St. John's House Surgery - Worcester - Name 'Em and Shame 'Em

[craigwalsh]

I have been registered at the St. John's House Surgery in Worcester for 17 years (except for a few years when I was back in Hawaii --- but the "system" unregistered me, I didn't). I've been healthy for most of this period, and haven't needed their services. I just received a copy of my entire handwritten chart yesterday --- obtained under the provisions of the Data Protection Act. It's only eight pages, most of it illegible.

I have been suffering from chronic pain since last summer, and managed to complicate matters by fracturing my back (T11) in early May, 2006. The Worcester Royal Infirmary did not diagnose this fracture correctly, despite my spending 11 or so hours in A&E.

The folks at St. John's have been really quite lousy at helping me to cope with my chronic pain. Heck, they admitted this themselves in a letter to an insurance company on my behalf from Dr. R. Ingles dated November 3, 2006:

http://www.aquarena-springs.com/images/st-johns-1.gif

I saw Dr. Ingles on September 15, 2006, after seeing (privately) a pain consultant that I found fairly useless --- Dr. J. J. Lee at BUPA South Bank in Worcester. My thoughts about Dr. Lee are contained elsewhere --- click here (http://www.sucks.org.uk/?p=22). There's even a recording of him yelling into my wife's voice mailbox: turn on your speakers and pump up the volume.

Dr. Lee wouldn't actually prescribe medication: he told me that I needed to see my own GP. It took from July 7 (when the orthopedic specialist first mentioned a pain specialist) until August 24 for me to see Dr. Lee. It then took until September 15 for me to get an appointment with my GP.

In this period my wife, Marjorie, had found the Pain Management Unit at the Royal National Hospital for Rheumatic Diseases in Bath. They were happy to do a two-hour initial consultation (privately, not on the NHS): they just needed a referral from my GP. Dr. Ingles refused to refer me, even though the folks at BUPA would pick up the tab.

Instead he prescribed Dr. Lee's recommended Durogesic (fentanyl) transdermal patches (http://www.duragesic.com/) (50 mcg/hr). He didn't mention that these are an opioid: they're really morphine, but packaged in little patches. A bit like what you'd take for seasickness. Not at all what heroin addicts would take down some dark alley in the East End.

Dr. Ingles didn't tell me that constipation was a certain side effect (although he maintains he did), nor did he give me any advice or medication to cope with this problem. I have requested a copy of my medical record from the Surgery, and the notes from Dr. Ingles' September 15 consultation aren't there: just an indication "comp." "Comp" = computer? Strange that my request under the Data Protection Act was somehow thought to exclude information held on a computer. (I will follow up on this.)

Dr. Ingles didn't tell me that fentanyl is a Class A Drug (http://en.wikipedia.org/wiki/Misuse_of_Drugs_Act_1971#Class_A_drugs). If I were to give one of these to my wife, thinking it would help her, I could be found guilty of a felony under the Misuse of Drugs Act 1971. (Don't worry, my wife and I don't share medication.)

The results of my taking the Durogesic patches are documented elsewhere (http://www.sucks.org.uk/?p=12). They were a complete disaster for me. I again asked (on October 6) for a referral to Bath, and the letter was sent on October 11.

After my meeting in Bath on November 16, and still not knowing that I was taking addicitive opioid medication (Tramadol and BuTrans patches (http://emc.medicines.org.uk/emc/assets/c/html/displaydoc.asp?documentid=16787)) I decided that I'd had enough of medication that seemed to make things worse, and not better. So I peeled off the patch and flushed it, and stopped taking the eight 50mg Tramadol tablets per day, as prescribed.

Then I thought I was getting a cold. Hot and cold flashes, but no fever. Headaches. Nausea. Surprise, I was having withdrawal symptoms from opioid medication. The NHS had made me a junkie, and didn't even bother to tell me.

The pain in my back and legs has, of course, increased. But I would rather cope with it than with all of the problems of the opioids. And they weren't doing a great job of controlling the chronic pain anyway.

