Nerve root compression
Discussion
Had a very strange day today and need some advice on how to proceed.
Quick summary
June onwards - I have had pins and needles down my right arm and stiff neck and managed with pain killers and going through the process of getting an x-ray on the NHS. I was have been unable to work due to symptoms but as I am self employed I did not need a certificate.
September - Had a xray and waiting for results
October - Results come through clear just as pins and needles increases and pain gets worse. Locum doctor (American) doesn't want to refer for MRI even though he agrees it is the next step because of the cost and explain the pain and I am told to buy Solpadol over the counter (which as I find out is not available over counter as it contains codeine)
Last weekend - Pain increases 10x fold. Visit to A+E in the middle of the night, another xray again shows nothing. Hospital asked me to go to doctor to get referral for MRI due to cost but agreed to do it once I explained I had tried. No pain killers given despite severe pain.
Monday - Made a private GP appoint hoping that he wouldn't be restricted by same budget constraints. Gave me a cortisone injection, muscle relaxants and stronger pain killers. Said that in his opinion I needed an urgent MRI..
Today - Fortunately MRI came through quickly arranged by hospital. I had the scan and at the end I was told not to move off bed and that the results were not good and I was being taken to A+E majors urgently. I then had someone sit with me until I could be seen by a doctor and I was not allowed sit up or leave the bed. A doctor then explained that my spinal cord was compressed (C6/C7) severely and he hadn't seen one that bad and that it didn't make any sense that I hadn't lost any strength in my right arm or shoulder and the results didn't match the symptoms. I was told it was serious and they would need to release the compression, they showed me the scan results and I could clearly see a thick cord that was at one part compressed to a third of a its normal size. Whilst waiting to see an orthopaedic surgeon I was then told I would probably be put in surgical clothes shortly for theatre. Another 30 mins later the doctor returned to say that the orthopaedic surgeon would not be seeing me and there would not be any operation and that he has asked me to be discharged with a letter for my doctor to be referred to his clinic!!!
As you can imagine I am now very confused to how serious this is, should I wait it out on the NHS, should I try and go down the private route bearing in mind I would still need to pay for a couple of consultant appointments, probably another MRI scan as NHS wont give me access to the ones I had taken today...
I now have an appointment with my GP tomorrow to talk this through. Any opinions on how I should play this and what I should be insisting on if anything and is this is serious as it appears?
Thanks for any help given..
Edited for spelling and mistakes.. I blame the painkillers :-)
Quick summary
June onwards - I have had pins and needles down my right arm and stiff neck and managed with pain killers and going through the process of getting an x-ray on the NHS. I was have been unable to work due to symptoms but as I am self employed I did not need a certificate.
September - Had a xray and waiting for results
October - Results come through clear just as pins and needles increases and pain gets worse. Locum doctor (American) doesn't want to refer for MRI even though he agrees it is the next step because of the cost and explain the pain and I am told to buy Solpadol over the counter (which as I find out is not available over counter as it contains codeine)
Last weekend - Pain increases 10x fold. Visit to A+E in the middle of the night, another xray again shows nothing. Hospital asked me to go to doctor to get referral for MRI due to cost but agreed to do it once I explained I had tried. No pain killers given despite severe pain.
Monday - Made a private GP appoint hoping that he wouldn't be restricted by same budget constraints. Gave me a cortisone injection, muscle relaxants and stronger pain killers. Said that in his opinion I needed an urgent MRI..
Today - Fortunately MRI came through quickly arranged by hospital. I had the scan and at the end I was told not to move off bed and that the results were not good and I was being taken to A+E majors urgently. I then had someone sit with me until I could be seen by a doctor and I was not allowed sit up or leave the bed. A doctor then explained that my spinal cord was compressed (C6/C7) severely and he hadn't seen one that bad and that it didn't make any sense that I hadn't lost any strength in my right arm or shoulder and the results didn't match the symptoms. I was told it was serious and they would need to release the compression, they showed me the scan results and I could clearly see a thick cord that was at one part compressed to a third of a its normal size. Whilst waiting to see an orthopaedic surgeon I was then told I would probably be put in surgical clothes shortly for theatre. Another 30 mins later the doctor returned to say that the orthopaedic surgeon would not be seeing me and there would not be any operation and that he has asked me to be discharged with a letter for my doctor to be referred to his clinic!!!
