Why won't GP admit my mum to hospital?

[DukesOfTripHazard]

She is vomitting green bile today and has eaten/drunk very little for days and felt nauseous for weeks. She has a churning stomach that is very tender and painful and she's extremely weak and shaky with chattering teeth even though she doesn't feel cold. She's 81.

Last Thursday when she slightly less unwell than this, but was feeling desperate, we took her to A&E where they did various tests, which came back normal but because of 'slow movement of stomach gases' seen on an xray, they kept her in overnight. They discharged her the next day with a letter for her GP to request a colonoscopy.

Since then she has deteriated to the point where she can't keep food down and (please re-read first sentence at this point - Mobius loop of old age, perhaps!).

My sister called the GP out today and said she and mum were at end of their tethers and whatever is wrong with mum's stomach needed to be looked into with her as an in patient as she is getting very weak. GP was eventually persuaded and told my sister to collect a letter from the surgery this afternoon. BUT GP has just called to say he won't admit her, but will come round tonight at 8 with an anti nausea injection and discuss things then.

We feel that he is not doing enough. Any medics have an opinion on this?

Take her straight to A&E.

take her back to A&E then.

It has got worse over the last few days.

I think we have to wait for the GP visit but that is certainly an option afterwards.

I hate how it feels like we are fighting him for what we think is right.

Sounds like gallstones to me. (Your description almost exactly describes my symptoms.) Ask them to do an ultrasound to check for gallstones and blood test to check her liver function. Please take her straight to A & E. My GP told me it was all in the mind and told me to take paracetamol (which are useless for gallbladder pain). I couldn't keep anything down at all, and was vomiting bile. I went to A & E, was correctly diagnosed within half an hour of arriving, admitted, stabilised and operated on. Gallstones can be very dangerous - I think if one splits the bile duct.

Thank you Mrs S That sounds awful. I will be gallstone aware and grill GP accordingly. However, she did have blood test when she was in A&E last week.

It could be bowel obstruction. Sounds like she has deteriorated. Definitely go to A and E.

Is the GP usually this obstructive? I would definitely take her to A&E. If you decide to wait for the GP to come first, then be prepared for a fight! You need to find out what he thinks it is and why does he think she does not need to be admitted. Obviously

Go to A&E, don't wait for GP. There is clearly something really wrong, she is very elderly, don't take the risk. GP might just lure you in a false sense of security, really this should be sorted out and the sooner the better.

This really does sound like gall stones, my dad had all this too...particularly the tender stomach (and constipated). It turned out his entire gall bladder was hard as a rock, they operated and took out a single huge stone which is now exhibited at the university hospital!

What does your mum want to do? Does she want to go to hospital. If so I'd take her straight away and now worry about the g.p.

Agree with others a&e don't wait for dr. She is too ill by the sounds of it to take any chances waiting any longer.

Bloody hell ! Sod the GP - get down to A & E now !

Might be something might be nothing but your Mum's age will not help matters.

Hope all is ok .

Octogenarians don't take much to tip them over the age in terms of fever. You must take her to hospital. I would not be waiting for a GP if she's that ill.

Sorry that didn't sound very clear - chattering teeth can be a sign that she's going into shock. That's very dangerous at her age. Get her to A&E.

Just asked DH (hospital doc but not in geriatrics/general medicine) he said that dependent on how long she's been unable to keep food down (if it's not very long give anti-sickness a chance to work) but based on age and previous hospital admission, if she is very weak and has had no food for a couple of days take her take her in to A&E if your GP insists after a repeated request to admit her(or if he takes too long to come out and see her)
Personally (& non medically) I'd go with your gut feeling, you know her and how she's been compared to normal try to look at it rationally and calmly and then go with your gut!
Hope she's better soon

yes, sorry should have said my dad had the chattering teeth as well and we got an ambulance, they were fab, wrapped him up and whisked him away. The paramedics were excellent.

It isn't actually the GP who admits her - he/she will contact the hospital and request a bed. I suspect that the GP has rung to arrange the admission and the on call doctors or bed managers (depending on the local procedure) have declined to accept her. So either he hasn't made the case properly or they haven't listened or they are heaving at the seams and trying not to take in patients who don't need to be there or a bit of all of the above. You've done the right thing by going this route but if you feel your mum is getting worse then take her to A&E. Ironically this will just make the hospitals admission problems worse as they struggle to clear A&E but that's just tough for tem quite frankly. Your bottom line is she can't keep food/drink down and at her age she's going to really run in to trouble if this continues.

