Worth complaining or should I not expect anything more from the NHS?

I’m not generally disposed towards complaining but wondered what the STW collective view is on here.

Eight weeks ago today I damaged my knee. Felt a “twinge” after being out for a run. Thought I could walk it off but after 3 days could barely walk, so went to A&E. I had an x-ray (which doesn’t show tendons or ligaments) and was told I’d damaged my cruciate ligament.

A&E sent me away with an appointment the following week to see the knee fracture clinic.

Appointment 1> (Dr.1) Sent me for another X-Ray and then said the knee seemed fine and was likely to be a strain. No harm done, keep walking on it normally and have some physio. See you in two weeks

After 2 excruciating physio sessions, my physio wasn’t happy. Sent me back to the fracture clinic.

Appointment 2> (Dr.2) Disagreed with Dr.1. Said I needed an “urgent” Ultra Sound Scan, suspecting Patellar Tendon damage. Also said no more physio, no driving, no walking. Leg in a splint. See you in a week after the Ultra Sound.

No ultra sound appointments for 2 weeks. Finally had it yesterday. My knee is now swollen to double the size of my good knee and will not bear weight. The ultra sound showed about 8 large “pockets” of fluid around the patellar.

Appointment 3> (Drs, 1, 2, and 3) all poking and prodding at me before deciding to drain my knee (Jeezus H that smarted). They now want me to have an “urgent” MRI scan (2-3 weeks wait apparently) before they can decide on what to do next. No idea when they’re going to send for me but not expecting to get another appointment inside a month.

Am I being fobbed off, or is this about right. If I am being fobbed off, is it even worth complaining?

Hey feel free to go private if you aren’t happy with the free service the NHS provides. Edit: yes I know it’s not “free” per se, MY TAXES etc.

Doctors can only make their best guess, no?

Hey feel free to go private if you aren’t happy with the free service the NHS provides

Sorry, did you say “free”

How is it Free??

Hmmmmm

It would have been nice to have got to where you are in a few weeks less for sure. Unfortunately medicine is not an exact science and there is rationing – so you cannot send everyone for every test just in case – the docs try to decide who needs the tests.

I’d chase up the MRI -make a bit of a nusience of yourself might help – its an unfortunate thing but those who shout loudest get the best treatment on the whole.

If three docs all had a prop and poke my guess is one was a senor bod and if they can’t find an obvious issue then that may be the best they can do – hence the MRI. If you haven’t seen the orthopaedic consultand yet then I would have thought you should have done

So – try to make a gentle fuss and see if you can get the MRI more quickly – tell them you are unable to work and losing money or something that is not too far from the truth.

As regards making a formal complaint – wait until you actually have a diagnosis because it may be that the path you have been on is reasonable for what your injury is

Ah, I see you edited it

If you’d been that worried you wouldn’t have cluttered up A&E with a 3 day old injury, what harm did you do walking around on it for three days?
Personally 2-3 weeks for an urgent knee MR scan sounds pretty good, ask a private provider how long it would be before they can fit you in, then go and see the same ortho consultant privately. When the private hospital messes any surgery up, your local NHS can then take over and repair the damage (same consultant again).

such injuries are sometimes *relatively* hard to diagnose. Every person/affliction is different; medicine is sometimes an art rather than a science.

How do you think you are being ‘fobbed off’? I understand your frustration, but your wait sounds perfectly reasonable for an urgent but not emergency condition

cheers TJ. Like I say, usually I’m not given to making complaints and I work in the public sector myself so I know how it can be. I just thought that after eight weeks I would be somewhere further along towards a diagnosis.

If its any help I was waiting for an MRI scan last year. I phoned them and said if they had any cancellations I could get to the hospital at very short notice. Got one the next day.

Bregante are you paying for the service at the NHS? If not I’m confused by your comment?

In my experience the interpretation of X-rays is very difficult and can be contraversial between doctors, and they can be used for rough looks at tendons and ligaments, they just don’t show up very well.

My two penny worth is to say that doctors in the NHS are generally trying pretty ahrd to make the most of the resources they have available whislt dealing with a wide variety of ill informed public, who thanks to the internet think they know the answer before they even see a doctor. Not suggesting you fall into this catagory but I can definitely understand why they don’t send everyone off for all the tests straight away!