As you can imagine I am now very confused to how serious this is, should I wait it out on the NHS, should I try and go down the private route bearing in mind I would still need to pay for a couple of consultant appointments, probably another MRI scan as NHS wont give me access to the ones I had taken today...
I now have an appointment with my GP tomorrow to talk this through. Any opinions on how I should play this and what I should be insisting on if anything and is this is serious as it appears?
Thanks for any help given..
Edited for spelling and mistakes.. I blame the painkillers :-)
Edited by aero93 on Wednesday 7th November 09:10
Edited by aero93 on Wednesday 7th November 09:22
Quick update -
I see my doctor yesterday who was not impressed by the shambles. Unfortunately despite me asking the doctor at A+E if my GP would be able to see my scans on the computer and being assured he would now they are "on the system" he couldn't! So that is another lie/mistake whatever. I just wanted my own GP to see exactly what I did and see if he was as concerned as the the doctor assigned to me at the hospital/his assistant and myself.
My GP has prescribed Lyrica (Pregabalin) and some more Co-codamol and Diclofenac. My referral to see the Neurosurgeon that decided (when in A+E) that I didn't need an operation to relieve the pressure immediately first appointment at his clinic is mid Jan... :-(
I can continue to live with the pain as I have had it for so long now but to have no guidance on how I should be continuing is really frustrating. Obviously there is common sense but do I not drive just in case, or how about going swimming? or trying to exercise and keep mobile in general? Is an inversion table a good or bad idea? Any advice appreciated as ever..
I see my doctor yesterday who was not impressed by the shambles. Unfortunately despite me asking the doctor at A+E if my GP would be able to see my scans on the computer and being assured he would now they are "on the system" he couldn't! So that is another lie/mistake whatever. I just wanted my own GP to see exactly what I did and see if he was as concerned as the the doctor assigned to me at the hospital/his assistant and myself.
My GP has prescribed Lyrica (Pregabalin) and some more Co-codamol and Diclofenac. My referral to see the Neurosurgeon that decided (when in A+E) that I didn't need an operation to relieve the pressure immediately first appointment at his clinic is mid Jan... :-(
I can continue to live with the pain as I have had it for so long now but to have no guidance on how I should be continuing is really frustrating. Obviously there is common sense but do I not drive just in case, or how about going swimming? or trying to exercise and keep mobile in general? Is an inversion table a good or bad idea? Any advice appreciated as ever..
I work for the ambulance service, and so see a lot of injuries to the spine. My clinical experience however, is different to the doctors you see in the hospital.
My first advice is to forget your GP. The G stands for General and you need a specialist.
C7 is here (where it says 7th):
Not trying to scare you, but if something nasty happens there you will be paralysed from the neck down.
If I were you, I would go to A&E again and again explain everything and make sure they understand your pins and needles and loss of feeling. If they try to discharge you, get someone to give you a written undertaking that your condition is not serious and will not lead to paralysis (they will not do this, but it just may get them to admit you).
Good luck.
My first advice is to forget your GP. The G stands for General and you need a specialist.
C7 is here (where it says 7th):
Not trying to scare you, but if something nasty happens there you will be paralysed from the neck down.
If I were you, I would go to A&E again and again explain everything and make sure they understand your pins and needles and loss of feeling. If they try to discharge you, get someone to give you a written undertaking that your condition is not serious and will not lead to paralysis (they will not do this, but it just may get them to admit you).
Good luck.
I can be of no use whatsoever, but best of British mate. Keep us updated.
Probably of no help or relevance, but I read this thread yesterday: click.
It mentions that the risks associated with surgery made 'the profession' averse to operating as it may do more harm than good. This may explain why the surgeon became unavailable? All of this is my interpretation of layman opinion and reports so not worth 2p in the real world.
Probably of no help or relevance, but I read this thread yesterday: click.
It mentions that the risks associated with surgery made 'the profession' averse to operating as it may do more harm than good. This may explain why the surgeon became unavailable? All of this is my interpretation of layman opinion and reports so not worth 2p in the real world.
There's a helpline here http://www.spinal.co.uk/page/contact-us
I'd ask your GP to refer you to a Spinal Unit/Orthopaedic hosp where the levels of knowledge and experiance are greater.
I'd ask your GP to refer you to a Spinal Unit/Orthopaedic hosp where the levels of knowledge and experiance are greater.
Thank you for all the wishes and advice so far.
