South doc / A and E experience

barbarag49

Hi all,
Sorry if this is inappropriate forum - just getting used to this.
Just wondering what people think about this - not sure whether we should do anything or just leave it. A few weeks ago my husband became ill with a pain in his side, fever and vomiting. Same thing happened a month ago and when he vomited he got better so we thought it was food poisoning or something. The pain didn't go away and Saturday night we went to South doc. By this time husband couldn't walk without being doubled over and was in agony. The doctor said it was a kidney stone. He said it might be appendicitis and if the injection he was about to give didn't alleviate the pain to go to hospital. The injection worked and he prescribed painkillers, said it was a kidney stone ('if it looks like a dog and barks like a dog, it's a dog). 3 days of painkillers, no relief. GP three days later, rushed him to hospital saying he needed emergency surgery for appendicitis. While in hospital we met a horrible doctor who said my husband didn't look in enough pain to have appendicitis. He pretty much accused him of faking his pain. Ignored for 5 hours, a surgeon eventually examined him and said he needed surgery straight away. Appendix had broken off, bowel pushed it up against his stomach. 6 days in hospital on intravenous antibiotics, massive scars. As I say, don't know if we should just leave it but I can't get over the fear of what if we didn't go to the GP. Misdiagnosis of the kidney stone was so dangerous because we expected pain.

stretch00

Hi,

From a clinical perspective, its possible that kidney stones and an infection associated with them, coupled with the pain of a stone on the move might present as flank pain in the same area as the appendix, so the initial trial diagnosis is plausible. I would find it difficult to consider this a misdiagnosis. The actions of South doc appear reasonable and logical as does his advice to you to got to hospital if injection didn't work, equally as the gatekeeper, your GP having further information available to him - the recent continuation of symptoms history - appears to have acted in a reasonable and logical manner and considered renal calculi/colic less likely at this point and sent you on to hospital. The measurement and assessment of pain is always a contentious area, but in very simplistic terms, pain is what the patient says it is until proven otherwise, and should be treated accordingly. I have seen the toughest of people squirming with pain from appendicitis, and kidney stones so it appears that here is where things may have gone wrong - when someone appears to you to have not taken into account the significance of the pain, and associated it with the other symptoms. To address that issue, I would suggest that you contact the patient liaison staff in the hospital, and submit a formal complaint seeking to either meet with the doctor and have him explain his rationale and subsequent events or receive a written response. There are many reasons why it can take 5+ hours to be seen in an Irish ED, and it is very likely that simple activity levels were to blame, and given the history that you have presented, it is difficult to say that the outcome of non laparoscopic surgery and significant medication would have been any different given that original symptoms presented about a month prior. I hope this is of some use to you, and to answer your question - no, don't just leave it, contact the hospital regarding the apparent delay in assessment, and put your mind at rest.

barbarag49

Thank you for your reply. I agree with you and my real difficulty is not with south doc so much as the doctor in A and E. Having said that, even after administering the injection in south doc, it was half an hour after before my husband could even stand to leave the premises. Even if it had been a kidney stone / infection, his pain was so severe (10 out of ten on the scale) on reflection I can't believe we weren't sent to hospital. Our GP said it was wrong of the south doc to place the decision whether or not to go to hospital in our hands and that if appendicitis was suspected (which it was) then we should have been sent to A and E. As for the wait in A and E, I fully expect and understand this. But it would have been much easier to wait for 4 or 5 hours if we knew it was appendicitis and were awaiting a bed rather than being left sitting there having been told it was not appendicitis and being utterly terrified as to what it might be. I think we will follow your advice re: patient liaison, just to put it behind us completely. Thanks again.