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"Nerve injury and how I feel the NHS could have done more"

About: Queen Margaret Hospital / Trauma & orthopaedics

(as the patient),

A week or so before Xmas (2017) I skidded on ice and crashed my car.The next day and for a week or so my neck was quite stiff due to possible whiplash but I didn't feel it was anything to worry about and so didn't seek any medical assistance.

A day or two before Xmas I began to feel what I thought was a pulled muscle under my left arm near the armpit area. By Xmas day the pain had intensified to the point where I needed pain relief. On boxing day I noticed the pain was mirrored in my right side and now I could feel numbness on my left shoulder blade. The pain worsened in my right side and was concentrated more now in the shoulder area. I went to my GP after the surgery re-opened from the festive period by which time the pain had all but gone in my left side. The numbness in the left shoulder blade persisted though and the pain in my right shoulder was stopping me from sleeping. Pain relief and rest was advised after discussing possibilities of the cause.

Brief History 

In 2013 I had very similar symptoms which came about after a days work (Fencer, that day we were taking down an old fence, taking out old staples, rolling up old wire and pulling posts out of the ground).  The pain was in  my right shoulder and after a week it had me in tears, I also developed extreme weakness in my hand and arm. I was unable to move the tip of my thumb or the tip of my index finger, grip strength was also affected. Pushing away with the back of my hand, elbow tucked was now near impossible. This eventually lead to Severe muscular distrophy of the Infraspinatus as well as other muscle wastage around the shoulder and pectoral area. 

After months of hospital and GP visits which included an MRI scan and nerve conduction test I was informed that I was suffering from Brachial Neuritis. Brachial Neuritis was a condition which I had suggested as a possibility after carrying out some research on my symptoms. I was told that nothing could be done and that nobody really knew much about the condition. I struggled to come to terms with the fact I now had a weak arm which was visibly smaller than my left side. Before this problem came about I was physically in the best shape I had ever been in, I was dedicated to training 5 to 6 days a week. 

I went from content, fit and healthy guy to a defeated man hooked on pain medication within a couple of months. 

I did eventually manage to self taper off the painkillers I was using excessively but struggled to get back into training with the same enthusiasm as I had before.

Fast forward to Jan 2018 when I spoke with my GP regarding my similar symptoms as to those of Brachial Neuritis from 2013 ( I was informed by the consultant I was referred to back in 2013 that this was a one off rare condition which wouldn't come back). My GP referred me to a specialist and offered me opiate based pain relief even with a history of opioid addiction. I was put on a painkiller after begging for anything other than opiates. A few days after visiting the GP I woke up in the morning and noticed that I could no longer lift my right arm more than about 6 inches from my hip (like if I was to assume a crucifix position). The pain now was truly unbearable and on top of the paralysis my right arm and shoulder was full of numbness and pins and needled in my right hand and fingers. My GP again sent a message to a specialist, this time saying I was urgently needing seen.

I was signed off work for 6 weeks and when I did return it was purely out of the desperation to earn money as sick pay does not cover much. The loss of movement I suffered back in 2013 was nothing when compared to the debilitating blow I received this time. My work history and skills to date have always been manual with most jobs physically  demanding too. I now must come to terms with the idea that this injury will change my life forever and that I cannot continue to work in a manual job. I struggled with pain in my shoulder and arm on returning to work and because of this was only able to work 2 or 3 days a week.

Eventually in Feb 2018 I had an appointment with a specialist at the Queen Margaret Hospital, Dunfermline. I finally had an opportunity to get some answers and discuss treatment which could enable me to regain movement in my arm again. My GP had referred me to the Orthopedic surgeon but this was not who greeted me on my trip to the hospital. Instead I was seen by the physiotherapy team which deflated my expectations instantly. Upon telling the physio my story and after an examination they told me that they did not know anything about the Brachial Neuritis condition and would need to "look it up". They physio said they would try and call me back within a day or two after speaking with their colleagues to discuss the next course of action. I felt as though I had been completely ignored and that the NHS had no interest in helping me. Here I am with my livelihood and ability to provide financially for my children on the line and I get treated like I am making a big fuss about nothing. I asked about any kind of surgical options to repair damaged nerves, to which I was told there was no such option. A quick google search was all that he needed to do to find that in fact there were surgical options for Brachial Neuritis, such as nerve grafting and evidence shows that time is of the essence as prolonged symptoms decreases the chances of recovery and regaining full motion in the affected area.

