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>> No. 4077 Anonymous
1st December 2016
Thursday 11:18 pm
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My nan injured herself on the stairs a year ago and GPs are useless.

She was trying to get away from my grandfather, who was chasing her in his dementia, and slipped. Her left foot folded, or curled, and she put the full weight of her body onto that part of the front of the foot that was in contact with the ground, crushing it.

She says it turned "black", and now she has pain whenever she walks. She says the pain only occurs when she puts weight on her left foot; it doesn't matter where she puts the weight on her foot relative to the site of the damage. The pain now is the same as it was a year ago; it hasn't spread or got worse, but it can change in intensity throughout the day. The pain occurs in the part of the foot that was folded, and the back and side of her leg up to the back of her knee, and when particularly bad the front or shin. Nowhere else such as the rest of the foot or the kneecap.

She hasn't had, or been offered, any tests such as an x-ray. She went to a doctor three weeks after the incident and was apparently not given a diagnosis, just advised to take paracetamol. I went with her to a second appointment last week and the doctor diagnosed permanent nerve damage, again advising merely to take paracetamol or other prescription painkillers. I hadn't been fully informed of her symptoms and examination history otherwise I would have questioned it more, and my nan can be a bit doddery in both explaining and understanding everything in the surgery. Either way, her children are suspicious of the NHS doctors and think they are deliberately doing the bare minimum of work and expense necessary to make her well. I'm inclined to agree; it's amazing that they think they can make a proper diagnosis without getting at least an x-ray.

What do you lads think?
Expand all images.
>> No. 4078 Anonymous
2nd December 2016
Friday 1:15 am
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Have you thought about accompanying her, or another family member, to a doctors appointment? It can be quite easy to be steam rolled by a GP trying to get through dozens of patients in a day, it's happened to me and I'm pretty gobby all things considered.
>> No. 4079 Anonymous
2nd December 2016
Friday 1:30 am
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Is there any particular reason she ended up at a GP instead of A&E?
>> No. 4080 Anonymous
2nd December 2016
Friday 1:40 am
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This. Older people are notorious for underplaying their symptoms. Crushing chest pain is "feeling a bit peaky", a fall heavy enough to cause a displaced hip fracture is "a bit of a tumble". They have this weird, near-suicidal reluctance to tell doctors the truth. Every A&E doctor knows that you never take a geriatric patient's word. I suppose it's just a misplaced manifestation of the stiff upper lip, but it means that older patients are often massively under-treated outside of emergency care.

GPs are ridiculously overworked. They don't have time to coax the truth out of an elderly patient during a seven minute appointment. Some GPs will go out of their way to investigate, but they're the exception. Most are just desperately trying to keep up with the workload. Unless you give them your history and symptoms in a neatly wrapped package, they're not going to make a good diagnosis.

Keep pressing the matter until she gets a referral to a specialist. If you're sufficiently persistent, a referral becomes the easiest way to get rid of you. Make sure that someone goes with her to every appointment.

If you can, make GP appointments early in the day. GPs often end up running late by the afternoon and have to rush people through to get back on schedule. Nobody will give you an extra couple of minutes if they're half an hour behind schedule and have a waiting room full of disgruntled patients.
>> No. 4081 Anonymous
2nd December 2016
Friday 6:15 am
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>I went with her to a second appointment last
>> No. 4082 Anonymous
2nd December 2016
Friday 1:19 pm
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Well she didn't go immediately because no-one would have been able to take her without leaving my grandfather, who needed constant care, on his own.

Thanks for this advice. So in short, keep making appointments, do so early in the day, and ask to be referred to a specialist.

It's stupid that GPs are overworked to the point that getting proper diagnosis and treatment means needlessly taking up more of their valuable time.
>> No. 4086 Anonymous
2nd December 2016
Friday 6:24 pm
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Clearly in your nans case there is a problem and she needs to see a specialist, but the doctor is probably so used to seeing 10 people a day with sprains and strains that he just reels off the standard spiel without thinking about it.

If you are a first-aider, the advice "by the book" is that if you have a suspected sprain or strain, you tell the patient: "if you can walk on it it's not broken - go home - R.I.C.E. - it's normal for it to turn black - see your doctor in X days if it doesn't get better."
What then happens is that the patient goes straight to a doctor anyway, the doctor tells them the exact same thing. Then the patient goes straight to A&E, and they get told the exact same thing again.

The guy who taught me first aid was a great guy, he drifted a lot into teaching us about situations where you shouldn't do stuff by the book, which was getting him into trouble whenever his teaching was assessed. One thing he told us was that if you think it's a strain, ignore the book, just send them straight to A&E because they'll end up there soon enough anyway, and giving them the "correct" advice wastes more time in the long run.
>> No. 4089 Anonymous
2nd December 2016
Friday 8:29 pm
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>Well she didn't go immediately because no-one would have been able to take her without leaving my grandfather, who needed constant care, on his own.
Not immediately is understandable, but three weeks!?
>> No. 4091 Anonymous
2nd December 2016
Friday 9:20 pm
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Do you have any idea what it's like to live with an Alzheimer's patient and have all your family working full time jobs?
>> No. 4093 Anonymous
2nd December 2016
Friday 10:09 pm
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What sort of shitty job were you doing that they wouldn't let you go home to sort out a family emergency?
>> No. 4095 Anonymous
3rd December 2016
Saturday 3:12 am
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I believe you've posted here about your situation, and you have my sympathies, but if a relative's foot turned literally black and you didn't take them to A&E immediately then you weren't thinking straight.

No offence meant - just speaking plainly.
>> No. 4096 Anonymous
3rd December 2016
Saturday 7:44 am
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I think you're both missing one key point here, which is that the OPs nan didn't tell him, or at least massively underplayed her symptoms as >>4080 said.
>> No. 4098 Anonymous
3rd December 2016
Saturday 2:12 pm
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At the time, I was living on the other side of the country and she was living alone caring for my mad grandfather. It was 5 o'clock in the morning when this accident occurred and probably a weekday. She couldn't go to the hospital by herself. When she got around to telling her children what had happened she probably did downplay her symptoms. What really happened is lost to the passage of time now, but it doesn't matter.

Even as I type this I can hear downstairs my mum raising her voice at my nan over the phone - something like 'well is it in your ankle or is it in your knee?' It's difficult to get a straight answer out of her and she seems to change her mind from day to day. Yesterday she said the pain used to only be in such-and-such a place and I said hang on you told me before the pain hadn't spread. What can one do with a patient like this? At this point I think we'd have to trust in either a specialist or an x-ray to find the truth.
>> No. 4104 Anonymous
3rd December 2016
Saturday 7:58 pm
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Glad I'm a filthy Italian. We don't chuck our grandparents into abusive care homes, or let their feet rot for weeks. There is something wrong with you English people.

Take a week off, go to your nan and get her to a hospital.

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