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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To have expected more from my GP

52 replies

GoodnessKnows · 08/03/2014 06:12

Having been to the GP with hip ache for years and been given no explanation or offer of treatment other than an immediate pain injection (which I refused as I wasn't happy to have that if they couldn't tell me what it was or how it could be remedied), I asked my him for a referral to a private consultant.

Following 2 private CT scans, a tumour was discovered. It was in my spinal canal and spinal cord (sacral tumour). When this news was delivered I was, understandably in shock and had to wait for the op to remove what turned out to be a cancerous tumour. The possibility that it would be a cancerous tumour had been present from the outset, although the surgeons had believed (appearance on MRI) that it would be benign.

I am eternally grateful and ever so aware for having had private insurance and the confidence to ask the private consultant for am MRI when even he told me nothing would show up to explain my 'hip ache'.

Here's the thing...
I'm not cross about the GP not having found it. I'm aware that it was a typically asymptomatic tumour and that the hip ache was nerve damage as a result of something that would've been hard for them to find. It's thankfully been removed (5 weeks ago) and while I'm physically recovering well, the gravity of it all has suddenly hit home and it's been quite an emotional time.

My problem is this:
I gave the result of the MRI and the consultants's letter to my GP when the tumour had been found. I was in a state maaaaaaajor understatement. GP receptionist asked whether I wanted an appointment or a call. I asked for a call. To his credit (and with respect to the seriousness of the 'situation', ,y GP did call me the next morning, before surgery. But he didn't ask to see me. I was left alone, waiting, in bits emotionally, crying sporadically when my son asked me to fun to the car park with him (wondering whether I'd be able to walk again after the op., etc.). It was such a hard time. That 6 week wait for emergency surgery was worse than the op and recovery time which ain't been a walk in the park, let me tell you I'd do it all again rather than go through The Wait-- .
I'm still not getting to the point, am I...
I didn't want to make am appointment with the GP before or after the op about my emotions because I didn't have any medical need to. But I did need hand-holding. By my GP. By the person in the community responsible for my medical care. I thought.

I was discharged and given a letter which had also been sent to my GO stating that a Duty Nurse was supposed to home visit daily to inspect and dress my wound although it had only just been undressed, it was shockingly raw. I can't drive for at leeeeeeast 6 weeks.
No Duty Nurse has ever been to visit me.
The on,y GP visits have been to check I have exactly the right number of the high security type drugs I'm now on. No pain management discussions. Appointments two weeks apart.
Left.

I'm resourceful. I'm assertive. I'm also not stupid. I called the hospital that discharged me and begged to speak to the Pain Team that were caring for me in hospital. 2 minute chats on a weekly basis (they're not supposed to do this but have been so kind) have given me guidance of how to reduce my meds ALONE.
If not for them, I'd have stayed on all the drugs I was on 5 weeks ago: oxycodine, oxynirm, gabapentin, ... the list is (almost) endless.

I'm grateful to them and am grateful to a cancer charity who I called in tears on Monday. I was having am emotional break down but like a post traumatic shock / survivor's guilt thing. Not logical, guilt-ridden (as know I should be so grateful and was only grateful and positive for the first 4 weeks post op.). Friends and family didn't understand this huge emotional shift and nor did I.

And finally, here's my point... my GP has been an invisible bystander to what has and is still (early days and yet mire dodgy/ questionable CTs) the most awful and real health scare /threat and upset in my life (not the first but the most intense in terms of time). Until I find out that it was cancer, I had nowhere to turn. I called Macmillan twice before (biopsy inconclusive pre op) but felt fraudulent and like I was taking their time and money just as was worried in bits but prob not cancerous a/c to consultants I needed my doctor then, I need him now. Not to go on a waiting list for counselling when I can't drive. But to see him for 10 mins a week to talk. To know he cared. To know that he was behind me medically when the black hole opened and I'd fallen in.

I feel for those who are in that situation now or who may be at some point. I have friends and family and they we're great. But I do feel that the silence of my own GP failed me.

