To be so disappointed with my GP's service - bit long sorry

[Filimou]

Basically I have two separate health problems, firstly I have had a cough since January, at first I just put it down to winter coughs/colds etc. However, it is getting worse, particularly at night, some nights I wheeze so much I get really out of breath.
After I had had it for a while, I tried to make an appointment at my GP to see a doctor, but now you have to go through a triage nurse. The nurse, called me in, listened to my chest and said “well your chest is clear so its not an infection, just rest and drink fluids”. This has been going back and forth with the same outcome/response for months. It is now getting worse, especially at night.

I also have a crap knee, was diagnosed with osteoarthritis a few years ago and a little damage to my cruxiate. This can occasionally flare up, and have been trying to manage it over the last few years mainly by getting my weight down but the past month or so I can barely walk on it, I can’t put any weight on it and it gets so stiff and sore.

The regular nurse was off sick last week when I called and the nurse I saw agreed that the cough isnt normal and so sent me for a chest xray and also a set of blood tests to check for infection and arthritis. I called the doctors, and spoke to the nurse (again), and she told me that they had come back normal so no action required. I asked what we do next and she said nothing. So, I am just supposed to live with a knee so painful that I can’t really walk up and downstairs without discomfort, I cannot bend without pain, walking or sitting for a long period can be extremely painful and kneeling is out of the question, and on top of that, a cough/wheezing that is so bad I can just about get my breath.

Tbh, the doctors at my surgery are really good and they have been great with the various ailments DS has had, but I just cant ever bloody get to see one.

I am currently waiting for the practice manager to call me back (maybe today, maybe tomorrow), would I be within my rights to demand to see a doctor and bypass the nurse completely? I am just so tired and fucked off, so don't know if my disappointment/anger is just an overreaction.

I have the same breathing problems. They've tested me loads but nothings come up. Can you ask for physio for your knee? Iv also got knee problems but with both of mine. Im having to manage it with pills and physio.

So glad it's on the way to being sorted. It will really help the dr if you keep a symptom diary from now until then - what makes you wheeze, how long it lasts, what time of day, what relieves it, how long it lasts etc.

If anything is diagnosed please sue them. It's the only way to change things. My cousin waited 6 months for an MRI result and was for some reason told by a nurse with a degree that he was thought to have MS so they weren't going to chase the lost result. Idiot that he was trusted her and resigned himself to life with MS and then died from a massive (treatable) brain tumor. I did nurse training once, not the brightest buttons.

Long while ago I've chest infection which left me with extreme cough
I wasn't even able to sleep
My GP prescribed me sleeping pills after making sure my chest is clear

I was shocked at first but they helped straight away and after a few days the cough was gone totally

I'm not sure if it can help but I wasn't able to breathe for over three years
my GP came to conclusion that at same point in my life I've had mine nose broken and wall moved
I left it that way and got use to it,occasionally helping myself with hay fever medicines

For my big surprise my problems went away after two courses of antibiotics for completely different heath condition
:-S

That's awful. Have you tied using an inhaler- does a friend have one? To see if it helps. Also do you smoke- if so try and cut down or stop or use an e-cig I was a smoker three months ago I promise I'm not judging!

I lived with a ruptured cruciate and they didnt even scan me the test is if your knee wobbles from side to side, does yours? Like can you move it a bit either way? Get a support on it until you get seen, and sorry I've just seen post above about asthma x

You have asthma, I suspect.

Ask to see a GP, and when they make the diagnosis ask them politely to educate their nurses on the differential diagnoses for nocturnal coughing.

Your case highlights exactly why the government should stop encouraging nurses to work above their competence levels.

That's awful. Have you tied using an inhaler- does a friend have one?

Don't do that! Inhalers are not an auto-cure for asthma and, depending on any underlying conditions, can be dangerous in themselves.

It's essential to go through the diagnostic process and be prescribed the correct inhaler. Also, as blue "emergency" inhalers are broncho-dilators, you may be masking the symptoms of a different condition.

You should only share inhalers in a dire emergency!

