GCA treatment in A & E

[Trenny]

Has anyone with GCA gone to an A & E department for headache/eye trouble etc? What was their reaction? I would be very wary about going to one unless the symptoms were *very* bad and by then it might be too late to save my sight.

[DorsetLady PMRGCAuk volunteer]

Hi Trenny,

If in doubt - go!

That's where mine was diagnosed - unfortunately too late to save right eye, after 18months of no diagnosis. I had no idea what GCA was (never heard of it or PMR), unfortunately neither apparently did GP, but after 3 days of 'eye' problems was directed there by my local high street optician. Thanks to his suggestion, my left eye was saved.

In A&E after describing symptoms was seen by on duty ophthalmologist, who within half an hour had tested bloods, diagnosed problem, and within an hour of arrival I was downing 80mg of Pred!

My message to you - or anyone - is if you have any eye problems, especially if you already have PMR then A&E it is.

Not the nicest place to be, my late husband and I spent many hours there due to his heart condition - but it's really a no brainer!

[SnazzyD]

Hello,

I was diagnosed in A&E. admittedly the out of hours GP has phoned them with their suspicions (I had no previous history) about the burning in my temple and fuzzy long vision. I was picked out of the signing in queue by a doc who knew I was coming and after taking my history, I had 60mg Pred in my tummy within half an hour. If I had just walked in, I would hope the triage team would have seen the red flag symptoms and reacted accordingly.

Why would you be wary and only go if it was very bad? What is your concern/worst case if you did?

[Tonylynn]

If it is an eye problem then a hospital with an eye casualty department is probably the best place to go. Anyone diagnosed with GCA should make sure they know where their nearest eye casualty department is situated.

[PMRpro Ambassador]

I know of at least 3 or 4 people on the forums who I personally have told to go to A&E, who were correctly diagnosed and given pred at the correct dose level. There are others who were told by some of the "long established members" who had GCA themselves. A couple went and were rejected the first time so I sent them to a larger hospital which had a rheumy department. My optician in Scotland would send his clients with ?GCA directly to A&E, didn't waste time with sending them to the GP.

There isn't time to mess about - and evenings/night/weekends that is the place to go although a phone call to 111 in the UK might result in some assistance. In Yorkshire the paramedics are taught to recognise possible GCA and to treat them as a medical emergency - same as stroke or heart attack.

[Brantuk]

I've had three visits to A&E to get my eyes looked at since being diagnosed with GCA 18mths ago. Fortunately my local hospital has a rheumatology dept and a good eye casualty arrangement, so they are well versed and react reasonably quickly to provide the care needed - although it did entail sitting in a half day queue. If you suspect anything wrong with your eyes - any sudden changes - then go to A&E asap and insist on treatment if necessary - only one occasion I needed to up the prednisalone for a short while to a previous higher dose. Your eyesight is precious.

[Sho-Sho]

I went to A&E when feeling very unwell and with very bad headaches, it was a weekend and no doctor available! I had no visual problems, but I was admitted straight away and later that day put on 60mg of steroid, they kept me on for five days and had a temporal biopsy which proved positive.

[jinasc]

I have sent people to the A&E and told them if they run into a problem to insist on seeing the A&E Consultant. Only one ever encountered a problem and her companion insisted on the on duty Consultant being called. Problem resolved.

If they have the time, I also tell them to download the BSR guidelines and give them 3 links.

If it is a Saturday, I send them off to the nearest optician ...... then no problem at all, opticians generally ring the hospital, write a note and hey presto.

It was very different 10 years ago, now GCA awareness has been raised and the Fast Track system has been given publicity.

The three charities, run by volunteers have done sterling work and they all need support and members.......