Would I be unreasonable to go to a&e?

[flanjabelle]

If I would, please please don't flame me as I am laying here in tears because I don't know how to cope anymore.

I have lower lumbar pain that has been becoming more and more severe over the last year. I have received appalling care including fuck ups meaning I have been discharged from physio accidentally, putting me back at the start of the process, only to be told physio won't help me anyway (after waiting for another referral and seeing them again). The gp fobbed me off for months before finally ordering an x ray and blood tests to look for rheumatoid arthritis and any other auto immune diseases that would be attacking the spinal area. I am waiting on the results.

Back to now. I have barely slept for two weeks due to the pain. I am on co-codamol 30/500 and gabapentin which do not take my pain away. I wake more than 20 times through the night, cannot get comfortable in any position. I am in constant pain through the day and am at the point of breaking down. I have a 2 year old. How the fuck am I supposed to parent like this?

My gp has fucked up again. He has told me that they have exhausted their options so I need to go to the pain management clinic, but then forgot to order the referral. I have asked again and again and today they have admitted that it was only just sent through.

I am at breaking point. I can't get out of pain. I can't sleep. I can't parent a toddler. It feels like someone is squeezing my spine with a vice. I don't know what to do.

If iabu to go to a and e, what am I supposed to do? I have coped and coped and I can't cope any more.

I checked with the pharmacist about the medicines, they are ok to take together. Good night everyone.

I'm pretty sure you can also take amitriptyline with that lot, but double check with a pharmacist before you do. If you need to, i mean

Don't take the mental health leaflet personally. I believe thag CBT counselling can help people with chronic pain cope with it all a bit better. I don't think the Dr would have been saying anything against you at all. Plus when you're in so much pain it's very easy to get a bit depressed.

Yeah the mental health thing is totally normal. I was told about this at my pain clinic appointment and to start with I thought he meant I was imagining the pain and stuff and got a bit defensive. He explained that it won't really help with the pain but can help me manage it mentally as it would drain anyone being in pain so often and a lot of people do not realize if they are depressed..which having pain near 24 hours per day is likely to make you. Also he said if nothing else, I could use the meetings (when/if they star) to sound off at the psychiatrist about anything I wanted to..just to get stuff off my chest. Someone totally impartial who you can moan about ANYTHING to without fear of upsetting them or offending them or whatever. Which sounded quite tempting I have to say.

Hope you get some sleep

If you have spasms, a Tens machine is my life saver. Basic amazon one, about £20, I couldn't have retained sanity without it - mine is 2 crumbled discs and something weird now going on under my shoulder blade.
Physio made me much worse then eventually I got an extra and a specialist.
I really hope you are feeling improvement tomorrow

Hey OP. Hope you have slept ok when you read this. I had very similar symptoms a couple of years and I know it's hell. I don't have kids- I can't imagine how you're coping.
I wanted to share a little trick I was told by an NHS physio i saw....
Like you, my gp wouldn't refer me for an MRI.
Likr you, I really needed one.
When the physio saw how much pain I was in she told me to go straight to a&e and to tell them about the pain but to say id gone in as I'd poo-ed myself that morning and was really worried (I hadn't btw).
I went to a&e, told the fib and because they do worry when people are suddenly incontinent, I had an MRI that day. The results were analysed and I was referred to a spinal surgeon straight away.
It didn't feel morally right to have to lie and it was embarrassing BUT it got me the MRI which I badly needed.
Good luck. It will get better xxx

Hope you sleep well

Morning everyone. I managed to fall asleep at about 11 once the tramadol had kicked in. I tried to stage taking the tablets so that I wouldn't feel like I had been hit by a train and took the tramadol last thing. I didn't wake up in agony again and again through the night, so that was fantastic. Feel rather drugged this morning still, but at least I don't feel like I'm going crazy through sleep deprivation.

My mum is going to have dd for most of today so I can rest and try and pull myself together. I feel terrible about it, but I just need some time to sort myself out. It's a duvet day for me.

