To think that the Consultant should do SOMETHING to help a woman in pain?

[Blazing88]

Been ill since January. Finally accepted something might be wrong (!) and rang doctors for an appointment. Had to wait 3 weeks. Was then sent for blood tests. Another 3 week wait. Test results back today - allegedly, there is nothing wrong.

Symptoms are:

indigestion, acidity and burping
feeling full
bleeding
feeling tired and breathless
pain, nausea
difficulty swallowing

This is my mother. She's 60 something, normally in good health.

The consultant told her the blood are clear, therefore there is nothing wrong with her.

She is in extreme pain, both sides of her body, to the extent that she can't sleep properly at night. The indigestion/acidity etc, she has been given tablets for, but it's still a painful experience. She has gained weight recently and the doc says it's probably just post menopausal weight gain. (she believes she is eating no differently and the weight is just piling on)

Being a typical bloody 'old' person (she's not old, but she seems now to have turned into one :( ) she is now saying that she is not going to do anything else, as if it was something sinister (ie stomach cancer) it would have shown up in the blood.

Can anyone medical advise? What should she ask to be tested next? What could it be? I think she should insist on a scan, even go private if needs be, but would that be worthwhile?

She is being so stubborn about this (the doctors are always right blah blah) but I think she should insist on a second opinion/more tests. I just don't know what tests she could be asking for!!

She should definately get a second opinion.

If she is bleeding vaginally post menopause, especially in addition to all of the above, she needs to be screened for ovarian cancer (is this what the blood test was? CA125?) and even if that is negative, they should probably do an ultrasound in light of all the symptoms. Not wanting to scare you/her unduly, but ovarian cancer is often late diagnosed, so better to get it checked asap.

My dads bloods were within fine but he had bowel cancer. Luckily his doctor referred him due to age.

Not to worry you but to tell you to keep pushing

Definitely get a second opinion. If still no further support ,write to GP listing all symptoms and impact on her life as once something is in writing it can help.

When you say bleeding... From where?

I agree, she needs a definitive diagnosis, there is clearly something wrong, that sounds awful. Where is the bleeding ? Can you go with her? Can you persuade her to go again (ideally to a different doctor) "just to set my mind at rest Mum and /or You must get help with your sleep" if she won't go otherwise?

If this was a referral via gp, gp might not be impressed either. Possibly suggest someone in different speciality (eg if that was gastro and bleeding is pv, she must see gynaecology

Woodlice No, this is exactly the type of information I need.

My mother is very very stubborn. Very bright (academic) but also very accepting of 'authority' ie she's been told she's fine, therefore leave it. Ignorance is bliss blah blah.

I've had a right go at her tonight, and she's agreed finally she probably should do something - but says she feels silly going back to the doctor, and what should she say/ask for etc. This is a woman who hates taking goods with receipts back to the shop, if she's changed her mind, so she doesn't bother!

I've said I will do a bit of investigating (ie google/mumsnet!) and see if I can come up with specific questions she can ask the doctor.

So brilliant. Please continue with medical advice (off to google CA125myself now!)

Yes, agree ovarian cancer needs to be screened for. It doesn't always show in the CA125 bloods. Try to persuade your Mum to get a second opinion.

Can she get a second opinion?
Given her symptoms I would have thought they would do an endoscopy to check her stomach is ok. If the bleeding is minimal it may not be bad enough to drop her iron level yet, but it is still worth investigating. Push to see a gastroenterologist if you can.

Best question is, 'if there's nothing wrong, why am I feeling like this, what will you do to help, when will I feel better, and what date should I come back if I'm not better?' The 'when should I come back' generally prompts action as it means they know you will bother them!

I think the main issue is they now live in the back of beyond (East Anglia) and she never sees the same doctor twice (lots of locums) so doesn't feel comfortable going back.

I think she should just go private (she has the money) but where to go? She's obviously close to London/Cambridge so could go either really.

But how do you go about seeing an expert??!

Private GP first if she's near London. They will send for ultrasound and do more bloods I would imagine. Then refer accordingly.

Who was the consultant, i.e. what specialty?

Has she seen a copy of the letter?

Is 'nothing wrong' what your mother told you was said by the gP or a direct quote from a consultant's appointment?

My experience in healthcare is that a consultant would be pretty cagey about saying 'nothing is wrong' but would be more likely to say 'these tests are within normal limits, nothing else I can suggest at the moment, come back if not improved or consider referring to this other specialty'.

