Meet the Other Phone. Only the apps you allow.

Meet the Other Phone.
Only the apps you allow.

Buy now

Please or to access all these features

General health

Mumsnet doesn't verify the qualifications of users. If you have medical concerns, please consult a healthcare professional.

Is a Psychiatrist really the best person for this?

4 replies

Saidthesharktotheflyingfish · 06/08/2018 21:50

Lovely FiL has been left in limbo by the NHS and we would appreciate some advice on where to go next. Just over a year ago, he had a malignant nodular melanoma removed.

Recently, over a few months, FiL has rapidly become very confused, to the point where he can no longer cook or care for himself, has had to stop driving and has exhibited inappropriate behaviour such as nudity. Whilst he has been a little bit forgetful for a while (I'd say normal old age forgetfulness for a man in his 80s), this is a sudden and rapid deterioration. He was put under the care of the dementia team and a consultant Psychiatrist who booked him a CT.

The CT showed what appeared to be a 'blood filled mass' so he then had an MRI. The mass had apparently grown since the first scan; we were led to believe it was a tumour which was bleeding from the second scan report, and he was referred to the neuro-oncology team. They have reviewed his scans but not seen him, and now say they are as certain as they can be that there isnt a tumour, just a bleed. He will have another scan in a couple of months for any change, but he has been discharged back to the care of a Psychiatrist for what we are told is vascular dementia. And that's where our problem lies....

Surely someone who has a bleed on his brain which continued over a number of weeks should see someone other than a psychiatrist? A neurologist, a stroke consultant, someone like that? Should he really be having some other expert input, and if he should, what specialty should we ask for him to be referred to?

Apologies for the long post, and for all the questions, we feel a bit abandoned. Thanks.

OP posts:
lyrebird1 · 07/08/2018 00:54

Hi, I am sorry that this has happened to your FiL. It must be very difficult for you to deal with. It could be worth looking to see if your area has a community neuro-rehabilitation team. They tend to be a multi-disciplinary team with physios, occupational therapists, speech therapists etc. I found them really helpful after surgery for my spinal cord lesion.

It sounds like you have been passed from pillar to post a bit. I would maybe consider getting PALS involved to liaise with the hospital. It doesn't have to mean a complaint, but they are very good at getting stuff done (knowing what actually needs doing helps as well as how to navigate the maze of NHS admin!)

I would think about what your priorities from further input, as that would affect to some extent the specialist who would be best to see. Care plan - maybe stick with psychiatrist. Possible rehabilitation - Neurologist probably. Monitoring of mass - Neurosurgery. That said, it wouldn't be unreasonable to have more than one consultant involved. You (or other family) might have to be a bit pushy with requesting referrals from GPs though. Good luck. I have found from experience that you have to become a bit of an expert in managing a health problem!

swingofthings · 07/08/2018 07:17

vascular dementia can fall under the care of various consultants. It could be a geriatric consultant, general medicine, neurologist, but indeed, also psychiatrist with a specialty in dementia. A psychiatrist, unlike a psychologist is a doctor and would have gone to medical school.

I expect if he has been discharged from the care of the oncology team, it is likely that they don't think surgery is appropriate, but I would ask them how they came to that conclusion.

GeorgeIII · 07/08/2018 07:36

I would say a neuro surgeon. But they must have reasons why they don't want to operate, or is he on medication now which might stop the bleed? I would ask to see his notes, though don't know if you can do that. His GP gets a copy of his tests I think, so you could start there.

Saidthesharktotheflyingfish · 07/08/2018 07:57

Thanks everyone, really appreciated. Interesting that there have been several suggestions as to which specialty should be caring for him, hence our confusion. The psychiatrist is a nice chap (although he hasnt even seen FiL yet either), but the reality is that he probably only did anything other than psychiatry at F1 and F2 level and it feels like we need additional specialist input. Whatever has been bleeding in his brain surely needs further investigation.

PALS at this hospital is a nightmare. I tried for 2 days to get through on the phone and in the end had to leave a message only for the chap who called me back to put the phone down on me. I was only chasing up the MRI scan results - politely I might add Shock

OP posts:
New posts on this thread. Refresh page