Homerton Hospital Is Bottom Of The List
In The Times today, there is an article, which is entitled Ambulance List Shows NHS Trust With The Worst Delays.
My local hospital is Homerton and it gets a very honourable mention.
At the other end of the scale, four trusts accepting patients by ambulance reported no delays of more than an hour, led by Homerton University Hospital in east London.
It is interesting that Homerton is down as one of the best.
My GP reckons it has improved greatly in the last few years. He also says, that they seem to have more spare capacity, than the other hospitals in the area.
The hospital removed my gallstones using endoscopy and I walked out to a waiting car. I could have taken the bus, if required.
I also had a knee X-rayed, where the GP gave me a chit and told me to just turn up unannounced in one of two specific three-hour periods. I was in and out in just over ten minutes.
Homerton seem to be thinking hard about their organisation and methods.
Could this be why they are the best on the list?
So what is our South London Mayor doing to improve transport to this much improved hospital?
He’s cutting out, one of the major bus routes to the hospital.
How Celiac Disease May Affect Your Risk for Gallbladder Disease
The title of this post, is the same as that of this article on verywell.health.
I am posting, as I am a coeliac, who has had gallstone problems and want to be able to find the article easily in the future.
Goodbye To My Gallstones
It is now some weeks since I said goodbye to my gallstones.
They were in my bile duct and were discovered by using an ultrasound probe on an endoscopy at Homerton Hospital. I didn’t even put on a hospital gown.
I had that endoscopy, as I did my two previous ones at Addenbrooke’s Hospital in Cambridge to check for coeliac disease without a sedative, as Addenbrooke’s likes to be efficient and cutting out sedatives reduces the manpower required, cuts the need for recovery beds and allows patients to drive home.
After this endoscopy, I came home the way I arrived – on the bus!
I would say that a good endoscopy operator should be able to do the procedure without a sedative. Although in this case, the nurse holding the oxygen tubes up my nose, was stroking my beard to calm me down. Not that I needed it! But it was a nice action!
I had the removal of the gallstones with a sedative, but I only remember the anaesthetist saying something like “Lovely” as he threaded the camera and attachments down my throat.
They broke into my bile duct from the duodenum and then inserted a balloon, which was then inflated to flush the stones back into my duodenum.
I must have dropped off and I woke without any pain or even discomfort.
One complication for me, was that I am on Warfarin, but I dropped my INR to one before the operation, so that there wasn’t blood everywhere.
I have had some after effects.
Where Has My Constipation Gone?
Since I was about sixty, I have suffered from constipation and my GP has prescribed a laxative.
I felt it was a family trait as my father was also a sufferer.
But since the operation, I have only taken one pill, that may not have been necessary.
My Appetite Has Returned
I am certainly eating better and I have not put on any weight.
Conclusion
If you have gallstones and removal is suggested, go for it!
Has Ciprofloxacin Attacked My Tendon?
After my gallstone operation, the hospital gave me a week’s Ciprofloxacin, which is an antibiotic, to take.
I took one tablet on Thursday evening and another on Friday morning. But as I returned from shopping at the Angel, it felt like I had a splinter in the heel of my left foot.
The pain was so bad I could hardly walk this morning.
I have had plantar fasciitis in the past in my left foot, and as someone, who has spent a working life looking for connections in databases, I wondered if the Ciprofloxacin had anything to do with it.
So I looked up the data sheet on MedLinePlus, which is a trusted site, from the US Library of Medicine.
The data sheet starts with this Important Warning.
This is the first paragraph of the warning.
Taking ciprofloxacin increases the risk that you will develop tendinitis (swelling of a fibrous tissue that connects a bone to a muscle) or have a tendon rupture (tearing of a fibrous tissue that connects a bone to a muscle) during your treatment or for up to several months afterward. These problems may affect tendons in your shoulder, your hand, the back of your ankle, or in other parts of your body. Tendinitis or tendon rupture may happen to people of any age, but the risk is highest in people over 60 years of age. Tell your doctor if you have or have ever had a kidney, heart, or lung transplant; kidney disease; a joint or tendon disorder such as rheumatoid arthritis (a condition in which the body attacks its own joints, causing pain, swelling, and loss of function); or if you participate in regular physical activity. Tell your doctor and pharmacist if you are taking oral or injectable steroids such as dexamethasone, methylprednisolone (Medrol), or prednisone (Rayos). If you experience any of the following symptoms of tendinitis, stop taking ciprofloxacin, rest, and call your doctor immediately: pain, swelling, tenderness, stiffness, or difficulty in moving a muscle. If you experience any of the following symptoms of tendon rupture, stop taking ciprofloxacin and get emergency medical treatment: hearing or feeling a snap or pop in a tendon area, bruising after an injury to a tendon area, or inability to move or to bear weight on an affected area.