Another trip to A+E today!!! I went back as I was told that if I lose any strength in my right side or notice any difference to come straight back in. Well this morning I was unable to pick up my 8 month little girl or hold my own body weight leaning against a wall (which I could on Sunday) and the pins and needles had travelled back to my finger tips after previously stopping at my elbow.
I was seen quickly and this time a neurosurgeon explained something that the doctor didn't last time. It is not my spinal cord but the nerve root next to it that is compressed at the C6/C7 level. After a number of tests he was happy that it hadn't got any worse and that I was safe to go home. He advised me to carry on life as normal for the moment but don't do anything that would put my head in danger, no rugby, football etc.. Not that I feel a could even think about anything like that at the moment. Apparently running, jogging and swimming are all ok which surprised me. A far more laid back visit today compared to Monday and the panic stations that were activated.
I am in the process of getting a copy of my MRI scan which will then give me the option of taking this private which I think I will do for at least a 2nd opinion to reassure me. Then I will weigh up the private costs against waiting until Jan to start the NHS process.. The other good news is the pain is much more bearable today compared to the last couple of weeks. It must be the new drugs kicking in :-)
Another trip to A+E today!!! I went back as I was told that if I lose any strength in my right side or notice any difference to come straight back in. Well this morning I was unable to pick up my 8 month little girl or hold my own body weight leaning against a wall (which I could on Sunday) and the pins and needles had travelled back to my finger tips after previously stopping at my elbow.
I was seen quickly and this time a neurosurgeon explained something that the doctor didn't last time. It is not my spinal cord but the nerve root next to it that is compressed at the C6/C7 level. After a number of tests he was happy that it hadn't got any worse and that I was safe to go home. He advised me to carry on life as normal for the moment but don't do anything that would put my head in danger, no rugby, football etc.. Not that I feel a could even think about anything like that at the moment. Apparently running, jogging and swimming are all ok which surprised me. A far more laid back visit today compared to Monday and the panic stations that were activated.
I am in the process of getting a copy of my MRI scan which will then give me the option of taking this private which I think I will do for at least a 2nd opinion to reassure me. Then I will weigh up the private costs against waiting until Jan to start the NHS process.. The other good news is the pain is much more bearable today compared to the last couple of weeks. It must be the new drugs kicking in :-)
I managed to get a copy of my medical records and MRI scan today.
To quote the report:
"There is a reversal of the normal cervical lordosis.
There is a large right posterolateral C6/7 disc protrusion/extrusion flattening the right side of the cord and causing compression of the right C7 nerve root.
Normal vertebral body heights and marrow signal throughout.
No significant foraminal or central canal stenosis at any other level.
Neurosurgical referral is advised."
Any opinions on what this actually means and whether I should be safe to wait until mid Jan for my NHS appointment or to start looking at private options?
Thank you..
To quote the report:
"There is a reversal of the normal cervical lordosis.
There is a large right posterolateral C6/7 disc protrusion/extrusion flattening the right side of the cord and causing compression of the right C7 nerve root.
Normal vertebral body heights and marrow signal throughout.
No significant foraminal or central canal stenosis at any other level.
Neurosurgical referral is advised."
Any opinions on what this actually means and whether I should be safe to wait until mid Jan for my NHS appointment or to start looking at private options?
Thank you..
aero93 said:
Any opinions on what this actually means and whether I should be safe to wait until mid Jan for my NHS appointment or to start looking at private options?
Thank you..
it's the same surgeons regardless of NHS or private Thank you..
There is no acute spinal cord injuries care in the private sector and only one private spinal injuries rehab facility in the UK which does not take anything acute so you'd be stuck in a general surgical bed without the specialist nursing and physio input you'd get on an NHS Neurosurgical or Spinal injuries unit until deemed stable enough to go to that one unit ... and if you deteriorate while at that unit guess who is picking up the pieces, the good ol' Nash !
Ideally the GP should have referred you for MRI and/or spinal surgeon opinion in October as it sounds like you'd got quite clear symptoms then
Edited by mph1977 on Friday 9th November 22:05
Try not to doctor-shop amongst specialists, ie seeing successive ones until you get an answer you want.
I do stress specialists here, because you can only get a proper opinion on your problem from a neurosurgeon or an orthopaedic surgeon specialising in the spine.
Successive ones you see may all agree on the advice.
Try and get the referrals done on the NHS, by your GP practice, but not by the initial chap, who sounds frankly dangerous!!
