gp/hospital urgent appt

frankie1star

My daughter has been unwell since end of July, she has lost a lot of weight over 1 stone, has discomfort/pain on eating. Been scanned for gall stones, but she doesnt have them, although her scan showed sludge in her gall bladder. At one point recently, she was losing a 1lb per day, but that has slowed up. After numerous visits to her gp, I went with her, (when she was losing 1lb per day) and advised them how poorly she had become. She has previously/still suffers with symptoms of ME, but if she is careful with her health, she keeps it under control. GP agreed to refer her for an urgent gastro appt. Appt came through 10 weeks after for beg November. Things plateaued for about a week, and she resigned herself to being seen then. Then she got worse, her GP wrote again to the hospital. In the meantime, she had a really rough night with vomitting, and looked slightly yellow, so I took her to A & E. they suggested pain killers, but could not influence her gastro appt, told her to return to GP.

After about a week, I suggested she phone the consultants secretary to chase appt up. She spent a whole day waiting for phone calls, phoning bookings clerks being told one thing and then contradictory other things. I finally intervened, and spoke to PALS, and to cut a long story short they explained:- when a GP makes and urgent referral, the consultants downgrade it to routine, despite the weight loss, apparently all gp's say there is weight loss. the 2nd letter written by her gp, used the incorrect terminology saying 'the patient would like her appt brought forward' (words to that effect), and unless her condition changes clinically, they would not expect to see her before the routine appt. I appreciate that there are patients in worse health than her, but given her medical history, she cannot sustain the weight loss, and I am concerned she will become chronically ill again, or end up with an eating disorder (being unable to eat). In the meantime her gp wants to sign her off, but with a proviso if her employers would allow her some flexibility to work from home, he would refrain from signing her off for 2 weeks. Her employers are furious and I believe she is also in danger of losing her job to add to it all. The hospital have brought her appt. forward to Oct 19th, but I just dont know what to do for her, she is detriorating before my very eyes.

Any helpful advice gratefully received

Errata

when a GP makes and urgent referral, the consultants downgrade it to routine

This is completely untrue, unless you're referring to your daughter's case and not cases in general.

Fire_Fox

She cannot lose her job for health reasons without the proper lengthy procedure being followed. Your daughter should accept the medical certificate so the employers have proof of her health issues. Just keep taking her to A&E when necessary, they will admit her to hospital if they believe there is clinical need.

Do bear in mind that weight loss as fast as 1lb a day is largely dehydration not fat or muscle loss - 1g of the carbohydrate fuel glycogen is held alongside 3g of water. Try to have her consume calorie dense foods and drinks little and often from arising to going to bed, a mix of protein and carbs plus healthy fats assuming she has not been advised to avoid this. There are medical meal replacement/ meal supplement drinks that are designed to help patients with the symptom of anorexia gain or maintain weight.

frankie1star

via the help of a nutritionist, we have her eating every 2 hours, a very lean and high protein diet, she drinks litres of water per day

Fire_Fox wrote: »

She cannot lose her job for health reasons without the proper lengthy procedure being followed. Your daughter should accept the medical certificate so the employers have proof of her health issues. Just keep taking her to A&E when necessary, they will admit her to hospital if they believe there is clinical need.

Do bear in mind that weight loss as fast as 1lb a day is largely dehydration not fat or muscle loss - 1g of the carbohydrate fuel glycogen is held alongside 3g of water. Try to have her consume calorie dense foods and drinks little and often from arising to going to bed, a mix of protein and carbs plus healthy fats assuming she has not been advised to avoid this. There are medical meal replacement/ meal supplement drinks that are designed to help patients with the symptom of anorexia gain or maintain weight.

frankie1star

Errata wrote: »

This is completely untrue, unless you're referring to your daughter's case and not cases in general.

so do you think PALS, have it wrong?

frankie1star

just to confirm PALS spoke to the booking clerks, and that is what they were informed by them, and they also read the gp referral letters to me, it seems it was the 2nd letter that is contentious

Fire_Fox

frankie1star wrote: »

via the help of a nutritionist, we have her eating every 2 hours, a very lean and high protein diet, she drinks litres of water per day

Nutritionist or state registered dietician? I am not in any way suggesting they are wrong because there are often restrictions on what can be tolerated, but without sufficient carbohydrates the body simply does not hold water effectively however much you drink. This can lead to rapid scary weight loss but some of it is quite quickly reversible once normal eating patterns can be resumed.

Errata

frankie1star wrote: »

so do you think PALS, have it wrong?

If they were referring to your daughter's case - no. Otherwise - yes.

frankie1star

Fire_Fox wrote: »

Nutritionist or state registered dietician? I am not in any way suggesting they are wrong because there are often restrictions on what can be tolerated, but without sufficient carbohydrates the body simply does not hold water effectively however much you drink. This can lead to rapid scary weight loss but some of it is quite quickly reversible once normal eating patterns can be resumed.

there are plenty of carbs in the form of lentils, potatoes, complex carbs

frankie1star

Errata wrote: »

If they were referring to your daughter's case - no. Otherwise - yes.

why do you think I have been told this?

Fire_Fox

frankie1star wrote: »

there are plenty of carbs in the form of lentils, potatoes, complex carbs

So it's not very high protein, sounds like a low fat diet to me? :huh:

frankie1star wrote: »

why do you think I have been told this?

Your wording in the OP suggested it is always or usually the case, if you only meant in your daughter's case that was not at all clear.