Me "I want referral back to Rheummy", Doc "Not a chance"

bigjl

Trialia wrote: »

Actually, no, they did NOT. It is hypochondriac, do your research before posting.

The etymology of the term "hypochondriac" does not agree with what you assume it is. Knowing the difference between "hypo" and "hyper" doesn't mean you understand the rest of the root of a word, and assuming that you do just makes you look stupid.

1839, "illness without a specific cause," earlier (1668) "depression or melancholy without real cause," earlier still (1373) hypocandria "upper abdomen," from L.L. hypochondria "the abdomen," from Gk. hypokhondria (neut. pl.), from hypo- "under" (see sub-) + khondros "cartilage" (of the breastbone). Reflecting ancient belief that the viscera of the hypochondria were the seat of melancholy.

Your right, I mixed the two up and have deleted my innacurate post, will remember not to post when on pain meds and with little sleep as it leads to mix ups.

bigjl

hannahO wrote: »

So it's not just this OP's condition that are difficult to get diagnosed but there are many others and many others wrongly diagnosed cases. It happens

"The problem is that even if PMR is diagnosed properly, GPs might not be aware of guidelines from the British Society of Rheumatology for patients to be referred to a rheumatologist."

PMR is awkward to diagnose, mainly due to the usual investigations can also indicate Inflammatory Arthritis, such as RA. A lot of the symptoms are very similiar to other conditions, quite often confirmation of a PMR diagnosis is when the petient is given a course of steroids, PMR tends to improve rapidly over the first week.

This is a quote from the Arthritis UK website

" Normally polymyalgia rheumatica will be diagnosed and treated by your GP. However, you may be referred to a rheumatologist if there is any doubt about the diagnosis, or if there are complicating factors"

The CRP and ESR are only a guide, when they are elevated then you may be referred to a Rheumatologist, though it is not unusual for some conditions to only be confirmed after treatment is instigated, if the Pat doesn't respond to a specific treatment then that condition can be ruled out.

GP's are inundated with patients with a virus that insist on getting antibiotics, which do nothing for a virus, though they will treat any bacterial infections which are secondary to the virus.

The most common being upper respiratory tract infections and chest infections, the colour of the sputem is relevant, and relates to wether it is viral or bacterial, though some GP's just give out antibiotics as they don't want the hassle of a patient complaining that they never got any "pills"

Note that overuse of antibiotics is a very significant cause of MRSA.

The simple fact is the OP has no raised inflammatory markers which means unless there was something else that they where concerned about there was little point in a referral, and they hadn't taken the Amitriptyline, which is a common treatment for neuropathic pain.

By stopping taking this medication she has unwittingly become non compliant with her treatment regime.

snoop2008

prettypeach wrote: »

Yes, good point Torbruk. Cally if you haven't seen the letter(s) the GP would have received, you are entitled to see it usually.

http://www.nhs.uk/chq/pages/1309.aspx?categoryid=68&subcategoryid=160

It's good to know exactly conclusions have been reached and what exactly's been said. You can also find out things they have not told you directly already.

For each consultant I have seen, they either give you or send you a copy of the report and send a copy to you doc. The only report I did not get was my blood tests. When I asked my doctor for it to give to my dentist regarding EDS, she said it was not for me to see, even though I know what the tests results were. Good luck

TOBRUK

cally6008, I do hope that you have contacted your consultant to try and see him again, please let us know if you have been able to do so.

cally6008 wrote: »

Brief summary of doctors appointment I just had. Not in any order as such.

(100 tablets in april 2010-sept 2010 = 5 months = 20 per month ... yep I'm necking them down 4 times a day like the box says to .. NOT!!!)

Me - I want to be referred back to Rheummy cos he said to go back if I felt I was getting worse

Doc - You were sent to Rheummy before to be checked for Anklosingspondylitis and Rheumatoid Arthritus due to your gran. Your recent tests were all fine and normal, there's no inflammation showing so no point referring you back to him.

.............

Doc - Fibro and chronic fatigue are where you have pain allover and you have trouble getting out of bed, are housebound and you cant work or do anything. Your tests were fine with no inflammation showing so there'd be no point sending you up there as there'd be nothing they can do for you.

Doc - Do you still take Amtriptyline ?
Me - No, I came off it, fed up of feeling like a zombie in the morning
Doc - I gave that to you so that you could get a better nights sleep and wake up feeling refreshed
Me - I'd rather wake up tired then wake up feeling ddduuurrrrr and groggy

...............

T
Visit docs again (preferably after no tablets for a week so I'm having an extremely bad day), sit down and go .. I've got this, this, this and this and just because I cant do the bending thumb backwards doesnt mean I havent got that and I want a definite answer this time so stop fobbing me off and send me to Rheummy .. please

Gawd, it took me 3 years in pain to get the Hypermobile diagnosis from Rheummy the first time round (started in 2004)

Ding .. ding .. round 2

I know you may be having some problems taking Amitriptyline and bigjl is right in saying:

and they hadn't taken the Amitriptyline, which is a common treatment for neuropathic pain.

