Regular GP has left the practice...what now?

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4 months 5 days ago - 4 months 5 days ago #29478 by EBWest
Hi, everyone...

Has anyone else gone through a change of GP recently? I'm struggling a bit, to get a good relationship going with my new GP, who was recommended to me by my old GP. My old GP was brilliant for chronic pain and understood that I was not an addiction risk, (after a long running argument bewtween us, which ended up with me finally agreeing to see a, 'pain specialist', (he was a psych, so not a pain, 'specialist'), and over our seven year doctor/patient relationship, we became quite good friends. This new GP is at the same practice and I did make the effort to speak to her BEFORE asking her give to give me low dose opioids, to make sure she would be confortable with it, (many doctors aren't, due to mass media hysteria over the, 'dadadum...opioid crisis...in the US), and once she'd met me and read my files, she was happy to continue as my new GP. Thing is, before christmas, I had a long power cut. My partner was away for the weekend and my five cats looked as if they were deciding which piece of me they'd like to start eating, if I didn't get them some food - pronto! Soooo, I looked at the emergency release on the electric garage door, COMPLETELY mis- read the instructions and proceeded to pull the door up manually, putting my considerable weight into it. Well, predictably, the cord snapped and I fell heavily on my back, onto the boot of my car. It really hurt. I already have disc bulges, spina bifida and osteo arthritis in the area that I hit and the fibromyalgia wasn't even a consideration, initially. I manged to get through christmas, long drives to family, baby sitting etc, with the judiciuos use of endone, aloing wth my normal meds, but as I write, I cannot stand for longer than three or four minutes without experiencing exrcuciating pain in my middle back, pins and needles in my feel and sharp nerve pain in my middle back. I ordered an xray with my old GP, but when I saw my new GP to get the results, she told me there were no fractures and that she couldn't understand why I was still getting pain there, as the accident happened a month ago. I said to her. 'Well, it's probably a case of the fibro exacerbating a soft tissue injury. What else can I do, that I'm not already doing, to help it heal?'" She simply looked blank when I mentioned fibromyalgia and suggested that it must all be in my head and, 'do I have a psychiatrist?' Hmm. I thought the old, 'It's all in your head', mentaltiy of practitioners was a thing of the past and while I genuinely like my new GP, I worry that my care is going to be compromised, if the new GP doesn't have a working knowledge of chronic pain conditions....should I persevere with this new doctor, do you think? Or, should I cut my losses now and embark on the very difficutl task of finding a GP who is willing to maintain my low does opioid regime, upon which I so heavily rely, for quality of life? Any insights and advice will be much appreicated...

thanks,
Myalgic.
Last edit: 4 months 5 days ago by EBWest. Reason: spelling mistake

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4 months 5 days ago #29484 by Johnno
Hi EBWest,

If you go back to General discussions and go down to no 5 “A letter for those who suffer chronic pain “ print it out and give it to the new GP and just ask them to read it and can we discuss my pain tomorrow,if they’ve read it you’ll have helped at least one Dr just be mindful that GPs see a wide range of patients and some are only after strong pain medication to on sell.
Johnno

as long as I wake up alive I'm happy
Because it could be worse
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4 months 3 days ago #29515 by EBWest
Hi, Johnno...

Have just read the letter. It's fantastic - explains what we go through, without any drmamtics and doesn't alienate the health profession. Well done. I will definitely print a copy and give it to my new GP. Thanks :)

Bec.

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3 months 1 week ago - 3 months 1 week ago #29582 by EBWest
Afternoon all :),
I'm hoping you can help me with my anxiety, which has now kicked into over -drive, after an uhappy visit with my newish GP yesterday. Actually, it's more than anxiety; it's anger, disbelief, fear and depression that's assailing me. I took the,'letter', to her in the hopes that she would have a valuable insight into our plight and thus be able to look after my medical needs with compassion and understanding. She didn't read the, 'letter', for a start, explaining that she was time poor, (which I understand). However, things really went south when she questioned why my previous GP had ordered yearly pap smears for me, (I had changes last year, and also had cervical cancer in my mid twenties, so a yearly smear is a good idea for me). She finally agreed to perform the smear, but complained about it, saying she felt it wasn't really necessary. Then, she asked me how my back was going after my fall and I told her that it was improving with daily, intense hydrotherapy, which I do at home in the pool. I also walk,and do gentle yoga evey morning. she said that shew wanted me to see a phsyio and dietician, vai (No name) I told her that I didn't need a phsyio, or a dietician, because i'd already been seen and had been given all the info I needed, to be able to look after myself at home. She insited, so now I feel I'm wasting not only my time, but the (no name) nurse's time and the other health professionals' time as well, as my weight is still slowly coming off, thanks to the regime that my old GP put me on and my back is slowly coming good again. Then, she really upset me. She said, 'Well, do you you still get back pain?", and I replied, "Of course I do. If you see my notes, you'll see that I have badly degenrated discs in my cervical and lumbar spine, that I have adhesive capsulitis in both shoulders, that I have osteoarthritis in my spine, pelveis and knees, that I have osteoperosis, that I have scoliosis, that I have spinabfidia and that the whole lot is exacerbated by fibromaylgai'. Then out it came. 'I did psychiatry as a resident. Fibromaylgia is controversial and I don't believe it is a disease of the body. It is a mental health issue.'

