[Closed] Foot sprain - A&E or MTFU?

Thank you for your googling skills and making my point Drac. As I said.....the system doesn't appear to be screwed, f*ck*d, or broken. Despite the enormous strains put on it and the constant criticism from some quarters.

Ay? They declare in major incident and you think that's fine.

Members of the general public are not really the best placed to be able to self-diagnose what might be an emergency or not.

It's not a complicated but do get what you mean that people can't use common sense to work out what's an emergency to them doesn't always warrant A&E and there are many other options.

I am sure any right-minded A&E doctor would rather see someone and say 'no, it's just a sprain, take some [insert name of correct drug here] and rest up'

They'd rather they used another pathway.

Mine's definately not an emergency so can I have the STW verdict - strap it up, leave it alone, elevate and ice pack, hut tub and a beer?

[url= https://farm2.staticflickr.com/1525/26414766906_4f0afbb3f5_c.jp g" target="_blank">https://farm2.staticflickr.com/1525/26414766906_4f0afbb3f5_c.jp g"/> [/img][/url][url= https://flic.kr/p/GfbzVC ]foot[/url] by [url= https://www.flickr.com/photos/89686376@N04/ ]WCA![/url], on Flickr

On a mildly more serious not, Drac if you comment please say the right thing as I kind of trust your judgement but would hate to amputate because you recommended it as a joke but forgot the smiley face

Therein lies the problem. Members of the general public are not really the best placed to be able to self-diagnose

Is it members of the general public with no medical training who operate these minor injury units?

Or possibly they are trained medical professionals?

Even the most basic triage would indicate that this is not an emergency.

What has you MIU said WCA?

I can't examine or diagnose on the web. 'D

But if it helps it's not an emergency.

Even the most basic triage would indicate that this is not an emergency.

Or a bit of common sense.

On MIUs....

I thought I would just research MIUs in my town (admittedly, they aren't something I would automatically think of attending)...

I live in Harrogate and the main hospital in the district is Harrogate hospital, however they don't have an MIU – I would have to go to Ripon (12 miles) or Selby (34 miles) to get to a MIU. So, in that scenario, is the correct course of action to go to the Ripon MIU or to go to the much more conveniently-located A&E at the main hospital in the district which is 2 miles from my house / 1 mile from work / 2 miles from our girls' school.

I would have to go to Ripon (12 miles)

Do you have a car?

Do you have a car?

For what it's worth, our hospital says [url= https://www.hdft.nhs.uk/patients/in-an-emergency/ ]suspected broken bones or dislocation mean a trip to A&E[/url]. The OP could reasonably believe they have a broken bone (as I said before, members of the public are not really able to self-diagnose).

should/could I drive 12 miles?

Well he can walk, so I guess he can drive.

If not, what about a friend or partner who could help out?

Yeah some of them aren't close by Otley might be closer. Not sure if Harrogate has a unit within the A&E too some do have a section to filter off those that can't work out that sore toes isn't an emergency.

Yes but if I (like the OP) had a sprain (that may be a break), should/could I drive 12 miles?

Best walks 2 miles then or maybe he should get an ambulance ask for an R1 response because he can't work out if he's going to die or not.

For what it's worth your local authority says this for sprains or breaks.

Minor Injury Units (MIU)

We have Minor Injury Units located at Ripon Community Hospital and at Selby Hospital. These can provide assessment and treatment for:

Sprains and strains
Broken bones
Wound infections
Minor burns and scalds
Minor head injuries
Insect and animal bites
Minor eye injuries
Minor injuries to the back, shoulder, and chest

[i]What has you MIU said WCA? [/i]

A&E is within hobbling distance (one reason for choosing this house) and MIU is down at the South Hants where parking is a nightmare and extortionate, the queues always seem long and full of wierdos and it is raining.

I thought I would rely on the STW hive mind for diagnosis. They have chosen my car, where to live, tyre size etc. I have lost the power of independent thought 🙂

I also think I have broken or badly bruised my big toe on the other foot but google gave this advice : Most broken toes can be cared for at home and medical treatment may not be necessary.

so I am ignoring that pain

For what it's worth your local authority says this for sprains or breaks.

They also say

Is it an emergency?

