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"My Dad has had a terrible time"

About: Queen Elizabeth University Hospital Glasgow / Bones, joint and fractures

(as a relative),

Over the last few years, my Dad has had a terrible time. He has osteoarthritis and needed a knee replacement. He went for his pre-op check and his surgery was cancelled due to an abnormal heart rhythm. He was referred to Cardiology who determined that this heart rhythm was normal for him and he was assymptomatic so the surgery could go ahead. This was all very good and thorough and we weren't too put out by the delay in surgery.

All the problems started when the knee op wasn't successful. He was in pain, he felt that the front of his knee was grinding on something. He went for, what felt like, appointment after appointment and was told this was normal over the space of about 18 months they just kept telling him to come back in 6 months until eventually he got a scan and lo' and behold his patella was not positioned correctly which had led to the grinding feeling he was having. Again, he was told to come back and eventually someone put him forward for surgery again. Again he went to pre-op and again the anaesthetist cancelled the surgery because of the heart rhythm despite the fact the ecg was unchanged from his previous, he had no symptoms of an abnormal heart rhythm and he had a note from a cardiologist saying this was all fine for him. I believe all the delaying was due to his age, at this point he is 82 and I'm starting to think they're just waiting for something else to "do him in" so they don't have to worry about an octogenarian ruining their successful statistics...

Anyway, he goes through all the rigmarole again and gets his knee surgery, this time with a spinal block rather than general. We go to visit him in hospital to find he has wet himself (no feeling below the waist because of the spinal block), he was mortified and was trying to climb over the bed rail to get himself cleaned up. As this was a single room (as all the QEUH is because "infection control") if he had fallen whilst climbing over, how long until he was found and what injuries would he have sustained? Also, bed rails are known to cause serious injury by raising the height someone has to fall as well as posing a risk of entrapment and crushing injuries and yet the NHS put bedrails up on anyone over the age of 65 it would appear...

There was a spot of blood on the floor that day that my mum says was there when she dropped him off and that was still there when we went back the next day. I cleaned it myself using the alcohol gel in his room.

He was in pain and was receiving oxycodone right up until he was discharged on paracetamol only. Not even the Co-Codamol he was on before discharge paracetamol. So he gets home and is still in a lot of pain but thankfully, his GP sorts him out.

During recovery, my dad falls and injures his shoulder, he can't lift his arm but my Dad being my dad doesn't do anything about it. Eventually, my mum manages to get a referral for an ultrasound and it is discovered he has 2 torn ligaments in his shoulder. Consultant advises the surgery is "urgent" and arranges this for about 2 weeks time. We were delighted that something was getting done so quickly but alas, the pre-op, heart arrhythmia on ECG so they couldn't possibly operate. Cardiology appointment was not marked as urgent so surgery was cancelled because he hadn't had his 3rd letter saying this man has a heart arrhythmia but it's fine...this was in March and his urgent surgery was then moved to the end of June. Not exactly that urgent then? Meanwhile, my dad is in pain, unable to do anything in the house because he can't move his arm and is depressed and also driving my mum insane.

He was admitted to hospital with epigastric pain at the start of June and was found to have gallstones. They also found altered blood in his stool but sent him home for an endoscopy as it wasn't felt this was urgent. Endoscopy not arranged til August. So, today, despite the pre-op having been and there being no concern with the ECG this time round, (maybe they've seen the umpteen letters saying "this man has a heart arrhythmia but is assymptomatic and it causes us, the heart specialists, no concern at all") we are told the surgery will be cancelled because the anaesthetist wishes the endoscopy to be carried out prior to the surgery....

This is so frustrating! The surgery that was deemed URGENT in February has still not been carried out by June. And once again, we are left to feel that it's because of his age (now 83) that noone wants to operate on him. He is in general good physical health but if no one wants to operate on him then just tell him so that we can make other plans. Intense physio, analgesia, occupational therapy etc.

Also, when he was receiving IV antibiotics in hospital there was only one nurse signature on the label when there should have been 2 which makes me think it wasn't checked by a second nurse and the ward is therefore not practising safely.

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Responses

Response from Nicole McInally, Patient Experience and Public Involvement Project Manager, PEPI, NHS Greater Glasgow and Clyde 6 years ago
Nicole McInally
Patient Experience and Public Involvement Project Manager, PEPI,
NHS Greater Glasgow and Clyde
Submitted on 19/06/2017 at 11:31
Published on Care Opinion at 12:23


picture of Nicole McInally

Dear Fionnghal

I am sorry to read about your Dad’s experiences and I appreciate that this is a difficult and frustrating time for all of you.

You have provided a lot of information and highlighted a number of concerns. I think it is important that we look into these concerns and respond to them.

Please be assured that I will share your post with the General Manager for the service. Can you please contact me directly at Nicole.McInally@ggc.scot.nhs.uk with your Dad’s personal details including his date of birth so that we can look into this further? I would be grateful if you could quote the reference number: 375423

Please pass on my apologies to your Dad.

Kind Regards

Nicole

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Response from Ian Reeves, Consultant Physician, NHS Greater Glasgow & Clyde 6 years ago
Ian Reeves
Consultant Physician,
NHS Greater Glasgow & Clyde

I'm one of the doctors in the medicine for the elderly dept. i.reeves@nhs.net

Submitted on 19/06/2017 at 19:24
Published on Care Opinion on 20/06/2017 at 09:29


picture of Ian Reeves

Dear Fionnghal

Thank you for sharing your story on Care Opinion. Your Dad's care sounds fragmented and impersonal to the extent that is the opposite of person centred care.

It sounds like there are multiple medical specialties, all trying to act separately, which is inappropriate when someone has more than one condition.

You also clearly describe issues with post operative 'delirium'. This is now a major focus for the hospital, and for improvement work within the orthopaedic wards. There should have been infomration for you, such as this for reducing the risk of falling. It would be useful to know if you received these.

http://www.healthcareimprovementscotland.org/our_work/person-centred_care/opac_improvement_programme/falls_prevention_leaflet.aspx

http://www.healthcareimprovementscotland.org/our_work/person-centred_care/opac_improvement_programme/delirium_toolkit.aspx

I'd like to add to Nicole's offer to help as well.

I don't think I am one of the doctors involved in you Father's care, but I'd like to try and help with cajoling/emailing/investigating if I can.

Best Wishes

Ian Reeves - Consultant in Medicine for the Elderly QEUH and GGH

I.reeves@nhs.net

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