Instead I was referred to a physiotherapy program and had zero expectations of regaining any more movement of my right arm. Now into March 2018 when Physio starts, 3 months now since I first presented my symptoms to my GP. The 1st session was aimed at stretches and exercises on my neck. About an hour after leaving my session, my neck was as stiff as it was after my car crash and also had shooting nerve pain down my entire right arm. The pain worsened and left me sleepless all weekend then absent from work all week after.

This is when I connected the pain in my shoulder with my neck and now firmly believe that all my nerve issues are stemming from the neck. This would explain the numbness and pain on my left side as well as the severe issues on the right side. I argue that that the Brachial Neuritis diagnosis is questionable, especially given that I was in a car accident and potentially suffered whiplash as a result. Perhaps this has also resulted in a trapped nerve in my neck? A trapped nerve in the neck can be caused by whiplash and has very similar symptoms as Brachial Neuritis. I now question the diagnosis given to me in 2013 and wonder if I would have been told the same if I had not suggested it as a possibility? 

I feel extremely let down by the fact my car accident did not seem to play any role in my diagnosis or treatment. No scans were ordered on my neck to rule out a trapped nerve due to whiplash, just an assumption that it was the same condition that I was labeled with in 2013 and there wasn't anything they could do.  

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Responses

Response from Gillian Ogden, Head of Nursing, Planned Care, NHS Fife 6 years ago
Gillian Ogden
Head of Nursing, Planned Care,
NHS Fife
Submitted on 04/04/2018 at 15:00
Published on Care Opinion at 21:54


picture of Gillian Ogden

Dear victornb36

Thank you for taking the time to post your story on Care Opinion.

I was sorry to read that you had been involved in a car crash and the continued pain and symptoms that you have suffered since then. It sounds like you are having a difficult time as a result of this and I would be keen to support you in seeking the explanation and care that you need.

I would be grateful if you would contact me directly on 01592 643355 ext 28144 to allow me to discuss your concerns further and to identify who is best placed to support you moving forward.

I look forward to speaking with you.

Kind regards

Gill

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Update posted by victornb36 (the patient)

Thanks for the response Gillian although a quick Google search shows its almost word for word standard response to many unhappy patients who have their own stories to tell.

Anyway my situation has only got worse, I am now on day 8 of pain I couldn't have imagined. Its got worse each day and has often brought me to tears. Right now the tears all dripping on my phone as I type. I toughed it out untill 3days ago when it was just too much. Dr put me back on medication which was completely useless and done nothing. The pain is just unbelievable and the worst I have ever experienced in my life, constantly booming shooting pains plus short sharp pains that make me vocally scream. Back to Dr who gave me other medication, this helped tske the edge away but not on tge short sharp pains. Npw waiting for the Dr to phone me as he is trying to get me seen by a specialist neurologist asap as in today or tomorrow. I thought the fact I couldn't lift my arm suddenly would have called for similar immediate action. Because of my right arm being unablentp function as notmal, it totally changes everything about my life, I went from keen cook with specialty.

Response from Gillian Ogden, Head of Nursing, Planned Care, NHS Fife 6 years ago
Gillian Ogden
Head of Nursing, Planned Care,
NHS Fife
Submitted on 11/04/2018 at 17:06
Published on Care Opinion at 17:54


picture of Gillian Ogden

Dear victornb36

I am so sorry that my response to your post didn't help you in any way. I know you feel that people have given up on you and that you feel let down as a result of that. I don't want you to feel this way and I do genuinely want to help you get the care and support that you so desperately need.

Your situation is awful and I am concerned and sorry to read that your pain has become so bad over the last few days. I can see from your most recent post that you are in touch with your GP and it sounds like they are actively trying to get you the help you need quickly. Your details on Care Opinion are anonymous so I am unable to help unless you contact me, so please give me a call on 01592 643355 ext 28144, to allow me to help you too.

Kind regards

Gill

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