AIBU to feel that this doctor

[cory]

could do with polishing his bedside manners?

Took dd to the orthopaedics specialist today, after she has been suffering knee pain and difficulty in walking for around 2 months.

Dd has Ehlers Danlos syndrome (hypermobility type) so she gets a lot of pain anyway.

But she also had an operation on her meniscus a couple of years ago, and the new pain is around that area and according to dd feels like a meniscus pain rather than joints.

So we went to see the knee doctor at children's orthopaedics.

The information about her op etc was all in her file.

He did not have the file. All he had was a small file containing the last year or so; presumably the old one got too large. Somehow he made it sound as if it was very odd that she should have had an operation when it wasn't mentioned in her file, as if he didn't really believe in that. We explained that this was not the main file.

At this point he seemed to lose interest in the meniscus operation altogether and seized on the Ehlers Danlos syndrome instead (which I had mentioned in passing, as other medical history).

He made dd go through all the hypermobility tests and kept repeating in an accusatory voice "WHO told you you had Ehlers Danlos syndrome"? I rolled off the whole list of specialists, but he seemed very unconvinced, and kept questioning dd. When I mentioned the genetics department, he asked if she'd had blood tests. There are no blood tests for Ehlers Danlos- so either he is talking total crap or he thinks I've made the whole thing up and have never been to the genetics dept.

He had a bit of a feel on her knee but clearly didn't find anything. Which is fair enough- perhaps there wasn't anything to find. But wouldn't you expect him to tell you that, and then maybe try to discuss what might be going on? You know, on the assumption that the patient might be interested?

Instead he just told us that he was referring dd to physio and swept out of the room- without a word of explaination as to what she was referred for?

Doesn't this strike you as odd? Wouldn't you want to know what you were having physio for? And would you really trust a doctor who referred for physio without reading medical notes referring to an operation?

The bad news is -whatever the state of dd's knee, we cannot afford this. Dd was doubted at the onset of her diagnosis and again by her headteacher in junior school. She is still under psychiatric treatment for anxiety and depression. She is about to be assessed for anti-depressants. Being in constant pain and having people tell her she is making it up or imagining it has seriously messed with her mind, to the point of school-refusing and self harming and contemplating suicide. I had only just got her to the stage where she felt able to go back into school again. This is going to send her right back. It was so unnecessary.

Ok he was probably only having a bad morning. Too busy to try and get her notes, feeling embarrassed about it, trying to cover up- but he doesn't have to deal with the fallout. I do. And I'm fed up with clearing up other people's mess.

that does sound crap cory. Can you ring the consultants secretary and ask for an explanation? Can you go back but see someone else who can be bothered to find the notes.

Poor dd!
I wonder if he needed the full notes before he could decide what to do? It is really difficult working from tempory notes but that is no excuse for poor manners!
Perhaps contact the patient liason officer (pals)? At the very least the full notes should be available at the next appointment.

I see what you mean, magso- but if he needed the full notes to decide what to do, why did he just send us off to physio without offering a further appointment? That is my point- we're not getting a further appointment, he is sending us off to physio without making any arrangements to actually diagnose dd.

It could be that he thinks it's the Ehlers Danlos playing up- but he seemed to doubt she's even got EDS.

He did say come back in 4 months if it isn't getting any better, but 4 months is a long time not to be able to walk.

Sorry your DD was so upset by the doctor's manner, it's shameful that a simple admin detail re:lack of full notes has caused such upset. if you don't receive a copy of the letter to your GP after clinic, phone up and ask for one, you/DD are entitled to one. just to clear up a point though - it's not the doctor's fault re:the full notes not being available, its not their job to get clinic notes, it's the admin support people.

I used to work for an orthopaedic surgeon. He was actually superb, and had very good communication skills. I'm wondering if it might help your daughter to know that in general, orthopaedic specialists are the the butt of all the other doctors' jokes. If so, show her these (no offense meant to any surgeons reading!)

On a more serious note, the other posters make a lot of sense. And perhaps a chat with your GP might help your daugher to feel her symptoms are being taken seriously.

