frustrated with gp re pain meds.

[Runrig01]

Ever since I had my stroke in 2018, I’ve not been allowed nsaids, due to the increased risk of further strokes. My then gp prescribed butec patches, which in the 5.5yrs have only been increased twice to the current 15mcg. I was given Tramadol for breakthrough pain which I don’t take too often. A box of 100 lasts 3 months. On Tuesday I called her as my pain was 8/10, she said she’d need advice from their pharmacist and would call me back. I assumed same day due to my pain level. Nope, didn’t call back, ironically the surgery was shut Wednesday for training. So by Thursday I was bedbound with the pain, hubby requested a home visit. A lovely paramedic attended, was disgusted she hadn’t returned the call, but could clearly see I was in agony, and promised to go back and speak with her.

So she calls, wait for it , and says you need to remove your butec patch and stop tramadol immediately, then tomorrow start lower dose of zomorph. I said out of the question, that will exacerbate my pain, which is currently 8/10. She asked what I wanted and I said something like Oramorph for breakthrough pain, which she initially said they have a policy only to issue to palliative patients. Told her I have no objection switching once the issue with my knee is sorted, but it is madness when we still don’t know what’s wrong with my knee. Upshot is she prescribed oramorph, ordered an ambulance as she thinks we might be missing something 😂! I’ve been telling her since 8th July about the knee pain, which she continued to insist was coming from my back, and my AS, despite never examining my knee. I’m certain it’s tendon damage and an orthopaedic colleague dr agrees.

So now in A&E seen by orthopaedic dr, who feels as well as tendonitis I’ve either partially torn or completely torn my lateral ligament. Spent the night in a corridor, only to find they couldn’t do urgent mri on the Saturday, and could be 2-3 days. So they let me home, to return urgently when slot comes up.

Now my useless gp is due to phone today to discuss this switch, yet my pain is still 7-8/10. I’ve been told potentially I may need surgery. The A&E Dr is the first dr to examine my knee properly and was surprised no one has picked it up in 8 weeks. I told her I’ve given my gp my view on each visit.

Am I being unreasonable refusing to switch whilst this is going on. Shes concerned about my total opiate usage, which with the patch equates to 36mg morphine, but currently using tramadol takes it to 75mg, but that is not my normal dose. Not looking forward to her call, as I know we will end up arguing, she likes to keep talking over you. I currently can only walk about 6 steps to my ensuite for the loo, ant attempts at more, has pain deep in the shin, knee and thigh. Cryin B out in agony in the night, which I hate as it disturbs hubby, who needs bud sleep as he’s working. Thankfully he’s wfh as much as possible and my daughter who’s in Leeds is staying on and wfh here as well to help out. Hope everyone else is having a better time than me.

[Annscottie]

No words seem adequate but sending best wishes and hope for speedy resolution. x

[helixhelix]

this is outrageous, and also horribly inefficient! Had the GP taken proper steps weeks ago there may have been no need for paramedics etc.

There us never much point in loosing your cool with a GP, but I think you do need to be politely forceful and perhaps say you are going to formally complain to your local commissioner. Your treatment is seriously sub-standard! Sure opiate overuse is dangerous but you are requesting this in a very specific circumstance and for a a time limited period.

But hope you get MRI soon and some effective help.

How do I find the commissioner?

Contact your local integrated care board (ICB) for complaints about primary care services (GPs, dentists, opticians or pharmacists) and secondary care, such as hospital care, mental health services, out-of-hours services, NHS 111 and community services like district nursing.

Every ICB will have its own complaints procedure, which is often displayed on its website.

Find your local integrated care board (ICB)

[Runrig01 in reply to helixhelix]

Thanks. I’m always polite but put my points across. Much the same as when I’d advocate for my patients, when Drs made similar suggestions. She is nice as a person, but very dappy. She’s even phoned in the past and just dropped a bombshell of having pulmonary fibrosis, without any explanation of what would happen going forward. I felt that should have been a case of we need a F2F to discuss results. I would hate an elderly person living alone being given that news on the phone.

Hopefully hear today or tomorrow about mri, hubby is hiring a wheelchair as I can only do around 6 steps. I need to have my wound dressing changed at the practice today. I fell 8 weeks ago because of the knee buckling, and gashed my leg. Every dr blamed the knee on the fall, despite the knee pain and buckling starting a week earlier. Although my rheumatologist had ordered a spine and pelvic mri initially, but on seeing me 12 days ago, he organised an Mri of the knee, but haven’t received a date for that one yet.

[Deeb1764 in reply to Runrig01]

If going in to see GP take someone with you to take notes and make sure you dont leave till you get the answers needed. Unfortunately it takes on some occasions reinforcements to back us up!

[J1707-]

omg !! That’s atrocious. I feel you need to complain. To prescribe without even seeing your knee is unprofessional and potentially dangerous. Stick to your guns and reminder she failed you and until you have a diagnosis and an appropriate plan then there will be no changes. Hope your MRI happens sooner than later .x

[Stills]

That’s disgraceful, GP should be reported and reprimanded. Wishing you better times

[Runrig01]

thanks everyone, I even bought a cricket type splint to keep my knee from buckling. I thought it might also reduce the pain, but sadly it doesn’t. I can’t even tolerate walking to the kitchen to make a cuppa, as standing on my leg within 20-30 secs is excruciating, and unable to tolerate crutches, as using muscles to hold leg off the ground to hop is also excruciating. Hubby and daughter have been marvellous 🤪

[medway-lady]

Sorry to read this and with CKD I’m also not allowed NSAIDS but when I broke my leg and ankle last year the A&E did offer me some pain relief pills the problem is I can’t remember the name. So there has to be something, I didn’t take the prescription as the paracetamol worked and I was advised to take regularly before I thought I needed it as that way it works properly. Would Pregabalin help it did work when I got Shingles a few years ago otherwise can you get some advice from the NRAS as you in such an awful situation. My mum had a cracked vertebrae and found that Butrans patches helped for that but I don’t know if that helps you.

