Monday, January 30, 2012

waiting for a diagnosis

This is emerging as an interesting experience from inside the healthcare system. First of all there were conflicting potential diagnoses between German and English doctors, which in fact would have required almost opposite treatment. I was then unsure as to how to enter the NHS - having used the emergency department in Berlin, I was not sure whether to go to emergency or my GP when I returned to the UK... I think I made the wrong choice in going to my GP but in the end I got to the Trauma Clinic which is where I had to have a repeat xray and eventually I was referred for an MRI. This is the golden key to my diagnosis as it shows what is happening inside my knee joint - I want to know the status of my ligaments and my meninscus! But then, the comedy continues - because the registrar did not note my request for an MRI as urgent, I was told I would have to wait 4-6 weeks.... not happy... hobble back to the trauma clinic... ignored by the doctors...only the nurse would talk to me and interpret a message to the doctor... eventually she agreed to call and ask for my request to be urgent...So later that day I was offered a cancellation for the following day. I was told to make a follow up appointment in 3 days by the doctor, the clinic administrator could only make it in 5 days and the MRI technician told me it normally takes 10 days for data to be transferred approx 500m up the hill! This is despite the fact that there are posters everywhere advertising the new online medical record system! This is a challenging time for me. Every day I am involved in helping healthcare clinicians to better understand and use recent research in their healthcare practice. Almost 10 years ago, I was in a team that reviewed all the scientific evidence about whether joints should be rested or mobilised early after injury - the literature is fairly unanimously behind early movement... Yet I am stuck limiting my early movement in fear of the first not so nice potential diagnosis... Stuck in a rut again!

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