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NHS pain relief, lack of it

83 replies

brahelper · 26/03/2016 21:52

Ladies I have read a fair few threads on here of similar stories so thought I would post my issue even tho I am not a mum I hope you can offer opinion's.

I have numerous times in the past had fallout's with the NHS refusing to give me prescription strength painkillers for tooth ache, luckily tho in those case co codamel and ibuprofen (or naproxen) would at least take the edge off.

Well Starting Tuesday last week I started having almost constant head pain and extreme tiredness, even tho was tired I couldnt really sleep for anything more than an hour at a time. Iniotially the main problem was the sleep as headache was mild.

Then Thursday morning I managed 6 hours sleep for the first time in about 3 days, but the tiredness wasnt gone neither the headache. At about 2PM I went to try and have a nap due to the tiredness then suddenly liker a switch was flicked I had extreme headache, easily the worst pain I have ever had. I was already under naproxen as I take it for other health problems so took paracetomal but both of these had absolutely no affect.

My GP surgery refused to give me time to talk to a GP, not even over the phone, their policy? goto A&E.

According to NHS guidelines I qualified for 999 help but rang 111, and they arranged an out of hours gp appointment at my hospital. That doctor examined me and said I needed further help from A&E, after another hour wait the A&E doc seen me and then tried to transfer me to a neurologist but someone overuled him and I was to be transferred to A&E majors instead, I waited 6 hours for this transfer with no pain relief given, in absolute agony. I did observe sitting up vs lieing down the pain eased slightly but only a bit, it was still unbearable.

When I got to majors they did their usual routine (which seems the same no matter what the issue as if its scripted), which was blood tests and blood pressure tests. Was told to wait 90 mins for blood test results, still given no pain relief. After about 40 mins a doc came to see me and asked me questions, he asked the same questions at this point asked 4 times as if these people dont talk to each other. I was then finally given plain relief, but even tho I told them I had already hit the max dosage for 24 hours and it had no affect, guess what they gave me? you guessed it paracetomal and ibuprofen, one wonders what one has to do to get things like morphine. The dosage wasnt higher than over the counter stregth either was 1gram of paracetomal and 2 tablets of ibuprofen. Result no affect.

I ended up having a CT scan which was clean, and after that point (now about 6am) I heard some kind of ward manager pestering my doctor to discharge me, he didnt for another 90 mins whilst also asking me more questions and examining my head, but eventually he got overuled as she sent another doc to discharge me, she was shouting about me so everyone could here almost every 5 minutes "is he gone yet?". He then told to wait whilst he gets some powerful painkillers, I forgot the name but it wasnt the paracteomal or ibuprofen. The other doc came back to ask why I wasnt gone yet (following another shout from the manager) and I said waiting for painkillers. About 30 secs later I heard thi smanager shout "what!!! tell him to go home and take paracetomal, if he doesnt do what you say call security".

At that point I left.

Now is saturday night, pain is still severe, almost constant, and now I keep feeling faint as well. I already complained to the laison service although I expect them to backup their own colleagues.

So I left with no diagnosis other than what was ruled out with CT, and no pain relief.

The NHS is aweful.

I have been thinking given I was there on my own looking rough, unshaven etc. maybe they thought I was some kind fo addict after drugs, but if thats the case they should give people the benefit of the doubt.

OP posts:
brahelper · 28/03/2016 08:29

Ok I will be leaving soon, back to A&E.

My pain tolerance may be lower than others, but it is what it is and yes I am struggling to concentrate on anything, using this forum isnt helping, but also sitting doing nothing is bad as well as time will just trickle by. For me its actually worst with eyes shut and lieing down. Things like coughing and sneezing make my head feel like its trying to be ripped open. Also I have the page massively zoomed in, using my phone for things like texting is too hard as an example due to the small screen.

I have never asked for drugs in a&e (which they would know if checking my notes), hence my suggestion of them checking my notes. I didnt even actually ask for drugs there either, about an hour before I left, I was offered a repeat of what they gave me which I said no, I then changed my mind and asked if I could have another set (even tho I think they were no good, one can always hope). A&E staff really should be trained to deal with upset people, in pain etc. but it seems they trained to assume people exaggerate or are drug seeking, which seems to be why they only issue when is a confirmed diagnosis. Like I said before I dont care what I am given as long as it works, if paracetomal works then great, I also agree always try the weakest first, as an example I never take co codamel unless everything else fails, which proves I am sensible. However as I have tried to explain a dozen times now, paracetamol and ibuprofen were already tried and failed. It as if people are going out of their way to find excuses for what is a clear failure. Also as I have said multiple times, you cannot treat people as if they all built the same, because we not, different people have different tolerances to different things, for that reason alone a one size fits all approach is unfit for purpose.