The problem that remained was that I couldn't sleep. My legs would begin to ache in the evening, just when I was trying to get comfortable. The ache would be instantly relieved if I moved them, but would then come back when I stopped. If I fell asleep before the ache, it would just wake me up --- in 10 or 20 minutes. I did a lot of research on the internet, and foun the website for Restless Leg Syndrome (http://www.rls.org). The symptoms described on the website were exactly what I was experiencing.

RLS can come as part of opioid withdrawal: I've looked on many detox websites, and have spoken with about six or seven after-care detox nurses. I even purchased and read a scientific article entitled

RLS can also come following a spinal injury: I fractured my back in early May, but have been on painkillers ever since. Now that I've quit, cold-turkey, perhaps there's nothing to mask the RLS.

( . . . to be continued . . . there is a limit on the size of each posting . . . )

[craigwalsh]

I wrote a letter at night on December 1 --- my 8th sleepless night. During these eight days I'd been into my GP's surgery twice (November 27 and November 29), spoke with the worthless GP Out-Of-Hours Service virtually every night, and even had an Out-of-Hour doctor come to see me once. (He said he "believed" in RLS, but had no medication for it. He said he could give me a sleeping tablet that would work: he called it a "Z tablet." But there were none in his fishing-tackle sized box, so that was it.)

Here's the letter I faxed at 4:10 AM:

Dr. Claire D. Webster
St. John’s House Surgery
28 Bromyard Road
Worcester WR2 5BU


URGENT – PLEASE REVIEW AS SOON AS POSSIBLE – THANK YOU

http://www.aquarena-springs.com/images/Dear-Doc.jpg
Thank you for spending so much time with Marjorie and with me on Wednesday afternoon.

A brief recap, for the record. I’ve been disabled with tremendously painful bilateral Achilles’ tendonitis since August 2005. I complicated matters by fracturing my back (T11) in early May 2006, and the NHS added to my misery by misdiagnosing this fracture. It was only when BUPA repeated my CAT scan three weeks later that the fracture was located. The pain from my Achilles’ tendons is now overshadowed by the unremitting pain from my back. The fracture seems to have somehow “set off” my long-standing roto scoliosis.

I have seen many of your colleagues, and they have tried, in vain, to prescribe medication to relieve my pain. I was referred by Mr. Grainger to a “pain specialist” at BUPA South Bank, Dr. J. J. Lee. I saw him on August 24, 2006 and found his advice fairly basic --- and totally useless. As my chart will show, Dr. Lee recommended an increased dose of Tramadol, and the addition of other medication (durogesic patches, oxycontin). Dr. Lee said these should be prescribed by my own GP, and this was done by Dr. Ingles (I believe) on September 15. He prescribed Durogestic DTrans 50 mcg/hr fentanyl transdermal patches. I picked these up at the chemist on September 18, and tapered off the Tramadol during the first three days of wearing the patch.

By Saturday, September 23, I was in tremendous pain --- so much so that I attended the GP Out-of-Hours service at Worcester South Bank. I had an awful experience there (a formal complaint was sent to John Rostill about this on October 17, 2006 and I have a meeting scheduled with John this Saturday to discuss the event). In the end I spent a further three hours in A&E, and the young house doctor knew so little about Durogesic patches and Tramadol that he had to call someone at their home.

Back to my GP. This time I saw Dr. Salter. He told me that Dr. Ingles should not have prescribed the “medium strength” of Durogesic patches to begin with, but should have started at the lower dose. Dr. Salter prescribed BuTrans 10 µg/h buprenorphine transdermal patches on October 19. He also told me to up my dosage of Tramadol from several 50mg tablets per day to eight 50mg tablets per day, plus eight 500mg tablets of Paracetamol.

