General Practitioners may be Bad for one’s emotional Health

General Practitioners may be Bad for one’s emotional Health!

Seven days ago my Patient Information Leaflet saga began and, on this the seventh day, I received an early morning telephonic communication from the medical practice. Once again it was a receptionist making the call and she duly read out a (quite lengthy) statement from the prescribing doctor declaring his infallibility. It actually stated that he was well aware of side-effect and contra-indications but as he was prescribing a very low dose (100mg when the capsules are made in only 50 & 100mg); I would have considered 50mg to be very low dose in this instance.

My primary concern was the positive declaration that one should not take this medication if they’ve taken the specific medication I was on within the last two weeks. Of course being some sort of God the GP obviously didn’t feel it was worthwhile to deal with this specific.

Of course it was said that I could arrange an appointment with said doctor to discuss the issue but, what’s the point of consulting a GP who offhandedly (as witnessed by my wife who sat in on the appointment) ignores anything the patient says if it doesn’t suit his agenda? In any case it always takes ages to get an appointment. Although I had been quite prepared to start taking the new medication two weeks after having taken the last dose of the previously prescribed ones, this wasn’t presented as an option so I now have misgivings about taking it at all, which as the receptionist says “that’s the patient’s prerogative”.

I can only assume that patients are supposed to ignore Patient Information leaflets, as they may prove challenging to the GPs’ omniscience. 

MEDICATIONS Mess Up - Contra-indications

The two previous posts refer to this same topic! I suppose this is simply an update.

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MEDICATIONS: Current state of play. I've now stopped taking both amitriptyline and sertraline ('cold turkey' as followed GP's advice to return unused ones to pharmacy - that was before I'd read the leaflet with the Trazadone that he recommended I started that evening) but am not taking Trazodone.

My beloved OH visited my GP's surgery to point out the information warning me not to take the Trazadone; the receptionist took the details saying the duty doctor would contact me this afternoon. Mid-afternoon one of the practice receptionists called me to say that the duty doctor said it had to be dealt with by the GP I saw yesterday but he won't be there until next Monday. It seems obvious to me that contracted GPs are afraid to challenge even wrong decisions by a practice partner.

A Further Post Script to previous post

This post is a further postscript to 

FRUSTRATIONS of a Medical and Medicinal Kind

 as someone who has been taking amitriptyline at night for more than a couple of years it's a good job that I thoroughly read the Patient Information Leaflet! To replace amitriptyline and a low dose of sertraline my GP has prescribed a drug (which I'm supposed to start immediately) which explicitly states that one "should not take Trazodone if I've taken amitriptylene within the last two weeks".

It also states special care should be taken if "your age is above 65years, as you may be more prone to side effects" and "take special care if you suffer from conditions like abdominal pain, muscle weakness, mental confusion"

I am 71yrs 7months of age, and suffer intermittently with abdominal pains and muscle weakness as part of my general state of unwell-being (ME). Even mental confusion was present not long after I first succumbed to ME at the end of 2003.

FRUSTRATIONS of a Medical and Medicinal Kind

This post also appears on 'Mal's Murmurings' under the title 'CONSULTATION FRUSTRATION'

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It shouldn’t really be like this; anger and despair turn out to be the result of a visit to the GP. Having finally yielded to my beloved’s advice, I got around to arranging an appointment with my local doctors practice. My reluctance to make this appointment is the knowledge that they’re only equipped, or allowed the time, to deal with a specific singular ailment, not a complex multiplicity or whole people.

First annoyance came when he (being the doctor) stated that the medications I was on had a tendency to conflict / counteract each other to some degree. Considering the length of time I’ve been on this assortment of potentially self-conflicting cocktails, I begin to wonder why the practice had been oblivious to this over the course of the past couple of years.

When conflicting advice, between medics in the same practice, as to whether certain meds should be used pre-emptively or only when absolutely necessary, adds a further quandary for the patient as to the efficacy of using the practice at all.

