Well, I've just come back from having cataract surgery on the second eye, and it's great.

I went back 3 weeks after the first one, last Tuesday in fact, and was told that there's a 3-month waiting list for the second eye.  I told them I could come at short notice, could take a cancellation, could even go to another hospital about 15 miles away where the same team also operate.  In between all this we changed our car last Thursday and it had to go back today because of a couple of faults.  So B was out and was coming back by bus - the phone rang: 'We've had a cancellation, can you come in straight away?'  Bit of a panic because until B came home I hadn't even the taxi fare, howeve he arrived, I went to hospital by taxi and came back the same way.  So not a 3-month wait, 4 weeks in between one eye and the other!  We thought B had done well - 7 weeks between one eye and t'other, but I've done even better!

Anyone who is a bit doubtful about having this done - it's a little bit uncomfortable for a short while, but really, it is so, so worth it.  The difference is incredible.  I now have perfect vision in both eyes, which I haven't had since I was a child.  People complain about the NHS but what would we ever do without it? To get the same thing done in the private sector would have cost a few thousands, and I even get paid by HSA for the day-stay.  Can't be bad.

Now, I've got to lose weight, I have a gynae problem which needs surgery, I need to get down to 70 kg (11 stone) - I'm getting there, but oh so slooooowly!!  About a stone and a quarter to go - I'm down to 78.6 kg today.  Have dropped from size 20 to size 18 - I just gave away a whole lot of size 20 clothes to a lady who was raising money for our local StrokeBusters.

Hope your Mum is OK, Kazzie!

Margaret

Further to the discussion on age discrimination in health care.  I am 72, and so far I have experienced no such thing!
    I discovered in early May this year that I need gynae surgery.  Both my GP in May, and my gynaecologist in August, emphasised the weight problem, but at no stage did either of them even hint at any form of ageism. I have been losing weight very slowly - approx half a pound a week - and recently I was phoned by Gynae Admissions who asked if I was ready for the surgery.  I explained that I hadn't yet reached the level desired by the surgeon, but a few days later I had another phone call saying he was willing to do this even though I was 78 kg instead of 70 (which would have been 11 stone).  I'm still losing - 77.6 kg today - and I'm due to go into hospital for surgery on 29th November.
   Yesterday I went for pre-admission assessment and had a long session with a nurse in the gynae ward.  She talked to me like a human being, explained everything, checked through all my history, and again, no ageist discrimination at all.  She asked me about my sex life.  Now, some people might assume that a woman of 72 has no sex life left, but that wasn't the assumption at all.
   I'm due to be admitted at 9.30 am on the 29th but after being seen again by the surgeon, the anaesthetist, being clerked-in etc I should be able to go home for the night, coming back for 7 am the following morning.  Of course I'd much rather do that than just sit in hospital.  I should be home in 2 or 3 days if all goes well. I am just looking forward to getting it over with and getting back to my normal life.  B and I have recently joined the local leisure centre and we go to the gym and the pool. I intend to carry on losing weight until I get to what's considered normal for my height, which means losing another 4 stones.  But as Magnus Magnusson used to say 'I've started, so I'll finish!'
   I must re-emphasise, at no stage have I found any ageist discrimination at all in my recent dealings with the NHS, or at any time, come to that.
   Can I suggest that it may be down to expectations i.e. if you expect ageism you may get it? Or lack of assertiveness? The way some people of my generation appear and behave, they look and talk in an 'elderly' way, if that makes sense.  There are women who come to our church, and the first words out of their mouths are 'isn't it cold?' This was on a beautiful sunny autumn day, a bit of a nip in the air but I was still in short sleeves!  Some people, if you say 'how are you?' you get a long discourse on their tablets, their symptoms, what the doctor said, and so on.  These are people whom I describe as acting, speaking and behaving in an 'elderly' way.
    Kazzie, how's your Mum doing?
   Margaret

Hi there, sorry for the very belated reply owing to holiday and new job etc

I am very sorry to say that I believe age discrimination does exist in the health service.  My mum went back into hospital in November for the ongoing bowel problem.  The first ward she was in was a general one, though tended to have more elderly people in it.  When anyone rang their bell it took quite a while for anyone to come.  During those first few days when my mum was in such agony they had to give her morphine, one night the lady opposite fell off her commode.  My mum was awake and rang the bell but because she knew how long they would take, she dragged herself out of bed and into the corridor to call them (despite the fact she has been too weak to walk for a while now). 

