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Hello

I would like some advice please.

Last week I had a cataract operation under local anesthetic. Towards the end of the procedure I really did feel pain and jumped. The surgeon told me to be still! Shortly after this on two further occasions I again felt pain and shouted from underneath the face covering. The surgeon said he was nearly finished. I was blinking and he told to stop blinking! I had no control over my eye. By the time the procedure was finsihed I was a quivering wreck! I was so upset and crying. I just wanted to go. Back on the ward my blood pressure was something like 202/197. The nurse was very concerned. I had to sit and sit until my pressure came down and she would let me leave. The Surgeon came to see me but I could not talk to him. I asked the nurse to note in my notes so relieved it was over. The next day I wrote a letter to PALS to have my experience logged just in case, in time problems may show. At the moment is this the correct course of action? This has made me scared to have a op. under a local anesthtic ever again.

Thank you

Ouch it hurts

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Yes, you're doing the right thing so far.

 

I think you should go and talk to your GP, tell him exactly everything that has happened.

 

Keep your own note about everything that has happened, dates and times and anything that has been said.

 

If you think that you have suffered some permanent damage or distress then come back here

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Thank you for your reply. I am pleased that I am doing this correctly. Yes I will go to my GP next week.

At the moment my eye is coming along fine. I was concerned about possible damage to my sight - but that seems to be ok at the moment. Physically I think I will be ok but it was how I felt during and after the op. I will never never consent to a local anasthetic again neither will I advise anyone else to go through this.

My next appointment is for the eye test in October. Once this has been carried out I am not sure whether to attend another Surgeon on a private basis outside my area, just to check that everything is fine.

Would this be a good course of action?

Ouch it hurt

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I attended my GP and gave him a copy of the letter I had sent to PALs and also the Surgeon.

He seemed just to file this, listened, but did not make any suggestions nor have a look at my eye and told me to let him know how things go.

I think I am now going to make an appointment with my optician so that he can actually look into my eye.

At the moment my eye is fine. It does ache from time to time, but it is still early days.

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Seconding what BankFodder has already said - you're going about this in exactely the right way so far.

 

If it will reassure you, by all means get your eye checked out either by your optician or go back to your GP (did you specifically request that he examine your eye?), but do bear in mind that one week post surgery it will be very early days and they may not be able to tell if there's any damage because surgery by itself causes some disruption. I have no clinical experience whatsoever, but your GP/optician will be able to explain this more clearly to you.

 

It's personal opinion only, but I would not bother paying for anything privately at this point. You will be splashing out a lot of money, (private consultations alone are pricey letalone the cost of scans and investigations), and if this does proceed to legal action, you would have these exams as part of the claim. You could be completely wasting your time and money.

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I think this is more than worth a complaint to the trust of the hosital you attended - thankfully there seems to be no physical damage - BUT there could have been - and another person may not be so "lucky"

 

Contact the hospital and ask for their complaints procedure - that will get you started.

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Thank you both very much for your advice

 

Yes I am taking this slowly at first as my eye does need to settle down to start with.

 

I have made an appointment with my optician as he is a nice chap and very thorough

 

At the moment apart from a little bit of aching I think I am ok - it's just that if I hav to have my other eye operated on I will be quite frightened, even if they knock me out!

 

I have written to PALs with a copy of this letter to the Surgeon. Once I have had my eye examined and chat genrally with my optician, then I will have to decide whether to make a "formal" complaint.

 

If I do, I am not sure what I should say apart from the content of my original letter.

 

I will be back next week when I have seen the optician and hopefully will have a lot more explained to me - as I felt my GP did not take this as it was worrying me

 

Thank you both again

 

Ouchithurt

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You're very welcome - however I would say whether your optician says there is any damage or not I would still make a formal complaint.

 

The fact that you felt pain whilst you were supposed to have been under anaesthetic is very worrying and I would like that matter addressed not for my own piece of mind but so the hositpal are aware and perhaps prevent a similar situation in the future.

 

It's not about getting anyone in trouble or anything like that but I think a hospital needs to be aware if this has happened.

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I went to see my optician this morning. I did not explain my experiance before the examination

 

At the end he said that it was a very neat job and that my sight is fine

 

I mentioned that it still aches a bit, he said that it was 3 weeks since the op. and to give it another few weeks.

 

When I returned home I had a letter from the Surgeon, in reply to my original letter, with a copy to PALS.

 

He emphasises that I was an extremely anxious patient. I was worried but more of the unknown as I had been assured I would not feel anything. The sharpe pain "I apparently felt was subconjunctival antibiotic going into the eye. This is invariably felt by many people in varying severity and is usually not totally eliminated by local anaesthetic".

