Bollocks II (The best and the worst)

'The patient is a 37 year old male, he initially had groin pain for the last five weeks which he thought was muscle strain. However two days ago in the process of self examining his testicles he discovered acute tenderness and swelling in the area of the head of the epididymis. He is normally fit and healthy, although he is a shift worker. He takes no medicine and is not allergic to anything. He has not been sexually active for the last two years and has no urinary symptoms or symptoms of any sexually transmitted disease.'

I'm sitting in my GP office, the GP himself looking rather bored. The patient is myself and I'm a little concerned. I discovered the tenderness last night and while I treat myself for most injuries and illnesses, this is a bit outside of my sphere of knowledge. The GP surgery sees me ten minutes after I phone for an appointment – so full marks there.

The GP examines me, and hands me a prescription for Flucloxicillin, an antibiotic that on getting home and doing some research seems to be not ideally suited for my problem. Still, what the Hell, it's a week course and if it hasn't resolved I'll see him again.

A week later I'm back sitting before the same GP, the pain has got worse and spread into the other side of my groin. I'm a little more forceful.

He examines me. Well, he examines my healthy testicle and completely ignores my left one, the one that is paining me.

“Are you going to refer me to a urologist?”, I ask, “maybe under the two week rule?”

He smirks. 'That's not very helpful' I think.

“Go to Queen's A&E”, he tells me quite sharply, “Maybe they will scan you, if not phone me and let me know”.

It's not really an A&E job, but he can refer me through A&E – I just need a referral letter.

“Are you going to write me a referral letter?”

“No, just turn up”, he tells me.

This is naughty, the GP should write the letter and talk to the speciality – I try telling him this but he isn't listening.

“Just go to A&E”, he says, “Let me know if you are lucky”, and he motions me towards the door.

I leave thinking that I need a new GP. However I consider myself honoured, I've never heard him say more than four sentences during a consultation.

I hop on the bus to Queen's hospital already rehearsing the apologies that I'm going to make. I'm taking the bus because I suspect that the cost to park will be greater than the cost to getting two buses.

I reach Queen's, grab something to eat from the canteen and head to the A&E. I chat to the greeting nurse, starting with an apology, but he apologises to me.

“We don't have urology specialists at this hospital”.

I grit my teeth and think about strangling my GP.

“Your best bet is to go to King George's hospital, they have urologists there – sorry”.

I let him know that it's not his fault that my GP is an idiot and hop back on a bus to get home.

The bus breaks down and I walk the rest of the way. It's not been a fun day so far.

I decide to drive to King George's hospital and damn the cost – in reality driving and parking saves me £2.40. I head into the A&E to book in, the first thing I do is chat to a doctor at the reception. He listens to me and asks for the GP referral letter – I tell him that the GP told me that I didn't need one and that I apologise for the (lack of) actions of my GP.

The doctor calls over someone who I assume is one of the admin managers and asks her to ring the surgery.

With professionalism and grace she phones the surgery, explains to the GP that he's done the wrong thing and asks him to fax over a referral letter, the GP agrees to do this.

During the rest of my stay at the hospital no such fax appears. Sadly I'm not surprised.

I wait ten minutes before I'm seen by the triage nurse, considering I feeling rather relaxed my observations are a bit worrying (SpO2 of 95%, BP of 141/92 Pulse of 99), I think I need to take up some sort of exercise once this is over.

Once more I apologise to the triage nurse, she's very nice and tells me that she'll have a chat with the urologist as she is in the department at the moment.

I wait for about an hour, I'm not too sure how long exactly because I've got my nose buried in a Rick Dakan e-book. A young lady doctor appears and calls my name. We find a consultation room and she examines me and takes my history. She's got a very pleasant manner to her even if she does tell me that these things take longer to get better in the 'older man'. I splutter somewhat until she looks at my notes and, somewhat confused, notices that I'm only 37.

I think it's time to lose my grey beard.

She gives me two different courses of antibiotics better suited to fight any infection of the epididymus and books me in for a scan next week. I'm impressed with the speed of the scan and with the bedside manner of this doctor, the antibiotics will fight any infection (which is what I think I have) while the scan will rule out anything more malign like cancer or testicular torsion.

I head home happy that I'm being well looked after.

In one day I saw both the best, and the worst, of the NHS – I'm so unimpressed with my GP (I dread to think what my GP would have suggested if I hadn't pushed for being referred – would he have referred me or tried a different, equally ineffective, antibiotic), and yet I'm incredibly impressed with King George's hospital and the urologist and nursing staff there.

I have my scan on Monday – hopefully it'll show everything normal. Fingers crossed.

—–

For those that saw the last episode of Battlestar Galactica – did anyone notice that when Lee Adama took his helmet off he had a hairstyle reminiscent of a certain 'Ace' Rimmer?

16 thoughts on “Bollocks II (The best and the worst)”

  1. My other half had similar thing few yrs back. Must admit got him seen by my collegues in A&E straight off – more as it was causing us ++ stress (new yr spent thinking it could be cancer not great!).Hope you feel better soon – you'd be surprised how common it is – when He did say to some of his friends about it several of them had had it as well!!

  2. Glad that King Georges were good to you, i have nothing but praise for that place, but Queens… what a useless hospital poorly set out confusing and just poor, shame as most the staff seem to want to work. To think they wanted to close king georges A & EGet well soon Tom!

  3. A similar thing happened to me with my GP telling me to go to A&E. I suffer with eczema in my ear canals. Every few years, my ears get bunged up and they need syringing.I woke up one morning (almost 9 months pregnant) with my ears completely blocked. This is painful, I can't hear and it makes me dizzy. So I rang the GP to make an appointment with the practice nurse to be told (and I quote verbatim), “our nurse doesn't do ears”.

