The Nhs

[ccc]

Does it hurt?

It is swollen?

They're the indicators they have to work on unless they have x-ray vision.

It hurts but it is not swollen. Apparently that means if it was broken it has healed and I can go for a run. Now I know I have not been to medical school for 6 years - however I will take a stab that this advice is completely 100% wrong.

From what happened and how it was I don't think it was broken - however it may have been. Having looked at various chats on web it seems this sort of thing can range from minor bash that doesnt feel too bad but drags on - to massive swelling not being able to put your shoe on etc...

I have only broken one bone in my body before. That was my wrist when I was much younger. And that didn't swell up. So the lack os swelling really does not fill me with much confidence that it is not perhaps cracked in some way. Anyway - enough of my detailed chat you must be bored - at least I will know next week. I better be using a smiley emoticon when I provide an update !!

[SarahBell]

It hurts but it is not swollen. Apparently that means if it was broken it has healed and I can go for a run. Now I know I have not been to medical school for 6 years - however I will take a stab that this advice is completely 100% wrong.

From what happened and how it was I don't think it was broken - however it may have been. Having looked at various chats on web it seems this sort of thing can range from minor bash that doesnt feel too bad but drags on - to massive swelling not being able to put your shoe on etc...

I have only broken one bone in my body before. That was my wrist when I was much younger. And that didn't swell up. So the lack os swelling really does not fill me with much confidence that it is not perhaps cracked in some way. Anyway - enough of my detailed chat you must be bored - at least I will know next week. I better be using a smiley emoticon when I provide an update !!

Is it warm to touch? (warmer than other bits of extremity? NO not that one)

I had severe pains in my wrists for years when I was younger and they refused to xray them saying if I hadn't had an accident nothing would be broken.

I now have painful hands too and the joints aren't warm or swollen but it doesn't stop them hurting. One doc sent me for an xray and said she'd send me again in a couple of years if they still hurt as there was nothing showing on them.

Maybe I'm just mad though?

[RichB]

Is it warm to touch? (warmer than other bits of extremity? NO not that one)

Thought that was horses?

[Kurt Barlow]

Had an MRI and that was fine...

Lymes test? Don't know. They did lots of blood tests but I don't recall that one and not sure about b12 either.

Can I get a copy of my hospital records to find out what they did?

(Or do all results get sent to GP and it's easier to ask GP? I assume it's the same request but to different places cos they don't do proper joined up thinking)

I see :-

The health records manager, GP or other healthcare professional will decide whether your request can be approved. They can refuse your request if, for example, they believe that releasing the information may cause serious harm to your physical or mental health or that of another person.

Wouldn't that do your head in!

Sounds like the NHS.

A numb face sounds like either a periphal neuropathy or a CNS issue. Thats why I mentioned and MRI because this would show any lesions on the CNS inc the brain. Both B12 deficiency and Lymes can cause symptoms as you describe. Lupus also comes to mind.

I would definitely ask about Lymes disease testing because can cause Bells Palsy (which is one possibility from what you describe). If you do go for it read up first because GP's know feck all about Lymes. Ask that the blood test is the wetern blot not the useless Elisa test.

[SarahBell]

Thought that was horses?

You don't want to be touching horses extremities.

I thought humans too.

I have reynaulds which makes my hands cold so I suspect mine will never be warm

;-/

http://www.nhs.uk/conditions/broken-toe/Pages/Introduction.aspx

How do I know if I’ve broken my toe?

A broken toe will be painful, swollen and red. There may be bruising of the skin around the area and sometimes a collection of blood underneath the toenail. You will find it difficult to walk and wearing a shoe will be painful.

If the break is severe, the toe may stick out at an angle.

Most broken toes, especially broken little toes, can be cared for at home (see box, left) and medical treatment is not necessary.

[Lagarde's Drift]

ccc stop being a wuss and get an Xray. well done for thinking about the chiropractor.

and no, without XR vision (and even with Xrays sometimes), you cannot rule out a fracture.

The NHS is geared towards the old, young and bone idle, so broken toes are fine for them. Not for someone who intends to keep running for the rest of their life.

