Saturday 9 March 2013

Learning from Experience.

Two linked staples of the current media agenda are the need to 'cure' the NHS and the challenge of the  'baby boomer' generation's entry into '60s' which relate to their age rather than their era.  How will an overstretched, under-skilled, morale-deprived NHS cope with the needs of a generation which has lived its life as a centre of attention and which will not conform to expectations of age?

Despite the awful experiences of both parents at the hands of the NHS, I have tried to remain open-minded, but recent experience has made me pause.

I am not ill. I have always enjoyed robust good health, last visited a doctor two years ago and have stayed overnight in hospital only for childbirth. In my final 12 years of work I was absent through illness once ... for three days. I consider a visit to the doctor an admission of defeat; if I do have to resort to it, I use the appointment to seek advice on how to help myself.  Like the ex-teacher I am, I read and research carefully to aid this process.  I believe in self help.

In the past three months I have been suffering excruciating pain in my lower back, groins, buttocks, hips and legs:  I have never had an unbroken night's sleep and, at its worst, the pain has reduced me to yelps and tears in public places.  I have refused to see a doctor, hoping instead that yoga, stretches, heat and as little ibuprofen as possible would see me through.

Finally, after one crying jag brought on by gardening,  I acceded to my family's pleas.   GP 1 told me we would have to find out where this pain was coming from.  GP 2 agreed.  There followed blood tests which were pronounced absolutely clear. Yesterday came the X-ray results; I had to discuss these by phone with G.P. 3 .  Thus began a demoralising conversation:

 First the good news.  My X-rays showed wear and tear in both hips and lower back that is normal "for someone born in 1950".   No need for ortho consultation  as we are "a long way away from that"   Just pain killers and anti-inflammatories (GP2 had advised avoiding them if possible).

So, I ask, it's just self-help to deal with this pain then?  

Yes.

Should I just keep at the yoga , swimming etc ?  Should I assume any exercise is good?

"Mmmm"

The pain sort of reminds me of sciatica I had years ago.  Could that be a possibility?

"Oh well that doesn't show on an X-ray because it's nerves"  He can certainly tell from my level of articulacy that I will already know this, so

!!!!!!!!!!!!!!!!!!!!!!!!!!!!!   I see.

What we're interested in, he says, is whether you need an ortho consult.  And you don't.

So really, I need to do self help to deal with this .........?

Uhuh! (sic)

At that point I thought there wasn't much more to say!  Whatever he wanted to communicate, what I  actually heard was,  "You're 62, woman!  This pain is normal for that age.  Sort it. Buy some pills. Now get off the line because there are tens of others behind you."

Personal anecdote this may be, but it raises some serious issues.   I am a highly educated, retired professional, articulate, comfortably off, time-rich and well acquainted with Google and You Tube.  However, the area I live in and which this large practice serves has major deprivation as its norm.  In fairness, my need to be sufficiently pain-free to enjoy gardening, tennis, walking, yoga, foreign trips, must pale into insignificance compared with the GP's caseload of diseases and ailments which are exacerbated by poverty and lifestyle and lead to lower than average life expectancy.  Many 62 year olds in this area are in the last decade of their lives.  If good fortune, self-help and heredity play an appropriate part, I have good reason to expect another twenty years and more.  Which of us demands the GP's attention?  I understand.

But surely, when that GP recognises from a voice, from questions and reactions that a client is capable of self-help, given a bit of extra advice, why not offer it, in the hope of increasing the years before she joins those who need referral to a specialist?  Thousands of us are willing to self help if we are simply pointed in the right direction. The assumption must be made that we are looking for another twenty or thirty years! We're looking after ourselves, watching our diet, our alcohol intake; we don't smoke, we exercise, we hone our intellectual skills; we are the Boomers.

I have now spent hours researching the cause of the pain I am experiencing, because I simply will not give in to it.   Normal wear and tear does not produce this level of pain; sciatica and piriformis syndrome do!  And strangely, in researching the latter following a remark from my yoga teacher, I found a list of symptoms I could have written myself!  I now know from my research  that the GP could have given me a phone number (as one of his staff has now done!)  for self referral to a physiotherapist; that there is a huge online advice resource for my NHS area; that osteopaths and chiropractic are governed by safety regulations; that the practice can arrange acupuncture; that Youtube is laden with suitable exercise videos; that diclofenac is causing concern and that you have to  be careful with ibuprofen ................... I have the intellectual capacity, the wide circle of supportive peers, and the technology to research;  what about the 62 year old who does not have these resources? 

We all have to learn how to see the ageing of the Boomers as a plus to society, rather than a drag.  Many of us are more than willing to look after ourselves, given targeted  support when we really need it. A few minutes pointing us to appropriate support will leave space in the GPs' waiting rooms for our less fortunate peers.