I am not from the UK and am not familiar with the bureaucracy.
It is my understanding that the protocol for the treatment and diagnosis of B12 written by the British National Formulary is actually written as guidelines for hematologists.
If that is correct, a ploy to get medicial help is have in writing a desire to have those guidelines explored and would a referral to a hematologist be appropriate.
In the USA there is no risk to a physician to not do something. It does help to have them consider another GP may solve what they could not.
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WIZARD6787
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The British National Formulary is pretty much a reminder of medicines available - active ingredients, products and dosages, costs to NHS, etc. Aimed at doctors and other prescribers in general. Tends to be very much simplified.
The lists of medicines are derived from an NHS database - Dictionary of medicines and devices (dm+d) - probably not accessible abroad.
Well that will not work then. Thanks for clearing that up.
When in Scotland I printed out a copy of the Guidance for Hematologist and it included not just the guidelines but the biochemistry information concerning B12.
When my B12 test revealed 106 ng/l I was referred to a haematologist quite promptly and he advised me that I had nothing to worry about and that I just needed to take B12 orally for a while … no folic acid or vitamin D both of which were also low. Very much a lottery as to whether the experts are knowledgeable about B12.
So, General practices are the small to medium sized businesses. They are contracted by NHS commissioners and they provide generalist medical services in a geographical area.
There are 3 types of GP contract arrangements practices. Personal Medical Services (PMS), General Medical Services (GMS) and Alternative Provider Medical Services (APMS ).
They are still businesses and that is what we are dealing with business men and women. So, going in and asking for a referral to a Haematologist, the answer is, You have Bob Hope and NO Hope. The GP decides, they are the Decision Maker. They are a Clinician, a Manager and a Care Co-ordinator. Many GPs display the Dunning–Kruger effect which means that they over-estimate their ability and skills.
Please note that whilst training to be a midwife, working alongside one, I delivered a baby who had been lying in an abnormal position. When we had left the room, the midwife said, I have never had one of those before. Have you ? I laughed and said, No. She said, You were so calm. I shrugged.
It is only with hindsight, I realised because lots of mates are from farming stock, you just get on with things. You patiently help and calm injured animals, feed them, groom them and sprint after them when they break loose.
Medical training in minor procedures is pretty much, See one, Do one.
I could have written in the USA a huge bureaucracy. The USA military being thought of as the largest although with more robust accounting the medical bureaucracy could be the largest in the USA.
In the USA the ones most people come into contact with might be more accurately seen as in sales and on commission. Most could not begin to run a successful business as that takes more than training.
There are those that wish to be healers. They are for the most part followers and the wishing is more robust than their healing.
Then there are the healers of which I have encountered one in my life. It is obvious when you meet one and they practice humility.
Yep we def need more of that in this sad world now. A smile costs us nothing but lights up someone else’s day just that wee touch of kindness goes a long way. X
The human body is to be revered. This is the ethos that I practiced and still do. I know some stuff but there is a mammoth amount that I do not know. So, with honesty, I bow down to my own short comings.
The Human Genome Project was a phenomenally large scale world wide project and I do not pretend to understand it.
Many of us have posted about family members also having P.A/B12D and we can trace it through previous generations.
For me and anyone else with Gluten issues, I know that this is on Chromosome 6 which has 172 million base pairs. So, scientists and researchers have spent an enormously long time mapping that out.
As far as I know, but I am happy to be corrected as I am not a Geneticist, to date they have not found the chromosome for P.A./AMAG/B12D but that is not to say it does not exist.
It really is a case of being progressive and having innovative thinking.
🤣😂 Look, I studied Mathematics, so we know about gravitational forces, planetary orbits. The same patterns occur over and over in nature.
For example, the Chaos Theory - Edward Lorenz - weather systems and irregular heart beats. However, most Mathematicians are philosophical, so we laugh when people are getting stressed because we do not bother with Thanksgiving. People running around panic buying. We know that time and calendars are a man made concept based upon………. But it is not and will never be accurate. So, most things are an illusion.
If you look at an atom and binary fission whether that biological or nuclear. You will see either multiple fission or a release of a large amount of Energy. Einstein’s Theory of Relatively and also the Law of Conservation of Energy. So, as someone who can program a computer :-
a) Is someone dictating and typing for me ?
b) Am I using a piece of technology that translates my voice ?
c) Am I typing myself ?
d) I have thought of my posts and replies well in advance and am just sliding parts of windows of data window using ‘a rolling # searchalgorithm and compiling them ?
How long is the average computer program ? Well it depends in what language ? What functions you want ?
Einstein reputedly said imagination is more important than knowledge. He also stated that he came up with the theory of relativity by thinking what it'd be like to ride a beam of light.
Take a ride on a molecule of injected cabalamin in the bloodstream.
If a physician can convince someone to take blood pressure medication that shuts of part of the brain with unknown consequences and unknown long term effects that is a sale and the residuals are monitoring for life.
The sale of an operation/procedure is lucrative regardless of the outcome to the patient.
Closing the sale is part of the physicians methodology.
Making a sale quickly means more sales. Focusing on the quickest sale is lucrative.
"Well your tests are all within range I think we are headed in the right direction." Suggest a few life style changes. Can make 4 sales/hour easy 6 sales per hour if you hustle. Plus your fig from having a nurse take your blood pressie and weigh you. You can buy that second house in no time. Don't forget to keep that brand going that you have a calling, patients health is your top priory, and the problem is the insurance companies, patients and big pharma. You are wonderful and have the training to support your brand. Pretend you are elite, must not show you are common. Bow tie is a nice touch.
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