Now maybe for you getting a few hours sleep here and there, having severe headaches for several hours at a time, and unable to sleep is something you can find tolerate in the long term? me, not really, its been an absolute nightmare trying to get to the end of this easter weekend, never mind facing a scenario where I might be expected to accept this for years to come. Like I said I wouldnt be able to handle it and would probably end my life to end the pain.

Now its all well and good going no about NICE guidelines, but means nothing when no reference documentation is posted to backup the claim. The sites I linked to are not random links of google, look at who authored them. Also whilst playing the discrediting game what about the manufacturers of paracetomal itself saying its only suitable for moderate pain? Do the manufacturers not know what they doing? this hasnt been addressed here. Its no surprise really that the nhs has to pay such huge amounts of compensation every year with this kind of attitude so common.

Now thw problem is I have had a look at NICE, and I cannot say I am surprised because I am not.

They do not suggest paracetomal for persistent heavy migraines.

www.nice.org.uk/guidance/cg150/ifp/chapter/Treatments-for-migraine

Now I know NICE will now be discredited, so what next?

By the way this will likely be the last post until I am back, no idea how long will be but I am hoping for better luck, although I expect most of the four hours will be them repeating the same processes instead of carrying on from where they ended.

OP posts:
Believeitornot · 28/03/2016 08:32

If you're rambling on in a&e as you are here then you might be confusing the medics or they just won't listen as you're quoting NICE etc at them

Write yourself bullet points and stick to them when you go in.

PacificDogwod · 28/03/2016 08:37

I have been following your thread from the start and have not posted because I don't think that you are in a place where you are open to a meaningful discussion.

There are many types of headaches, most of which will NOT show up on scans and LPs - those investigations are designed to rule out dangerous causes of headache.

As your imaging tests show no structural abnormality, you are left with migraine/clusterheadache, tension-type migraine, medication-overuse headache or some form of neuralgia.
A+E is not the right place to manage your problem, nor are ever stronger painkillers.

IMO you may benefit from seeing a specialist headache clinic or chronic pain clinic. Bearing in mind that pain management includes many many other strategies other than just analgesia.

And you cannot see why the concern about the addictive nature of these drugs in a problem and will be considered in prescribing?! Confused. Ok, then.

On reflection, maybe you should see somebody privately who will prescribe what you want, and not what you might need. Honestly.

I am sorry you are in pain, but the angry, distrustful and nasty attitude that comes across from your posts is making me cross.

Don't know why I posted really, I suppose I succumbed to your invitation for an argument Grin

lgold75 · 28/03/2016 10:29

This is the sister of the poster who will no longer be posting on here anymore on my advice.

The way he has been treated is close to bullying, I have noted that some posted including PacificDogwod have posted enough information to suggest they have a profession in the health industry, which of course would also suggest they are going to be defensive of their colleagues, I am a solicitor but do not do healthcare cases however during this episode I contacted a colleague who does and she assures me that healthcare professionals are notorious for getting to admit to negligence. I could post some examples here which she explained are truly terrifying and in nearly all cases the NHS will never voluntarily admit negligence instead happy to spend high amounts of money on legal fees to fight right till the end. She has never seen the NHS change its policy in lost cases and because of this has had several cases where the same mistakes have been made repeatedly.

Now has my brother been angry and aggressive, yes. But it is clear to see it has been due to provocation. I can see people repeatedly telling him that he should be tolerating crippling headaches and that pain relief treatment is less important than managing addiction levels. Been told your problem isn’t important would offend you would it not? It has taken him an hour to write some of his posts requiring a lot of effort due to the headaches to put his argument across but the replies are as if the posts haven’t even been read, I double checked the NICE guidelines myself and its clear to see that A&E did not follow NICE guidelines, he should have been given a triptan alongside the paracetamol as one example, but was not. So the people suggesting they were NICE compliant have also clearly not read what has been explained else they would know the guidelines were not followed.

He only had a single CT scan, not a LP or any other scans.

He was given no advice on how to manage the migraine until he can see his GP, which given he seen them only on the first day of a four day weekend it would have been a reasonable thing to do.

I can also assure you he isn’t rude to medical staff and doesn’t like to question them as we all know egos can be damaged and one thing doctor's hate is been questioned about their ability. He also did not do anything except be extremely polite during his visit, yet he has been repeatedly accused of the following and expected to not stick up for himself on here.

Exaggerating his pain levels
Seeking drugs
Demanding morphine
Been rude to A&E
Going to A&E instead of out of hours GP (yes he told you the GP referred him to A&E)

On the advice of my colleague when I join him in A&E later I will be recording all dialogue between him and the staff, and be rest assured if there is anything questionable happening this will be raised with the liaison service immediately and I will pass this onto my colleague. He asked me to not do this in fear of upsetting them, but as far as I am concerned enough is enough. He very patiently waited 6 hours on Thursday, allowed two people in front of him due to his kindness prolonging the wait further and then got treated like this. He also spoke up for a women screaming in pain in the waiting area asking for her to get immediate treatment, to be told they on it, but two hours later no one seen her.

