Fobbed off by doctor what should I go back and ask for?

[SnarkyBag]

Have been having bad lower abdominal and lower back pain for three weeks. Spoke to doctor over the phone three weeks ago and they said to have blood tests and said they didn’t need to see me in person. Tests back all normal this week (including one for ovarian cancer markers)

Phoned again yesterday as back and abdomen pain still bad. Another phone consultation and doctor just said the back sounds muscular skeletal and to self refer for physio and advised I go to the pharmacy and buy buccastem? I have no nausea or sickness so am a bit baffled by this.

I feel I need to phone back and insist on a face to face appointment but want to know what I’m insisting on when I do if that makes sense? I can’t do much at the minute and I’m going to struggle working next week if the pain stays at this level.

Maybe follow their advice, first? See physio. Sometimes, back pain etc means you have to stay off work, that doesn't mean they can find a miracle cure. They'll have asked to rule out 'red flags', they've done tests, and recommended things to try. Try those, before 'insisting' on anything.

Have you actually taken the doctor's advice and got physio and taken something to settle your bowels?

What are you worried about it being?

It doesn't seem obvious that you need to insist on a face-to-face appointment if you haven't yet taken the doctor's advice and your blood tests are all ok.

Yes obviously I’ve followed the advice so far. I’ve had two private physio appointments and will continue to see them and I’m taking the buccastem which is doing nothing. I asked about pain relief as little is helping and he just said don’t take ibuprofen anymore as it’s not good long term for the stomach. I’m worried because I’m also very fatigued at the minute and I’m struggling to do normal day to day life as feel so unwell most of the time.

I may well be being unrealistic in my expectations but am in a lot of pain and stressed that I can’t keep up with day to day life let alone my job. I struggling to work a full day so work is back logging up and at some point it’s going to become apparent that I can’t currently fulfil my contract (freelance)

I am sorry you're in pain, but your OP says you phoned yesterday.

Things take time. Wait another week, then book a review with the GP. Most things get better on their own. You've had bloods, and a GP review already.

I’ve had ovarian cancer. My CA-125 blood test for ovarian cancer was normal, yet I had a tumour measuring 10cm x 6cm on my left ovary.

You need a scan urgently. Can you see a different GP? Either way you need to be seen and referred for tests.

I’d expect a doctor to at least palpate your abdomen when you’re complaining of abdo pain.
And mention that it’s affecting your ability to work.

Few questions.... What has your Physio said?
What pain relief are you taking?
Has anyone asked you to provide urine sample to rule out that?

“I’m worried because I’m also very fatigued at the minute and I’m struggling to do normal day to day life as feel so unwell most of the time.”

Ring and say that, insist you are seen. Doctors seem to have forgotten they need to see service users.

How painful is painful? What I’m trying to get at is that if it’s so bad you’re not able to function normally then it warrants a treat to A and E as it could be anything from appendicitis to ovarian issues to ibs. I think I would ring 111 for advice. Blood tests being normal don’t always mean everything is okay.

I’d expect a physical examination and a urine test too. When I have a urine infection sometimes the only symptoms I get are back and abdo pain.

Hi nurse here. Do you think the dr said buscopan not buccastem? That can work for stomach cramps. And might make more sense. Did they request a urine dip? Are there signs of a uti?

No, doctors haven't forgotten that. Unfortunately, the number of GPs is dropping and demand is sky-rocketing. There was a 20% increase in GP workload in December alone. GPs are now juggling far too much work to be safe, and having to make compromises that we would never have made a few years ago, when workloads were safer. And the OP's experience is an example of that.

OP, I would ask to speak to a different GP and say that you would like to be examined. The normal blood tests are reassuring, but, with any symptom that is not getting better, it is important to review the patient. I don't think your GP did anything wrong with getting blood tests as step 1, but now someone needs to check you over physically.

I had these symptoms with ovarian cysts, i'd ask to be referred for a pelvic and abdominal ultrasound.

Ask to be seen OP. Telephone consults are no good.

Thank you I think you may be right and I’ve misheard him he had a very quiet voice! Buscopan would make a lot more sense.

Physio has suggested the back pain is related to my facet joints and has recommended some exercises and stretches.
GP has not asked for a urine sample and didn’t suggest what to do if the pain continues.

Def ask for more tests (urine) or go for private ultrasound if you can afford it - they’re not very expensive - that’ll rule out ovarian issues at least for peace of mind.,

please insist on a face to face appointment, i have no idea why GP's think their diagnostic skills are so brilliant over the phone. I'm an ex-physio and i would be wanting a Dr to exclude any other causes if you have ongoing bad abdo pain , this won't be coming from your facet joints.

p.s. do no other health professionals think it is it bizarre that blood tests are now a first line option before a physical exam? looking a patient in the eye is the basics of health care , what someone is complaining about isn't always what the essence of the problem.

I'm sick of this myself. I've had two pulmonary embolisms while my GP farted about trying to diagnose me over the phone. The latest was a heart attack diagnosed after a 12 hour wait in casualty.
I'm sick to death of it. I don't want to go to A&E each time I have a problem.
I'm medical myself and told my GP I was having a PE but he thought it was a panic attack with no physical examination whatsoever.
I'm trying to work 6 days a week to support my family and I can't keep spending work days in A&E not to mention it's putting a huge stress on hospitals.

Diverticulitis?
Urine infection?

Can you drop off a urine sample at the practice anyway, get that tested and eleminated anyway

I think I’m going to arrange a private ultra sound it will be worth the expense for the peace of mind or if something shows up it’s a start to getting answers.

@Sunriseinwonderland thats awful and really terrifying sorry to hear you’ve had such serious problems and that they’ve been missed by your gp.

I usually sing my gp practices praises in fact only at Xmas did I get a face to face appointment for my son on the same day and an immediate referal to orthopaedics.

The average GP now has 2,300 patients per year (up from 1800 a few years ago) and patients see a GP 5.5 times so that well over 300 appointments a week (allowing for bank holidays etc). We’re not working this way because we like it. It’s massively stressful and not what anyone signed up for. We are trying to meet rising demand with limited resources. If we give patient A more care, we have less time for patient B. That’s the reality.

OP you mentioned that you are fatigued and not sleeping. Is this because of the pain level?

Are you keeping a note of your pain levels, how long between pain relief doses you are pain free, and your pain scale?

And what pain relief are you taking? Paracetamol, codeine? You can have a chat with the pharmacist for advice.

If I were you, I’d document my pain for a two-three days, if it is keeping you awake then write that down too. Keep on top of regular pain relief and the buscopan and contact the surgery again if no improvement.

You could go into the surgery and explain to the receptionist the situation. Show her your notes and go from there.

I can more than understand this and think its disgraceful the workloads put on GP's but this person has still had to take up a phlebotomists time for blood tests, lab time for processing tests and a GP's time for looking at the results and feeding back to the patient...when you have potential outcomes that range from something that may have been super easy for a GP to diagnose face-to-face eg. constipation/gut irritation due to analgesia or a patient who may be reading far more into a situation due to anxiety and actually needs reassurance , why is face to face de-prioritised to this extent? it only creates extra work for other people within the health system and ultimately leads to mistakes, misdiagnoses and worse patient outcomes. I confess to being prejudiced as having worked in palliative care you do see the people who suffer the worst case scenario because of missed opportunities for diagnosis but I still can't see how a blood test is appropriate in this instance as first line of action (I concede the OP may well have other aspects of her history that may have influenced this decision). I am with a different GP practice to my husband and they are like chalk and cheese with availability of face to face appointments and ease of contacting the GP so I disagree that all GP's are working in this way because of necessity.