Blinking knee again!

July 26, 2017 at 9:01 pm | Posted in arthrits, arthrits, rheumatoid arthritis, fibromyalgia, joint pai, joint pai, Me, rheumatoid arthritis, rheumatoid arthritis, rheumatoid arthritis (RA) | 6 Comments
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Sorry – not my most inspirational blog post title, but I’m not feeling very inspired!

My knee has been playing up for a couple of weeks now – mostly the left one, as usual, with the occasional twinge in the right. At first I thought it had nothing to do with RA because the pain was in a different place – behind the knee, not to the front-right as ‘normal’, and there wasn’t much swelling … but over a couple of weeks the swelling has increased a lot (in its usual place) although the pain remained mostly behind the knee. My Pilates teacher (still loving the Pilates by the way) suggested it might be a pain caused by hyper-extending the knee, which I am prone to do, so  I spent a week very consciously NOT hyper-extending the knee and then realised that, given it was always significantly worse in the morning, and that it now involved significant swelling and  greatly reduced mobility, it was probably just good old RA again. So, today I plucked up the courage to phone the doctor. (It takes courage these days, believe me!)

It seems that the receptionists have now become triage nurses! I was not impressed. We used to get ‘Can you give me some indication of the problem if it’s not personal, so I can let the doctor know’ which was a reasonable request in my view. Today I got, ‘Can you give me a brief account of the problem please.’ Well it wasn’t personal so I said, ‘Yes, rheumatoid arthritis.’

‘Oh, you want pain relief then?’

‘No, it’s a bit more than that, I’m having an RA flare.’

‘Have you seen a physio? Do you think that might help?’

‘No, I don’t think so. I’m having a rheumatoid arthritis flare and I need to speak to a doctor.’

‘Oh … OK then …’

I actually wrote to the surgery via their contact form and told them what had happened and asked what training the receptionists, being non-medical staff, had if they were now supposed to be triaging to this extent. I said that I felt it was inappropriate and that the comments suggested a lack of understanding of the difference between RA and OA. I haven’t had a reply and I don’t expect one.

The doctor eventually phoned back at 11:30, meaning it was too late to go for the blood test that I should have gone for today, because you have to be there before 11! I explained the problem with my knee and he asked how long this flare had lasted. I explained that it’d been a while because I hadn’t twigged it was RA at first due to the pain being in a different place.

Now … this my American friends may find hard to swallow, but here goes … he asked about pain relief and I told him I was alternating paracetamol (Tylenol) and ibuprofen and it wasn’t cutting the mustard. He wondered about codeine and I said no (for stomach reasons). I asked about steroids and he said no, not yet, because ‘they can be problematic’ and then prescribed me a great big box of opioid pain relief tablets (meptazinol), 60 of the things! He said to try them out because if they helped it would be useful to know there was something else in my arsenal, which is true … and if they didn’t work, to come back next week and they would have me in for an examination and consider steroids … because all this was done over the phone.

So while you guys in the US can’t get an opioid for love or money now, or not without jumping through a million hoops, I just get handed 60 over the phone with a comment on the lines of ‘Don’t use them all at once. They’re only short term.’

He told me that the prescription would be with the pharmacy ‘in five minutes’. Luckily I took this with the pinch of salt it deserved because when I went to the pharmacy 1.5 hours later it had only just arrived!

Now he was probably, very sensibly, thinking ‘She’s had this two weeks, her flares rarely last even this long, it’ll probably be over in a few days and the pain relief will provide just that, relief, while it’s on its way out.’ And if he was thinking that, full marks to him because he’s probably right.

However, there’s a nasty, suspicious part of me that thinks even though the surgery says any comments and complaints won’t prejudice your treatment, he’s seen the comment I sent in and is thinking, ‘If I give her pain relief first, it makes what the receptionist originally said right …’ That’s probably nonsense – I’m prepared to admit to a tendency to be paranoid… but with the world going to pot in the way it seems to be at the moment, who knows!

I do have some comfort in the fact he’s a doctor I’ve seen before (actually face to face seen, a miracle these days) and do actually have some respect for, partly because I felt that he treated me as an intelligent person … so it’s far more likely he’s just easing me out of a flare with much reduced pain – and it IS much reduced. Of course it’s done nothing at all for the swelling or the lack of mobility in the joint, but it’s great to be relatively pain free and we’ll see how things go in the next few days.

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Bloody Surgery Again!

