Showing posts with label ERCP. Show all posts
Showing posts with label ERCP. Show all posts

Saturday, October 22, 2016

Sound Familiar?



I've not posted for AGES but just been talking to wifey who was telling me about another death at Lincoln County Hospital.... death by sepsis due to gallbladder complications.

Having a quick Google I found yet ANOTHER story...

From Stamford Mercury....link
Criticism of communication between Grantham and Lincoln hospitals during inquest into death
An inquest into the death of a man from Corby Glen raised concerns over communication between Lincolnshire hospitals, as an urgent procedure was cancelled when the patient received two appointments on the same date.

On March 22, Robert Hall, of Pridmore Road, died at Lincoln County Hospital from septicaemia, as a consequence of cholangitis caused by gallstones in the common bile duct. Also identified as a contributing factor was a perforated duodenal diverticulum – the first part of the small intestine.

A procedure to remove the gallstones, known as an endoscopic retrograde cholangiopancreatography, or ERCP, was attempted three days before Mr Hall’s death, but had originally been scheduled at Lincoln for three weeks earlier, only to be cancelled because he was due to see his treating consultant at Grantham on the same day.

Coroner Paul Smith said: “It does seem there was something of a hiatus in the communication between the various hospital departments and Mr Hall’s family, which led to two letters being sent to them only a couple of days apart with competing and clashing requirements to attend either Lincoln or Grantham Hospital on February 26.”

Giving evidence during the inquest, Mr Hall’s daughter Stephanie Tuohy said: “I rang Lincoln County Hospital on February 16 to explain that we didn’t know what the procedure was and that we hadn’t seen the consultant to explain anything. They readily cancelled the appointment even though it was supposedly marked as urgent.”

She then accompanied her 81-year-old father to his Grantham Hospital appointment, only to be told he should have had the ERCP. “He asked if he’d had the procedure and we said no. He asked why and he was absolutely horrified.

“He was actually quite rude,” she told the coroner. “It concluded with him saying that we were wasting his time and we were not to go back to see him until we’d been to Lincoln for the ERCP.”

It was not the only delay experienced by Mr Hall and his family. An incomplete form had already put back the initial MRI scan identifying the presence of gall stones, and when this led to the decision on January 29 to do an ERCP, a letter stating this was received by Mr Hall’s GP but not by the patient. The first time Mr Hall heard about it was when he received the competing appointments for February 26.
The next day, Mr Hall was admitted to Lincoln County Hospital with severe abdominal pain, and the perforated duodenal diverticulum was identifed and operated on with success.
He returned home, only to be readmitted for on March 13 when it was identified that the gall stone problems predominated.
By the time the ERCP was undertaken on March 19, one gallstone was too large to be removed. The plan was to try again once Mr Hall’s body had recovered, but he deteriorated rapidly and died on March 22.
Returning a short narrative conclusion, coroner Smith said: “Robert Hall died from septicaemia, that being a recognised complication of an ERCP procedure attempted on March 19, 2015 to remove a gall stone from the common bile duct.
“At the time the procedure was undertaken Mr Hall was recovering from a successful procedure to repair a perforated duodenal diverticulum undertaken on February 27, 2015.
“It is not possible to say on balance of probabilities whether the outcome would have been different had the ERCP been performed prior to that operation.”


What's frightening about that, is colangitis....which is what I had earlier this year AND because doctors are too stupid to realise the symptoms or that this is happening- because when it happens, it happens fast- I'm now apparently more susceptible to this condition and so I now carry a scanned letter on my phone from my consultant explaining to any fuckwit medical person that I'm not being over dramatic and to take my condition seriously. Mental isn't it.
Like any medical condition, you begin looking and you find things you wish you hadn't!... classic example!

Monday, May 9, 2016

Here we go again...but WORSE! What they don't tell you about Cholangitis

Friday 22 April. Half day shoot at Siemens. After I packed up and got in the car it was as if someone flicked a switch on me. I felt dreadful. I got home and collapsed onto the sofa and fell asleep. Before I knew it, Helen was home from work and I was spiking a temperature. This is not good. Surely it's not the flu returned!?
By the evening I was breaking out in shivers (rigours) followed by hot sweats!
Sunday, I'd had enough. I went to the out of hours doctor who, to be fair, wanted to admit me but allowed me home with some strong antibiotics and if I got worse, was to return to A&E. He had suggested it was either a UTI or to do with my bile duct. Oh and book and appt for Thursday with your GP. Ok, no problem.
I expected to feel somewhat better by Wednesday- which I didn't- so on Thursday at the GPs he sent me to A&E for a blood test. After a 6 hour wait, I was admitted to MEAU and transferred to Dixon Ward with what turned out to be Cholangitis. Fuck.
This basically means I have an infection in my bile duct. The blood test showed markers for this plus damage to my liver. This apparently is serious and can be fatal if not treated! A big bag of IV fluid is put into me followed by 2 IV antibiotics and another large bag of saline to get me stable.
More IV antibiotics over night and the following day and by the evening of day 2 my cannula is removed and I'm now on oral antibiotics.
I also go for an ultrasound scan to see if there's anything unusual. The scan results were clear. Yayyy can I go please! 😂
Dr Spencer is in charge of me. Decent bloke. Looks like Harold Bishop out of Neighbors. Seems to know his stuff and has a good bedside manner. He's checked the ultrasound and now-to be safe- wants me to go for an MRCP scan. This is an MRI scan on my bile duct. The idea is to check for 'grit' in there. Because of my previous ops in this area, it is likely that my bile duct is scarred. He needs to check because if there is 'grit' in there, it will have to be removed because infection will return quickly if it isn't remove. How to remove it? ERCP. Oh shit!!!


So, what to do? Prey there's no 'grit' and it's a simple cure. If it's not, I think I shall have to ask to be transferred to the QMC's hepto biliary unit. I'm a bit of a special case with this, so it needs doing by the right people.
As for now, I'm stuck in hospital over the bank holiday simply waiting for the scan. Could be Monday, expect it to be Tuesday. We'll see. Hospital over a weekend is not a good place to be. Boring doesn't come close! 
I can wonder about (accompanied) but it's just wondering through corridors. Talk about fed up with nowt going on!



Well I'm now a week on and out of hospital. I had my MRCP on bank holiday Monday and [eventually] got the results on the Tuesday. Bloods were also done on Tuesday to check if my liver was ok. What a palaver - no results from the MRCP in the morning and no bloods done over the weekend, so I had to wait and wait to see if I was going to get discharged or be in for another day. Eventually, Dr Spencer's Jr Doc turns up to tell me I'm ok to go... no proper results of the scan and blood test, just I'm ok to go...this is great but it hardly settles your mind! Scan was clear, ok but how's my liver function and anything else from the blood test! It's just cheerio and we'll get you back in 6 weeks at out patients.
A quick thank you to John from Metheringham and Patrick from Skegness- 2 guys also on the ward and we had a bit of a laugh which always made the time go just a little bit faster. Hope you are both on the mend.
Pleased to get home, but still feel quite tired- must be the antibiotics (I'm on 2 different ones: Metronidazole and Ciprofloxacin) which I need for another 3 days... side effects seem to be metallic taste in the mouth and light headedness.

Another bullet dodged by the look of it PLUS another condition that can be fatal if not treated and also another condition that isn't covered by Critical Illness Insurance. *sigh*


Here's a final glimpse at Lincoln's NHS food... from vaguely edible to crazy... just look at that jacket spud and how much cheese they gave me. CRAZY! 😂😂😂