Pain Thresholds...
Posted , 9 users are following.
Having read many posts, I wondering just how much pain a patient with severe arthritis needs to be in before the NHS will consider surgery. I have read posts where patients are in such excuriating pain they cannot work, and are suffering financially. In a situation such as this they will be in all kinds of debt before they can even consider returning to work, and this is going to impact significantly on their recovery. I am thinking mainly of patient on no hours contracts.
In the US, where I have lived and worked for most of my life, more than likely you would find yourself out of a job!
Surely, a diagnosis of severe arthritis should be enough to justify surgery, without compelling patients to suffer unendurable pain, for weeks/months on end, jeopardise their livelihoods, and then at almost the last minute, in many cases, cancel surgery the day before!
This is inhuman. The RSPCA would not stand for this, if in the case of an animal....! Would they...?
Is this common in the UK, now?
Best,
2 likes, 42 replies
kevin19230 susie74530
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lyn1951 susie74530
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rose0000 susie74530
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I also know you can pay privately without insurance it is around £10,000 or thereabouts.
Or you can go through the usual routes of the NHS. I have to say the hip care is exceptional for patients. They supply aids to your house, come out to check your home and offer community care afterwards, as well as hip school and general care. You will not receive this through the private pathway.
To qualify for hip replacement you have to have significant damage on your xrays and MRI. For some people they are not in pain, through childhood diease of different reasons, but for others they are in terrible pain. Usually these patients have left it too long for their own reasons, or the GP was slow to refer them etc...
A diagnosis of severe arthristis may not be enough if it does not show actual damage by xray. There are other ways to control arthristis such as anti inflammtories, biologic drugs that may help a patient without the need for surgery. Surgery may not be needed at all.
It is common in the UK for most patients to be looked after very well is my view.
susie74530 rose0000
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Many thanks for your response. I am due for a third set of exrays on Thursday, for obvious reasons - pain from arthritis. Had surgery performed in San Francisco for removal of the third distal joint, dominant hand due to arthritis in 1987, where I was initially diagnosed. So, I have lived with this situation for some considerable years. As a consequence of the surgery, I lost my living as an Interior Designer as I was unable to do the fine work required on the drawing board - technical drawing.
First set of exrays, the GP, a locum, I believe, advised that I did, indeed have arthritis in my right hip, but he went on to advise that should I have surgery, I would contract MRSA! Hardly encouraging and reassuring! Second set, taken around this time, two years ago, showed moderate to severe arthritis, and I was referred to a physiotherapist, who gave me a set of exerccises to do. Co Cadomol was prescribed.
My new GP, with whom I have been for over 10 years, stated that she was happy to put me on anti inflammatories, but for a limited time, only, I opted out. I am well aware that there is damage, because it presents during exercise, and is unmistakable.
As I have spent most of my ife in the US,, mostly San Francisco, I do not have private medical coverage, although I did in SF. I returned to the UK, to address issues with my elderly and increasingly frail Mother, now deceased. We were in London and although I was able to locate medical help for her, no GP would take me on as a patient, for whatever reason! So, the amount of lifting and heaving, moving furniture, etc., that I had to do, exacerbated and aggravated the arthritis. I was unable to obtain any form of pain relief, other over the counter, and quite frankly the local practices were not interested in my problems any more than Social Services, who became involved in the last year or so of my Mother's life. Overall, my impression was, that I was regarded as a machine to take care of my Mother, but maintenance and my own medical issues were ignored. Lack of any form of medical care, least of all any level of concern for my well being, continued for over eight years.
My current GP does take good care of me, and we are able to have intelligent dialogues as to diagnosis, prognosis and what would be the current best course of action. The new set of exrays, will reveal all that is necessary to either refer on or not. I suspect, that due to my current codition, it will be the former, but you never know...! Not much to be gained by referring a patient on for THR when the condition unsupported by Exray, and the pain experienced is from another cause!
rose0000 susie74530
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During the early stages there are so many things that can be done to ward off the surgery, and these are often used successful for a few years. I have had hip pain for ten years now before finally and somewhat painfully making the decision to have a replacement at the grand age of forty.