I think my post last night came across as if the doctor was not very good and that wasn't the case. I was just upset that it seemed like another dead end. He was very caring and sympathetic, but it seems that in my area the gp is the gatekeeper for the help I need. Referrals are not done by the doctors in a&e here anymore, but he phoned up the orthopaedics and begged to refer me after I went back in with my mum.

Posted too soon.

He was sympathetic, but was unwilling to tell my gp what he should be doing. He could see how upset I was that after all this time no one has told me what is wrong with me and could understand why I wanted the mri. He told me in my case it was pretty much unnecessary as from my symptoms it is clear that it is a herniated disc causing the sciatica and then I have the trapped femoral nerve as well. I'm a way just having someone say this is what is wrong has made me feel a bit better.

He feels that it will be the pain management clinic that will take this forward and has urged me to keep calling for a cancelled appointment, which was my plan anyway. I phoned them yesterday to find out what was happening and the first appointment they have is 17th June. So I will keep calling them each day to try and get a cancellation.

I wouldn't feel right fibbing about the continence, but I will be speaking to my gp about the problems urinating as I feel concerned now I know it can be a sign of serious problems.

I think I am going to have to take tramadol at night for the foreseeable future as well as the diazepam in the short term and the suppositories. Amitriptaline was not an option anymore as when I tried it I had such bad restless legs I was up all night anyway.

Not sure how to go forward with the gp now. I think I will get quite a frosty reception for going to a&e and going against what he has said. He has always said that I don't need an mri, that it would only happen if they were planning surgery and has refused to refer me to orthopaedics. I don't think he is going to be too thrilled.

Glad you slept well. I'm just putting it out there that prolapses can cause horrendous back ache alongside continence issues (and other symptoms)

So glad you got some sleep. I think you will feel much more able to cope after a few nights like that.

Please change gp if at all possible!

The mental health side of things, I feel funny about it because I have suffered with mental health problems in the past and I can feel that my mental health is deteriorating massively because of this and it frightens me. I don't want to be unwell in that respect. I have tried so fucking hard to stay positive, to follow the instructions of the gp and physios and have faith that someone is going to help me get better. I have lost that faith and it has made me feel completely hopeless and frankly depressed. I don't react well to antidepressants, I get horrific side effects, but I'm having to admit to myself that I'm not coping mentally. I am not sure how to feel right now, and have just been hanging on to the hope that with a plan in place I will be able to cope better. At the same time I am not willing to let myself sink into such a hole that I am unable to pull myself out. If anyone can make sense of that and has any advice that would be great.

Sadly back pain is often treated casually by HCPs as it does often resolve and equally often is a long-term chronic thing which can take some time to find something which helps be it physio or osteo or just drugs. Sorry you are having such a crap time of it but clearly there are a lot of us out here. I take anti-depressants now as chronic pain is depressing and it makes me slightly less pyscho bitch on bad days. Glad to hear you finally got some sleep and some help. Hang in there!

Glad you have slept and your mum has your daughter, a duvet day sounds very sensible indeed :) . Try to keep moving when you can , even just turning gently in bed so you don't stiffen up :)

I think that's fairly normal that GPs are gatekeepers for referals for chronic health issues, A&E generally wouldn't be able to do much unless it was an acute issue that required an emergency review by a consultant.

Not sure what I think about lying and won't say what I think about an nhs physio advocating it. Except that whilst you might get a rectal exam and an MRI they won't necessarily do anything more. It's cauda equina syndrome that requires emergency surgery , it's cauda equina that causes problems with genital area or bladder and bowel. It means that the disc(s) are portuding enough that they are compressing the spinal chord and could in the worst cases cause long lasting damage to the nerves below the level of compression. It requires emergency surgery.

They can tell from an MRI scan if you have cauda equina - all you'd likely get from lying is being told exactly what's wrong (ie. disc issues at what levels of the spine) and review by a neurosurgeon or orthopaedic surgeon. You wouldn't get surgery immediately unless it was indicated you did have cauda equina, you might find you are put on the waiting list for theatre eventually but they seem to want people to try everything else first.

