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Vinay

Brief Outline: Vinay was diagnosed with a urinary infection but, when the pain continued, he found it hard to get tests done because of confusion over where he was registered. He went to see a GP several times in his home and university cities, as well as to A&E. Calcium deposits and kidney stones had been causing the pain.
Background: Vinay is a postgraduate student and lives in a shared house. Ethnic background / nationality: British Indian.

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Vinay rarely saw the GP as a child as he was usually healthy. More recently, he had lower back pain while at university, which involved ‘toing and froing quite a bit’ between different surgeries in his home and university cities.

The pain started after Vinay finished his undergraduate degree and went back home for the summer. He was diagnosed with a urinary infection but, when the pain continued, he found it hard to get tests done because of confusion over where he was registered. He went to see a GP several times in his home and university cities, as well as to A&E. He had pain around the lower back and sometimes his chest, and found it increasingly difficult to sleep. 

Vinay encountered lots of problems trying to have a sonogram arranged (an ultrasound that helps doctors diagnose and treat medical conditions). The GP in his university city felt that it should be arranged by the GP in his home city as he’d been registered there. The GP in his home city said the scans should be done in the university city where he was living. When he finally got the scans done after re-registering at the university city, the test results revealed no problem. As the pain continued, he saw an urologist in his home city, who finally referred him for another sonogram. The results showed that calcium deposits and kidney stones had been causing the pain, some of which had passed through his system.

It took several months for Vinay to be diagnosed, during which time he had a lot of pain and no ‘explanation or no one offering to do anything’. He also had to ‘travel on a train to go to another city to go get checked out, to be told the same thing, to go back to...another city’. 

Around the time of interview, Vinay had been seeing the university mental health advisor because of low mood and anxiety. He found it helpful ‘having someone to vent to’ and hoped to continue seeing her after the summer holidays. He was also trying to ‘keep as positive as possible’.

For Vinay, improving health care was ‘all about sympathy’. He felt that health professionals should be welcoming and reassuring but understood the tremendous pressure on GPs to meet targets. In terms of mental health, Vinay encouraged young people to ‘channel their emotion and their feelings into some creative outlet or even some physical outlet, like a sport’. 
 

Vinay was wary of speaking to a GP about mental health and seeing a different doctor every time. A counsellor is more of a specialist in this area than a GP.

Vinay was wary of speaking to a GP about mental health and seeing a different doctor every time. A counsellor is more of a specialist in this area than a GP.

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Did you know that you could see the GP about things that weren’t physical pain?

I think genuinely I didn’t know that until I did my degree. I knew that the first point of call was a GP if you’re going through mental health issues, or psychological pain. But I didn’t know that until I’d done my degree. I didn’t know that was the first point of call.

Yeah, for all those issues.

Yeah.

Yeah, so one organisation has made this flyer to make people aware of all the different issues that you…

Right.

…could see, go and see a GP about. Did you know about any of these? Or is it quite new information?

I didn’t, I didn’t. Yeah some of these I, in my degree they said that the doctors would see. But the thing is, is I think I’m a bit dubious whether it would work because I think there’s certain professions that would probably be better equipped like a psychologist or therapist or counsellors. Because I think the doctors are so back logged with all these other problems they, some of these might be a bit too… it would be a complete different direction and maybe not of their speciality.

Yeah. Are you more likely to go to the doctor for physical pain?

Yeah.

And if you were having any other issues, maybe some that are on this list or other ones, you wouldn’t go to the GP?

Well I had, I’ve had a few obviously psychological issues as well. But I’ve been to see, I went to see the Uni mental health advisor for that because I felt that she had a psychological background. She kind of had a speciality and it was something that the Uni provided for me. So I thought it was just the most fitting,

Yeah, and that was completely separate to the GPs, it’s completely independent,

Yes.

Yeah, so a lot of GP’s surgeries do offer counselling and things, had you heard about that, you know they could, they can refer you to a counsellor. Had you heard about any of these services?

I think it had been mentioned, but I think with my experience of the kidney problems I didn’t want to be, especially when it’s mental health, I didn’t want to be placed on somebody else’s hands, and then somebody else’s. I thought it would be just easier to go to see one person straight away.
 

Tests showed calcium deposits and that Vinay had had kidney stones. Not knowing what was causing the pain ‘can almost magnify that pain and that experience’.