3 orthopaedic surgeons took 55 days to do a jigsaw and were proud of their achievement.
When asked why they were so proud they said because it said 2-3 years on the box.

At an orthopaedic meeting how can you spot the academic orthopaedic surgeon?
He's the one who can get his knuckles off the floor!

What's the difference between a carpenter and an orthopaedic surgeon?
A carpenter knows more than one antibiotic!

How do you hide a twenty pound note from an orthopaedic surgeon?
Put it in a text book!

How do you spot the orthopaedic surgeon's car in the car park?
It's the Porsche with a comic on the back shelf!

What's the difference between a rhinoceros and an orthopaedic surgeon?
One's thick-skinned, small-brained and charges a lot for no very good reason....the other's a rhinoceros.

What do you call two orthopaedic surgeons looking at a chest X-ray?
A double blind study.

Why do anaesthetists take an instant dislike to orthopaedic surgeons?
Because it saves time

How do you get an Orthopaedic Surgeon to refer you to some one else?
Ask him the time.

Total, I know it's not the doctor's fault that the notes weren't there. But I still think it was incredibly careless of him to discharge us and refer dd for physio before he's actually had a look at those notes. Surely, if the notes are worth reading- which I would have thought they were since the pain is at the site of an earlier operation- then it doesn't matter whose mistake it was.

And asking if dd had had blood tests for Ehlers Danlos was just plain ignorant. Which makes me more nervous about him not reading the notes, as there are obvious gaps to his knowledge. It was very noticeable when he gave dd the Beighton test that he doesn't actually know how many markers there have to be for an EDS diagnosis: he seemed to think if you can't do one of them then you haven't got EDS. Dd can't touch her toes, because her calf muscles are short. Why carry out a test without looking up how it works?

I have good reasons to be nervous about doctors who will not recognise the limitations to their knowledge: the first paed who saw dd when she was 7 diagnosed her EDS as psychosomatic pains and suggested that they were brought on by sexual abuse. Again, this was a man who didn't see the need to read her medical notes.

Cory - fully take your point that he could still ask for the full notes after the clinic (which hopefully he will do). I quite see given your previous scary experiences why this doctor has upset you and DD.

This reminds me of the dev consultant I saw just the once re my lad's dairy intolerance & it's impact on his development. At the time toddler DS was a scrawny sparrow and he reccomended feeding him double cream to build him up.

My Mum & I could barely keep a straight face for the rest of the appt between us and he is STILL the butt of family jokes at weddings, funerals etc over 5 years later. ; )

(We did stop by the reception desk on the way out of the hospital that day and ask to see another doctor for the next appointment btw - once we'd composed ourselves and stopped giggling).

Remind your daughter that there is an idiot in every village and that includes the community of doctors.

Sorry Cory, had not realised dd had no follow up appointment! That sounds very odd! Is it possible the doctor was distracted/ confused rather than disbelieving? There is nothing worse than feeling you are not believed or listened to.
Is the physio likely to be able to help do you think (forgive ignorance) either to help knee directly or feed back to specialist. If not could you ask your GP to refer for a second opinion - or request a review -perhaps after the physio has reported back? You sound very knowledgable ( as you have to be). I am so sorry you and dd have had such a difficult time.

That's the problem, magso. If we don't know what the cause of the pain is we can't know whether physio will make it better or worse.

The heavy exercise and pushing-against-pain programme dd was given years ago for her EDS made her very much worse and it's taken years to get her more or less back on track: we have later been told that it's likely that permanent damage was done to her joints. And the one who gave her that programme was a different doctor from the one who originally misdiagnosed her (but same hospital)- so we've had a few dodgy experiences (as well as many good ones).

Other problems she's had with her knees have included a malformed meniscus and bursitis: neither of which are likely to get better through more activity (ouch!).

If I only knew... If it's anything to do with the meniscus I would have thought she would need a scan, but I don't want to push for that if it's only her EDS... I can't afford to get written off as a hysterical mum when I've questioned so many decisions in the past.