If you’re in a life-threatening or serious situation you may need to call 999 for an ambulance or, if it is safe for you to do so, visit the Emergency Department at Harrogate District Hospital independently. Examples of emergency situations are:

Severe chest pains
Breathing difficulties
Heavy bleeding or deep wounds
Loss of consciousness
Serious head injury
Severe allergic reaction
[b]Suspected broken bones or dislocation
[/b]Overdose or poisoning
If a person has numbness or weakness down one side and/or has problems understanding what you are saying or has new problems with their speech

So you can see how it is difficult for members of the public to know what to do with their own hospital is giving them mixed messages.

Hahaha! WCA you're a [s]walking[/s] hobbling disaster.

So you can see how it is difficult for members of the public to know what to do with their own hospital is giving them mixed messages.

He's walking on it. It's not an emergency but I do see how some people can be confused but some simple thought would help.

Toes snap too easily. Look at the various sizes, shapes and angles of the toes in my photo. There may have been some blunt trauma required to generate that profile

Do you reckon it is worth going to the MIU?

I do see how some people can be confused but some simple thought would help.

Suspected broken bones or dislocation

So if you stub your little toe on the bed frame and it hurts a lot, goes black and looks a bit crooked, would you go to A&E to get it treated?

The OP is not in an emergency situation. He can even walk without a stick.

Even if he broken a bone in his foot, why would the A&E be preferable to the MIU for treatment?

Even if he broken a bone in his foot, why would the A&E be preferable to the MIU for treatment?

Do you reckon it is worth going to the MIU?

Worth [s]popping[/s] hopping along.

[i] why would the A&E be preferable to the MIU for treatment? [/i]

Because Accident and Emergency sounds dramatic where as Minor Injury Unit sounds like you are just a wimp.

When I use A&E it is either because I have been stretchered there or am unsafe to drive (A&E is walking distance).

I managed to walk about 1 1/2 miles with a badly broken ankle the first time I did it using my bike as a crutch. Triage nurse said if I could walk on it then it wasn't broken and to go home and rest it. Went back as the swelling was almost causing the skin to stretch and shear and was told I was stupid for leaving A&E without an x-ray for what was a clearly broken ankle. I pointed out I was sent home by triage and it went a bit quiet. A nurse later gave me a photocopy of all the medical notes 'in case I needed them for any dispute'.

Will head down when the rain lightens and see what they say.

To be fair to the OP, it's the sort of minor injury that lots of people go to A&E with (watch a few episodes of 24 hours in A&E and you'll soon see what I mean) and they never seem to get turned away. They might have to wait a while to get treated, but they if you're happy to wait a few hours...............

To be fair to the OP, it's the sort of minor injury that lots of people go to A&E with (watch a few episodes of 24 hours in A&E and you'll soon see what I mean) and they never seem to get turned away. They might have to wait a while to get treated, but they if you're happy to wait a few hours...............

They do but if you watch St G's has a minor injury section where they triage them to. Even if not just because they will see them doesn't mean it's the right place to be, taking up clinicians for a minor injury while more serious cases wait. Ambulances queue as there's no room because someone has a bit of a sore ankle has taken up a room.

[IMG] [/IMG]
Could be worse....

Okay I am back from the South Hants MIU
[b]
Approximate timeline[/b]
20 minute drive there
20 minute wait to see someone
10 minutes consultation with the delightful Claire
20 minutes to drive home

[b]Outcome[/b]
Yes, it appears I have sprained my ankle by twisting it inwards too much. No need for x-ray as there is no sign of bone damage. No need for strapping as this has no proven medical benefit. Rest, elevate, Ice, Ibuprofen and gentle exercise

I am happily reassured but not liking her statement that this might still take 6 - 8 weeks to get better so take it easy.

[b]

Not Serious Piss Take of the advice given[/b]
X-Rays are used to see if there is any bone damage but I can't see any so you won't get an x-ray
Rest your ankle and do these exercises
Keep you ankle elevated while walking around as normally as possible
We don't offer strapping or support for sprained ankle as these are not medically necessary but try to wear strong shoes or boots to support the ankle

Nice clear and unambiguous advice there then

😉

Video of hopping goose step please! 😆

[i]Video of hopping goose step please! [/i]
Not until I have finished resting and doing these exercises. I can't do two things at once...

For future reference, just checked to find a local minor injuries unit.

It actually called an "Urgent Care Service".

Two days later, I went to see a sports physio who actually fixed the problem.

Nice clear and unambiguous advice there then

And no 4 hour wait. It's almost as if it that's how it's supposed to work. 😀

Yup they can have different names.

OP should definitely have called an ambulance. He's a taxpayer and he pays national insurance after all, he should get full service. Daft to risk driving with a sore ankle; what if he'd crashed?

