Respiratory Ramblings…

NB: Under my new rules I consider the following to be safe.

 

Antibiotics:-

Like most people with COPD I’m extremely prone to respiratory infections. Normally, I tackle these myself as NICE, while paying lip service to GOLD, strenuously refuses to allow GPs to prescribe antibiotics in sufficient strength and volume to comply with its needs. So I buy my own.

However, a couple of months ago I had an infection which refused to respond when treated with my normal Amoxycillin, so I faxed my GP and asked for Doxycycline and, a major miracle, actually got it. This week I accidentally ordered codeine linctus. It’s not due yet and I don’t need it. Since I’ve been taking Oramorph I’ve needed codeine linctus only rarely – when it’s a case of take it or cough until I puke or pass out. Normally it would have been crossed out and a snotty note sent with the rest of my meds but I got it without the slightest quibble. This spirit of co-operation is very unusual and suggests he knows something about my condition that I don’t. Worrying.

Is my M.E. really Addison’s Disease?

 

The more I learn about Addison’s Disease the more I’m convinced it’s been creeping up on me for decades. Steroids, taken for my respiratory problems (COPD since 1996), have probably slowly trashed my adrenal glands. Taking steroids causes the adrenals to reduce their cortisol output until, eventually, they stop entirely, while also ameliorating the more dangerous effects of adrenal failure, aka Addison’s Disease – it explains so much that has no other explanation but which has tended to be written off as just more ME/CFS crapola.

Consider the timeline:-

My last letter to my GP re Addison’s Disease…

Hopefully my last, anyway – I still need injectable steroids for Addison’s support, hence this letter:-

***

March 29, 2014

***

Dear Dr. Xxxxxx

Thank you for your letter of March 26.

I am deeply unhappy to learn that, once again, APH have obscured vital information. What is wrong with these people? Does no-one there do their job properly? This ongoing incompetence is just one of many reasons for my reluctance to go anywhere near the place. I still don’t know, for example, why I spent about 10 days (unconscious for part of the time, I lost track), in the Stroke Unit in August last year – nobody would tell me.

To set your mind at rest, I have

More on Addison’s Disease…

As you might have read, Addison’s was diagnosed a year ago this month but, hey, here’s a fun fact – nobody bothered to tell me!

I recently figured it out and wrote to my GP (broken link to NICE fixed), requesting that he confirm the diagnosis, as I had received no support or information from him or anybody else during the past year. That was on the 20^th – today I got a reply (apparently he’s been on holiday and, of course, no-one had the brains to tell me).

He confirms I have Addison’s – not that I had any doubt, but that matters, as you’ll see  – and says that APH didn’t tell him, either. He’s increased my hydrocortisone (hydro from here on), script.  Don’t know what to, he doesn’t say. We’ll see.

In the meantime I can take antibiotics to treat my leg injury (I have to double my hydro dose if I take antibiotics now – that’s obviously why they made me so ill last year – I didn’t know that).

Lack of i-v expertise puts patients at risk.

Thousands of patients are dying from incorrect use of IV drips, warns Nice.

They go on to say (source, the Guardian, today), that “Patients’ lives are being put at risk by an “astonishing” lack of knowledge surrounding the correct administration of intravenous (IV) drips in hospitals in England and Wales…”

I’m not surprised.

Patients to be badgered into exercising by GPs…

NICE is apparently going to force GPs to press their patients to undertake physical activity. That will not be well received by this spoonie.

When I was well (i.e., prior to 1986, my last good year**), every holiday was spent backpacking (a sport which has nothing in common with gap-year oiks), as were many weekends, and when I wasn’t doing that I was out every available  Sunday with the Ramblers. I also, more often than not, walked to work and back – I covered almost

Preserve me from the numpties at NICE!

Source: Pulse.

***

NICE is insisting that its plan to get GPs to get patients with high blood pressure to exercise more are workable (and will apparently be imposed next year), despite the fact that the General Practitioners Committee of the BMA has denounced the plan as unworkable.

NICE’s intention is that GPs will demonstrate to hypertensive patients that exercise to drive up their heart rate will be beneficial, which is quite absurd. I know from experience that exercise drives up my blood pressure to highly dangerous levels. Ditto heart rate. Such a generalisation, by NICE, is simply stupid.

That there are some patients who will

Ed Miliband and the mental health problem…

Not for the first time, I find myself wondering exactly which planet Ed Miliband inhabits.

In his first major speech since the Labour Party conference he said that, just as Disraeli addressed the national challenge of sanitation in the 19th Century, and the foundation of the NHS followed in the 20th Century, the mental health challenge facing the UK must be addressed this century.

“One in four of us will have a mental illness at some point in our lifetime,” he also said.

He said, too, that, while

Bullshit advice from NICE re CFS…

From Pulse:-

GPs should advise patients with chronic fatigue to wait and see if their tiredness resolves itself with six months, recommend UK researchers who looked at the time course of symptoms.

NICE guidelines currently

Surgical rationing for smokers…

From Pulse**, today:-

“Exclusive: GPs have been blocked from referring smokers for any routine elective surgery unless patients quit or complete an NHS Stop Smoking course, under a draconian package of PCT cost-cutting measures.”

**Sign-up might be required.

For my money