 

He made no mention of the two other occasions after the initial sharp pain what this was, yet I was telling him from under the blanket.

 

I mentioned in my letter that he told me not to blink, as I did not know I was! His reply to this was "We do not normally ask the patient to blink but we do ask the patients not to squeeze if they are doing so during surgery"

 

Whether blinking or squeezing I know I did neither voluntarily.

 

Towards the end of the letter he suggests that as I am such an anxious patient he would recommend that if I have to have the same operation on my other eye that I have this under general anaesthetic.

 

He ends with his apology but is reassured that the surgery went well and there are no surgical complications.

 

I am really not sure what to make of it all.

 

I feel in a way that although not being flippant, he has tried to say that it was because I was anxious that I felt pain, but even when I was telling him he told me to be still

 

I would welcome various views on this, as I so unsure as to my next step.

 

Thank you

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I went to see my optician this morning. I did not explain my experiance before the examination

 

At the end he said that it was a very neat job and that my sight is fine

 

I mentioned that it still aches a bit, he said that it was 3 weeks since the op. and to give it another few weeks.

 

When I returned home I had a letter from the Surgeon, in reply to my original letter, with a copy to PALS.

 

He emphasises that I was an extremely anxious patient. I was worried but more of the unknown as I had been assured I would not feel anything. The sharpe pain "I apparently felt was subconjunctival antibiotic going into the eye. This is invariably felt by many people in varying severity and is usually not totally eliminated by local anaesthetic". Did the sugeon tell you this was a possibility before hand? If he deemed you an "anxious" patient and it is "invariably felt with many people" you would have thought he would have told you about this being a possibility so you would be aware of what might be the cause if it happened - if not that is negligent on his behalf if he observed this factors prior to the op.

 

He made no mention of the two other occasions after the initial sharp pain what this was, yet I was telling him from under the blanket. This needs to be questioned again then - a complete answer should not pick and chose what they answer.

 

I mentioned in my letter that he told me not to blink, as I did not know I was! His reply to this was "We do not normally ask the patient to blink but we do ask the patients not to squeeze if they are doing so during surgery"

 

Whether blinking or squeezing I know I did neither voluntarily.

Towards the end of the letter he suggests that as I am such an anxious patient he would recommend that if I have to have the same operation on my other eye that I have this under general anaesthetic.

Hmmmm because they did such a great job with the first anaesthetic!! Reccommending a more risky procedure is frankly laughable when the reason you are anxious is now down to their actions.

He ends with his apology but is reassured that the surgery went well and there are no surgical complications.

How nice that he is reassured - perhaps he should consider that your feelings are the most important thing and you are definately not reassured by this matter or his response.

I am really not sure what to make of it all.

 

I feel in a way that although not being flippant, he has tried to say that it was because I was anxious that I felt pain, but even when I was telling him he told me to be still

 

I would welcome various views on this, as I so unsure as to my next step.

 

Thank you

 

I really do think you need to contact the hospital and ask for their complaints procedure - has any of his suregery notes etc been independantly checked??

 

I doubt it - it seems that they have tasked the surgeon with writing you a general "sorry if you felt like that but please go away" letter.

 

The response is not acceptable from my veiwpoint as there has been no investigation conducted by the hospital trust.

 

That should be the minimum that they do.

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It would really all depend on what investigations found etc - plus generally disciplinary procedures are kept secret so you may never know if any action was taken. This is not always the case - particularly in the GMC get involved but just be aware sometimes you will never know.

 

I would ensure for your piece of mind that you at the very least makle sure the hospital trust has investigated this matter thoroughly - normal investigations take 20 working days under the NHS so i can be quite confident that an investigation has not been opened in your case - especially as the response you got came from your surgeon and not from their head of department etc as would normally happen.

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Hello

Thank you for your advice.

 

As I have never complained in such a way before do you know if a doctor/nurse would be reprimanded in any way?

 

Thank you

 

Ouchithurt

 

My advice is to stop thinking of it as a "complaint" as such - it's your health, your well-being and you have every right to ask questions. You're not "complaining", you're asking valid questions about things that you didn't understand at the time, and still don't.

 

If you decide to write back and take this further, before you put pen to paper, sit down and ask yourself "what do I want to get out of this?", then explain this to them in the letter after you've written down what it is that is still bothering you.

 

I can only speak from my own experience of working in the NHS, but we don't look at this type of thing as someone trying to get anyone into trouble - if there are things that we're missing out of patient information then we NEED to know about it. Nobody will get into trouble unless they've done something to warrant getting into trouble - in which case that needs to be sorted out anyway.

