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Dr.Saleem
Dr.Saleem, Doctor
Category: Medical
Satisfied Customers: 781
Experience:  MBBS
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Dear doctor.. can you please help me I was living before

Resolved Question:

Dear doctor.. can you please help me I was living before in West Yorkshire, I was diagnosed with ankylosing spondylitis. Shortly after that , I muved to London. More than year before specialist referd me for mri scan. Year after when I sen another specialist . He told me , that I god where and there. A told him my pain it is worse . My knee and my hip is so painful. I am on trmadol samtimes 4 time a day . With another pain cilers. His answer was that he can help me .bicouse NHS will not cawer the cost. So my next mri scan will be next year. And because of that he saining me of from the list. Eparently that is the prosidger. Caple off weeks ago . I had so strange pain. For 2 days I cudend walk . Samting was happening to my weins there was puft up. And Samting muving inside . My gp give me naproxen tablets 500mg. They helpt dzast for little while. The pain is worse my hip is giving me so matsh pain. I can't thecke. Most of the nights Ai am a week. Pain celers oll the time. I god a stomach alcer as well. I can't theck the pain eny more. In day time I can't function. . I am single mather .my oldest is 9. Younger is 4. I don't know what to do. Where I turn to ged help.
Submitted: 8 months ago.
Category: Medical
Expert:  Dr.Saleem replied 8 months ago.
I am sorry to hear about you problem. I understand that it is difficult for you to get your daily activities done - even the basic ones. Just before we go any further, what I have understood is that you are suffering from Ankylosing Spondylitis and you are having severe disabling pain and that you have tried various painkillers. Is that correct? How much have you been briefed about your condition? Immediately, however what you should try doing is stop naproxen and switching over to Dicolfenac 75mg (twice daily, with meals). Also, gentle stretching exercises and avoid sitting idle for long. Incase this doesn't solve the problem (and since your condition is a long term condition) we may need to start you on other medications which ca give good relief e.g. sulfasalazine or biological agents e.g. infliximab or rituximab - however the latter are expensive), for this your GP will refer you to a Rheumatologist (a joint and immune system specialist). Short pulse steroids may also be needed. To summarise: stop naproxen (as it is very mild) and start diclofenac (you might experience acidity in stomach, if so take some over the counter antacids e.g. ranitidine). If no relief re-visit your GP and ask him to refer you to a rheumatologist as you are very upset and disturbed by the condition and so that the rheumatologist can maybe start you on sulfasalazine or biological agents +/- short course of steroids (as these are prescription drugs). Keep physiotherapy ongoing. I hope this helps solve your problem.
Customer: replied 8 months ago.
Dear Dr Saleem. Thank you with oll my hard. I dzast wanted to ask you . My doctor is a gud doctor . Bad don't know if I god rithe to ask him to referring me son as possible. . To specialist. To be firm with him. Bicouse eny referal I am asking him . Theck mounds .. for my last referal I was weiting 8 mounds. By the time the specialist seen me another 5 maund. Last time I told him . Can you plz do that son as posible. Writhe urgent. He replaying I am a doctor not you. I am not raisyst bad he is not born in the UK . I thing he is more thinking about his buget. Eny way . Plz devise me what is my right. Bicouse tumorow I be bucking a appointment . And I need to know what I shud telling Dr soon. Thank you
Customer: replied 8 months ago.
Dr sood.
Expert:  Dr.Saleem replied 7 months ago.
Once again I am sorry to hear all your difficult times. It is quite astonishing that your GP behaving like this. He should be satisfying you and not bossing you around. However, yes the referral I understand does take time, simply go to him and tell him that you are still not well and that you are physically unwell and getting very very disturbed mentally and that your day to day living is becoming disabling and that your family is suffering. He should consider referring you to rheumatologist. Unfortunately, he is not bound to refer you but on humanitarian basis it could be possible. Also you can get a private check up, but that costs money and at times (not always) the private specialist also asks for a referral. Here is a website (by NHS) that may enlighten you further:http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/gp-referrals.aspx I hope all this helps Regards
Expert:  Dr.Saleem replied 7 months ago.
Another thing to convince a GP is to mention some 'red flag' symptoms. These are symptoms which imply that the condition you are suffering is progressing and requires usually specialist referral. For ankylosing spondylitis: acute severe backache, visual impairment and breathlessness are potential red flag symptoms. Also that you are suffering walking... These are suggestions to help you get a referral.
Expert:  Dr.Saleem replied 7 months ago.
OK, so you might have more questions or want to give me more information: Please use reply to expert if you have further questions. When you are ready, please click a positive rating [hopefully excellent—that’s how we are paid, per rating]. If you forgot something, come back. I am here
Dr.Saleem, Doctor
Category: Medical
Satisfied Customers: 781
Experience: MBBS
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