Is one entitled to one’s health records from a private hospital? I am now retired and can no longer afford private health cover. I’m being treated on the NHS for a heart condition and would like my private records to be made available to the NHS.
Keith Basson, Warrington.
In a word: yes. The data held in your records is your data and both the private hospital where you were treated and the practitioner who treated you are legally obliged to provide you with that information.
It is possible that part of your records is held at the hospital, while your consultant will also have copies of some of your data — and there may also be a degree of duplication.
In any event, make your request in writing, initially to the medical records officer at the hospital.
A full set of records will include reports of investigations such as X-rays and other scans and laboratory tests, as well as clinical notes from your doctors.
The data held in your records is your data and both the private hospital where you were treated and the practitioner who treated you are legally obliged to provide you with that information, writes Dr Martin Scurr (file picture)
If there are no notes in the file when you receive it, write a letter to the consultant to request a copy of the notes he holds.
Some organisations charge a fee for providing copies of medical notes, which I think is rather irritating. Given what the hospitals charge, they should really provide the service for free, or at least ask for only a very minimal fee. (Many level excessive charges for sending the files, which, in this computer age, cannot take too much admin time.)
You may also be requested to collect the files, rather than entrust them to the post. Most facilities will not send such documentation by email on account of the need for confidentiality and the potential problem of them being hacked. When it comes to getting hold of NHS hospital records, contact the records manager, or patient services manager, at your hospital trust.
For the past 15 years, I have experienced an intense pain in my gullet, often brought on by eating or drinking. It can cause hiccups for a short while, but these usually end within minutes.
However, 18 months ago, the pain was so intense I briefly passed out. Recently, it happened again — this time resulting in two cracked ribs and a black eye.
Blood tests and an ECG have found nothing.
Ian Hughes, Bromsgrove, Worcs.
What an alarming turn of events. I think it’s most likely that the bouts of pain are due to irritability of the oesophagus — the muscular tube linking your throat to your stomach — because of acid reflux.
I note that you do not seem to have suffered the more typical symptoms, such as heartburn (a sense of acid heat or discomfort in the region of the oesophagus — this can occur anywhere between the bottom of the sternum and the back of the throat), acid sensations or difficulty swallowing. So I think your oesophagus is being irritated by so-called ‘silent’ acid reflux.
Acid reflux is due to the valve at the top of the stomach malfunctioning, allowing acid to pass up into the oesophagus.
Studies indicate that acid reflux is the most common cause of oesophageal pain, even when there are no other obvious signs of reflux, such as hoarseness.
The painful sensations you describe occur as a result of acid — or hot or cold food — triggering pain receptors in the oesophagus wall. This, in turn, can at times cause abnormal movement or spasms in the muscular walls of the oesophagus.
One study of more than 900 patients investigated for chest pain, found that 28 per cent had abnormal movements in the oesophagus and 3 per cent had actual spasms.
So why did you faint? I suspect an intense spasm of the oesophagus may have over-activated the vagus nerve, which runs from the neck down into the abdomen and supplies both the oesophagus and the heart.
This would then trigger the heart rate to slow and blood pressure to drop, and the resulting brief lack of blood could have caused you to faint — what we call a vasovagal episode.
A trial of acid suppression is called for. This involves taking a proton pump inhibitor (for example, omeprazole, 40mg twice daily) for eight weeks to suppress acid production by the stomach.
Most physicians would prescribe this after an investigation by endoscopy, which is where a camera is put down the oesophagus to inspect the lining. However, your doctor may decide to prescribe this anyway.
If acid suppression does not help, I would talk to your GP about referral to a gastroenterologist with an interest in oesophageal function for further tests to confirm acid reflux (by measuring the levels in the stomach) and manometry (pressure-testing to see if there are spasms or any other unusual movements in the oesophagus).
These additional investigations would help to pin down the exact cause of your frequent bouts of pain.
In view of the potential for sudden collapse to cause serious injury, I urge you see your GP promptly.
In my view… Men fear it’s cancer, but it’s more likely a benign prostate problem
There is no doubt that, with high-profile examples such as Stephen Fry and growing awareness, prostate cancer is now much more on men’s radars.
Clearly, greater awareness is vital. But, more often than not, men’s urinary problems are not the much-feared cancer.
About 50 per cent of those aged 50 and 80 per cent of those aged 80 have urinary symptoms due to benign prostatic hyperplasia (BPH), a non-cancerous condition where the prostate gland becomes larger.
The symptoms vary over time but gradually worsen over years, and include hesitancy (difficulty starting), weak stream, a sense of incomplete emptying and getting up at night more than once to pass water.
What worries me is that many men become concerned these symptoms are a sign of prostate cancer, when most men with prostate cancer have no symptoms — or only minimal ones — until the cancer has spread, commonly to the skeleton. Then there is bone pain, weight loss and occasionally pain in the groin area or blood in the urine.
About 50 per cent of those aged 50 and 80 per cent of those aged 80 have urinary symptoms due to benign prostatic hyperplasia (BPH), a non-cancerous condition where the prostate gland becomes larger (file picture)
The confusion arises because the conditions may occur in tandem, and age is the main risk factor for both. Screening (being checked to see if there is cancer when there are no symptoms) is not as simple as having the blood test for prostate-specific antigen (PSA), which leads to too many false positives and a small incidence of false negatives.
The best way to screen for prostate cancer is with a digital rectal examination by a doctor, supplemented by the PSA blood test. Abnormalities should be followed up by an MRI scan — and a biopsy if there are any suspicious areas.
It is no longer considered good enough to carry out a biopsy without an MRI first. In fact, it’s expected that later this year, MRI scans will officially become a first-line investigation.
The message is, be aware. And if you do need screening, ask your GP about a scan.
For further information on this issue, visit the Urology Foundation.