MEDICAL MATTERS

[Stanley]

Lovely to see you posting Ken and knowing that even though you might not be posting you are reading the threads.
Ian, that really worries me. I shall have to find out what is going on. I shall mail him and ask the question.

[plaques]

Some years ago when My established doctor retired I was allocated another one who was new to the practice, At first this didn't make any difference since I rarely used the service. Unfortunately after Covid-19 he disappeared into the woodwork and in my mind became Dr Griffin from H G Wells the invisible man. Finally I requested a different doctor who is absolutely brilliant but still left me as his 'named' doctor. The result in that unless I can request any results to be diverted otherwise they drop into his black hole.

[PanBiker]

Similar story with our family Ken. First family doctor was Dr Robertson who covered about the first 30 years of my life from birth and well into married life. When he retired his patients were transferred to Dr Brown who covered the next 25 - 30 years or so until he retired. I was then transferred to Dr Manzur who I expected would probably see me out! He is still very much there but apparently no longer my GP? Practice manager although named does not seem to have a unique email address, they only seem to use a generic reception@ address.

[Tizer]

Our Taunton GP practice doesn't provide personal email addresses and not even a general one on their web site. It was only by persistence that I got them to give me a general practice email. When I was having those recent problems over breathlessness and X-rays and also with a skin problem I used the general address and added `FAO Dr xxx' in the title. The doctors got the emails forwarded to them but there was never a reply by email, only by phone (or none at all in one case).

We too were moved from our original GP during the Covid pandemic. He was approaching retirement and went part-time because of the work stress.

Plaques, a few months ago when I asked to see my GP I ended up with a `trainee' but he was a qualified hospital doctor and apparently had to undertake a period of time in a GP surgery to understand how it works. He was from the Middle East and I could cope with his English except for the speed with which he talked, running all the words together. I had to keep asking him to repeat sentences. Perhaps he really needed training in how to speak to patients!

[PanBiker]

I can understand transferring patients when retiring but not when the doc is relatively young. The thing is, if you see the same doctor as I have always been used to, you build up trust and a rapport with them. They also have first hand knowledge of your medical history, certainly under their watch. I don't have to explain to my own doctor why my toes don't work he already knows. The whys and wherefores of that was the first question that I was asked by the associate guy yesterday. I have read his consultation notes on the NHS app and the majority of the stuff covered what my own doctor would not have to ask.

[Stanley]

I mail Hassan at the general practice address but mark it for his attention. I think they get through to him but have no way of being certain as I don't get replies. Why is it that everybody seems to be avoiding contact with live human beings these days?
I once had the privilege of a long conversation with a man called Stafford Beer at Manchester Business School (Have a look at THIS Wikipedia link) He told me interesting stories about the Allende government and the activities of the Japanese government in the US in WW2. At about 2AM when we were both with drink taken I asked him if he could encapsulate the essence of communication in an aphorism. He said this; "Communication is not how a message is sent or how it is received, it is what is understood." His example was 'Send reinforcements, we are about to advance' being received as 'Send three and fourpence we are going to a dance.' And the only way the sender gets to know that is if there is a reply. I feel so many public bodies need to take note of Stafford Beer's work in Management cybernetics!

[Wendyf]

The red lesion on my arm has now been diagnosed by the dermatology department at Burnley as Bowen's disease, which means it is a slow growing squamous cell skin cancer in its early stages. He has asked the surgery to prescribe a 21 day course of ointment to remove it. The thing is, that diagnosis has been made purely on photographs, no one has actually looked at it or spoken to me. I have been applying E45 cream twice a day for the last 10 days and it has pretty much healed up all by itself.
A friend with a similar skin issue went into Earby Surgery on Friday to book an appointment, the earliest available appointment for a phone triage was at the end of November, unless he manages to win the battle of the 8.00am online booking system.

[Tizer]

If the ointment is Efudix then it's what I had prescribed for similar benign carcinomas on my face during summer. If the problem returns after your E45 treatment and you have to use Efudix be aware that it makes the skin lesion worse before it gets better.

I've had my covid and flu vaccinations and I must be lucky because I had nothing more than a slightly tender arm for a few days. Mrs Tiz had her flu jab and no problems other than the same tenderness.

[Sue]

The red lesion on my arm has now been diagnosed by the dermatology department at Burnley as Bowen's disease, which means it is a slow growing squamous cell skin cancer in its early stages. He has asked the surgery to prescribe a 21 day course of ointment to remove it. The thing is, that diagnosis has been made purely on photographs, no one has actually looked at it or spoken to me. I have been applying E45 cream twice a day for the last 10 days and it has pretty much healed up all by itself.
A friend with a similar skin issue went into Earby Surgery on Friday to book an appointment, the earliest available appointment for a phone triage was at the end of November, unless he manages to win the battle of the 8.00am online booking system.

Bob was told he needed a non urgent biopsy on hid. That was 5 moths ago. Continuous application of moisturiser and it has nearly gone.

[Tripps]

I've just composed and then deleted a post on this subject - connecting the above with the words of Professor Dalgleish. For me the penny dropped this morning. However it's none of my business. I read that the above skin conditions are not at all serious which is a relief. I will just say there is a lot more to a vaccine, than whether it makes you feel rough for a couple of days.

[PanBiker]

The receptionist said that she had a 12 o'clock appointment free for Mr Laith? A physicians associate who could see me and enter the consultation onto the system which would be picked up by the doctor, (whoever that may be). I accepted of course and went to see him, he had a look, agreed that the problem did not seem to be inflammation which is what the previous meds were for. He has prescribed me Co-Codomol and suggested I exercise to see if that makes a difference. I said I didn't want to end up on opiates for any length of time as that is only a temporary prop that will not reveal the actual problem.

