Patient pain at arthritis cancellations

Patient pain at arthritis cancellations


Staff shortage leaves patients facing summer of suffering

Anton McNulty

A YOUNG woman with acute rheumatoid arthritis predicts that she and fellow sufferers will endure months of chronic pain and illness due to the cancellation of outpatient appointments in Merlin Park Hospital for the summer.
The HSE announced last week that outpatient rheumatology appointments for around 850 people in Mayo, Galway and Roscommon have been suspended for the summer due to staff shortages. Over 1,400 people are also currently on a two-and-a-half-year waiting list for the Rheumatology Department in Merlin Park.
Speaking to The Mayo News, 34-year-old Stacey Grealis, who suffers from an acute form of rheumatoid arthritis, said she was shocked and horrified when she heard of the cancellations.

Fear
The Ballycroy native, who needs crutches to walk, said her condition often causes pain that is so severe she requires hospital treatment. She does not know how she will cope now that  Merlin Park’s rheumatology outpatient service has been cancelled.
“The condition affects me every day and can flare up anytime. I have gone from an active young woman to a woman who is not able to walk without crutches and no longer able to work. If my shoulder joint becomes badly inflamed, it swells up my neck and my blood pressure goes through the roof,” Stacey told The Mayo News.
When such an inflamation starts, Stacey’s normal course of action was to phone Galway to get an appointment. It can take as long as seven days to get seen.
“The last time I rang them was on June 11, and they were not able to see me until June 18. I was still in chronic pain with my shoulder, and unable to get sleep it was so bad,” Stacey said.
Emergency cases will still be seen at Merlin Park, on a case-by-case basis, but Stacey fears that she will be left in pain for even longer the next time her condition flares up, now that the service has been reduced. “They were so overstretched before that it took them seven days to see me. Where I will come in the line now? Who knows,” she said.

Early diagnosis is key
Stacey was diagnosed in 2003 after the waiting list to see a specialist was so long that she sought private treatment. The waiting list now even longer, she says, and sadly, without early diagnosis, there is less chance of preventing the condition from worsening.
“I am very unwell, but if I had not got my initial diagnosis I would be a lot worse,” she said. “There are people who are very worried who have had appointments cancelled and who will not get appointments until November or December.
“There are currently 1,477 people on the waiting list in Galway. If you get a diagnosis and a treatment plan within three months you have a better chance of going into remission in the first year. There is research to back that up. People are very worried and frightened because of these cancellations.”
The condition Stacey suffers from not only affects her joints but also leaves her fatigued, stiff and she is not able to fight infection. She described how people with rheumatoid arthritis suffer from stiffness, and it may take them a couple of hours ‘to thaw out’ after waking up in the morning. The average age of diagnosis is 35, and women are twice as likely to be diagnosed as men.

Staff crisis
During questions in the DΡil, Labour Junior Minister Alex White said that a number of consultants will take up positions in Galway over the coming months, including one for rheumatology.
Stacey explained she has spent the last ten years ‘back and forth’ to Merlin Park and is not surprised by the cancellations, describing the hospital as in a crisis.
“I went to my last appointment for 4pm but was not seen until 7pm because the staff were so overstretched. The doctors and nurses are there from eight in the morning. They are doing their best for the patients, but they are not getting the support.
“I once had to go to Merlin Park, three times in one week because there was no bed. On one occasion, I was one of 44 people on trolleys in a corridor and I was told it would be best to go home.
“Alex White said there were three consultants, but I would disagree with him on that. One consultant is on maternity leave, one is a locum and the other consultant also looks after general medicine in UCHG. He has a lot of other responsibilities and spends half his time in the university hospital. It is an impossible task.
“If the consultant happens to leave Merlin Park, there might not be any services at all. A rheumatology nurse specialist retired in March and her position has not been filled, and they also need an occupational physiotherapist and a clinical nurse specialist. There does not seem to be any strategy for dealing with staffing,” she said.
A report in 2011 recommended that there would be nine rheumatoid consultants in the north west hospital region, with one consultant for 88,000 of a population. Stacey said the figure is now one consultant for 177,000, and she is calling on the HSE to deal with the problem.
“I am a member of the Mayo Support Group that has campaigned for a rheumatology service in Mayo but to no avail. If they provide a consultant and services to Mayo General, it will take the pressure off Galway and will reduce the waiting list and also the outpatient list. Considering the vast majority of patients are travelling from Mayo to Galway, it only makes sense.
“I would plead with them [HSE] to sit down and put a strategy in place to ensure there is appropriate waiting lists and to ensure people get the early intervention required to prevent long-term disability,” she pleaded.