I do stress specialists here, because you can only get a proper opinion on your problem from a neurosurgeon or an orthopaedic surgeon specialising in the spine.
Successive ones you see may all agree on the advice.
Try and get the referrals done on the NHS, by your GP practice, but not by the initial chap, who sounds frankly dangerous!!
I broke my spine, crushed my vertebrae and dislocated my right hip falling out of a tree when i was 8. landed on a concrete pad. Had a lot of treatment and severe pain over the years in and out of hospital and ten years ago was actually paralysed below the waist and in a wheelchair and in grinding and continuous agony to boot.
Finally saw a brilliant neurosurgeon at the Queen Elizabeth in Brum: quite outstanding in his field. He warned me that there was a real risk of permanent paralysis at best, and given my health, which is compromised, (I am also diabetic (22 years) and have serious heart problems), there was a real chance of death. However he thought there was a chance of a cure.
He did cure me and since then the remaining lack of feeling then still apparent has gradually disappeared and I no longer need the wheelchair at all. Still have to be very careful walking etc and must sit in a lumbar support chair. But every physical function (including romantic) now works.
If you want a neurosurgeon to tell you the facts and advise on the best procedure PM me and I will give you his name and number. I would certainly take this very seriously. You are a young man to have such a problem. You need to get this treated straight away.
Finally saw a brilliant neurosurgeon at the Queen Elizabeth in Brum: quite outstanding in his field. He warned me that there was a real risk of permanent paralysis at best, and given my health, which is compromised, (I am also diabetic (22 years) and have serious heart problems), there was a real chance of death. However he thought there was a chance of a cure.
He did cure me and since then the remaining lack of feeling then still apparent has gradually disappeared and I no longer need the wheelchair at all. Still have to be very careful walking etc and must sit in a lumbar support chair. But every physical function (including romantic) now works.
If you want a neurosurgeon to tell you the facts and advise on the best procedure PM me and I will give you his name and number. I would certainly take this very seriously. You are a young man to have such a problem. You need to get this treated straight away.
Thank you for the excellent advice so far guys..
I realise that the neurosurgeons sometimes work for both the NHS and private and therefore private are not necessarily better just because you pay.
I only mentioned private to speed things up and as the current neurosurgeon that see my MRI scan on the day is NHS only I would now be looking for another neurosurgeon for consultation and to progress as I cannot really wait until mid Jan as the pain is unbearable and also stopping me from working and this means no income due to being self employed.
If anyone out there can recommend a good private neurosurgeon in the Essex area or there just so happens to be a cervical spine surgeon here that would like to view my scans to give me a second opinion :-) then please feel free to get in touch..
The names that I have been recommend so far are Jonathan Benjamin and James Kellerman if anyone can second them or suggest others..
Thanks
I realise that the neurosurgeons sometimes work for both the NHS and private and therefore private are not necessarily better just because you pay.
I only mentioned private to speed things up and as the current neurosurgeon that see my MRI scan on the day is NHS only I would now be looking for another neurosurgeon for consultation and to progress as I cannot really wait until mid Jan as the pain is unbearable and also stopping me from working and this means no income due to being self employed.
If anyone out there can recommend a good private neurosurgeon in the Essex area or there just so happens to be a cervical spine surgeon here that would like to view my scans to give me a second opinion :-) then please feel free to get in touch..
The names that I have been recommend so far are Jonathan Benjamin and James Kellerman if anyone can second them or suggest others..
Thanks
aero93 said:
........Whilst waiting to see an orthopaedic surgeon I was then told I would probably be put in surgical clothes shortly for theatre. Another 30 mins later the doctor returned to say that the orthopaedic surgeon would not be seeing me and there would not be any operation and that he has asked me to be discharged with a letter for my doctor to be referred to his clinic!!!...
I'd have been straight in to ask who was in charge of the whole shambles and demanding some sort of explanation as to how the whole diagnoses could be so quickly reversed for no apparent reason.Maybe there is a perfectly good explanation but obviously nobody could be bothered to give it to you.
I've often found the best way to get some sort of result in the English system of anything is to ask who you need to speak to to lodge an official complaint.
King Herald said:
I'd have been straight in to ask who was in charge of the whole shambles and demanding some sort of explanation as to how the whole diagnoses could be so quickly reversed for no apparent reason.
