Gp,dishonesty, Denial, Altering Records,

A record of medical expeiriences at totton health centre, from drs, Alvyn and gaunt.
1st appointment with dr alvyn.
　
I had been experiencing , light headedness and the symptoms concerned me enough to seek advice, however as a patient that tries not to bother a doctor unless absoluteley nessisary, I recalled that I had been taking "Nytol" for the past 3 wks or so and the very morning of my appointment I realised that although Nytol didn’t work for sleep it was most likely the cause of my swooning, under normal circumstances I would have cancelled the appointment not wishing to waste a doctors valuable time,
However,
　
I had been passing what appeared to me as pieces of skin in my urine and so prepared a piece of the tissue between two pieces of plastic as a microscope sample in order to save more time beleiving that presenting very thing itself would save much explaination,
This is how my appointment went.
Firstly I offered my hand as I said good morning, it was declined , I did not mind this, as I find more value in a Doctors ability than their "bedside manner"
I started by telling of the dizziness and swooning that I thought to mention only so that if I was wrong and it wasn’t the Nytol, I could well be back in a week or two if a were still swooning,
when I said I was swooninng, he told me to use another word, which I did replace with 3 or 4 other words that didn’t actually express the feelings as well , but when I mistakenly said swoon again , was told off as a teacher would correct a pupil using slang, it was the first time I had met any-one as well spoken as Dr Alvyn not knowing the word "swoon" but I said "it probably doesn’t matter now as I may have found my own reasons for the symptoms,and I could be wasting both our time to explain any more of a problem that may not exsist. But I do have another concern, I am passing something like pieces of skin when I pee", " passing " what do you mean passing?" he said, "urinating "I said" its probably just the plumbing blocked a bit" "plumming?" looking baffled again "yes" I said " the waterworks, you know?"
"No I don’t know, what are you talking about, what plumbing?" shaking his head as he spoke, I said "The urinary tract" wondering what on earth the problem was with comunication " oh I see, well whats happening? He asked, I replied " When I urinate I pass pieces of what looks like skin, but better than explaining, I have a sample to show you" and took the sample out pointing out that both sides were visiable , one side pearly white the other brownish and handed him the sample, he glaced at it as if disgusted "whats this" he said, I told him it was the skin I was passing in my urine, he tossed it back to me and asked me to describe what was happening, asking if it was gritty "no it isnt" I said " I would recognise a gallstone if I had one, "its like skin as I said, this is it, just look at it" and as I reached for it he stopped me and said "forget that I want you to describe it, what do you mean skin?" " I said "like the skin that peels when you get sunburn," he just looked at me quizical as if not understandig a word,and again pointed to the sample saying, "There it is, you can see it, it looks just like a piece of skin" "forget that!" he said firmly, "you describe it", I was baffled.
At this point I was wondering if I had walked into a mans nervous breakdown, so ended by saying I will try and get a urine sample and show him, and there the "consultation" ended. Without a further appoinment suggested.
some days later I was passing ever larger pieces and thought , this cannot go on without investigation, I never had a sample bottle and so sterelised a small jar by boiling for 30 mins or so inc lid. And made an appointment,provided the sample and was confident of showing the real thing in more of a form he may recognise.
2nd appoinment.
I reminded him of the last visit and told him how stopping the Nytol did end the swoo,,,,,,,,,dizziness, but was still passin,,,,,,,urinating pieces of skin and handed him the bottle, which he took to the window and said "this is contaminated"without even testing it, "what was in this jar" I said I couldn’t really remember but I sterilised it "what was in it" he persisted I said " I don’t remember" what was in it "he sai again "you must remember" " it isnt relevent but meat paste I think" "exactly," he said trimphantly while dumping the sample in the bin without even testing it. He honestly believed I was stupid enough to have contaminated the sample with something as large and visiable as the piece of skin!!!!"
He then gave me a sample bottle saying provide a sample in this if you get it again , and try not to contaminate it again, I found his attitude insulting and a disgusting way to talk to a patient, again no future appointment was suggested ,but I made one anyway.
I had to cheat, to be heard, and the night before my appointment I took samples until a piece of skin appeared, then put it in the fridge as I know it is normal to provide new samples the morning of the appointment.
3rd appointment.