[ccc]

Is it warm to touch? (warmer than other bits of extremity? NO not that one)

I had severe pains in my wrists for years when I was younger and they refused to xray them saying if I hadn't had an accident nothing would be broken.

I now have painful hands too and the joints aren't warm or swollen but it doesn't stop them hurting. One doc sent me for an xray and said she'd send me again in a couple of years if they still hurt as there was nothing showing on them.

Maybe I'm just mad though?

Nah not warm. Just feels strange. Who knows. If it is not broken then I will just get on with it. No worries. Just due to the amount of sport I do I am incredbbly wary (probably too much so) of potential chronic injuries. I know a fair few people that have them. And they sound like a nightmare for someone who regularly trains sometimes twice per day.

You don't want to be touching horses extremities.

I thought humans too.

I have reynaulds which makes my hands cold so I suspect mine will never be warm

;-/

http://www.nhs.uk/co...troduction.aspx

How do I know if I've broken my toe?

A broken toe will be painful, swollen and red. There may be bruising of the skin around the area and sometimes a collection of blood underneath the toenail. You will find it difficult to walk and wearing a shoe will be painful.

If the break is severe, the toe may stick out at an angle.

Most broken toes, especially broken little toes, can be cared for at home (see box, left) and medical treatment is not necessary.

Not wanting to sound too cynical - however that is the NHS and they are trying to get people to look after it themself at home.

People get stress fractures and apart from the pain sometimes nothing else shows up at all.

Anyway - by the sounds of that it is prob not broken. Still - I am gonna find out.

ccc stop being a wuss and get an Xray. well done for thinking about the chiropractor.

and no, without XR vision (and even with Xrays sometimes), you cannot rule out a fracture.

The NHS is geared towards the old, young and bone idle, so broken toes are fine for them. Not for someone who intends to keep running for the rest of their life.

Quite. I imagine if you got a Doc who was similarly into sports and had similar injuries themselves - they may show a bit more empathy. Seems the 'normal' ones don't care. Interestingly I have had a funny ringing in my ear for ages now. Went to doc ages ago and they sent me to specialist with no asking and then I got an MRI just to check in case it was something serious. I didn't say or ask for anything. Totally opposite of this.

I suppose the potential to be sued if they miss a brain tumour has been stuck on some list . However potentially ******ing someones keep fit activities - does not carry the same potential recourse ?

The really strange thing is why private places wont do it walk in for £££. Surely for something like this a GP's note is not required at all ? I find it strange they turn down easy money.

Anyway. I shall have a few bevvies this weekend to ease the pain.

[Guest eight]

You don't want to be touching horses extremities.

Was once in a queue to get into a football ground (Hillsborough, as it so topically happens) and the police horse next to us started having a rather copius wee. So the guy in front thought it would be funny to grab its tadger and point it at his mate. How we laughed. Naturally he was arrested; I dread to think what kind of charges they could land on you for that.

[Lagarde's Drift]

People get stress fractures and apart from the pain sometimes nothing else shows up at all.

I suppose the potential to be sued if they miss a brain tumour has been stuck on some list . However potentially ******ing someones keep fit activities - does not carry the same potential recourse ?

The really strange thing is why private places wont do it walk in for £££. Surely for something like this a GP's note is not required at all ? I find it strange they turn down easy money.

Toe stress fractures are incredibly rare, I would imagine.

Once a doctor suspects a tumour (for you, it was probably an acoustic neuroma ) you get sent into the system. As you are aware, for cancers the NHS is rather good value for money.

I agree about the weird private thing. People get whole body scans privately, why can't you just get a toe XRay? Weird.

[ccc]

Toe stress fractures are incredibly rare, I would imagine.

Once a doctor suspects a tumour (for you, it was probably an acoustic neuroma ) you get sent into the system. As you are aware, for cancers the NHS is rather good value for money.

I agree about the weird private thing. People get whole body scans privately, why can't you just get a toe XRay? Weird.

Aye sure they are - just saying that sometimes your bones can have serious issues and there are no obvious signs. I don't accept the one size fits all way of working out what you may or may not have. Especially when there is a fairly inexpensive and simple way to know 100%.

Yes quite impressed with the whole scan thing. Then again - it is obviously at the expense of other areas of the system.

