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"The Elusive Diagnosis"

About: The Walton Centre NHS Foundation Trust / Neurology Whiston Hospital / Accident and emergency Whiston Hospital / Cardiology Whiston Hospital / Ear, Nose and Throat

(as the patient),

After a great day outdoors walking with friends, a night of chest pains, palpitations and numbness has left me in limbo being passed from pillar to post.

I woke up that night with extreme chest pains, and when i woke up i felt very dizzy, lightheaded and my heart was palpitating. I rushed straight to A&E at Whiston Hospital but by the time I arrived, the symptoms were mostly gone. ECG,  troponin and full blood count were all fine. The clinicians assumed a case of a panic attack and i went home the next day. 

This was just the start, as weeks passed, i had difficulty breathing where my chest felt very heavy. Just two weeks later, my face went numb and i lost my balance completely when sitting in a restaurant. I collapsed onto the floor. I wound up in Lancaster A&E and no scans or tests were completed except an ecg. Diazepam was given and a suggestion that there could be a neurological problem was given.

After travelling home, my condition continued to deteriorate, to the point where i can no longer walk around the house without feeling faint, like the floor is spongy, intense dizziness and jittering of vision and awful brain fog with a host of weird sensations around the body

I had several visits to A&E where a diagnosis of Anxiety kept beinf made, despite being perfectly healthy only one day before symptom onset.

I often wake up in the middle of the night with palpitations, so i had a 24hr holter/bp mononitor fitted by the Community Cardiovascular Service. Whilst on the monitor i only had some mild symptoms and the readings came back as okay. 

I subsequently had only a routine MRI (no contrast used) and a chest xray and both these results were normal. The ENT department checked thoroughly and suggested a case of BPPV (vertigo). I have had several physio sessions which have not yet resolved the symptoms.

I have spoken to my GP on several occasions who has made further referrals to cardiology and neurology as urgent due to the severity of my symptoms being debilitating.

I am only 21, i have gone from walking 15 mile hikes with friends, to being barely able to walk around my own house due to the balance and coordination problems, numbness and dizziness. To my dissapointment, the cardiology appointment at the community cardiovascular service was rejected without providing any reason to my GP, and neurology appointment at The Walton Centre was downgraded to routine with a 14 week wait.

I was even admitted to a Acute Medical Unit at Whiston Hospital, but i was later discharged without any indication of any possible diagnosis.

Unfortunately I am still currently severely unwell, and am unsure what to do - from being  a perfectly healthy young adult just three months ago, I now struggle to do the basics like shower, cook, and walk around due to the nature of the physical symptoms. A set of conflicting diagnoses have left me at a crossroads.

No plan has been made for treatment or elimination of conditions and every time the symptoms get bad, the A&E assume the problem is Anxiety due to my past record, and don't complete more thorough tests due to my age. 

A destructive combination of risk assessments, assumptions and poor communication between departments and my GP has left me in limbo and I don't know what to do next.

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Responses

Response from Whiston Hospital 3 years ago
Whiston Hospital
Submitted on 29/10/2020 at 15:26
Published on nhs.uk on 30/10/2020 at 09:51


We are sorry to hear that your recent experiences at Whiston Emergency Department and Acute Medical Unit were not to your expectations and we would like to assure you that your feedback and comments will be shared with these areas to help improve our patient experience and satisfaction in the future. If you require any further information please contact the PALS department on 0151 430 1376.

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Response from The Walton Centre NHS Foundation Trust 3 years ago
The Walton Centre NHS Foundation Trust
Submitted on 30/10/2020 at 08:44
Published on nhs.uk at 09:57


Thank you for your comments and we are sincerely sorry to learn of your experience. If you would like to discuss your concerns further please contact our Patient Experience Team at patientexperienceteam@thewaltoncentre.nhs uk or call 0151 556 3091 or 3090 who will be able to support you further.

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by MrTech (the patient)

Thank you for your responses.

Unfortunately I have already contacted the PALS team at Whiston Hospital on several occasions who have passed my concerns to the lead clinicians claiming that no treatment was necesarry. Even when I attended A&E the clinicians stated that it's rare for someone to show up and claim the floor feels spongy and a lack of sensation. I was told that A&E commonly treat heart attacks and conditions that are obvious like a broken bone.

I am dissapointed that my case keeps being "swept under the carpet" and treated as a case of anxiety because I strongly dispute this - I have had anxiety in the past, and it feels nothing like what I am currently experiencing. I believe that assumptions are being made - looking at my past record, seeing anxiety and using this to prejudge the causes of the symptoms. One clinician reccommended I self refer to a free counselling service. I took this advice, but when I had my initial consultation, they were not too worried and did not offer any counselling sessions, simply an online course.

The dizziness, lightheadedness and faintness are worsening every day, but I feel like I cannot attend A&E because I will simply sit there for 9 hours, have the same bloods taken every time which will come back fine (because they test the same ones on every visit) and then I will be sent home feeling no better than when I arrived.

I would like to see both the AMU department and the A&E department to create diagnosis/treatment plans for more complex cases which cannot be resolved immediately, such as listing potential conditions and then testing for each one strategically. It would also be more helpful if less generic responses were posted on here.

I observe what happens is that the main symptom (e.g. palpitations) is noted and the clinical pathway/checklist is followed for this only and the other symptoms (lightheadedness, fainting, dizziness, loss of balance,loss of sensation) are then overlooked. Even if that pathway was exhausted on several previous occasions - the same tests are carried out again.

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