I showed him the bottle and pointed at the piece of skin in it without handing it to him knowing he would probably have binned it, and I was right, as when he looked at it he straight away said "contaminated" and I had to persist in convincing him that what he was looking at is coming from my bladder, "your telling me that is coming from your bladder? Looking sceptable,"Is it painful?"
"no" I said, "then how do you know its coming from the bladder" "I feel it" " how do you feel it" and that started a whole new interogation,when I tried to say it was how I would imagine a bubble coming through, he just looked at me as though I were a simpleton, but he finally said leave a fresh sample on the way out, regardless of the fact that I told him it wasn’t every time I went to the loo and the size of the piece in the sample meant it could well be another day or two before another sample would appear, and put the original sample back in my pocket, and sure enough on my way out produced a sample devoid of any (squamous metaplasie) as it was later to be discovered,and so simpley emptied the original sample into the new bottle which was at last duly sent off. I can only guess how long it would have taken to be dignosed had I have not cheated with the sample.
I had an apointment, about a week later with Dr Alvyn but he was apparently on leave in new zealand, which seemed odd as the appointment had only been made days earlier and no mention of his leave was mentioned I therefore, felt more kindly toward him in case he did have personal problems though very releived to see a different doctor , Dr Gaunt , who arranged an apointment at the urology dept with mr smart. "to find out what was going on in there"
I told mr smart of my experience with Dr alvyn, and he did say that what I was passing was quite common but the size was exeptional to the point of very rare, I thought it didn’t matter now as I had at last got through, I first had a cystoscopy and then an operation to remove the squamous metaplasia.
although I had been saying all along that I didn’t feel any symptoms before the operation, it was'nt long before I realised that I most certainly had symptoms but had put those down to another condition I have which is " ankylosing spondulitis" so learned to accept and live with it ,and upon explaining this to mr smart he told me never to assume something is automatically to do with that condition, because you have a chronic spine condition you should not dismiss any ache yourself, you must see your doctor whenever you are in doubt.
Which leads me to Dr Gaunt and an unrelated matter,
As already stated the operation on my bladder had so improved my outlook that I had plans too seek employment in the new year, but felt I needed to get back into working condition first as I had not had employment for so long and I am not a lazy man. I felt the need to acclimatise to the disciplines that work would require.
However.
I believe I must have done too much too soon as after getting up as if already in employment, and finding work in gardening ,sawing firewood, cleaning etc, I found myself awakened in the night, around end of Nov early Dec, in the most extreme pain ,emanating from my spine, mid shoulder, I was numb yet even in the numb areas feeling great pain.
I called the health centre and explained all to Dr gaunt, this was the first of several calls and on each occasion I became more desperate as each call it was as though it were the first call, and I found myself having to repeat how I lived alone and was barely mobile, still being told a prescription would be ready to pick up, in spite of the fact that I REPEATEDLY pointed out that I had no-one to pick it up for me, I had dificulty just walking, but twice I recall being ignored and having to basically crawl to pick it up.
Christmas was upon us but I did manage to make and get to an appointment with Dr Gaunt. My pain was un-disguisable, my head was bobbing up and down, my left arm had all but lost any use at all, and was very embarasing,and I found Dr Gaunt very sympathetic looking but simply prescribing yet more painkillers.
I managed to get some shopping and get a taxi home. Christmas came and went and early jan I called again and yet again had to remind him and explain in broken syllable speech, I am in great pain, I live alone, I have no-one to pick up a prescription, I am nearly out of basic food, all I want is enough pain relief to be able to go shopping, I said there was no way that I could pick up another prescription as even if I called a taxi I don’t think I could get in or out of it!!! He agreed to fax a prescription to the pharmacy even then asking if I could get someone to pick it up ????? if I could get some-one to pick it up it will be ready straight away ??????? So I repeated yet again. I live alone, I have no-one to pick it up, I am out of food, I need to draw money from the cash point to pay for the shopping. I am truly alone, all I want is enough pain relief to get my shopping, please can you arrange a delivery of the painkillers, he said he would, and I waited, some hrs later I phoned the pharmacy, and they said yes they had the fax and would be delivering the painkillers the next day, no urgency had been added to the fax!!! I appealed to them that I needed immediate relief and within the hour they arrived with the medication.