When the doctors started worrying about the perforation she was transferred to a specialist ward and given a drip and anti-biotics for a few days, with only sips to drink.  The pain started to ease, colour came into her cheeks and she was even getting bright enough to talk about us going shopping at Christmas if she was better.  When the drip was taken out, she was on clear fluid for a couple of days then the last day she had two very small mousses and a very small ice cream.  Then they discharged her.  I phoned the ward to try and get some instructions about her care at home, what diet she should follow, what should she do if she gets pain again (bearing in mind she still wasn't eating proper food) and the nurse was quite rude to me, telling me to ask my parents if I needed to know anything.  I think they asked my mum some 'leading questions' in order to say she had no pain (she hadn't at that moment, but it hadn't gone completely).  That night, at home, she was in pain again and has had pain ever since, sometimes really bad.  She goes two or three days without eating and then just eats a tiny amount, mostly bringing it all back.  I contacted her GP and he went to see her but wouldn't put her back in hospital, saying she wasn't as bad as before she went in last time.  Apparently she is supposed to be having a further outpatients appointment but hasn't received any letter to confirm it yet and it wasn't on the discharge form so I know her GP won't bother to look into it.  I cannot believe that a younger person would be left like this - they would have been off work for two years at least.  My father feels she is deteriorating every day before his eyes.  She has lost a lot of weight and hasn't got the energy to go the bathroom now.  My mum feels embarrassed when I interfere and contact the doctor but I don't know what to do anymore.  I did email the consultant but no response.  Perhaps I should write him a letter.

Hello Kazzie

I'm very sorry to read of your Mum's problems.  Yes, by all means write the consultant a letter setting out clearly all that you've said to us.

I had the gynae surgery at the end of November and all went well.  But, as always, I found I had to be alert, aware and assertive.  I had to, because I wanted a spinal instead of a general anaesthetic and I refused to wear the TED stockings.  I also had to be quite assertive to ensure I got the vegetarian food I wanted. I had to insist on the Saturday morning that I didn't want to be sat out of bed with an indwelling catheter - it was just too darned painful and I kicked up a fuss.  A HCA then came along and said 'we can take it out, we've just looked in your notes and it states out after 24 hours'.  I said 'I TOLD you that!'

However, I was in for the minimum time.  Admitted Thursday, preliminaries completed, home for the night, back for 7 am day of surgery, up on Saturday with all drips and tubes out, to shower, home Sunday morning.  I don't hang around in hospital if I don't have to!

I'm now back to driving again, once the 4 weeks has passed.

As against your Mum's experience, my daughter, aged 46, is having a terrible time and it's just delay, delay, delay.  And it's not lack of assertiveness with her - anything but!

It sounds as if your Mum hasn't had her problems properly diagnosed.

With best wishes

Margaret

I am a help the aged volunteer and I was asked by a 80 and 70 year old to get the council, their landlord to put their heating and gas on.  There had been a leak and the council then refused to put on the heating until as the Tenancy Manager said they "de-cluttered" their home.  I helped as best I could and got the 70 year old to move out carpets but at some stage it was obvious that the
state of the house did not need this sort of ultimatum and that the elderly should have received help from the Supporting People scheme/voluntary services etc and charities accessible to the Social Services the year BEFORE  when the elderly people complained about the state of their home.   Finally  social services broke the stalemate created by housing so that they paid for a cleaning firm to help.

Meanwhile from September to December (2 1/2 months) they lived with no heating except a blow fan heater of 500 watts.  I complained and the gave them three blowfan heaters, despite the fact I mentioned that with the dust in the house and respiratory illnesses blow fans were not suitable, and of course very electric expensive in usage.

