A woman with a distended stomach that makes her look five months pregnant has suffered for months with severe pain and no treatment.
Poonam Nand, 35, first went to her Auckland GP in March, and was subsequently admitted to North Shore Hospital suffering from abdominal distension.
After undergoing a scan and X-ray, it was found she had fibroids on her uterus and faecal loading of her colon.
Four months later she is still awaiting treatment, despite having seen her GP five times, been hospitalised a further two times, and seeing a gynaecologist.
"My abdomen is really distended, like as if I am four to five months pregnant. I am not really sure why that is happening – and I am in constant pain, as well as every five to 10 minutes there is a sharp pain," she said.
"I'm in so much pain and there's so much pressure from my abdomen that it's hard to walk and sit down properly, and I have to wear loose clothes because it is really uncomfortable, but I don't know where and whom to ask for help."
The Waitemata DHB says Nand has received an appropriate treatment plan and her case has been handled "within the Ministry of Health's expected timeframes".
Nand, a mother and wife, said she'd been passed from doctor to doctor over the past few months but had only been given pain medication.
"I couldn't bear the pain any more as it had worsened and my abdomen became more distended so I went to the Emergency Department on July 3 in hope something would be done," she said.
"However no tests or ultrasounds were done, and a team of doctors said they will discharge me and do an MRI scan in four to six weeks' time, and then see me in the clinic in three to four months' time.
"I've been putting up with this pain since March and they just keep sending me home."
Nand was admitted to hospital again between July 6 and 10, where she received blood tests and stool swabs and was told to wait until an MRI on July 22.
"I am really frustrated, I know it is a public system and they need to prioritise patients, but in my case I don't know what to do and I am losing faith in the system," she said.
Nand's GP said she was understandably very frustrated that no definite cause or diagnosis had been found.
"The ongoing issues have impacted her in all areas of her life and she is very upset about this. It has affected her work, finances and family life. She is in constant pain," the GP said.
"She's had a CT and X-rays and is awaiting MRI scan. She is on several medications for her pain."
While there's been delays in seeing specialists, the GP said Nand's condition was not acute or life-threatening.
"The plan is for her to have a one-hour appointment with a gynaecologist who she respects after the MRI to discuss where to go to from here.
"I am hopeful she will get some answers from the MRI and next specialist assessment," he said.
Waitemata DHB spokeswoman Dr Jye Lu said considerable resource had been invested in helping to identify Nand's health issues and to develop an appropriate treatment plan.
"As a result of working closely with Nand and listening to her concerns, we have always
seen her well within the Ministry of Health's expected timeframes.
"We stand by the quality and timeliness of our care," the associate clinical director of gynaecology said.
"We remain committed to working with her to achieve the best health outcome."
Director of Ascot Central Woman's Clinic Dr Simon Edmonds explained that fibroids are a non-cancerous growths on the muscle layer of the uterus - which very rarely become malignant.
"They cause a number of different symptoms, and are actually very common.
"Depending where they are - inside the uterus, on the wall of the uterus, or pushing on the outside - they can cause various problems; with the two main issues being heavy periods, and when they get big they can cause pressure symptoms - so a feeling of fullness, pushing on the bladder, and pain and discomfort in the pelvis."
Despite these symptoms, Edmonds said treatment isn't necessarily urgent, and wait times across DHBs in Auckland can range from six weeks to eight months.
"So waiting four months at Waitemata is kind of in between, but if she went private she would be seen within 2–4 weeks," he said.
Edmonds said there were three factors that would make treatment more urgent.
"What would make a fibroid operation more urgent is if you think it might be cancerous; if they are grossly anaemic and losing a lot of blood; and thirdly if the pressure blocks the bladder and a catheter has been put in.
"Otherwise, as awful as it is with pain and discomfort, if the patient doesn't have those three symptoms then these waiting times are not unheard of."
Edmonds said waiting times are dictated by urgency and the number of doctors equipped to perform the surgery.
"In public, if you are doing complex surgery or a laparoscopic, then there is only one or two people who can do it so they can't put you on a general list.
"There will also be have another 50 patients waiting for surgery who are also in pain and discomfort," he said.
In order to improve wait times, Edmonds said there needed to be political investment.
"From a political side of things, there needs to be more investment in the health service. There needs to be more money so you can have more doctors and nursing staff," he said.
"This case highlights that, as she is probably someone who is quite unwell and taking days off work so the economy is losing out."