How can we get the attention of an NHS Orthopaedic Surgeon?

The only way to get an NHS orthopaedic appointment is through your GP referring you but he should state one specific problem, eg which hip is worse?

I think Larsonsmum has actually got another appointment with an Orthopaedic Surgeon but would like some advice as to how to impress upon him/her that she is in intolerable pain.

I'm afraid I can't help, but I'm sure others have been in a similar position, Larsonsmum and will be able to give you the benefit of their experience.

I walk with a painful limp now following ortho surgeon simply not listening and dismissing what I was saying. They had missed a fracture - there were two where they only thought there was one. Nothing I said about barely being able to put my foot to the floor made any difference - they just kept patting me on the head and sending me away. So you have my sympathy.

The surgeon needs to listen to ALL your problems because they will impinge on each other. A decision needs to be made about prioritising treatments and tackling these in the most favourable order.

I was told that my limp, due to foot fracture, would not make any difference to my hip replacement. I am not sure that they were right about this, as hip replacement now giving me hell. This is why there needs to be an overview rather than just honing in on one thing at the beginning.

It may well be that, sadly, your combination of problems makes treatment very difficult, but you need to know that everything has been looked at and a reasoned decision made with your input.

Go to your appointment with a detailed list of what you want to know.

You could keep a written diary of every single difficulty you have each day and how long the activities of daily living actually take to perform. Score your pain and stiffness each time on a score of 1-10. Take the diary with you.

Izabella. - Good idea, might make it clear what is most urgent.

Larsonsmum so sorry to read that our NHS has failed you, yet again.

Have you someone quite assertive who can go to the appointment with you perhaps?

Sometimes the problem with consultations not just that the clinician doesn't appear to be listening but also the patient who is often nervous/ in pain/frustrated says too much and the whole picture gets confusing. My experience of sitting in with consultants etc is that the clearer and more concise and insistent (without rudeness of aggression)the patient the more the consultant responds. The old 'broken record' technique still works well. Say what you want/need, don't be put off, say it again and again - nicely, until it gets through.

You have to be really fit and well to be able to deal with the NHS these days.

DH was in excruciating pain last year from a trapped nerve caused, as was discovered, by crumbling vertebrae in his neck. He was in such pain he had difficulty talking to GP. He only got a referral to a specialist when I accompanied him on GP visits and did the talking for him.

The moral of my story Larsonsmum is take someone with you who can really insist on just how much pain you are in and keep reiterating it all through the consultation.

Larsonsmum I think you simply need to ask your surgeon what he means by "too many orthopaedic issues going on". Does he mean too many so that he doesn't think you would recover from a hip replacement? I know a certain level of fitness helps in the recovery process. Sometimes doctors think they have explained something when in fact they have just confused you. Hope your problem gets sorted out.

Charleygirl is right you need a GP referral on whichever problem is worse. If it is a hip then you need to tell the Surgeon of how that particular problem impacts on your life. Its important that you concentrate on that particular problem, if it stops you driving, if it wakes you at night, if it is affecting bathing, dressing,walking anything else that it makes a problem for you. You should already be on pain relief and anti-inflammatories if not speak to your GP about this.
I am awaiting my second hip-replacement so do know about the debilitating pain I wish you luck.

Larsonsmum The way you are assessed for referral for hip/knee replacement is by GP completing with you something called The Oxford Assessment Score. It is a series of questions about pain, debility etc. and in this area you have to score less than 20 to even get a referral. This is in addition to X-ray evidence and your BMI. You can get Oxford Score info on Internet.

lucky how can an experienced and competent orthopaedic specialist not know that a limp will affect a hip replacement?!

My daughter had a hip replacement at 19 and how she walks, what shoes she wears and so on impacts on her hip all the time. For example if she walks on uneven terrain (say cobbled streets) her hip is sore the next day.

larsonsmum sorry, I meant to add - there is good advice on here. Good luck with your next appointment.