However,
The next day was my birthday, so I can say with certainty that it was 8th jan and I was in every bit as much pain as ever , I knew it was impossible to even attempt to try and go shopping, and had , as told to Dr Gaunt, run out of even the most basic food, and decided that I would have to call social services for help which really was going to be hard for me as I pride myself on self reliance, but late that evening, I had a knock on the door,
My son who lives in Australia, and had no idea of my health situation as I don't share my medical life with either he or my daughter, I am a great believer in a mans health being between himself and his doctors, yet he had sent me a delivery from Tesco's, all the basic food I needed, to feed me for at least a couple of weeks. Even the delivery men could see my difficulties, and unpacked all the food away for me, and even made me a coffee, how did they see my pain that a Dr couldn’t?
I confess that I am embarrassed to admit that I chatted online to my son, sounding cheerful and grateful as would normally be at such a gift, yet, when alone again I ate something, and from no-where I broke down like a weak child and cried like a baby.
I spent some days with bed rest and happily slowly improved and soon was able to manage to make and attend an appointment with Dr Gaunt, I specifically asked for an x-ray as although he was certain "its probably just the spondulitus" I was not, and said if indeed it was then it’s a new twist as I had never experience this level of pain in the decades of suffering it. He duly arranged an appointment for an x-ray,
the radiologist recognised the extent of pain I was in,(a mere shadow of the pain of some weeks earlier) and I asked if I could look at the x-ray, and he and I were looking at the spinal column, and both noticed that all looked fine until a particular area that he said doesn’t look right and would need more investigation, baring in mind that it was only the spine we were looking at.
Some days later I had a call from Dr Gaunt to say there seem to be a shadow that needs a ct scan to investigate and assured me not to worry as being the spine it wasn’t as sinister as would be within other places such as the lung etc.
I had the scan, and waited, and was told to see Dr Gaunt to discuss results,
When I saw him he said "you have emphysema ime afraid, my reaction was to say " I have been smoking for decades and would be very surprised if my lungs weren't damaged, and I would be an idiot if I didn’t admit that I deserve whatever my smoking has caused, but what about the spine? What was it?
"Oh ime more concerned with the emphysema and think we can assume it was "your old problem that nothing can really be done. I would like you to talk to someone re giving up smoking, and we will keep a close eye on you lungs" but what about the lungs I asked, are you saying its was really,as you say just the spondulitis? "I'm sure it was lets concentrate on the lungs"
To this day I still don’t know what caused such extreme pain, I know, however it wasn’t caused by emphysema, and I very much doubt it was anything to do with spodulitus.
My discomfort is now manageable, though whereas I could mow my lawn in an hr or so I now have to mow in small 15 minute pieces, and that is how all other aspects of my prior health has gone, the pain is not totally absent but is now manageable, I believe in adapting to whatever health throws at you and am content to manage this without medical intervention, feeling sometime that I am as restricted in my activities due to fear of causing the return of the intense pain rather that actual pain itself, and so I require no action re spine as I have it controlled. However whereas last year I was being complimented on my garden it is now a jungle, and feel sure my neigbours must think I have eithr become idle or hit the bottle, but attitudes are less friendly as before .
　
my next experience returns us to "squamous metaplasie" involving both Drs Gaunt and Alvyn.
after my operation , I had another cystoscopy some time after and was shown the remains of the condition, all was as well as hoped, my biopsy had been negative ,there were remnants of pieces that I was told ,would probably pass in my urine over the coming months, I was told that due to fluid retention I may be required to self catheterise but a later examination would be more informative and was told that in six months, I would have another cystoscopy.
The following July I duly had this.
All was apparently well, though no reason was found why I had, had the squamous and was assumed to have maybe a past infection was not noticed by me and possibly caused it, I did need to cataterise, which I welcomed as the discomfort of a permanently full bladder was manageable yet positional damaging in the future.
As coincidence has it again, my son was visiting from Australia as was an annual pleasure and I was glad my medical situation meant I could be well for his visit.
However, the nurse from Hythe incontinence dept called while he was here to bring catheters and instruct on the use, and this was the first he was aware of any health issue, but his worries were laid to rest when I showed him the description of the condition online at Wikipedia.
I had to explain to the nurse that I felt I may have an infection which she agreed with and suggested that I wait until that was cleared up before I catheterise and not to worry as with good anti biotic it will be clear in a very few days, and she would call the doctor and arrange for me to pick up the prescription.
