"Emergency diagnosis and surgery"

Recently I, a very healthy, fit, slim, adult, with no prior health issues presented at the Emergency Department with severe stomach cramping. The pain would come in waves and was quite localised to upper central abdomen. A junior doctor on rotation kindly looked after me and put me at ease. After a little trouble putting the cánula in, the medication kicked in and the pain dropped. Blood tests came back ok and after staying a little while longer I was given the ok to leave. No ultrasound was given because the department was closed. The doctor gave the instruction to go to my GP, suspected ulcer, but if the pain got worse to go back to the Emergency Department.

The pain got worse; I went back to my GP the next day who referred me for an ultrasound. By the time I got home I couldn’t walk the pain was so bad and I was bed ridden for the next 3 days. Pain was so unbearable I went back to the ED. The same approach was taken, medication, bloods and some stomach prodding. Bloods came back fine, pain relief did not work and I was unable to lie flat, e.g. I had to stand and bend right over or curl up in a ball with my knees up, crying in agony. No food had been consumed for 6 days by this point and very little fluid. The registrar thought it was appendicitis or gall stones, even though those areas were not particularly painful. It was the weekend and so the registrar said no ultrasound was available but they would help organise one through the hospital during the week. Someone would be in touch.

The opioid did not work so more medication was given which essentially made me numb. I was released with Panadol and codeine. By the time the drugs wore off at home I was in agony and the next day I went back to hospital in an ambulance. I couldn’t walk and the pain was unbearable. I was left on a bed for about an hour before I could go into emergency as it was busy. The ambulance staff stayed with me until I was checked in but what became very apparent was that I would be ignored until there was a bed for me, which ultimately meant staying in agony for this time. How can this be right?

The next doctor that saw me administered pain relief, took bloods etc. and then said, this is your 3rd visit let’s get you upstairs and sort this out. Hallelujah! Should it really have taken 3 visits to the ED?

Once on the ward a junior surgeon came to examine me. Within 1 minute the surgeon dismissed the other suggested diagnoses and confirmed a CT scan was needed as potential peritonitis/intestine issue. 24 hours later I had had 60% of my large intestine removed and my appendix (intussusception). It was a medical emergency. This happened 7 days from my first admission to ED.

The news came like a bolt out of the blue and did not go well. Why is it that there are always at least 4 medical professionals surrounding your bed?! I feel it is very intimidating when receiving bad news and from my perspective unnecessary. I requested information in order to understand and buy time to process what I had been told.

I need to say a special thank you to Dr Meg, for her patience, support and outstanding communication skills. She really did do her absolute best to try and explain the situation and put me at ease (as I was quite hysterical by this point) whilst still expressing the seriousness of the Issue. Dr Meg spoke with my GP friend and showed me all of the results to explain the nature of the medical issue. This sort of approach (building trust for the patient) has got to be the future of medicine.

The surgeons, and the support team were excellent and I have no doubt that they  pulled together so they could operate on me immediately. The nurses on my ward were also excellent, although I would say rushed off their feet is an understatement.

Because I was readmitted into hospital after being released I missed my results at the outpatient clinic and as such I need to wait 6 weeks to find out the news and speak with a surgeon.

I have chosen to tell my story for several reasons:

1. To provide commendation where required

2. To raise a major concern over the unavailability of ultrasound/X-ray services after hours and at weekends

3. To raise concerns over the approach taken to treating patients in ED (is it about finding out the issue or giving people drugs to numb the pain and send them home?)

4. Communication time frames post discharge - 6 weeks is too long to wait before you have a chance to understand the full scope of what has happened and ask questions/seek results.

5. Bedside manner or the lack thereof when delivering bad news. I have heard too many horror stories from friends, family who are confronted by resources who seem to have forgotten the impact of said news on the patient’s emotional wellbeing. The effects of which are felt long after the surgery is finished.

6. Waiting room at ED - no assessment of people whilst they are waiting.

I hope that this email goes some way in helping improve processes/hospital focuses and that the people at the hospital that really go above and beyond and sincerely thanked.

Thanks for saving my life.