From a moral perspective .. neurosurgeons and orthopaedic doctors are dealing with very sick, seriously injured and seriously ill patients. Being called down to A&E or having a patient brought to the ward for on the day distracts from that. It doesn't seem 100% right to me. Whilst I can understand the need for diagnosis and help , it is honestly genuinely better for everyone concerned to go via the GP surgery and be honest about what's going on.

If you are in worsening severe pain seek help yes - but hopefully the gabapentin will help as a sort of background drug with the diclofenac reducing inflammation over time.

I do empathise, I have occasional sciatica when I get home from my work and can't imagine how it must feel to be that way all the time :(

Hope I don't sound like I'm lecturing anyone , just wanted to say what I'm thinking.

personally I would go, as its an emergency situation and they give you the right painkillers (i.e. amttryptaline) and prompt enough of a drama to get your referred

OP this thread here refers to some good painkillers/SOLUTIONS
www.mumsnet.com/Talk/general_health/2440665-Endless-Back-Stories-Support-For-Back-Pain-and-Sciatica-Thread-8

Sincerely, stress is a HUGE part of back pain- I am not disputing you are in agony but the anxiety factor of not sleeping and not having a path forward exacerbates it, and if an A&e visit gets you some better painkillers so be it, and/or referred for an MRI

secondly, you need to pay for osteopath or physio. As its really helps- with the pain and they can give you exercises. If you have a local community facebook page, join it and ask for advice as then you get good locals ones

THE EXERCISES REALLY HELP!!!!

I 100% think you need some attention, and this shit fucking GP is not helping and the stress is making things worse

you deserve attention, and if you have to go to ICU or MIU to get it, so be it

I never ususally send people to A&A (on mumnset!) but in this case

sorry saw updates.

Please please get yourself sorted in pain clinic, and then start the exercises, and find an osteo/phsio- THIS IS KEY

even if for today you can lie on floor ice the pain and do some gentle stretches

fwiw I got my back pain handed through osteopath/gentle exercise and pain killers

then my dad died, and guess what? it came back and was agony! Its such a shit mix of anxiety an physical, I feel for you

Glad you had some sleep, it makes a big difference. I found the diazepam had a double benefit as it reduced the spasms but also took the edge of the panic I was feeling about the pain. I was constantly stressed waiting for the next spasm to hit which meant the muscles never relaxed. The combination of diazepam and codeine meant I was able to relax and the muscles could start to lengthen again. Hope today goes OK and keep badgering for the appointment with the pain clinic.

Glad you managed to get some sleep OP,like I said before put in an official complaint about your DR and I'd be looking to change to a different GP surgery as well.

I didn't get immediate surgery but I did get the MRI that otherwise I would have had to wait for and then informed the future treatment. It was the best thing I did and the best thing the physio could have done for me at the time. No regrets.

Please don't shout at me but one of my best friends, who has terrible chronic back pain, has really benefited from regular acupuncture.

I don't know why it would work, it sounds ridiculous, I'm kind of embarrassed suggesting it, but I just wanted to pass it on in case.

I think the sleep deprivation has caught up with me. I have been asleep since 9am. I thought oh I'll just nap for an hour. And bam. It's nearly two o clock. That feels very strange.

Your body must have needed it OP.Hope the pain relief keeps helping and that you get another good nights sleep tonight.

Why would you feel embarssed itwas? acupuncture for back pain is approvd by NICE as far as I am aware. There is evidence of it's efficacy.

Yes please don't be embarrassed itwas, I have actually tried an acupuncture nerve block to try and stop the pain, but i don't know why but the pain got significantly worse. This was done by the private guy I borrowed money to see at first. It was after this that he said he was not touching me until I had an mri. I agree that acupuncture can work miracles as my mum benefitted greatly from it, and I had every faith in it, but it just didn't work for me.