Thanks all! I do have a referral which on this recent occasion I've waited 6 months for, and that was deemed very urgent by my GP, Rheumatology Consultant, Pain Management Consultant, (who has done SI joint injections for me, and deems that and the Scoliosis are all related to hips), but clinic receptionist said it was an absolute waste of time them writing in support, as "Consultants are a law unto themselves".

I am very assertive, as is my husband, and we are both professionals, but that counts for nothing with these consultants, as I know from other's experiences too. I say that, as have been through it so many times.

We have total documentation, MRI scan reports, x-ray reports, dozens of letters from the private Orthopaedic Surgeons, 3 X private Physiotherapists, 2 X NHS Physiotherapists, NHS Orthotics, NHS Podiatrist etc, etc, of all that is wrong - severe Osteoarthritis, fractured cocyxx, SI joint dysfunction, Degenerate Lumbar Spine Disease, Scoliosis,Pelvic protrusion, both hips requiring replacement, right knee requiring replacement, moderate right ankle Osteoarthritis, Bursitis in both hips, Illiotibial Band Dysfunction, extreme foot issues, Mixed Connective Tissue Disease. Also have OT reports and have numerous aids in home to help me. Really don't know what else we can have in support of my appointment/requirements!

For those who asked - can't sleep, can't walk, can't drive, can't sit, can't stand. That's all, lol!!

Perhaps you could ask what s/he would feel you would most benefit from? Hip replacement or pain clinic. Is a hip replacement possible with the other problems you have? I had a hip replaced 16months ago and given other problems it was not a walk in the park. As others have said you have to be pretty fit to get through elective surgery. And there are no magic wands . Best of luck for your appointment.

My GP was dubious about my first knee replacement because he thought I was too young. However he sent me back to the consultant I had seen the year before who looked at my new X Ray and said "Oh this has deteriorated!" and booked me in straight away. Some of them are very good.

I have full sympathy for you Larsonsmum but I'm almost too afraid to say this but do you think maybe you are actually overloading the consultants with diagnosis and documentation until they decide that they actually don't know where to start with your problems?

You seem to of had lots of private treatment and diagnosis from private surgeons, can I ask why you haven't had your hips/knee replacements done in the private sector? It doesn't make sense to me to pay for all these reports but then not have the surgeries.

I know the wheels of the NHS turn slowly but they do usually get there in the end.

In my experience it is difficult to get a diagnosis at an NHS orthopaedic clinic (at least in our local hospital) because you never see the right person. The consultants take the next file off the top of the pile so when I needed a hip op I was seen by the elbow specialist and then the shoulder specialist. They are very reluctant to refer you for an MRI. They prefer to send you for Physio. According to the news the waiting list for a hip operation is over 18 weeks. Even when I could not lift my right leg in the physio clinic no one mentioned it could be the hip that had gone.
That said, BUPA sent me to a specialist clinic where they told me I just needed to wear calibrated shoes for an hour a day.
Larsonsmum you have my sympathy. By the time I was diagnosed I could not sleep and there were days when I could not even walk round my house, never mind go out. I realise now I was becoming addicted to pain medication. However after the op I awoke pain free and have never looked back.
I hope you can get this sorted soon.

Flipping heck Larsonsmum - I will never grumble about my painful hip again! I do hope that some way is found through this maze and that eventually you are able to tick some of these problems of your list.

I'm sorry to hear about your complex health issues - it sounds like there is a lot going on that may take several surgeries over several years to deal with.

I think that the complexity of your case may be causing a longer wait as usually you see the surgeon that deals with your particular issue ie hips, knees, spinal etc. But in your case you have issues relating to all of these which means you may need to see a consultant that deals with especially complex cases. It may also be that some of the procedures will be more difficult to carry out with the other complex problems you have.

Can you identify a specific issue that you would like dealt with first? Which condition means the most to your mobility and quality of life? the knee? the hip? the spine? Then you could get your GP to send a specific remiss - for example - to the knee replacement team rather than a general but vagur referral that lists lots of different problems.

You also write that you have been seeing private surgeons - can they not treat you? Or are they recommending that you see the NHS because of the complexity?