David Gillon

Thank god for doctors who read the notes!

2022-11-22T18:03:49Z

My sister went along with my mother to the GP earlier, because of a bunch of minor symptoms that individually could be read as "she's getting old", but which we suspected meant the dosage for one of her conditions is too low. And it's a rare condition - 5/100,000 - that none of the practice doctors have shown signs of understanding before, leaving everything to the specialist, so she expected to have to argue.

Doctor "Yes, I think you're right, you should have had a follow-up appointment with the specialists months ago, I'm upping your dosage and writing to their secretary to get this sorted."

Thank god for doctors who read the notes in advance!

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Well that was silly

2022-05-16T15:57:08Z

My GP's surgery has been nagging me to have a blood pressure test as I haven't had one in about five years, and they had a drop-in blood pressure testing clinic today so I went along.

I was caught out by the weather, which is unexpectedly hot and sticky, and even in just a t-shirt and body warmer I was overdressed, which didn't help. Plus their fold-away tables were too low for me to find a comfortable position to rest my arm - and if I chocked it up with my right hand my left hand started twitching uncontrollably, which was obviously concerning.

So I wasn't surprised when the reading came in high. But I wasn't really expecting it to be that high. And while it dropped on a couple of retests it was still in the make an appointment zone. So they started trying to work out if anything was pushing it up artificially:

Them: "Well, the heat and the stickiness won't help, what about medication?"

Me: "I'm on Butec, it's an opioid for pain relief."

Them: "Well, both that and the pain might push it up, so would a bunch of other things, like coffee and ..."

Me: "Oh, crap, I literally drank a full pint of coffee just before I came out." *Headdesk*

I just didn't think about it, I was having my lunch, needed a cold drink, and the cafetiere was a) half-full, b) had gone cold, and c) right next to me.

So hopefully that's all that's wrong. But I've still got a phone appointment for next week.

(Not that a phone appointment for checking blood pressure makes much sense).

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Life imitating fast-talking, bah

2021-11-16T14:58:13Z

I had an over-the-phone medication review yesterday.

This was with a pharmacist my GP's surgery has now added to their team, so not only was it over the phone, it was with someone I've never met, and who obviously didn't know what my diagnosis was (she did eventually ask, but only well into the discussion).

Given the only medication I'm on is a strong opioid*, these things always go the same way - the medic tries to convince me I don't actually need it any more. It turns out this is an even easier argument for them to make when you're not sitting in a wheelchair in front of them.

So I was half-expecting to have to dig deep into symptoms and consequences, and I did.

After finally establishing that yes, I did indeed still have exactly the same levels of pain it was prescribed for, we then had the traditional pushing for alternatives, "Have you ever been referred to the pain management team?"

Yes, repeatedly, and they don't think I'll ever not need strong painkillers.

Which pretty much shut her down. And she then said the one thing to convince me she did have at least partial access to my notes by pretty much quoting my GP verbatim from the last one of these: "well, you're on the lowest dosage and it is working, so I suppose we can leave you on it."

So that's done for another year or two.

And then my hips started hurting, a lot.

I'm not certain it was entirely due to the meds review, not only was my pelvis visibly more rotated than it's been in a while, but yesterday was also the last day in that patch's theoretical 7-day duration and there's a bit of individual variability in how long they really last, but having to think about these things is never helpful for actually controlling how much pain you actually feel.

(I'm mostly fine today, possibly a bit stiffer than usual, but pain levels are relatively normal).

* In patch form, so <s>almost impossible</s> extremely difficullt to abuse.

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More Power Igor!!!!

2021-04-12T17:26:58Z

FB Memory from 2011:

"Saw new spinal specialist last night, being sent for nerve-conduction tests, which are apparently done by a Professor Magnus -- I seem to have strayed into a plot from Sanctuary. Though if someone has to stick needles into me while yelling 'more power, Igor', then I guess Amanda Tapping is as good a choice as any!"

I'd completely forgotten when this was, I'd have said much earlier in the Oughties if I had to guess, and I'd utterly forgotten about "Sanctuary", which I rather liked.

(The actual test wasn't nearly as painful as nerve-conduction testing is normally reputed to be, but I felt the conclusion of "something's clearly not right" could have been more useful. And I didn't get to see "Professor Magnus, I got his deputy instead :( ).

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In other idiocy

2019-11-22T20:17:33Z

I may have kicked my Kindle Fire into the bath. I thought I'd gotten away with it, but nope, it shut down later. Or at least the screen did, the rest of it, such as the alarm, still worked until the battery ran down. Try turning your alarm off when you can't see the icon to swipe....

At least I timed it right for Black Friday.

Had an appointment with my doctor this evening for a medication review, which is code for "we want to take your opioids away" (I'm only on one drug). Convinced Dr Singh(1) to wait six months back in the spring, didn't hold out much hope of keeping them this time, but this time the appointment was with Dr Singh(2) (I'm not certain if they're sisters or not) and we talked about my experience of pain, and what had worked and what hadn't, and at the end she said "I normally don't like keeping patients on opioids, but actually, you're the ideal candidate*."