Took them 4 weeks to diagnose my double puenmonia and then bronchectsis on top. The bronchectsis made the initial diagnosis difficult as I don't get a temperature with infections - basically don't give up, don't take no for an answer, please make sure you see a doctor

You sound a but like me so keep pushing if your spirometry comes back normal. Don't let them fob you off. I have cough-variant asthma that only bothers me when I catch a cold and they usually give me a short course of prednisone if the cough hangs around.

It seems odd that you can't make an appointment with a GP if you are prepared to wait. Many surgeries have triage for minor ailments for people wanting appointments within a couple of days but usually if you just say "I'd like an appointment with Dr X please, when is the next one" there isn't a problem, and as both problems are chronic there is no rush.
I'd be doing the broken record "I want an appointment with Dr X" repeatedly and telling them Dr X can discuss it with you if they aren't happy.
If you have asthma spirometry will be normal and you need diurnal peak flows to diagnose it anyway, although if you're getting on a bit and have been a smoker COPD will be more likely in which case spirometry will help.

"Sue them" yes because the way to help make the NHS be more efficient is to remove money from it and stress out GPs at a time when GP recruitment is poor.
You have to prove you have suffered for medical negligence cases to succeed and I doubt a few weeks of coughing really counts as suffering.
The triage system sounds crap though especially as a nurse not a doctor is doing the triaging. Usually triage is just for urgent appointments, it sounds as though they are very understaffed if they waste nurse time screening all appointments.

I'm a nurse and I'm a bit shocked at the nurse acting as a gatekeeper to medical services.

I know loads about my own speciality, to the point where I've been able, on occasion, to advise the medics but I'd be the first to admit I know pretty much hee haw about most other branches of medicine.

That is the fundamental difference between nurses and doctors, doctors career paths allow them to pick up knowledge in breadth as well as depth.

I love the nurse practitioner role, I think its amazing (I'd like to be one) and, if used properly, can really improve things for patients but I think the NP at your surgery is being used inappropriately.

Instead of phoning turn up one morning when they first open and ask for a doctors appointment. I have ongoing problems like you i just say its complex the nurse will not understand. Its
You who has to suffer not them, i hope you feel better soon.

2rebecca who mentioned sueing? she said formal complaint the only way to get things done is complain in writing so they can't weasel out of it at a later date if things get tragic

Cough that gets worse at night? Big red flag for asthma. I am really surprised this wasn't picked up.
You can self refer for physio for your knee in most localities these days, might be worth a try.
And yes, speak to the practice manager

Wow, I had no idea this thread was still going. Thank you for all your replies.
I do agree that the problem is the nurse practitioner being used inappropriately.
Fwiw 2rebecca I would never sue the NHS. I never said I would. I only wanted to lodge a complaint to let them know that their current system is wrong. A nurae should not be used as a gatekeeper to a doctor.
Oh and while I am at it Im 34 (not really getting on a bit ) and I have never touched a cigarette. I made that decision after growing up in a smoke filled house.

As an aside I was up most of last night too.

Theodorus was keen on sueing.

I am weeks away from qualifying as a nurse and I can think of a few things that could be the cause of your persistent cough that would need further investigation. However, as a nurse, I am not qualified to investigate those causes and so would refer you on to a doctor. I don't even have a field of specialism yet or even my qualification to know that.

Nurse practitioners are a great thing when used correctly, like in a community setting for palliative care for example. There are some awesome NP's there. In A&E also, I had one look after my cat bite on my finger (don't ask! lol). I had one diagnose the tonsillitis I knew I had last weekend at the walk in GP clinic. They have a GP and a NP on duty at weekends to see patients. Receptionists triage (even more dangerous imo).

Anyway keep at them to see the GP. You need a bit more investigation. I'm thinking asthma as you are describing exactly how I am when my asthma isn't under control. Especially the night time coughing. Pollen is really bad this year too for some reason and not helping my poor lungs. I've never smoked either for the exact same reasons as you. xx

I'm really surprised the practice nurse didn't suggest asthma - asthma is one of the conditions nurses are supposed to be really clued up on these days. I must admit when I read your OP asthma was the first thing that came to mind (bear in mind that I don't have any medical qualifications - it just seemed like a plausible explanation under the circumstances).

I know the NHS is under strain, but it seems like an odd way of going about things.