And his partner can't possibly take him they go out on a Friday night, it's their only night all week they've worked hard all week.

Also a. It of a drive from a hotel in Sweden.

Drac, you don't always need to think of the defensive answers, sometime comments are dumb enough/tongue in cheek enough for the simple reply.

Ps leg now elevated with some frozen artichoke cooling it while watching re runs of MASH. How much more can I do to recover? The colours are prettier now as well

Drac, you don't always need to think of the defensive answers, sometime comments are dumb enough/tongue in cheek enough for the simple reply.

V8 isn't being serious. .

V8 isn't being serious

Edit; oh and his partner could follow in the car, because, you know, you always get seen quicker when you're rushed in by th'ambulance... 😆

Drac - Moderator

Ay? They declare in major incident and you think that's fine.

No I don't think it's fine. I said I think that the system isn't [i]"screwed",[/i] despite the enormous strains put on it. The comment in your link suggests precisely that :

[i]However it said it had not been forced to cancel any operations.

By declaring a major incident, hospital bosses are able to bring in extra staff - allowing them to open extra beds to cope with the demand.[/i]

BTW in an example of staggering irony I came off my bike less than a couple of hours ago, after phoning 111 they have booked me in for 11 o'clock this evening at the out of hours GP services at Croydon University Hospital, with a suspected broken collarbone - I kid you not 🙂

I suspect that they will send me for an x-ray and possibly treatment at the A&E department. I'll let you know if the 'major internal incident' declared at Croydon University Hospital is helping them to cope or whether they are "screwed" 8)

Having to declare a major incident, which as the name suggests, is kinda reserved for you know, incidents that are unusual and major in nature, in order to deliver the core product sounds pretty screwed to me.

I wonder what they'd do if they actually had a major incident to deal with whilst they were dealing with their internal, pretend major incident? Would they declare an EXTEREMELY major incident, enabling them to crack open the clone pods, and start feeding the staff amphetamines to enable them to work triple shifts? I'm with Drac. If a Trust is declaring MAJAX for the day job, it's in dire straits.

Screwed to me means broken ie, incapable of doing what it's supposed to do, which in the case of A&E means not delivering the service it exists to provide. Obviously some people have a different definition.

However it said it had not been forced to cancel any operations.

By declaring a major incident, hospital bosses are able to bring in extra staff - allowing them to open extra beds to cope with the demand.

Declaring a major incident in order to cancel holidays, cancelling days off to force staff to come I'd say means they were screwed. It was only that which meant the operations weren't cancelled.

Screwed to me means broken ie, incapable of doing what it's supposed to do, which in the case of A&E means not delivering the service it exists to provide. Obviously some people have a different definition.

I'm lost me.

Screwed to me means...incapable of doing what it's supposed to do

Ignore requests to mtfu.

Just go and see a sports physio. I 'sprained' my foot badly in 1997. Went to GP when it was still hurting 3 days later. He said 'use a stick'. Used a stick for a few weeks, it got worse. Paid to jump a queue to Orthopaedics via NHS - they were confused and put it (ankle) in a cast to 'let it settle', and gave me crutches. Then shortly after my other foot started swelling (wtaf???).

After months of increasing agony in both feet and ankles, not being able to bear weight on either I paid to see a private sports physio. He straightaway [b]diagnosed the initial sprain as a subluxated ankle joint[/b]. He sprayed some cold stuff on the ankle and relocated the joint sharpish.

Some relief but by this time I'm being treated for some chronic inflammatory arthritis in both feet and ankles. After 6 months of not being able to stand let alone walk my employer let me go. I was now in a wheelchair and in so much pain it was only relieved by assisted hydrotherapy.

The initial sprain occurred at work, owing to some unseen spilled liquid. I had a witness. My employer actually requested that I sue them for compensation. The no win no fee people 'can't adequately prove causation'. ie walking on a subluxated ankle for months didn't necessarily cause/activate the arthritis. Just a weird coincedence then eh? Ho hum...

I'm still suffering daily pain and discomfort 19 years later. Although the disease is in remission and I'm no longer in a wheelchair, the damage to joints is permanent, I cannot run, and can only walk short distances. For someone who used to walk 35-40 miles and cycle upwards of 140 every weekend - quality of life, employability and overall fitness levels have changed

Needless to say, everyones mileage will probably vary, but if I could go back in time I would go straight to a reputable sports physio. My situation is hopefully very far from typical bit I would advise anyone NOTt to MTFU if that means the you walk on an injured joint. Do not do so until you have an expert opinion as to when, and how.

