Into the system

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The surgery phone line opens at something like half eight, so I was determined to get up early on Monday and ensure I got an appointment as soon as possible. For once I had a bit of decent sleep and didn’t manage to make the call until mid morning. I explained that I had just filled in the registration forms on Friday but was told that I could make an urgent appointment if necessary. The lady on the phone asked my name. ‘There’s been a problem with your registration, because you didn’t give your last address!’ Remember I haven’t lived there for eight years, and hadn’t needed to recall it in the meantime. Luckily, when I saw the practice nurse at the walk-in clinic, she had tried to access my notes on her system. I had been registered at a student practice in Norwich. They knew I no longer lived there, so I wasn’t on their books any more. This meant that the practice nurse couldn’t access my notes. However, when she tried, I did get a glimpse of my previous address and I remembered the road name. So I gave it over the phone to the surgery receptionist. ‘Do you know the postcode?’ WHAT? I haven’t lived there for eight years! It came straight into my head, I know not from where! ‘I’m afraid we haven’t got any slots this morning, try phoning back at two!’ I slumped back onto the couch in a pit of despair. I would have to get straight on the phone at two.

The problem with the registration really worried me. Also I was worried that I wouldn’t get to see the doctor that day. If I was to take any more time off work, I needed a doctor’s certificate. I was straight onto the phone at two. For about five minutes I kept getting the same message: ‘the surgery is closed between the hours of one and two.’ COME ON GUYS, it’s five past. Eventually I did get through and was mightily relieved when I was told I could come in at three something. She obviously didn’t say three something, it’s just that I was so concerned about my registration problems that as soon as I put the phone down the actual time had gone from my head. I went upstairs to my room and searched high and low for my previous address. Going upstairs and doing the search wore me out. Thankfully I found an old bank statement. Now it was about two twenty and I had to get there for three something. I thought: ‘it might have been three ten, or quarter past, I’d better get a move on!’

I was shattered when I got there. The receptionist must have thought I ran there. She said: ‘you know you’re really early!’ My appointment was three forty. I told her that I had found a letter with my previous address, so she took it to make a copy. As she did that I asked why not having my previous address would hold up the process. Her reply shocked me. Doctors get a certain amount of funding for each patient they register. The people giving out that funding look for any excuse to block the registration, believing it to be a bogus claim. I thought to myself: ‘does that mean if I couldn’t find my last address I’d be blocked from registering anywhere?’ I hope that could not be the case!

Sitting waiting in the surgery I still felt a fraud!

The doctor was great. I explained that I had had the cough for ten weeks now. Also I bought in the packaging from the two courses of antibiotics I had taken to no avail, in order to show him. He did a similar check to the people from the walk-in clinic, but he did one thing they hadn’t done. You’ll probably be familiar with it, we’ve all had it done before. He tapped in various places on my back. Following this he sat down and said he was concerned. I had a long term cough that hadn’t been shifted by two very good courses of antibiotics. Also as a result of the tapping he could hear that there was some problem with my lung. He booked me in for an x-ray. He said it was a walk-in clinic at the hospital, so I could go any time tomorrow, but I should try to go early. I saw him typing out the requisition form for the x-ray, which he handed me anyway. On it he put ?pneumonia. So I knew what he was looking for. But he also said: ‘in the absence of any other evidence I have to assume this is a chest infection for now, so I’m going to prescribe an even stronger course of antibiotic.’ He also gave me a sick note for another week.

A suspected chest infection

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Some time between summer and mid September 2013, a juggling friend, Joseph, said to me: ‘your passing would be much better if you weren’t so out of shape.’ This is typical of Joseph’s banter. I thought he was right too (I wasn’t going to say that to him though!) I thought this might be an age thing – as you age you have to work harder to keep the same level of fitness. It transpires the reason I am so out of shape is that I am ill!

Thinking back, the first symptom was that I was struggling to keep strenuous passing patterns going for any length of time. But at that point, it didn’t seem like I was ill. The first feeling of illness was a chesty cough. I often suffer from coughs, so I thought nothing of this. There was also an unexplained shoulder pain. It felt like I had bashed my shoulder really hard against something, but I don’t remember any such incident. There wasn’t one! The cough got worse. I had some quite nasty coughing fits. But I still thought: ‘give it time and it will go away!’ But I gave it a lot of time.

I had another problem that contributed to my procrastination about seeking help. I had not seen a doctor since I moved from Norwich eight years ago, and was still registered there. So after about eight weeks of suffering with this very nasty cough I went online to find my nearest NHS walk-in clinic. There was one about a mile away, which is open long hours, seven days a week. That was ideal. I wandered up there one Saturday, got an appointment and was pleasantly surprised by how quickly I got seen. I explained to the doctor that I had had this cough for eight weeks. He was quite concerned. He asked if I had lost any weight. I said no, because I was not aware that I had. It turns out I had lost a stone and a half in those eight weeks! He took my blood pressure, pulse and temperature. He never said so, but they were all normal – my pulse was high, but within the normal range. Then he listened to my chest as I breathed in and out deeply. He said it was a concern if a cough persists for more than four weeks and ideally he would send me for a chest x-ray, but he couldn’t do that because I wasn’t his patient. Really, I needed to register with a local doctor. He had to assume that I had a chest infection, so he prescribed a course of antibiotics. I was happy, I had a diagnosis and now had access to the cure. So I went away, and dutifully took my antibiotics. They seemed to have no effect until Thursday, when I thought I felt a bit better. The course finished on Saturday. By Monday I was back to the dreadful coughing fits.

