My GP telephoned me a couple of weeks ago saying he was cutting my Phyllocontin Continus by half, as he had been advised by the consultant at APH that the full dose was toxic.
I pointed out that the toxicity was based on blood tests that were now 4 months old and, when they were done I had lost a huge amount of weight – 31kg – which resulted in an effective overdose, hence the apparent toxicity. I had now regained much of that weight, had no reason to suspect that the full dose was still toxic, and would appreciate a fresh blood test.
I got one.
What I didn’t get was any word from my GP about the result which, as he’d initiated the problem, would have been basic courtesy (a debate I’ve had with him in the past, best summed up as “Talk to the bloody patient!” and which was not well received). However, I have just had a repeat batch delivered – at the full dose. QED!
The thing is, Phyllocontin is the bedrock of my COPD medication – everything else builds on that foundation. Reducing it by half was problematic enough in APH, when I was effectively doing bugger all; it would never work at home, not unless I had someone to look after me. This isn’t an assumption – I know it from the odd occasion when I’ve run out
The next test will be the battle for the control of Tramadol. He’s decided he doesn’t like me taking it alongside morphine and Gabapentin. He’s also decided, based on no evidence whatsoever that the decision to add it to the mix was mine.
However, when I was first prescribed morphine and Gaba (Gaba takes time to build up to the maximum dose – I couldn’t wait and pushed the process, but that’s another issue), they simply didn’t work – they did nothing at all. However, on the advice of the District Staff Nurse, I took them as well as my normal pain meds – mainly Tramadol – rather than instead of, and all was well (I got no advice on the subject from my GP and, at the time, was in no condition to ask). I’ve stopped the others, but retained Tramadol which seems to be the main trigger.
Enter, a few weeks ago, my GP bitching about Tramadol and accusing me of making a unilateral decision to take it. Truth to tell, I couldn’t recall right then whether I had or not – it sounded like something I’d do! A little thought, though, and I recalled the Staff Nurse, so I fired off a fax, apprising the awkward sod of the facts, and there the matter rests as I heard no more.
Crunch time is next Monday, when I order some more Tramadol. Oh, and if he thinks he’d going to charge me for such a shit level of service, where I can only get effective pain control when pushed to the brink of suicide, he can fuck right off!
I have tried taking Gaba and morphine without Tramadol, and we’re right back to where we came in – they simply do not work. Not, at least, at the prescribed doses. Gaba is almost maxed out, though there is considerable leeway with the morphine but, as the current combo works, isn’t wildly expensive, and has no major side effects that can’t be controlled (and my breathing, which arguably should have been trashed, is better than ever), surely it makes sense to leave things as they are, and not change them purely out of pettiness?