It looks like Elaine’s cancer has returned. She had CT and MRI scans on Monday – we don’t yet know the results. Yesterday, she had a colonoscopy and the doctor who performed it said it was his opinion that there is evidence of the “return of the disease” – again we won’t know for definite until the samples have been analysed. It probably means another two week before we know the prognosis and possible options.
We now feel that Elaine should have been seen much more regularly than she has been.
Letter sent by me (Chris) to the consultant, copied to the chief executive, and our GP.
Dear Mr S,
I am writing this two days before we know Elaineâ€™s prognosis in respect of the scans and colonoscopy she is about to have tomorrow and Tuesday. Many of the matters I raise below will not have been within your area of responsibility but I am outlining them so that you can understand Elaineâ€™s frame of mind.
At the outset, I would like to express our greatest appreciation and gratitude for the NHS and the kind and sensitive support and expertise we have received from the nursing and medical staff.
However, I am writing to express some of Elaineâ€™s worries and concerns. She is very, very anxious because of some of her experiences last year at the Royal Calderdale Hospital.
Bowel op: 24th January 2005
Reversal: 7th February
Liver operation at St Jamesâ€™: 31st May 2005
Chemotherapy: March 2005, July 2005 to January 2006
Why did this go wrong?
After her operation Elaineâ€™s ileostomy bag presented many problems in that it kept coming away from her body. She also developed very badly excoriated skin in the region which was very painful.
Elaine is not squeamish and has in the past done some nursing training. She has had no difficulty in helping others change their bags. When Elaine complained about the problems, she was not taken seriously by the Ward sister who gave the impression that the problems were all of Elaine’s making. As did the consultant: “You cannot stay in hospital forever. I have 86 year old ladies who do this.”
Yet, highly trained stoma nurses were unable to affix it so that it remained attached for more than a couple of hours or so.
Since then Elaine has seen other peopleâ€™s stomas and photos of them on the internet and realises that hers was not properly formed. She has never been offered an explanation for what happened.
If the outcome of the scans and colonoscopy mean that Elaine has to have a permanent stoma, she is terrified that all this could happen again.
Post operation care
Elaine was returned to the ward from the ICU very early after the operation. We asked for an individual room but were told that this wasnâ€™t possible, even though there were empty rooms constantly available during Elaineâ€™s whole month in the hospital.
At times she became desperate for sleep. It also seems to both of us that priority for single rooms could be given to those learning how to use and manage an ileostomy bag; especially if that person is, like Elaine, having very serious problems with the bag management.
Senile, incontinent patients were on the same ward. These ladies were often awake right through the night disturbing other patients. The kidney infection Elaine caught was probably caused by this.
Visitor regulations were not enforced so that a large family with loads of young children was right next to Elaine’s bed, giving Elaine great distress.
When Elaine had visitors and wanted some privacy, objections were made by the Ward Sister and one of the staff nurses when she pulled curtains round her bed. This was a complete contrast to St. Jamesâ€™s Hospital where the staff appeared surprised when Elaine asked if drawing the curtains around her bed was acceptable to them.
Elaine was told that something was seen on the liver by Mr. S that was probably benign but should be checked. On her discharge at the end of February she heard Mr S tell one of the staff nurses to arrange an MRI as soon as possible but this only happened a few weeks into her first course of chemotherapy which began in mid March. The MRI was eventually done at Elaineâ€™s insistence and did not occur automatically, as Mr S had instructed. In the event, Elaine had to have half her liver removed at St. James Hospital. Had Elaine not insisted, it may have become too late for surgery.
Acidic burning defecation
Elaine has complained about this ever since she left hospital in February 2005. No-one has been able to give her an explanation, or even acknowledge that they understood what she has been talking about. At times she has felt like she has been disbelieved & had considered seeking a private consultation about it.
Elaine has had several admissions into hospital with these and has had several of them which she has managed at home.
Elaine was told to expect six monthly scans and an annual colonoscopy. She has had one scan at St James in November 2005 but the colonoscopy hasn’t happened. Her last and only colonoscopy was in January 2005. She was not given any information about how many times she could expect to be seen in Mr Sâ€™s clinic.
We now understand that the protocol for her type of illness is three monthly consultations which she has not had.
After not hearing for some time, I urged her to contact the hospital. She contacted the stoma care nurses in April and spoke to one of them named L. She informed L of our concerns that she hadnâ€™t received an appointment for the colonoscopy and asked her if she could investigate. She said sheâ€™d get back to Elaine, but didnâ€™t.
In May, I persuaded Elaine to phone again. She was told that she had missed an appointment for that very day: 17th May. We had not been notified of it.
Wednesday, 24 May
At the re-arranged appointment, Mr S finally took the “acid defecation” seriously, and made an examination where he saw something bleeding in the bowels
For the past 10 days, Elaine has been in a state of terror, fearing the worst. It has led to her seriously contemplating suicide as she now has little trust in the system and a horror of a permanent stoma which may not work as the last one didnâ€™t. No-one should have to go through what she has been put through in the past ten days; surely the NHS is mature enough to be able to offer some kind of support for people waiting like this, or to move procedures so that the waiting is minimised.
But much of the fear has been caused by her earlier experience, outlined above.