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kaberett... goes a little like this.
We greet and exchange pleasantries. "How are you?" gets asked. I do the very brief run-down of what my PHQ-9 has looked like; my GP remarks that last week my counsellor dropped him a note about how I was doing; I respond that I've been dealing with some deadlines I'm finding stressful because they're blocking me on coming back to work, and consequently have been doing lots of Interpersonal Skills and Self-Soothing and had the option of seeing counsellor yesterday night but decided not to.
But, I say, I think you actually asked me to make an appointment so we could talk about the fact that I've increased my mefenamic acid dose...? OH RIGHT, says my GP, yeah, I just assumed it was about the mirtazapine, how's that going? So I summarise how that's going (I think I'm hurting slightly less and functioning slightly better, but it's hard to tell; I'm definitely hurting less while trying to get to sleep). And what's your dosage? says my GP, 500 three times a day every day? Yep, I say, up from 250 three times a day every day. And you're taking omeprazole daily as well, right? Yes, yes I am, because I have mysterious undiagnosed stomach pain not attributable to H pylori, but the omeprazole seems to keep it under control. We have a brief conversation about whether my plans are to stay on the mefenamic acid long-term; I repeat that I've been on approximately this regime since 2012, haven't had any stomach pain, and that he can refer me to a pain clinic if he likes but honestly they'll just tell him that they want to increase my amitriptyline (which we can't do without decreasing my anti-depressant because of the compound cardiac effects, and thus the trade-offs arise about whether we really want me to be on a TCA as my antidepressant and what the risks thereof are), and the only alternative is to reduce everything else and up my codeine but I'd rather keep the opiates for special occasions. Yeah, okay, he says, but if you get stomach pain... yeah yeah yeah I know, I say.
So, I say, now we've sorted that out, can I have enough of all my scrips to get me through the holidays? Oh howsabout I just up your prescriptions for all of them to two months' worth, he says, followed by some chatter about what precisely constitutes two months' worth of any given medication and why he'd prescribed me the number of tablets he had.
Prescriptions get printed off.
One last thing, I say: I've got an appointment with the hypermobility clinic, it's in March (ugh, he says, pulling a face, March, that's ages away -- nah it's fine it's way better than some Clinics I Have Known, I say), could I please have a copy of the results of the lung x-rays from last year to take with Just In Case, even though they presumably should have a copy? He starts poking at the system: I'm sure I sent it to them but yeah, by all means, he says. I'm sure you did, I say as he digs it out and prints it off, but -- okay, I love the NHS, but I don't always trust it to do paperwork, alright? My gynae back in Cambridge managed to not tell the hospital he was operating on me so they had to find me a bed in a hurry when I showed up for the afternoon theatre session having been nil-by-mouth for six hours. I love Andy Prentice, I really do, he's brilliant, but he's shit at paperwork.
... Andy Prentice, says my GP. Now there's a blast from the past, I was on his team for a while as a student.
I grin.
I tell the anecdote about the time I showed up post name-change, confused the hell out of the registrar, and Andy when summoned looked at me, looked at my notes, and said "Had a falling out with your dad, then?"
My GP corpsed. I grinned cheerfully, waved, and said goodbyes while heading out the door. It had been exactly ten minutes.
I find it quite frustrating trying to work with medical professionals who (a) can't cope with dense rapid streams of information and (b) don't trust me. This perhaps explains why, and also perhaps explains a bit better what I am offering to do when I offer medical advocacy.
Meanwhile, for my own records, the actual summary on the lungs!
We greet and exchange pleasantries. "How are you?" gets asked. I do the very brief run-down of what my PHQ-9 has looked like; my GP remarks that last week my counsellor dropped him a note about how I was doing; I respond that I've been dealing with some deadlines I'm finding stressful because they're blocking me on coming back to work, and consequently have been doing lots of Interpersonal Skills and Self-Soothing and had the option of seeing counsellor yesterday night but decided not to.
But, I say, I think you actually asked me to make an appointment so we could talk about the fact that I've increased my mefenamic acid dose...? OH RIGHT, says my GP, yeah, I just assumed it was about the mirtazapine, how's that going? So I summarise how that's going (I think I'm hurting slightly less and functioning slightly better, but it's hard to tell; I'm definitely hurting less while trying to get to sleep). And what's your dosage? says my GP, 500 three times a day every day? Yep, I say, up from 250 three times a day every day. And you're taking omeprazole daily as well, right? Yes, yes I am, because I have mysterious undiagnosed stomach pain not attributable to H pylori, but the omeprazole seems to keep it under control. We have a brief conversation about whether my plans are to stay on the mefenamic acid long-term; I repeat that I've been on approximately this regime since 2012, haven't had any stomach pain, and that he can refer me to a pain clinic if he likes but honestly they'll just tell him that they want to increase my amitriptyline (which we can't do without decreasing my anti-depressant because of the compound cardiac effects, and thus the trade-offs arise about whether we really want me to be on a TCA as my antidepressant and what the risks thereof are), and the only alternative is to reduce everything else and up my codeine but I'd rather keep the opiates for special occasions. Yeah, okay, he says, but if you get stomach pain... yeah yeah yeah I know, I say.
So, I say, now we've sorted that out, can I have enough of all my scrips to get me through the holidays? Oh howsabout I just up your prescriptions for all of them to two months' worth, he says, followed by some chatter about what precisely constitutes two months' worth of any given medication and why he'd prescribed me the number of tablets he had.
Prescriptions get printed off.
One last thing, I say: I've got an appointment with the hypermobility clinic, it's in March (ugh, he says, pulling a face, March, that's ages away -- nah it's fine it's way better than some Clinics I Have Known, I say), could I please have a copy of the results of the lung x-rays from last year to take with Just In Case, even though they presumably should have a copy? He starts poking at the system: I'm sure I sent it to them but yeah, by all means, he says. I'm sure you did, I say as he digs it out and prints it off, but -- okay, I love the NHS, but I don't always trust it to do paperwork, alright? My gynae back in Cambridge managed to not tell the hospital he was operating on me so they had to find me a bed in a hurry when I showed up for the afternoon theatre session having been nil-by-mouth for six hours. I love Andy Prentice, I really do, he's brilliant, but he's shit at paperwork.
... Andy Prentice, says my GP. Now there's a blast from the past, I was on his team for a while as a student.
I grin.
I tell the anecdote about the time I showed up post name-change, confused the hell out of the registrar, and Andy when summoned looked at me, looked at my notes, and said "Had a falling out with your dad, then?"
My GP corpsed. I grinned cheerfully, waved, and said goodbyes while heading out the door. It had been exactly ten minutes.
I find it quite frustrating trying to work with medical professionals who (a) can't cope with dense rapid streams of information and (b) don't trust me. This perhaps explains why, and also perhaps explains a bit better what I am offering to do when I offer medical advocacy.
Meanwhile, for my own records, the actual summary on the lungs!
There is accentuation of the bronchovascular markings due to asthma. There is no acute focal collapse consolidation. Normal cardiac outline.