Maybe there is a perfectly good explanation but obviously nobody could be bothered to give it to you.
I've often found the best way to get some sort of result in the English system of anything is to ask who you need to speak to to lodge an official complaint.
Now I have had time to sit back (in pain) and digest it all I agree.. And I will take it up with someone.. I can only suggest that as on the day as it was all happening so fast and was so surreal that I was just happy to get out of there. Little things keep coming back to like I was even told off for trying to find my phone in my pocket whilst I was laying down as I was "risking damage". They also said the must take a blood test just in-case it is something else and they also forgot to do this.Maybe there is a perfectly good explanation but obviously nobody could be bothered to give it to you.
I've often found the best way to get some sort of result in the English system of anything is to ask who you need to speak to to lodge an official complaint.
I did ask for the Neurosurgeon to come and speak to me but was told he wouldn't be able to.
I will take this further with someone from the NHS once I have had a second opinion privately and understand the current status of my neck issue. Although I am not happy with how I was treated and not kept informed sufficiently I don't want to make a fuss over nothing.. I am hoping it is just bad communication rather than bad medical care.
aero93 said:
Although I am not happy with how I was treated and not kept informed sufficiently I don't want to make a fuss over nothing.. I am hoping it is just bad communication rather than bad medical care.
It is not making 'a fuss'. They as good as told you you were on the verge of instant paralyses, then in the space of minutes you were suddenly okay?? Obviously someone made a BIG mistake, and lets hope it was in the diagnosis, not the the decision about treatment. aero93 said:
Now I have had time to sit back (in pain) and digest it all I agree.. And I will take it up with someone..
Try the PALS (Patient Advice and Liaison Services) at the hositial where you were messed about. No idea if that system works though.Your story is a bit worrying as I fell flat on my arse in icy weather a couple of years ago and was baffled that it felt like I'd broken my arm yet I was sure it didn't suffer any impact. It gradually got better but still twinges all the time and hurts sometimes. I've never done anything about it as I felt there's be nothing to see.
King Herald said:
aero93 said:
........Whilst waiting to see an orthopaedic surgeon I was then told I would probably be put in surgical clothes shortly for theatre. Another 30 mins later the doctor returned to say that the orthopaedic surgeon would not be seeing me and there would not be any operation and that he has asked me to be discharged with a letter for my doctor to be referred to his clinic!!!...
I'd have been straight in to ask who was in charge of the whole shambles and demanding some sort of explanation as to how the whole diagnoses could be so quickly reversed for no apparent reason.Maybe there is a perfectly good explanation but obviously nobody could be bothered to give it to you.
I've often found the best way to get some sort of result in the English system of anything is to ask who you need to speak to to lodge an official complaint.
mph1977 said:
King Herald said:
aero93 said:
........Whilst waiting to see an orthopaedic surgeon I was then told I would probably be put in surgical clothes shortly for theatre. Another 30 mins later the doctor returned to say that the orthopaedic surgeon would not be seeing me and there would not be any operation and that he has asked me to be discharged with a letter for my doctor to be referred to his clinic!!!...
I'd have been straight in to ask who was in charge of the whole shambles and demanding some sort of explanation as to how the whole diagnoses could be so quickly reversed for no apparent reason.Maybe there is a perfectly good explanation but obviously nobody could be bothered to give it to you.
I've often found the best way to get some sort of result in the English system of anything is to ask who you need to speak to to lodge an official complaint.
It is not unknown for A&E to be 100% wrong in their treatment plan in the complicated areas such as surgery. A doctor you may be seeing, but a generalist like a GP. Who should say nothing unless he knows it to be 100% correct, particularly if he is going to refer you on to the true specialist.
In my experience, the hardest patients and conditions to treat are the ones who steadfastly cling on to (and why wouldn't you?) the first diagnosis and treatment plan they were given, usually by A&E.
I mean no offense to any particular doctor group here, but 14 years in the NHS has taught me much.
The_Doc said:
Yes, this. And moreso A&E assuming a diagnosis incorrectly and jumping to conclusions based on their good-natured interpretation of the MRI.
It is not unknown for A&E to be 100% wrong in their treatment plan in the complicated areas such as surgery. A doctor you may be seeing, but a generalist like a GP. Who should say nothing unless he knows it to be 100% correct, particularly if he is going to refer you on to the true specialist.
