Your NHS Stories Please

[outertrial]

Hello all. I used to be 'rugged' but I changed my name because when people googled me I was showing up on this gyne board. Sigh.

Anyway I thought it would be good to get together a thread of everyones NHS experiences. If youve had any experience of the NHS at all, most of us have had at least a GP appointment, then please take a few minutes to post it here.

I think this is important as for many of us the NHS is our first and only point of contact for medical problems and its either that or suffering in silence, which I think an awful lot of people are doing. So if we could get some sort of dossier going of what to expect I think it would do a lot of good.

I just dont have the thousands of pounds it would take to get this problem sorted privately so am trying to go the NHS way. To date I've seen:

1. A GP. Very helpful, referred me straight away to an endo  as he said it was a bad case.

(2 months.)

2. An endocrinologist. Said there was nothing wrong with my hormones and it wasnt a bad case anyway.Tried to talk me out of going further. Told me to come back in 2 months.

(2 months.)

3. 2nd endo visit. Confirmed there was nothing wrong with hormones. By this point I had already got a PS appointment.

(5 weeks.)

4. PS visit. Said I need lipo but I have to lose weight and go back in a few months before they will agree I can have it. No idea whether they do the procedure much or not, whether its a breast clinic or not, whether they'll give me the green light next time or not, or whether the PCT will agrree to pay for it or not.

So overall its not too bad bearing in mind its free, but I just wish there was someone at the start who would say yes or no, Im mindful throughout this process that all it takes is a no and Im back to square one, after having already cost the NHS a small fortune in tests and various professionals already. There is also the possibility that the surgeon who ends up working on me wont be experienced in the procedure and wont take enough out, which seems to be a common complaint. I am concerned by this as the PS I saw spent a lot of time warning me about complications so I suspect he will err towards the conservative when/if it comes to it.

A big plus for the NHS is that I do feel like Ive been treated with respect and kindness by all the people Ive seen. No one's accused me of timewasting or made me feel bad because of this condition though I have had to be firm about wanting surgery.  Seeing the GP was a huge weight off my mind and the endo visit cleared up a lot of question marks.

Time will tell what happens next. Over to you.

[phantom]

Hello outertrial

I think your experience is probably quite similar for many of us here.  As a medical rep, I deal with the NHS everyday and so from the start, I knew the NHS was not the best route to pursue for surgery for gynaecomastia.

Most cases of this condition are not pathological, ie. caused by something going wrong by the body such as hypogonadism.  Most men have some degree of breast tissue before we are born, so it it deemed to be 'normal'.  Unfortunately, some guys have more than others and it can become a bigger problem at adolescence as hormones ravage our bodies.  It's highly unlikely anyone would be offered surgery until after adolescence as for many guys, any breast growth can go away as our hormones settle down.

So is treatment of gynaecomastia cosmetic or corrective?  No one would refuse dental treatment to a child with slightly deformed, yet 'normal' teeth.  This is a debate without any real conclusion.  I don't think it is unreasonable for the NHS to ensure you are of the correct weight before surgery.  I was overweight two years ago and lost four stones in two years to make absolutely sure it was not just fat-related and to prove to myself that I had taken every reasonable step before committing to surgery.  As I am sure you agree, nothing would be more frustrating for other people in the queue for surgery than waiting behind someone getting treatment because they had spent all their lives eating pies!  The NHS has limited resources and where possible has to be spent on the most needy - which I know does not always happen.  I don't know the figures, but a certain percentage of heart patients die on the waiting list for surgery.  This is an ethical discussion I am not going to get into, but personally, I would not want to explain why my surgery is more important than the next guy's triple-heart bypass surgery.

So treating gynaecomastia is very much down to personal and professional opinion.  If you can convince your GP that you have significant glandular tissue present and it is affecting your daily life on a psychological level, then you are in with a good chance for referral.

My case of gynaecomastia was quite obvious.  My GP was very understanding of how it was affecting me, such as only wearing certain clothing, in a certain way.  Walking around with hunched shoulders and dealing with people's comments.  She was happy to support me through treatment through the NHS.  But from the start, I decided not to use the NHS for surgery.

