To think she can't be left in agony?

[QBee2022]

My DM is 54. She spent 15 years as an alcoholic, 5.5 years ago she nearly died from it, did a massive stint in ICU and recovery. She has been sober ever since.

She is reviewed yearly by gastro and liver consultants and everything on both fronts have been clear for years.

A consequence of her drinking is that her joints are suffering from necrosis, she needs hip replacements and a shoulder one. She is in AGONY, absolutely agony and has been in agony for years due to a mix of covid impacts and our hospital being a hot mess. Her right hip was due to be done Tuesday coming. She was rung today to be told its not postponed but cancelled due to her history of liver problems. She will not be allowed hip replacements by her consultant.

We want to challenge this, her liver consultant has never been consulted with. I strongly believe if she doesn't receive it she will either self-medicate from alcohol which will kill her or the pain relief she's on will become a new addiction. She is prescribed morphine which doesn't help and she's scared of how addictive it all is.

The consultant seems to think she just needs to learn to live with the pain.

AIBU to think they can't leave her in agony? Or that there should have been a wider discussion with her team on the risks rather than what has happened which is seeing a history of the liver and it being a flat no?

She was put on the list with her pre-op done in April and there's been a lot of small errors along the way and they left it until today to cancel. I'm devastated for her

An orthopaedic surgeon must have listed her for the procedure in the first place so I would go back to that Surgeon and ask for a full explanation as to why they are now saying it's not appointment. If there was a valid reason why they can't have surgery then she wouldn't have been listed and gone through pre-op. To cancel an operation with no real explanation as to why or any discussion with your Mum is shit. You can try raising a complaint through PALS as well.

*not appropriate

I'd contact PALS immediately. And get an urgent GP appt to see what the suggested way forward is.

If surgery is not deemed appropriate then absolutely she can be left to manage the pain with medication, it happens all the time. But absolutely you should ask questions about why this decision has suddenly been reached and possibly you should challenge it. Is there any chance that her liver has been worsening and she's not told you?

Yanbu that's not good enough as pp said contact pals. Expecting an alcoholic to have only morphine as a treatment is pretty stupid too.

I would query and politely bit firmly keep pushing. I do wonder of they have found significant problems with liver or kidney functions

I would want the full reasoning setting out in writing so you can argue/complain as required.

My alcoholic relative has suffered with various necrotising wounds including bone infections and has always been treated with compassion by the hospital.

OP "She was rung today to be told its not postponed but cancelled due to her history of liver problems. She will not be allowed hip replacements by her consultant."

you need to find out exactly what this means and why they decided this.

my first thought is - do her liver problems put her at high risk of death from anaesthesia?

for example
pubmed.ncbi.nlm.nih.gov/22450699/

If there was a valid reason why they can't have surgery then she wouldn't have been listed and gone through pre-op

I was thinking maybe something showed on the pre op blood tests that have made the consultant decide it isn’t safe to go ahead?

Did they give her a full explanation? Has she just relayed that to you in anger?

Thank you. She's left a voicemail for confirmation in writing of the reasons and I'm drafting a letter now.

I've got her most recent 3 years of liver results in front of me, last one was March. Stable and normal. Her consultant for liver is on AL but her secretary just rang to confirm she has had no contact from orthopaedics.

Her actual consultant she's never met, never spoken to. She's seen multiple different people, paper work lost, repeat appointments due to note errors. It worries just as much something has been missed as it has been so all over the place.

Sadly, I think if her choice was between death and this pain she'd rather take the risk of being dead.

Sounds like they’re just trying to strike people off to clear the waiting list. Disgraceful. I don’t see why they would clear her for the op knowing her history then turn around and say this last minute.

As others have said push for a full explanation as to what is preventing the surgery. There would have been a multi disciplinary meeting so it should be documented as to what the issues are. Your gp should be able to check on the system for any further information that you're not currently aware of. The gp should have been cc into it.

Most hospitals run a paperless system now. Any written notes should be scanned into the patient record. The specialist will dictate a letter into the computer which is then typed up by the sec. A copy is sent to the gp and sometimes the patient. The letter will also be on the system along with who accessed any of your mums info and when. It should be easy to track who's been involved in the decision process. Your gp should also be able to see all of this.

She contacted GP this afternoon, they have received nothing but forwarded copies of all her results which has saved her needing to dig them out

That sounds awful. I hope she gets the help she needs soon.

If the gp has nothing either then a clear and full explanation has to be pushed for which the gp can help with. If needs be a formal complaint can often illicit further information . This is wrong on so many levels and I hope you get the answers and apologies you deserve.

OP "Sadly, I think if her choice was between death and this pain she'd rather take the risk of being dead."

I fully understand and respect this. However, a surgeon and associated team will not take that risk.

i hope you find there's been a mix up or something.