Forum

Requesting Change of Consultant

How easy is it to do the above on the NHS? Has anyone done it? What sort of time did you have to wait?

I am due to see the same consultant for the fourth time in less than a year in a couple of weeks. First couple of visits I did not like his manner, but at that point was diagnosed with Tranverse Myelitis and he was very confident it would be a one off episode.

l It wasn’t and an MRI during the second episode in December showed a new lesion on the brain. He was fairly dismissive, said likely MS of the benign and mild type (mobility issues due to loss of function of first one side of the body, then weakness in the other, nystagmus, twitches - mild?), no action taken to rule out other conditions, no support, but I could have a lumbar puncture if I want. Hmmm.

I have not recovered well since October despite two lots of steroids. An MS medical professional who worked with this person has advised me to request a change as my experience is common with this particular consultant. I have heard very negative things from other MS patients.

Not sure what to do as know my next visit will be frustrating again.

Help!

Hi ZigZag,

Not sure i can help regarding your consultant.

Tried to this in hospital,regarding Doctors,asked for a second opion,who turned up,her boss,they just would not listen to me.Didnt help that my speech was bad.In the end i signed my self out,but back in two days latter,this time they listened and took my advice got out 5 days latter.

Do you have a MS nurse that could help you.

I wish you good luck with your problem.

Take Care.

Chris.

Uh-Oh - something is not right, here …

At the hospital that I attend, they will not prescribe two courses of steroids unless there is at least 6 months between them.

Of course, I don’t know what dose you had - but the issuing pharmacy should. Go and ask them what you actually had, and confirm the dates. The norm for MS is a pretty hefty dose every day for five days and it may be that you had a small dose which did not actually do any real good. If you went into hospital and had the steroids by IV, you could phone that department and ask them what you had. Then ask your local pharmacist to comment.

Now you could be looking at two treatments too close together, or, two treatments that were too small to do any good.
In either case, that is good reason to see your GP and ask for a referral to a different Neurologist (preferably in a different hospital). This is much the same as asking for a second opinion (which you have the right to do) but with a valid reason.

Best get this sorted now.

Geoff

Thanks for the responses.

Chris, consultant has given the ‘likely MS’ diagnosis but no access to an MS Nurse. My GP was however directed to the MS Nurse to discuss the latest dose of steroids.

Geoff, I’ve had two courses of oral dexamethasone 16mg for 5 days with taper over 10 days (very horrible experience) in April and November last year. Most recent course was early Feb, which was 5 days 500mg methylprednisolone, a less hideous experience than the dexameth.

I was very reluctant to take the third course as I was led to believe you should not have more than two courses a year.

It is a big concern when another professional suggests very strongly to request a switch of consultant. They are both at the same hospital, but the consultant I have been advised to try to see is actually the MS Clinic consultant.

Yes, you can switch consultants - I did, although it was 7 years ago. All I did was ask my GP to refer me to the new one. The new one is an MS specialist. The previous one wasn’t.

Any neurologist who tells a patient that their MS is likely a “benign type” (which can only be diagnosed retrospectively after at least 10-15 years!) when they’ve had TM with significant loss of mobility followed fairly quickly by a second relapse also requiring steroids is a blithering idiot and should be avoided at all costs! OK, it may be that time will prove him right, but I certainly wouldn’t take the risk if I were you - I’d want a neuro who actually gives a damn!

Why not go and tell your GP what you’ve told us? The fact that the other consultant is a specialist may be enough of an official reason to transfer.

Good luck!

Karen x

The usual steroid where MS is concerned is 5 days, at 500mg methylprednisolone, or the IV equivalent). The use of dexamethasone is somewhat less usual (yes, I am picking my words carefully here) where MS is concerned. It is commonly used in treating laboratory rats, and for other vetinary purposes. I really do think that you need to chat to a pharmacist, and a quick Google will soon show you why.

Geoff