These medications did not really reduce my level of pain. Instead, they “changed” me into someone listless, disinterested in life, no appetite, horrible constipation, etc. At no time did Dr. Lee (the supposed “pain specialist”), Dr. Ingles, or Dr. Salter warn me of the risks of opioid addiction. I was not allowed to make an informed choice. I was not advised, even by the pharmacist, that BuTrans is a Class A drug. Instead, I saw cute little patches --- that remind me of seasick medication --- in a lime green box.

If you prescribe addictive opioids you need to very carefully advise the patient what you’re doing, and advise the patient about the side effects and the risks of withdrawal. I don’t care if you have ten or ten thousand other patients waiting in the waiting room. This is important, serious stuff --- before you convert a patient into an opioid addict, you need (at least in my opinion) to be very, very sure that the patient knows what (s)he’s doing. And you need to remember that folks in pain are not necessarily the most lucid people on earth. So put it in writing!

Initially Dr. Ingles refused to refer me (at my request) to the Pain Management Unit in Bath. I couldn’t understand his refusal --- particularly when BUPA would be paying the bill. When I went back again, he agreed to the referral. I saw a physician and a psychiatrist in Bath on November 16. They expressed surprise at the fact that I was not given tablets or some method of coping with the severe constipation that I was experiencing.

After my visit to Bath, I decided --- on November 19 --- that I’d had enough of the groggy, depressed, disinterested feelings caused (I thought) by my medication. And I wanted to see how bad the pain would be without the medication. At no time was I warned that the opioids could not just be stopped --- that I needed to go through a detoxification regimen.

I peeled off the patch and stopped taking all Tramadol on November 19. Yes, the pain in my Achilles’ tendons and my back has come back with a vengeance, but it never went away with the opioids. And I feel better able to cope with the pain now that I am me, and not some drugged out addict. Thanks to the NHS.

I went through a fairly tortuous time last week. Had I known, I think I would have checked myself into a detoxification facility. But I didn’t know. That’s my point.

And now the Restless Leg Syndrome (http://www.rls.org) remains. This is a known symptom following opioid withdrawal. When I saw Dr. Ingles on Monday, he didn’t want to see my internet research --- he knew better. And he told me, in what I personally feel was a patronising and highly offensive manner, that this is “not a debating society.” What does that mean? That he does not want patients to try to understand what’s happening to them? I think the fact that he played a material part in my addiction speaks volumes. This darned well should be a “debating society,” with the patient actively participating in his or her own treatment. Who does Dr. Ingles think he is?

Dr. Ingles didn’t like the fact that I’d looked on the horrible internet.

I haven’t slept more than about ten minutes at a time since last Wednesday night. I am now about eight days without any real sleep. I am exhausted, I feel like crying or lashing out --- or both. I’ve called the GP Out-of-Hours service on most nights, and a doctor actually came out to see me at about 4:00 AM yesterday (Thursday). He had no real solution. He talked about another sleeping tablet --- he called it a “Z Tablet” --- but he didn’t have it in his big bag of medication. How useless is that? He said he’d send an e-mail to the surgery, but I don’t know if he did so. And if he did, nobody at the surgery contacted me.

Here I am again, with another sleepless night. I just can’t do this much longer.

Despite Dr. Ingles dislike of the internet, attached are a couple of scientific journal articles about RLS following opioids withdrawal. I’ve now learned that the EU approved medication of choice is Mirapexin (pramipexole).

I simply can’t go another night without sleep. I don’t want to keep calling the GP out-of-hours service (just spoke with them again) --- because, quite honestly, they can’t do anything for me. And it all sounds so trivial: “restless leg syndrome.” What a silly name. Sounds so girlie-girlie.

If you are able to prescribe Mirapexin, I would like to pick up the prescription this morning. If you are unable to prescribe this, please advise me, as a matter of some urgency, what type of specialist I should see. Neurologist? I will then call around (Cromwell Hospital, etc.) and find a neurologist who can hopefully evaluate me quickly --- today. [ . . . ]

I’m sorry to write such an awful, grumpy, nasty letter. The experience of opioids withdrawal, with continuing sleepless nights as a result of RLS (does Ekbom Syndrome sound less girlie?) --- with continuing, unremitting pain in both of my legs and almost all of my back --- is pretty much more than I can stand.

http://www.aquarena-springs.com/images/sincerely.jpg

Dr. Webster left me a voice mail mesage a little after 9:00 AM to say that she would not prescribe the medication for RLS, but would refer me to a specialist. She suggested a neurologist.

