Seriously, choose the right GP!

I have seen several Health Care Professionals (HCP) over the years who have been very helpful, however I seriously advise to find the right GP: one who listens; thinks about you and not the budget and who doesn't go on what he/she 'thinks'.

For example one of my GP's didn't want to put me on fentanyl because, 'I personally don't like fentanyl', fortunately I was able to put my arguement across she eventually agreed (didn't go on it in the end for my own reasons).

Then today during a phone consultation told me I shouldn't be taking what I am, tramadol and severadol together as one causes less effect than the other. I explained it gave me better pain relief than what I was on previously but he kept talking about contraindications, instead of how it affects me. He relented but I need to make an appointment to discuss further. For that I will definitely see one of the other 2 GP's who always listen and ask me what I want and are happy to give it to me as (as long as it is safe). It shouldn't be this difficulty to get help with pain relief, it's not their personal thoughts or beliefs.

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  • Hello

    Regarding contraindications, some medications just do not get on with other tablets, these medications are like drinking cyder and strong whiskey, they just do not mix and can be in some instances can be dangerous.

    Medications need to be selected to prevent problems, not make further ones

    Although I suppose we all can make informed decisions and decide to take that risk.

    We are all adults, I would expect they will look at things in that way

    Good Luck

    BOB

  • I have been taking Tramadol and sevredol for a couple of years now (Sevredol for breakthrough pain, it's the tablet version of Oromorph ) under the supervision of my Pain Specialist. I do trust him and he is one of the top guys in Europe. If it wasn't safe I'm sure he wouldn't have prescribed it. I've had no problems with these drugs together, but of course not everything suits everyone which doesn't mean they are contraindicated. We have to be mindful that GPs, except for the very few who take a special interest, are not trained in Chronic Pain. Good luck everyone.

  • On the other hand I've had "just qualified" consultants almost force me to take a drug that is seriously contraindicated to three of my other meds. Had to leave that clinic because I could no longer trust them. Yes we do have to be smart and stand up for ourselves, and maybe check contraindications for ourselves on Medscape (avail. as an App.) where they are categorised by level of risk.

  • Hi sharelle, I agree with you about choosing GPs especially with long term pain or chronic illness. It takes a lot of trials and tests to find the best relief of symptoms for the individual , and to do this requires interaction between patient and medical staff and the government is not qualified to make such decisions, doctors should not feel we the patient can't make informed decisions about our own health care. Good luck & best wishes with sorting your drugs out with the GPs.

  • Thank you, your support is appreciated

  • You are putting yourself in a dangerous position. GP's ought to have feel for what a drug does based on the results they see in other patients.

    Some drugs can produce psychotic effects without the patient realising it. I know one person who had a stay a mental hospital as the result of taking codeine and an antidepressant together. GP's who hand out drugs to keep their patients happy are not functioning well as a GP. While a GP who needs to persuaded to do a particular drug combination is probably doing a far better job.

    Some people cannot process codeine because they do not have the enzyme to break it down into morphine. So Codeine would be a waste of medication for them. The same sort of thing applies to many other drugs that are available.

    Drugs can lead one into a false sense of security, It is said: "it is easier to see the spec of dust in someone else's eye than the plank in your own." If you are doing drug combinations check with your partner or someone who knows you well on a regular basis to ensure that you are remaining mentally balanced. Another person will notice any differences while you would not be aware of any.

    Hope this helps

  • I do not think it is mental problems the gp is worrying about, but breathing problems. But hey- if a combination works it works. I am on full tramadol + codiene whilst waiting on a second procedure on spine. At this stage I want to resume light work, but to do this I will need 2x codiene or something stronger. I cannot do my previous work as it requires a lot of bending and standing. But when I was there, I needed a lot of both types of painkillers. And I am ashamed to say that I have not worked for a whole year. I may have gone back if I had fentanyl or morphine, I may not have needed to go off sick pre-op at all. And thats what it is about. If YOU function under a combo that suits, it should not be removed. I do not have imaginary pain, it is clearly visible in scan or xray, but Drs still quibble over codeine and will only let me have 28 30mg every other day (along with the usual amitriptyline, baclofen,and diclofenac). Where I lived before I could have 200 x30mg per fortnight to keep me working and FUNCTIONAL! (If there is a drug at present I really should not be taking- it is diclofenac, as it can harm fusion rate- but nobody even questions that. But is probably why I have had to seek more treatment). Functionality is key, whatever keeps you moving and doing useful stuff is GOOD!!

  • thank you, it's nice to have a reply that is not patronising x

  • I think you learn through trial and error how to deal with health professionals when you have something like chronic pain. My first attempts at getting some help with my pain resulted in me being labelled "just over-anxious". Failing to respond to certain prescibed medications led to me being discharged from a hospital clinic with the strong implication that the pain was all in my imagination.

    I am fortunate that I have found a number of GPs at my practice who listen respectfully and there is one in particular who has gone out of his way to help. He admits to not being an expert in pain management so that probably helps.

  • that's great you have found someone who is on your side

  • Maybe I should have added I've previously taken this combination with no problems and changed my antidepressant due to contraindications. I'm also a health professional with a specialism in pain meds. But thanks for the support

  • New GPs really don't like me..I know what works for me..that when the pain is bad I need Diazapam..it knocks me out and relaxes the muscles..won't find anything better..I just explain that I came to them as part of a package..me and my meds..which works very well for me..why the need to change it just because Diazapam is addictive..I hate taking tablets so I could never go down that road..i admit to the new GPs that I used to be addicted to chocolate..stops them in their tracks

  • I might try that! x

  • That is good! They seem happier to prescribe things like co-dydramol if I explain that I know it can be addictive and that I will only take it for a couple of days at a time during a flare up.

    Yes, I do have a good GP and he is supportive, but he won't just let me get away with getting everything I want! I went to see him once with a list of things I felt I needed for my pain (some of which were unrealistic). He persuaded me to see a pain consultant once more instead and he was right, it was the best thing for me. But then again, I think I also got lucky with that particular pain consultant (my 4th!), another good person who listens and respects.

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