OP posts:
GoodnessKnows · 08/03/2014 18:37

Hanlou, no it IS my GP's duty to manage my meds as that's who I've been passed onto to do so. He's also taken that role vs passéd me on to a Pain Team. No the consultant doesn't do this for me. They see me only regarding tumour after-care -
at 6 weeks and to do further CTs etc.

OP posts:
GoodnessKnows · 08/03/2014 18:40

Basse, the hospital did send a letter to my GP instructing their District Nurse to visit 'daily' once I'd come home.
I'll chat this over with my GP when he counts my pills next week. Wink

OP posts:
GoodnessKnows · 08/03/2014 18:43

Hanlou 'intent on receiving emotional support':
erm I think that 'intent' sounds like I'm being demanding and bratish, when I've actually been quite desperate. Very different things.
I'm sorry to hear that you've been through such a difficult time, yourself. I hope that you've had the support that you've needed along the way.

OP posts:
GoodnessKnows · 08/03/2014 18:44

Vodka, that's EXACTLY what I mean. How's your sister now?

OP posts:
GoodnessKnows · 08/03/2014 18:45

Vodka - friend, not sister. (No memory. I blame the meds. Lol)

OP posts:
GoodnessKnows · 08/03/2014 18:47

Miscellaneous, exactly! So worrying that this is happening to others. Very scary.
As for GPS having 10 minute appointments... I'd have appreciated TWO minutes face to face just to say he knows what's going on and to explain it to me.

OP posts:
Bassetfeet · 08/03/2014 18:49

You have been so let down Goodness. So let down .
Please take it up with your Gp practice . Beyond awful care .very angry for you .

GoodnessKnows · 08/03/2014 18:50

Basse, thank you for asking about my wound. It's incredible considering how scary it was. Even the physios were alarmed when they saw it initially. Holes in it (open parts). I used an oil called Trilogy Organic Rosehip Oil. That seems to have worked wonders too. It's all closed now and the scar is no longer raised. I have a new puffy bit of bottom but I'm just grateful I'm ok and that I don't have to look at it (it's behind me - literally Grin). It's my 'brave trophy'.

OP posts:
GoodnessKnows · 08/03/2014 18:53

Kundry, I don't have one but I've found a fantastic cancer charity and just going once so far has made THE most enormous difference. I can't convey how much better I feel knowing there's someone who understands the shock, terror and survivor's guilt I've been going through for the last 2-3 months. It's actually helped to shift it. Things are raw (I cry if I talk to friends about it) so it's wonderful to have this place to go. Going again the week after next. Thank gd for them. Going to do some charity raising for them too which gives me a positive focus as I don't want to take from them without giving back however I can.

OP posts:
Adeleh · 08/03/2014 18:55

Thanks for a swift recovery, and I'm sorry you've had such a difficult time. I think what you're describing is how we'd all like our GP to be -an old-fashioned family doctor - and here is till a real need for that, as your experience shows. So YANBU to mind that your emotional needs haven't been met, but it's not your GPs fault that surgeries don't operate like this anymore.

Adeleh · 08/03/2014 18:59

'there is still' I mean.
I had the most wonderful GP in Ireland. You'd always have to wait 2 hours at least in waiting room because he always overran, but he was an excellent doctor and v caring. He'd definitely have called in your circs, but we had to pay 2000 euro a year health insurance AND 50 euro a visit. More investment in NHS needed.

iamsoannoyed · 08/03/2014 20:10

I am sorry about your illness. I can understand why you feel shell-shocked and am glad you have found some support.

I'm guessing you felt totally lost. However, on several points YABU.

I do share you concerns re medication- although your specialist should have given the GP specific instructions about the weaning down regimen for you medicines (you don't make it clear exactly what the letter for the GP specified, so sorry if they did and your GP ignored it). If your specialist didn't, and with you being treated privately, they may well have assumed you had been given assistance regarding this- although GP should probably have checked with you. If you asked for help with medication and didn't get it, then it's understandable you aren't happy and YANBU.

