• No lesson seems to be so deeply inculcated by the expertise of Life as

that you Never Should Trust experts.

Lord Salisbury 1877

Just another Blog by a grieving relative.  Just another stab at an ailing Health Service.  Just another neurotic conspiracy theorist mouthing off.

Pass.

Google up something more cheery.  If, you are under middle age that is!  Who would blame you?

But if you are middle aged plus, you will blame yourself someday for not reading on.

In fact, your Life may depend on it!

What you shall read over the following story can be substantiated by my late mum’s hospital records.

Many of you will recall the kind, caring treatment given a relative or friend during their stay in hospital.

This is good!

I only hope and pray that those who treat the sick with all the skills and reverence that their Oath demands will someday take the step that is desperately needed to ‘Blow the Whistle’!

What we read in newspapers is generally forgotten in a short space of time.   Try cutting out the articles and filing them into an envelope.   Very soon you are going to need a box!  (No pun intended).

Ask yourself.  ‘Who am I?  Then ask yourself, ‘Are the horrors I am reading about daily, the medical care I can expect in my time of need?  ‘Dont I have Human Rights?’

I think I know what your answer will be.  I also know this.  By the time you have read all of this you shall be infinitely more informed than you could ever possibly imagine!

Also, the facts that you are about to read have not been taken from patients prescription leaflets (which only tell enough for the Pharmaceutical Companies to cover themselves) but have been taken from various Medical Sources of Information.

God Bless!

  • Article 1 of The Universal Declarationof Human Rights

All human beings are born free and equal in dignity and rights.  They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.

  • Article 2 of he Universal Declaration of Human Rights

Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as reace, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status……..more.

  • Article 3 of The Universal Declaration of Human Rights

Everyone has the right to Life, Liberty and security of person.

  • Article 7 of The Universal Declaration of Human Rights

All are equal before the Law and are entitled without any discrimination to equal protection of the Law.  All are entitled to equal protection against any discrimination in violation of the Declaration and against any incitement to such discrimination.

Thousands of people have already died under the auspices of the Liverpool Care Pathway.  Let me make it clear that No-one, absolutely No-one has the right to perpetuate misery on another human being no matter what label they ring around it.    Article 3 of The Universal Declaration of Human Rights:-

  • Everyone has the right to Life, Liberty and security of person.

Which part of The Human Rights Act  did the people who thought up the application of this L.C.P. outside of Marie Curie run hospices not understand?

No one single person has the right to dictate that another’s views as to whether they wish to live or die, are to be completely and utterly ignored, ‘regardless of the consequences for that individual’.

  • Article 8 of The Universal Declaration of Human Rights

Everyone has the right to an Effective Remedy by the Competent National Tribunals for Acts violating the fundamental rights granted by the Constitution or by Law.

I have often heard the ‘Law is an Ass’ and if indeed this is untrue, then it is most certainly Comatose in all of the aforesaid because if it were indeed awake it would have to peel off its blindfold, and put an end to this heinous activity.  If it is not to be seen as impotent, it has a Duty to address this classic example of the command  ‘Physician Heal Thyself’.

One thing puzzles me though.

How is an Effective Remedy given to someone who has been unlawfully killed on the Liverpool ‘Care’ Pathway?

I am not an accomplished author, so please bear with me!

Having said that, I doubt any accomplished writer could make this up.

The Physician’s Oath

I solemnly pledge myself to consecrate my life to the service of humanity;  

I will give to my teachers the respect and gratitude which is their due;                 

I will practise my profession with conscience and dignity; the health of my patient will be my first consideration;  

I will maintain by all means in my power , the honour and the noble traditions of the medical profession, my colleagues will be my brothers; 

I will not permit considerations of religion, nationality, race, party politics or social standing to intervene between my duty and my patient; 

I will maintain the utmost respect for human life, from the time of conception, even under threat, I will not use my medical knowledge contrary to the laws of humanity; 

I make these promises solemnly, freely and upon my honour.  

On January 22nd mum had been increasingly short of breath over the past week with a slight cough and poor appetite.  One ankle was slightly swollen and her blood pressure was slightly raised.

*The blood tests taken on 22nd showed an increase in the Liver Function Tests and slightly raised Sodium, Chloride and Urea.

Would this not signal something affecting her liver?  Also possible dehydration? What about the Furosemide, Amoxicillin, Salbutamol inhaler?

