Aneurysm

[annieigma]

would like some advice please. Woman aged 66, had headaches, went to doctor, was told it was probably sinus problems and was prescribed some medicine. to cut a long story short, three more visits, different doctor said it could be migrane, also patient had pain in rib area, was told it was a skeletal strain. Headaches got worse, painkillers prescribed. three months down the road, headache so bad amulance was called, stronger pain killers. two days later, another episode, taken to hospital this time, kept in for one night, MRI machine fully booked, so sent home to return three days later when there was a slot. next night, the patient was at home and had a fit, passed out and died a few hours later in hospital. post mortem was two aneurysm's, one in the brain and one in the abdomen. Do you think her life could have been saved if the first Doctor had sent her for a scan, or is it usual practise to try a few simple things first??

[Cloverjo]

She could probably have been saved if a scan had been done and an operation to repair it had been done in time.

However, the symptoms don't suggest that that was her problem, so the doc is not to blame for not sending her for one.

My dad had a massive aneurysm which was only picked up by a "well man" clinic scan. Luckily, he was operated on just in time.

[Mamyalynne]

The simple answer is , yes - if the scans had been initiated and the aneurysms had shown at the start she may well have survived.

However as Cloverjo says, GP work through from the simpler reasons for pain and work from there, logically they have to work that way, could more have been done - possibly.

Sad to hear the news of your friend/relative.

[KARL]

This sort of thing seems to happen all the time. I was abroad when my wife phoned to say her mother had died and, as she described the story of how she fell ill three days earlier, my immediate reaction was that she was describing a heart attack. The GP prescribed medication against indigestion and (if I remember correctly) also pain killers. On the third day she called for a home visit and another doctor came who went straight for the phone and called an ambulance. She was taken to hospital and put on a drip with blood thinning infusion and a nurse stationed by her side. A couple of hours into this she died of a (the) heart attack.

Someone else went through something in excess of a year of examination and treatment against digestive problems but then, following an intervention by her husband, was diagnosed with advanced ovarian cancer.

There is no question that if these and your friend's cases had been looked at from a worst case perspective with a view to eliminating it, they would have fared much better. As Mamyalynne indicates, GPs are inclined to deal with patients on a "lowest threshold" basis with a view to speed and minimal/simplistic intervention, a conveyor belt in/out principle. They need to be extremely alert to avoid misdiagnosis on that basis and, unfortunately, "slips" and mistakes are not uncommon, even also at specialist level. The cost of a thorough approach (including worst case consideration at the outset) in every case would be prohibitive and in fact cannot be undertaken by any public health service. Examples like these will continue to be a fact of life. There is however a strong argument for being quicker to pick up persistence of symptoms which point toward a worse, if not worst, case scenario. Also, specialists need to be show greater readiness to consider passing a patient to a different speciality where the symptoms could indicate that area also.

[237SJ]

It does sound like more investigative procedures should have been carried out but with the best will in the world, it does seem a bit strange that there were two life threatening aneurysms at the same time and maybe there would have been nothing that could have been done that would make much difference. Just my opinion though.

[Sqad]

IF.....IF ....IF.......IF.....retrospect is a useful tool.

Yes of course her life would have been prolonged had the investigations been instigated earlier, but in the UK, there is only a certain amount of butter which needs to be spread very thinly and hence MRI scans tend to be "overworked." In other countries e.g USA medicine has to be paid for, is a source of income, so patients are often "over investigated".....is that a bad thing or a good thing?
Doctors are human and mistakes are made and always will be.........

\\\or is it usual practise to try a few simple things first??\\\

Depends on the signs and symptoms presenting, but yes, it is usual to try the simple things first.

Terrible story from the OPer but unfortunately far too common.

[annieigma]

Thank you for the replies, and i was actually in the same hospital yesterday with my 27 year old granddaughter, and same situation, MRI scanner fully booked, you just hope someone misses an appointment so you can jump the queue, the Male nurse that was doing the medication etc. was running around like a headless chicken, he would head for one room, then get called to another by a relative in the corridor, we just watched him running, yes running, everywhere.
The A and E has a screen, that said average waiting time to get attention was six and a half hours, although children were seen almost immediately. My Granddaughter had collapsed and been admitted with stomach pains, nothing showed on the x-ray, so they sent Her home with pain killers to await a MRI scan. Two years ago she had cancer of the thyroid, it was removed and she had radio treatment, results were good on last check up, but it is a worry in case the cancer had spread.They have suggested the pain could be gall bladder, as an X-ray sometimes doesn't show small stones, so now we wait.

[Sammy48]

Annie, if gallstones are suspected, they could do an ultrasound which would show them up better than an MRI.