Regarding DNs doing dressing changes (or not, as was the case)- it's not the GP who usually arranges this directly (at least not where I work). The hospital should liaise with the DNs directly before discharge. So I can see why the GP might not have arranged to unless the letter specifically asked them to- as opposed to something like "dressing to be changed by DNs on day x, y, z with A, B. C", which could easily be interpreted as simply "for your information".

Also, the GP may well have simply have had to ask the hospital to make the referral, as I've worked in some areas where the DNs service won't accept referrals from post-op patients from GPs without very specific instructions regarding type of dressing etc).

When it comes to emotional support- it would be great if GPs had the time to phone all patients with difficult/devastating diagnoses, but we'd need more GPs and more than 10 minute appointments. If the GPs were to call everyone who had a difficult/devastating diagnosis, they wouldn't have time to do much else.

You asked for a call, and the GP called. Did you ask for more emotional support? If so, and the GP said they'd give it to you but didn't provide it, then YANBU- otherwise I think YABU.

Ultimately though, if you have lost all confidence in your GP, I think you should approach them about this to see if they can explain why things hadn't been the way you had expected them to be.

Bassetfeet · 08/03/2014 21:15

Goodness very pleased to hear your wound has healed. Have noted your tip re Rosehip Oil. I am huge advocate of Aloe Vera which will be similar . Keep the area gently moisturised . You are doing just fine x

hanloumac · 08/03/2014 21:36

Sorry maybe I have become too familiar with the system! I understand that emotional support does not easily come from the GP's or consultants. If they felt you were struggling they would refer you to a psychologist. Also it can be months before my GP's receive my update letters, I saw my GP two weeks ago he'd still not received my notes from December to say I was clear.

'Intent' may not be the correct word, but you have sounded like support was important to you from the beginning? Am I incorrect?

I've been through a hellish time too, I knuckled down and stayed positive! I always remind myself their are always people in a worse position than myself. I can see you have really struggled and had a hard time. I have spent 14 weeks in isolation in a leading oncology hospital and you aren't approached by Macmillan or such like to see how you are coping and my GP hasn't rung for a general catch up at anytime. Sorry if I sound harsh but I think you have to be the one to lead your follow up support i.e. ring GP's, chase DN if not appearing etc.

Hope you're feeling better soon!

poubella · 09/03/2014 07:19

Yes the meds become the GP s responsibility on discharge from hospital. I had a call from oncologist to increase some meds but the GP would not do it without a letter and we had a farcical few days of non communication between GP and oncologist. It did not help my stress levels !
No, I am not on a thread on mn but I have read it. My cancer is pretty unusual and I did not want to be recognised. I am also a health professional and my privacy is important to me.
Being a health professional did not help me navigate the health service though.

GoodnessKnows · 09/03/2014 07:57

Thank you all for your kind words.
Adeleh, I think you're spot on.

OP posts:
GoodnessKnows · 09/03/2014 07:57

I wish you well, Hanlou.

OP posts:
Supercosy · 09/03/2014 08:15

Hi OP, I think I remember reading your thread in health. I'm so sorry for your horrible ordeal and glad that the op was a success even though the whole thing sounds like a nightmare for you.

I have a few things to suggest based on my own experience of being ill, albeit not with something as drastic as a tumour. I have found that once you are "under the hospital" the GP can sometimes be loathe to advise you. I went to see my GP once, ended up seeing a locum because mine was ill and she kept saying "call your consultant....wait till your next consultant visit". It was really frustrating because my consultant appointment wasn't for several months and the question I had wasn't that complicated, I really just needed reassurance.

The part about the nurse never turning up to check your dressing is really poor. I would definitely make a complaint about that.

Finally, I actually changed GP (change to a different practise altogether) during the course of my illness because my own GP was completely unsupportive and, this made me feel worse and reluctant to go and see her even when I felt really ill. I now have a GP that is absolutely supportive, takes time to explain things to me, makes really helpful suggestions, is positive about my chances of beating my illness and when I'm feel dreadful keeps in touch, sometimes on a daily basis. Is there any possibility that you could change GPs? Do you have any friends who could reccomend a really good one?

