Bits Of Me All Over The Place

Security concept: Lock on digital screen, contrast, 3d renderThere’s bits of me all over the place.  There’s plenty bits of you too.  This post is about data protection and rights to personal information, and is a kind of natural progression from a previous post I wrote describing my frustration and incredulity of being refused access to my medical x-rays.  Thankfully, recent changes in UK law have now made accessing personal information a legal right.  However, as I recently  discovered, a legal right of access does not automatically mean a simple seamless process.

The Data Protection Act of 2018 now grants the following rights to individuals regarding their personal information:

  • be informed about how your data is being used
  • access personal data
  • have incorrect data updated
  • have data erased
  • stop or restrict the processing of your data
  • data portability (allowing you to get and reuse your data for different services)
  • object to how your data is processed in certain circumstances

(Source: https://www.gov.uk/data-protection)

Obviously, the somewhat alarming reality in which we live is that there’s shitloads of data held about every single one of us in a seemingly infinite number of systems for a multitude of different purposes, and most of us are completely unaware of who is collecting and storing our data and for what purpose.  I imagine it would be an impossible task to locate all data held about us, and then tweak it to our personal permissions according to the above criteria of the new Act.  That is certainly not my purpose here.  My interest in the new Data Protection Act is that it now grants me access to personal medical information which was previously denied to me, so I have quite a task ahead of me in accessing and collating it all.

Over the past couple of months, I have made some progresspatient-record-keeping-clipart-1 in my crusade for personal medical information.  I have experienced an unnecessarily protracted and frustrating hoop-jumping exercise before managing to get copies of some more recent x-rays from one hospital, and am in the throes of trying to access further x-rays from a different provider but so far have made zero progress with that.  But hey, I am determined, stubborn and have plenty time at present so I will continue to request and nag and fill in however many forms they throw at me in order to get what I want.  So yes, the Data Protection Act has helped in some respects with this; medical providers can no longer refuse outright to share that information with you, but it seems they are not obliged to make it a short or simple process.

A few weeks ago, I decided to get the big guns out and request access to my medical records.  I wasn’t sure where to start, so asked my GP.   I received a positive and relatively encouraging response, so hoped the actual process would be equally smooth but apparently not.  The procedure at my surgery so far has been as follows:

  • ask GP if it is possible to have access to medical records
  • tell Reception I want to access my records
  • await telephone call from someone who instigates the process
  • complete telephone conversation, then go back to surgery to collect the Information Pack
  • read the Information Pack, complete the attached questionnaire and return document to surgery
  • surgery staff check questionnaire responses and screen my ‘suitability’ for access: ‘competence’, whether I am listed on any ‘at risk’ registers, whether accessing my records could have a detrimental effect on my physical or mental health, whether having access would put me in a situation where abuse could occur, (etc etc).  Should Safeguarding be identified as a result of sharing records, access can be denied for the protection of the patient.
  • if I survive the above screening process, I will be invited in for a face-to-face meeting with the Business Advisor to discuss the implications of access, and to have an ID check.  Then the Advisor will make a decision – apparently this could take several weeks, since no staff are allocated solely to dealing with requests for access.

Evidently, medical providers are nervous about unleashing information which has previously closely guarded and secure within their systems and buildings.  But what are they afraid of?  Is it that they don’t trust us to keep our own information confidential?  Is it that they see us as too ill-informed to understand the medical information recorded about us?  Is it more a fear that their professionalism and levels of knowledge and skills could somehow be seen to be diminished or undermined once Joe Public gets hold of his / her records?  Or perhaps it could be the fear of litigation resulting from poor judgement or error leading to legal proceedings?  Medical records have most certainly been fiercely guarded for as long as I can remember (and rightly so) thus reinforcing the kind of god-like status which some medics seem to acquire in the eyes of both their patients and their staff; enabling access to medical records could certainly burst a few bubbles.

But requesting access to your medical information shouldn’t necessarily be seen as a negative step.  Medical information about yourself can, and should, enable an individual to better understand their condition(s) and therefore better manage their symptoms, and I would expect that most people who request access to this data have good reason for doing so.  In my case, I want access to clarify something which I have wondered about for decades.  The first surgery on my left leg was performed when I was a child (I was around 9 or 10 years old) and I don’t honestly know what the procedure entailed.  At the time, I was told that I had torn a cartilage in my knee and had surgery to remove it.  I want to know the name of the procedure and what was actually done – was the raggedly cartilage removed and the rest left in place, or was the whole lot taken out?  If the latter is the case, then this could account for all the subsequent problems I have had with osteoarthritis over the years; if only the torn areas were simply trimmed away, there would be less reason to pinpoint the procedure as the reason for the aggressive osteoarthritis which I have developed since.  When questioned about the rapid pace of development of my arthritis, consultants deny or avoid the question of whether it is related to my historic knee injury, yet lower ranking medical professionals remain astonished that I have three joint replacements at my age, and two have been urgently needed and performed within the last 12 months.  My intention is not to apportion blame or start legal proceedings, it is simply to gain a greater understanding of what has happened with my body and why it seems to have gone so badly wrong.  The surgical  procedure performed when I was a child is the most obvious culprit and could have impacted on my on-going problems with arthritic deterioration in my joints and, perhaps most importantly, could indicate whether I have any other nasty surprises to look forward to in the near or more distant future.  Alternatively, it may have no bearing and my condition could have developed independently.  Until I know the name of that early procedure, I cannot even begin to consider the implications of it, if indeed there were any.  Accessing my records may or may not provide any answers to these questions, but I think they are the best source of information that I can hope for in my quest to better understand my condition.