I made a bunch of telephone calls --- ever tried to find a neurologist on a Friday afternoon, in the UK? Thankfully Dr. Ben Turner, a consultant neurologist at Barts, was willing to see me in the afternoon at the Cromwell Hospital (http://www.cromwell-hospital.co.uk/htmlpages/home.asp) in London. I was driven the 120 miles to London, and Dr. Turner took a complete medical history, gave me a neurological exam (I assume it was --- he did a lot with little hammers, tuning forks, and a sharp thing on the soles of my feet), and prescribed a gently incrasing dose of ropinirole. At my request, he also prescribed a handfull of sleeping tablets --- Zolpiderm (possibly the errant "Z tablet").

I got back to my home in Worcestershire at 10:00 PM. I took my first Adartrel (ropinirole) tablet, 0.25 mg, and a Zolpiderm --- and I slept like a baby. My first real sleep in over a week.

It was only because we have the luxury of BUPA coverage, and someone to drive me to London, and because I can be a bit pushy that I was able to see a consultant neurologist with less than four hours notice. I thought Tony Blair didn't want to have a two-layered NHS. What's this?

I'm angry --- very angry --- that Dr. Ingles didn't take this seriously when I went to see him on Monday, November 27. I tried to be an informed patient, and the few web print-outs that I brought described my symptoms exactly. And the back injury and opioid withdrawal made it, at least in my opinion, all the more convincing. But the arrogant, self-important man refused to even look at what I'd brought, and pointed out that "this is not a debating society." In other words, he tells me what's going to happen, and I have no say in the matter.

No wonder I created this website. How many arrogant know-it-all GP's like Dr. Ingles are there out there?

According to the Daily Telegraph this Thursday (November 30):


Family doctors are earning an average of £106,000 a year according to the first full analysis of their tax returns since they began working under a new contract. The figures for 2004-05 from The Information Centre, the NHS statistics organisation, say GPs' earnings rose by 30.4% in a year. . . . The British Medical Association said yesterday that GP's deserved their pay, which had fallen behind in recent years. . . . NHS Employers, which negotiates the GPs' contract, said it was "disappointed" that extra money to improve services had resulted in pay rises. Earlier this year the Government conceded that it has underestimated the cost of the new contract, which was £300 million more than anticipated. The Conservatives accused the Government of bungling the negotiations. . . . Matthew Elliott, chief executive of the Taxpayers Alliance, said GPs should earn a good wage "but this increase doesn't seem very fair."

[craigwalsh]

After my first decent sleep in eight days, I woke up refreshed. There was a recorded delivery letter for me. From the St. John's Surgery. How stange.

With incredible speed --- faster than they could prescribe the correct medication --- they told me to get lost:

http://www.aquarena-springs.com/images/Dr-S-G-King.jpg

It's curious that Dr. King made no effort to point out any of the alleged "considerable factual inaccuracies" in my letter. Oh, how silly of me! "This is not a debating society," according to his partner, Dr. Ingles. And heaven forbid that any of them would want a patient to have any involvement in his or her own care.

So there you have it. I have been a patient at the St. John's Surgery for 17 years (except for a period when I lived in Hawaii, and the "system" unlisted me). My medical notes from these 17 years only fill eight handwritten pages, most illegible. Two of the 17 are the nurse's notes when I came back to the U.K. in 2002. The surgery was happy to have me as a patient as long as they didn't have to see me.

They completely failed to play any sort of a role in my treatment for chronic pain. And when I really needed their help, with the RLS, they refused to listen to my concerns. When I put them in writing, at 4:00 AM, they kicked me out of the practice within 12 hours of receiving my letter.

