This Little Piggy...Is Getting The Chop. #TBofB's Mel gets ready for surgery..

Today (Tuesday – you know my rule about days changing), I went to see my Orthopaedic surgeon again. This time, along with parents, my lovely EB nurse was by my side, too; the surgery being discussed wasn’t just new to me and my family, it also was new to the surgeon and the EB team. Oh yes, my feet were stamping on new ground.

Miraculously for an hospital appointment, I was called in a bit early! Well, my mum was; the room was titchy, I was right by the door and the SpR wanted to go through my medications, which my mum knows far better than I do *shamed face*. I and my dad were soon escorted into the room next door, where my tootsies were to be inspected. As we sat there, Dad asked if I was okay and, out of nowhere, tears burst forth. What if the consultant had changed his mind, Dad? I hate them. I truly hate my feet, and I need something, anything. Luckily, in these situations, Dad Hugs are the best treatment, especially when accompanied by a kiss on the head, and comforting words muttered into your hair while tears rain onto his jumper.

We underdressed my feet, and the SpR soon came rushing in, eager to have a look at these freaky feet, only before seen on the most bizarre x-ray ever taken. I don’t think he’d ever seen EB before, or heard of it before I first went to the clinic a few weeks ago, so he had a good look from every angle, “hmmmming” away in between asking me questions. I was glad he took such an interest – EB usually scares young doctors more than the debt they’re in!

Next in was the consultant, a lovely man who had given me some hope that my feet could be made more tolerable. He was almost excited to see my feet without their dressings, claiming he’d been waiting ages to do so (fibber – it was three weeks!). Again, much intense peering at my piggies, asking exactly where my pain is and exactly what it feels like.

No one has apparently ever seen toes do what mine have done. I’ll let you see the x-ray at the end… It shows why so many questions needed, and still need, answering!

I absolutely despise having my feet touched, as no part of them feels normal, either hurting like all hell or making me cringe, heave or jolt away. So I was amazed I didn’t panic when I saw the gloves going on, or pull away as he reached out. I realised, in the back of my mind, as I was letting him feel my most icky foot areas, that my feet had crossed the line from being so painful I wouldn’t have them touched, to being so agonising I would do anything to get help.

He had a gentle press, pull, poke and prod, carefully twisting my feet to the angle they should sit at (a scarily long way from where they do). Thankfully, he remembered exactly where my most terribly pain bit is and pulled his own hand away before he touched it. I couldn’t help but smile at my mum and EB nurse, who were both tensed and ready to pounce should he cross the line in their minds.

He confirmed that I am walking on my bones right under the skin; most people have pads of fat in the pressure areas on their feet. I have none at all, which explains a lot of the pain. Another new one for the surgeon!

Out came his iPhone for some snaps, as we exchanged questions, and a decision was made. He would take bones from the toes on my right foot, and see if that eased some of the pressure and pain. Once it was healed, and if it was successful, he would do the same on the left (which is more complex and so not a good starting point). If it didn’t help…well…then we might have to consider amputation. As it is, I’m the only one who will consider it. My parents verge on putting their hands over their ears and running away, shouting “lalalalalala! I can’t hear you!”. Purely because they are so scared for me. So I won’t consider it aloud anymore, for their sakes.

He said they would get back to me with a date for the surgery, at which point SpR went out of the room, to reply to a bleep, I thought. A few moments later, he was back: “You’re booked in for 1st December, if that’s okay?”. What NHS waiting lists?!

I listened and watched happily as the consultant took a surgical best practice outline for EB patients from my EB nurse, genuinely grateful for the help. Phone numbers, names and emails were swapped to co-ordinate everything and everyone needed to make the surgery as atraumatic as possible for me. Gratitude swelled inside me, making me feel rather emotional.

Now plans are underway for phase one of Fixing my F*cking Feet!

Come December, it’s all I’ll be blogging about!

Mel xx

Look at my toes – that’s why the ball of my foot is under such pressure, and thus SO painful. The surgeons have only ever see toes curl over before – which the very ends have done. But the 90 degree angle is a medical mystery. Someone call Scooby Doo and Quincy, MD!

Why The NHS Reforms Really Are The End Of The National Health Service

Guest blog with thanks from Richard Murphy of Tax Research UK. Originally posted here

One of the most pernicious aspect of the Tories’ NHS reforms is one of the least known.
At present we have a National Health Service because the Department for Health (and it’s Welsh, Scottish and Northern Ireland equivalents) all have a statutory duty to ensure that there is a health care service for all in this country free at the point of supply.

That will not be the case after Cameron’s reforms go through. The Department for Health will not have such obligation in England, at all.