Anyway, a couple of the prescribed medications are no longer to be used; they are replaced by a single different medication. Worrying for me is the following statement, on the Patient Information leaflet:

 take special care if you:

suffer from conditions like abdominal pain, muscle weakness, mental confusion.

[there are times – regularly for the first two, occasional for the latter - when I can tick all those boxes]

The doctor further suggested that I should use co-codamol instead of tramadol, even though I’d had to stop using co-codamol, because of the effect it was having on various abdominal organs, a few years back. Tramadol, thankfully, remains on my prescription.

Next came the little prep talk suggesting Graded Exercise Therapy would help, even performing the same limited exercise on ‘bad’ as well as ‘good’ days. Obviously he has no understanding of what a PwME’s (even moderately so) ‘bad’ day is like. I explained that even the visit to the opticians, a limited amount of exercise involved, was sufficient to cause payback, his response was that obviously was too much exertion!

Well, it seems that I’ll have to stick with my own pacing regimen which essentially curtails any exertion on bad days and, ensuring that I always have some spoons in reserve when I exercise on good days.

The preceding events, at least their physical & mental toll, necessitate a temporary postponement of my visit to hospital for further blood tests

I’m quite proud of myself for refraining from the use of expletives during this little rant; expletives remain in my personal domestic space for the time being

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Malcolm Evison doctor even told me that there's no connection between overload of pain stimuli and the corresponding nausea that I experience !!!

GOOD TIMES - BAD TIMES - Strangely NORMAL TIMES

Wrists in strong supports, left hand clasped tightly in armpit by right upper arm, right hand grasping left shoulder, upper left arm clasped tightly to side, and I want to scream. The nagging aching pain and discomfort little eased by 100mg of tramadol swallowed a couple of hours ago.

Everything felt fine when I decided to move from reclining to upright posture, but then just switching on laptop and tapping a few keys was sufficient to bring back the heavily aching nausea-inducing pain in the upper arms; the sensation not too dissimilar to a state of total exhaustion when one is prohibited from rest or sleep.

When lying down a throbbing ache envelops my knees; bending knees to make a tent under my shrouding fleece temporarily alleviates the gnawing knee pain. Next it’s the toes that are the problem, a sudden burning sensation in lower digits all too swiftly feels as if my skin is being grated by the restraining pressure of what are usually quite normal socks. This latter item swiftly becomes an instrument of torture and, their removal does little to relieve the sting.

It’s beginning to feel like some sort of punishment as atonement for having two reasonably good days. On Friday I finally managed to visit the opticians, first time I’ve managed that since 2003, previous attempts having been thwarted by sensory overload and/or panic attacks. I t really felt like quite an achievement to have undergone a range of tests by both optometrist and optician. The optometrist was genuinely interested to learn a little about ME (and my denouncing of the wastebin CFS diagnoses) and really put me at ease.

Fired up by this amazing achievement, next day I decided to attend to one of my problem PC’s that I hadn’t touched since September. No amount of online research (and subsequent application) resolved the issues that had thwarted my efforts last year. There was nothing for it other than fresh installation of Win 7 and countless updates to be applied.

By mid to late evening I was quite shatteredly exhausted but, having go to bed sleep proved extremely elusive. Illusory sleep turned out to be the lesser nocturnal oppression. Wrists, elbows, lymph nodes, and lower digits screamed out for attention. Tubular bandages over elbows and much of the arms, elasticated metal spined wrist supports offered little in the way of pain and discomfort relief and, the burning flayed skin of the toes screamed out in accompaniment to my expletive laden vocalising. An application of moisturiser to feet and toes proffered temporary alleviation but, I’m not sure whether it was the emollient or the massaging effect of its application that provided this relief. This procedure was repeated several times during the course of the next couple of hours.

 By 11.19 this morning I reluctantly emerged from the duvet lair only marginally less exhausted than the previous late evening. What of today? You may well ask! The first paragraph describes some of my afternoon.