Tests showed calcium deposits and that Vinay had had kidney stones. Not knowing what was causing the pain ‘can almost magnify that pain and that experience’.

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I felt severe pain in my lower back. It was like stabbing pain as well as dull pain and it was always uncomfortable. It felt like it was moving around, like the pain would be moving from place to place in different places, different regions, and when I went to sleep at night it was very difficult. As a, whatever side I slept on, the pain seemed to transit, moving around quite a bit.

I got the results almost straightaway. They told me, “Oh yeah there’s a few calcium deposit’s there and we think they’re indicative of stones. You might have got rid of some of them.” Yeah it was almost instantaneous. 

Yeah. Did you know at all before the point that they confirmed that it was kidney stones, that it could be kidney stones or…?

I think for a large portion of time I was just unsure about what it was. I just knew that I was having a lot of pains in my kidneys. A lot of burning feelings and I didn’t know what it was I think for a while. I kind of guessed it was kidney stones, but your mind can sort of play on it, and when it, when you’re in pain, you can sort of exaggerate and you don’t know what it is. And I think the unknown is something that can almost magnify that pain and that experience.
 

The GP in Vinay’s home town felt he should see the university GP. The GP there told him his records were still at home. It took months to find out what was wrong.

The GP in Vinay’s home town felt he should see the university GP. The GP there told him his records were still at home. It took months to find out what was wrong.

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I think it was when I got to about June, July time last year and I started getting pain, which they diagnosed as being kidney stones. And I kind of wanted to get to the bottom of what that was at the time, figure out what it, what was causing the pain because I didn’t know, it was just, just pain. So to try and get some insight into it and also try and alleviate some of that, was the main reason why I went.

Was that around June-July last year?

So yeah, just after I finished my degree.

Degree, yeah. Were you back in your home town or still at the University City?

That’s where the difficulty was, is I had the, I had the issue from that point until I’d gone to Uni, so it was a mixture of both places, which made it difficult because what happened was neither GP practice was willing to help me as such because they were putting the issues on the other one. 

So they were like, “Oh you were resident in [at the university city] so that practice should handle it,” whereas the practice in [my university city] said, “Well you actually live in [name of home town], you should handle it there.” So I think for a long period of time, for months, nothing actually happened. And neither practice was willing to sort of do much.
 

Vinay understands that receptionists work under pressure and have to deal with complaining patients. But it’s important to be sympathetic and welcoming.

Vinay understands that receptionists work under pressure and have to deal with complaining patients. But it’s important to be sympathetic and welcoming.

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Do you go to a reception desk or do you have to tap into a machine?

There, I think there’s a bit of both really. Some places obviously there’s a machine that you can find yourself on, and some places you go to the desk and check in.

Yeah. How, what’s your experience been of the receptionists at the desk, you know the GP’s surgery?

Some of them are, some of them are okay and some of them can be very, very cold I think in many cases. But, like I say, I understand a lot of pressure is put on them and they’re seeing so many people who all are complaining about their issues, so I can understand that they almost shut off to an extent.

If you were going to give any message or advice or tips to them, say they were going to have some training or something like that, you know in terms of improving, what message or advice would you give to the receptionists?

The only thing I can say is they have, I can understand the need to almost shut off and not become too involved. But I think with the same token with the doctors, they need to sympathise, that there are people who have got issues. Some of these issues may be just benign and not that important in their minds, but I think pain is subjective and if it’s something that’s bothering an individual, they just need to be a bit more sympathetic towards it. 

And I think if they’re maybe a little bit more welcoming, even if they don’t generally mean it, if they come across originally as more welcoming I think for some reason that can be more comforting. And some of the negativity and some of the feelings that you have that are synonymous with pain may, you know, lessen. And I think you might feel more comfortable being in the doctors’ environment rather than having a cold sort of, “Yeah, just sit down.” Which some of them may do.
 

At a younger age, one of Vinay’s parents went with him to the appointment. Later there was ‘an understanding’ that he’d want more privacy.

At a younger age, one of Vinay’s parents went with him to the appointment. Later there was ‘an understanding’ that he’d want more privacy.

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Did you go by yourself or did you go with your Mum or your Dad or somebody else?

I think Dad drove me down there, went with me as well.

So both of you went to the appointment. So can you remember what happened at the appointment? You spoke to the doctor? Was this a GP you’d seen before or somebody new?

