GP 9 Rheumatologist 0

[ChinaWuntoo]

Following my rant ‘So angry’ about my ex-rheumy (sacked him on Friday) I had a good telephone appointment with my GP today. He doesn’t get a ‘10’ because he hadn’t read my letter although we discussed it (he’s not good at paperwork).

He agreed that we don’t need a rheumatologist anymore. YIPPEE.

He agreed to put me back on calcium (rheumy took me off).

He agreed to send me for a DEXA scan at a later date (rheumy never mentioned it).

Most important, he agreed with my suggested taper regimen - thanks DorsetLady - (GP went against the rheumy 'demand'). This was after some pressure from me: partly this was necessary because he had difficulty in getting his head round 9mg as a dosage - he knew it was easier for him if I went 10mg / 7.5mg on alternate days. I assured him that I have a 28 day dispenser and I can manage the numbers. This afternoon I picked up my prescription and he’d worked it out correctly (partly, as he admitted, because ‘I had done his work for him’.

Who needs rheumatologists? Certainly no-one needs a bad one who thinks he knows it all, ignores NICE guidelines and in other ways hasn’t got a clue.

I’m thankful for my GP. He may not be fully up-to-speed with PMR but he trusts me and listens to my ‘suggestions’. YIPPEE

[Bcol]

Result. 😀😀

[PMRpro Ambassador]

Excellent. Honestly - what is so difficult about handing the patients scripts for 5mg tablets and approximately 4 or 5 times as many 1mg tablets? Filling a dosette bix is hardly degree level applied maths is it?

[ChinaWuntoo in reply to PMRpro]

You may say so - and I agree. But GPs don't often prescribe such mixed numbers, I suppose. At least he acknowledged that I had done his work for him!

Of course, I suspect that the rhuematologist didn't even try to get his head round it and that's why he prescribed alternate days of 10/7.5 - with no regard to my needs or welfare. How long would it have been before I had a flare, dropping from 26 weeks at 10mg to overnight at 7.5mg?

Well, it's all turned out well in the end and I am sure my GP will follow what I suggest. I must discipline myself to move on or the stress will send a flare.

I am very grateful for this Forum and members who are certainly up to speed!

[PMRpro Ambassador in reply to ChinaWuntoo]

Mine manages it very well - and she can be pretty daffy at times!!!

[DorsetLady PMRGCAuk volunteer]

Result!

[MrsNails]

I always showed my GP the Maths & he’d change my Prescription accordingly....

I had to submit a Claim Form to the Travel Insurance Company, l took two forms with me & offered both, one with my name & address on, the other fully completed he only had to sign, he chose to sign & not charge me £30 or whatever the fee was then!

I used to do it in work all the time 😉 the Doctors were always happy to sign & not waste time.

So if you present them with the hard work done ie the Maths/Dose/Total Required they usually pleased that you’ve done it for them.

[ChinaWuntoo]

An aside: for us in UK: MrsNails, what you and I consider 'normal' consideration for others and trying to be helpful does usually pay off with sensible people.

Why do I get cross with Boris and his mates who today issued extra restrictions about social gatherings (of which I approve), say they will be rigorously policed and then say they start after this weekend?

Another rant over!

[piglette]

I was talking to my consultant’s secretary and she said she did not know why she bothered to type up letters for GPs as none of them ever read them!

[PMRpro Ambassador in reply to piglette]

Not just GPs - judging by some of the rubbish sent out by hospitals!

[piglette in reply to PMRpro]

Not as bad as Boris’s latest government guidance.

[PMRpro Ambassador in reply to piglette]

"The rule of six" you mean? And the other rule of 6 - at least 2 yards, the 6ft length of a coffin as I like to think of it, between you and someone else ...

[ChinaWuntoo in reply to PMRpro]

You heard that? From Italy? They don't hear that even in the next London Borough - and I'm serious.

[PMRpro Ambassador in reply to ChinaWuntoo]

I watch Sky News. But a lot of what BoJo comes up with also appears on our local online newspaper.

[ChinaWuntoo in reply to PMRpro]

In the cartoon section presumably?

[clover-4 in reply to ChinaWuntoo]

🤣🤣🤣

[PMRpro Ambassador in reply to ChinaWuntoo]

There is a great deal of amazement here at the entire sorry story but they are kind enough not to laugh. Usually ... I think it is relief at the Italian gibmint no longer being looked at as the loonies of Europe - they appear quite efficient and sane at present!

[piglette in reply to PMRpro]

All our Zumba, keep fit, Pilates, art classes etc are panicking as they don't know if they are included in the 6 only rule.

[Bcol in reply to piglette]

Hi Piglette, from what I can glean if your classes are in a designated sports or leisure centre, Covid secure, then you will probably be OK, with the usual social distancing etc. If the classes take place in a community or church hall I. E. a room you hire just for the class then the answer is probably going to be no. Peter

[piglette in reply to Bcol]

It is a village hall of which I am chairman. We have a live in caretaker. We are Covid secure. Matt Hancock did say today that The 6 rule does not apply to exercise, mind you I am not sure I trust Matt Hancock 100%!