I think you need to her to A&E NOW!!! Sorry for the caps and I don't want to scare you but her symptoms sound EXACTLY like my nan's in the days before she died. Her GP was bloody useless (much like your mum's) and refused to admit her to hospital. It was left to late and she died a 4 days after the symptoms started, she was 79. [hsad]

I am going to go slightly against the grain and suggest you wait for the GP. And yes, what is your mums preference? If she is mentally fit, she may not want to go to A and E.
IME A and E is not a good place to go with an unwell person who needs a specialist opinion. Far better to be referred in by her GP to the appropriate speciality.
If she has already had tests done is there the possibility that her dr or even she herself know more than you??

Sorry, I have no idea obviously, but feel communication has not been the most wonderful. Find out what her dr is thinking and tell him what your fears or worries are.

Good luck! I hope your mother feels better v soon.

Meant to add, I really hope she gets seen too and feels better soon.

Perhaps bowel obstruction, but either way she needs to be seen quickly. Hope she is better soon :(

I'm with NorthernLurker.

If you're not happy with the advice your GP is giving you - do whatever you feel is right, and if that means taking her to A+E then do it.

From bitter experience with my beautiful Mum age 79 the Dr's aren't always right - I had to argue for them to test her for DVT's when they were suggesting arthritis -it was multiple DVT's .

After my Mum had a short stay in hosp, our Dr's practice then ingnored the obvious symptoms that she had raging C Diff and prescribed anitbiotics for a 'chest inf' - the worst thing that you can give to a C Diff patient.

I'm not meaning to upset you, but go with your instincts.

Hope your Mum has a speedy recovery.

Hope your mums ok.

Thanks for all your messages. The doctor came last night, and poked her in stomach which was extremely painful. He wondered if this and the cystitis-like symptoms which won't go away despite antibiotics suggest diverticulitis. He wrote a letter asking for this to be investigated and called an ambulance and I left my mum and sister waiting to go to hospital.

Horrified to wake up to this horrendous email from sis this morning:

"Hi it's 6.30. Have just got in and am heading to bed - thought I would send an update first. Started off okay - lovely husband and wife team paramedics took us in ambulance. Got to A&E about 10.30 - It was packed out and the the paramedics had to wait with us for about 45 mins to get signed in.

Then we spent an hour waiting for an A&E room. Finally went to room 8 and they did the gory business of putting the cannula in to take out blood be ready for drip etc., ECG, BP etc. A very gentle and sympathetic doctor pitched up and after prodding and poking said he would do a bladder scan. A machine was brought in which does an ultrasound type thing on the bladder showing if there is urine retention. It showed that there was urine retention and the whole story according to this doctor moved to the bladder. He said they would need to put a catheter in and then send her home with some different antibiotics on a 10 day prescription and would set up an appointment for the urology clinic in a couple of weeks time. Eek, this was obviously greeted with an appalled reaction from mum who obviously wanted to stay in hospital and get sorted out as an inpatient, but the doc said all the bugs in hospital meant that it was far better for her to go home and that is what he would want for his mum etc.

BUT the nurse couldn't get a catheter in - she tried twice but couldn't. Then we had to wait for a long time for the doctor who was off performing some elaborate task elsewhere. Then about two-ish the doc came back and tried to put a catheter in but also couldn't. So he said - okay you are going to get your wish to stay in met. But then mum having had her bladder tweeked so comprehensively asked for a bedpan and did a massive pee and the doc said - ah if you can do this we will send you home with your new antibiotics and get you back for the clinic.

By now it was about 3am and we threw up our hands and didn't know what to do and the nurse came back and said to me have you got money for a cab because hospital transport might take from 2 to 3 hours to be available. I said how am I supposed to manage with a cab she can't walk and I can't carry her. So then the make-things-happen instinct kicked in and I walked over to the block of desks where the A&E doctors and nurses hang out and do their admin, I looked for the most switched on person I could see - a female doctor in a polka dot top - and said I needed some help. She looked bemused so I said I needed some help from a woman. She perked up at this and had an ambulance organised in about 10 minutes.

The paramedics got us into the ambulance but mum was so nauseous and weak and in a pitiful state that paramedic said this is not on and she went back into A&E to kick some ass and then while we were waiting in the ambulance the doctor who saw mum rang his boss and was told that he should admit her to a medical ward (as opposed to A&E). So we got off the ambulance and went back to room 8 and she had the whole frigging admission thing done again. And they put her on a drip and gave her pain relief and anti-nausea relief and saline etc. There was a point after this started happening when she was talking so faintly I couldn't hear a word and I thought there was going to be another disaster but she rallied and at 6am she was still waiting for a bed on the ward and they said I should go home and get some rest. just before I left the first paramedic turned up and we told her everything that had happened and she said the hospital is one of 4 of London's trauma centres now, in the past when then were very full ambulances would automatically divert to other hospitals but now they are not allowed to. Tonight at the peak of the action there were 70 people for treatment in a unit that is set up to handle 30".

And that's the state we're in