Not only does the NHS Suck, but so do the doctors of the St. John's House Surgery (http://www.stjohnshousesurgery.co.uk/) in Worcester.

http://www.stjohnshousesurgery.co.uk/pagepix/cover.jpg

According to their own website, which I suspect is out of date, the current doctors are:

Dr Stuart Geoffrey King
Dr Geoffrey Douglas Thurston Holehouse
Dr Robert Alan Ingles
Dr Trevor John Duncan Jones
Dr Mark Andrew Young
Dr Claire Diana Webster
Dr Julie Butler
Dr Amanda Bond
Dr Ayesha Rahim

If they disagree with any of this, they can always add their comments here. If they really disagree with any of this, they have my address and can pass it to their solicitors.

I wonder if it's worth re-registering with another surgery in this area? Will they all be the same?

It may be worth pointing out that these opinions are my own, and this website is domiciled on a server in the United States. This is a "consumer commentary" website as defined by court decisions in the U.S. For more information on "consumer commentary" websites, please click here (http://www.couttssucks.com/artman/publish/article_13.php). As Justice Brandeis said, "If there be time to expose through discussion the falsehood and fallacies, to avert the evil by the process of education, the remedy to be applied is more speech, not the enforcement of silence."

[craigwalsh]

I was just surfing through the internet and happened to find the website (http://www.worcslmc.co.uk/index.htm) for the Worcestershire Local Medical Committee. According to this site:


Worcestershire Local Medical Committee is the elected statutory body representing the interests of all the family doctors working in the county of Worcestershire. The LMC provides assistance for general practitioners on all matters relevant to general practice such as NHS Regulations, GMS and PMS contracts, GPs Terms and Service of Conditions, complaints and partnership issues. The LMC represents GPs in discussion with local and regional health authorities. The pastoral role of the LMC is the key function.

There were some interesting downloads on the website, such as the doctors' views on the Patient Experience Survey and the NHS views on "excessive prescribing." The latter contains this little gem:

Some PCOs, in an effort to cut costs, are providing a list of drugs they wish to stop providing within their PCO area. They are, in essence, advising GPs that they should no longer prescribe them. We have had queries regarding whether GPs could be in breach of their contract should they fail to provide such a drug for a patient and if indeed PCOs can exact a financial penalty for prescribing such items.

I mention this website here because the current chairman of the Worcestershire Local Medical Committee is none other than Dr. Robert Ingles.

Dr. Ingles of the "this is not a debating society" remark. And Dr. Ingles of my September 15 visit where the strong opioids were prescribed.

(Although I made a formal request under the Data Protection Act for all of my medical notes, the entry for September 15 just says "Comp." Possibly this means that the notes are in a computer? I have asked the practice manager to please clarify this, and to provide all records --- including those that may be held on computer --- to me.)

[gp2]

"Zolpidem can become addictive if taken for extended periods of time".
as it binds to a benzodiazepam receptor it is similar to temazepam.

[craigwalsh]

At my request, he also prescribed a handfull of sleeping tablets --- Zolpiderm
Don't worry --- after my Adventures With Opioids I am very, very careful about what medications I take. The neurologist only prescribed about six or eight Zolpiderm tablets, and I only took two of them.

As the ropinirole (prescribed by the neurologist in London) started to take effect, the RLS no longer kept me awake. So there's no need for the "Z tablets."

Here's a snippet of a letter from the neurologist to my GP:

http://www.aquarena-springs.com/images/Restless-Leg-Syndrome.gif

[craigwalsh]

I received a letter today from Kath Garrad, the Complaints Manager at the Worcestershire Primary Care Trust, dated December 22, 2006. She explained, "we have today received comments in connection with your complaint concerning your treatment from St Johns House Surgery, and I enclose a copy of the response that has today been received from the senior partner, Dr S G King, to the points you hve raised.

http://www.aquarena-springs.com/images/St_Johns_House_Surgery.gif

Of course, and not surprisingly, Dr. King's letter does not address even one of the specific points I raised in my formal complaint.