GP consortia will have a legal obligation to provide services to those registered with them. But note, you have to be registered t enjoy the service. It will not be a right: it will only be a right if you are registered.

And there will not be an obligation on consortia to provide universal health care free at the point of delivery, quite extraordinarily. If a consortia decides it cannot supply a service because it is too costly or it has run out of budget then it will be able to decline to do so. GP consortia will not be an NHS: they’ll be a selective healthcare service because they’ll have a statutory duty to supply a service for which there will be increasing demand at ever reducing cost and that will necessarily mean they’ll ration – which will impose impossible conflicts of interest on GPs.

And what for those who do not or cannot register with a GP consortia or who need the services their GP consortia cannot or will not supply? For them their health care supplier will be their local authority. Yes, it is local authorities that will have the duty to supply universal health care after the reforms come into effect.

Of course, local authorities have no mechanism to make those health care supplies. And nor are they being given any budget to deliver them. But you can already hear Cameron saying it’s not his fault that they won’t be able to deliver – it’s their legal responsibility and if they fail it won’t have anything to do with him.

Except of course it will. He, Lansley and Clegg are responsible for this reform. The reform will end the right to universal healthcare. And it signals the end of national healthcare – and brings in an era of supposedly local healthcare when there is no mechanism to supply it.

That’s not chance: that’s further evidence of designed in failure in the scheme the ConDems are proposing. And there’s only one reason for that designed in failure: it is complete contempt for democratically controlled supply of services for the benefit of all the people of this country when what Cameron and his friends wan is the opportunity to capture control of those services so they can rake billions off them to enhance their personal wealth.

We don’t have long to stop this deliberate act of destruction. And if the Lib Dems toe the party line we have no hope of doing so.

Will dogma destroy the NHS? I hope not – bit only vociferous action can prevent it. That I do know.

Ms H Cushion's Story

In June of this year the monitoring of 18 week NHS operations waiting list times was removed by the Coalition. It was revealed by the health professionals Pulse Magazine yesterday (source: http://www.pulsetoday.co.uk/story.asp?sectioncode=35&storycode=4127972&c=2 ) that  by September, the number of patients waiting for more than 18 weeks for their operations had jumped by 15%. 

I have personal experience of this, having waited for 25 weeks for foot surgery, finally removing myself from the waiting list after finding another surgeon to treat me.  In March of this year I was diagnosed with Hallux Rigidus (arthritis of the big toe joint) at the Luton & Dunstable Hospital and added to their waiting list for a chilectomy (bone shave).  Just five weeks later I was offered the opportunity to have the operation at a private hospital as the waiting time was going to surpass the Government's 18 week target. In order to meet their targets I could be treated by the middle of May. By this time however there was serious doubt that the chilectomy would solve my mobility and pain problems so I advised the waiting list registrar that I had a re-assessment in June and she agreed to post-pone the private operation until the results were through. 

 

Having seen a consultant on the 1st of June who was happy for me to go ahead with the chilectomy, I again contacted the waiting list office.  Imagine my shock and dismay to be told that as the 18 week waiting time was not now crucial to them, following the removal of the monitoring, my private operation was no longer an option and I would remain on the waiting list indefinitely.  By this stage I had been waiting for 10 weeks and my pain was increasing and mobility decreasing.  In April I had been signed off sick from work as I could no longer perform my duties as a home carer.

 

From the middle of July I have spent most of my days in an armchair, unable now to stand or walk for more than a few minutes.  In September, following a second opinion consultation with a different surgeon, I removed myself from the waiting list, having waited for 25 weeks. I was now due to have both feet treated and as I had waited for so long, the damage had increased to such an extent that the operations would now include joint replacement and stabilisation.  However, following an administration error, I was discharged by the new surgeon!  Finally, last week I was back in surgeon B's chair being assessed.. I left his office with a date for surgery, X-Ray and pre-op appointments.  I will finally have my (now far more scary) operation on my right foot on 4th January, my now deteriorated left foot will be addressed once I am able to weight bear on my right. 

 

I am certain that had I been treated within 18 weeks, not only would the operations I am now facing not be as severe or expensive but I could also have kept my job (I was *released from my contract* in November).  Next year is filled with nervous anticipation for me, the recovery times for the surgery are long and painful and I am facing eviction from my home as my contract here terminates on the 28th of December.  Another legacy of the Coalition government's new policies is that I cannot rent privately again as I am now unemployed and the letting agent's insurance companies will no longer take a risk on benefits claimants. 

 

So please be upstanding for our Coalition.. well, you go ahead without me, as I cant. 

 

Note from BofB: We are committed to being a non party political campaign. We do not censor the stories sent in to us, the political opinions in this story are those of the author.