My husband experienced heavy spontaneous nosebleeds every other day during most of December & also a persistent dry cough with chest discomfort which we thought was because of the cough &, leaving him very lethargic and anxious. Our GP surgery advised us to go to A&E for nosebleeds. We visited A&E twice & following examination discharged him with no treatment. In desperation we saw private consultant who diagnosed aneurysm at rear of nose and cauterised it immediately. During January my husband felt tired & listless with pains. He already had an ECG at GP surgery which was negative. He was referred to hospital for ECG and they retained him immediately, placing him on list for urgent triple bypass. I looked at various websites for info on nosebleeds (aneurysm) & heart disease & found various references with possible links. I wrote to the hospital to complain that their A&E did treat him which is why we went private at a cost of £350. They wrote back saying their A&E did not treat him as they could find nothing wrong and didnt think he had lost alot of blood. They also stated there was no link between the nose-bleeds & the diagnosed sudden heart problem & their specialist consultant questioned where I got the information from, saying there was no link with nose-bleeds and coughs to heart problems. All I wanted was an apology! Surely the websites which gave me the information cannot all be wrong?
The only link with the circulatory system and nosebleeds that I am aware of is high blood pressure. High blood pressure over time can be a risk factor for heart disease or other heart problems. Blood being very thin from Aspirin or Plavix can also be a problem. Obviously there are many other unrelated factors which can cause nosebleeds including blowing it too hard.
When at A&E was it made clear to the Doctors what all his symptoms were?
Yes - we told them he had a dry persistent cough, felt very tired, spontaneous nose-bleeds virtually every other day & although the blood was pouring from the front, just as much was flowing down his throat, causing him to 'cough' it up as well. It was horrendous, we didnt know whether it was just from his nose, or whether he was coughing up blood. He was not blowing his nose, the nose-bleeds happened at any time, i.e. midnight, 3 - 4 am or when he got up. On the first visit to A&E doctor said his blood pressure was above normal but not dramatically high to cause concern, during second visit to A&E doctor took blood levels, was not concerned because blood level appeared normal and advised him to see our GP for referral to ENT. Both doctors were told he had a cough and he constantly tasted 'salty fluid' (which is still happening). The nosebleeds continued up to 21st December just before Christmas, the nearest appointment offered was for January, therefore we went private because we did not want the grandchildren to witness the awful blood scenes, thus the reason for going private to try to get something done. In reply to our complaint, the hospital said the doctors could not see the problem; when we went private the consultant had no problem diagnosing the problem immediately, explaining it was an aneurysm at the back of the nose which kept building up and bursting; he cauterised it immediately and our appointment took all of 45 minutes.
If there were unexplained bleeding, it seems the problem should have been diagnosed before discharging. How could it have been missed if if there was bleeding at the time? At least there should have been a referral to eye, nose and throat specialist. You won't get an apology because that would indicate having made a mistake.
I knew I would not get an apology. I just feel very angry! As far as the hospital is concerned they are saying our GP should have referred him to ENT. The GP did, but due to impending Christmas, the appointment could not be made until January. I dreaded the thought of continuing spontaneous nose-bleeds throughout Christmas/New Year with young children present. In direct conversations with extremely worried close family, & friends & acquintances who were (and still are) aware of my husband's experience, their reactions are the same - bewilderment that A&E did not treat on both visits. The first doctor recorded that he could find no bleeding source on examination, altho he did see a small blood clot and that my husband was discharged with sensible advice (i.e. no coffee, no tea, no chocolate). The second doctor recorded that he found no source of bleeding (therefore nothing to cauterise) and his haemoglobin level showed he had not bled excessively. (It appears bleeding intermittently over 3 weeks is not considered excessive - I threw out two lots of bedding/pillows etc where one side was covered in excessive amounts of blood when he bled unexpectedly during the night)
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