We wrote to the old woman's doctor because she developed an ulcerated leg and it appeared there were no notes left by the district nurses who visited to indicate when the ulcerated leg had been her condition.  The doctor, (it doesnt have a signature so it could have been written for him) indicated that it was "the patient's responsibility to clean up the house" but that she was "quite clearly not capable of doing it herself".  The letter did not answer the specific question which appertained to a the formal complaints I have lodged with social services, housing and the London Government Ombudsman, that this is a case of benign neglect, and that such neglect is directly to the detriment of their health. 

He concluded that if she needed help from social services other than installing her gas, heating or general cleaing then she should "let him know", as if the original letter had not specifically requested that he comment upon her medical condition and ulcerated leg and whether 2 1/2 months without adequate heating might exarcebate good health.  In fact we all know ulcerated legs are due to poor circulation.  He then said "may I suggest that until the gas central heating is installed that the electric heaters are used if possible".

I would love to believe that the doctor actually wrote this as I am most worried that his letter appeared to be a letter written for the benefit and justification of the the council landlord and little and no reflection of his role as a medical practitioner.

Does anyone know how one can get an opinion about what the adverse effects on the elderly are if they are told to endure an entire house without heating and given a blow fan heater of 500watts?  I am sure that the wattage is below the BTU levels that would create a heated roomof 18-21 degrees. But how do I get acknowledgement that the medical person is more likely to dismiss the elderly than aid them in taking action on a terribly inept council housing management organisation? 

Should I report him to the BMA? or tell the police that I think that the medical information for the elderly is being subverted towards the agenda of benign neglect and a hurried and early death?

Pease write him a letter and send by registered post then phone and phone again.  Quote the campaign by help the aged....

My mother received a diagnosis of cancer in Aug 2006 and had treatment which didnt work, we moved hospitals and location and the next doctors decided a different cancer type and this chemo didnt work either.  We dont crticise the work of either to diagnose and understand the difficulties. but due to our persistent reminding we finally got sent to one of the two specialist hospitals in the country and on the day we met the consultant was admitted because he said she needed a major operation or would die in 6 months. 

Throughout this experience we have found doctors and nurses to be most kind and helpful and often swamped by patient overload in central London hospitals.  Because the elderly are forgetful and often very anxious as  patients information was typed and sent to us which helped us know what was going on, and this offset the horrendous waits for seeing these doctors which often was over 2 hours beyond the appoitment time.  This is due to the excessive numbers of people accessing our national health.

I complained that the elderly should not be made to wait for this length of time in particular as they were old and they were ill.  The Consultants said that there was nothing they could do as they tried to help each patient effectively.

When is our government going to deliver a health service that clearly is responsive to those citizens who are here on a permanent basis as opposed to citizens who have arrived as migrant workers and whose families may not be actually lawfully receving treatment? As sad as I am for anyone unwell it is about time that we decided to use the hospital number linked to national insurance numbers and real identification of our citizens in the manner that Spain and France does, or else the many people of many other countries will be continually accessing our services to the detriment of the elderly.

By all acccounts many elderly expats will be returning to UK to get health treatment when France and Spain cease to provide it to them after the age of 65. 

I wrote to the Dept of Health to clarify if they have ever had a system that can actually check the accuracy and authenticity of documentation used by patients for residency - thus access to healthservices and they wrote back (finally) and said that it was true that they could not guarantee the authenticity of any documentation that they used to qualify access to the healthservice and had never been able to do so...

If the healthservice did not give me the impression that the elderly should be the ones who are given a lesser level of treatment (a sense that they can wait they dont work, they can wait they dont have any antidiscrimination legislation, they can wait they are bound to die soon anyway) then I would never have written this. One cannot have that attitude to people due to race or disability or gender, so why our elders?

 It is a real shame that if the health service was not so pushed then we could all feel alot more compassion for any other people from other countries accessing it. I found the level of cleanliness and standards in Spanish hospitals when I worked there for 2 years was fab, but I could not have got any friend visiting my home treated there because they related my NI number specifically to my right to access health, not to my mobile phone number or a bank statement.  

And I feel this issue is also pertinent as many eldely people in the UK are feeling that they are treated less favourably than someone who is younger.  I want other people to be able to access our system and I am in favour of universal health service but not at the expense of our elders (whether they are asian, black or white, resident or citizen!). 

