I’m sure anybody reading to my blog regularly (unlikely, I know) wants more of the political stuff, rather than the personal. Yet, occasionally, the personal overwhelms whatever is happening in the outer world and I haven’t had time to absorb the news. Which means on a day like today, I write about the stuff that really matters to me.
That said, I’m not entirely sure why I’m writing a blog post today except for the feeling of normality it gives me. I’m exhausted, after about three hours of sleep last night. The humidity (90% at 4am) was partly to blame but I also had a crap-load of adrenaline still pumping through my system.
My mum had a slightly better day yesterday but, in some ways, worse. Her bad neck (the medical term is cervical spondylosis) had eased somewhat compared to the height of the flare, but she had more vertigo and associated nausea for more of the day. By the time it hit 9pm, she was feeling pretty rough. This is a pattern I’ve noticed and, reading around, I know why. That time at night is always the worst time for arthritis, apparently, since the cortisol – a natural anti-inflammatory in your system – drops due to the circadian rhythm, which makes you sleep at night, be awake during the day.
So, 9pm, I was a little freaked out, not sure what to do. I knew there were drugs in the house that could control the vertigo and nausea, but they weren’t prescribed for her. I ideally needed a doctor to tell me it was okay to give her them so, just to be certain I was doing the right thing, I rang 111 at 9pm. I got through the countless layers of messages telling me not to use the service if it was coronavirus related, got to the music (with yet more warnings) and then got through surprisingly quickly, by about 9.20. This is where it all begins to get complicated.
The woman I spoke to was really helpful but, unfortunately, she’s no doctor. She just works from a script. It’s the same script as on the NHS website, which means twenty minutes of answering questions to see what kind of service we needed. Except, we didn’t want any service except to speak to a doctor or, failing that, a pharmacist. But no, the system is the system, and after 20 minutes, they told me to take my mother to an emergency room within the hour.
Well, a little part of me freaked out.
Now, of course, ignoring medical advice is generally a bad idea but the part of me that wasn’t freaking out knew that I’ve been here before. They’d said the same two years ago when she had really bad knee pain because of her chronic osteoarthritis (misdiagnosed by our GP as early stage osteoarthritis due to our GP not getting the right X-ray done*). I didn’t take her then because it would have been cruel to make her walk to a taxi, wait in A&E, only to be told she had osteoarthritis in her knees. We knew that. We just wanted help with the pain until her appointments. The same was true last night (plus, as my mum told them in no uncertain terms, she’s shielding on behalf of my sister… No way she was leaving the house to go into A&E). Not should she. She has bad arthritis in her neck which sometimes flares. We’ve been here before. She had a bad attack of this in 2017. It’s a miracle she’s not had one since but if it doesn’t subside enough (and, touch wood, the symptoms do seem to be less each day), she really needs to see a specialist…
So, I explained all this, and the lady on 111 she said she’d get a doctor to ring.
Two hours later, a nurse rings… I explain all of the above again since the guy (I’m still not entirely sure I wasn’t talking to an AI since he was so precise in his manner) wanted to diagnose her symptoms. I said, causally, “I know bad neck arthritis can cause vertigo” and he said “I don’t know”, which pretty much sums up the situation I was in. That was 11pm. He said I needed to speak to a doctor since my questions were about medication.
By now, my mother had got through her rough spell, got sleepy, I’ve helped get her to bed, and she was soundly asleep. I had to wait up for the doctor’s phone call, which finally came at 1.15am. By then, I’d been sitting holding the phone for over four hours…
They answered my questions – which were really simple questions – and that was it. Probably on the phone for less than a minute. But by that point, sleep for me was out of the question.
I wrote yesterday about the loneliness of the NHS and how a system that used to be quite personal and patient orientated has become a system that all too easily loses sight of the individual. My mum is of that age where, really, a doctor should be keeping an eye on her beyond whatever blood tests the computer prints out on set days of the year. Certainly, the system should have more granularity between “you don’t need help” and “get to an emergency room immediately”.
Naïve? Some would say that it is, though the stark difference between the NHS under Blair/Brown and how it operates under the Tories transcends my political opinions. It is objectively true that Labour care more about the NHS than do the Tories and that resulted in a significantly better service. Not just a bit better. I mean a lot better. For example, I forget the number they used to have where you could quickly talk to an expert (might still have been 111) but it was much better because it didn’t have a call centre mentality or a flow diagram of outcomes.
