Limited clinic access - gonorrhoea

In September 2002, I contracted a sexually transmitted infection (STI). I began to suspect I might have something, but a trip to a genito-urinary medicine (GUM) clinic routinely takes three to four hours, which really puts you off going for a checkup unless you're sure there's a problem. So it wasn't until the sore throat was really bad that I went to get it looked at. By that time I'd had sex with several other people.

I went to St Bart’s GUM walk-in clinic, one of the few places in London you don't need an appointment. I got there in good time to find the doors locked and a sign saying “Due to too many patients, we have closed the clinic early”. This, I now know, is not unusual.

Short-term solution

The trouble was, the next day I had to fly out to Eastern Europe for 10 days, so I couldn't just come back the next day. A few days into the trip the sore throat was unbearable and I took about five day’s worth of an antibiotic I had with me. It was Erythromycin, which is used for some STIs. It seemed like a good idea at the time and appeared to solve the problem.

Two weeks later and back in Britain, I suddenly got ill. The tendons in my knees swelled and my heart was in trouble: I had chest pains, breathlessness, and so on. Doctors kept telling me they didn't think there was anything wrong with me, and I was more or less told I was suffering from anxiety. They prescribed anti-depressants, but I didn’t think that was the problem.

Long-term illness

A few months later I developed stiffness in my joints. I was told I was too young for arthritis but that they still weren’t sure what the cause might be. Fortunately, by then I'd worked out what was going on by doing a bit of research on the Internet: I was having a reaction to the earlier STI.

After insisting on a rheumatologist appointment I was diagnosed with reactive arthritis, also known as Reiters syndrome. This was a full 10 months after first being seen by doctors.

Reiters syndrome is untreatable and 18 months on I still have it, and may well always have it. It's a complication of gonorrhoea or chlamydia. My initial raging sore throat pointed to me having had gonorrhoea. I'm left with arthritis, eye problems, heart problems and inflammation affecting my bowel, spine, urethra and tendons.

A problem waiting to happen

I'd had gonorrhoea half a dozen times in the past but never any complications. The one time it wasn't diagnosed and treated properly I get Reiters syndrome. No-one will ever convince me that it is a coincidence. If I'd been seen by that clinic when I went to them I doubt my health would've been ruined like it has. Incidentally, my local GUM had a five-week waiting time to be seen, but the last time I checked it was even worse: they'd closed their books to new patients.

It'd be interesting to work out the cost to the NHS of what's happened. I've had endless GP consultations, two trips to Accident and Emergency, a rheumatologist consultation, several cardiologist visits, x-rays, heart tests, eye tests and more.

My understanding is that reactive arthritis happens in one out of every 100 cases of gonorrhoea and chlamydia. With the skyrocketing rates of STIs and the NHS GUM service totally ill-equipped, I guess quite a lot of people are heading for what I've been through.

Supporting data

Waiting times for GUM clinics are longer than they should be: an estimated 28% of emergencies were not seen within 48 hours and 29% of symptomatic patients waited for more than two weeks for an appointment. CMO Annual Report, 2003

Studies show that around 30% of individuals waiting to be seen continue to have sexual intercourse despite being symptomatic. Dr Kevin Fenton, Health Protection Agency, 2003

GUM clinics are reporting increases in the number and proportion of complicated STI cases. This is most likely due to the long wait people are facing when seeking treatment. Failure to treat STIs quickly can lead to serious and long-term health problems. This can dramatically increase the cost, both to the individual’s health and the public purse. Health Select Committee report, 2003