Private thing is very strange. Especially as it is not a legal requirement. I can see why they cover their bases with lots of other things. Makes sense to me. However something like this. Very strange.

Anyway rather depressing. All the chat on the recent thread about running is making me very jealous. Full time athletes who are out for years must literally go loopy.

[porca misèria]

Was once in a queue to get into a football ground (Hillsborough, as it so topically happens) and the police horse next to us started having a rather copius wee. So the guy in front thought it would be funny to grab its tadger and point it at his mate. How we laughed. Naturally he was arrested; I dread to think what kind of charges they could land on you for that.

You're takin' the ....

[Habeas Domus]

Heres my little NHS story - had a ski accident in switzerland which involved an operation and some hardware screwed into the bone, the Swiss surgon informed me in no uncertain terms that "you will have to have a second operation in 18 months time to get the hardware removed"

Back in the UK, get a referral 18 months later - advice from the NHS consultant was "no we'll just leave that in, we do things differently than the Swiss, you'll be fine", so I immediately asked if he could refer me to a private hospital for a second opinion.

He refers me to HIMSELF on the one day of the week when he works privately, 2 weeks later (in a private hospital 5 mins drive from the first one) the advice from the same guy: "Yes I definitely think it would be wise to have the hardware removed"

So I got the work done but it cost £5000 (not covered by the ski insurance) - a big chunk of my savings at the time - and thats why I couldn't afford to buy a house!

[ccc]

We do it differently to the swiss = they do it properly. Was telling my pal about this last night and he works with loads of indians - if they have something serious needing done they head back to india to get it done privately and for good value - they tell him it is so much better than the nhs - how depressing

[Lagarde's Drift]

If you're not old, young or bone idle the nhs is not for you. It is great if you ate, though. I wonder how the poor in India fare with their healthcare. I would ask the same of the swiss but somehow I don't think anyone's poor there.

[RichB]

Heres my little NHS story - had a ski accident in switzerland which involved an operation and some hardware screwed into the bone, the Swiss surgon informed me in no uncertain terms that "you will have to have a second operation in 18 months time to get the hardware removed"

Back in the UK, get a referral 18 months later - advice from the NHS consultant was "no we'll just leave that in, we do things differently than the Swiss, you'll be fine", so I immediately asked if he could refer me to a private hospital for a second opinion.

He refers me to HIMSELF on the one day of the week when he works privately, 2 weeks later (in a private hospital 5 mins drive from the first one) the advice from the same guy: "Yes I definitely think it would be wise to have the hardware removed"

So I got the work done but it cost £5000 (not covered by the ski insurance) - a big chunk of my savings at the time - and thats why I couldn't afford to buy a house!

I wonder if that really tells you more about the NHS or the private system?

[SarahBell]

I wonder if that really tells you more about the NHS or the private system?

Or just the twisted nasty relationship the two have.

[ccc]

Just in case anyone is interested. Went to Chiro - she gave it a proper examination rather then just a wee prod. Said the same thing as the others. No point getting x-rayed. However she did actually bother to explain why to me and said the others should have done the same. So their advice was actually reasonable - they just didn't bother to explain to me why. Being such a small bone the chances of any crack showing up are very slim - and even if it did we apparently all break our toes quite often during our life - so it would not even be easy to tell if the crack was recent or something I did when I was 8 years old.

Anyway - she was saying a few bits of research recently seem to indicate that exercise is the best thing for inflammation - contrary to normal opinion. So back on it - swim and yoga on Wednesday and a good cycle today and feels not perfect - but pretty good.

London 2012 is still within my grasp.

[aussieboy]

Now before I start I will make it clear that by all accounts - for emergencies and the rest of it they appear to be very good. However for any sort of minor ailment ? What a crock of shite.

Stubbed my toe 4 weeks ago which is normally no big deal. However it is actually worse now than it was just a few days after I did it. Went in for an x-ray just to check if broken or not. They dont do x-rays apparently. Said for me to come back if it didnt get better. So I did a week later. They told me the same thing. I did inform them that it had got worse and not better - however they just were not interested. Last time I had to get an x-ray through my GP it took about 4 weeks from start to finish. it is ridiculous.

