What to do if GP won't refer to specialist

[rankin1st]

Hi can you advise Dr wouldn't review to see hematology not had INR checked for years on apixiban and struggling with memory and fatigue.

[HollyHeski Administrator]

Hi, can you confirm you have been diagnosed with Hughes/APS?

There is no checking of INR when you are on apixiban, INR only relates when you are taking warfarin.

The memory and fatigue is this new? Have you had your iron, ferritin, B12 levels checked? As this could be related.

Is there a reason your GP wont refer you?

[rankin1st in reply to HollyHeski]

Hi Holly, thanks I responding on behalf of family member who has been diagnosed years ago with Hughes syndrome. Had DVT and clots on lungs. They are elderly and GP just says it's memory old age etc, took info about doacs and asked to be referred as not since haematology since hospital admission years ago. Memory fatigue got worse since the med change.

[HollyHeski Administrator in reply to rankin1st]

Thank you in supporting your relative, who changed the meds, from what and to what?

I would write to the surgery first, asking for a referral to an APS specialist, insisting that your not happy being on DOAC when it's now not advised for APS patients.

Have they done recent bloods on checking B12, ferritin, iron etc?

[rankin1st in reply to HollyHeski]

Dr changed meds about 1-2 years ago, Med Changed from warfarin to apixiban, patient not felt as good since, memory worse so much so couldn't even count cash the other day! Persistent cough recently, pain in arm, fatigue. Dr just said see age UK for memory assessment, it's arthritis, none of which are diagnosed! Patient won't let us go with them. Did take bloods but she didn't know what for.

[HollyHeski Administrator in reply to rankin1st]

Other than supporting the patient, you can't do all this without their consent.

I know it's hard and frustrating but this does need to be led by the patient.

The patient needs to write to the practice manager and put in a complaint.

Or go to Age UK and see if you can get a referral through them.

Either way, patient is entitled to see an APS specialist.

[MaryF Administrator in reply to rankin1st]

Let us know your area, (sorry if I have already asked that), and I can try and list some local specialists both NHS and private. MaryF

[rankin1st in reply to MaryF]

Thanks Mary you replied on another thread will try and encourage her to self refer to London Lupus, much appreciated