Broken back diagnosed as sprain/strain

[matab]

My husband was hit by a car cycling to work a 1.5 years ago. It was travelling ~ 50mph & sent him flying forward & he landed on his bottom. He was taken to A&E on a back board & xrayed.They saw a 70/75% collapse of T12 and 40% of T11 & they reported this as NAD (nothing abnormal detected) and NBI (no bony injury). He had reported abdominal pain & they found raised amylase & a problem with prothrombin clotting time. He also had completely numb areas of his buttocks. They told him he had a sprain/strain & that he should be better in a few weeks. They rang my work and told them the same.

My husband couldn't walk, but was helped in to a wheelchair He moaned if I moved it so, to push more smoothly I asked if I could leave the bags at reception. They refused (but I just left them there anyway). I tried to persuade my husband to ask for an ambulance, but he was too embarrassed to ask for one. He had to crawl in to the house and couldn't make it up the stairs to bed. He has had to sleep on the sofa ever since.

He did not recover. We asked for a wheelchair-they refused. He asked for an MRI scan. He was given another xray which reported 'evidence of compression fractures at T12 and L1'. The GP reported this to pain management as minor fractures of long standing that are above the site of his current pain. It was true that he did have a worse pain lower down, but T12 still hurt

He developed a hump in his upper back & he had lost 2.5 inches in height. The report from pain management told him to think less about his insurance claim. His legs had been swelling and going all red & blotchy then the red blotches turned brown. Nothing was done. He then lost feeling in his foot. They did a d-dimer. It was negative so they sent him home.

I complained to the chemist that nothing had been done so she advised me to go back & complain again until something was. He rang & they then perscribed support stockings. We asked for him to be referred to a neurologist. He was told they would refer him to a orthopaedic s. who might then refer him to a neurologist (His notes still stated 'no neurological problems' and they deny hearing about the loss of feeling in his foot & other problems)

3/4 months later he got an appointment. He was told he must have had a fall from a great height as he walked in. He said no, he had been hit by a car and catapulted forward. The Dr nodded. He then showed us the collapse at T12 and 11 & we showed him the hump in his back. He ordered more xrays and discovered breaks at T6 & T7 where the humps were. We went through his history, but he recorded 'no neurological problems' in his notes but doesn't deny that we told him like the others. He says they were not urgent problems as they were of long standing. He advised an MRI and we had to wait 10 weeks.

I was horrified by what we had discovered 11 months after the injury & wanted things speeded up. It was refused. The MRI eventually showed a burst fracture at T12 that projected into the spinal canal stopping just short of his spinal cord. It showed continuous damage between L1 and T5. The vertebrae and discs look abnormal & the spine is straight at this point instead of having its curve. Although I can see this, and the clinical director at the first hospital that sent him home after 2 hours agrees that they are all damaged (I showed him the MRI during a visit to complain), the report only mentions the most obvious breaks at T6&7 and T11&12.

His oxycodon does not seem to be as effective and he was getting increased pain. It seems to be from piriformis syndrome due to his sciatic nerve being trapped in his damaged, numb buttock tissue that is causing the worst shooting pains up his back & down his legs and making his legs go numb.

Surgery to fuse his spine or free the nerve sounds risky. The surgeon has never even done a piriformis release before. The rehab programme offers walks and bowling! It doesn't seem to cater for his level of damage, but we shall have to wait and see how he gets on. We think sleeping on the sofa and being sent to physio and made to travel a few weeks after the accident has really harmed his recovery.

[craigwalsh]

Hi, Matab ---

Thank you for your posting on the forum. Your husband's experiences with the NHS sound awful --- but also sound very familiar to me.

The folks treating your husband sound like they are great at not writing things down, and then suffering selective amnesia. In my previous life (as a banker) we wrote everything down always. Did a memo of every meeting, and almost every telephone call. They're called "contemporaneous notes." I found this interesting description of such notes on a forum (http://www.etclaims.net/?p=32) dealing with Employment Tribunals:


Where (as there often is) there is a dispute before the tribunal about what was said or done on a particular occasion, tribunals tend to set great store by any notes of what happened that were made at the time. These are often called 'contemporaneous notes,' and the party that has contemporaneous notes is usually at a great advantage.

This requires forethought. Often when things start to go wrong between employer and employee, neither side realises that the dispute may end up in the tribunal - and neither side keeps careful notes. Once an employee does realise that his or her employer's behaviour is or may be becoming intolerable to the extent that a tribunal claim may have to be made, it is prudent to start keeping detailed contemporaneous notes of what has happened.

Notes need not only to be genuinely contemporaneous; they need to be in a form that convinces the tribunal that that is what they are. For this reason, handwritten notes are better than word-processed notes, because it is obvious when handwritten notes have been altered. For the same reason, ink is better than pencil. A bound notebook or exercise book is better than loose sheets because it is obvious in what order the entries have been made. Each entry should give the date of the events it describes, and also (if different) when the entry was made. It is best to write up each incident on the same day when the memory of it is freshest, but if the events of several occasions are written up a few days or even weeks later, the date on which the notes were made should be recorded.

It is very important to be strictly accurate about this. Witnesses - on either side - do from time to time produce documents that they claim were made at the time when in fact they were made much closer to the hearing, but any attempt to fudge the truth here is likely to be disastrous. It is surpringly difficult to cover all traces of a document having been created later than it is supposed to have been created, and once a document of this nature has been discredited, the tribunal is likely to be extremely sceptical of any other evidence given by the same witness.

I find that computers are great for keeping contemporaneous notes because they time-stamp everything.

I'm sure the folks in the NHS already really hate you --- so perhaps you could follow up each meeting with a brief, friendly letter. "This will confirm our recent meeting at which I said x, y, and z --- and where you did a, b, and c." It's a shame whenever things come to this, of course.

Soon, I suppose, we'll all be walking into our doctor's surgeries with video cameras.

BTW, when my own GP's surgery de-listed me, our local Primary Care Trust had the task of finding me a new GP. I had a hard time getting through to most surgeries on the telephone, so finally persuaded the PCT to help me out on this.

The new surgery, to which I have been "assigned," is much nicer than our old surgery. I've only had one doctor's visit there so far, and it was head and shoulders above anything I experienced at our old surgery. So far there has been no indication that the new surgery knows I was bounced off the books by the previous surgery, nor has there been any indication that I am less than welcome. (But it's early days still . . . )

Perhaps a change in doctors might be good for you and your husband?
His oxycodon does not seem to be as effective and he was getting increased pain.
I learned that you need an almost constant increase in the dosage to just remain on a level playing field. I got a lot of useful information, and supportive person to speak with, when I called the small Over-Count Drugs Information Agency (http://overcount.b0x.com/). Call and speak with David --- he's only there on Tuesday evenings, though. I found him very helpful: he did more to enable me to understand the various Class A medications that had been prescribed to me than my GP or anyone else.