to go to A and E!?

[outofoptionshelp]

Hi, I made this account out of desperation as I need another opinion. I have suffered with hip pain for 4 years now, had surgery to try and help 2 years ago but pain has restarted. Now, I fully accept that chronic pain is not an emergency but...

Wednesday morning, my hip gave way, I fell, and I am now in such pain it is awful. I have taken Tramadol (prescribed by my GP for the last year for the pain, not the fall) and it doesn't touch the pain. I have rung my GP surgery and as I need painkillers, they refuse to give me an emergency appointment and instead I have to wait until next Thursday. There is no bruising or swelling in the area, but it is just so painful, especially when pressure is applied. However, I can walk pretty much normally.

So, AIBU to go to A and E considering the strength of painkillers I will need, even though there is no bruising/swelling and I can walk??

In Edinburgh we have a minor injuries unit that would deal with this kind of thing quicker than a and e would. Def worth getting it checked out if you are in that level of pain as its not normal.

Thank you, I always feel so guilty with anything health related as I feel I waste everyones time, hence why I've never set foot in a and e so don't know what counts as an accident/emergency. Would minor injuries be able to prescribe painkillers that strong then?

Call 111 and try to get OOH GP. And then find a new one!!

That is rubbish of your gp. I'd ring again in the morning and say you are unable to cope with the pain and ask for an emergency appointment. If they refuse again then it will have to be a+e. You have fallen, so surely it's possible something could be fractured/torn/broken? I'd be switching gp's if they do refuse, and sending a letter of complaint. So sorry you're in pain right now OP.

I agree with the advice to phone 111. If A&E is the most appropriate place then they'll tell you. Good luck!

Ring today and ask to speak to a GP. You need to get past the receptionist!
Failing this go to A&E because you have fallen. Expect a long wait. I was there recently and from start to finish it was four hours. I was right to go I had a fracture.

A&e isn't the place to go for a prescription. You may get something for the here and now but not anything long term. I would say if it's not an accident or an emergency don't go. I know you have fallen a couple of days ago and that you're desperate but with no visible injury and still being able to walk etc I don't think this would fall into that category. Call 111 and they'll refer you to an OOH GP, or first thing call your GP and demand an appointment. Maybe what you need is not yet more pain killers, although I know you are in a lot of pain but proper follow up care after your surgery. Ask the GP to prescribe something for now and refer you back to your surgeon/chronic pain team/physio.
Your minimum wait would be 4 hours in a&e.
Hope you're feeling better soon x

I rung 111 and A and E are now expecting me within the next few hours. They also gave the very useful advice of taking parcetamol and ibuprofen when I explained that Tramadol isn't working

thank you so much everyone

Magic paracetamol hey?!

I know they say a&e are 'expecting you' but I wouldn't be surprised if they really have no idea. Take a book and some things to do. They'll probably be quieter if you can get there ASAP esp before shift change at 8. Good luck.

My plan is to take my laptop, may as well finish some work while I'm sat there hahah, make the most of a boring trip!

Hope they help

God what a fucking mess things are in. Having to beg for help.for serious medical conditions. I am ashamed to have a purple passport. Luckily I don't have to live there. Stop making people guilty for legitimately needing medical care. They are the stakeholders not a burden.

Is it an accident? Is it an emergency?
Phone the gp back and demand a same day appointment

Seeing as it is possible to break part of your hip and still walk, albeit in pain a&e is the right place to go as op will need an xray

I work in a and e. If I had a pound for every time 111 told a patient we were expecting them I'd be a rich woman. We don't have any communication with 111 at all. If you're weight bearing I doubt if you'll be a high priority and we'll probably send you back to your gp

Today 08:40 Palace2

I work in a and e. If I had a pound for every time 111 told a patient we were expecting them I'd be a rich woman. We don't have any communication with 111 at all. If you're weight bearing I doubt if you'll be a high priority and we'll probably send you back to your gp

Yay. You sound lovely. You really need to be moved to a less stressful area, outpatients or endoscopy or something. When nurses lose their empathy, they need to be removed from front line services. Nurses like this are the ones who curl their lips and send people home who then die because they really were ill rather than going to A and E just to piss the nurses off.

It’s true that we don’t have any communication with 111. Severe pain would be taken seriously though. It wouldn’t be a waste of time

Rather than just sneering at the stupidity of patients in desperate pain begging for help, why not take up the fact that 111 staff are either lying, or NHS staff are ignoring important communications. I always thought a duty of care included flagging up issues that could cause pain, suffering or death of a patient. If you don't, you have blood on your hands.

Okay - 111 tend to always tell you to go to A and E - its a very poor service compared to NHS Direct, which did give other advice (walk in centre, send round an out of hours GP, pharmacist).

But if you are in that kind of pain you could have damaged your hip, and need an X-ray/scan. My DH fell off his bike (cycle) on the way to work once. He managed to cycle the rest of the way there - but couldn't walk when he got off, which is how he ended up in hospital with a fractured hip.
His Dad fell over, then kept falling - eventually they x-rayed him and it turns out he'd fractured his ankle in the first fall.

Hi everyone! Back home now. I’m back on crutches again and they did an X-ray to double check it wasn’t bone related. They believe it was all to do with tendons and the scar tissue from the previous surgery. They said to me that most people in my position wouldn’t be able to walk as well as I was but it was because I had managed to walk normally for such a long time that I can deal with most pain now.

I may have misunderstood your post but analgesia is given using a ladder.
Which is additive.

So paracetamol
Paracetamol + NSAID (eg. ibuprofen)
paracetamol + NSAID + weak opiate (eg. Dihydrocodeine)
Paracetamol + NSAID + strong opiate.

Obv. People shouldn't take drugs that are contraindicated eg. nSAID with GI problems.

If you jump straight to the "strong" drugs and omit the simple analgesics you miss their effect.

Studies comparing patients taking Morphine alone with Morphine plus Paracetamol /NSAID showed that the second group took a lot less Morphine. The Side effects and potential addictiveness of Morphine should be enough to persuade you all to start simple and get strong.

Apologies if I've misunderstood but the advice to take Paracetamol/Ibuprofen AND Tramadol is sound. However if you were taking them all already I can understand why you were quite so frustrated.

opinionated

The woman on the phone was suggesting to take just paracetamol and ibuprofen rather than the tramadol which was why I was annoyed as I’d explained that tramadol with paracetamol and ibuprofen all taken together aren’t controlling the pain. Sorry I didn’t explain myself properly and reading it back it is easy to see how you misunderstood.

Is it an accident?

Yes. OP fell.

Is it an emergency?

Yes. OP is in serious pain and may have injured a bone, muscle or tendon.

I wish people would stop coming on MN and making out you should only go to A&E if you're dying or have limbs hanging off. It's happened far too often that people have tried to dissuade posters from going by arguments of this type only to find that actually the poster concerned had something extremely serious.

A&E takes one of two routes:

(a) you're in dire need and they admit you
(b)(i) you get sent sent home with a care sheet and told to go to your GP
(b) (ii) you get a precautionary xray and sent home

It was not unreasonable to go to A and E. I have seen people walk with an impacted hip fracture. Rare, but possible.