How to go about a private GP appointment.

[Alphabet1spaghetti2]

Would be grateful for any advice as I think my brain has glitched.

How do I go about booking a private GP face to face appointment ? It is for suspected stomach cancer. Is bupa better than Nuffield, do I need to find one that specialises in Gastric or pain relief? Or are they generalists? Google is giving me the impression that I need to book a face to face at a private hospital as opposed to a clinic based GP.

Dh has seen his Nhs GP and has been referred on the two week pathway, but is in pain and needs to know what he is facing. Nhs GP has refused pain relief other than paracetamol and has refused a sick note for his work. Apparently they are two separate issues and need two more appointments - the next available appointment is a month away. He only managed to get an emergency appointment after 2 weeks of daily phoning. Dh was prescribed antacids. He had been referred for blood tests, (2 weeks for results) stool tests (2 weeks for results) and endoscopy. Our local A and E has some of the worst wait times (18+ hours) and understandably Dh would rather be in pain at home rather than on the floor of an and e. The hospital wait for scans which are around 26 weeks.

I am so sorry to hear your update @Alphabet1spaghetti2 .

I do not have any medical knowledge, so cannot help in that way but just wanted you to know that I am praying for your husband. xxx

Same for me, crossing everything that you will have some more positive news after a horrible few days.

Often if you are self funding, once you have paid to see the consultant privately, they will refer you back into the NHS system, having bypassed months of waiting lists.

This has happened to us twice. Got a surgery date for 8 months away. Paid to see the surgeon privately, had the op done on the NHS within 2 months.

Really sorry to read this, Alphabet. As a pp said, no discharge without a detailed pain management plan.
If DH feels that there is hope, that’s what you have to cling to. Although it might not sound great, nothing is actually known until they have the biopsy results.
I’ll be thinking of you both.

I'm sorry that they are mucking you both about, have they explained why there's a delay or why they couldn't get the endoscopy down, are they planning another procedure or helping with the stricture, has he been referred to the gastroenterology team, district nurses, pain team, dietician, speech therapist for a swallow assessment if he has strictures. Who is going to monitor his inr blood levels if he's home with warfarin.

@moggiek i hear you. But when it walks like a duck and talks like a duck and they say they are looking for a duck, and a big nasty duck at that…. It’s unlikely it’s going to be a giraffe. I get the holding on to hope, but in a way that’s just as cruel because it stops you doing what you need to do. Not just what you want to do.

@TraitorsGate yes and here is a tumour blocking his oesophagus. Biopsy of that tumour needs to be cultured/grown. Planned biopsy of his stomach shadows and lymph glands couldn’t be done due to this tumour as the camera couldn’t get past.

zero plans for anything else. Sending home to wait on the biopsy plan. I’m guessing warfarin levels will be measured at hospital because our dr surgery no longer does any blood draws you have to go to
one of three hospitals.

How frustrating, did they discuss stenting or widening his oesophagus. What about eating, drinking, pain control. I would speak to the doctor and nurse and ask what the plans are, he can't just be left the same way he was before he went into hospital.

@TraitorsGate you would think that wouldn’t you - any sane person would. But apparently that can because that’s exactly what they are doing. Dh has to just wait at home.

honestly I can’t do it. I can’t get my head to wrap around this.

So sorry OP. It's awful he's been left to just wait it out.

Them you thinks it’s an unsafe discharge …..gets PALS on board…..don’t be fobbed off…..what have the dieticians said?

I too am sorry to hear your update and dismayed at how you are being treated. They can't send him home without pain relief, that's awful. I would see about complaining too, but I know that you probably just don't have the headspace for that as well. Is there anyone else that can help you with things like that, writing letters or anything?

Actually contacting PALS first thing in the morning is a good idea. They can go to the ward and ask for you the questions suggested before. I would say you don't think it's safe for him to go home until more plans are confirmed.

PALS may be a good call, OP. Tell them you're concerned about managing his pain and blood thinner management.

tell them you are unable to care for him at home, request social care support and ask them to confirm in writing the details of his safe discharge. Has he had an assessment on how he can get around at home when he doesn’t have the current pain relief? Paracetamol for pain relief does not sound adequate. Especially over a weekend where there is less support available. I’m so sorry you’re having to deal with all this, you both deserve more support.

