To push for second opinion

[Witchesandwizards]

DH hurt his knee at a trampoline park 8 days ago. It wasn’t enough to stop jumping, but the next day he was in excruciating pain and couldn’t walk and went to A&E. He was convinced it was tendon or ligament damage because he hadn’t done anything particularly severe, but the initial tests didn’t indicate this and he had an X-ray which revealed a fractured knee - a chunk (consultant’s word) had broken off his femur. The consultant said he’d never seen a piece that big before, just ‘splinters’ and explained that the pain was the soft tissue rubbing against the rough bone and that it would probably need to be screwed back.

However, after a CT scan he was told by another doctor that it was probably an old break and that it was likely the new injury is soft tissue damage, but to be sure he would need an MRI and that one would be scheduled in about FOUR WEEKS.
So he left. In agony, with crutches, 60 x Tramadol and no diagnosis for at least a month. He can’t walk, sleep, drive or work. He needs to drive for work (medical sales), is due to fly to NZ on 27 Dec to see his sick father, and to NY for work on 12 Jan.
I know the NHS is stretched, and isn’t responsible for our lifestyle choices, but we’re in limbo and I’m stuck with work, primary aged kids and a useless husband 😂.

A friend runs a gym used by a lot of professional sports teams and they have amazing rehab people, one of whom looked at the X-ray and said it’s possible the fracture is old but the new injury is the tendon pulling the chunk of bone away.

Are we wrong to expect a quicker diagnosis when the injury is so debilitating? We have contacted PALS, but so close to Christmas, I’m not holding out much hope, and may take him back to A&E and explain he is getting worse, not better.

Go private

I'd definitely ask for a second opinion, he needs to know exactly what the situation is and exactly what his options for treatment are.

Apologies for nitpicking but this is confusing.
A friend runs a gym used by a lot of professional sports teams and they have amazing rehab people, one of whom looked at the X-ray and said etc.

How could the person from the gym's rehab team look at your husband's NHS xray?

Well it’s not life threatening so you really can’t expect the NHS to prioritise this (there is a wait because they are other people who have been waiting longer/have more need). It’s not the NHSs fault that you husband, a grown man, hasn’t even sorted out health insurance.

Blanktimes - DH took a photo of his X-ray. They said they couldn’t be sure without an MRI but the description of what happened plus position of the break, made it likely.

Racecardriver - take it you don’t live in the uk? Very few people here have health insurance unless they get it as a benefit from work.
Er, that’s why we pay tax and have the NHS. Just like our kids don’t go to private school. If he still lived in NZ this grown man would indeed have health insurance.

Back story - ten years ago, I ended up with an external fixator and was on crutches for 18 months because I didn’t have the correct treatment on my knee, and as a result will need a knee replacement before I am 50.
It’s a sensitive subject.

He has been given a diagnosis.
Whatever the injury, he would still be in the same position, i.e. Unable to drive fly or anything. If you're so bothered, pay for a private MRI.
I've got to wait 8 weeks to have a cancerous mole removed. I'm not making a big fuss!

Soontobe - what’s his diagnosis?

I can see how stressful this would be, especially as he is in pain.
Unfortunately I think you need to adjust your expectations. Even once he has had an MRI , if he requires surgery there may be a very long wait.
Of course someone in Pain should be diagnosed and treated quickly but the NHS is overwhelmed and sadly this is the reality now....
Has he seen GP re pain relief?

Soontobe60, sorry about your cancerous mole but pain isn't a competition! If OPs DH is struggling to walk and is in pain then leaving him that long without an MRI is a problem for them.

As annoying as it is I think it is unrealistic to expect things to happen overnight and sometimes a bit of waiting is needed to see how the body heals with rest.

If he knows that it won’t do any harm, he is happy to take painkillers and push through to keep mobile and stop muscle wastage. A month of not using it if he can, will cause further problems.

By all means you can ask pals for a second opinion 🤷‍♀️ although you've said your friend said they can't be sure without seeing an mri, presumably the nhs doctors think exactly the same.

MRI time is extremely limited in the nhs, so a four week wait really isn't bad, especially for something that isn't life-threatening. I'm sorry he's in pain, but as PPs have said, even if he could have his MRI sooner he'd still be unable to walk at the moment.

I'm really surprised they haven't immediately MRI'd it.

I think you should consider paying for it - it's about the same price as flying to New Zealand?

Unfortunately some things just take time. My DH had a slipped disc some years back, incredible pain and as you say, mega strength painkillers rendered him unable to drive, work or do anything much. NHS say nothing is done for at least 6 weeks because 'most' incidents of sudden back pain resolve themselves in that timeframe but it's not their responsibility to sort out contingency plans for your work and travel, you've just got to deal with it as best you can. It's crap, and it's a crappy time of year but if you can't go private, that's what you are left with. My DH ended up with spinal surgery 3 days before Christmas, three months after it first happened.

I would get an MRI privately if you can afford it. That should speed up diagnosis at least. Even if he then has to wait for an operation then at least hes on the queue for that.

Sorry you’re in such a bind OP. Not sure what a second opinion would achieve though, if he needs an MRI and the wait is 4 weeks, a second opinion won’t change the waiting time. A private MRI will be £££.

Incidentally (and I know it won’t help now) but this is exactly why I pay for private health insurance. I can’t afford to risk getting sick and having to wait for NHS treatment.

I think they are waiting for the MRI because soft tissue swelling will hide any other injury and make diagnosing the true problem difficult, if not impossible, on the images.

MRI scans aren't completely magic, and image quality makes a lot of difference when trying to see the problem. I think you have to wait for the swelling to go down, as suggested. Inconvenient, I get it, but that's imaging for you.

It's hard to understand how it could be an old fracture as your DH would have been in incredible pain when the original fracture happened so would have surely noticed.

It sounds like the fracture is an avulsion fracture as the ligament/tendon has pulled some bone away. Chances are this means the joint is more unstable than normal so I'm surprised that a consultant has said he's okay to use his leg like normal to be honest.

If he ends up having a screw to fix the fracture he may be able to weigh bear straight away after surgery (pain permitting) so non weight bearing for eg 1 month whilst awaiting scans and surgery is similar to being in a cast so it should be similar in terms of regaining strength etc afterwards.

If pain relief isn't helping go back to your gp rather than a&e. They can prescribe just as much as hospital docs.

Hopefully the wait for the scan isn't as long as you think.