As it was last Friday when I visited the practice I thought I would leave it until Monday or Tuesday to check the progress of the med's that the associate prescribed. Well it's now Wednesday, no email received or notification in MyGP of a new prescription. I understand that as an associate he may have to get it signed off by a GP, nevertheless, I rechecked on MyGP today and looked up the consultation. The medication is suggested but marked as NOT ISSUED. I thought that this may be because you can buy Co Codomol over the counter so I checked and here's the rub. You can only buy the weakest codeine strength (7.5/500) and not the ones he suggested, (30/500) they are only available on prescription.

I rang the surgery for some clarification as I was told to try them for about a week then report back. I hung on as no 2 in the queue and then after it was my turn and the phone was answered I only got about 20 seconds before the line was dumped! I rang back and was now no 3 in the queue, it took 10 minutes to get an answer. Nothing in progress, which I already knew! Receptionist said she would flag the error and try to get it actioned. I still think it's a waist of time as exercise makes it worse but I am trying to do as I am told.

[Tizer]

You can only buy the weakest codeine strength (7.5/500) and not the ones he suggested, (30/500) they are only available on prescription.

I first encountered that rule 20 years ago when I was suffering severe back pain spasms. I was told to take one tablet each night so I could sleep. I didn't need many because the pain soon lessened (thank goodness) but we kept the remaining tablets for many years and used the odd one now and then for anything too painful for the ordinary low dose CoCodamol. They're very effective but that unfortunately makes them addictive and that's why they're only on prescription. Too many people lack the self-discipline to avoid addiction and my doctor then knew me well enough to prescribe them. That takes us back to that problem of not having a permanent doctor again!

[Tripps]

the med's that the associate prescribed.

The NHS website says simply :-
However, currently PAs are not able to:
prescribe
request ionising radiation (eg chest X-ray or CT scan).

[Stanley]

Aren't these 'associates' just a way of trying to convince us we are being attended to when in point of fact there aren't enough doctors working full time to cater for us? In other words, an official con trick.
Of course if you want to pay you can have a doctor........ (Is that where all our doctors are? Working in private practice?)

[Tripps]

Aren't these 'associates' just a way of trying to convince us we are being attended to when in point of fact there aren't enough doctors working full time to cater for us?

Correct.

File under "Dumbing Down" a sub file of the main file "Government failure of strategic planning".

The Mail is 'on the case' Physician Associate Note the lack of accountability to any professional body.

Remember 'Virtual Wards' from my posting last year - twenty patients at home with a DIY kit and a laptop, with a nurse to ring up if the computer said so, or you felt it necessary?

[PanBiker]

When the experiment is over and I have to report back I will insist on seeing a real doctor. Preferably the one that knows my history and that I have had for the last 8 or 9 years! I may have to declare an emergency for a sore toe which I should not have to do but this state of affairs is of their own making. I cant refer myself to a physio or for and x-ray or scan so what is a bloke to do? At the end of the day, one faulty digit is affecting my mobility and it seems will not mend itself.

[Stanley]

You're a perfect example of the problem with GPs now Ian and why I say I am so lucky. You are in a ridiculous situation, at one end you have the best brains in the country working for you and at the other end they are letting you rot quietly.

[Tizer]

The Mail is 'on the case' Physician Associate Note the lack of accountability to any professional body.

It was on OG the day before the Mail published that article...

Physicians' associates are not doctors.

[Stanley]

If we can see the flaws in these schemes, why can't the people in charge of the health service address them?
Oscar Wilds once described people who knew the cost of everything but the value of nothing. I often think this applies to the people who run our great social services......

[PanBiker]

Well, this is a record, MRI scan on the 19th (8 days ago), letter today with my results. Signed by my named neuro nurse Roisin on behalf of the radiology interpretive team and Mr Anderson.

She reports no changes since my last scan and confirms my next scan which will be in two years in 2025. Scans are done at 1,2,3,4,5,7 and 10 years so just two more to go. Looks like they may also be at Leeds.

As usual I also have the backup of booking an appointment with my surgeon Ian Anderson via his secretary Deborah if I have any concerns or simply wish to discuss the latest results. I think this can be classed as perfect post operative and ongoing care.

[Big Kev]

That's good to hear Ian

I've been for a field vision test and a scan of my eyeballs, a requirement for the DVLA in response to my declaration of a macroadenoma. They were a bit confused initially as it was the endocrinology team that arranged it.

[Wendyf]

Good news Ian.
Kev, I dread the field of vision test! I used to enjoy the one that was part of my annual eye test, it was a bit like a computer game, but now have to take one for my opthalmology appointments on a more serious machine.
When I was first diagnosed with high eye pressure the wait for an appointment with the Burnley opthalmology department was about 6 months so I chose to go private at Gisburne Park. The service then moved to Beardwood Hospital in Blackburn where I went on Wednesday afternoon but that has now finished and my consultant is moving to Rochdale. We decided it made sense for me to be referred back to his NHS clinic in Burnley.

[PanBiker]

Thanks both. Yes, certainly can't fault the service from Airedale and the Leeds Teaching Trust.

I hope the test for both of you go OK and get the results you want.

[Big Kev]

Good news Ian.
Kev, I dread the field of vision test! I used to enjoy the one that was part of my annual eye test, it was a bit like a computer game, but now have to take one for my opthalmology appointments on a more serious machine.

It took me a few goes to do it right, I kept moving my eyes every time a light flashed. It took a lot of concentration to keep looking at the little orange light in the middle of the machine.

[Stanley]

I have a feeling that If I hadn't kicked my licences into touch I would be having major problems with things like this FOV test. But you don't need to pass one for running a lathe....
I hope you both keep passing the tests.....