Gosh, sounds like you have been in the wars yourself, Margaret!  Glad to hear your eye surgery went well and hope you have fully recovered from the gynae surgery.  Incidentally my mum had a pre-assessment by phone for her second eye several months ago but nothing has happened since then.

I didn't write to the consultant because my dad telephoned their GP and tried to explain to him exactly how my mum is.  The GP seemed to manage to turn it round to the fact that it was her fault because she wasn't taking her tablets - in fact these are just anti-sickness tablets and she tries to take them as much as she can, but often is too sick to keep them down!  They said if she doesn't take them, the hospital wouldn't want to know about helping her further, basically.  He said that from the hospital letter he received last month, they had finished with her case and he was not expecting any more outpatients appointments, despite the fact the consultant told my mum when she was being discharged that she would continue as an outpatient. 

Personally I think it is obvious that the reason the pain subsided in the hospital was because they fasted my mum (sips only) for a few days and gave her a drip (the normal one) plus also drip bottles containing anti-biotics.  Obviously her colon was getting a good rest.  She managed to feel not too bad on tiny amounts of very soft food and they seemed to think she was cured!  I know hospitals are busy and want to get rid of patients asap, but you'd have thought after all that work they'd have tried her on solid food for a couple of days and observed her.  Perhaps I expect too much.

The GP did agree to write to the consultant so I thought I'd better wait and see what happens.  But I just feel that something is very wrong with the way he is acting.  Meanwhile my mum told me today that the pain (which varies from niggly to very bad, but never goes) was so bad last night she felt like killing herself.

Many thanks for responding.  I haven't had time to digest everything you say but on the face of it I agree with an awful lot of it.  I also think it is a great pity that British nurses are qualifying without jobs to go to or qualified nurses being made redundant when wards are closed, yet the NHS is apparently paying a fortune for bank nurses, most of whom are from abroad.

Hello Iceni
   It's so complicated, isn't it, when you get all these different people/bodies/authorities involved - the GP, the council, everyone seems to be 'covering their a*se' as the Americans say, and the needs of people are buried underneath all of this.
  I would have thought there was enough evidence about the effects of inadequate heating on people who e.g. don't move about enough to stay warm - isn't that why the Gov't have the WarmFront scheme? HtA have evidence about older people dying from the effects of cold, even in a mild winter. 
   You mention 'elderly people' and 'the old woman'.  I'm constantly having to remind myself that people probably look at me in that way, although I don't think of myself as 'elderly' or 'old' - perish the thought!! I'm 72 and my husband is 73 - he's out this morning running a seminar in a sheltered housing complex where the 80 and 90 year olds are desperate to learn to use their laptops!!
   Regarding leg ulcers, these are serious and need treatment, if they don't get treated they can lead to leg amputation.  Seriously!! Is the lady diabetic as well, by any chance? Infection can easily get into the ulcer and can spread, and the scenario you describe, where dust is being blown around, is very serious.  She does need urgent treatment for those leg ulcers - amputation would make her completely immobile and probably unable to live at home.  Phone the District Nursing Service as a matter of urgency and get someone to give her proper treatment. You say 'we all know that leg ulcers are due to poor circulation'.  Unfortunately it's not quite as simple as that. 
   Even with a person stuck in a chair and unable to move, leg exercises are possible, and it would be a good idea to encourage these.  Prop your feet up on a stool and circle your ankles, the kind of exercises that are now recommended for long-haul air travellers, or which are taught following surgery in hospital. 
   Margaret

Further in this saga..  Well -  I don't know what is discrimination or what's not any more.  All I know is that when we saw the consultant privately he revealed that it was the surgeon who performed the colonoscopy that caused the tear that led to peritonitis.  They couldn't operate because my mum was too weak.  Now she is going to be admitted as a matter of urgency but she will probably need surgery which will be dangerous. They might have to build her up with intravenous feeding before any attempt is made.  I just feel that I have been trying to get her help for two years and it has all been delayed while she become older and weaker.  He did say that we shouldn't have had to make a private appointment and if the pain gets unbearable just call an ambulance.