I was having coughing fits maybe twice a day. Often in the afternoon and evening. When I had them they were severe. I would cough until I wretched and occasionally there would be spots of blood because I had coughed so hard. Once they were over, I would appear quite normal for the rest of the day, although I did get out of breath very easily.

At work on Monday (yes, I was still going to work!) I had a horrendous coughing fit! This was during a break between picking up passengers. I then had three ladies to take a short distance before my lunch break. I thought: ‘I can take these three ladies to their club, then call in sick, return my bus to the depot, and my relief driver would very easily make the next pick up in plenty of time.’ When I picked up the second lady, the step on my bus would not go back under the minibus. I kicked at it for about five minutes but to no avail. So I had to call in a breakdown as well as reporting sick!

I returned to the walk-in clinic. I felt like a fraud, because I was in one of those lulls between the coughing fits, so appeared outwardly normal. This time I had to wait a little longer for the appointment and my heart sank when I was called in by the practice nurse. I thought maybe they had me down as a hypochondriac and wanted to get rid of me. I told the practice nurse my story. She did the same tests as the doctor had done and she said to me: ‘I can’t see anything wrong with you, you look well to me!’ Despite her protestations, she said she would get one of the doctors to sign a prescription for a stronger set of antibiotics. Once again, I left there happy.

The next day I got a call from my manager, asking me when I expected to return to work. I said that I’d been put on antibiotics, so if they started to do the business, I hoped to be better by Thursday! I spent the next two days on the couch watching daytime T.V. Sometime on Wednesday I decided to phone work. I was in one of those lulls, when I appeared outwardly fine. I said that I thought the antibiotics were doing the trick, but looking at the very long list of side effects I didn’t think it would be safe for me to return to work before I finished the course. One of the common side effects was difficulty sleeping at night. To be honest, I hadn’t had a decent night’s sleep for several weeks! Another possible side effect was drowsiness. I’d spent two days mooching on the couch, so it wasn’t clear if I was experiencing this, I hadn’t really tried to do anything. But the leaflet said if you experience drowsiness, then you shouldn’t drive or operate heavy machinery. So I explained that I would finish the course on Monday, so I should be fit to work then. When I put the phone down I thought that I must have sounded fine to him and I didn’t feel too bad. Once again I felt like a fraud! That afternoon and evening I had two disgusting coughing fits.

I spent the rest of the week on the couch. The antibiotics weren’t working. I had to get registered with a doctor! So on Thursday I went online to find a decent local practice. I spotted one with decent opening hours and good patient reviews which was a bus ride away but only about a mile or so. I marked that as my first choice. My second choice was closer, but not reachable by bus. Also the walk there involves half a mile up a steep hill. Usually these points about accessibility wouldn’t cross my mind. I regularly used to walk the three miles to work. But in my current state they were crucial. I headed off to my first choice. The journey there was hard, because there was a bit of a walk at either end of the bus ride. The receptionist asked: ‘what’s your postcode?’ When I gave it to her she said: ‘I’m sorry you’re outside our catchment area.’ My second choice was maybe ¾ of a mile away. Usually a short walk, but I had to get a bus. There was still a walk to the surgery. Knackered, I sloped up to the door only to see a sign saying ‘the surgery closes at 2 on Thursdays.’ That’s not what it said online! My stomach was churning with rage. Now I had to face the long walk home, but still not registered with anyone. On the way home I passed a surgery that was opened. I hadn’t checked it out online before, so I consulted my phone. It only had one doctor, and didn’t have great reviews. In my current state I was sorely tempted to say: ‘sod it! I need a doctor.’ But I wandered home, dejected.

The next morning I phoned work again. Again I was in one of those lulls. However the pills weren’t working. So I said: ‘I know I said I’d try and come in on Monday, but if you asked me if I could work tomorrow, I’d have to say no. Monday’s three days away, so it’s hard to say what I’ll be like then. Also I’ll be taking two of these pills on Sunday and the last one on Monday, so really I can’t come in then!’ After the call I felt the same as before. ‘I’m a fraud.’

That afternoon I struggled up to my second choice surgery to try and register. The receptionist gave me a map with their catchment area marked out and asked if I lived within it. My insides knotted, but thankfully I live right on the edge! There were two forms to complete. First the registration form, but also a form outlining my current state of health and any medication I’m on. I wrote that I had a chest infection and was on antibiotics. Also the receptionist probably saw the state I was in when I arrived at the surgery. She took my forms and said: ‘it usually takes seven days to register, but if you need and urgent appointment we can try and fit you in.’ I was still feeling like a fraud (!) so I said: ‘I think the antibiotics might be starting to work, so I won’t ask for an appointment now.’ The surgery doesn’t open over the weekend so that condemned me to another two days of suffering. The journey home was downhill so should have been easier. Naturally, I suffered another severe coughing fit.