  • The G.P. who gave mum Furosemide omitted to tell either of us that her urine should be measured along with her fluid intake when she prescribed this, as it can lead to dehydration.

*Neither mum nor myself were ever informed of this!

Why tell the patient anything?

On January 23rd mum had ‘a marked improvement, less dyspnoeic(shortness of breath), eating more and was more alert, o/e chest clear, No ankle oedema(swelling), kept on Furosemide and Amoxicillin and to be reviewed on the 2nd of February.’

On January 25th she ‘continues to slowly improve. Having Furosemide (spelt wrongly as Ferusamide which appears to be a common spelling among medics) dose split as 20mgbd and dyspnoea lessening,  o/e chest clear.  Plan continue Furosemide 20mg when antibiotic finished.’

On January 26th the G.P. wrote a prescription for Fortijuice – Forest Fruits 200ml liquid various flavours (Taking no notice of her records showing an allergy to citrus fruits).  The pharmacist informed me they only had a small selection of Fortisip and I told her mum could only take banana or apple – absolutely no citrus – as she was highly allergic to this, and every G.P. knew about this.  Every one except her latest G.P. apparently!  She had already tried Fortisip the previous November and another G.P. had noted that this had given her diarrhoea!  This was the banana flavour. Mum tried a little of the apple, but thought it too tangy.

On the 22nd I had asked the G.P. outright if mum’s iron was okay when I saw her breathless, as I knew this can cause breathlessness, and was told it was alright.

On the 23rd the Haematology results that the G.P. had tested reported:-

Ferritin       30                             Normal Range 15-300

Folate                                          Normal Range 200-800

Vit B12                                         Normal Range 210-1000

Ferritin:  Ferritin values may be inapropriately elevated by inflammatory disease.  Values between 15-45ng/ml should be viewed as Borderline particularly in the Elderly.

Folate:  Folate values between 200-250ng/ml are borderline.

Vit B12:  B12 vlaues between 210-250pg/ml are borderline.

Neither mum nor myself were ever informed of these test results! 

Borderline Ferritin, No Folate, No B12?

Four years previously mum had a stroke from which she made a remarkable recovery, and it was noted then by the Hospital records:-   *Tendency to become low in iron!                            

*Neither mum nor myself were ever informed of this!

Why tell the patient?  They don’t need to know!  Arrogance knows no bounds.

On January 29th the G.P. noted in her records Ferr. 30 borderline.  From results of 23rd?

Serum Ferritin level is the biochemical test which most reliably correlates with relative total body iron stores.  Low levels indicate low iron stores. However, the test is difficult to interpret if infection or inflammation is present, as levels can be high even in the presence of iron deficiency (WHO et al, 2001).

If inflammation is suspected to be spuriously affecting the ferritin result, practitioners need to consider other markers of inflammation (e.g. white blood cell count, platelets, C-reactive protein) or measures of iron status (e.g. iron, total iron binding capacity), and seek advice from haematology or clinical biochemistry if in doubt about selection of further tests and interpretation of results.

B12 can affect the iron in the body (which transports oxygen) and most people as they age become depleted in this.

Low oxygen can also be caused by anaemia, creating breathlessness.

Clearly this G.P. gave no consideration to these facts, or even whether her breathlessness could have been caused by the Inhaler, or the Furosemide, not to mention dehydration (again something common in the elderly).

On Tuesday 30th January, the G.P. visited mum, who was improving- but when she was going to bed the previous night (we always did a choo choo train, partly so that I could guide her through the door and partly to give her a laugh) I noticed her little heart was racing a bit- so I asked the G.P.  if mum could have some oxygen for ‘occasional use’ in case she became breathless.

Incidentally another G.P. in this practice had given mum Piriton the year previous which she had tried before trying the inhaler.  Unknown at the time is:-

Drugs: Chlorpheniramine (Piriton)  

Concern: Anticholergenic: AE, urine retention, confusion, sedation.

Bear in mind this was merely my suggestion/question as mum had no complaints whatsoever.    I had asked the local pharmacist about this possibility many months before and he was quite laid back about it saying ‘You just ask your G.P. for a prescription, I have a lots of patients who get this’.

The G.P. stated that if mum needed oxygen ‘she would have to go to hospital for assessment’.  As G.P’s only give oxygen as a last resort?

