is worth at least looking into the private route, and they may also offer the local anaesthetic option.

DB had this done under local as a teen by our GP. I’ve also had it done under local, but as an adult. NHS, took almost five years waiting! Wish I’d gone to a private podiatrist, who I now see and could have done it almost immediately for about £300. Very quick, nowhere near as much pain as I was expecting. Just had to keep clean after. It’s a very quick process and you don’t feel a thing. Over in about 15 mins.

Dd had hers done by the GP when she was 11 or 12 under local anaesthetic.
I'm always surprised by the variance in procedures offered by different GPs.
You'd have thought it would be across the board.

what a load of crap

So it wasn’t the practice nurse. It was the GP with the practice nurse most likely assisting. I work at a surgery and we have a GP who is accredited and trained to perform minor ops. This is not everyone and not every surgery. We also accept referrals from other surgeries in the area.

No it was definitely the Practice Nurse, the GP came in when it was almost complete to give a prescription for pain medication which she didn't need.

Take someone to a&e 'before they get septicemia'?

How about before they have an accident, or an injury, or before they have anything wrong with them at all?!

I think you are addressing the wrong person.