Now she did say that the treatment for a sprain or a broken toe was the same - so no point in x-ray. Well that is fair enough up to a point. But mine is not getting better it is getting worse FFS !! And you dont have to be a medical expert to know that means something is wrong and simpel rest is not going to fix it. Because I am resting it and it is getting worse. FFS the logic is pretty obvious.

Could be a ligament tear or tendon or similar damage - who knows. Or it could be a break near the joint - and according to numerous chats on the internet this can lead to long term issues and arthritis etc.. However foto rule out any of this I would need a scan and an x-ray. Anyone know how I could get one of them easily ? And I dont mind paying !! Can I just wander up to a private hospital and say scan this and let me know what the score is please ?

I have read various health/sport forums and people from other countries very casually say things like 'I went for a scan just to make sure it was nothing serious'. Is this possible in this country if you are not some sort of professional sports person ?! How do I just go for a scan to put my mind at rest

Was in France a few years back skiing and got a wee niggling pain in my achilles. Went to the health centre in the resort. Within a couple of hours hours had seen both a doctor who had x-rayed me - and then a scan bloke who did some sort of scan to have a look at the fibres. And I got medicine and taping and cream and this all cost me only £70. Job done - know it is nothing serious - away you go. 4 hours. And I even got given the x-eray and scans in case it flared up again to giev to another doc if required. How many weeks or more probably months would it take to get the same in this God forsaken country

Anyway - rant over. I just needed to get that out.

You have answered your own question. I'm sure if you develop preventable arthritis in 30 years time you can have a nice cathartic experience suing the NHS.

A little.

But I am still pretty pissed off at the money that I pay into a service that on many occasions is a pile of piss.

Sounds like your running is going well. I am rather jealous.

The value you will rip out of the NHS will, over the years, in all likelihood far outstrip your contributions. Unless you're an evil banker or something in which case you will probably be going private.

[aussieboy]

By the sounds of it he thinks he gets a good service - but you do have to pay €50 for it. Bring it on !!

As for my toe thing - anyone here with any medical knowledge ?

Is it possible for a doc to 100% know if a bone has healed properly (Or even know if it was broken in the first place) without doing an x-ray ? I don't think so. And if not - them just telling me to head out and get back on bike or try to run again is shocking advice. Is it not ?

Amazing: you ask on an internet forum for medical advice having received some already, face-to-face from two (I think) highly trained GPs and for free.

Why would you more likely trust anonymous advice? Because it fits in with your own view of what's wrong?

I'll give you one bit of advice for nowt: the Xray won't pick up everything. So if there's nothing to see seen, what next... CT scan? Homeopathy?

Dude, you've stubbed your toe. Who hasn't. You're seeming a bit obsessed... perhaps a turf to Psych rather than Radiology.

[ccc]

You have answered your own question. I'm sure if you develop preventable arthritis in 30 years time you can have a nice cathartic experience suing the NHS.

Already is arthritic. Just one bash and you can get permanent joint damage. Although she says it should calm down gradually - but cannot be guaranteed. Will just have to see how it goes.

Chiro had way more knowledge of this stuff than the other two. Suppose bones are her speciality but you would have thought a Doc or a minor injury clinic bod would have a bit more knowledge.

The value you will rip out of the NHS will, over the years, in all likelihood far outstrip your contributions. Unless you're an evil banker or something in which case you will probably be going private.

You reckon ? If this is the case then how exactly does it work ? All depends on how healthy you are of course. So I suppose if you do end up getting shafted money wise - you could also be grateful for not having to have to use it that much.

Roughly speaking if you use half of your NI contributions towards the NHS - I paid through myself and employer contributions about 3k towards the NHS last year. I am sure it all balances out. Until you start work you pay nothing - and yet get a quite a lot of usage - and then as you get older you use it more.

All the money comes from tax - so if it is not covered by the UK's NI contributions it will have to come from elsewhere.

[ccc]

Amazing: you ask on an internet forum for medical advice having received some already, face-to-face from two (I think) highly trained GPs and for free.

Exactly how was it free

I pay a fortune for these services and these 2 didn't even bother to tell me some basic facts that would have made it clear to me. Not much to ask is it ? The private sector seem able to do this. And it doesn't cost them any more money. Just basic customer service.

