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.

For example yesterday I had a lady presenting with a new, lower pelvic pain and spotting with a missed period; I referred her directly to A&E as I suspected ectopic pregnancy which is a life-threatening emergency.

A woman came in today and mentioned that she gets terrible pain with her periods. I didn’t refer her to A&E because she hadn’t had an accident and it wasn’t an emergency. OP has this same, predictable pain every month which makes it a chronic issue and not immediate reason to suspect ovarian torsion.

I hope I never have the misfortune to be nursed by the likes of you @WhackingPhoenix. Then again, some of the NHS nurses I have had to deal with appear to have had an empathy bypass.

If you have Walk-in Centres in your area go there first, if not A&E. Don’t delay.

I had pain just as you described, excruciating lower abdominal pain that just got increasingly worse. Contrary to many comments…. “You wouldn’t be in work” …that doesn’t necessarily follow, I’m a secondary teacher and needed (or so I felt) to continue with my lessons. Doubling up on my lab bench intermittently during the lesson and joking with my y11’s that I’ll probably be alright if I pass wind 🤣🤣.
I could barely walk and struggled to drive so I went to a walk-in centre on my way home. They had a feel around…. Then sent me directly to hospital.
I was in surgery the following morning having a snooker ball sized “chocolate cyst” removed from inside my ovary. I was told that it was close to bursting and I’d had a “close call” ( possibly a bit dramatic! )

Don’t delay, get yourself checked out.
Xx💐

@WhackingPhoenix I pray to god I don't ever have to be seen by anybody like you.
How awful!

What a shame. I’m very good at my job with 100% track record of good feedback from patients and have never misdiagnosed or missed anything dangerous. I’m suitably trained and experienced to know what needs A&E and what doesn’t and can act accordingly so I don’t really give a monkey’s what you, a stranger on the internet, thinks of me and how I work. 🤷🏼‍♀️

Because I said that A&E wasn’t a shortcut? It isn’t

Go. Ours has a triage system, so anyone they deem not needing the AE part goes to different area to see a Gp.
this is what I did, saw the Gp person who then walked me back to AE as she examined me and I was then admitted onto a ward for quite a few days treatment.

I actually gave you advice on how to access appropriate gynae care in my first post Gynae assessment is emergency triage/care for gynae issues, which you have.

I've explained SO many times that I have had no choice but to 'work' today, if you can even call it that. I've been able to send some emails off in between trying to ease my pain. I've not once in my life attended A&E for anything other than a critical emergency with my DH. I wouldn't waste their time.

I was merely asking for some guidance following being advised I couldn't be seen.

This is a NEW thing following my gastric surgery. I've not been dealing with this for years, I've been dealing with infertility for years.

Uncontrolled pain with your usual measures is a valid reason to present to hospital. It’s very likely the cause won’t be found in ED - the purpose of ED is to get the pain under control and rule out emergency conditions requiring immediate intervention. You will need a gynae referral forum your GP if another cause isn’t found.

Ir will be a standard part of getting a pain history to ask about any connection to the me menstrual cycle. The PPs advising you ‘not to mention ovulation’ who don’t know this clearly don’t understands the basics of pain assessment and their ignorant advice should be ignored.

My local A&E triages you and you either stay in A&E or go to ambulatory care. I think there might be a GP as well but I'm not sure. I went earlier this year (I'm one of those time wasters, I wasn't actually dying) and ended up in ambulatory care where I saw a couple of doctors and was sent on my way with antibiotics and told to go back if I got worse.

111 to rule out ectopic or appendicitis which are an emergency. Partner had appendicitis and 111 arranged out of hours GP, then went straight to hospital ward. No need for a&e then either.

Otherwise I’d be asking GP to prescribe stronger painkillers.

Don’t worry about the people saying you can’t be in pain because you’re posting online or able to work.

i had severe pain from gallbladder attacks and after an attack I walked to my doctors office and he said it can’t be gallbladder because if I had just had an attack I wouldn’t have been walking to the office (I didn’t drive back then and had a baby so didn’t want to put her in taxi without a carseat) I convinced him to do an ultrasound and my gallbladder was full of tiny stones! So yes it can be whatever you think it despite you being able to work or post online. At least you will have your scan soon! Good luck for it and with your fertility journey.

I was the same @LongStoryShorty, I actually thought I had indigestion! I ended up at A&E and it turned out I had pancreatitis.

If you read the thread people she saw the GP.

At my local walk in centre you now need an appointment. This is what used to be called having a GP, in the old days pre covid.

Also - I carried on working when I had appendicitis. Until I collapsed. Even then I got a cab to minor injury unit and they took one look at me and called an ambulance. I don’t recommend it.

I have stage 2 endometriosis and have previously attended out of hours doctor twice with the pain, once it was so bad they thought I had appendicitis(this was before I knew I had endo) I would maybe call 111 first for advice and go from there, they may be able to get you an out of hours drs appointment for some stronger pain relief? X

A&E will rule out a surgical emergency and then send you home to the care of your GP. I note that you’d said you just want to find out what is going on but sadly it won’t fast track a scan or diagnosis.

Hope the pain gets better soon & that you get some answers

To be clear though - that's the way to access gynae care in your area. As far as I'm aware a self referral service into secondary care gynaecology isn't a nationwide initiative and certainly doesn't exist in my area from anything I can see.

We have self referral physio and various other bits. But not self referral gynae as far as I can see and I've checked the local trust website and the ICB websites and googled it - so to get a gynae referral here you'd need to be referred by your GP and couldn't just put yourself into the system.

I actually think it's one of the difficulties of the NHS - I can see why they don't unify things everywhere because different areas have different problems but it does make it harder to give people the right advice and for them to find what the right thing to do is.

111 to rule out ectopic or appendicitis which are an emergency. Partner had appendicitis and 111 arranged out of hours GP, then went straight to hospital ward. No need for a&e then either.

111 can’t rule out an ectopic or appendicitis. If you have symptoms of either then they need to send you to be seen too properly - where depends on your area. A lot of 111 operators would arrange for you to go to A and E, out of hours GPs are not available everywhere.

Ridiculous that your gp won’t see you until 2nd week of January

A friend’s father had stomach pain. Went several times to his GP. Told it was ‘just’ constipation. Even though he felt guilty for doing so, he finally took himself off to A&E as he felt he was getting no where with his GP who just wouldn’t take his pain seriously. At A&E they scanned him. They found stomach cancer and he was dead 6 months later. As pain is impossible to externally verify, some GPs just won’t take it seriously. To the materially devastating impact on the patient.

What? Every month on the same date with a reasonable expectation that it is not? If that's the case no wonder the NHS is falling apart.

I don't discount the pain that OP is in, but from what she tells us, she reasonably believed it was neither of those things.