April 28, 2016 at 2:35 pm | Posted in rheumatoid arthritis (RA) | Leave a comment
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That’s doctor’s surgery, not a need to have surgery, I’m very glad to say!

I put in a repeat prescription two days ago, went in to collect it today, only to be told they didn’t have it in at the chemist. (The usual route is for me to deliver my requirements to the surgery, and they pass it on to the chemist, who is thankfully very nearby, for collection in 48 hours.)

So I went to the surgery and said, ‘I put in a prescription two days ago but they don’t have it at the chemist.’

‘Oh well, it can be up to 48 hours.’

‘It’s been more than 48 hours.’

‘Well it can be up to two days, if you put it in on Monday morning, it might not come out until later today.’

‘Why say 48 hours then? It’s been longer than 48 hours. Please could check on the system and see if it’s been done.’

Rather unwillingly she checked the system and said, ‘Yes, we issued it on the 19th,’ and sat back with a satisfied smile. ‘We issued methotrexate, folic acid, hydr… hy… hydrer … can’t pronounce it but we issued all that stuff.’

Deeeeeep breath … ‘OK, well they don’t have it at the chemist. What now?’

‘Can you go over to the chemist and check?’

Really deeeeeeeeeeeeeeeeep breath. ‘As I said, I’ve just come from the chemist.’

‘Well could you check again. It might be there.’

Well, it’s only up the road, not like I have anything better to do … oh wait, yes I do … never mind. Back to the chemist.

‘Could you check on the shelf please – the surgery say they issued it on the 19th. It’s happened before that it wasn’t on the database but it was on the shelf.’

So very grudgingly the pharmacy assistant checked the shelf. It wasn’t there. ‘Well it wouldn’t be,’ she said, ‘ it wasn’t on the database.’ I’m getting really tired of repeating myself at this point but I said, ‘It’s happened before. Would you mind ringing the surgery and telling them, or shall I carry on being a yo-yo and go back and tell them again?’

‘Would you mind going over? It’ll take us ages to get through to them!’ Well I had to concede that was a fair point so I went back over. By this time I had lost any vestige of patience i had. Funny, my mum thinks I’m very patient… but that’s just an indication of her extreme impatience!

I went up to the same receptionist, glared my most menacing penguin glare and said, ‘I’m back.’

‘Oh … it’s not there then?’

‘Funnily enough, no.’

‘But we issued it on the 19th.’

‘You said.’ More glaring.

‘Well have you had the methotrexate?’

‘No, of course not. I haven’t had any of it. That’s what I’m saying. It’s not there.’

‘Well …I can’t understand why they keep disappearing …’ HA! So it’s not just me this is happening to then, marvelous! Good old surgery ****’s up again! ‘Well, I’ll print it out right now.’

‘I’m going to run out of my medications by tomorrow night – I can’t wait 2 working days.’

‘Oh no, we’ll get a doctor to sign it and send it over this afternoon.’

So I’m waiting to see if they get it right this time – good job I have spare methotrexate as it takes the pharmacy three days to order it in!

 

Blood test delay – well handled?

July 19, 2013 at 11:47 am | Posted in Me | 2 Comments
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I went into the surgery for my blood test yesterday. I got there in good time and signed in, waited until ten minutes after the appointment was due and went up to the desk to make sure the auto sign-in had worked properly. The receptionist asked who the appointment was with and I didn’t know as it wasn’t my usual nurse, so she found me by my name and assured me I was signed in. I then asked her whether I was the next patient and she said there was one person in front of me.

While not delighted, at least I knew there was a delay so I went and sat down again. Ten minutes later another receptionist called out ‘Is Pollyanna Penguin here?’ and I went up to the desk. It was now 20 minutes past my appointment time. She explained that the nurse I should have been seeing wasn’t in and that another nurse had hoped she could see both sets of patients but was (understandably) running late. She assured me I would be seen if I wanted to wait, but said that otherwise they could re-book for a week’s time, if that was OK.

This is a vast improvement on the way things ran a year or so ago, when the receptionists would just let you sit there all day, and if you went up to ask what was going on they didn’t know! I’ve had a couple of bad experiences like that in the past, so I thought this was a pretty good way of handling it.

The only thing is … when I went up to ask after ten minutes they knew the situation, so I wish someone had thought to tell me then. I know, I know – it’s only another ten minutes, right? But still, I had a busy day yesterday and I could have spent those ten minutes more productively at work than sitting in the doctor’s waiting room playing Angry Birds and feeling like one too!

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