Is it worth seeing a specialist for Costochondritis?

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My other half has had some rotten luck with his health recently. He's not long recovered from Viral Meningitis, things were looking up, and then he suddenly had pains in his chest and the feeling that he couldn't expand it properly to breathe. This caused him multiple panic attacks which were very distressing to him and a lot of difficulty sleeping. He's also had nerve symptoms (numbness, tingling, 'hot' sensations) anywhere from the top of his chest to his belly button.

He has had an ECG, two chest x-rays and numerous blood tests, so the dx is Costochondritis. He is on Naproxen, a short course of Prednisolone, and 50mg of Sertraline for the panic attacks. He also has asthma inhalers. Only the Sertraline seems to have any effect for him (in preventing panic attacks).

We went back to our GP this morning who is a decent, no-nonsense type of guy, but hubby wasn't happy that he wouldn't refer him privately (he has BUPA), saying there was nothing wrong with him and that it would clear up by itself. Now my husband doesn't know what to do and is thinking of going back to work next week regardless. This wouldn't bother me much, except for the fact that he has to drive a long way there, and has been complaining of dizzy spells.

For those of you who've got this condition, is it worth paying out of pocket to see a Rheumatologist? Can they provide any more relief?

 

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  • Posted

    No, don't pay. Go to GP again and specifically ask for a referral. Since it costs nothing to the NHS because of his private insurance, they don't have a reason to refuse. Try to get someone who has heard of costo before, as well as post viral fatigue syndrome, fibromyalgia and ME. Or you can also try to self-refer -- my GP surgery were very slow in issuing and sending referrals, so I just called up my insurers, got authorisation code, with the code called up a hospital and made an appointment with a rheumatologist who was free the soonest. Referral never arrived, insurance still payed just fine.

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    • Posted

      Thanks for your reply, JuditD, but in the GP's words, it would be 'totally useless' to refer him, so unless we want to complain about that, I can't see us getting anywhere with it.

      I'll give BUPA a call and see if they would accept a self-referral without the GP's blessing if he wants to go, thanks. smile

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    • Posted

      Do BUPA have GP service -- an online chat kind of thing? My company is with AXA and they do. Worth asking if you call them anyway.

      My GP actually called a meeting with other (more senior) GPs to see if it would be completely silly to refer a costo patient to a rheumatologist and they were OK with it. Which is why it took that long. Just keep insisting or seeing another GP. Being brushed off doesn't feel right.

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    • Posted

      Thanks again, JuditT. smile

      Well, BUPA say they can't triage musculoskeletal issues for which he's already had treatment; however, if we pay for the first consultation, BUPA will pay for the second as it's essentially a self-referral from the Rheumy. The referral can come from any doctor, apparently. There are only two GPs at my surgery and the second one only works part time.

      Did a Rheumy help you with your costo at all? 

       

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    • Posted

      If the rheumatologist helped... Well, hard to know.

      I think they look at the issue differently. He moved me around, twisted arms, prodded sore bits to determine which are was sore -- not something the GP did. He also switched me from naproxen to meloxicam (better tolerated on the long run plus it's only one pill a day, good for the forgetful ones...) as I had a bad reaction to naproxen, and ordered an MRI scan and a CT scan to confirm that there was nothing more seriously wrong with bones/joints (eg tumor, untreated bacterial infection etc), ran a couple of blood tests as well for the same. I don't think you can have enough tests if you are of the anxious kind. It certainly helped me put my mind at ease.

      He also mentioned other illnesses (see previous response) just to see if it's really costo or something to do with a prior viral illness. That part of the investigation was never conclusive, but in retrospect I think I have/had fibro and not clearcut costo.

      18 months later: I've been off meloxicam for 8 months, pain is a lot less, there are completely painfree days.

      I hope your other half will recover much quicker than that though! Good luck!

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  • Posted

    Hi,

    I was referred to a pain clinic under the NHS, and that has been really helpful. I saw a consultant from the refractive angina clinic because my pain came on after a heart procedure went wrong and the cardiologist accidentally perforated my heart. They were very keen to refer me! We didn't know about costochondritis, but after none of the heart tests were positive (apart from the heart rhythm problem I started off with), the pain clinic started different pain medication until we found the one that worked for me. I use a synthetic opiate called Tapentadol and it has transformed my life. After 18 months I can now get on with my life. Unfortunately I have had to take a medical retirement because I was unable to work, but I am now enjoying life at last. It has been a month now and I am excited about being able to do normal everyday things at last.

    So I would suggest that pain relief makes all the difference. I had pneumonia last year because I was in too much pain to cough so my lungs became congested. I hope you get some relief for your husband.

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