I suppose, if I were to get political, this difference seems ideological, if not theological. Labour see government as there to help the individual; Tories see the individual doing things for themselves and want the minimum of government investment. There was a time when it was considered terrible to self-diagnose. People were mocked for using the internet to research their symptoms (which, admittedly, can still be a bad idea). Yet increasingly the Tories treat the internet as a way to make the onus on people to understand their symptoms and choosing the level of care. That’s not necessarily a bad thing, though I also know I’m not your average punter. I’m quite scientific, happy spending long hours doing research, and I am fairly literate. Perhaps not a model for everybody and it still doesn’t overlook the problem that, after all this, it’s still hard time to get any care unless you pay hard cash for it…
Anyway, tomorrow, I’ll see if the GP will prescribe the same drugs that helped my mum through the last boute of this she had (naproxine and cyclizine). If I recall correctly, she should have been on a maintenance dose of the former to help keep the inflammation at bay but, through all the trouble getting her knees fixed, she’d been taken off them (clearly somebody – including me – assumed her knees are okay, forgetting about her neck). Beyond that, I’ve noticed consultants are doing video calls with patients so I might have to pay to get her seen by a neck expert. I know there are ways to treat this ranging from medication up to surgery but it feels wrong that, again, the system is so binary.
I also need some sleep. I’m even too knackered to mention the football, most of which I missed.
* One of the things I’ve learned about knees during the last few years is this: if you think you have knee problems that might be caused by osteoarthritis, make sure your doctor gets your knees x-rays whilst you’re standing up. This was the first thing the consultant did, tutting as he muttered about the pointlessness of having them done whilst the patient is lying down. Makes so much sense when it’s explained to you. Lying down your knee joints open up. On the x-ray, it will make it look like you have loads of cartilage between the bones. Standing up, you can see if the bones touch. Better yet, get an MRI. You shouldn’t have to (they’re bloody expensive, ours cost £600!) since a proper x-ray should reveal all this but when we did (because we couldn’t understand the diagnosis because of her intense pain), turns out she had almost no cartilage in her knees. Chronic osteoarthritis instead of hardly any… I’d have sued for medical negligence but, well, ordinary people don’t do that, do we?
2 thoughts on “111”
Sorry to hear about your mam, hope she feels better soon. Realistically the days of GP home visits is over, they voted to stop them last November if I remember rightly, citing overwork as the reason. The government rejected the vote and said GP’s would still be required to carry them out in their contracts, but in practical terms there is little the government can do to force the issue.
I don’t think it is an ideological issue around the NHS as much as an ideological issue with regard to public spending. There isn’t a single public service that is better than it was 15 years ago. Labour has always spent more, once upon a time they used to tax to spend, under Blair they borrowed to spend while also riding the coat tails of a global economic boom. The substantial extra money that the NHS received under Blair, was in effect borrowed money and that was unsustainable given our tax base as it stands. Add to that the fact we have an extra 1.5 million pensions to pay out each year, plus the associated health costs arising from that elderly population and it doesn’t take a genius to figure out something has to give. Until someone can persuade basic rate taxpayers to stump up more money, as they do in countries such as Sweden, France and Germany then ALL public services will suffer from chronic underfunding.
Thanks Rob, appreciated. Hopefully getting the inflamation under control. She seems (touch wood) a little more herself today.
I think the public spending angle is merely another facet of the ideaological, which is why I mentioned it’s like a theology; Catholicism vs Protestantism, the church vs the individual. Modern politics is just another version of that, the constant struggle of individuals wanting to be individual but also needing the state to keep them safe. Where politics goes wrong on both sides is when decisions become too ideaological, beyond what’s sensible. I believe that many Tories (Thatcherite more than One Nation) resent the NHS on a gut level and abhour the idea of the state helping people who, they would say, are unwilling to help themselves. They might have a point but it usually then passes from reasonable argument to dogma. Not saying that centrism is the answer to all our woes but so many problems stem from policians drifting into ideaological neverneverland.
I see your point about money, growing elderly population, etc. but, at the root of it, we still have the clash of psychologies, and, as we’re seeing with the right wing populism at the moment, politicans understand the power of appealing to people’s selfishness.