Some of ways I knew I definitely needed one were similar for everyone: I couldn't bend, can not put shoes or socks on, can't walk far (longer than 10 minutes) can not bear to stand still and and can not live a normal life. These things can be controlled by various forms of pain relief which definitely be explored but there comes a point when they do not work, and in fact the damage on the xrays points to the need to replace.
If your joint has a few more years then this is a wonderful thing for you! You are very fortunate. Especially if you can get your pain under control and can enjoy your life. I had hoped never to have the replacement, but sometimes you end up with one anyway. Once you get to that stage Susie, I am sure you will be well care for, please try not to worry.
I am not sure how badly your hip is affecting you, and how limited you are in what you can do. It is good to discuss with the doctor what can be done in terms of support.
Good luck with your xrays, and make sure you ask to have your back checked as well. The pain signals often get mixed up!!!! And the pain presents in the wrong place in that area...It is good that it is free here in England and you do not have to pay high insurance costs anymore, because this kind of care costs a fortune from start to finish. I am always amazed at how much an MRI is, or a simple blood test! My bills are horrific!
cathie38426 rose0000
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Portugal, to cover us also in uk, is horrendous.
Cathie
cathie38426 susie74530
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if you need a consultation, or xrays, I think it has
always been like that. I was bone on bone with both
hips. A hip replacement will cure arthritis in your hips,
but not general arthritis pain, caused by ageing.
Cathie
vanessa88276 cathie38426
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rose0000 cathie38426
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General arthristis can now be treated with biologic drugs which will preserve joints, so well worth looking into.
cathie38426 vanessa88276
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if one hip could not support you when you had the other
one replaced they would, sometimes reluctantly, do both
at the same time. A consultant's decision, based on your
xrays and general health. Good luck, you will get a fuller
picture on Thursday.Take a list of questions written down and have
someone else in the room with you, because you won't
remember everything he says.
love Cathie
cathie38426 rose0000
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hip bone is one cause for THRs. You must have suffered
a lot of pain with early onset arthritis. You will benefit very much
from the THR. Nearly there now.
love Cathie
Hailea susie74530
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i waited just under 4 years to have the first one done I was in agony with both but not as bad as now. I am 8 months since having my left hip done and will be going in for my right hip 10 days before Christmas.
I am am in so much pain now I went to my pre op in a streacher because I can't walk. I was also on gas and air ( nitrus oxide ) for the 30 mile trip to the hospital because the pot holes and switch backs made me suffer.
Good of thing was I phoned ahead and they were waiting for me wheeled me straight in did my tests and shipped me off home again all within 30 mins.
vanessa88276 Hailea
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Hailea vanessa88276
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Thankyou
I am still very scared even though i have had one done. I have actually had my ESA stopped in the last week by the job center because they don't beleive I am in this situation and they class me as fit for work. Yes really.
I try to do some things like help make dinner by peeling potatoes and stuff like that. But other than wrapping christmas presents and the odd job here and there I can do without having to sit upright I can't do a lot. It hurts too much to even get up to go to the loo some days but you just have to get one with it.
The hip I have had done is ok. But it is stiff due to lack of mobility.I do get a little pain. But because of the cronic pain of the right hip I can'rt really tell how god / bad it is. I will have to have physio when I can
after this op. My muscles have disapeared from my calf mu butt and my thigh through imobility. Once I am fixed I am going to take it easy and work up to at least being able to use my gym equipment at home.
I have lost a lot of weight bewcause I am not eating propperly because of the meds I am on. Not a bad thing I guess but you have to eat to mend and heal.
vanessa88276 Hailea
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susie74530 Hailea
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Thought I should write and suggest that you ask you GP for a letter setting out, exactly what your medical position is.
All the best,
Susie
Hailea vanessa88276
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Just be warned it isd very, very difficut to get ESA since the government changed the rules. Just tell the truth but becareful what you say and how you say it.
Hailea susie74530
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It was still taken off me. Thje fact that I can sort of sit up in bed they said that I was fit to sit at a dest there fore fit for work. They don't care how you get there or what happenes in a fire I am classed as fit for work.
Lucky my other 1/2 is my registred carer so I was put on income support and not forced to go to work.
Hailea
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lyn1951 Hailea
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susie74530 lyn1951
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Best to you both,
Susie
lyn1951 susie74530
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