Been told not to attend A&E by gp receptionist..

[shallwego]

Hello,

Following from another thread of mine, regarding painful ovulation (will summarise below)

• Been TTC for almost 3 years

• Had bloods taken by GP (day 21 bloods) and was advised at the time that this would show endometriosis or PCOS issues

• Had a GP appt yesterday to get the ball rolling with fertility help, mentioned that I get very painful ovulation, and she advised that endo / PCOS wouldn't in fact show in bloods, only a physical examination would determine this.

When I'm in / around ovulation, I get EXTREME crippling cramps in one side of my ovaries / lower abdomen, radiating across my pelvis. They're so awful I often feel like I'm going to split in half. When I sit and then stand again, I can barely stand up straight. It's crippling and lasts a LOT longer than the seconds / sometimes hours that others explain and experience during this time of the month. We're talking days. Sometimes 2/3.. and the pain is MUCH worse than my period pain.

I phoned the GP reception today, as I'm having a really hard time with the pain today. They've advised that nobody can see me there until 2nd week of January; and so I must get on with it until then. Fine, but pain killers are literally not touching the pain and I don't know what to do with myself. I'm at work and can't even stand straight. It's like someone's sawing me in half from hip-hip..

So I asked the receptionist if she would recommend I attend A&E for guidance in the meantime.
She almost screamed 'NO' at me. That they're under pressure (which I'm fully aware of and understand completely) but I honestly don't know what to do with myself 😞

So my question is.. would I be unreasonable to attend A&E after work? I just want help and answers. I'm so scared and in so much pain.

Some of the replies on here are so harsh to poor OP who is in crippling pain.

If you can wait until after work I'd suggest a walk in centre rather than a&e if one is near you.

I have so much sympathy for you pain. It sounds awful. You need help.

BUT if it is the same as you had on previous ovulations and you know it is highly likely to get better, why on earth would you go to a and e?

And the advice people have given to not tell the a and e doctors your suspicions is rather selfish of them. They will be running around doing lots of tests that you probably don't need while people are sitting on trolleys with life threatening illnesses.

You need help from your GP and maybe gynaecology. Going to a and e will be a waste of your time and dangerous for people who need urgent care.

The system is broken. You should have better care. But going to A and E doesn't help you, but helps the system a bit more.

No. Its not an accident or emergency. Your GP should be dealing with this. Drop in centre would be better than AE.

This is what 111 is for, not Mumsnet or GP receptionists.

I think OOH GP would be more suitable as a starting point, which can be accessed through 111. You absolutely need some more appropriate pain relief, but if you know its all linked with ovulation and is cyclical, then you don't need the diagnostics of an emergency department. They can provide analgesia though, so if you're not getting anywhere with 111 then by all means attend.

I have endo and also have this as a symptom. Lots of painkillers get me through life. I personally wouldn’t attend A&E it’ll just be exhausting and a waste of time.

Hi OP. It does sound like it could be endometriosis from your description. A physical examination won’t show whether you have it, neither will bloods. Only surgery can diagnose it or, occasionally, it can be seen in MRIs or ultrasound.

With regards to the pain, you don’t know for sure what is causing it so I would advise A&E. If it is endometriosis pain I’m afraid there’s not much you can do in the short term apart from taking strong painkillers, using heat and waiting for it to pass. Naproxen and/or codeine might help. Other treatments include hormonal drugs (not ideal obviously if you’re TTC) and laparoscopic surgery to remove the endometriosis lesions. Removal of the endometriosis lesions, if they are present, may increase your chances of getting pregnant.

I’m sorry you’re experiencing this. I have endometriosis and have had to call an ambulance on a couple of occasions due to extreme pain. People who rubbish it really have no idea what they’re talking about. There is support available at Endometriosis UK.

This.
IME GPs are rubbish at dealing with pain.

@Zeeza you ate totally correct. All of the advice not to disclose something relevant is dead wrong. The NHS is in its knees. We don’t have the resources to be doing every possibly test, when some basic information would help narrow down what investigations to run.
People have an idea that the OP would have been given a whole load of investigations just because she rocked up in A&E. They are more likely to have dosed her up on analgesia and sent her home for her GP to sort.

And if the pain is on your right side specifically then definitely go to A&E as it could be a problem with your appendix.

Not much help, but I have PCOS and a physical exam by GP is not how it's diagnosed. It's an internal ultrasound, performed in a hospital (or you can have it done at a private ultrasound clinic). Usually the ultrasound alongside symptoms etc are used together to diagnose

Like you say you were expecting to manage and then something happened during work that changed that.

Blood tests are also important in the diagnostic process as they need to look at hormone and cholesterol levels.

I would call 111, don't immediately go to A&E. see what 111 suggest! Most likely scenario at A&E is that you will wait hours then be fobbed off with painkillers and told to see your GP.

This is correct. Go with severe pain and not mention ovulation. Less likely to be dismissed.

If someone is in that level of pain they will instruct them to go to A&E. Phoning 111 is a waste of time.

Severe, unbearable pain that is not relieved by painkillers and is not passing is an emergency. I’m not sure what part of that people are struggling to understand.

Please read the OP's last post, her GP is seeing her today at 5pm.

Sorry to hear about pain. A member of our family I went with by ambulance to A&E. After 5 hours wait we just took a taxi home.

Thanks for that, I somehow missed it. I’m really glad.

If your well enough to go into work and concentrate on your work for the day then I would say your not unwell enough to go to A&E they are under enormous pressure with very limited resources.

Instead I would again contact your GP and ask for a telephone appointment with the duty Dr today or tomorrow. If the receptionist is unwilling to oblige ask to speak to the Practice Manager they can usually sort out a phone call if you mention this. Or alternatively ring 111 for advice please only attend A&E on advice of Duty Dr or 111. People go to A&E with life threatening injuries heart attacks, severe breathing difficulties, head injuries, severed limbs please save A&E for real emergencies.

Going against the grain but if this happens every month and you’re already having tests done for if, then it’s not an accident or an emergency.

I would have phoned 111 and got an emergency appointment or out of hours appointment instead.

I am glad you are seeing someone today.

Just seen the update.

I'm almost 100% sure it is not mittelschmerz.

Instead I would again contact your GP and ask for a telephone appointment with the duty Dr today or tomorrow.

@RitaSueandBobtwo She doesn't need to do this, her GP is seeing her at 5pm today. OP updated the thread half an hour ago.