Getting a second opinion in the UK?

[sarahfh]

Hi, I was just wondering if anyone has any advice on getting a second opinion in the UK?

As I understand it, I need to get the GP to refer me for a second opinion, which is fine. But I wondered whether it is possible to request that the second opinion be from a specific consultant?

Basically I am currently undiagnosed, suspected IBD and I'm not happy with my current consultant, but initially when I was referred it was to be under a specific consultant, but I have been seen by a member of the team. I want to be referred to see the actual consultant that was on my initial letter but I don't know if that is even possible? I have checked out that consultant online and his page on the private hospital he also works for states that IBD is basically his main special interest.

At this stage I'm being told it is all just IBS and to just live with it. It's a little complicated though, my symptoms match IBD, more Crohn's than UC, far more than they do IBS, but so far most my bloods have come back fine, as has my fecal calprotectin. I had a colonoscopy and yesterday had my follow up and was told that the patch of inflammation they saw in my terminal ileum showed no inflammation on biopsy, and my large intestine which looked normal on colonoscopy showed mild, non specific inflammation at biopsy. My vitamin D is also low and I have to get supplements from my GP,and my IgA was also low.

I will be honest, I don't like the consultant I've seen so far. She has completely ignored the fact I'm very underweight (BMI 15.2) and to be honest just seems to want to get me in and out as soon as possible. She hasn't explained anything to me and doesn't seem to actually want to help. I'm due to see her again in about 8 weeks and if buscopan doesn't help my symptoms then she is referring me to the dietician instead. Since all my symptoms started my gut instinct (no pun intended) is that there is something more going on than just IBS, but now this doctor has me doubting myself and my own judgement, even though obviously I know my body best.

So I guess my other question is, is it worth me getting a second opinion?

Thank you if you have read this far, and thanks in advance for any advice!

 

[ronroush7]

Hi and welcome. You need to go with how your body is feeling. I am going to tag fuzzy butterfly.

 

[nitty]

Hi,

My husband is an NHS consultant and he said that even though patients may be referred to him by name, they will not necessarily be seen by him - it could be one of his consultant colleagues or a registrar. He said you could ring the outpatients clinic where you were seen and ask if you can specifically have an appointment with your preferred consultant, although that could mean that you have a longer wait.

I think it may be a bit early to ask for a second opinion at the moment. IBD can be notoriously difficult to diagnose and it may be a case of ruling some things out first, as this doctor seems to be doing. Give the Buscopan a go and maybe then, if you have no improvement, you could look at other options.

In the meantime, you could ring the outpatient clinic and ask who your next appointment will be with - it could have been that the doctor you saw first was just covering for your guy anyway.

 

[sarahfh]

Hi,

My husband is an NHS consultant and he said that even though patients may be referred to him by name, they will not necessarily be seen by him - it could be one of his consultant colleagues or a registrar. He said you could ring the outpatients clinic where you were seen and ask if you can specifically have an appointment with your preferred consultant, although that could mean that you have a longer wait.

I think it may be a bit early to ask for a second opinion at the moment. IBD can be notoriously difficult to diagnose and it may be a case of ruling some things out first, as this doctor seems to be doing. Give the Buscopan a go and maybe then, if you have no improvement, you could look at other options.

In the meantime, you could ring the outpatient clinic and ask who your next appointment will be with - it could have been that the doctor you saw first was just covering for your guy anyway.

Hi Nitty, thank you for the reply.

I will give outpatients a call once I've spoken to my GP and see if I can request the other consultant, that seems like the easier option that getting another referral made, especially as this one took 4 months to get an appointment. I think the one I have seen so far is a registrar rather than consultant, I've had two appointments with her.

I've had mebeverine before when I initially went to my GP about my symptoms a few years ago and sadly it didn't do anything but make my nausea worse, so I'm honestly not holding out much hope, but I'm going to try it anyway so they can tick it off the list. I have had mebeverine to try again between appointments but again it just caused unbearable nausea. I have had my symptoms on and off for years but this is the longest they have been on and the most they have disrupted life, it's been about 8-10 months now.