I have just looked up 'strictures' on the internet (narrowing of the bowel) and find that they are caused by scarring due to having chronic inflammatory bowel disease for a long time.  The symptoms are exactly like my mum's.  I do hope that everyone who is reading this saga and has unpleasant symptoms of ANY kind will learn that, depending upon their GP/consultant/hospital, they might have to push and push for medical help, otherwise they might in the long term find themselves in the same situation as my mother.

Postscript to my mother's story: she was eventually admitted to hospital and died rapidly a few days later.  I am not going to post details but suffice to say that her death was caused from a complication of two existing factors, both of which were known by consultant and GP and left to get worse.  It is my belief that if she had received the attention and treatment she deserved from both GP and hospital in good time she would be alive now.

The moral of this story is to be assertive if you know you need treatment, whatever your age, and don't be fobbed off and let your chances of recovery be ruined.

Kazzie, I am so, so sorry.  Your mother suffered terribly in her last few days/weeks/months even though you did your best to help her.  Even the cataract surgery was useless to her in terms of improving quality of life.

I completely and absolutely agree with you when you say that 'the moral of this story is to be assertive...whatever your age'. This is what I've thought for many years and I'm constantly seeing examples.

Nevertheless, even assertiveness isn't always enough.  My daughter fell over in her office in November, needs another hip replacement, this was eventually scheduled for the end of February.  You couldn't make this up but...her surgeon phoned her yesterday morning.  He'd been on a ski-ing holiday, fell over and broke his leg.  So, her hip replacement is delayed until who knows when. 

In the meantime she'd had a phone call from an OT questioning her about the height of her bed, the number of grab-rails, whether she could get into the bath etc etc even though she'd sent in a form detailing all that! She said 'I am tired of being spoken to as if I have one brain cell, I'm going to get a hat which says "It's my legs that don't work, there's nothing wrong with my brain!" '

Someone had said to her 'they talk to you like that because they're used to dealing with little old ladies who're confused'.  I said 'They look at us, see that we're older, and imagine that we've lost the one brain cell that we had to begin with!'

So yes, I do agree about assertiveness, it can be learned, I have a good friend who learned it from me.  And I am terribly sorry about your Mum.
  
Margaret

Thank you Margaret, for your kind words.  My mother did indeed suffer especially in the last two days of her life which I will never forget.  Coincidence that you should mention the cataract surgery because a few months ago the hospital did a 'pre-assessment by phone' with her for the second eye (because of her difficulty in getting there), which I thought meant the appointment would be imminent but she never did get an appointment and didn't chase it up as her other condition was getting worse.  I am intending to take the whole matter of my mother's lack of care further and have already started the process.

Re your daughter's hip replacement, I would have thought that the surgeon's work would have been split between other members of that particular surgical team so that the extended wait wouldn't be unreasonably long.  But maybe that would be too easy!  I hope she doesn't have to wait too much longer.

Hello Kazzie
   I am sure that you have grounds to make the most serious of complaints in respect of your mother's care/treatment/lack of. To think that all this time she was treated for something like 'irritable bowel syndrome' when in fact her bowel had been perforated at the time of an earlier colonoscopy and no one appeared to be aware of it until the private appointment!!  Bowel contents leaking into the abdominal cavity is a very serious condition requiring emergency treatment - think 'burst appendix' and no wonder she was in so much pain. 
   It's not quite as straightforward as all that, for my daughter.  The last time she spoke to her surgeon he explained that they were possibly looking at a 3- or even 4-stage procedure, it's not simple because there's very little bone there and she may need some kind of pelvic reconstruction.  He was phoning round all his patients explaining what had happened and offering them the option you suggest - however, he's hoping to be back at work within about 3 weeks even on a knee brace, and he's put her at the top of his list.  She's already been off work since November, has had to activate her mortgage protection policy and a loan protection policy (fortunately both these are paying up) and may well be off work for a year or longer, depending.  So, the fact that she's in the working age-group hasn't given her any special privileges that an older person might be denied.
   With best wishes,  Margaret

Goodness, doesn't it make you realise just how much you need to make sure you have contingency plans for financial obligations.  Mind you, I haven't!  I am intending to look into health insurance for myself and partner.  I hope your daughter doesn't have to wait too long.

Best wishes

Kazzie