Just a rant about my gp's surgery. Again.

[puncturedbicycle]

I rang my usual pharmacy to order a repeat prescription of levo and although they have repeats, they're expired. I guess between adding t3 and also just needing less levo for some other unknown reason, I've been using it more slowly than usual. (I need enough levo to take away with me for three months, so I thought it would just be easier to get the script for the higher dose which I will use more slowly rather than having the gp adjust the script to my current dose and then trying to get three months of it out of them, but it was not to be.)

So I rang the surgery because I'm having trouble getting there (I have agoraphobia) and the nice receptionist set me up with a six-digit PIN to use their phone ordering system to order my levo.

But my levo is not on the repeat script system. The only meds which I'm allowed to order on repeat are for psoriasis, last prescribed probably four years ago and I have never asked for another script.

So of course I tried to ring again but the phone line wasn't working. I rang four times and it never even rang, which I think is what happens when the system is overloaded.

Eventually I got through and found that my levo - levothyroxine, the medicine I purportedly have to take every day for the rest of my life - is not on the repeat prescriptions list. The receptionist's theory is that some meds require a review and perhaps I'm due a review so I have to go in and talk to a doctor about it.

Just as well I have an appointment. I already have at least three separate things I'm meant to be discussing. I've had a note from the doctor saying: Oops! No one noticed at the time but after your echocardiogram - last August - we were meant to listen to your heart again, and please come in so we can check your painful breast. And when my last test results came in they insisted on making an appointment to talk about my thyroid bloods like they do every time they show results in accordance with taking liothyroinine (low tsh, low t4). So add my new script to that.

I thought of making another appointment to keep in my back pocket in case it doesn't all get sorted out tomorrow but the first available appointment is on the 7th May, almost a month away, by which time I'll be abroad.

Any thoughts? I'm now beginning to worry that almost two weeks is not going to be enough time to get three months of levo out of them, or that they won't let me have that much at one time or whatever other obstacles they can construct. So instead I may find myself having to 1) spend £200 seeing a private doctor abroad to get a script for levo or 2) ask my partner to collect it one packet at a time and post it to me.

Is it just me or is this bonkers?

[HarryE]

It's bonkers! Yup!

[puncturedbicycle in reply to HarryE]

Well thanks for your validation! I wondered if maybe I was too demanding. Perhaps I should have started this process six weeks ago. Or six months!

[HarryE in reply to puncturedbicycle]

Haven't you heard??? They aren't there for our benefit you know

[puncturedbicycle in reply to HarryE]

My mistake.

[helvella]

You might not get three months worth of levo out of them at all! This page explains what might happen in cases such as yours:

nhs.uk/chq/Pages/1755.aspx

Going abroad for three months or more could leave you getting enough to allow you to get there and arrange a supply there. But it looks rather as if it depends on the combination of your GP, you and which way the wind is blowing.

The MHRA report on levothyroxine in the wake of the Teva problems says:

9. Levothyroxine should be prescribed and dispensed in quantities covering three months supply, where appropriate, in order to address issues of continuity of supply and also to improve convenience to patients.

mhra.gov.uk/Safetyinformati...

And this BMA document says similarly:

bma.org.uk/-/media/Files/Wo...

Rod

[puncturedbicycle in reply to helvella]

Thanks for that Rod.

The first link seems to say that the gp can give you three month's worth of meds but not more: "If you need regular medication for a stable long-term health condition, your GP can prescribe a maximum supply of three months."

And the third link says possibly twelve months can be prescribed: "Sometimes a doctor may give six or even twelve months supply on one prescription (for example the contraceptive pill, or thyroxine with a regular review in surgery once the patient is safely stabilised)." The first link is the more recently updated, but I may print out that BMA document and bring it with me as it better serves my purpose.

There often seems to be some issue between the gp and the pharmacy, so last time I went away I had to ask the gp for an extra paper script, which they filled out incorrectly and I got one packet of pills where I would normally get six. I'm prepared for there to be a lot of back and forth.

[helvella in reply to puncturedbicycle]

Unfortunately, the first link also says:

If you're going abroad for more than three months, your GP may prescribe medication to last until you can make arrangements to get it at your destination.

Which is open to all sorts of interpretations - such as "Just enough to get you there plus a few days."

Best of luck!

Rod

[puncturedbicycle in reply to helvella]

I guess the devil can quote scripture, but it seems quite straightforward to me: I'm not going away for 'more than three months' and according to the quote, it's only an issue if you're going for longer.

Which is why I will print the BMA document and bring it with me.

[Hidden]

How frustrating. You couldn't make it up could you. Good luck for tomorrow

[puncturedbicycle in reply to Hidden]

Cheers. xx

[eeng]

Thyroxine isn't very expensive online - at least it's a lot less than the £200 for an appointment abroad.

[puncturedbicycle in reply to eeng]

Interesting. I think I heard it's dangerous to buy online - ? I think it was Rod who suggested to someone that it wasn't a good idea. Maybe someone else will have a clearer memory of that discussion and refresh my memory.

[puncturedbicycle in reply to eeng]

After saying that I had a quick look online and it is carried by an online pharmacy many of us are familiar with.

[puncturedbicycle]

Is anyone still paying attention?

Doc was running an hour late but the lovely receptionist warned me and said I was welcome to come back in 45 minutes, so I went home and had a bite to eat. Much nicer than sitting there like a lemon for an hour.

Lovely new doc - locum I think - had a look at all my recent notes, weighed me ('We haven't weighed you in seven years'), asked lots of questions while simultaneously doing several other things, listened to my heart, did a referral to the breast clinic and - hurrah - wrote me a script for three full months of levo.

While she was in my file she saw the script for t3, which another gp had said he couldn't promise to continue to prescribe because of the cost, and although I said I sourced my own she gave me a script for that too.

There is still the matter of the amazing vanishing heart murmur which the private doc hears but no one else seems to hear. I don't know what to think about that, but the echo said everything looked normal, so I guess for now that will have to be good enough.

All in all very satisfactory.

[Aurealis]

Brilliant news ! Glad you had a good experience. Have a good trip.

[puncturedbicycle in reply to Aurealis]

Cheers.