 

 

Joined At The Hip

osteoarthritis-final-1170x500

We’re inseparable, you and I.

Wherever I go, whatever I do,

From events of importance to the mundane daily trivia,

You are always with me,

An unrelenting presence

Consuming my body and penetrating my mind.

 

When you first introduced yourself,

I’d barely hit adolescence.

There was considerable head shaking, disbelief even.

“She’s way too young for this.  How can this be?”

And they were right –

You were far too old for the likes of me.

Nominal interventions to get rid of you failed.

I learned to adapt and reluctantly accept that

You were here to stay.

 

Crunching, grinding, crumbling,

Bone eroding to dust,

Rattling osteophytes detach and stab into my nerves,

Gasping, whimpering, wincing and weeping.

Bone on bone, friction, abrasion,

Burning, aching, throbbing,

Limping, shuffling, hobbling.

You are much more than a degenerative disease.

You are a malignant parasite,

A sadist, a narcissist, a controlling monster,

A shameless attention seeker

Who heaps pain and humiliation upon me with every movement.

I reluctantly surrendered a part of me to you long ago

But your greed knows no bounds,

You always want more,

As you continue on your quest to consume me,

Utterly and completely.

 

But what will you do then, when the job is done?

When there’s nothing left for you to feed on, damage, destroy?

You have taken over my world,

And I have no choice but to adapt my life

To accommodate your gluttony.

My hopes, aspirations and opportunities

All modified, dashed or carelessly abandoned

As you, slowly but surely, dominate my past

And take control of my present and my future.

 

Disintegrating, decaying, fragmenting,

The fragile relentless rot of a dilapidated broken body.

You are my whole world,

You define me.

I limp therefore I am.

Red tape and jumping through hoops

This is an update relating to a previous post, But it’s my body, isn’t it?, and my ongoing quest for access to copies of the various medical images and x-rays relating to my osteoarthritic condition.  During a recent appointment with a consultant, I asked the Awaiting-Imagesquestion again, and happily this time the response was more positive.  However, so far I appear to have made little if any progress in attaining this apparently simple goal, and I’m puzzled about how or why this should be the case.  Is it that the medical profession are afraid to give you access to such things because they are concerned that you will do something silly such as starting litigation processes, or is it simply a case of disorganisation and lack of communication?  The fact that this is the first time I’ve had a positive response to this request is interesting, and perhaps has some connection to the new Data Protection law which was introduced into the UK last May.  Certainly in the past, my requests have consistently been greeted with a resounding “No, you can’t!”.  So I am now wondering whether it is a case of if I jump through enough hoops, I will get there in the end; or perhaps it’s just that they’re hoping I’ll just give up and walk away?  The saga so far is that you simply couldn’t make this stuff up…

following consultant appointment

me: I was wondering, would it be possible to have copies of my MRI and X-ray images?

Consultant: Yes, of course.  Go to Radiology and put in a request.

Radiology Assistant:  No you can’t.  We don’t do that here.  You need to go to MRI, in the basement.

MRI Assistant:  No, I’m afraid we don’t do that here.  You need to go to Radiology.

me:  But the consultant sent me to Radiology, and they sent me here.  I’ve just come from there and they said to come here.

MRI Assistant: OK, well that’s the wrong information, we don’t deal with that here, so the only thing I can do is to give you this form.  Complete one form per image request, scan it, then email it to the mailbox address on the form.  There’s no room number or contact telephone number I’m afraid, just a mailbox.

at the local Medical Centre

me: Hi, I’m trying to request copies of my x-rays and MRI images from the hospital.  I’ve been given this form, and I need the dates and the name of the doctor who referred me for each image requested.

Medical Centre Assistant:  Ok, no problem, just take a seat, it could take a while…

me: Do you have access to these images?  Presumably they’re kept on my electronic file?  Can you issue copies of them?

Medical Centre Assistant: I’m afraid not.  They can only be requested from the hospital where the images were taken.

at home, after scanning, printing out 4 forms, completing 4 forms, re-scanning the completed forms, and writing an explanatory email about requesting the information

me: FFS!!!  the b**ody attachments are too big to send!!:-(  I’ll have to take them in in person.

back at the hospital again

me:  Hi, I’m trying to find where the PACS department is?  I’ve got a form to deliver but there’s no room number or telephone number.  Can you help?

Information Assistant:  Oh, I’ve never heard of that.  Try the General Office, down this corridor here.