After reading that, I decided the best thing to do was to call a doctor, so I dialled 111 and within three hours I was seeing a young local doctor in his surgery.
He decided to be prudent and changed the antibiotics.
I have since found out from this page on celiac.com, that not all Ciprofloxacin is gluten-free. Mine was from a company called Torrent.
Prioritising Patients
Homerton hospital is hoping to remove my gallstones on Thursday by endoscopy, so it’s just a fairly small procedure.
I do wonder if there is a shortage of nurses, doctors and other staff at the hospital caused by either the Covids or the fuel crisis, if some operations will be cancelled.
At no time, in the diagnostic process was I asked if I was in pain. Which I am not!
Surely, in the Age of Covid-19, where there is great uncertainty about predicting hospital capacity just a few weeks in the future, I should have been asked a few questions, so that urgent cases could be given priority if necessary.
As they must have been there for a few months causing me no trouble, surely a few extra weeks won’t make much difference to me.
The Diagnosis Of My Gallstones
I arrived at Homerton hospital as instructed today for the endoscopy.
Strangely, it was C’s birthday.
The procedure would involve passing an ultrasound probe down my throat and through my stomach to take an ultrasound image of the lump close to my liver.
I’d had two endoscopies before in the late 1990s at Addenbrookes to check for coeliac disease. One was a normal one, but in the second, I was also providing a sample of fluid for a research project at Cambridge University.
I seem to remember at Addenbrookes, I had been instructed to turn up in something like a tee-shirt and shorts, which is what I did. In this case, I took my shirt off and put a hospital gown over my cord trousers.
As I’d had the two endoscopies at Addenbrookes without a sedative, I suggested strongly, that they do the investigation without one this time as well.
The doctor, who was of an age to be very experienced, said he was up for it and we went for it without a sedative.
There was two big differences to the procedure at Addenbrookes.
- There were more staff, than Addenbrooke’s doctor and a technician.
- They were fully gowned up, as opposed to normal clothes.
But, then I got the expression at Addenbrooke’s they were aiming for speed and they were only confirming their earlier diagnosis of coeliac disease. that had been made by a genetic test.
Everything this time, went without a hitch.
- I was laying on my left side.
- I had oxygen tubes up my nose.
- With my right hand I can feel the probe in my stomach.
- To calm me down, a nurse was stroking my beard.
After not a long time, everything was done and I was walked back to recovery area.
Within half an hour, I was informed by the second doctor, that I had got gallstones and they would be taken out by endoscopy on September the 30th. Later they will take out my gall bladder by surgery.
I got the impression, it was the first time, that he’d seen this procedure without a sedative, as he described me as the Star-Of-The-Day. But then I’m a London Mongrel, with more survival genes than a garden full of Japanese knotweed.
I went home the way I came – On the bus!
After Effects
The only after effects were that the air in the theatre had dried me out and my left left arm hurt because I’d been lying on it.
So I vowed to drink a lot of fluids before the operation and do something to improve the strength of my damaged left arm.
Medical Misdiagnosis
According to Professor Graham Neale at Imperial College, about 15% of conditions are misdiagnosed by the NHS. 15% is not one in six as the Times states. It’s actually nearer one in seven!
I heard him on Radio 5 last night and he was saying that this is one of the biggest problems facing health systems around the world.
Too right it is!
Let’s assume that we can cut this level by ten percent. On a straight economic case, it should cut the health care bill by at least one percent. So getting to grips with this is a major challenge that will bring enormous benefits.
The Times talks of one possible IT-based solution.
The NHS in Scotland has launched a pilot project where computer software with a diagnosis checklist is installed in GP surgeries to prevent errors. The programme, involving 25 GP surgeries, uses a commercial company called Bluebay, that gives doctors access to written information on how best to treat certain conditions.
I must admit, that I do have a special interest and knowledge of misdiagnosis. As I am a coeliac, and moderate a group on the Internet about it, I’ve come across quite a few who have been misdiagnosed for years.
But then you can see the problem, if like me you have bad skin, joint pains, severe dandruff, gallstones, mild depression and migraines, would you have thought that the problem was a gluten-intolerance?
The other problem is that there is no record of diagnosis. To me as someone who analyses data for a living, it is a goldmine, that could give a rich vein of results. Doctors always state reasons why this should not happen. But then pilots have had an anonymous reporting system for years. No-one ever complains about that!
We do not need major changes to get a decent increase in efficiency. We just need doctors and other health professionals to make the best use of the information that could be readily available.
And judging what I said earlier on saying sorry, they could learn from that too!
The Anonymous Widower 