In my experience, the hardest patients and conditions to treat are the ones who steadfastly cling on to (and why wouldn't you?) the first diagnosis and treatment plan they were given, usually by A&E.
I mean no offense to any particular doctor group here, but 14 years in the NHS has taught me much.
But two minutes of explanation could have avoided a whole load of stress and worry, rather than just treat the patient as another member of the great unwashed? It is not unknown for A&E to be 100% wrong in their treatment plan in the complicated areas such as surgery. A doctor you may be seeing, but a generalist like a GP. Who should say nothing unless he knows it to be 100% correct, particularly if he is going to refer you on to the true specialist.
In my experience, the hardest patients and conditions to treat are the ones who steadfastly cling on to (and why wouldn't you?) the first diagnosis and treatment plan they were given, usually by A&E.
I mean no offense to any particular doctor group here, but 14 years in the NHS has taught me much.
14 years in the NHS must have taught you that much too?
King Herald said:
The_Doc said:
Yes, this. And moreso A&E assuming a diagnosis incorrectly and jumping to conclusions based on their good-natured interpretation of the MRI.
It is not unknown for A&E to be 100% wrong in their treatment plan in the complicated areas such as surgery. A doctor you may be seeing, but a generalist like a GP. Who should say nothing unless he knows it to be 100% correct, particularly if he is going to refer you on to the true specialist.
In my experience, the hardest patients and conditions to treat are the ones who steadfastly cling on to (and why wouldn't you?) the first diagnosis and treatment plan they were given, usually by A&E.
I mean no offense to any particular doctor group here, but 14 years in the NHS has taught me much.
But two minutes of explanation could have avoided a whole load of stress and worry, rather than just treat the patient as another member of the great unwashed? It is not unknown for A&E to be 100% wrong in their treatment plan in the complicated areas such as surgery. A doctor you may be seeing, but a generalist like a GP. Who should say nothing unless he knows it to be 100% correct, particularly if he is going to refer you on to the true specialist.
In my experience, the hardest patients and conditions to treat are the ones who steadfastly cling on to (and why wouldn't you?) the first diagnosis and treatment plan they were given, usually by A&E.
I mean no offense to any particular doctor group here, but 14 years in the NHS has taught me much.
14 years in the NHS must have taught you that much too?
OP seen by A+E doctor ( probably an F2 or Core trainee - SHO in old money) - talks to his/her boss who says ' get an MRI ' one or both the A+E docs smile sweetly at the radiologist who says yes - OP gets scanned
A+E junior doctor sees scan and sees provisional report - rings the ortho on call ( another junior) who comes down sees the scans , sees the Op gets all excited, runs off to speak to his/ her Registrar or Consultant who looks at the scan and says - send the OP back to the GP to get referred to Neurosurgery unless there's any 'red flag symptoms)
Ortho junior with tail between legs , rings A+e junior and says send him back to the GP to get neuro referral
mph1977 said:
given the OP mentioned a couple of doctors being involved at the A+E stage ... here's a perfectly 'normal scenario'
OP seen by A+E doctor ( probably an F2 or Core trainee - SHO in old money) - talks to his/her boss who says ' get an MRI ' one or both the A+E docs smile sweetly at the radiologist who says yes - OP gets scanned
A+E junior doctor sees scan and sees provisional report - rings the ortho on call ( another junior) who comes down sees the scans , sees the Op gets all excited, runs off to speak to his/ her Registrar or Consultant who looks at the scan and says - send the OP back to the GP to get referred to Neurosurgery unless there's any 'red flag symptoms)
Ortho junior with tail between legs , rings A+e junior and says send him back to the GP to get neuro referral
A very complete and detailed explanation, except you missed the two minutes where somebody explains the mistake/error/misunderstanding to the near-terrified patient.....OP seen by A+E doctor ( probably an F2 or Core trainee - SHO in old money) - talks to his/her boss who says ' get an MRI ' one or both the A+E docs smile sweetly at the radiologist who says yes - OP gets scanned
A+E junior doctor sees scan and sees provisional report - rings the ortho on call ( another junior) who comes down sees the scans , sees the Op gets all excited, runs off to speak to his/ her Registrar or Consultant who looks at the scan and says - send the OP back to the GP to get referred to Neurosurgery unless there's any 'red flag symptoms)
Ortho junior with tail between legs , rings A+e junior and says send him back to the GP to get neuro referral
Gassing Station | Health Matters | Top of Page | What's New | My Stuff