Now, my fibromaylgia diagnosis was handed down by a highly respected rheumatologist at Gold Coast Hospital, who went to great lengths to explain to me, precisely what the illness was and what I could expect in terms of it affecting my body. He did tell me that there were a few medicos out there, who, 'didn't believe in it', (pft..it's hardly like the illness is the bloody tooth fairy), but that this was a decreasing problem. Well, it hasn't bloody decreased in Toowoomba, as far as I have experienced.

I told my newish GP that I didn't agree with her that FM was controversial at all, and I also told her that numerous studies performed in Europe and in the States, were showing promising indications that pathology will be found. She laughed. Then, she started bagging my psych, saying that as far she could see, he wasn't addressing my mentqal health issues, because in her opinion, my mental health hasn't improved under his care. How the hell can she possibly make this judgement, when she's literally only seen me three times? I'm extremely happy with my psych. Because of his intervention and guidence, I'm now able to cope with going shopping or dealing with social encounters.

So. I've lost a really good GP, who knew a greart deal about the effects of chronic pain and believed that FM is, 'real', and have been seeing this new GP who thinks that my pain is all my head and FM is a fairytale. I'm terrified of trying to find another doctor, as the hysteria around opioids plays out over here and I'm equally terrified of being accused of doctor shopping if I do try.

So bloody miserable...sorry for such a long post.
Bec.
Last edit: 3 months 1 week ago by Johnno. Reason: Sorry myalgic no name but I would report the gp to the practice manager or Qld health

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3 months 1 week ago #29584 by EBWest
Oops! Sorry, Johnno. I thought that, (no name), was a service provided by the dept of health, (federal), to offer assistance to people with chronic illnesses, although they do call them EPC's or something now. You'll need to delete or otherwise alter an earlier post of mine, where I suggested to someone that they contact the, (no name) at their local medical practice. Apologies for the incovenience...and yes, a phone call to QLD Health is on the cards for Monday morning...if I can get the anxiety under control. Take care
Bec.

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2 months 1 week ago #29679 by EBWest
Still hunting for a doctor who's willing to look after me. I really don't understand why, if a chronic pain patient who successfully uses low dose opioids as a part of their multi disciplinary pain management regime, has had their care plan and medications regime signed off by a respected pain sepcialist is STILL considered, 'too difficult to manage'. I approached a doctor last week, who was very sympathetic, but who said that he couldn't take me on while I used low dose opioids, because the Chief Registrar had decided to audit him on account of him having written more opioid scripts this year, than for the same period last year. His practice is surrounded by over fifties resorts and aged care facilities, so it's a no brainer that his opioid script perscriptions have increased. We have a large ageing population, with all the usual chronic pain causing illnesses so common sense would dictate that the number of patients requiring access to opioids will increase, over time. I'd love to have a sit down with this Chief Registrar and have a good chat about their decision making processes. I have a very strong feeling that the reason why we who require low dose opioids are being vilified and denied access to the only PBS medication that works for us, is purely a financial one. Apparently, the cost of supplying Targin, Oxycontin and Endone on the PBS has blown out in recent years and the Federal Government is desperately trying to claw back as much money as it can, by any means possible. This new doc said he would be happy to look after me IF I tapered myself off the thrity miligrams of oxycontin I take a day and switch to Orphrenadrine Citrate. I resesarched this Orphrenadrine and for all intents and purposes, it is a more dangerous drug than oxycontin. The side effects are a great deal worse; it is not recommended that you use both oxycontin and orphrenadrine together, as there is a strong risk of accidental overdose; Oprhrenadrine is adddictive, just like Oxycontin and to top it all off, under current guidelines, Orphrenadrine is not be used in chronic pain cases - it is purely for the treatment of acute pain as an ajunct to other therapies, such as physiotherapy, (essentially, the same rules for oxycontin). I am so bloody ropeable right now. Why would a drug that has worse side effects and an equal risk of addiction be suggested as a replacement therapy for chronic non cancer pain patients who use low dose opiods??? According to our legislators and health professionals, the reason they're against perscription opioids is that there are too many accidental overdoses and that they care for their patients. I'm calling that out as crap. They do know that low dose opioids can work well for chronic non cancer pain and recent research in the US confirms this. I really think that at the end of the day, it is ALL about money. Over it.

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