Why would you more likely trust anonymous advice? Because it fits in with your own view of what's wrong?

I was just interested in what others had to say on the matter. The internet can be very useful for this. Other people may have had a very similar injury - always useful to hear real anecdotal evidence.

I'll give you one bit of advice for nowt: the Xray won't pick up everything. So if there's nothing to see seen, what next... CT scan? Homeopathy?

Dude, you've stubbed your toe. Who hasn't. You're seeming a bit obsessed... perhaps a turf to Psych rather than Radiology.

I am a bit obsessed. Much of my life is keeping fit and being active. For others a stubbed toe that is not getting better is no big deal. For myself however it is. If a footballer had the same issue they would be sent in for scans and all sorts. Why exactly should I accept a sub standard service just because I am not a 'pro' ?

My training is just as important to me as it is to any other person who does it every day of their life.

All the NHS had to do was show a bit more care and actually listen to what I was asking and give me a bit of information. My chiropractor had no issue doing this and it took about 20 seconds.

Looking at a full private medical cover is circa £2k per year. On top of the 3k I already pay - that means I am looking at around £5K per year for a medical service that I would class as decent with coverage for emergency stuff and also quick dealings for non emergency stuff.

I don't think the service we get is THAT bad - however the next person who tells me I get it for free and it's so much better than places like the US can expect a visit to A & E themselves.

[aussieboy]

Exactly how was it free

I pay a fortune for these services and these 2 didn't even bother to tell me some basic facts that would have made it clear to me. Not much to ask is it ? The private sector seem able to do this. And it doesn't cost them any more money. Just basic customer service.

I was just interested in what others had to say on the matter. The internet can be very useful for this. Other people may have had a very similar injury - always useful to hear real anecdotal evidence.

I am a bit obsessed. Much of my life is keeping fit and being active. For others a stubbed toe that is not getting better is no big deal. For myself however it is. If a footballer had the same issue they would be sent in for scans and all sorts. Why exactly should I accept a sub standard service just because I am not a 'pro' ?

My training is just as important to me as it is to any other person who does it every day of their life.

All the NHS had to do was show a bit more care and actually listen to what I was asking and give me a bit of information. My chiropractor had no issue doing this and it took about 20 seconds.

Looking at a full private medical cover is circa £2k per year. On top of the 3k I already pay - that means I am looking at around £5K per year for a medical service that I would class as decent with coverage for emergency stuff and also quick dealings for non emergency stuff.

I don't think the service we get is THAT bad - however the next person who tells me I get it for free and it's so much better than places like the US can expect a visit to A & E themselves.

I don't want to labour the points or get into some debate about homeopathy and its mates, but:

- there is no evidence that chiros work other than via placebo. If he had a crap bedside manner, then he would have little to offer so bully for him.

- I think we're agreed that over the long term you did not pay a fortune for your consults so let's leave that one.

- When a NHS doc listened to you and showed concern, you dismissed this post hoc as a fobbing off. Looks like there's no way to win with you.

Two things: (1) the last thing you want is to end up in the "treatment trap"; (2) catastrophising about possible long term effects is not linked with a fantastic prognosis. That'll be my contribution to the online anecdotes.

Edit: typo

[ccc]

- there is no evidence that chiros work other than via placebo. If he had a crap bedside manner, then he would have little to offer so bully for him.

Have you ever been t o a chiropractor ? Now I know they have differening views on things. However mine is very much about bones and joints and how they fit together. Doesn't seem to be too much into how this all affects different organs and everything else.

I can assure you there is more than a placebo going on. They do manipulate bones and the such. You sort of know this when it is happening.

- I think we're agreed that over the long term you did not pay a fortune for your consults so let's leave that one.

Sorry ? I paid 3k for the NHS last year. And have so for the past 5 years. I can certainly assure you my cost to them has not been anywhere near this amount. And as I have pointed out - this works out at 50% MORE than the cost of comprehensive private medical cover.

- When a NHS doc listened to you and showed concern, you dismissed this post hoc as a fobbing off. Looks like there's no way to win with you.