If I had, I would have been denied the choice of surgeon.  The chances are I would eventually have been operated by either a general surgeon or a plastic surgeon that probably had a huge caseload of female mastectomies, reductions and augmentations, but very few male chest reduction procedures to boast.

As far as I was concerned, this treatment had to be right first time.  It's a real shame that surgery is not more freely available, but even if it was, for me at least, it would have to come down to who was doing the surgery.

I am fortunate that my GP was very understanding and given my age (32) and knowledge of the subject area, she knew I was doing this because I really, really wanted it and that I had done everything I could without depending on the NHS alone to sort it out.  My GP insisted that she was there for any post-operative needs.

So whilst my experience with the NHS has been limited for this issue, I hope that gives you some information you can benefit from.

Cheers.

[outertrial]

Thats a good post. In my case though they said I wasnt overweight. It would seem Im a 'fat thin person'. ie, theres not much of me but what there is is fat not muscle  

It would be very interesting to hear from anyone who has had the surgery on the NHS.

[phantom]

Here is a recent thread from a recent NHS patient:

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=8;action=display;num=1137697563

Look through all the UK section as there are a few more.

It seems the vast majority of guys here go private.  It seems that the private surgeons have a much higher caseload of male chest reduction procedures.  If you go for NHS make sure you discuss what exactly they intend to do.  Will they be looking to remove as much glandular tissue as possible?  Will they deliberately be leaving some behind?  Will they just focus on fat tissue alone?  The reason I say this is because it seems lesser experienced surgeons (where male chest reduction is concerned) often place more emphasis on fat rather than glandular tissue.  But this is something that is very individual on each patient.

My surgeon (Mr Levick)  always seems to aim for a high level of tissue removal, both fat and glandular.  But I would be interested too to know how other guys rated their NHS treatment.

[radio-boy]

Anyone had surgery on the NHS?

I have been refered to a Breast surgeon, kinda terrified that they will have had little/no experience of doing male breast reductions.

[phantom]

radio-boy

Be assured that your NHS surgeon is qualified and experienced enough to carry out the work.  It really does come down to their skill and both yours and his/her expectation.

I chose Mr Levick for an added level of peace of mind - but even then there is no guarantee of a pleasing result.  For all I know, the NHS surgeon I could have ended up with may have done a better job - in my opinion.  It's very, very subjective.

I chose not to go NHS because I did not want to be bounced between my GP and the hospital over several months before they said 'yes' and then wait a few more months for a surgery date.  And in the (unlikely) event I needed revision I'd have to wait many more months again and may have been subject to a good case brought by myself to justify further work.

There are many excellent NHS plastic surgeons that are trained to the same standards as those that work in either both NHS and private or exclusively private.

The point I tried to make to you on another post is that whoever you decide to use, including Mr Levick is to scrutinise their working practices and only go along with any particular surgeon that gives you confidence with them.

[outertrial]

From what Ive heard the danger, such as it is, with this nhs is the surgeon not taking enough out rather than botching the op.

Private surgeons are generally expected to get it right first time if possible so if you go to a bad one i suppose things could go wrong. Ive never heard of this from NHS ops presumably because they go by the 'if in doubt do nowt philosophy' but I have heard of cases where you go through all the hassle, and the op and the compression vest only to find theres not much difference after it all.

[alan]

 in  response to Phanton  and you  other  guys. I  have  had my op  done on the  NHs  twice  the  first  time when i  was 20 which  was  not very  good. The  second time was  when i  was 40  last  year.  i  was referred by  GP to  the Royal London Hospital ,  and the  operation  was undertaken by Dr Patel specialise in plastic.  she  was  very understanding. I only had lipo. This was because I had the  the glad  removed at the  first  op. there was no scare as there  was no incisons  ie cuts .

Although  i was  told initially  i would have to  go on a waiting list for about  18 months .The  process  from  Gp  refrral  to  having the  op took about 8-9 months .

I would  advise  anyone  having this  type of op  private or NHs  is make sure you  have your questions  to ask,  ie  are they  going to  remove the  glad  if  not  why not,

where  are  they going to make  the incision which is best  through the nipple  area. How much  of a reduction will the operation  acheive

[radio-boy]

Thanks for that alan. Why was your first op so bad?