Yeah, someone I’d known, yeah.

Someone you’d known, someone you’d seen before?

Yeah.

At a younger age?

Yeah.

And when you spoke to the GP were you doing most of the talking or was your Dad doing a lot of the talking?

I did the talk, he actually, Dad waited outside. So he just drove me down there. I did most of the talking. GP did a little bit, just kind of listened.

And is that how you usually have your appointments, where say your Mum or your Dad drive you there, and they wait outside while you go inside?

Yes.

Yeah. How, has that always been the case?

I think when I was younger, they’d come in with me. But I think there’s a certain point where obviously, as we got into adolescence, they gave us more privacy. And then we’d tell them what we want after we leave.

Yeah. So did they, did you kind of talk about that? We need more privacy now, or is it something they said, “You’re old enough to now…”

Yeah I think it was just a given, an understanding.
 

Vinay was confused about which GP he should see and where his medical records were held. He was referred to hospital in his home town.

Vinay was confused about which GP he should see and where his medical records were held. He was referred to hospital in his home town.

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So how come you went back to [your home town]? Was it because you happened to be there or because they said your records are there or....

So they said, “Your records are tied up in [your home town],” which I found peculiar ‘cos I thought what had happened was my records were being sent to [the university doctor] from being registered there. But apparently they said, “Oh no, your records are in [in my home town] and you have to get it sorted through them.”

Yeah. So you went back especially to get that sorted?

Yes.

So you then, did you then go back and see the same GP?

I saw a urologist.

Urologist. In the hospital?

In the hospital.

Yeah. And what happened there, can you remember the appointment?

He was quick to do the sonogram. He straightaway, because he knows, he realised that I’d had it for a period of months and I was in pain. And he kind of just said yeah, “We’re gonna do the sonogram for you.”

Yeah and did he, did you get your results from that straightaway or did you have to wait for a few days or?

Yeah I got that, the results almost straightaway. They told me, “Oh yeah there’s a few calcium deposit’s there and we think they’re indicative of stones. You might have got rid of some of them.” Yeah it was almost instantaneous. 

Yeah. Did you know at all before the point that they confirmed that it was kidney stones, that it could be kidney stones or…?

I think for a large portion of time I was just unsure about what it was. I just knew that I was having a lot of pains in my kidneys. A lot of burning feelings and I didn’t know what it was I think for a while. I kind of guessed it was kidney stones. But your mind can sort of play on it. And when it, when you’re in pain, you can sort of exaggerate and you don’t know what it is. And I think the unknown is something that can almost magnify that pain and that experience.
 

When Vinay fractured his finger, he was given an x-ray and had his finger plastered. He was disappointed when he couldn’t get a follow-up appointment.

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When Vinay fractured his finger, he was given an x-ray and had his finger plastered. He was disappointed when he couldn’t get a follow-up appointment.

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I had an issue when my finger was broken or fractured. And that was the day before Valentine’s day. And the incident occurred and I ended up going in a taxi to be taken to [hospital name]. And they got that sorted quite quickly, within three hours they could see obviously the blood there and the finger was out of place. And they did an x-ray and they told me it had been fractured. And they just told me to bind it together. So that was the main thing they told me to do but...

Did they bind it together?

They bound it together originally. But after that they didn’t give me a fracture clinic appointment. And I rang through on many occasions and there was no service. There was no-one to even pick up the phone. So I couldn’t, I didn’t have any way of getting in contact with the fracture team. 

So I actually had to bind it myself for the next five or six months and, yeah I rang, I tried to ring through. I went to the hospital and they said to me that I would have to get checked out again, just to go by their services again, and I didn’t. I couldn’t be bothered with it. I sort of just taped it myself and it’s kind of healed. It’s kind of sort of a little bit out of place but it works, that’s the main thing.

Did you go back to the hospital again then after....

I did go back in, when I tried to, obviously I showed them, “Look, clearly there’s a break here. There’s this and this, can you put me through the referral with the fracture clinic again.” They were adamant that they would do and I still didn’t hear anything from them for a while. And I think I got quite frustrated and just, because I’d carried on taping it myself, because I had my, I was doing my Masters and working and there was a lot of things on at the time, but I just couldn’t, didn’t have the time to chase it up.

Yeah. Did you ever go to the GP at all about that or...

