So, today I saw Dr L about my medication review.
I explained what had happened (That every time I spoke to Dr Rh, he tried to take my pain relief away), and said, being bluntly honest for once; “If he thinks it’s physically damaging me, he can do a liver function test. If he thinks I’m an addict, he can come out and say it to my face. I’m not annoyed that he wanted to review my medications, though I am annoyed that he thinks that he can unilaterally decide what’s best for me without speaking to either me or my consultant, I’m mostly just annoyed that he went behind my back and changed my medication, even after three other GPs and two consultants have said it was appropriate.”
Dr L seemed shocked that I wasn’t going to pussyfoot around anymore, and started with the mealy-mouthed objections;
“Well, it puts us in a very difficult position…”
“We just want to do what’s in your best interest, and being on morphine really isn’t in your best interest…”
“We’re concerned with taking the safest course of action…”
All shot down with my usual replies. Prove that it’s doing me more harm than being in constant pain would do. Tell me why being in pain is a better course of action than not being in pain. If it’s safety that you’re worried about, why don’t you gatekeep the famously-bad-for-the-stomach-and-liver NSAIDs as much as you do the much-less-likely-to-cause-invisible-harm opiates and benzodiazepines.
Then she came up with the blatant lie; “It says here that last month you discussed possibly reducing your MST”.
No, no I didn’t. I told the last doctor about how I took my MST – In that I didn’t take anywhere near the full dose per month, in that I took a full dose at night if I wanted to sleep for the full eight hours, and that I took a full dose in the morning if I wanted to do anything more energetic than lie in bed – And that seemed to mollify her that I was appropriately suffering (After all, if I took all my medication all the time, and slept soundly and felt fantastic when I was awake, I’d be an addict). We’d not discussed reducing my dose at all, and yet there it was in my notes. The notes which notably didn’t contain any of the information that I’d been asked about at the last session.
Dr L didn’t write down anything about my actual rates of consumption either. So I assume that I’m going to get the same “Ooh but opiates are fun things for naughty boys, not lifesaving medicine for good ones” rhetoric again the next time.
She did however swap my Sumatriptan for a Zolmatriptan nasal spray, which will hopefully work to stop the migraines but without the painful heart palpitations and chest tightness and blurry vision and inability to sit upright or breathe. So that’s a start.
I am still far, far too tired for this battle. Today, I’m going to ring Dr D, the consultant rheum, to see if I can get an appointment with him and get my Stanmore referral. This feels like it should be work for someone who isn’t incredibly ill.
A Very Bitey Zebra 
Your next planned step sounds very sensible.
Why can’t your doctors respect you as a grown up (in severe pain) and just have an adult and informed conversation about your pain relief? Drat them. The poor record-keeping makes me cross as well (former NHS bureaucrat speaking here).
Love, Cathy xxx
Apparently just cutting people’s meds to “force” them to ring for appointment is part of the practise’s strategy, since it “makes people come in to get more”.
Why they can’t just ring me up and say “You’re due a review!” or even tell me at the regular-ish appointments that I go to about once a month is beyond me. All more stuff basically designed to make the longterm medicated feel like a criminal that’s gone rogue and being irresponsible in having managed their condition well enough to not have to see a doctor every week.
The poor record-keeping makes me fume, so I imagine you must be incandescent.
Bless! Yes I can get a bit incandescent now and again. Mrs Very Angry of Berkshire,no less.
Transactional Analysis theory tells you that Adult-Adult interactions give good results.
So why do doctors go for Controlling Parent-Adapted Child? It’s not going to produce a positive interaction. Piffle and wiffle. And that’s strong language for me.
😦
That sort of extra-patronising “We know what’s good for you, so the drug you think is yummy is really icky-poo-bad, and the one that makes you feel sicky is really good for you and will make you grow up big and strong!” thing that they do when they think that you’re not as intelligent as them makes me want to vomit. Not sure why they so firmly believe that they know better than I do which side effects I can tolerate and which I really can’t (The classic example always being the SSRI that destroyed my sex drive, which I thought was a fate worse than pure depression, and which they refused to take seriously, versus the SNRI which made me a bit gobby, which they decided for me was completely inappropriate and took me off it against my wishes.)
You need a patient advocate. I would have some choice words fir these people, one being malpractice.
they need a chlirine klyster with cactys suppository chaser, frankly. Unethical behaviour in clear breach of nice guidelines afaict
The trouble is that a patient advocate means having to talk to more people, make more phone calls, deal with more people’s weird prejudices, and I’ve not got the energy for that. Basically, the only person I trust to not be out to get me is me, or my friends, who sadly aren’t professionally involved with the NHS.
a patient advocate does not have to be involved with the NHS. You can empower anyone you choose to speak on your behalf. Or swear on your behalf.
Ah! I’ve done this a couple of times then – Had a friend come to a few appointments with me many years ago to try to get across to the GP that this wasn’t just “I’m worried about me” it was “EVERYONE is worried about me”.
If you’re ever in the Grim North, feel free to disembowel some doctors on my behalf 🙂
He could pelt them with rock-hard stale Garibaldi biscuits. That’d teach them a lesson they’d never forget.
nah i would use the cake where i mistook curry powder for ginger…
On the record keeping (it annoys me possibly even more than it does Cathy): insist that they correct it; such notes are potential legal documents which can be called into court (been there, done that, fought a barrister to a standstill); there are DPA implications also, in that the GP is required to make sure that data pertaining to you is accurate and handled appropriately, neither of which seem to be the case here.
I think the problem is how they parsed the word “discuss” – As in, we did “discuss reducing my medication” as in “She said ‘would you like to reduce your medication?’ and I said ‘no, that would be a really bad idea”. No idea how to go about getting it corrected, or what to correct it to. If I asked for my full notes, would it be on there?
Also, welcome to the blog – Inky will be along shortly to make you uncomfortable 😛
I very much doubt that Inky will make me uncomfortable, dear boy 😉 He hasn’t managed it yet – irritated with his uniform fixation, maybe…
You have the right to ask to see your clinical notes (contact the practice manager); if you are not happy with content (see above) you can ask for a correction to be inserted.
Do not be fobbed off if that is what you want. It is your legal right and the practice should have the relevant policies, procedures and mechanisms in place. If they don’t they are naughty and Rong.