to ask if this is an OOH job?

[jorahmormont]

Long story short, months of agonising stomach pain. Back and forth to doctors constantly, told they suspect an ulcer. Been taking tablets so now I get say a week pain free followed by a week in agony.
Doctor told me to book a h.pylori blood test. Can't get through to the phlebotomy service, have been trying for 4 weeks now. Just started a new job and in the middle of training so can't take time off anyway.

Yesterday the pain was so bad all day I felt constantly sick, it was right up in my shoulder as well as my stomach, dizzy, unable to focus, everything. Got worse when I got home from work, couldn't regulate my temperature, had a fever and was in so much pain. My stomach has swollen and it feels like there's a solid lump when im standing up, its literally rock solid. Today I feel marginally better but I'm still stuck in bed, temperature is fairly high and I am in pain. My heart is still skipping beats and jumping all over the place.

I don't know if out of hours could do anything for me. DP is adamant I don't need it but the pain has never left me like this before.

WIBU to go to out of hours? They'll be so busy this weekend :(

Well done Jorah.
Maybe write a wee list of symptoms down while you wait.
Make sure you tell them about the shoulder tip pain.
Do not minimise how unwell you are.
Best of luck, another nurse here who is very glad you are at a&e.

I don't think anyone thought it was attention seeking. Many of us have been in this situation where we don't want to go, we don't feel confident it's worth going, etc.

You are clearly completely genuine, please don't worry about that.
I hope you are seen soon. Did triage nurse take your temp? I always get hot when I am anxious in places like that x

What is A&E going to do for OP today that Nurse Practitioner couldn't do yesterday?

Hope it's nothing serious and you're not waiting too long.

Chest x ray

further investigation if necessary

treatment for potential perforation

honestly read the thread!

I have read the thread... I suspect OP will go home with precisely same diagnosis & treatment as she got from NP. Will be interesting to see what happens, though assuming I don't get shouted at for daring to ask questions, that is.

IIjkk - A&E can do a full set of blood tests, and erect chest xray. If clinically necessary they can order a CT scan and ask for a surgical review. If they send her home they can dispense painkillers and antibiotics there and then rather than make her wait until Monday. The nurse practitioner can't do any of these.

And if there is nothing a doctor can offer that a nurse can't, then why the hell did I spend 5 years at medical school?

Yes, she may well get sent home the same as yesterday, (and probable will be) but I would be a lot happier once they confirmed there is no escaped gas in her abdomen (the xray) and that she doesnt have pancreatitis (blood test for amylase).

Look if you don't agree with the various HCPs who have posted then feel free, it's quite possible she will be sent home with the same diagnosis however this way, the more serious options can be ruled out, while they could not yesterday.

Not sure why you are arguing this? Do you think it is a waste of time?

Maybe A&E will diagnose her without doing any of the fancy tests and send her home again with exact same diagnosis and recommended treatment.

Maybe A&E will suddenly magically diagnose her chronic problem that the GP & primary system were unequipped to identify. What is so wrong with the primary care system that they can't identify & treat a chronic problem after many efforts but A&E can? Or can they?

OP is there, you have precisely what you want, sheesh, why are you guys yelling at ME for asking questions about the role of A&E in the medical care system?

Oh jorah I think most people think that you NEED attention
get well soon

Not shouting lljkk. I'm just confused by your point - I still can't understand what it is. Perhaps start another thread if you have a question?

I don't think this is helpful to the OP.

She didn't see a GP though. (Or did I miss it?) She saw a Nurse Practitioner who, in my surgery, is qualified to do Pill checks and check for sore throats. If that's sufficient, as Wildfire pointed out, why do we need A&E at all. Heck I'll go in and start treating people in A&E.

There are many time wasters at A&E, but OP isn't one of them. We haven't got what we wanted, we were concerned about her and would rather have her well and at home.

An xray to rule out a life threatening illness is a fancy test? Right.
Nobody yelled at you btw.

Ahh OP. I am so glad you are there now and I really hope you get the same diagnoses but the lump would worry me too.

I understand being scared. I have health anxiety and going to A&E would cause me huge panic attacks.

Lots of us here sending you virtual support and thinking of you.

The deciding factor in coming to a&e was the fact that the nurse practitioner didn't even look at the solid lump thing. It's bigger than usual, solid as a rock and so painful and I am not happy with it.

I don't know where else to turn for help with it which is why ive come here. If they tell me its nothing, just the UTI and gastritis, fab. The triage nurse seemed surprised I wasn't seeing the hospital about the ulcer.

A&E is filling up. I'm sweating buckets :( one person been called through since I arrived.

A&E have all sorts of diagnostic equipment that a GP won't necessarily have. That's why they might be able to diagnose something the GP has taken a while to. The GP has identified that she might have an ulcer, but it's that information combined with the OP's symptoms that call into question whether the nurse practitioner did all the tests she should have done.

Most HCPs are great, but they are human and even the best occasionally get things wrong. It's never a bad thing to get a second opinion if you think that might be the case. Particularly if the potential complications are very, very serious.

OP.

Hopefully you won't have to wait too long.

You did the right thing going. It is potentially too dangerous to mess around with.

I hope you get seen soon. Please inform someone if you feel worse while you are waiting.

Started putting together a list of symptoms. My body is a bit of a mess at the moment is my conclusion :(

On the bright side there's some right characters here.

jorah - glad you're there, and I hope they find out it is nothing serious!

Reading this thread, one thing I'm worried about is do you tend to minimize your symptoms when talking to people? I do this, and have gotten sent away many times when things were actually serious: for example, they ask, scale of 1 to 10, with 10 being the worst pain you can imagine, and I say something like 6, because I can image a lot of pain! I'd put my labour contractions somewhere around 5, and the SPD pelvis-being-torn-apart pain that came along with them about 7 or so. I'm sure other things would hurt far worse. But when an HCP hears that, they think, oh it doesn't hurt. Because they expect people in pain to think its really bad and to say 9 or 10. Or they ask, can you walk? And I say, Yes, because yes I can, even though I sometimes have to stop and sit and rest because it is so painful and occasionally fall down. But it's not like I can't move my legs! I've had to have my DH come with me on visits to make sure I don't downplay things. Sounds that wouldn't help with you, though...

So, anyway, all that is to say, when you see someone, please try indicate that things are pretty bad, and don't feel embarassed about it.

Jorah, I'm glad you are there. Please don't let anyone make you think you're wasting time. Even I f you do come out with the same diagnosis, it's important that you get examined by someone more qualified to rule out anything more serious. Remember that the HCPs on this thread have ALL encouraged you to go to A&E.

I do downplay things, but I don't know what my pain tolerance is. Labour was a breeze but I've cried at clicking my shoulder out of place so it's a bit weird. I described this as a 5 but if im honest it's a 7 or 8. On Friday at times it was undoubtedly 10 :(

I used to get called a cry baby when I was younger and it stuck with me massively. I "toughened up" and now downplay everything.

Was feeling really grotty as I haven't washed my hair, but people have just come in in pyjamas so I don't feel too bad now.