 

From a personal view point, if you are indeed an anxious patient (and there's no shame in that - I'm particularly cringey about having things done to my eyes...they'd probably have to give me a general anaesthetic just to get me INTO the hospital, never mind for the op itself!), being forewarned is forearmed. Perhaps if you'd have known what was going to happen during the op, you would have had it under general in the first place and we wouldn't even be having this conversation.

 

I'm really glad to hear your optician gave you the thumbs up on the op though. At least something good has come out of it. :D

Edited by MsWeatherwax
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Thank you for your replies.

 

I would like to know why the pain and which made me jump, why I was told not to blink when I had absolutely no feelings that I was! Also when I told the surgeon it was hurting why did he continue. Why not a few more more numbing drops to keep me more comfortable?

 

As to being anxious. It was more "fear of the unknown". When you lay down the Surgeon says hello and then the next thing is you see a scalple coming towards your eye - I was fine as I thought that's it the worst is over.

 

I have to go back to the hosp. Wednesday this is for my eyes to be tested, as the optician would do.

 

I am now finding that most of the time I have floaters. Some are little dots others are like small lengths of cotton thread zooming around my eye. I would like to know if this is normal as I did not suffer with this before the op.

 

Thank you all very much

Ouchithurt

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OK, Ouch - all of that sounds perfectly reasonable and more than warrants a good explanation! What about something like this:

 

Dear ..................

 

Thank you for your response to my previous query.

 

However, I still have some questions and concerns that I do not feel have been adequately answered - as I am due to have surgery on my other eye, I would be far more reassured and confident as a patient if I could address these concerns well in advance.

 

1. Although I experienced enough loss of feeling in my eye to be unaware that I was blinking (I was asked to stop blinking, which I found very difficult under the circumstances), I still experienced considerable pain, causing me to physically react, which was very alarming and unexpected - I would be very reassured if you could explain to me why it was not possible to admnister further local pain relief at this point, or at least for the surgeon to cease what he was doing.

 

2. As to being anxious, I would describe the feeling as more "fear of the unknown" than anxiety - when I laid down the Surgeon said "Hello" and the next thing I was aware of was the scalpel coming towards my eye.

 

I feel that if I could have these queries answered, I would be better prepared for my next procedure and perhaps it would be possible to agree a different approach to the surgery - maybe a general anaesthetic as suggested in your previous correspondance.

 

With kind regards

 

Yours sincerely

 

OuchItHurts

 

To be honest, I'm unsure whether you'd like to progress this as an actual complaint, Ouch - I'd certainly understand if you do and if this is the case you may want to word the letter more strongly.

 

However, if you are more concerned with making sure the next surgery isn't as traumatic at this stage, this may be the route you want to go down first. It is of course up to you, and if you give me a shout I'll be more than happy to help you in anyway I can.

 

 

Also, I have left the bit about the floaters out of the letter - if this is something new that is occurring post-op, I think it's important that you speak to your GP or optician again (or mention them at your out patient appointment), not wait for a response from PALS...apart from anything else, they're bliddy annoying. :-D

 

All the best, and I hope this is helpful.

 

MsW

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Thank you very much for the draft letter. Yes that describes how I would like it worded.

I shall certainly mention at the appt. on Wednesday about the floaters.

 

Many thanks again

 

Ouch

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I went to the Hosp. yesterday and I have been discharged

 

They checked my sight, which is fine. Quite good now.

 

Pressure behind my eye is normal about 14?

 

I told them of all these dam floaters. This was explained that these are little bits from the laser and that they should settle in time.

 

I do hope so as did not have these before and they are so annoying!

 

I told them my eye aches and is sore at times, not all the time and they explained that the tear ducts are not working properly yet?

 

I should have told her, they work fine as I was crying buckets directly after the op.

 

Now everything is over and everything is working fine I think I will write and ask for the complaints procedure.

 

I do not want to cause trouble, but there was a reason I could feel pain during the op. I can only believe the Surgeon when he addressed the first sharp pain, but the other two occasions I would like to know why I felt pain and why the Surgeon still continued. Why I was told to stop blinking and honestly I did not know I was doing this! I did not knowingly blink - who would in their right mind when a chap is leaning over you with a skelpel!

 

I will sit over the weekend and using the draft letter here as a base, shall tweak it to fit what I would like to know

 

Thank you, will let you know how I get on

Ouchithurt

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Hi Ouch

 

Really glad to hear that you've got the all clear, I'm sure that's a big weight off your mind.

 

You can probably find the complaints procedure on the Trust website - might speed things up a bit for you. Good luck!

 

All the best.

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