I need to get some sort of a handle on it soon as unfortunately it's meant I've been off sick from work a lot and I'm really close to losing my job.

The consultant I am hoping to see does work privately and my mum has suggested we pay privately for a consultation with him, but to be honest we can't really afford it, especially if he wanted to repeat tests as I'm assuming he couldn't access my records so far and I don't think I can either.

I'm not very good at being assertive and standing up for myself which isn't helping, but to be honest I just don't have the energy or strength to fight for my health any more. It's hard enough finding the energy to shower right now.

 

[fuzzy butterfly]

Hi Sarah, what nitty said is the easiest way to go for now. Your consultant can access your records easy enough as I am under the impression that all records are on a database now anyway. The paper copies should be at the hospital you go to also.
Try ringing his secretary to book in with him specifically, for your next appointment, though it may be that you have to wait a little longer depending on how busy he is.
Best wishes and I hope that it doesn't take much longer for you to get diagnosed and treatment to get you feeling better.
Let us know how you get on please and give us a shout if you need any more help.

 

[Agent X20]

As Mandy says, try the Consultant's secretary... that usually works for me... I often phone up to make sure I'm seeing the guy himself and not his awful registrar. If you want to try a private consultation you will be seen very quickly. After the first consultation the consultant can put you on their NHS list so you don't pay for further treatments... if he/she doesn't agree to do this, you won't them as a consultant anyway.
Good luck.

 

[sarahfh]

Thank you everyone, I've given outpatients a call to see about changing over but I've been told I will have to be referred by my GP for a second opinion so I have an appointment with the GP in a couple of weeks to see about that. I've been given the date for my next follow up appointment and I'm really hoping I can get it all changed before then to be honest.

My mum is getting more keen to go down the private consultation route as she thinks it may mean I get time to ask questions and have results explained to me properly. I'm still not sure and I honestly don't feel like I should have to go down that route to have things explained to me properly. But I will see what the GP suggests. It looks like my 25th birthday present could end up being a private consultation though!

I think the other thing is I don't let on to doctors how much I know and that I do my own research, not in a big headed way but I don't let on how clever I am. Before I got ill as a teenager I was hoping to become a doctor and was on the right track accedemically so I'm not stupid, and I still like to research and understand. But I don't let on to doctors because of course I respect them and their education, I don't want to come across rude or disrespectful or anything, so again I don't stand up for myself.

I can understand where they are coming from, in all honesty, because my bloods always come back fine and there was nothing horrendous on my colonoscopy, but there have been little things like the mild inflammation on biopsy, vitamin D deficiency and low IgA, that I feel like there is obviously more to it all than just IBS. Although thanks to that doctors attitude I'm still really doubting my own judgement which I hate.

I worry that I will turn out like my mum, she has lupus and spent years back and forth to the doctors with all tests coming back fine until she was pregnant with my younger brother and we nearly lost them both she was so ill, then it took them another 13 years to diagnose the lupus and realise it wasn't just rheumatoid arthritis. Because it took so long she has had irreparable damage to multiple joints and one of her kidneys.

I picked up my buscopan prescription yesterday so will give it a try, although my pain isn't really cramping. It's more of a burning, like lots of hot pins being stuck into my intestine in the same place over and over. It's so hard to describe. Sometimes it gets sharp and gripping too and recently it's moved so it's both sides of my belly button, each side is between my belly button and hip bone, it's so odd.

 

[fuzzy butterfly]

Hi Sarah, to be honest I believe that if let the doctor know you are not stupid and you know what you are taking about, you tend to get more info than if you go right right and don't question what they are telling you, coz then they try to fob you off n get you out of the office /surgery. Speak up hun, get the help you need. Best wishes to you Mandy