At this we were about to say ‘we will just leave it meantime’ when back came the retort ‘besides if she needs an x-ray?‘  Bear in mind there had been no suggestion of anything until I; stupidly as it turned out; asked about occasional oxygen.  I asked why would this be and was told that it would check her heart was okay.   This was the first time this was even suggested!

At this mum said ‘I don’t want to go to hospital…’ and I said ‘I don’t want you to go to hospital either mum, but if you need an x-ray?’  At this, mum sighed resignedly and looked a bit forlorn.

I first of all asked if mum could just go to A&E and was talked out of this under the auspices that ‘she might have a three and a half-hour wait’, so we agreed to wait for the ambulance.  I asked how long we would have to get ready before the ambulance came, in order to make mum something to eat and drink as I knew from past experience that there was probably no food or water available.

How sickened am I to be so correct?

*The G.P.  stated “Well it’s not an emergency, so about one thirty?”  confirming mum would have time for a sandwich and a cup of tea before the ambulance would arrive.  G.P. would finish the rest of her list of home visits then return to the office and phone for an ambulance from there.

The G.P.’s records show that @ 12:42p.m. on Jan 30…. She recorded:- marked deterioration, very dyspnoiec at rest(breathless), P/e tachycardia (heart racing), Chest PN dull at right base, BS ves.  Refer rec physc.

  • (No beds with care of the elderly.)

I had already asked  about A&E but advised against this because it could be about a three and a half hour wait!

No beds for care of the elderly, yet G.P. knew this @12:42 to write in her records and did not advise mum or I of this?

  • First observations for any Readers to check please?

If she was typing her notes @ 12:42pm after finishing her rounds of patients, and after phoning to check if there were any beds?

A) Why did the Ambulance Crew write in their form:- Urgent. Ex copd.  Pt. was seen by G.P. today 13:00, arrange A&B, would phone with Pt./ details to….. -not C/O pain on route.

B) Ambulance Crew could only get this information from the G.P.  therefore she must have informed them it was Urgent (which would instigate a faster response from the Crew – which can lead to their own blood pressure rising unnecessarily).

C) Ambulance Crew could only get the time of 13:00 from the G.P. yet she was back in her office checking about ‘no beds for care of the elderly’ before 12:42 in order to start her notes?

D) How could she have seen her patient @ 13:00?

  • This must be unlawful?  If e.g. a department of forensics were to check on something about a patient and required the correct times.
  • N.B. about No pain in the Ambulance!
  • If the G.P. was delaying the time in order for mum to have something to eat and drink, then this would be an explanation –  But!
  • If mum was an Urgent case, would we have been told “It’s not an emergency, so about one thirty?
  • If mum was not an emergency, why tell the Ambulance Crew Urgent when the Time of Call was 13:25?
  • The Ambulance Crew Bust a Gut and were at Patient @ 13:37 and Time Left was 13:50 and we arrived at the Hospital @ 13:57,  illustrating my point about unnecessary stress placed on them!

A letter was sent from the G.P. dated 30/01/…..

Dear Doctor,

I would appreciate an admission for the above-named patient.  I have been looking after her at home for the last week with an exacerbation of COPD with probable super-added cardiac failure.

She has been treated with Amoxycillin and 20mgm. b.d. of Frusemide.(G.P.’s spelling).  N.B. mgm. should read mg.

No mention of Salbutamol inhaler?

Neither mum nor myself were ever informed of the possibility of a super-added cardiac failure.

It is time all of this Arrogant Secrecy was abolished.  One would think they were talking about a Robot – not Human Beings!

The Secret Service has nothing on this Latin based Secret Code Language!

Ask yourself.  Who does this suit?

On examination she has a tachycardia, is tachypnoeic at rest and examination of the chest revealed dullness to percussion at the right base.

Where are any medical records about the patient?

On the previous September mum had been sent by another G.P. in the practice, for an electrocardiography test and    ‘The results showed Normal Left Ventricular function and the only positive finding really was Some Left Ventricular hypertrophy.’

The G.P. congratulated mum stating “As a matter of fact your results are quite remarkable for a woman of your age.”

There was Never anything wrong with mum’s heart even when she died, except that it stopped!  And No Wonder! As you will see for yourself.

  •           This is merely Act One.
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