Up=date on painful injections and value of perseverance with an overburdened NHS!!

[rosyG]

Thought you'd find this interesting!1 After being told to go to Moorfields A and E by their advice line staff, I waited for hours- until the last train home from London and had to leave A and E with out being seen.

Totally exhausted last night and thought maybe I needn't bother as things seem to have settled somewhat- dull pain , not the severe pain I described before .This morning, however, I returned to a more sensible frame of mind and took myself off for another 5 hour wait.

This time it was well worth it- I described the extreme pain as soon as the anaesthetic drops wore off, and what had happened since. The doctor put some of the yellow drops in my eye and diagnosed 2 small corneal abrasions- and he has given me a discharge letter saying these might be due to the speculum used for the injection ( I had recounted what happened and that I thought this was the cause)

He prescribed Choramphenicol ointment- rather than drops, and I think this will stay in place for much longer.

I was able to ask him all sorts about BVRO and future- e.g. effect on cataract ops and other matters- very pleased with a excellent appointment- pity the staffing can't match demand at present.

I feel pleased to have the letter which I will take to my next injection appointment and ask for extra care when they insert the speculum

[2468G]

Hi rosyG. Well done for persevering. Must have been an exhausting couple of waits but ultimately worth it for the information and help you received. We have marvellous staff in our NHS but just not enough of them for the whole population.

Hope your eye recovers now you have some ointment.

2468G

[rosyG in reply to 2468G]

thank you- such a great doctor and answered many things there is not enough time for when I go for injections

[Hidden]

Glad you are feeling better sorry you had a bad experience. I have performed over 2000 injections and always take great care.

It is quite difficult to scratch the cornea with the speculae as you look up to put it in the bottom and down to put it in the top keeping the cornea out of the way, but can happen on removal more easily (people tend to squeeze). There are multifactorial reasons for 'abrasion' post or pre injection.

We are indeed human, and will always strive to do our best, and I will always administer an injection as I would like it done.

I was saddened by replies to your original post, there appeared alot of negativity towards injectors.

We can only do our best.

[rosyG in reply to Hidden]

Interesting as I wasn’t asked to look up and look down. My feeling, and I worked in the NHS when younger, is that refresher courses would help this particular nurse. I think she has given many injections but certainly has forgotten the minimum conversation requirement to reduce risk of serious infection

As patients, we need to feedback to staff so that standards remain high and we are not put at extra risk. All other injectors have been excellent as I’m sure you are too

[Hidden in reply to rosyG]

indeed maintaining high standards should always be at the forefront. A refresher is never a bad idea and things do change - the new Royal college of ophthalmologists guidelines Feb 2018 on intravitreal injections is available to read.

[rosyG in reply to Hidden]

Thankyou I’ll have a look !

[Hidden in reply to Hidden]

I am sure you all do your best, especially since you are so hard-pressed for time and there are so many of us. I am grateful for the treatment as it is preserving my eyesight as long as possible. But there are differences between injectors. Out of 9 injections I have had 7 different injectors and the experiences were different with each one. On two occasions I felt no pain at all during the injections, just a dull pressure after the anesthetic drops had been placed in several places of my eye. On two other occasions I was ready to jump of the couch. It certainly made me squirm. Thankfully it only lasts a few seconds. But as you said, you are doing your best and I am quite sure that no injector sets out to hurt a patient carelessly or purposely. So keep up the good work and THANK YOU.

[Hidden in reply to Hidden]

No thank you. Take care and good luck.

[yotboy in reply to Hidden]

This is the first I've heard of any negtativity towards injectors!

I'm sure I am not alone in saying that without doubt the injectors - without exception in my 40+ injections- are firmly in the group of the loveliest most caring people I know!

Kepp up the excellent work!

[Hidden in reply to Hidden]

Hi wheezyl, re any negativity - we only report here to each other what our actual experience has been. I haven't seen anyone tar all injectors with the same brush.

Of course people can only do their best but like any profession some are better than others and patient feedback is a vital component in support of continuing professional development - especially as any substandard performance may result in actual harm to a person. I always thank my inj and nurses when they do a good job but the fact remains that there is a variation.

I'm glad you are so caring, empathetic and conscientious and most probably in the majority. Thanks for choosing this field of work - we are very grateful!

[maryparry]

Good for you, of course the cases of AMD are growing dramatically and the staff to help are not

[Hidden]

Well done, glad you got treatment x

I would be interested in any info you were given on brvo .

[RosMacularSociety Partner]

Dear rosyG,

I am glad to read that the hospital has identified the cause of the problem and that therefore a repeat can be guarded against in the future.

Kind regards,

Macular Society helpline

0300 3030 111

[rosyG]

Thank you for your help Rosalyn.

I will take the letter and ask for care inserting the speculum and taking it out- thanks to Wheezyl's advice on removal

[Catseyes235]

So glad you persevered and passed on info. Moorefields was like a second home when had thyroid eye disease.

I had absolutely no pain - in fact didn't know it had been done - with first injection. Subsequent injections have been with different nurse each time. I asked if that first nurse had left but no - she was now the leading nurse practitioner and in fact did my injection. Not as pressure free as first one but she doesn't use clamps. She sticks a patch of sticky backed papery stuff over eye then opens a slit in the middle which holds the eye open.

I suggested that she does more training sessions with the rest of the staff. I do think we need to mention more any pain or discomfort . I met someone who had been having injections for years and just expected 2 days of discomfort after and had never used hypomellise drops herself after as no one had suggested this and she never complained!!

Good luck to all of us!! Two weeks to next injection and start to count down the days . .silly I know but there you go.

[rosyG]

- Ive been lucky as only soreness until the last one! The pain was exceptional so I will take the A and E letter re corneal abrasions and ask them to be extra careful!!