How a rapid self-referral helped prevent a serious appendix problem

A sceptical self-diagnosis

As a GP herself at Sloane Medical Practice, Dr Nicola Harrison is well aware of the need to keep an eye on potential health worries. It was a Sunday evening when she first started feeling pain in the right side of her abdomen. “I’d had a whole body MRI for cancer screening 9 days before, so I knew my right ovary and kidney were okay,” recalls Dr Harrison. Six months prior, she’d experienced pain in the same place over a weekend, which she almost went to hospital for, until it went away on its own after 2 days. Dr Harrison suspected her previous worry may have been appendicitis, but she wasn’t sure. “This felt exactly the same six months later, and was getting worse.” Dr Harrison’s pain continued to worsen overnight and she started vomiting, so she took Monday off work.

At first, she was still unsure if she really had appendicitis. “The pain wasn’t as bad as I had assumed appendicitis was”, she recalls. But as her other suspicions of what could have caused her pain were ruled out by her recent MRI, plus the additional new symptoms of vomiting, she realised that she needed to check in with an expert. On the top of her list of people to contact was Mr Ahmed Karim, a colorectal surgeon at The Lister Hospital. 

Dr Harrison had Mr Karim’s number from when she’d referred patients to him, so he texted him the details of her symptoms and how she was feeling. These symptoms were a cause for concern for Mr Karim, so he asked if Dr Harrison could come in to be examined.

Comfortable care from clinic to bed

Fortunately for Dr Harrison, Mr Karim had space in his clinic that day to see her. After being dropped off at The Lister Hospital by her husband around 4:30pm, Dr Harrison was guided to the clinic by Mr Karim. “He was very kind. He carried my bag for me because I was bent double in pain,” Dr Harrison recalls. Worried about Dr Harrison’s symptoms, Mr Karim admitted her for a CT scan and blood tests to assess her condition. While waiting for her scan, Dr Harrison was impressed by the attention to detail of the care team in making her stay as comfortable as they could. To give Dr Harrison some IV painkillers, the nurse and healthcare assistant inserted a cannula slightly above her wrist. “I’d never seen this before, usually they’re inserted into the back of the hand,” explains Dr Harrison. “But they told me it was so I could have more movement of my arm. Even that simple thing, giving me free movement of my wrist, was amazing.”

The painkillers soon took effect, which left Dr Harrison wondering if she really did have appendicitis as the pain almost went away. She was transferred into a wheelchair and taken to have her CT scan by a porter, who ensured that her comfort was maintained throughout. “He made sure it was the smoothest journey,” remembers Dr Harrison. “He knew that I was in pain, so he warned me of any bumps e.g. when crossing into the lift.” Dr Harrison had her CT scan around 7pm, and was wheeled back to her room to await her results. To her surprise, the results of the scan confirmed that Dr Harrison did have appendicitis and she was shortly called by Mr Karim saying that he was returning to The Lister Hospital that evening to perform her appendicectomy operation. 

From admission to surgery to back home, all in less than 24 hours

From coming in for her appointment; being admitted from the clinic; having her CT scan; to speaking to her anaesthetist and being prepped for surgery, it all took 5 hours – the very definition of a rapid referral! “It was the smoothest thing ever,” she says. By 9.30pm that evening, Dr Harrison was in for her appendectomy with Mr Karim. “I came to after the surgery and I felt good, and really hungry because I hadn’t eaten for quite some time,” recalls Dr Harrison. “They found me a sandwich at midnight!”. Mr Karim had even called Dr Harrison’s husband as next of kin that evening as she was coming around, to inform him that the operation had gone well, and he needn’t worry.

The team kept an eye on Dr Harrison throughout the night, checking her observations and offering her painkillers as needed. Before he started his shift the next morning, Mr Karim came to visit Dr Harrison at 7am and told her the operation went smoothly with no problems at all. 

By 2pm the next day, less than 24 hours since coming in for her appointment with Mr Karim, Dr Harrison was on her way back home. “I still can’t quite believe it was appendicitis, because in my mind it’s this excruciating pain,” Dr Harrison says. “But I was really lucky to have had it assessed and dealt with so quickly, before it ruptured.” Dr Harrison was advised to take two weeks off from work to recover from her surgery. “I didn’t think 2 weeks off would be necessary at first, as I felt so well post-op” she recalls, “but I really did need two weeks as I was exhausted.” 

Dr Harrison returned to work after her recovery period, with no long-term impacts to her health. Had she delayed seeking care, her experience could have been much more serious, with her appendix having the risk of rupturing. But through realising she needed treatment, and utilising The Lister Hospital’s Medical Concierge Centre, she was able to get the diagnosis and treatment she needed before it became a larger problem.