Finally, I found some of the best support I received was from an amazing accupuncturist. Not only did I find her treatments really effective but her seeing my body as a whole and her concern for my mental well being as well as the physical was really comforting.

I really hope you are able to find some people that are able to support you better through this recovery period. I totally understand that horrible feeling of "being left" with something frightening and getting the impression that nobody really cares how you are getting on or what is happening to you. I think in actual fact they are just incredibly stretched for time. Best wishes to you.x

Supercosy · 09/03/2014 08:18

Sorry Op, I didn't rtft! You have found somewhere that is helping to give you that emotional support and I'm so pleased to hear that. Yanbu at all to feel upset that this was something your GP couldn't/wouldn't provide.

GoodnessKnows · 09/03/2014 10:16

Supercosy, you're right. They're stretched for time. I'll tell the GP about the Duty Nurse thing. I'll also emotion to him while he counts my pills that one appointment every two weeks just to prescribe didn't really cut it for me. I want to explain to him that the hardest but was having the diagnosis and then being churned out to deal with that alone. It wasn't my GP's fault, nor the consultant's, really.

Just one of those difficult situations, really. But it was odd to be given such big news by the consultant - news that was not only shocking but scary as hell and have no point of contact. Not a helpline, nothing. I feel a but embarrassed now to be expressing how I felt and my concern for others who find themselves in this situation. I do realise how lucky I am. But it must be said that feeling thankful, relieved and in shock are emotions that can coexist.

If cancer is found, there are telephone numbers and support (not necessarily from the GP but there are fantastic cancer charities to help emotionally, etc.). But when they don't know what it is and you're dealing with Big Shit, it's a pretty dark and scary place to be. That was the worst. Mumsnet reeeeeeeally helped during that time. So did RL friends. I'm rambling. Just processing it all.

It's been a whirlwind of 'adventure'. Within three months so much has happened. I'm grateful and ... traumatised. I'll get through the trauma now that I've someone trained to talk to ;)
Xx

OP posts:
Kundry · 09/03/2014 10:53

Remember it's District Nurse not Duty Nurse (there's no such thing as a Duty Nurse). Your GP doesn't employ or manage the District Nurses so while you can tell him or her about the problem, he can't look in to any complaint you have about them - you would need to complain to their management.

GoodnessKnows · 09/03/2014 11:39

Must've got the title wrong. I'm not bothering to complain formally but I'll raise the question of why one didn't visit when he next counts my pills. After all, the hospital (NHS) sent him the letter requesting that he arrange it and she works in the surgery as part of the practice.

OP posts:
Supercosy · 09/03/2014 11:49

Totally understand and I think what you are expressing has been felt by many others. My friend was diagnosed with ovarian cancer, then imediately sent to a specialist nurse to talk over any of her concerns, given her phone no etc. She then went home to await the date of her surgery. In the weeks that followed, every time she called the specialist nurse to ask a question she was told the nurse was on holiday or not available. In fact she ended up with no one to talk to apart from her friends. I'm not saying the nurse is wrong to go on holiday, clearly she wasn't but apparently there was no one else in the hospital that could do the same job. There needs to be more support. Who wouldn't feel totally freaked out and panicked by such news?

Supercosy · 09/03/2014 11:52

Sorry, me again.....totally agree. Being undiagnosed and very ill is the most horrible, scarey, no man's land. I was at the lowest point ever in my life when that happened to me. When I finally met my new GP who put things together and did her very best to explain what was wrong with me and actually acknowledged what a hideous 18 months I had I could have wept with relief. I felt like it was my birthday when I left her room....finally, someone who listened and understood and was willing to help me. Once again having accupuncture was also a huge boost for me.

Supercosy · 09/03/2014 11:53

I wish you the very, very best GoodnessKnows. xx

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