AIBU to expect reconstruction on the NHS

[Welshmaenad]

Probably v outing but never mind.

Last summer I developed a large, rapidly growing breast abscess (it was about the size of an apple under my areola). I was referred to breast clinic and sent for an ultrasound. Ultrasound operator confirmed it was a sealed abscess "full of gunk" and then decided to biopsy it despite no request from the consultant to do so. Consultant then saw me before I left, aware of biopsy. No antibiotic cover offered (have since discovered this is best practice guidelines).

Over the next few days I became very unwell, fever, rifles, vomiting, breast hugely swollen and red/sore, pus leaking from biopsy site which expanded and started going black. On gp advice I presented at a&e. Another ultrasound confirmed biopsy had ruptured abscess and contents had dispersed through my breast tissue. I was admitted.

Following day I had extensive surgery to remove necrotic tissue. The day after that I was taken back to theatre as there was more necrotic tissue, I was then isolated and informed I had necrotising fasciitis. I spent three further days in hospital, then discharged in oral antibiotics, district nurses daily to repack wound. They ended up removing g about 50% of my breast tissue. I was unable to work for four months.

Seven months in and wound us still 2" deep and being packed though I am now in work. Aftercare has not been great from the hospital side - GP surgery nurses have been fab though. Yesterday I was in clinic and saw a registrar, I asked about reconstruction (was told by surgical team at the time this would be done). He "doesn't see there will be a need for it and it looks ok". It is not ok. One breast is about 3 cup sizes smaller than the other, hangs in a sad triangle, folds itself in half if I put an underwire bra on and doesn't fill the cup, half the nipple is gone, a great puckering scar has formed. It looks like an anus. I have a boob anus.

AIBU to expect them to at least try to make it look normal? I'm being made to feel I should be grateful they saved my life. My life would not have been in danger if they hadn't burst the bloody thing. I could have it drained via needle aspiration with no surgery at all. Several people have suggested I sue for med neg. what would you do in my position?

IMO You should get this reconstruction no question.

Im sorry you have been through that how traumatic

You poor thing. Yes you definitely should have it reconstructed. Keep pressing and take it higher if need be.

Jeezo you poor thing that sounds horrendous!!! Yes of course they should be correcting the appearance of your breast. The whole ordeal sounds awful

I’m also generally pretty anti sueing the NHS, but I don’t think you’d be unreasonable to pursue that if this isn’t resolved.

Have you made a complaint? Please do so.

If they won’t reconstruct then I can see why you would sue in this case, in order to have the funds to reconstruct privately.

plus there is four months of lost wages.

was your employer sympathetic OP

I think I would be opening a complaint with PALS seeking clarification on exactly what criteria I was supposed to meet and how I wasn't meeting it as well as making it clear I was seeking legal advice about the whole thing.

Your strongest point (to my non-legal, non-medical mind) is you saying you have since found you should have been given antibiotics.

The surgical option was only ever an option and most likely they would have always sought to avoid surgery if possible, but you should have been treated appropriately medically.

Have you made an official complaint ? To PaLS and make them aware you will be seeking legal advice

Yes Brie I would only do it so I could have the correction done privately, which is likely to be expensive.

You should definitely complain. What they did was dangerous. Without a complaint they may continue to do this without following best practice procedure.

You deserve any support required from the NHS to make it as right as it can be

Re: my employment - I didn't actually have an employer at the time. I graduated last July and was looking for my first qualified job when this happened. I was registered with an agency too but was unable to start work as I was still unwell and being seen every other day for packing. In December they taught me to do it myself and I started an assignment in January.

I would be seeking legal advice....this is negligence

If you’re not happy then start by going through PALS. You can look on the hospital’s website for their number and make an appointment.

I think you should make a formal complaint about your treatment, including what the recent clinic doctor said (write it down word for word before you forget exactly). And YADNBU to expect reconstruction on NHS given the circumstances. Leaving you with an abscess without either draining it or treating it sounds odd - possibly negligence?

First step is to make a complaint about the procedure and after care through the pals service. Set down what you want from it, investigation as to why it was done, why you weren't offered anti biotic cover (would this be expected usually) also reconstructive surgery to repair the damage caused by their treatment.

It sounds like they are brushing you off which is unacceptable however they need to save money where they can so, sadly, you need to go down the route of "I'm not going away until you've sorted this out".

Jumping straight to threats of sueing is going too soon, in any litigation you will need to show that you have allowed them opportunity to do what is right/needed. So start there and go through the process.

Record everything, names, times and dates of phonecalls, appointments etc. Keep every email and letter. Good luck

If you still have a wound needing to be packed, then hold off on the "big guns" for now; a reconstruction would presumably not be a good idea at this point. When it has healed then that would be the time to quietly insist on being assessed for reconstruction, and make sure you speak to a consultant if necessary. Hope you get resolution eventually sounds a horrendous experience you've been through.

If you have household insurance you may find you have cover to pursue a claim.

Ah Packing EVERY OTHER DAY Christ OP how awful.

Just a point where posters are mentioning PALS. In my area PALS do not deal with formal complaints, more trying to resolve issues informally, not sure if this is the case everywhere.

Absolutely get your ducks in a row, all copies of paperwork, names, dates, advice given as recommended above.

Start asking at what point in your treatment plan reconstruction is advised, confirm who makes the decision and take it from there.

You ar sosososo NOT being unreasonable but it’s all about funding, I can’t honestly tell you I heard an horrific discussion between 2 breast doctors along toes lines of breast reconstruction following breast cancer I being debated as to whether it can be classified as cosmetic and rhereforw totally banned under public funding, completely outrageous and just horrific to even contemplate the thoughtxxx

I used to manage complaints and serious incidents for the NHS.
Complain through PALS or direct to the chief executive.
Your account is very clear and it could well be considered a Serious Untoward Incident ( which requires formal investigation).
Include in your complaint that you want a formal investigation so that the service can learn from this incident.
The physical, emotional and financial effect on you.
That you want your breast to be restored to its pre-surgery state as nearly as possible.
You would want this done by a surgeon of your own choice.

This is awful.

You need to speak to Pals at the hospital. And unless the consultant also says this, I really wouldn't take the word of a registrar as gospel.
You can also choose your NHS hospital nowadays ( used to be called choose and book) so have a look and research into surgeons in the wider area with breast reconstruction as a specialism, a plastic surgeon on the gmc specialist register and also on baaps and bapras and ask for a referral from your GP on the NHS. It is absolutely your right to do this and also I believe your right to have rconstruction.

imsosceptical im not surprised ive seen posts saying that on here before

You can bet they would hum a different tune if it was their own wives and their own sexual gratification would be affected.

Misogyny is alive and well in the NHS.

This needs its own #metoo movement.