But,,,,,,,,,,,Dr alvyn had returned from his sabbatical,
The nurse called me to say that a prescription would be ready for me to pick up imediately,and I had to leave a urine sample, when I picked up the script I noticed at the pharmacy that it wasn’t for a sharp short antibiotic as the nurse had suggested, but a low dose over a ten day course,
My son , who had experience of bladder infection, said we should ask the pharmacist for something better as he felt what I was prescribed was wholly inadequate and the sort of thing generally used to please patients that don’t really need anti biotic, it was pretty definite that Dr Alvyn wasn’t going to take the nurses word for it that I had an infection without a urine sample and so mentioned this to the pharmacist who offered the use of the phone, but I had to explain to my son that I could not seem to communicate with Dr Alvyn in the same room let alone on the phone so accepted it would have to do.
My sons visit had been well planned, and I was to meet his fiancé for the first time and he had spent £500+ on opera tickets, but , within a couple of days my infection had worsened to such a level that I could no way have sat thru a long opera and had to cry off, the day he was leaving I had begun to pass blood quite profusely, the toilet bowl looked as though I had poured neat ribena down it, and decided to call the health centre as soon as my son left later that day as I wasn't going to worry him before he left, yet within moments of his leaving I had a call from the health centre telling me to stop taking the original prescription as I needed another. I literally waddled down to the centre and picked it up, it was for amoxalin I think 250mg, I was soaking wet and angry, and made my feelings known when I picked up the prescription saying as loud as I could how I entirely blamed,Dr Alvyn for the miserable days I had suffered. When my son called for a few hours before catching his plane I told him of the situation, but he wasn't happy even then and described the amoxalin as a bog standard biotic and said why 250mg you need at least 500mg. I told him to leave it as it did seem to be working,
However,
Within days of finishing the course the infection returned and I made an appointment to see a Doctor saying I would see any doctor but Alvyn, I also phoned the nurse as I was running out of catheters which she had said details had been sent to the surgery and it should have been all arranged and would follow it up and get it sorted, I told her of my experiences to date and she did say that Dr Alvyn had been "rather brusque" with her.
I next saw Dr Gaunt and he prescribed amoxalin again but the 500g and I was back with hope , yet days after finishing the course the infection again returned and he prescribed another anti biotic again same thing and I was back again with the infection after the course , and was then prescribed another ant-biotic , again at the end of the course infection returned , I saw Dr Gaunt again and he prescribed Ciprofloxacin 250mg being told it was a very expensive medicine but I was worth it, a few days after I completed the course I was back again with the returned infection and Dr Gaunt prescribed the same again but the 500mg which I was not happy about and repeated my thoughts re under dosing,
I had a basic education but recall how we were told how, if the full course of anti biotic are not taken or the dose is too weak then the microbes will be resistant to that antibiotic and far harder to cure, both Fleming and Jennings spoke of the biggest threat to this amazing medication was under dosing, even more threatening than overprescribing, this I was taught back in the sixties, since then too many have been used, it is agreed, but lowering the dosage as opposed to reducing the prescriptions given out is absolute maddness,in my opinion and my experience was baring that out. And felt I had become a human petri dish.
I left with what I was given but asked for him to accept a urine sample after the course to check it had gone before it built up again,feeling that to allow it to regroup was just going to add to the feelings I had of being turned into a walking superbug breeding unit, but I believe the urine sample was clear even though I was suspicious and uneasy and rightly so as its obvious symptoms returned within a day of providing the sample. And sure enough all the past was back and I returned yet again to Dr Gaunt, repeating "If this carries on with this cycle I will be breeding a whole new superbug" and he agreed.
