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"A tale of two cities"

About: Nottingham NHS Treatment Centre(Nations Healthcare) / MRI scans Nottingham NHS Treatment Centre(Nations Healthcare) / X-rays Nottingham University Hospitals NHS Trust - Queen's Medical Centre Campus / Accident and emergency Nottinghamshire County Teaching PCT Salisbury District Hospital

(as the patient),

A year ago I fell off my bike and dislocated my shoulder, as a result I visited the London Road walk in centre. This is where the story began. And I must say that I cannot praise the nurse in the walk in centre highly enough she looked after me well in spite of being able to do very little with the resources available.

I was taken to QMC A&E and had X-rays on my shoulder which was then put back. However, what was not noticed at the time was that I had damaged my back.

A few weeks after the accident I went to my GP with sciatica down my right leg. My GP did the tests and diagnosed the problem. He told me that this would, most likely, clear up on its own. He didn't prescribe any drugs at this stage.

The sciatica didn't clear up however, but, because I had been told to be patient I didn't go back to my GP until July. I was due to be going on holiday and just wanted to know if there were any painkillers he could prescribe. My GP was concerned to see me and to see that I was still in pain. He prescribed Paracetamol and Diclofenac at this stage and referred me to be seen by a specialist. I went back to my GP later and he prescribed Tramadol in addition and signed me off work for two weeks.

After several weeks I was seen by a Physio who did give me exercises to do which really helped. However as I work away from home in Salisbury it was not easy to arrange appointments. The team though were very helpful and accommodating. My physio, Judith Gray, has been extremely kind and supportive even though I have been very emotional during this time.

On return to work I started to endure symptoms of Kidney stones, I have suffered with these for some years and have been treated in Nottingham for them over this time, so I recognised the signs. I took myself in to Salisbury A&E and was admitted over night.

Salisbury have been absolutely superb with the way they have treated my kidney stones, it culminated in having a stone removed. They are now investigating the underlying causes and I am waiting for the results of these tests. I have been suffering with kidney stones since 1992, this is the first time they have been properly investigated. Salisbury have been pro-active, efficient and very good at keeping to time with appointments. A whole new experience for me.

During this time I was still taking Tramadol, I have subsequently realised that this was having a dire effect on my emotions and physically. I had reached a point where everything felt too much, I was getting anxiety attacks and was unable to sleep. I was also shivering uncontrollably for much of the time.

I visited my GP about this and the growing back pain which seemed to be getting worse. I was put on to some more pain killers. No link was made between the Tramadol and the psychological symptoms I was displaying, even though I got very emotional with the GP.

It was my wife who suggested that the shivering and emotional symptoms may be withdrawal symptoms from the Tramadol. At one point I had a seizure and was taken into QMC for investigation. It was put down to my kidney stones but I am now certain it was caused by Tramadol. I have stopped taking them and now feel very much happier though I still have the back problems.

My physio, who through all these emotional times has been really supportive helping me to focus on the positive improvements, referred me to have an MRI scan, my GP had already suggested that he believed that I should have an MRI.

I was then seen after a long wait by a Locum Mr Quinnell at QMC. After seeing me for a very short consultation he too said I needed an MRI scan. The third person to say this, but I was no closer to having the scan!

Eventually I actually had the MRI scan in December. The appointment came through reasonably quickly (about 2-3 weeks I think).

However, the results to the scan have been anything but quick to come through.

In fact, Salisbury hospital, who were removing a kidney stone under a general anaesthetic contacted QMC to chase the results and managed to get them faxed through to them so that they wouldn't make my back problems worse whilst operating. Once again, Salisbury were pro-active and frankly much more efficient than Nottingham.

It wasn't until mid January that I received the appointment from Nottingham to see Mr Quinnell to go through my results, even though the results were completed in December. After all, I had seen them and had them explained to me in Salisbury.

After another short consultation (which was an hour after the appointment time) Mr Quinnell told me that I would need an operation and that it should be within 4-6 weeks. I have been in touch with his secretary a couple of times now and have been told that I now need to be referred on to another consultant, Mr Coreshi, who will then decide if I need an operation.

I am reaching a point of total frustration. My life is severely restricted by the back pain, I am unable to walk very far, 10 minutes walking is my limit.

I feel that I have been passed from pillar to post, and it feels that I am simply being moved from one waiting list to another. I have had this issue for a year now, and don't feel any closer to a resolution, my work life is suffering and my home life is suffering. I cannot enjoy any of my normal pass times or hobbies and my family are getting frustrated with me. I am 42 years old, but frankly I feel more like 82 years old.

In summary, my GP has been ok, but should not have prescribed Tramadol. It has had a severe effect on me and I would urge anyone taking it to stop, the effects are dreadful. My physio has been wonderful, really very helpful and supportive.

Salisbury hospital has been efficient, pro-active and friendly. Nottingham has been appalling. In stark contrast to Salisbury, they have been inefficient, slow and unsupportive. The communications from them have been slow arriving and unhelpful when they do arrive.

I think my story shows that in parts of the NHS this work well, but not in all areas. Nottingham could learn a lot about how to treat patients from Salisbury.

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