I take Amitriptyline along with other pain medication to try and get the pain under control - and recently had the dose increased. I suppose you have to decide whether some affects from taking the Amitriptyline outweighs and are worth it if it is effective in releiving some pain. It is also not advised just stopping this medication suddenly and without consulting your GP.

You didn't take any tablets for a whole week - I would be very lucky if I didn't take tablets for half a day!

cally6008 wrote: »

In 2004, all my pains and problems started. I was literally walking one foot in front of another, very slowly and could not stand without leaning against something. (think old woman stooped over n shuffling along without moving her feet very far). I was like this for 3 years. Then I left my full time job, took some time out and my health slowly improved although not to the point of pre-2004 which was pain free and fully active.

Several doctors later ...

In August 2010, my doc told me I was having an irritable bowel syndrome flare up. This was after me having excruiating stomach pains within minutes of eating anything. I did not know what was wrong and only seen him after symptoms carried on for 10 days. I did not self diagnose myself.

In Sept 2009, my doc said I had fibro. He prescribed codeine. I am now on my 3rd lot of 100 since Sept 2009.

In Sept 2010, my doc now says he only thinks I may have fibro.

Anyways I dont have to explain myself to you

To be honest, being on 3rd lot of 100 since Sept 2009 is very low intake if you are in so much pain, and I'm not being funny and I'm not suggesting in any way that you are not suffering. Are you also on any other pain medication?

If you aren't satisfied with your GP you really should see another. I totally understand the reasons why you would want a definite diagnosis as it is then you know what you are facing and aswell as this then appropriate treatment can be prescribed accordingly.

Trialia

I think... noncompliant or not, some of you may not understand just how bad side-effects from amitriptyline can be, judging by the last few posts.

When I was given amitriptyline, one 10mg dose was enough to put me to sleep for 24 hours and make me feel like a zombie for 22 more - and by zombie I mean I was sitting staring into space, unable to think, let alone do anything, for the whole time until it wore off. I'd rather have my incapacitating unmedicated pain level and be able to think even a little bit than be like that, a useless puppet. There are some side-effects that really are not worth the trade-off, and that's one of them.

prettypeach_2

I had horrendous effects from amitryptiline - at dosage for depression, can't remember exact dosage.
In the end I was having heart symptoms and came off it cold turkey because I was panicking. And before anyone comments, I KNOW it's not good to come off anything like that. Ideally a doctor should be consultant and it should be done gradually.
Of course I had horrendous effects from stopping it like that - psychological - but at least my heart went back to normal.
I would never take amitryptiline again.

clemmatis

Yes, amitriptyline side effects can be bad. I got my GPs to give me nortriptyline, which also treats chronic pain but is less likely to cause side effects, instead. (I had a bad reaction to amitriptyline once.) It is still sedative, but not as bad.

edit. posted at the same time as prettypeach. Prettypeach, that is what I had, on that dose. The only reason I didn't panic was that it also sedated me! I rang the doctor, he agreed I should come off it. You did the right thing when you came off it, though you should have told the doctor really afterwards. It can, at high dose, damage the heart. Years later my current GPs persuaded me to try a low dose, but on the understanding that if I got anything like that, I would stop taking it. I didn't but did get very drowsy, so I asked for nortriptyline instead.

Trialia

clemmatis wrote: »

Yes, amitriptyline side effects can be bad. I got my GPs to give me nortritpyline, which also treats chronic pain but is less likely to cause side effects, instead. (I had a bad reaction to amitriptyline once.) It is still sedative, but not as bad.

Mm. My problem when they gave me nortriptyline was that I started having visual hallucinations - really nasty ones. Auditory, I get and can deal with, but visual, not so much.

prettypeach_2

clemmatis wrote: »

Yes, amitriptyline side effects can be bad. I got my GPs to give me nortriptyline, which also treats chronic pain but is less likely to cause side effects, instead. (I had a bad reaction to amitriptyline once.) It is still sedative, but not as bad.

edit. posted at the same time as prettypeach. Prettypeach, that is what I had, on that dose. The only reason I didn't panic was that it also sedated me! I rang the doctor, he agreed I should come off it. You did the right thing when you came off it, though you should have told the doctor really afterwards. It can, at high dose, damage the heart. Years later my current GPs persuaded me to try a low dose, but on the understanding that if I got anything like that, I would stop taking it. I didn't but did get very drowsy, so I asked for nortriptyline instead.

Thanks clemmatis :beer:.
I did mention it to the GP later, they tried me on 3 different anti-d's in all. He didn't really pass any comment.

I put on loads of weight with ami and had started having really weird dreams when I thought I was awake but not like normal ones like that.. It was really horrid.

I think the dose for pain is quite a lot lower though.

clemmatis

Trialia, nortryptiline causes side effects in fewer people (and is less sedating). Both it and amitryptiline can cause hallucinations, nortryptiline will cause it in fewer people. I read up on all this after I had the bad reaction to amitryptiline.

prettypeach,

I did mention it to the GP later, they tried me on 3 different anti-d's in all. He didn't really pass any comment.

I don't entirely blame him for not saying anything! -- different a-ds, well, it can be really difficult to find the right one. (I know that isn't a very helpful comment!)

Yes, the dose for pain is a lot lower and that's why I agreed to try it for pain, though with the agreement I could just stop it.