But, and it’s a big but
He said " I don’t think it the infection causing your symptoms, I think the soup you describe passing is probably from the tumour" . "tumour? What tumour " I asked" "the one in your bladder of course" I said "you make it sound like I have cancer" . "yes " he said,as though it was something I had already been told of "that’s what metaplasie is, its cell changes, meaning cancer" I was dumbfounded and said , "that isn't what I was told at urology the biopsy showed no cancer, and I also looked on Wikipedia , which may not be a definitive source but fully concurred with what I was told at urology, are you sure,? I asked" "Absolutely "he said but I could write pages of how it was described to me , everything I said was dismissed as symptomatic of cancer, I told him I was told to expect some debris in my urine of pieces of squamous, "there you have it" he shrugged, "but this isn't squamous" I insisted, he dismissed this saying" it probably isn't the large pieces that you are expecting but ime certain it is the squamous. I just said please refer me back to the urology dept, I knew he was wrong, and trying to get him to at least check his facts fell on deaf ears, he told me that it wasn’t necessary as they were fully aware of the diagnosis and will see you next July. "no" I said "they are not aware of whats happening"
I left baffled, how was I to get through to him and returned a week or so with a sample of thick awful gunge and 2 used catheters showing how they were so blocked I couldn’t even hope to empty my bladder without drinking enough to bursting point so that I could push this stuff out and even then when I get down to the level of this substance the catheter stops so my bladder is never fully empty,
"well its good you are drinking a lot, well done but the squamous will settle at the bottom of your bladder causing this. I left again and suggested that he at least look on Wikipedia as I had. Baffled as to how to communicate I wrote a letter, a mere sketch of all I had said.
　
Not having a printer at the time, I went to the library to have it printed, but the printers were all booked and thought why should I have to write anyway and decided to give another try at breaking through face to face,and hopefully get through the fog and made yet another appointment, when I saw him next I took more used catheters and mentioned that my right testacle was aching and I was truly fatigued, he just shrugged his shoulders and said it was perfectly understandable I would be feeling tired with what I have to put up with again I persisted in asking to be referred back to urology, I left wondering if anything I had said was sinking in or if he would at least humour me by looking up "squamous metaplasie".
Christmas was upon us again, and from experience I knew not to hope for too much before the new year, and I was right , it was miserable, so 2 Christmases and a visit from my son all ruined by what I was seeing as medical incompetance,,this may not seem a serious issue but good times are few and far between in a solitary life.
When new year arrived I was baffled as to how to deal with this situation, then the very morning I was getting ready to put in a repeat prescription, when a letter dropped through the door from the surgery, my heart leapt, at last, something is happening. Upon opening it finding that it was just an invitation to have a flu jab. I was angry, not only had I already been offered and declined that before I had also been for spirometer tests, all the things that nicely give the appearance of being well looked after when in reality I was as a man with severed limbs being offered a haircut,.,.,.,. So in very large writing I wrote on the back of this letter something like, can you please refer me back to the urology department as a matter of urgency,
and put it in an envelope addressed to both drs alvyn and gaunt. Along with my prescription.
I had little hope of any attention being given to this and so I wrote another letter , shorter and more direct than the one previously written though unsent, and had that and my previously written letter ready printed if I found myself ignored, which of course I was, and when I went to pick up my prescription, I asked if there were any messages left from Dr Gaunt, there were none so I asked that he be given my letters one written on top stating that I hadn't sent it and the shorter one.
That evening, I had a call from Dr Gaunt he said he was puzzled and started to say that he wasn’t aware of the problems as he was reading , I stopped that in its track asking "if there was one single word in the letters that I had not told him of face to face, point it out" he said "ok, but I don’t think you made it as plain as it reads, and I fully admit I did make a mistake regarding the Squamous metaplasie and ime happy to refer you back to urology, but you mention a swollen testicle?" " Yes" I said "the only thing new to you as its only been swollen about a week, and as a matter of accuracy I must point out that my left testicle is the swollen one yet the aching one I told of was the right one." And he made an appointment to examine me.
upon examination he phoned the hospital as a matter of some urgency and I had an mri scan the following day. Where the scan operative said it appears to me that it is the infection you spoke of (I have repeated all that is written here to every medical Dr Nurse and Consultant I have seen through this misery, and asked nothing from them ,I would not expect any to commit an opinion, but what has struck me most profoundly , is the reactions, I.E. not once was anyone surprised!
I asked the operative doing the scan to please make sure that adequate dosage of antibiotics was to be used, he assured me he would and said he would phone personally .
