"Disparate care for pain management"

About: Abergele Hospital / Pain Management Robert Jones & Agnes Hunt Orthopaedic Hospital / Pain Management Royal Alexandra Hospital (Rhyl)

(as the patient),

I have suffered since 2004 with chronic back problems following a car accident from which followed a legal claim against the driver of the other vehicle and have subsequently lost my job.

I have as a consequence done the rounds and to date have seen 4 different orthopaedic surgeons, a neurosurgeon, a consultant Rheumotologist, 3 different physiotherapists, undergone acupuncture, a 3 week stay on the Functional restoration programme had referrals to the spinal clinic who then referred me onto the pain management clinic where I have been today.

The bottom line is they all tell different stories have different approaches make vastly opposing suggestions and seem to lack any real understanding of the condition and its real effects on day to day life.

This was brought home to me very vividly yesterday when I was subjected to a 3 hour multidisciplinary appointment with the Pain Management Clinic at the RAH in Rhyl.

They totally contradicted what I had been told back in 2007 at the FRP programme in Gobowen, when I suggested that this was contradictory I was told that things have changed and that the initial advise from the FRP to work into the pain on the basis that for general quality of life it was better to achieve something on my good days and accept that I will have bad days but at least will have achieved something was in fact bad advise and that I should stop doing anything once I feel the onset of pain and instead achieve jobs over a longer time in small stages was the way forward.

This was illustrated with what can only be described as the lamest analogy, "instead of washing your car in one go you should wash it a panel or section at a time, living in the real world quite clearly this would mean you would never have the satisfaction of having a clean car, for you only need to take a car out once or twice for it to get dirty!"

This also falls down in another respect which none of the team seemed to appreciate which suggests a clear lack of understanding of chronic pain, they say don't do things which cause you pain, without explaining what you do when you live 24/7 with pain and on their scaling whilst it may at best only rate 4 on a good day the problem is, just filling the bucket with water would raise that so therefore it would appear they are suggesting to do nothing!!!

I then was asked what I expected from them and said that at the spinal clinic the senior physiotherapist there after examination and based on my past history felt that my condition had now progressed so far and also given that the long term use of NSAID's was causing other kidney and urological problems that he felt I would now be a candidate for epidural, I was told here that I was now beyond consideration for epidural, so where in the past 5 years was I at the stage for consideration? Why was that point allowed to pass? I was also told early on that my symptoms were not severe enough to be considered suitable for surgery, now I am considered beyond the scope of surgical suitability!

I explained during the consultation how depressed this whole situation had left me, the despondency with loss of job, inability to take part in my pastimes and interests, their answer, give up the idea of finding suitable work, look for something as a volunteer, give up my passions and hobbies take up something less physically demanding! This to my mind is demoralising and to my mind only adds to the feeling of despair and worthlessness.

In conclusion, I came away after 3 hours with a book on pain management and told accept it is something I am going to have to live with! This seems an utter waste of resources and has had no personal benefit and from the bigger picture suggests a health service which has no coordinated strategy and understanding of the real life effects of pain on the patient and frankly little concern for their overall well being, instead being happy to pass me from pillar to post, each not understanding or working to any cohesive agenda. At this moment in time the only answer I am left with for a pain free life exists in a bottle of whisky and a large dose of pills.

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Responses

Response from Robert Jones & Agnes Hunt Orthopaedic Hospital

Our aim is to provide high quality services for all our patients and we are disappointed that your experience has not met the standards we set. The Trust is committed to listening to patients and improving their experience. If you would like the issues you have raised looking into, please contact the Trusts’ Patient Advice and Liaison Service by telephoning (01691) 404606; by emailing PALS.office@rjah.nhs.uk or write to PALS Officer, the Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, SY10 7AG