[PMRpro Ambassador in reply to piglette]

100%????? Every time I see him pronouncing I get the impression he's making it up as he goes along after the first 2 sentences past his pre-prepared notes!!!

[piglette in reply to PMRpro]

I am amazed he still has a job. Mind you Williamson is still there. I think they are keeping him on so he can be used as a scapegoat.

[PMRpro Ambassador in reply to piglette]

I never thought I'd say how sensible MrH has become - his performance at the Health Select Committee was impressive.

[piglette in reply to PMRpro]

Were you watching the same Mr H?

[PMRpro Ambassador in reply to piglette]

He asked some very pointed questions when I was watching ...

[piglette in reply to PMRpro]

I must admit I cannot actually remember anything he said as I was rather unimpressed. At the beginning I thought he was great, then he let me down.

[PMRpro Ambassador in reply to piglette]

I thought he was the most appalling Health Secretary - but he has redeemed himself a tiny bit. Only a bit though!

[piglette in reply to PMRpro]

Andrew Lansley was the worst Health Secretary ever in my opinion.

[PMRpro Ambassador in reply to piglette]

Dreadful man - but maybe wrong place, wrong time? Possibly?

bmj.com/bmj/section-pdf/187...

But he wasn't loved in the NE!!!

thenorthernecho.co.uk/news/...

[piglette in reply to PMRpro]

Wrong place, wrong time, wrong man!

[Bcol in reply to piglette]

Fingers crossed then but you should be OK. Regarding the last point sadly, nowadays I actually don't trust or have faith in the integrity of any of them.

[piglette in reply to Bcol]

It is like swimming in treacle, muddy crystal clear.

[123-go]

Well done for persevering with your GP and getting him to send you for a dexa scan. Sounds as though your rheumy deserved the big heave-ho.

[SheffieldJane]

That was very productive anger. Well done!

[ChinaWuntoo]

To you all - many thanks. I feel better this evening. And fairly confident that the GP and I are singing from the same song sheet - well, he's a particular type of Christian so not quite the same songs .

[Suffererc]

Yes I do agree. Well done you.

[Louisa1840]

Thank you for confirming what I already know China! My family convinced me to go and see a rheumy because they were worried about me though I was more than happy with my lovely GP who is always open to my suggestions. She knows about this site and was very quick to diagnose PMR when I first presented over 3 years ago. She has a friend with PMR so that really helped! The rheumy is okay but I would much rather see my GP. Specialists tend to be too "up themselves" to be approachable ........... shouldn't it be about relationship, mutual trust and respect?

[ChinaWuntoo in reply to Louisa1840]

Yes it should - according to the NICE guidelines and other recommendations. I think it also is a fundamental principle of our NHS. Actually it's stronger than that - our wishes should be considered.

[Heron82]

Hi surprised you are on a 10/7.5 mg regimen. Why not dose reduce in 0.5 or 1mg amounts? I have had to switch to 0.5mg reductions trying to get below 19mg.

I have to put in a good word for GPs, my GP surgery is very thorough and calls to go over blood results and letters and have been extremely supportive throughout. Don't forget some of the practices have ca. 24,000 patients to cover.

Glad to learn that you have the support you now need though. Good luck.

[ChinaWuntoo in reply to Heron82]

Not me. As I said, I argued against that regimen and GP agreed to a very slow taper of 1mg spread over 8 weeks.

[Dambusters]

Never had a Rheumy. I was lucky that my GP knew about PMR and she has been superb.

[ChinaWuntoo in reply to Dambusters]

Feed my prejudice! Is your GP young?

Based on my vast experience of 1 rheumy, they're all bad!

[Dambusters in reply to ChinaWuntoo]

Yes, she is just qualified. Has relative with PMR so knows the sproblems.

[ChinaWuntoo in reply to Dambusters]

Interesting - not that I'd wish PMR on anyone, of course. I do suspect that training in UK now is likely to include some consideration of PMR/GCA - my diagnosis was made by two recently qualified locum GP's who seemed to instinctively know what my symptoms suggested and did all the rught things speedily. Mind you, I told the first one that my sister has PMR so that will have alerted her.

[Scarter770]

My rheumatologist retired 5 years ago. My GP has been taking care of me on this since. He knows I am well aware of how flares feel and how the body reacts. He has given me two separate scripts. One for 5 and one for 1 mg. That way I can slowly taper and keep up.

[ChinaWuntoo in reply to Scarter770]

Another good GP who listens.

[Dambusters in reply to Scarter770]

That's how mine works too

[Viv54]

Half the battle of you have a good GP and on board !😊

[Pome]

I must be lucky, doc just writes me a script for 200, 1, 2.5 and 5mg tabs, my Rhumys happy with my taper(Dorset Lady's). I've just told them this is what I'm doing like it or not. I've learnt a lot from this group, without the info here I would probably be a lot worse off.