As for MTFU - nearly every day I wish I'd been a big ponce back then and I maybe wouldn't have had to spend the rest of my life proving how much of a 'man' I am dealing with daily/nightly pain and disability along with all the compromise you have to endlessly chew on

Sorry about the (badly-penned) earl-morning rant above, but the endless MTFU trend grinds my gears. Sl here's another. Mrs MR (chipping in here) - used to be a triathlete, training with a 'guru' runner who achieved some celebrity in the running world in his time. Her lower legs finally began to really hurt after running up to 100 blocks a day for a couple of years. He constantly exhorted her to run through the pain. He'd bark in uber-manly fashion - 'no pain no gain!!!'. So she ran through pain for about seven months until shin-splints finally put pay to any running. So she earned the pain, but where was the gain?

She also had a (and now two) subluxated shoulder joint and has been waiting for diagnosis/restorative physio from NHS for over a year, even as they worsen daily. No amount of bullying from me would get her to go and see a private consultant, as she will, unfortunately 'MTFU' through any kind of pain. Waiting on the NHS has once again brought chronic disability to the family. She's (according to latest consultant) now facing possible shoulder-joint fusion 'down the line', which is unthinkable. I care for her full-time, and we wait, and we wait. It's soul-destroying to see someone you love (anyone, even) in so much pain, so vulnerable, so dependent, and suffering so much uncertainty. It all started from a broken collar bone and subsequent surgery (NHS). She also 'MTFU'd' back then, coping with an untreated 5-piece clavicle fracture and torn rotator-cuff. It took second and third opinions to agree to fix via surgery (the bone was almost through the skin, yet it took constant aggro from me to acquire repeat X-rays from different angles to identify the extent and severity).

MTFU be damned. Unless of course you are being eaten alive by a bear, with an arrow in your neck, and a sprained ankle. But seriously. Sort Shit Out Right Now is much more important than any notion of testosterone being a cure-all.

@MalvernRider - spot on. I'm in constant pain from an ankle injury 25 years ago caused by hitting the ground (the falling bit was ok) whilst climbing at Stanage. I did get it X-rayed at Casulaty (no minor injury units at that time, entry point to the system appeared to be that or GP). Radiologist and houseman thought it was broken, registrar said it wasn't, told to take pain killers and keep mobile.

I did but after 3 months of getting worse to the point I couldn't cross the road in the time the lights stayed green a physio friend insisted I see a physio. First sessions were incredibly painful - tapping the bottom of my foot with 2 fingers had me suppressing a cry. After 6 months my legs were back to the same size rather than being able to circle the top of my right leg with finger and thumb of one hand.

I eventually got a referral to orthopaedics who diagnosed an old break and offered to fuse the ankle. After discussing the pros and cons we agreed it was best left alone,

I'm not bitter about the mistaken diagnosis - people make mistakes, X-rays can be hard to diagnose but my mistake was taking a dose of MTFU and not going back to the GP to get a referral when it didn't get better.

I'd now go to whatever part of the NHS is correct (not A&E) if it happens again and ask for more help early.

Apart from a couple of posts this thread seems a bit 'willy waving" to me. OP has come here asking for some specific advice - trying to do the right thing. Why not have less of the patronising and bit insulting posts and stick to giving them some solid advice. Maybe even stop some of the bickering?

I know it's STW but even so...

You're right jamj1974 I was a tad blunt, sorry about that Flaperon. I get like that after nights especially after ones where some incidents weren't pleasent. Sorry again.

All rested up now so shouldn't be as grumpy but I'll probably still take the piss.

I'm not bitter about the mistaken diagnosis

I am. Though it doesn't make me hate the NHS , it makes me further hate what our leaders are making of it. We have a 'filtering' system in the SW, a consortium with whom your initial diagnosis somewhat hinges on which initial 'level' of specialist you are granted after initial GP consultation. In my wifes case she went 'backwards' from seeing a shoulder consultant to being-re-referred 8-9 months later to a physiotherapist ('because we relocated', huh?), who after saying 'we can treat this with physiotherapy', then 'forgot' to report back to the GP, who then somehow overruled her treatment plan and 'expedited' an appt with another shoulder consultant who as yet does not wish her to begin physio. WTF? 12+ months of ping-pong and reverse leap-frog = treatment stasis + ever-worsening injury and possible permament loss of function. I am enormously embittered and at a loss, tbh.

^^ that is totally understandable!