I questioned, for example, what seemed (to me) to be their ease in prescribing Class A narcotics without as much as a warning to me that the drugs were addictive, and without giving me any information on how to cope with the inevitable side effects (like constipation). Their initial refusal, despite the fact that they knew I have private insurance, to refer me to a Pain Management Unit. And Dr. Ingles arrogant "this is not a debating society" comment, coupled with his refusal to prescribe the appropriate medication for RLS.

Dr. King preferred claim that they spent "a tremendous amount of time and effort to try to sort out his medical problems." Yet my entire set of notes, from the 17 years I was registered at the practice, only filled eight handwritten pages (two of which were the nurse's comments when I first joined their list). If they spent "a tremendous time and effort" on my case, it was certainly not apparent to me --- nor did they achieve any sort of result.

Instead of addressing my complaints, it's easy to say that they don't like "a web site critical of the doctors at St John's House Surgery." That is, of course, this website.

The PCT has offered "an informal meeting where, with the assistance of a Lay Conciliator and, if appropriate, a Medical Adviser, and perhaps someone from the practice, we might be able to provide further explanations, or perhaps clear up misunderstandings." I will take them up on this offer, and will post further results here when available.

[zubzubes]

Dear Craig,

A fractured bone takes 6 weeks to heal in the average adult so why your back is still a problem I can only think it is psychosomatic.

You are an angry man who blames everyman and his dog for his "health problems" rather than taking a look at your own attitudes, lifestyle etc and making changes that might improve things.

Try reading Healing Back Pain by Dr John Sarno. It is your best chance.

Anne

[craigwalsh]

Hi, Anne ---

Welcome to the NHS Sucks forum. Thanks for taking the time to register, and for your various postings. I see that you've already managed to insult "concerneddaughter" and me, so you're off to a great start. :)

In my case, I have quite severe roto-scoliosis, and the fracture has reduced the size of my vertebra (at T11) by just over 25%. I have been advised by the orthopedic surgeons --- in Worcester and in London --- that a fracture of this nature upsets the "balance" of your spine. For younger folks, and folks with a healthy spine, the healing process can be very quick. For others, it can be quite unpredictable.

I have seen three orthopedic surgeons and three pain management specialists. None of the six specialists have been bashful, wilting violets. They had the advantage of seeing me, giving me a physical examination, looking at the x-rays, CAT scans, and MRI's. (You, on the other hand, have judged me and "concerneddaughter" via the internet --- quite a remarkable gift you have.) At no time did they mention the possibility of psychosomatic illness.

Heck, I'd have been happy if they told me that my pain was psychosomatic in origin! There are ways of "treating" psychosomatic pain --- and I would suggest the treatment of psychosomatic pain does not include liberal prescriptions of Class A narcotics.

Thanks for the suggestion about Sarno's Healing Back Pain. The Amazon.com review says:

According to John E. Sarno, M.D., TMS (http://en.wikipedia.org/wiki/Tension_Myositis_Syndrome) is the major cause of pain in the back, neck, shoulders, buttocks, and limbs--and it is caused not by structural abnormalities but by the mind's effort to repress emotions. He's not saying that your pain is all in your head; rather, he's saying that the battle going on in your mind results in a real physical disorder that may affect muscles, nerves, tendons, or ligaments. An injury may have triggered the disorder, but is not the cause of the amount or intensity of the resulting pain. According to Sarno, the mind tricks you into not facing repressed emotion by making you focus on pain in the body. When this realization sinks in ("and it must sink in, for mere intellectual appreciation of the process is not enough"), the trick doesn't work any more, and there's no need for the pain.

Sounds a bit "new age" to me, but his book is just over $10, so I've ordered a copy. I'll read it with an open mind, and see if it makes a difference.