No, no. I knew what, obviously it was a fracture and it just needed to be bandaged up.
 

Vinay had an ECG and urine tests, and was given painkillers. Later he was referred by his GP to see a specialist (urologist).

Vinay had an ECG and urine tests, and was given painkillers. Later he was referred by his GP to see a specialist (urologist).

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It got to the point where sometimes I’d be having chest pains as well and I didn’t know if it was all linked.

Yeah. So when you went to A&E the first time can you remember what happened?

They put me on the, they put me, they did an ECG when I entered and they tracked, they said “Oh your heart rates a bit quick,” or whatever it was. And then they put me through the paces of going to get seen. But they just, they said that it wasn’t indicative of kidney stones, through the urine tests that they did or something, and then they just sent me back off and said, “Take some Paracetamols or Ibuprofen or something.”

So did you do that? Take painkillers?

If it really hurt.

Yeah. And then at, when was the next time you went to A&E? Did you see your GP in between at all?

Yeah, I did.

Yeah. So did you, when did you go back? After A&E when did you go back and see your GP?

So the second time I went back to A&E was closer towards the point where nothing was happening and it still, the pain was still present and I was losing sleep over it. So I went back and saw them to try and, a last ditch effort to try and push them to try and get some testing done.

So then after that did you go to A&E again?

No, then it was going, from that second point I went to [my home town], and then tried to go back and see the urologist there.
 

When something ‘means a lot to you’, it’s important to see that the health professional is ‘engaged and paying attention’.

When something ‘means a lot to you’, it’s important to see that the health professional is ‘engaged and paying attention’.

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If the GP’s surgery had a telephone line that was specifically for people around your age group, where they could talk about mental health issues or anxiety about anything stress... about anything, exams or any of the situations, would you find that helpful, or do you think that you would still prefer to talk personally, you know face to face with somebody?

I think in some issues, it would be nice to have the anonymity. But in some other issues I think there’s a certain amount of, when it means a lot to you, you want to see if that person’s engaged and they’re paying attention. And I don’t know if you can gauge that over a telephone call because somebody could be just half listening to your issues, which could leave you feeling more frustrated and alone.

Yeah would you feel comfortable ever emailing, whether it’s a counsellor or a GP, about what you’re feeling, and then they email you back?

I think I’m more terrible with emails, I don’t reply as much. So I think yeah I don’t think it would work for me.
 

People can have a positive experience of a consultation if they feel that the GP has listened and empathised, even when the appointment is quite short.

People can have a positive experience of a consultation if they feel that the GP has listened and empathised, even when the appointment is quite short.

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I think people feel that when they come into the room, patients feel that energy, they feel like that, they’re only there for a second and that they almost are being passed off. Once that energy is removed and people feel like they are being listened to, I think it would really greatly improve the service of GPs.

Yeah. So it’s more, is it do you think about how they come across rather than the time of the appointment?

I think it is, I think even

Should the appointment times be longer?

Even in the time, the appointment they have, feasibly I think the time they have is probably the most feasible. But even in that time, if they can use that time to make that person feel more like they’re being listened to, and they sympathise with that individual, I think the person is more likely to have a positive experience in there. And it’s more likely to help, you know, rather than just sort of being so indifferent to it or being reserved from it.
 

It’s understandable if you don’t want to tell your parents everything about their thoughts and feelings. It’s good for parents to be supportive of that.

It’s understandable if you don’t want to tell your parents everything about their thoughts and feelings. It’s good for parents to be supportive of that.

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I know there is a part of you that wants to share what you can with your parents and that’s perfectly fine. But I think you don’t have to feel like you have to say everything. I mean there are certain things that you are liable to keep to yourself if you feel better for it. 

Maybe your parents are in the situation where they worry too much, or maybe they get too over-involved and that might not help your issues. I think first and foremost you’ve got to have yourself and your own health at the first most important, you know, at the prominence for everything. And I think sometimes if your parents can suffocate or hinder that, it’s not a good thing. They’re supposed to sort of supplement it and I think that’s what a relationship should be. 

And I think the flip side for the parents, they should be more supplementary and understanding if their children don’t want to tell them everything, within reason. I think they should be understanding of that because they don’t want to be too, to encroach so much because that can make, it can make your, the individual feel that their issues are more so affecting them than they really are. And plus it can also be seen as someone being a critical parent rather than a supporting parent.
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