With the difficulty swallowing, what about requesting a review by speech and language therapy, and perhaps dietetics re the weight gain? If GP doesn't want to do that, a barium swallow would be fairly appropriate as well, or ideally both. Barium swallow is good for identifying problems in the oesophagus which sounds like it might be a factor? Or the speech therapist might suggest a video fluoroscopy which is a more detailed swallow Xray.

Can you go with her?? Make sure the pain gets mentioned early and often. Pain is usually the buzz word that makes things happen in the NHS - well, not as often as you might hope but mention of pain that wakes you up at night is one of the things that bumps referrals up the list.

The specialty that springs to mind looking at the symptoms is gastroenterology, I wonder if that's the speciality that's already reviewed her?

Not sure what speciality the consultant was. I've said I'll leave her alone for a few days (let her get her own head round the fact that there's 'nothing wrong'!) and chat to her again about it when she feels more accepting to talk about it.

I shall ask her. Also, ask to see a copy of the letter, as I'm thinking maybe she just went to the GP today and the GP just said off the screen the bloods were clear?

Really doesn't help her. She's getting worse, not better and is now none the wiser. Maybe she (and I did to be fair) thought that something would show in the bloods and therefore a plan could be made.

What specialism is the Consultant she has seen? Or was it her GP?

Where is she bleeding?- if vaginal that is a trigger for an urgent Gynae referral to check for endometrial cancer (unless clearly due to something else e.g. just started hrt but I guess not the case at her age)

Fullness, gaining weight, indigestion- need to consider ovarian cancer- physical exam and a ca125 blood test and/ or ultrasound

I would go back asap and talk about these two things and query why she isn't being referred or having further tests.

Your mother has a long list of symptoms, have these important ones been lost in the noise?

meandjulio I could go with her yes. I do live miles away but am more than happy to travel down there to ask all the questions on her behalf.

She is so tired because she's not getting any sleep. She looks like she has a newborn in the house! She obviously can't carry on like this imo.

hopelessly I'm going to print out this conversation and just let my mum read through it.

I honestly think she would listen to strangers better than she would listen to me!

These are all great posts, please keep them coming. The more information I can get her to read through from unbiased people, the better. (she thinks I'm being a drama queen)

Bleeding from the vagina post menopause or bleeding from the rectum both meet the criteria for urgent 2 week wait clinics, regardless of the other symptoms.

As you said you need to try and find out what has gone on so far.

What consultant did she see gastro, gyne, ear nose and throat?
I would have thought an ultrasound scan of abdo, uterus would be a first thing to try. Maybe a chest xray for breathlessness.

Is she anxious and stressed about something so doc might dismiss it as stress related.

It might not be the doc but the way she comes over if she is trying not to make a fuss or be a nuisance, if that is her attitude.

You should go with her to GP.

Maybe it's not necessarily that she is being stubborn but that she is sticking her head in the sand as she is scared.

One way or the other, hoping you can persuade her to get her a second opinion soon.

treacle I'm sure that is probably the case, but she would never ever admit it.

Norah, Yes, I can almost hear her apologising now for wasting the doctor's time in the first place. So bloody silly.

TBH, I just want to be able to give her a short list of questions and then let her read this thread.

She's bright. She won't let her head stay in the sand for ever (I don't think)

I am early 60s but haven't bled for years - I would be v anxious if I had any bleeding and go straight to the doc.

Stomach and ovarian cancer do not show up in blood - get her back to the gp, go with her to the appointment, take NHs guidelines for screening of potential stomach, bowel and ovarian cancers and the triggers for these, stress how anxious, worried and in pain your dm is.

I would expect an endoscope (both ends) and an ultrasound (the gp can refer these now and then refer on to specialist guided by results.

I had bloating , pain, belching, stitchy pains - had gastroscopy and ultrasound - had swelling found in stomach from possible gastritis and large gallstones found - so 2 different things going on at once, given meds for stomach and referred to specialist re gallstones - all v efficient although now I have to decide whether to have surgery as specialist advises - but before I was worried as my paternal gf died in his early forties of stomach cancer so with symptoms that are warning signs of cancer I def felt. Anxious and worried I was writing off symptoms as ibs - which I was as it wasn't my ibs although probably hasn't helped and probably have seen more ibs due to these problems.

www.nhs.uk/Conditions/Cancer-of-the-ovary/Pages/Symptoms.aspx
www.nhs.uk/Conditions/Cancer-of-the-ovary/Pages/Diagnosis.aspx

Print out these to take with you

Blimey it's horrific that they haven't investigated for ovarian cancer properly with her symptoms