Perhaps PacificDogwod who might claim to be neutral and have no affiliation to the NHS can explain why he/she is getting cross about my doctor saying the NHS is not acting competent. I will kindly read your educated reply as to how this offended you.

As an aside my brother does a lot of voluntary work for CAG and deals with disabled people who keep been told they not disabled, he knows first-hand judging people to be well because "they doing something" is wrong and is a big reason why society is today against disabled people on benefits. This is likely also an influence on why he replied the way he did, too many assumptions have clearly been made that because he is able to post on a forum it must mean he only has mild pain.

By the way I am a migraine sufferer and have even had a stroke which started off my migraines, I have never once been told to take just paracetamol and ibuprofen to manage it, and I will be explaining this to the doctors if he is given the same advice again.

Ironically some good advice has been given here, before I leave I will be printing out the NICE guidelines and doing a bullet list, maybe to try and get the message across and also to stop them from constantly asking him again and again what medication he is on (and interrupting him before he finishes I may add). It will save a lot of the four hours handing them a piece of paper every time they start asking medical history. I think my brother is too nice and it allows him to be trampled on, won’t be the case with me having his back.

Finally at the request of my brother, he says thank you to those who have tried to advise him on what he can do to get through this tough period. He has attempted suicide before and his posts mentioning it have been very disturbing and is one of the reasons I have told him to stay away from here as he has history of feeling very down because of feeling a burden to the system due to his health problems, when I see he has been talking about suicide again like that it sends shivers down my spine so he will be staying with me until this is resolved.

What this situation has also highlighted is how right the government is to make doctors modernise the NHS working hours, as having things like GP's unavailable for four days in succession is clearly not viable, and yes I agree with him, out of hour alternative GPs are not an acceptable alternative.

Good bye.

Buzzardbird · 28/03/2016 10:33

I hope your brother gets some help with his pain soon.

FatimaLovesBread · 28/03/2016 10:56

I thought he hadn't been diagnosed with a migraine though? That was only a suggestion from someone up thread.
So why is he/are you saying they should have followed certain guidelines for migraine when that isn't yet a diagnosis.

Let's hope he can get more help on his next a and e visit

kirinm · 28/03/2016 11:08

I don't really understand what relevance any posters profession may have. If you think the NHS have acted negligently raise that with them - nobody here could admit / deny any liability on behalf of the NHS.

Your post is unnecessarily aggressive.

AugustinaDuBois · 28/03/2016 11:11

Igold75

Biscuit

So you think all HCP are in cahoots because they don't hand out morphine to anyone who asks for it?
Are those of us who aren't medically trained but suggesting alternatives, also in cahoots?
You are telling us we are bullies, but its you who is giving the whole "I'm a lawyer" spiel and will be threatening legal action to the poor doc in A&E (Who by the way is probably a JD and obviously already doing a 7 day week!)

Why don't you listen to the good advice on here and speak to SPECIALISTS! Rather than just bulldozing your way to getting what you want and not what you need?

HmmHmmHmm

TheFairyCaravan · 28/03/2016 11:17

I suffer with severe migraine and I can't lift my head or turn over in bed let alone write lengthy posts on MN when I'm in the midst of one.

Codiene are no good for migraines. Opiates are headache inducing to a lot of people, me included, and should be taken as a last resort. You'd be much better off taking 3 soluble aspirin in a glass of full fat Coke. That's as effective as a Triptan and has been recommended by the London Migraine Clinic.

Ice or cold packs on the back of my neck and my forehead help me immensely. They relieve the pain just enough for me to get to sleep.

I take 3 preventative medications, I have 2 Tripitans and Botox every 3-4 months. I've just started having acupuncture to see if that will help, too.

gamerchick · 28/03/2016 11:21

You'd be much better off taking 3 soluble aspirin in a glass of full fat Coke

Ooh remembering that one.

CockacidalManiac · 28/03/2016 12:15

Igold, piss off. Seriously.
Nobody on this forum has claimed to be anything, except you, and I seriously doubt your claims too. You and your 'brother' seem to share very similar family traits. Let's leave it at that, eh?

PacificDogwod · 28/03/2016 12:39

Oh dear lord.