How do you think you are being ‘fobbed off’? I understand your frustration, but your wait sounds perfectly reasonable for an urgent but not emergency condition

That was my question.

missingfrontallobe – Member
If you’d been that worried you wouldn’t have cluttered up A&E with a 3 day old injury, what harm did you do walking around on it for three days?

So I should have gone immediately I felt it? It could have cleared up in an hour. I went because on day 3 I got up and couldn’t walk on it.

j-me has the best idea here. worked for the mrs a while back, seen next day.

Bregante are you paying for the service at the NHS? If not I’m confused by your comment?

I’m not getting all “I pay my taxes” (as I say – I work in the public sector). My original question was. Is this normal service, or should I expect more from the NHS. If it’s about right, then clearly there’s no point complaining.

cheers j-me. I’ll ring them now 🙂

I understand that there is a theory of RICE for sports injuries?

Rest, Ice, Compression, Elevation?

I’d wonder if the OP in the process of “walking it off” thought of this as a means of self treatment? Or has there just been an overdeveloped sense of MTFU?

[edit] Your treatment process has been fairly normal, in fact probably better than a lot of people could have expected. Which part of the public sector do you work for?

feel free to wonder

Knees are totally hard to diagnose – if something is wrong with the boney bits thats easy to spot. But the squishy bits and the fluidy bits – if they start acting up and there hasn’t been an obvious trauma to have caused it then get ready for a long process of stabs in the dark. Could be an injury or wear and tear, could be an infection, could be, could be, could be…..

I had my knee suddenly swell up 15 years ago, 10 years of appointments, blood tests, physio, hydrocortazone injections, tests on the fluids in the knee, xrays, cat scans of my knee (and an xray of my spine), crossing off injury, arthritis, wear and tear, rheumatoid arthritis, lyme disease, cancer and more other things that I can’t remember I was non the wiser (although reassured to learn I didn’t have RA or Cancer or anything else). During this time the knee continued to sporadically swell up, and inbetween times would always have at least some fluid around it, but with less severity and less frequency. In the end I just stopped having it looked at.

If a group of joints act up – that gives some leads as to a cause, and it also eliminates a lot of potential causes. If one joint acts up it doesn’t really indicate or eliminate anything.

10 years?
I’ll STFU then 😳

I had an x-ray (which doesn’t show tendons or ligaments)

It does show ligament, though nowhere near like an MRI does.

I’ve had to wait on average 6 weeks on the 3 MRI’s I’ve had over the past 2 years. Hope you get yours sooner.

Bregante, that makes sense, sorry I was just a bit confused by your comment.

Hope the diagnosis, treatment and recovery go well for you.

One suggestion, make sure your shoes/cleats/pedals are set up right when you get back on the bike, I nearly re-ruined my knees with bad shoes!

I’ll STFU then

– no, press on as best you can – better to try and get a diagnosis while the cause might still be evident. However try and have it looked at it as possibly something other than an injury – the fact you were running before you first felt the symtoms might be completely co-incidental. Its you, not the doc, thats making the link between running and the sypmtoms and perhaps you are diverting their attention as a result.

In the end the only indication I got out of all the tests was that I appear to be of an genetic type that can have rheumatic responses as a result of the presence of other infections. But theres been no further detection of any lurgy.

Sorry you’re in a bad way but I don’t see that they did much “wrong”. Nothing wrong with chasing up but getting yourself pushed up the MRI list might be hard work

Your story starts out with a short-term knee problem that arguably you could’ve gone to GP with rather than A&E. However, they confirmed no emergency & offered a clinic appt

Clinic reassessed and still felt no major problem (OK, seems they were wrong but you were still walking at this point it seems – “keep walking on it normally…”).

Significant problems begin at physio appt. You’re referred back and they escalate investigation now that things have deteriorated. Shame maybe that you couldn’t have ultrasound there & then but I guess the system does what it has capacity for. MRI’s expensive so they won’t have loads of machines and hence have long waiting lists and reserve it for significant problems (unless you’re on BUPA I guess).

I don’t think you have any reasonable grounds for complaint. They X-rayed you the first time you presented and then continued to try to diagnose and give treatment as the situation deteriorated.