[zubzubes]

Hmmmph, my last message didn't post .

anyway,
I have a scoliosis too Craig so we have alot in common.
I wouldn't have thought losing a quarter of your vertebra would really matter - I've seem many old ladies with crushed vertebra who have no pain from it at all - they are just a bit bent.

I should think that doctors don't mention psychosomatic as they don't want a punch on the nose from patients convinced they have an abnormality.

Dr Sarno is an American and has been on the go for decades but due to the billion dollar industry that health is in the US is not accepted by mainstream medicine.

I hope you get as much from his writings as I did.

Anne

[craigwalsh]

Dr Sarno is an American

Me too. I'm not sure that's necessarily a good thing. :o

I will read his book with great interest. I've played with TENS machines and other non-prescription treatments, but with no success. I stopped taking the opioid medications in mid-November because they weren't killing the pain and were making me just dull, listless and depressed. The pain has increased a lot, but at least I'm more awake --- and I try to remain as active as possible.

I look forward to receiving and reading the book. I'm happy to try pretty much anything to get back my life.

[guinea.lane]

Hi,

I'm sorry to hear about your pain problems recently.

I'm very surprised to hear that you did not have any information about Durogesic. Every box of patches I get from the chemist has very clear information - including stuff about side effects and possible addiction - and I thought it was a legal requirement for them to have this with all medicines. I could scan a copy onto here for you if you would like?

I hope you get better soon, chronic pain can be really intrusive in your life.

I've got to say that I have some sympathy with your GP (clearly I've only got access to the limited story you;ve told here so might not be party to all the facts) - chronic pain / RLS are really difficult symptoms to treat and really difficult to live with. Perhaps if you had'nt torn off around the country looking for opinion after opinion and searching for the 'magic cure' you might have had a better relationship with your GP?

But hey, who am I, just another of those people with chronic pain awake at 3:30am.

I hope you're website makes you feel better, and maybe with time your views will mellow slightly as you gain more perspective and insight into being ill.

Take care

g

[craigwalsh]

Every box of patches I get from the chemist has very clear information - including stuff about side effects and possible addiction - and I thought it was a legal requirement for them to have this with all medicines. I could scan a copy onto here for you if you would like?I always read the little leaflets that come with medication. They're not always included, particularly when the chemist divides a larger package into smaller packages.

I can't say with certainty that there was no leaflet with the Durogesic patches, but I'm normally pretty good at reading and scanning this information. I can't check, because I turned in all unused medication to Boots about a month ago.

I did scan the leaflet for the BuTrans patches. Here's the only part about withdrawl from the medication:

http://www.aquarena-springs.com/images/butrans.gif

There is about five times more information about the correct method for the application of the patches. And this warning about stopping medication is no more sinister than on other non addictive medications. Personally, speaking from my own experience, I'd like this information to be bigger, bolder, more noticable.

If you could scan the Durogestic leaflet, particularly the part about withdrawl, I'd be most interested in reading it.

An update on my formal complaint about the doctors at St. John's:

In their letter of December 20, 2006 --- over two months ago --- the folks at St. John's failed to address a single one of my complaints. The PCT offered (by letter to me dated December 22, 2006), "an informal meeting where, with the assistance of a Lay Concilliator and, if appropriate, a Medical Advisor, and perhaps someone from the practice [where] we might be able to provide further explanations, or clear up misunderstandings."

I accepted this offer by letter to Paul Bates, the Chief Executive of the Worcestershire Primary Care Trust, dated December 29, 2006. I said I hoped that this meeting would enable me to have a better understanding of the actions (or inactions) of my former GP's.

My letter was acknowledged by the PCT by letter dated January 5, 2007. Kath Garrard, the Complaints Manager, wrote to say, "I have now requested any additional comments that the practice may wish to make [ . . . ] in the first instance. As soon as these have been received I will be in touch with you again, and will then make arrangements for a meeting."