Whether I am a HCP or not, I am also a patient.
Biscuit

NotCitrus · 28/03/2016 12:46

OP - have you ever been to a pain consultant or done a pain management course? I don't know much about headaches but if you are already taking paracetamol, codeine and amitriptyline, then the chances of another drug just adding side-effects rather than helping are quite high, and you really don't want to have muscle pains and diarrhoea to add to your current medical problems! They would also have to see if the head pain was related to existing problems in order to figure out a way to treat it. Have you tried gabapentin or tramadol? Or NSAIDs like ibuprofen or voltarol?

Pain management courses vary from a couple hours to four weeks as an in-patient - I did one that was 6 afternoons, every week, and it seemed waffly at first but really improved my life.

Also if you are a "complex patient", it's really worth producing your own A4 bullet point summary of your medical history and what you are taking and why, to help docs get up to speed quickly and take you seriously in their tight timescales. Best wishes.

SauvignonBlanche · 28/03/2016 13:06

Dear Lord!
Whilst I do feel sorry for the OP with his horrible headache I also feel sorry for the poor A&E junior doctor who is about to meet, and be recorded by him and his DSis. Hmm

I really don't think A&E on a Bank holiday weekend is going to be the answer to your your obviously complex problems and please remember the 4 hour target is only to be assessed, not treated and discharged!

Our local news was giving out warnings advising all but the most ill to stay away from A&E at the moment so they're obviously very busy.

expatinscotland · 28/03/2016 13:18

Now the sister is here.

Of course.

FFS.

Biscuit
CockacidalManiac · 28/03/2016 13:54

If this bloke and his bloody dreadful 'hot shot bar-room lawyer' sister turned up in my department with a tape recorder, I'd tell them both to fuck off to the far side of fuck.
Thank Christ I don't work for the NHS any more.

willowcatkin111 · 28/03/2016 14:32

In my experience A&E do a very difficult job extremely well. I have never been 'forced' out indeed I have been invited to stay overnight more than once and when I queried the 4 hour rule the doctor said 'let me worry about that'.

triballeader · 28/03/2016 15:05

NICE follow BASH Guidelines on management of Primary Headache Disorders.
Migraines: first lie is NSAIDs and anti-emetics if needed, second line the 5HTs [triptains] and then and only then additional pain relief from co-codomol based drugs.
Best self help: keep a headache diary to show your doctor. If your GP struggles to help get severe headaches under control they should refer to a neurologist with an interest in headaches. If that still is not solving things then a ref to a specialist headache clinic is advisable.

It can also take quite a while to get a diaognosis if your have a complex severe headache disorder [5yrs is not uncommon]. If your unlucky and have more than one type of headache disorder it can take even longer. [Try 30 years!]

I am classed as severely disabled due to a complex and severe headache disorder to the point A&E cannot treat me if I do go. The best they can offer is a nerve block. I have all the special order drugs that Hospital pharmacies do not routinely carry and Ultra High Flow Oxygen supplied at home [Chronic migraine and TAC] and a specialist nurse I can call 24/7 to arrange to be seen by a specialist neuro within 12 hours if I need it. Not a bad NHS service for a condition that was described to me by the Prof as 'it will not kill you but your going to wish it would'.

Take it from me its not NICE you need to print off to take with you its BASH.

longdays · 28/03/2016 15:34

The NICE guidelines say NSAID (ibuprofen) and paracetamol which they gave you. It also mentions tryptans - unfortunately this is often contraindicated with amitryptilline that you are already on.

lgold75 · 28/03/2016 16:58

You are a group of very nasty people, it feels like I am back in school where the bully and his gang are all round the victim. How old are you people, 10 years old?

He has a suspected brain gliomas, which was only found after I pushed for another scan.

Before anyone claims I am aggressive I am not the one telling people to piss off and doctors to tell patients to fuck off.

At least he is safe in a hospital ward now, they haven't been able to explain why this was not picked up on Thursday night. He was given Methadone and a sedative, to allow him to rest. I will be going back there tomorrow morning.

triballeader · 28/03/2016 17:15

CATs will only pick up on some things and not all. They are the quickest way to check for heamo' and similar injuries within the skull.
As an example my daughter had x-rays that looked a bit iffy but did not give detail, a CAT scan that showed absolutely nothing whilst it took an in-depth MRI to show her bone tumors up [benign but still need surgical management].

Truly sorry if on-going diaognostic tests prove it to definetly be a glimona.
Hopefully if it is it will prove to be both benign and respond to treatment.

Buzzardbird · 28/03/2016 17:51

Igold, that is a little unfair don't you think? I said that I hoped he got some help soon.

I am glad to hear that he finally has a diagnosis though.

longdays · 28/03/2016 18:21

Methadone?

I hope things improve

FiveGoMadInDorset · 28/03/2016 18:33

So he is a drug addict?

longdays · 28/03/2016 18:35

Not necessarily Five but methadone is unusual for pain relief without a definite diagnosis.