[Runrig01 in reply to medway-lady]

I’m currently using butran patches, and they’ve been increased from 15 to 20mcg for this pain. Pregabalin I’ve used previously for head pains but it caused rapid weight gain, and it’s more for nerve pain which this isn’t. Hopefully they will phone re mri soon, as in the early hours of Saturday they said 2-3 days

[Runrig01]

Thanks, I was a nurse for many years, so aware of the benefits of paracetamol alongside stronger meds. The Oramorph is not something I take usually. It’s helping this acute pain from the ligaments and tendons, but is only 100mls, so won’t last long.

I’ve used pregabalin in the past for the head pains associated with GCA, it helped, but gained weight quickly. As I say I’m more than happy to work with her once I have a treatment plan for my knee. Hubby has had to rent me a wheelchair for now, to get to appointments etc

[Mmrr]

I'm so saddened to read this.You are not being unreasonable asking to be taken seriously and have your pain controlled ( and to be examined).

I'm sure you know the process, but time perhaps to raise a complaint with the practice manager ?

[Sheila_G]

Oh bless you. You have not been treated well at all. You need a scan asap. Keep on at them. You will get there. Good luck.

[Runrig01 in reply to Sheila_G]

Phoned mri yesterday, who said despite it being marked urgent, it will probably be towards the end of the week. 🤞

[Bethany02]

Insist that your pain be managed by a professional and remind her pain is what the patient says it is

[Runrig01 in reply to Bethany02]

After our disagreement at trying to swap during an acute episode, for an injury we don’t know the extent of, she backed down. I suggested oramorph for between doses if needed. Initially she said the surgery had a policy of only prescribing to palliative care patients. She went to get pharmacists advice, which was to remain on current meds and add oramorph 🤪.

I phoned mri yesterday, and they hope to get it done by the end of the week, despite being marked urgent. Keeping fingers crossed I hear today or tomorrow 🤞

[Bethany02 in reply to Runrig01]

Definitely hope it's soon🤞

[Monkeysmum]

So sorry to hear about your awful pain Maureen, and the ongoing battle with your GP. It really shouldn’t be this difficult. thinking of you and sending a big hug. 🤗

[cyberbarn]

It sounds like your GP doesn't know the difference between acute pain and chronic pain! Sounds like it is time to raise a complaint with the practice manager, going to PALS if that doesn't work. Withholding pain medication from someone that has acute pain is one of those 'learning situations' that your GP can use for her next appraisal!

[katieoxo60]

Hello Runrig01, I am hoping that you have an MRI scan scheduled now or have had. I agree with others on post this is not good procedure, but recall a similar situation myself with my knee. No one even examined my knee but I ended up having a total knee replacement. Your Dr is merely following guide lines to reduce your opioids as is the current NHS schedule at present. Glad to hear the paramedics are backing you. The time to reduce drugs is after successful treatment, the drs allegiance should be to you the patient However there is a limit to how high a dose of opioids you can take so the DR in this case may be correct. Hopefully now your case has been highlighted you will get better personal pain control till your knee is correctly diagnosed and treated , but it should not be like this everyone's pain perception is different and hence control is different. My GP by the way did apologize in my case and followed it through immediately. Hope you feel a little better now its being addressed . Wishing you every best wish for relieve from the severe pain.

[Runrig01 in reply to katieoxo60]

I contacted mri yesterday, they have been inundated with urgent requests, but hope to do it by the end of the week.

I fully understand the current pressure for gps to review opioids, and am more than happy to comply once acute pain is under control. My usual current opioid usage per day works out at 40mg/24hrs. That has increased to 80mg/24hrs due to extra tramadol and some oramorph to deal with the knee pain, which seems very similar to labour pains. Keeping fingers crossed I hear soon 🤞. Thanks for your kind wishes 🤗

[BeachsideVia]

Tendon pain can be so painful, I know! Last week my herniated L4L5 disc acted up and pain got worse and worse. I went to urgent care and got a steroid shot. Had the same thing a year ago. also steroid dose packs for other various acute pain. Would steroids help you? reduce inflammation, no nsaids, one shot.......

I pray you heal quickly!

[Runrig01 in reply to BeachsideVia]

I had a weeks course on my A&E visit when I said I suspected tendonitis on 8th July, from sudden increase in activity. I normally walk 9 miles a week, but was on holiday and clocked 27 miles. It was only 20mg for 1 week, and it did reduce the pain from an 8 to a 4. However quickly returned. My rheumatology nurse then invited me in for a steroid injection, as X-ray showed an effusion. However rheumy was reluctant to inject, and ordered an mri. He didn’t want steroids masking the injury when scanning. They’ve organised the mri for tomorrow at 9am, then I have to return to A &E for treatment plan. As soon as I move, even just to nip to the loo it’s excruciating. The A&E dr believes I’ve torn the lateral ligament as well. Hoping if it has, it’s partial and just needs bracing . Thanks for your kind words 🤞🤗

[Intheend]

So glad to hear you have your MRI appointment. Hope results will be available quickly so you can finally get an appropriate treatment plan in place.

In the meantime I really hope your GP “allows”you adequate pain relief to tide you over🤦🏻‍♀️

Sending my best wishes