Need a doctor in UK for Lidocaine injections

[prodromos]

Hi, six months after my left-side thoracotomy I was yesterday told by my surgeon (USA) that I need to get Lidocaine intercostal nerve-block injections for a persistent pain issue I'm having. So, I need to find someone in UK who has experience on this type nerve-block (intercostal Lidocaine injections on the thorax). Any recommendations?

[Bananas5]

Probably being a bit slow here but are you saying you live in USA but want to come to UK for this procedure?

Paying for it privately I assume?

x

[prodromos in reply to Bananas5]

Sorry, I missed mentioning. I live in UK. Just went to USA for my surgery. It was my forth aortic surgery and it was quite complicated. So, now I'm back and in need for what I mentioned above.

[Hidden in reply to prodromos]

It may be a problem with you having surgery in the UK as you have been seen as a Private Patient in the UK so you may need to have insurance for the completion of your treatments, you will need to contact your UK GP and He may suggest different treatments that are performed here. You will need to arrange both doctors to arrange what may be required.

BOB

[Bananas5]

So you will have a GP here then who can refer you? That or the pain clinic is your first port of call. Well you have to get a referal through GP to see pain consultant.

x

[prodromos]

Yes, I know about the procedure. However, a cardiologist I am in contact with here, suggested that I ask other people who have had this treatment and see whether I can find a name of someone who knows how to do it with good results. Then we could get a referal to him. Going private could also be an option since my current condition (excruciating pain) needs treatment the soonest. Pain clinics usually start with medication which my surgeon prefers to avoid at first.

[Bananas5]

Seems an odd way round. Doing what your surgeon wants rather than trying tried and tested meds and altrnative therapy. If you did find one there would be a waiting list/ Yje excellent one we have up here is in Glasgow and last heard the queue was 18 months.

People who come to this site all have degrees of pain from horrendous tto horrendous +++++. Hopefully with the knowledge and experience we all have we can help and support through difficult times.

I can give you names of good surgeons across the countty but you will have to go through the assessment procedures and wait like anyone does.

x

[prodromos in reply to Bananas5]

Please, do so; thanks. Any info at present is of great value. I would appreciate it if you could give me those names and any other possible help for my problem.

[Hidden in reply to prodromos]

As Paton has mentioned and you have agreed you could go private as I mentioned before. The system here at this time is creeky to say the least and to be honest with having treatments out of the country it may be problematic to have work done in this case on the NHS. The waiting times can be long even for continuous treatment plans. All this will need to be discussed with your GP in the UK or possibly if you can get transferred across into the Private Sector, try calling medical insurance Companies that you have possibly used in the USA. This may be the quickest way to join up treatment plans. Are there any easier ways of administrating your medications, That my work out easier for you to get treatments here as you will need to be close to where you want treatment and other easier options may be given across in the UK.

BOB

[prodromos in reply to Hidden]

Thanks Bob. I’ve already attended my first post-op follow-up last month at Royal Brompton where I was referred by my GP. The problem is that by then I thought my pain was not of an issue, but checking the literature and speaking with other patients and med Profs I realized that if it remains under-managed (I’m taking nothing for it now) it could lead to chronic conditions. So, when I had my app with the cardiologist at RB I said nothing about my pain. Finally, I contacted my surgeon in USA and he suggested Lidocaine intercostal injections as being my only option (he is highly not recommending any meds). That’s how it all started. I understand that going through NHS it will take a long time before I get any treatment, so that’s why I thought of private, too.

[prodromos]

Just spoke with my cardiologist friend again. He says that what we are looking for is private treatment. So, please, if you could help me on this.

[Mockingbird]

Your GP would have the names of good cardiologist and if you said you wanted to go private he could refer you. However if you got a letter from your cardiologist in the US saying this was the treatment he wants used I don't see a doctor refusing the treatment. Best place to find a good cardiologist even private is your GP.

[prodromos in reply to Mockingbird]

To be honest I didn't think that my GP could help me on the private field, too. Thanks for the suggestion. I will definitely ask him about that. About being referred to cardiologist, as I said to BOB above, I’m already being seen at Royal Brompton by the cardiologists there. Also thanks for the advice on obtaining a letter from USA. If this works, then I will save a great deal of time.

[Hidden]

You will need too p.ay for the treatment as we have no health agreements with the USA.

Why do you need treatment here are you coming for a holiday ??

There are Pan Clinics here that I suppose would put you in contact with a surgeon.

Most General Hospitals will have a clinic that will do the injections, however you will need to contact a clinic before you come across, I would imagine you will need to be able to show records of your condition. and your Specialist in the USA will most probably know where to apply for treatment

BOB

[prodromos in reply to Hidden]

I had 4 aortic surgeries. First 2 in UK under NHS. However, I was away for a few years and have just returned a year ago. That’s why I had my last 2 surgeries in USA. I’m a little lost with this “injections issue” now, though.

[Bananas5]

I am more confused now.

Are you saying you don't suffer chronic pain NOW but having read the leaflets you may in the future?

You won't get any surgeon to treat a maybe.

Secondly why is your surgeon so against any drugs even pain relief when you may need it?

x

[prodromos in reply to Bananas5]

Following a surgery, any severe pain that persists more than 2 months without any significant change is considered to be chronic, but if it's treated on time it can have great to full relief. In my case what I was told I have is called PTPS (Post-Thoracotomy Pain Syndrome), which is found in up to 80% of patients undergoing such an op. Therefore, what my physicians are aiming is to avoid this condition becoming permanent. My pain right now (I'm new in the field of consistent pain), is such that affects my daily duties, can't drive, can't really sleep. I don't know if that is considered to be serious, but my life has never been like this before. However, what matters for me is to make sure that I don't "miss" any chance of doing something that will make things better in a long-term perspective.

My surgeon has as a principle not to give any pain meds before he has tried other options that may help. I go with it... It did work in the past.

[Hidden]

The pathway on the NHS if you are suffering Chronic pain would be an appointment with pain clinic. They will not assume that you may have pain as pain medications become ineffective over time. The RB will I suppose take their pathway as treated in the UK. That may be different from that of the NHS. as you are paying the bills

You have now returned, a treatment plan will have been worked out for you and will be having you back in if the need arises. This may be a review several times a year depending on your needs. You will I imagine not be given a plan for pain medications that may not be required. Again I will bow to decisions made by your Specialist in the UK. as the situation is different here from that of the USA. Good luck with your treatment.

BOB

[prodromos in reply to Hidden]

As I mentioned above I've already attended my first post-op follow-up at RB and my next one is scheduled for July 2016. So, since I haven’t mentioned anything to them about my pain at my previous app I guess that now I have to go to my GP again and ask for a new referral regarding my pain issue.

By the way, I’m not being seen as a private patient at RB.

[Hidden]

See your GP, if required He will refer you to clinic