General Office Assistant:  Oh, I don’t know where they are, and oh, there’s no room number or telephone number.  Just wait a moment and I’ll ask if anyone here knows anything about this…  I’m afraid it’s just a mailbox, we don’t have a name or location for them.  Can you email the information to them?

me:  Well, yes I can, but when I tried I could only send one attachment per email, so I’d have to send four separate emails.  I was hoping you could send it by internal post, but obviously not if there’s no room number or person’s name attached to it.

General Office Assistant: Well it would be Radiology that would deal with that.  Can you take it down there?

me:  I tried that last week but they said it wasn’t something that they dealt with, even though my consultant said to ask there.  Could you send it internally?  I’ve got all the documents in this envelope, and a copy of the email I wrote which has got all my contact details on it.

General Office Assistant:  Yes, I can try.  I’ll put a note in with it.

me:  Thank-you, that’d be great.  Also, could you ask them to contact me if there’s a problem and they aren’t able to deal with it, just so I know if it still hasn’t reached the right place?

General Office Assistant:  Yes, I’ll do that, no problem.  You should hear from someone within the next week or so.

 

So that’s that, and apparently is all I can do at the moment.  A week later, I’m still waiting and haven’t been updated about whether the forms have reached the correct destination or not.  I’ll give it another week, then start chasing them again.  How can something so apparently simple become so complicated?!  Meh, I have plenty time these days, plenty time for red tape and jumping through hoops…

 

 

 

 

 

But it’s my body, isn’t it?

X-rays, MRIs, arthroscopies…  Phwooooaaaaarrr!!  Who doesn’t like a good clinical image of the bits and pieces of the internal workings / failings of your own body?  It’s somethingawaiting-image89 that you rarely get the opportunity to see under normal circumstances.  Then, there’s the bits and pieces of bone and tissue that they remove during surgery – who wouldn’t want to have a bit of that and store it in a jar?  Well, ok, maybe the bone and tissue thing isn’t for everyone, but I suspect that most people feel some level of curiosity about clinical scans in their various shapes and forms.  I certainly do.  I love images in all their incredible guises, from fine art paintings to the humble x-ray; they’re often insanely beautiful, fascinating, inspiring things, and clinical images are simply incredible in the level of detail and information that they convey.  I could stare at them for hours, and herein lies the problem.

Unsurprisingly, I’ve had lots of x-rays, scans and images taken of my crappy joints over a period of many years.  These days, if I request it, I do get to keep a copy the clinical assessment report which lists the most recent findings; this is little more than a few lines, mostly in very large, unpronounceable words and medical jargon intended for professionals, not for the likes of me who are just into x-ray porn.  What I really want is to see the image, but this only ever happens when I have a consultant appointment, and even then, I only get to view this for about a minute.  I am genuinely fascinated by these images and want to look at them closely, so I deliberately quiz consultants about the images, which buys me a bit more time while I drool quietly to myself.

Tomorrow, I have an appointment with my consultant to discuss the results of an MRI taken a couple of weeks ago.  This is my first MRI and I have mixed feelings about this appointment because I suspect that I will be advised that I need further surgery.  However, the only part of this that I am looking forward to is seeing my MRI, and I’m rather ashamed to say that I’m actually quite excited at the prospect.  Most of the scans and images taken so far have focused on my bones to identify levels of degenerative change; however, an MRI reveals soft tissue, nerve pathways and ligaments, so the resulting image should be really quite amazing.  There is also absolutely no doubt in my mind that I will only get to see this image very briefly, and then that’ll be it, it will be quickly filed away and this fleeting moment of opportunity will have disappeared.

In the past, any requests I made about keeping what I perceive as ‘bits of me’, have been greeted with a resounding ‘no!’ and I fail to understand why this should be the case.  I kind of get that when I request bits of my body, to some people that may seem a bit strange or macabre even.  I readily gave consent for bone removed during my knee replacement surgery to be sent to the local university for research purposes – so why can’t I get to keep a bit of it too, for myself?  After all, it is mine, isn’t it?  I’m not sure what is going on in my head with this, but these things are somehow important to me – after all, the x-rays, scans, and ‘bits of me’ are precisely that, bits of me, that I feel some level of entitlement to keep or record in some way.

What I really want is to be allowed to keep copies of these images for myself, to look at them closely by myself, not just for their sheer beauty and aesthetic value, but also to gain a greater understanding of what is going on inside my body.  I’m not a patient-from-Hades with a fiendish plan to challenge consultants’ opinions, nor am I someone who will get hysterical and start imagining all sorts of potential medical horrors because I’m too ignorant to understand the image correctly.  I’m just an ordinary person who likes pictures, and who wants the chance to look at these amazing images of my body at my leisure.  I can’t see why this is such an issue, and in these days of electronic communications the cost would be minimal.  So, tomorrow I need to be brave and ask again about my rights to have copies of these images.  After all, it’s my body, isn’t it?  Surely I have more right than anyone to have a damned good gawp at it?