Hurrah for doctors applying logic, not opiod hysteria!

* Low dosage, I haven't built up a tolerance, it works, most other things don't, and I did a test a couple of weeks ago to confirm my pain levels are still where they were when this was first prescribed by going cold turkey for four days (I intended going a full week but it hurt too much).

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GP Parking Follow-Up

2019-05-21T17:53:11Z

Just at the GP's to make an appointment, and took the chance to comment on the signage for their new 'type in your reg number or get fined £50/£85' parking scheme.

'You've got all those signs up on your chest high reception desk, but there's nothing here on the wheelchair height desk for someone like me to see'.

'Yes there is,' says the senior one, slightly butting in now she's dealt with the patient she was talking to. 'Hmm, where's it got to now, people keep moving it. Ah, there it is!' and she reaches off to the extreme opposite corner to where you're looking when facing them.

Well yes, it was there. But the first thing you did when you walked up to deal with your patient was move the big 40l samples container that sits on the desk between where I was and where the sign was!

They also commented the scheme was put in place in February and they're having to add more and more signs because people aren't seeing them. Don't think it's occurred to them that the problem isn't the number of signs, it's the sheer wall of text with the details of what you're supposed to do buried in the middle.

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Surprisingly less of a pain in the backside than expected

2019-04-06T17:50:54Z

Despite my predictions of disaster, my long-distance controlled drug prescription renewal all went through without an issue and I had the filled prescription in my hand by 11AM the next morning. Which means I'm currently comfortable, rather than shivering my way through opioid withdrawal (last patch of the old prescription ran out overnight).

I strongly suspect both GP's surgeries were confused about the system (mine that it was possible at all, my mother's that it had changed in the past week), and that that's probably true of a lot of them across the country. Which isn't exactly reassuring.

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I said it would be a pain in the arse

2019-04-02T21:00:38Z

I'm still in Durham.

My Mother's GP Surgery: No, you can't have an appointment to get a repeat prescription for a controlled drug, because the whole system just changed and your own surgery can do it electronically.

Me: They were pretty adamant they can't do that for controlled drugs when I talked to them a couple of months ago.

Mother's GP: It all changed just 2 weeks ago. Byee!

Me to My Own GP's Surgery: They said it all just changed and you can do it.

My Own GP's Surgery: I'm pretty sure they're wrong, I'll bet they're confused about the gabapentin thing*. Best we can do is give it a try and see if it works.

So I'm stuck in limbo, needing the repeat by Friday, and may end up sitting in Urgent Care/A&E just to get a repeat prescription (as opioid withdrawal is narrowly worse than sitting in A&E). And I just had to email my GP saying 'whoops, didn't think about your normal 48 hour turnaround, can you put a rush on that, pretty please.'

I said it would be a pain in the arse....

* I'll bet My GP's Surgery is right. Gabapentin and pregabalin were just made controlled drugs, effective this week, but because the pharmacists whinged, they don't have the same restrictions as normal controlled drugs, like my buprenorphine..

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So, wheelchair

2014-09-07T16:31:19Z

Or rather convincing my GP I need a wheelchair assessment from Wheelchair Services as a first step towards getting a wheelchair that actually meets my need as someone with HMS and fairly severe seating issues.

I have an appointment on Tuesday, which almost certainly means I'll get the older, somewhat lazy doctor with fixed ideas rather than the younger one with more modern, flexible attitudes (who mostly does Mondays and Fridays). The advantage is that she's known me for 25 years, the disadvantage is that she's known me through 25 years of misdiagnoses and I'm fairly certain she doesn't know what my actual diagnosis is. I'm not even certain my diagnosis is in my medical records as that came out of the Pain Clinic rather than rheumatology or ortho, I'll have to dig out the pain clinic letters and see what they said.

So, problem: convince an old-fashioned, lazy doctor on the verge of retirement that a wheelchair is a good thing.

Points to be made:
I'm doing this whatever happens, but I'd prefer to do it with the support of the specialists
I'm prepared to fund a suitable wheelchair myself (ouch!), because the chance of getting the appropriate set-up via Wheelchair Services is likely nil.
I'm already walking better because of the pain clinic, this has nothing to do with 'giving up walking'
Walking better is just showing all the things I've given up doing and still can't do, such as going in to London
I tried out a chair for 5 days at Worldcon, 5*14 hour days, no negative effects, normally a single seven hour day, or less, on my feet is likely to put me in bed for the next day or more.
Trying out Kaberett's chair convinced me that I need a properly fitted solution on a rigid (or fold to rigid) chair, not just a cheap folding manual. It was possibly the most comfortable I've been in 25 years.
Getting a chair may be a necessary precursor to getting back to work.
My arms are increasingly an issue. I now have parasthesia in my left arm almost 50% of the time, my right shoulder has started to sublux regularly, using crutches may mean I'm walking, but stresses my arms and shoulders. A wheelchair gives options, creates the ability to alternate between crutches and chair and just basically creates a back-up plan.

Am I missing anything obvious? All suggestions gratefully received.

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