@BlossomToLeaves no. We have no one. It’s that bad that I phoned the Samaritans just so I could talk and cry on someone’s shoulder. It’s just Dh and me.

pain relief is going to be (as it is today) just good old fashioned paracetamol. They’ve taken him off to he morphine and he is just on iv paracetamol.
I am beginning to hate paracetamol with a passion. It doesn’t work well enough.

@Kitkat1523 no dietician involved.

@LizzieBennett73 pals will take around three
months to investigate. If they are even open in the morning. And to be honest I can’t do this, I just can’t take anymore on board.

@TraitorsGate i don’t really have grounds for unsafe discharge. Home is safe for him, Drs have decided that pain relief of paracetamol is adequate - partly because Dh will not admit he’s in pain. I can’t give a reason for him not to come home. I want him home but I don’t just won’t wash. So I’ve managed to look like an absolute tit when I’ve have said that paracetamol isn’t enough yo go home with.

I feel this past few days have been an absolute waste of time. Dh is not better in anyway - I would say he’s even worse now he’s also got a blood clot. And yes I am in total shock and just don’t seem to be able to anything or just function. I can’t cope
with it. I need a pause button if anyone finds one.

@Mezzaninemel. But that’s it. I can care for him - I’ve seen off 4 parents and worked in care. I’ve done
it. To say that I can’t is a lie, physically I can it’s just mentally I can’t , I’ve entered fight or
flight mode and fight isn’t an option, but flight
is looking very attractive right now. And that’s not a reason for no discharge. Dh wants to leave and there is no medical reason to keep him. My mental health doesn’t factor.

there simply isn’t a need for support, he doesn’t need outside care - I’m able to do it. He can get to the bathroom off our bedroom etc. as he can walk (from chair to chair) along the ward and even down the corridor today - again from chair to chair. But he can do it.

I’m sorry if I’m coming across negative or ranty. I am angry and totally lost. I don’t know what I want or need yet I should, because it was once my job to help families through similar and I’ve done it for our parents. Yet I can’t seem to do anything right or stop crying and be a bloody adult. I’m told it’s shock. I just don’t have anything in my tank to deal with any of this. How the bloody hell do people do it? I cannot even get the sodding car out of the hospital car park. Ffs.

You're in shock, so please go easy on yourself. They may be reluctant to prescribe anything opiate based due to side effects like constipation perhaps? And you have to be a bit careful what you take with warfarin which rules out aspirin/ibuprofen I'd guess. But it's pretty sobering to think they're happy to leave him with just paracetamol when they are talking tumours and blood clots.

Is your GP surgery helpful? They should have access to his hospital notes and they may prescribe something for him?

IV paracetamol is far more effective than oral ….. your DH will probably realise that all too quickly if discharged….if he’s not eating will they be prescribing something like ensure as a ttto?

@LizzieBennett73 the gp surgery sent him away on Friday with otc paracetamol. They are utterly crap even if we could get an appointment. It’s stand outside and hope you are deemed sick enough or fist in the queue at 7:50am to get one.

@kitkat. I know. I know only to well that the iv version is superior. I get the concerns around warfarin and opiates etc. I know we are back to square one with added shit. I know Dh doesn’t know or acknowledge this - he’s so far into denial today he’s in La La land. I also know that makes me sound selfish/arrogant and …..
ensure or similar we can buy, because he hates the prescription stuff but doesn’t mind the huel and h&b own brand. So that I can solve. Along with blending regular food to a smooth texture. No one in hospital has noticed he hasn’t eaten much if any food - he’s been nil by mouth Monday and Tuesday and sandwiches just get binned. I’ve told them -
but they just shrug.

I've just read this whole thread and I just want to send you a massive hug! We're all here for you to chat too. You're not alone.

@curlycurlymoo thank you. Talking does help me. Gets it out. I never really truly understood that until
now.

It's overwhelming, it's all happening so quickly. I would encourage him to ask for prn oramorph, lactulose and soluble paracetamol or Co codomol.

@TraitorsGate thats the word. Overwhelming too much for my brain to deal with. And it’s screaming no no no.
I know I should carry on as normal but I I can’t. My brain has but me in ‘park’ mode. I’ve gone numb. But I know there is so much I need to do before I collect him and not doing isn’t helping but I can’t do it. I can’t face going back to hospital either. I know I have to but I feel like we are back where we started.