Archive for the 'Health, or lack thereof' Category

Imperative

Posted by on August 23rd 2018 in A bit of a rant, Health, or lack thereof

It's been a while since I had a rant about the NHS appointment system. That's unforgivable but I'll make amends right away!

Way back in the dark days I was told, in no uncertain terms, that I must attend all LRI appointments as they were scheduled for justifiable medical reasons and based on individual recovery progress. I remember a senior nurse threatening to take me off the monitoring course when I had better and more important things to do on one monitoring day, despite her not having the authority or grounds for issuing such a threat.

But now it's becoming clear that it's only imperative when it's important to them... when it's important to me they don't give a shit, they just change the schedule without giving any medical justification whatsoever. It seems that their accountability to me has been dispensed with as unimportant.

The post-discharge appointment system is simple - turn up for a blood-test, wait for the results (usually 90 minutes), sit in the waiting-room until called, see the Consultant Haematologist, show him/her which bits are still working and which bits are falling off, and be given a date for the next appointment based on the available evidence. For me it started with appointments every two weeks, if all was going well then it went up to every four weeks, then every six weeks, then every eight... You get the idea.

Then they started buggering about with it...

The last regular consultation was on February 8th 2018, and after that I was due back 12 weeks later on May 3rd, but they bumped that two weeks to May 17th at short notice. There was no justification at the time, but I was told later that it was nothing to do with my progress, it was to accommodate staff holidays. Nobody asked if we had any holiday plans that might be upset by their buggering-about.

At that May 17th consultation they said I would be moved to a 16-week cycle despite me having some worrying "late effects" which they encourage us to record and to report. That made the next consultation date September 6th, and I was bounced to my GP to get advice about those "late effects". Later, I saw my GP and was told that despite appropriate tests they couldn't determine the cause(s) of the "late effects" and that it was the job of the LRI consultants to investigate them during the September 6th consultation.

And now I'm sitting here looking at a letter telling me that the September 6th consultation has been bumped FIVE WEEKS to October 11th. The letter starts with the standard "Unfortunately it has become necessary to change..." and goes on to include "We apologise for any inconvenience caused", but contains no justification whatsoever. And I know that my GP's surgery has told them that my "late effects" should be investigated by the LRI team, because I had to authorise the GP to send my Care Record to them.

Accountability? Pah! All they have to do to make this more palatable is to explain why, but that's not a part of their process. Or they could have kept to the plan, which was designed so they can find and address minor problems in good time before they become major issues.

One other thing about today's letter - it provides a phone number for me to arrange for an interpreter to accompany me to the consultation. I wonder if they can provide one who is fluent in Coprolalia.

At this rate I’ll have none left

Posted by on August 4th 2017 in Health, or lack thereof

I hate carpet-grippers!

On Three

Posted by on July 26th 2017 in Health, or lack thereof, Video (YouTube, Vimeo etc.)

Not sure that I agree with everything here, but it's a good effort:

 

AML’s Ass… well and truly kicked

Posted by on July 13th 2017 in Health, or lack thereof

There's good news for a change - for the first time since diagnosis way back at the end of 2015, all of my key test results are in the green zone. The consultant declared me to be "normal" - a sweeping statement that I soon corrected, much to her amusement. I've not been "normal" ever since the first time my Mum took me, newborn, out in the pram to go to her local butcher's shop. She parked me up outside, went in, bought her pound of flesh and then went home. A while later she realised that two things were missing - me and the pram! 😳 Mentally-scarred for life, I was.

Anyway, the usual caveats apply - in theory the docs could have given me someone else's results again, but I think I'll give them the benefit of the doubt this time.

Here you go:

It's been an interesting journey, thanks for sharing it with me.

Counter-productive

I went to Leicester General today for yet another venesection. While I was being bled they gave me my serum ferritin test result for the sample taken prior to the previous venesection performed on 27th April. That result was 427 × 10-6 g/L

Compare that to my serum ferritin test result for the sample taken prior to the outpatient consultation at Leicester Royal only the week before. That result was 366 × 10-6 g/L

That implies an increase of over 16%. With no medication or medical procedure between those tests.

Now, I've taken on board their assertion that they are OK with swings of up to 20% (regardless of whether I'm OK with them), but that applies to things which are supposed to stay fairly constant. In this case, however, we are dealing with something that's supposed to be a reduction protocol. There is no good reason for such an increase, yet I suspect they'll say that it's no cause for concern.

I'm no jerk but I do know the difference between shit and Shinola...

 

I'll get the result of today's test next Tuesday, and there will be another test prior to next Thursday's out-patient consultation. I reckon that those results will confirm that it's a lab problem rather than anything wrong with me.

It could be an interesting week at University Hospitals of Leicester. If they pin the blame on differences between what goes on at the test labs I'll be lecturing them about calibration, standards, and the like. I'll be on firm ground there. I think that their "swings of up to 20% are OK" assertion is just an arse-covering disclaimer because their labs/tests aren't calibrated against a common standard and hence results from different labs are not comparable.

If I had to put my money on one lab or the other, I'd slap it on the General. They have lots of experience with venesections and associated tests for haemochromatosis patients, and that's why the Royal send me to the General for my bleeds.

But it's the consultants at the Royal who decide on my treatment, and they act on the results of their own tests.

Of course, the usual caveat applies... they can't both be right, but they could both be wrong.

Up and down like the Assyrian Empire

Posted by on March 26th 2017 in A bit of a rant, Health, or lack thereof

Latest test results (from week 38 23/03/2017 test/consultation) plotted, so more boring blood-test result charts. I'm told that the results aren't important, so don't bother reading any further... unless you want to mouseover the charts to see how they look with spurious data removed, hence showing the real trends.

So far only points for week 28 (12/01/2017) have been removed in the mouseovers. You might recall that I ranted about those results here. The serum ferritin result of 998 from week 15 (10/10/2016) has long been discarded as pure fantasy. With those dodgy results removed there are clear ongoing downward trends to the whites and the newts over the last 4 to 5 months, and the whites are now bang on bottom-limit. But it's not important, they say.

In my opinion, the latest value for the Serum Ferritin (499, week 38, 23/03/2017) looks to be, well, rather convenient, seeing as they were aiming for a target of 500, and the previous three values were 696, 643 and 642. And yes, I did tell them almost exactly that at the consultation, and I also told them that the previous week the blood-letting staff at LGH were quite concerned that their venesection protocol had ceased to be effective. Time will tell if I have to declare that result as dodgy, but for now I'm letting it stand as either a valid but surprising good result or as testimony to data creativity.

But it's not important, as they say.

Yet for some reason they have changed my 6-weekly checks back to 4-weekly.

Hmm...