Page 3 | To be angry with comment from A&E doctor

TatianaBis · 07/02/2022 19:01

If she was angry rather than using it to justify her low eating, it's more likely to be true. You were there you know your DD you have a much better gauge than any of us on whether she was telling the truth.

Doctors can say such stupid things, it's quite possible

endofmytether4 · 07/02/2022 19:01

I have recently experienced weight loss due to extreme anxiety and in a very short space of time I lost about half of my body weight. I've had really dreadful side effects and look seriously unwell.

The doctor told me 'there's no cause for concern yet because you're only slightly under the BMI'.

SpinningTheSeedsOfLove · 07/02/2022 19:02

I can imagine a conversation:

ED patient: I'm eating 500 calories a day. That's not going to kill me any time soon, is it? Like, I'll still be alive tomorrow?

Doctor: Well, no and yes, you'll be alive ... and I know that there's no point me telling you to eat 1800 calories day ... but ... [voice fades out as ED patient hears what they want to hear]

OR

The Doctor really needs training.

MayThePawsBeWithYou · 07/02/2022 19:02

I am confused, if the clinic letter said she is eating 1100 cals a say how did the 500 cals conversation come up..

itsjustnotok · 07/02/2022 19:04

I think your daughter needs to make the complaint. You weren’t there and have no idea exactly how the conversation went. You getting angry on her behalf is understandable but she needs to complain because it happened to her and she knows what happened.

Bonnieonthelam · 07/02/2022 19:05

@whethertheweather

DD is 18 and anorexic with BMI of 14.5. After months and months of delays she is just starting to be dealt with by an NHS eating disorder clinic. They called her in for the first in person appointment to do a blood test and physical exam, where she fainted. Blood tests were apparently off, they said O2 levels were at 80% and blood pressure was really low. The doctor at the clinic was very concerned and walked her over to A&E across the road for more tests with a letter explaining her position and the results of their own tests.

Nurse at triage says she needs a blood test so to wait and that O2 levels are hard to check with a pulse oximeter as DD's circulation is so poor in her fingertips. 3 hours later a doctor calls DD in, says he doesn't need to check her O2 levels "as I can see you're breathing". He then went on to say to her that people can exist quite well on 500 calories a day and that it's the constant going up and down with calories from one day to the next that is doing her body harm. He did an ECG, said it was OK and sent her on her way.

AIBU to feel incredulous that anyone would tell an anorexic it was OK to eat 500 calories a day? DD is trying so hard to eat but she's lost 45kg in a year and the scales are still going down.

I tried to complain to PALS, but they've said as DD is over 18 she has to authorise the complaint and I feel she's got enough on her hands. I'm sure the doctor's doing his best in extreme circumstances, but I want him to understand the potential impact of his words on vulnerable patients.

Your daughter is quite clearly very sick and anorexia is a eating disorder as well as a highly complicated mental health disorder. Even if eating restricted calories is her choice (or compulsion) he certainly shouldn’t be making any comments like that or even be dismissive of the concerns the other dept raised. But at the end of the day this is a patient that needs mental health care rather than A&E care. She is also Over 18. I’d put your energies into getting her rehabilitated and healthy in the right department/speciality. I wonder as a former ED patient how many lies she has told you to get to the point she is at. I know I would frequently twist to truth to suit me and keep me on the path I wished to follow. The bigger picture is that she gets treatment and that you keep your Energy focused on that.

TatianaBis · 07/02/2022 19:10

She was in A&E because the ED clinician took her there...

FOJN · 07/02/2022 19:14

AIBU to feel incredulous that anyone would tell an anorexic it was OK to eat 500 calories a day?

No you are not being unreasonable but I'm doubtful that your daughter was told that and certainly not in the context it's been presented to you. You've had some excellent advice here from people who have experienced an eating disorder. I had a friend who battled with anorexia for quite a few years. She was a lovely person but was rarely honest about anything to do with food or her body image, it's the nature of the illness not the person.

MissLucyEyelesbarrow · 07/02/2022 19:15

@SpinningTheSeedsOfLove

I can imagine a conversation:

ED patient: I'm eating 500 calories a day. That's not going to kill me any time soon, is it? Like, I'll still be alive tomorrow?

Doctor: Well, no and yes, you'll be alive ... and I know that there's no point me telling you to eat 1800 calories day ... but ... [voice fades out as ED patient hears what they want to hear]

OR

The Doctor really needs training.

This. Either is possible.

MichelleScarn · 07/02/2022 19:16

l will approach the Trust. I don’t want the doctor crucified, just to have the potential consequences of his words brought to his attention
You don't want them to investigate first? Just automatic disciplinary?

LIZS · 07/02/2022 19:18

She probably "heard" what she chose to listen to and is selectively repeating that to you. Was there a nurse present?

MacauliflowerCulkin · 07/02/2022 19:21

@incognitoforthisone

Were you there when the doctor said this? Or is this just what your daughter reported back to you?

Because this sounds an awful lot like the sort of thing someone with anorexia would claim had been said to them when it actually hadn't. I had a close friend who was anorexic and she claimed more than once that medical professionals had told her that what she was doing was OK 'if she was careful' or 'if she just made sure she took multivitamins', but it was invariably either a conscious lie on her part or her convincing herself that she'd heard what she wanted to hear and not what was actually said.

I agree.

Louisianagumbo · 07/02/2022 19:28

A qualified doctor said that we can all live on 500 calories a day as long as we keep that number consistent? I'd be reporting him, not for upsetting a patient but for his questionable medical knowledge. I find it quite difficult to believe, to be honest. It's not that I'm saying your daughter didn't hear that, just that I wonder whether the doctor actually said it.