Yes indeed - I didn't realise at the time. You know hindsight is a wonderful thing.

There is a very simple way to win with me re. medical stuff. Know what you are talking about and give me good advice because I pay a lot of money for the service. Is that really too much to ask ?

Two things: (1) the last thing you want is to end up in the "treatment trap"; (2) catastrophising about possible long term effects is not linked with a fantastic prognosis. That'll be my contribution to the online anecdotes.

I agree to an extent. However it is a fine line. I know people who have 'fought' through ailments and if they had just given them a little more rest they would have been far better off. On the other hand I agree that you can get too bothered about potenital future issues. This is why I go to people I assume know what they are talking about to give me good advice.

When you were listened to by a medic who showed you consideration, you seemed to consider that as being fobbed off.

The things your chiro told you have no evidence base.

It is quite simple - I was told by two different people "We don't do x-rays for that"

The third added to this by saying "There is no point in giving you an x-ray because...."

You understand the difference ? As for no evidence basis - I trust someone who deals with bones and x-rays non stop every day of their life to know a little about this stuff.

[Radge]

6 pages, an appeal for anonymous interweb advice, 2 or 3 GP appointments and finally accepts the same advice from a chiropractor (how much was that?) who'd have a hard job pointing to an uncontested scientific study that showed chiropractic actually works, all for a stubbed toe. Gawd save us if you contract anything serious, CCC. I'd start looking at the other end.

!

[aussieboy]

Have you ever been t o a chiropractor ? Now I know they have differening views on things. However mine is very much about bones and joints and how they fit together. Doesn't seem to be too much into how this all affects different organs and everything else.

I can assure you there is more than a placebo going on. They do manipulate bones and the such. You sort of know this when it is happening.

I have to confess I have been to a chiro, at the insistence of my credulous partner. This was pre-med school: I went with no prejudices and even paid the guy. However, his knowledge of anatomy was patchy and what he did to my neck bordered on the criminal... I didn't go again, although the pre-neck-wrench massage was pleasant.

So, my dislike is founded on evidence and anecdote, which covers both bases.

Sorry ? I paid 3k for the NHS last year. And have so for the past 5 years. I can certainly assure you my cost to them has not been anywhere near this amount. And as I have pointed out - this works out at 50% MORE than the cost of comprehensive private medical cover.

Long term. We've had this discussion.

Yes indeed - I didn't realise at the time. You know hindsight is a wonderful thing.

There is a very simple way to win with me re. medical stuff. Know what you are talking about and give me good advice because I pay a lot of money for the service. Is that really too much to ask ?

You received good advice. See below.

I agree to an extent. However it is a fine line. I know people who have 'fought' through ailments and if they had just given them a little more rest they would have been far better off. On the other hand I agree that you can get too bothered about potenital future issues. This is why I go to people I assume know what they are talking about to give me good advice.

You mindset and history of doctor and "doctor" shopping indicates clearly that you are deep in the treatment trap. You are showing insight though which I hope means you can adapt to the discomfort until it goes away... or doesn't.

It is quite simple - I was told by two different people "We don't do x-rays for that"

The third added to this by saying "There is no point in giving you an x-ray because...."

You understand the difference ? As for no evidence basis - I trust someone who deals with bones and x-rays non stop every day of their life to know a little about this stuff.

Consistent message given different ways. The first two chaps may have been under time pressure (given the underfunding of the system what with GBP3k pa not being sufficient for lifetime cover (see above)).

Yours a typical story: doctor shopping until you end up with Dr Steve the placebo guy with his rudimentary knowledge of Gray's for Med Students and his lots of time for you because he charges by the hour.

There's no argument that the first GP needs to sort out their communication skills (I'm sure they'll be on an expensive training course soon).

Doesn't stop their clinical advice being spot on, though. They "Know what you are talking about and give me good advice because I pay a lot of money for the service.". However your issue seems to relate to them not explaining matters sufficiently for you, which seems to be the major beef so I'm not sure whether those are your true criteria for winning with you re.medical stuff.

Doesn't stop you undergoing pointless manipulation of your phalanges and metatarsals (what on earth will that achieve? Has Dr Steve told you?) so as far as your GP goes his/her care was substandard.