I cannot believe that I have put up with this for the last 8 years, since my really nice and on-the-ball GP left the practice. Yesterday I went to the appointment with the GP, Iron Knickers, that I had had to book 3 weeks ago after waiting online at patient.emissaccess (online booking) for her next tranche to be released. I booked it then so that the letter from my Neuro Rehab consultant, who would be writing to her to request my having B12 injections once a week for 3 weeks, would have been processed and the jab would be ready to go.
Duh. Rather optimistic. The letter had not appeared on her screen, she doesn't do jabs and the 'therapy room' where the injections are given are not part of the surgery and have a separate phone number. There isn't even a facility to book an appointment at the reception desk which is right beside the 'therapy room' door. But all that's small beef.
I took my BH along with me. At the time I wasn't quite sure of why I did so, to be honest. It felt a bit child-like; I just supposed I needed support. So, girded with the forum’s member’s suggestion about how GPs give needles to drug addicts and why not me (for self-injecting B12) and a comprehensive list of my symptoms as they cross over with B12, ME, Fibro and thyroid, all beautifully typed with the most relevant bits highlighted in a carefully chosen, delicate shade of non-aggressive pink, postscripted with a directly lifted quote from the BNF about the alternate day injecting protocol for neurological symptoms of B12 deficiency, I sat in the waiting room for the obligatory 40 minutes minimum and realized, to my surprise, that I had a mass of fretful butterflies battering at my guts to get out. I felt farty, sweaty-palmed, needing a wee but too fretful to go in case I missed her call and wasted 5 minutes of her precious, already constrained time.
Just thinking about it has sent me to the loo for the second time this morning. (That and the Movicol, I guess. And the bathroom is a bit of a trial – we had a water leak in the loo and lifted the carpet [I have now learned never, ever to fit carpet in a bathroom or a loo wherein lives a man] because it hadn’t dried after a couple of days. Someone, at some time in the past, has scrubbed those floorboards with that urine remover you can smell masking the pee in the worst of care homes. Like sweet, rotten apples. But I digress.)
I even said to the BH, “I feel anxious,” at which he was really surprised. Until after the appointment.
Iron Knickers eventually appeared for 0.3 seconds peering round the corner of the wall, beaming grin on her face as she called my name (she now uses my surname after I responded to her using my Christian name with the use of hers) before disappearing back to her room. We went in and it was like walking into a kind of toxic time bomb. You know that feeling when you walk into a room and the air is crackling with some kind of nervy energy? My own resolve freeze-dried. Smiling brightly, radiating a kind of efficient, no-nonsense vitality, she dashed off something on the screen then turned to face me with. “How can I help you?”
I started off about how I still felt nauseated after the GTN up the bum fiasco, describing how I had stopped taking thyroid meds for the last two days because of my BP shooting up since the event and my pulse rate remaining high after rocketing, and all she must have heard was, ’reaction’. She assured me that the abreaction had been noted on my file. I reiterated that, some eleven days later I was still feeling nauseated and a little vertiginous but I reckon she only heard ‘bad reaction’; she just did ‘puzzled face’, explaining that the response would have been instantaneous and would not linger. It was not until later in the day that I realised that she never questioned the fact that I have felt sick and swimmy-headed for the last 11 days.
It was when she asked me about how my BP and pulse rate were now and I had repeated that they had begun to calm after I had stopped the thyroxine for two days that she gasped, wide-eyed, and said, “What? You’ve stopped taking thyroxine?” I was really taken aback. I explained that T4 has a half-life of around a week even though T3’s is around 8 hours. Virtually bouncing in her chair she said, “But you’ve stopped taking thyroxine?” … yes, but only for a couple of days … “But you can’t stop taking thyroxine, it’s really dangerous …” no, i still have T4 in my system, i’m starting again today or tomorrow bec… “But you mustn’t stop the thyroxine…” … i’m not, i’ve jus… “Because it can be really dangerous …” I managed to calm her down a bit by assuring her that yes, I would re-start the bl***y thyroxine and in hindsight it was her perception that she had talked me into taking thyroxine again that enabled her to sit back in her chair and breathe again. Until I mentioned the words, “self-inject”. Now that, under any other circumstances, would have been funny.
I thought I was going to have to perform CPR on her as my husband ran for help. She sat bolt upright as though jolted by an electric charge up her derrière, hair flying, eyes bugging-out from her head with utter terror. She actually drew breath with a laboured “huhh, huhh!” We discussed the protocol of alternate day injecting. I say discussed, but what I actually mean is that she word-bombed me. About how ‘the alternate day protocol is for people who are virtually dying from neurological disorders, that the consultant, according to me because she hadn’t got his letter, was advocating once a month, that I would not know of the effect for some time because it has to build up, that I was not bad enough for more than that’… To sit in the teeth of her gale of cataclysmic warnings was enervating. She simply could not receive. I tried, with increasing weakness, to explain that by the time a patient was that ill the nerve damage would be irreversible, I tried to tell her that B12 isn’t toxic, it’s water soluble, that the quote from the BNF does not specify the degree of neurological impairment. Nothing I said penetrated. Her agenda was iron-clad and impenetrable. Foolishly I even tried to argue for the subcutaneous injections rather than intramuscular and her look of astonishment would have been comical had I not been so damn tired. She actually told me she didn’t think an injection into fat would work, that the B12 wouldn’t get into my bloodstream! I had to remind her that insulin is injected subcutaneously and yet she still looked incredulous. I didn’t bother to ask for needles.
It wasn’t until I left – with nothing more than the phone number for the therapy room nurses that I realised that a visit to my GP has become traumatic – probably for her as much as for me. My husband even asked her if she gets many patients like me, to which she replied, “Oh thank God no!” as she bowed over her desk with a groan.
I’m so tired.