I've heard nothing further, so have gently "chased" via e-mail.
Perhaps if you had'nt torn off around the country looking for opinion after opinion and searching for the 'magic cure' you might have had a better relationship with your GP?All consultants' visits were by referral from my GP, or from the consultants themselves. I think the hope of a "better relationship" with my GP is, sadly, Pollyanna thinking. I was registered with the same GP's surgery from 1989 (when I moved to my current residence) until late last year. I was healthy for most of this time, so never needed anyone at the surgery. When I did need help, it came in five minute appointments. Whether I stayed put in sunny Worcestershire, and accepted the tiny crumbs they were willing to dish out, or whether I tore back and forth to the Moon, I suspect the results would have been the same.

As with so many things, the NHS has (at least so far) proven itself incapable of helping me to understand why I received the treatment that I received. On my part, I have requested, paid for, and have received and analysed all of my medical notes --- both from the GP and from the various hospitals. I am not a physician, but I have done my homework as best I can.

The meeting was suggested by the NHS, and not by me. I almost get the impression that it was suggested in the spirit that I not accept the offer. But I did.

Now what? More silence?

As for dashing all over the place, I believe you either take what you get, or get what you want. I want to get better, to improve, to reduce my pain. And I will go wherever I must to achieve that. Of course, I'd prefer to simply go the few miles down the road to the GP's surgery. But that didn't work.

[matab]

Hmmmph, my last message didn't post .

anyway,
I have a scoliosis too Craig so we have alot in common.
I wouldn't have thought losing a quarter of your vertebra would really matter - I've seem many old ladies with crushed vertebra who have no pain from it at all - they are just a bit bent.

I should think that doctors don't mention psychosomatic as they don't want a punch on the nose from patients convinced they have an abnormality.

Dr Sarno is an American and has been on the go for decades but due to the billion dollar industry that health is in the US is not accepted by mainstream medicine.

I hope you get as much from his writings as I did.

Anne
Oh my. We have had this too. Comparison to old ladies whose bones have crumbled due to osteoporosis. It may have the same outcome (ie losing a significant part of your vertebrae) but it does not have the same cause - from a trauma - in our case, a car striking at ~50 mph.
You also can not compare one person to the next like this. One person might have measles/cancer/diabetes etc and be quite well and have few complications and others are unlucky and get it bad. Its can be the same with broken bones. We are not all identical and the causes of these injuries are not the same (even if the injuries look superficially similar) and perception of pain can vary dramatically even in the same individual. I have had minor scratches that hurt a lot and major wounds that I can't even feel. Its not logical and it is not due to ridiculous repressed emotions. I have had these two experiences on the same day! A big, deep bleeding gash should hurt, it didn't at all, a tiny scratch - should it hurt so much? But they always do don't they! If it hurts, it hurts and its terrible. You don't need to make these people feel worse.
Why is it Anne that you think you know so much about other peoples experiences that you haven't even met? I would stick to commenting on your own experiences if I was you.

[craigwalsh]

Why is it Anne that you think you know so much about other peoples experiences that you haven't even met? I would stick to commenting on your own experiences if I was you.

Hi, Matab ---

Firstly, welcome to the NHS Sucks forum. Glad to have you here.

Thank you also for your support and understanding. It is easy for people (including, I suppose, me) to make snap decisions based upon nothing more than what we read on the computer screen. I didn't take any offence at Anne's posting. I know what's happened to me, and I know how I've been treated --- or, more accurately, mistreated --- by my former GP's practice and by the NHS in general.

I do know, from speaking with my share of consultants, that the human back is a weird and wonderful mystery. Sometimes the problems are obvious and the cures self-evident. But I gather that my fracture has somehow upset the "Zen" of my back, and it takes time --- a week, a month, a year, or longer --- for this to be restored. Or for me to just adapt to the level of pain and begin to consider it "normal."

You're absolutely right. Unless you've walked in my shoes you don't really know the level of pain I feel every day. (Gosh, starting to sound like the lyrics to a spiritual . . . )

Forgetting my pain, however, the treatment I've received from the St. John's House Surgery (as evidenced by their letters, above) is pretty shabby. And that's the real point of this forum.