Within 1hr of arriving back home
I was called by Dr Gaunt , and I foolishly said, "now that we know it probably is the infection is there any need to trouble the urologist," but thankfully this time he said no he would still arrange a consultation, which moments later I was glad of as he said I will give you a stronger dose of Ciprofloxacin that seemed to work didn’t it, I said "with all due respect, I have had this infection since July, over six months, so it is apparent that nothing has worked to date and I have already had the stronger dose" he said "oh yes I see you have" obviously looking at the screen, "well I will give you a 14 day course as you've only had a seven day course before" I looked to the ceiling in disbelief, knowing that I may well expect a couple of weeks relief followed by another bout and prescription on the same cycle, I can but guess what damage this could potentially do to my liver, kidneys, and own immune system.
I am now awaiting the results of my ct scan which under normal circumstances, would just require my calling your surgery, but how could I trust that I would be given the right conclusion and so mr *******, the consultant has said he would see me again after the scan results and I now await an appointment.
If I have anything sinister, or otherwise, my actions will be the same, to do nothing is not an option to me, and while I am yet to decide what to do about this and how many copies to send to wherever necessary I have yet to decide, I must tell you now that I see it as my duty to patients future and past to see that this abysmal treatment isn't left unchallenged by more intelligent parties than I and as important, unbiased.
yours sincerely
chris howard.
　
Dear dr gaunt.
I realise you are very busy, and I would not like too ad to your workload if I am being somehow paranoid, I make no judgements on your advice, yet cannot help but recall having two samples thrown away and dimissed as "conaminated" by dr alvyn and no further apointment made and only my annoying persistance, led me finally being refered to mr smarts uroligy clinic where squamous metaplaisia was diagnosed.
my condition was, I felt, fully dealt with and explained I was confident that the matter was being well diagnosed and understood.
however, although I was warned of possible infection, which I did have after my last visit, nothing was mentioned regarding passing what is very thick , too thick to pass through the cathater" visually similar to congealed slimey chicken soup. This is such an outstanding symptom that I feel I would have been advised to expect it,
I was told that I would pass squamus from time to time and will be removed again when it should rebuild, I have seen such fakes since, yet the substance I am passing bares no resemlance to the skin flakes that squamas appears to be.
something, tells me that there is more going on in my urinary system than has yet to be diagnosed, and I must strongly ask you to arrange an apointment with mr smart or any other urology dept.
I enclose a small article from wikapedia , which I realise is famed for its inacuracies yet concurs with all I was told at the hospital.
Squamous metaplasia refers to benign (non-cancerous) changes in the epithelial linings of certain organs within the body. These cells assume a more squamous morphology. Common sites for squamous metaplasia include the bladder and cervix. Smokers often exhibit squamous metaplasia in the linings of their airways. These changes don't signify a specific disease, but rather usually represent the body's response to stress or irritation. Vitamin A deficiency can lead to squamous metaplasia.
I hope you will understand that my concern that a benign condition such as this could at anytime change to a more serious condition that could well be such that early diagnosis would be benificial, there is also the cocideration that no cause for the condition was found, therefore I must think it a possibility that the symptoms I am experiencing, could pehaps be the very cause of the squamus build up?
NONE, of the present symptoms were apparent at my last visit to mr smart, therefore, may I request an early appointment with the urology dept at lym?
yours faithfully.
　
　
　
　
Chris howard
98 players crescent
Totton
So40 9ba.
Dear dr Gaunt
I have suffered 6+month symptoms that you have explained as caused by the squamous metaplaisie already diagnosed and taken into account.
however,
if my condition is as you describe, and is a tumour, cancerous or pre cancerous etc, then it would mean, all I was told by the consultants at lym, and everything I have read since are wrong. As ive already tried to explain to you.
I told you of an ache in my testacle, it has now become swollen and more tender,
I would dearly love to accept your advice, but at the risk of offending, I believe you are wrong and therefore ask you to arrange a consultation with the specialists as a matter of some urgency as I believe time is critical should it prove to be something sinister, six months of trying to be taken seriously is more than enough time wasted.
To be doubted is unpleasant for both you, and I. May I urge you however to spare me a bit of time, and talk to a consulant and at least look at the written description of the condition available online.
Squamous metaplasia refers to benign (non-cancerous) changes in the epithelial linings of certain organs within the body. These cells assume a more squamous morphology. Common sites for squamous metaplasia include the bladder and cervix. Smokers often exhibit squamous metaplasia in the linings of their airways. These changes don't signify a specific disease, but rather usually represent the body's response to stress or irritation. Vitamin A deficiency can lead to squamous metaplasia.
if I am wrong please accept my apology in advance.