Wendybyrdesmissingconscience · 07/02/2022 19:30

I would complain to the hospital, the health authority and the general medical council.

Wrongkindofovercoat · 07/02/2022 19:32

So the letter from the ED clinic states she is eating 1100 calories every day or that is the goal ? , and yet 500 calories came up in conversation ? Is that not a little odd ? Why would the Doctor mention 500 calories ?

MayThePawsBeWithYou · 07/02/2022 19:36

Would your daughter agree to having another doctor examine her with you present.

Clymene · 07/02/2022 19:38

Anorexics lie. They lie like any other addict does. In any event, you can't complain as you weren't there and your daughter is an adult.

I'm really sorry, it's an absolute bastard of a disease and terrifying watching someone you love waste away before your eyes. I hope the clinic helps to get her back on track.

LifesABotch · 07/02/2022 19:38

OMG that is awful, and also inaccurate! What severely underweight person would be ok on 500 calories per day? Or any young person? Or any person at all?!

Definitely complain, and you can post feedback publicly on:

https://www.careopinion.org.uk/

Hope your daughter wasn't too upset or thrown by what the doctor said

lljkk · 07/02/2022 19:40

DD's BMI is currently 16.4 (ish).
I assume that every word out of her mouth is a lie or massive distortion of truths, tbh. At least with regard to her eating, weight, etc.

Fine to raise your concerns but don't be surprised if you hear a very different well-documented & evidenced account from the other side.

That principle would apply if it was other health conditions, actually. Friend's mother insisted that she'd had no advice about her X health condition. Friend's brother kicked off about the appalling health care their mother had received. Cue doctors producing heaps of letters which showed them trying to advise on X, and hardcopies of same letters were found in the mother's household. I don't know why some information doesn't sink in.

Lorieandrews · 07/02/2022 19:45

Medical negligence is one of the hardest things to claim for and this wouldn’t qualify. That’s bad advice to those saying it

I’m sorry but you werent there. You can’t make a complaint based off hearsay.

If she wants to complain your first step is PALS

Whomever said the dr wouldn’t be without a chaperone. That’s completely incorrect. She is 18. Unless he needed her undressed. There would be no need for one.

Huge amounts of incorrect information on this thread.

Tigandgab · 07/02/2022 19:48

I work in complaints for a mental health Trust. Anyone can raise a concern through pals, or make a complaint, without the consent of the patient. It will still be passed onto the service, and we will still respond in writing if a complaint. What we can't do is share clinical information that the complainant is not aware of. In this case we could reference the appt, as you are aware of it. We could also tell you that yes, the doctor said this but he meant x y or z. We would not be able to tell you any info about what your daughter said or details of her care and treatment eg. Medication. So,, definitely worth raising this with pals and then you can escalate to a complaint if you're not happy with the response

Soffit · 07/02/2022 19:50

If you didn't actually hear it for yourself then be wary of escalating it to medical negligence. They would try their luck with any case on nwnf regardless of whether they believed it or not. If something was said, it was probably an unhelpful casual comment which should not have been made, not a personalized plan of action. I remember going to the GP when I was pregnant from when DP and I had only been together one day in three months while he worked abroad. He said to me that I had no chance of being pregnant and that I should go out get drunk and party hard (not that I had ever done any of that!)
I was taken aback but I knew that he was wrong. Your DD recognises that the doctor was wrong and raised it immediately. Of course, he saw me a year later when I attended baby clinic and looked like he had seen a ghost!

privateandnhsgp · 07/02/2022 19:55

@Tigandgab

I work in complaints for a mental health Trust. Anyone can raise a concern through pals, or make a complaint, without the consent of the patient. It will still be passed onto the service, and we will still respond in writing if a complaint. What we can't do is share clinical information that the complainant is not aware of. In this case we could reference the appt, as you are aware of it. We could also tell you that yes, the doctor said this but he meant x y or z. We would not be able to tell you any info about what your daughter said or details of her care and treatment eg. Medication. So,, definitely worth raising this with pals and then you can escalate to a complaint if you're not happy with the response

You would divulge to a third party what a Doctor said to a patient in a confidential setting (with clarification about what they meant) without patient consent?

Shocking, and a clear breach of confidentially. SMH if you really work in complaints handling.

Lorieandrews · 07/02/2022 20:02

@Tigandgab

I work in complaints for a mental health Trust. Anyone can raise a concern through pals, or make a complaint, without the consent of the patient. It will still be passed onto the service, and we will still respond in writing if a complaint. What we can't do is share clinical information that the complainant is not aware of. In this case we could reference the appt, as you are aware of it. We could also tell you that yes, the doctor said this but he meant x y or z. We would not be able to tell you any info about what your daughter said or details of her care and treatment eg. Medication. So,, definitely worth raising this with pals and then you can escalate to a complaint if you're not happy with the response

You would confirm that he said that.? Wait. What? How could you divulge what a doctor said to a patient in a confidential setting?

TatianaBis · 07/02/2022 20:05

@FOJN

AIBU to feel incredulous that anyone would tell an anorexic it was OK to eat 500 calories a day?

No you are not being unreasonable but I'm doubtful that your daughter was told that and certainly not in the context it's been presented to you. You've had some excellent advice here from people who have experienced an eating disorder. I had a friend who battled with anorexia for quite a few years. She was a lovely person but was rarely honest about anything to do with food or her body image, it's the nature of the illness not the person.

Every anorexic is different. My friend was unusually honest about food and body image - although she couldn't always see your pov on her food intake. Once she was hospitalised she accepted she was too thin.

It depends a lot on personality, the particular complexion of their illness and where they are in the illness/healing process.