I can see why you’re frustrated with the most recent wait, but the only way you can have no waiting time to use expensive kit is if they buy so much of it that it stands idle half the time, and people keep complaining about that sort of thing in the NHS!

Your best bet is clearly to vote yes in the AV referendum and do your bit to try to stop the Tories from ever forming another Government.

(edit: or start paying for private health care)

If its any help I was waiting for an MRI scan last year. I phoned them and said if they had any cancellations I could get to the hospital at very short notice. Got one the next day.

good idea,

plan b if you are really unhappy is to actually turn up explain to the team the situation and sit there until a gap opens up. By day 3 you will be such a (polite) PITA that you will have been seen. Afterall the NHS spends a fortune advertising the fact that people fail to show to their appointments

My main issue is I spent two weeks after seeing the first doc at the fracture clinic trying to walk normally and having physio after having two xrays which wouldn’t show damage particularly well in the first place. Then when I go back I’m given the exact opposite advice by being put in a splint which restricts all if the movements that I had been encouraged to do and am concerned – but accept I may never know, how much additional damage this has done.
Thanks for the advice maccruiskeen

but accept I may never know, how much additional damage this has done.

… or if

Indeed

it’s called getting old mate 🙂

Its all about the ifs unfortunately – trying one thing, then trying another thing – thats the process.

First of all there is no theory of RICE in sports injuries – it’s PRICE (P is for Protect). Secondly there is no such thing as a sports injury, only injuries that occurred during sport. Finally knee injuries are easy to diagnose if the correct person is doing the assessment.

aye, but who makes the assessment as to who the correct person to make an assessment is? And what if it isn’t and injury – but just seems like an injury? ❓ ❓ ❓

Simple answer is you need an MRI – which is now being done.

In an ideal world it could have been done quicker but the flipside of that is if everyone who had a painful swollen knee went straight to MRI the wait would be massive.

Clinical judgement is necessary – and that is what it is – an opinion – which can sometimes be wrong.

It is highly unlikely much further damage done, although not 100% impossible.

MRI should give a diagnosis and a good idea of what needed for improvement.

aye, but who makes the assessment as to who the correct person to make an assessment is?

the person making the assessment? arguably this has happened hence the referrals

I’m still suffering issues with my wrist a year later due to a crap assessment by Dr 1 , rule no1, never, ever be the last person to be seen in a fracture clinic

I’ve had two similar experiences:
15 years ago partially tore the ACL in my right knee – very swollen, painful etc. 3 days later went to GP, sent to A&E, X-ray, referred to specialist, short wait of a couple of weeks, i think, for MRI. Then another short wait for arthroscopy, cant remember how long but less than a month. After follow up had a month wait for physio (this was classed as urgent), then physio for 6 months.

Currently: sprained left knee in early december, swollen, stiff and sore and not able to bear weight but not as bad as previous one. Self treated doing the RICE thing for a week, then flexing exercises from my previous physio in the second week, then gentle cycle machine, stair exercises from week 3. Think I tweaked it again stepping off a curb over Xmas as it swelled up again. treated as before but have a persistent soreness at the back of knee and around the knee cap so went to GP. Got an x-ray within 1-2 weeks, referred for an MRI with a one month wait (private clinic doing NHS work) and referred to a specialist with a potential 4 month wait. The waiting is frustrating but understandable as the referrals are triaged and I’m low priority – I can walk and cycle just can’t run, play football or snowboard :(. Ultimately I’m just hoping for a more precise diagnosis so I make sure I’m doing the most effective physio.

Sorry to go on a bit but thought it might provide some comparable experience.

Finally knee injuries are easy to diagnose if the correct person is doing the assessment.

What a load of twaddle.

Finally knee injuries are easy to diagnose if the correct person is doing the assessment.

What a load of twaddle.

He’s still a student – don’t let the real world crush his dreams just yet 🙂

Finally knee injuries are easy to diagnose if the correct person is doing the assessment.

What a load of twaddle.

Guess it depends what you mean by assessment. Physical examination? and/or x-ray, MRI, arthroscopy? Took all of those to get a definite diagnosis for my first injury. I could have had a numpty specialist though.

RPRT – why is saying that knee INJURIES are easy to diagnose a load of twaddle?