Back from GP---unsypmpathetic

[Diddydriver]

Hi everyone, I took in all you good people said and I did try to tell my GP how I am feeling, but he didn't seem very interested how I felt or in any symptoms I have with the meds. I also mentioned that my neck felt and sounded like walking on gravel, and asked him if it is related to RA or is something else is going on. He just said I could be RA or maybe OA and offered me codeine. I asked him about blood tests as I had not had any yet since starting MTX 4weeks ago, he told me that it was up to me to see that I have them on time. Seeing that I only got the letter from the rheumy late last week stating that I needed blood tests every 2 weeks for 6weeks then monthly how was I able to arrange them?? Anyway I have done that now. He seemed reluctent to see me if i had a flare and told me to contact the rheumy clinic. All he seemed to be interested in was issuing me a prescription for MTX , Hydro and frolic acid which he has put on my repeat prescription list. Maybe I am reading more into this than I should, or maybe he just didn't know what to do, never the less I do feel a bit let down.

Thankyou for reading this long post. Your comments would be welcome.

[dobsey]

GP's can't really help as you have been handed over to your rheumatologist So you are under his care now

I was like you I would wait till they told me I need a blood test I didn't know it was our responsibility to have the blood tests They should print you off quite a few request forms As I had to ask for them as well

The rhumy should have told you all this

All the GP does is give you prescriptions they can't do anything for you

That crunching in your neck when you move it is wear and tear they say , can't think of the name for it got brain fog but I have it in my neck and lower back but I didn't have it till I got RA and it came near on instantly within a month or so

So I say it is RA related. Sorry if this is not what you want to hear

I just wish they would spend the initial time with you to explain everything but they don't and you learn from trial and error

Take care keep your chin up x

[earthwitch]

It might be worth trying to find a copy of the rheumatology shared care agreement for your NHS region online - quite a number of them can be found online. That outlines exactly what is the responsibility of the GP and what is the rheumatologists. I think it sounds like your GP was copping out a bit - if they are prescribing, then they should really have the responsibility for ensuring you get monitored by blood tests appropriately.

[Diddydriver]

Thankyou dobsey, you didn't need to say sorry I prefer straight talking rather than pussy footing around the issue. I see the specialist nurse in 4weeks so I will ask for blood test request forms then.

[Livingston]

Not good of your rheumatologist to let you out of the clinic without clear understanding that you'd need to arrange blood tests.

Your GP will need to get on board with this a bit. The shared care agreement between rheumatology & them will dictate that the GP is responsible for monitoring your blood results and acting on them. So if your white count gets too low, your liver enzymes get too high or any one of a number of other things happen, your GP will have to step in & actually DO something - even if it is just phoning rheumatology for advice. The GP also has a degree of responsibility for making sure you are having bloods done regularly if they are signing scripts for MTX. Your GP is still your first port of call if you have a temperature, need any pain relief etc.

It may seem scary but how your management goes from now on will, to some extent, depend on you. Time to educate yourself about the disease and your medication. The NRAS website has lots of good information.

A good priority for this time of year is making sure you are on the GP practice list for a flu vaccination. If you've never had a Pneumovax before, you should probably arrange for one of those too, now you're on MTX.

[Diddydriver]

Thanks Livingston, due to having a heart condition and COPD I am already on GP list for flu jab also I had the pneumovax several years ago. I do think that I will ring the rheumy advice on Thursday as I am still confused ( I think my husbands dementia is infectious ) ha ha. Tomorrow I am going for a long awaited day out ( hubby taken care of after difficult arrangements made ) so looking forward to it. Shame it is going to rain most of the day when the trip is a sail up the river to Windsor, but hey ho got a brolly and a mac.

[nomoreheels]

Oh dear, it sounds as though you have a disinterested GP. Not on if that is the case being your primary care provider. Maybe he was having a bad day & if so let's hope he checks what his responsibilities are by the next time you see him. Your Rheumy should really have taken the time to explain about blood tests or not been so tardy sending instructions so he's not faultless!

I would contact your Rheumy team about your neck, "could" & "maybe" are not satisfactory diagnoses, yes it could be related to RD though in my case it's OA (cervical spondylosis) which my GP prescribe my meds for following a request from my Rheumy to provide my pain relief meds. You do need clarification though to ensure your taking the best med for the job.

[cathie]

I wouldn't accept this. GP should be linchpin for your treatment and be ready to chase hospital for you if necessary. I'm in a group practice and I've learned through trial and error who to go to. I hope you get more support in future

[benjijen]

I haven't seen my doctor since diagnosis, I call the rheumy nurse if I have a problem as she has the right experience. With regard to your neck, I have the same and found going to a chiropractor was brilliant. However, I can't afford it any more but if you can, or are in an area where it's available on the nhs, you should give it a try. Find a good one through recommendations, more expensive doesn't mean better. The hospital sent me for physio and, as usual, it was a complete waste of time. Good luck.

[julie01]

Hi everyone, my name is Julie and this is my first post, my GP practice have refused to participate in the shared care agreement as they say it is too much administration, how requesting a monthly blood test is too much admin I don't quite understand, I have spoken to the consultants secretaries and they have been brilliant, I will carry on going to the hospital for my blood tests and I will let them know when I have had the test and they will fax the blood result to my GP for prescription purposes, they will also send me a copy of my blood results for my records, I must admit I find the GP surgery frustrating and not always helpful, the only good thing is that they are open till 9pm on a Monday evening so I can get in after work to put in and request prescriptions. I hope your rheumatology dept. can help you.

[babssara]

Hi Julie01. Your post has really really shocked me. I worked in primary care management for many many years and have never heard the like. I really do hope you report your practice if not for yourself for any poor person in a similar position who is not able to get to the hospital regularly for b'ts etc. I would in the first instance write to the Practice Manager asking for a meeting. Depending on the outome of that I would report to your Primary Care Group. Can be contacted via PALS who are really helpful and will take your concerns really seriously (patient advisory and liaison service - your hospital will have their number). Don't worry about upsetting the practice, I'm sure the practice manager/partnership are unaware of this incident and like me will be totally astounded and upset and of course cannot act on it if they don't know. Please let me know