    DOESN'T DO EARS?????

    I'm going to adopt that idea to my work. Any tasks I'm not too keen on, I'm just going to claim I don't do them.

    The GP refused to syringe them himself as it is a nurse's job.

    So, they told me to go to A&E.

    Horribly embarrassed, I arrived at A&E reception and explained the problem. I was duly triaged. Unfortunately, because I was heavily pregnant and 'dizzy' I had to have an ECG and a foetal monitor….. I had been stuck on this monitor for 2 hours, pleading for someone to look in my ears as there was nowt wrong with my heart or with the baby, I just had bunged up ears.

    The ENT SHO agreed to see me on the ENT ward but I wasn't allowed to walk because I was 'pregnant and dizzy' so had to be wheeled up… I'm staff at this hospital and I saw just about everyone I knew, who all assumed I was in labour. I was so embarrassed explaining that I was in hospital, in a wheelchair because my ears were bunged up.

    Finally, the lovely ENT SHO hoovered out the goo and I was instantly better.

    What a palarva – and all caused because my practice nurse 'doesn't do ears'.

  4. Faulty GPs – a succession of them, four to be precise – ruined my childhood and affected my life (in terms of academic stuff that I didn't get the option on, unpleasant experiences I had to put up with, etc) to this day. Also, I still jump in terror when the doorbell goes – something related to aforementioned faulty GPs. I am now nearly 40.Which is why I want to heave everytime I see something or someone suggest “if you're worried, have a chat with your GP” – yeah, those all knowing avatars of wisdom and compassion in white coats.

    Please note I'm not saying there are no good GPs – there obviously are, but it is by no means 100%, or in my experience even 90%, of them.

    Sorry for the rant – hope the… erm, manly part gets better soon, and yeah – lose the beard, if you THINK it makes you look old, you're reaffirming a load of negative thoughts you just don't need.

  5. Worked with a urological surgeon who forever ranted about the GPs who gave course after course of antibiotics for UTIs, allowing the bladder cancer to really take hold, which was when he saw them.It's not just an NHS problem, goes on here in the US as well.

  6. If you as a health professional can't find a decent GP, what chance do the rest of us have?(I think I have found one, actually, but I'll only know for sure if I don't die over the next few years from something undiagnosed)

  7. We are always getting calls from people who's GPs are useless, though quite often we can give them the name of a good GP at the same practice. So good GPs are out there! You might have to go through a few to find them though.I think my best example of 'useless GP' was where we went to a 45yo woman who had been having problems for months, had developed a limp and was continuously going to the GP. She died less than 2 days after we saw her, most likely of a brain tumor. Though of course said 'useless GP' won't be touched by the GMC.

  8. re:ace – yeah i missed that but on a re-watch – you're right! (i was too busy waiting for something to happen in the last 20 minutes i missed it)but anyway, all the best with erm, yeah, all the best!

  9. Firstly lose the beard especially if its grey.Get well soon, any news on your new book?

    GP's in my experience fall into three categories.

    The I'm so busy why darken my door

    Will as soon as you arrive get out the drugs book and start flicking thru and soon as you start talking, work out what might work( assuming it's nice and cheap). So they can pack you off again, with the comment that if they don't work come back in week or two (when they will be skiing etc..)

    The ones who care and are really good.

    These never stay in the surgery very long and often replaced by the first ones or have so many patients you may have to wait for a days to get an appointment. (Assuming the 'helpful' receptionists allow you in at all.)

    the last lot a bit pill happy.

    My doctor falls into this category, I have pills to take for one thing, more pills to take to counteract the side effects of the 1st lot and some pink muck to counteract the side effects of the 2nd set of pills. It was quite expensive until the pharmacy told me about pre payment.

    Of course there are exceptions to all rules and these are my own experiences only.

  10. Seems most GP's are the same. Mine will get you into all sorts of clinics that are government target related and then everything you go to them for thereafter seems to relate back to weight smoking breathihng having long hair or nose picking. In the time it took for my Mum to die of cancer (Feb-Oct) the GP visited her once although she was housebound and refused a referral to MacMillan. The Doctors would listen to her symptoms over the phone write a prescription and then ask my Dad to go and collect it without even seeing her! Me thinks it's high time I changed GPS………….

  11. I had a very nasty dental abscess that took my NHS dentist three years to deal with it appropriately. (And that's a rant I've indulged on many an occasion.)While I was waiting for the dentist to get her act together, I'd go to the local GP surgery when the infection got too much to bear: pain, swelling, copious amounts of pus, and numerous ghastly symptoms as my body filled with bacteria.

    I'd detail my symptoms to whichever GP I got to see (you don't have your “own” GP in our surgery), explain that I had a dental abscess, and explain that I was awaiting dental treatment.

    So, what did I get?

    One GP prescribed loperamide hydrochloride (yes, they are for treating diarrhoea), one prescribed ant-acid tablets, and one referred me to an optometrist. Yes, really.

    One of them had a three-minute timer on his desk and that's all the time you got before he'd say “next”. I bet he does well in the efficiency stakes.

    I did have a fantastic GP in another part of the country some years back, but he quit and went into private practice. Not surprising, really.

  12. I had the EXACT same problem. Still do, actually, as I employed the time tested 'ignore it and it will go away' treatment. It comes and goes. Some days it's fine, others just a slight sensitivity, others almost too painful to touch. Sometimes bilateral, sometimes unilateral. I chalk it up to a vasectomy and a possible blockage in the vas, but who knows. Post op I had a similar feeling, though that was years ago.

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