helen-louise (baratron) wrote,

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Don't read this post if you are offended by swearing, because I am too upset to find politer language.

I had a fucking horrible experience this evening. I ran out of Efexor yesterday. Having been for once in my life organised, I had handed in the repeat prescription request on Monday night/Tuesday morning, and therefore expected there to be Efexor waiting for me at the pharmacy today.

HOWEVER. Allegedly, some "doctor" decided in her infinite wisdom that I couldn't have any more Efexor, even though I still had one repeat left before a review was due, because I hadn't had my blood pressure checked in a while. Never mind that I've been on it for, like, 10 years at this point, and if it was going to affect my blood pressure we'd have known that by now. Never mind that it is a drug that you must NEVER stop taking cold turkey because your head will explode. (Look up venlafaxine withdrawal syndrome sometime. It isn't pretty.)

So, this alleged doctor issued the prescription for everything else except Efexor, WITHOUT TELLING ME. There was a post-it note on the prescription to tell me I needed to have my blood pressure checked before more could be issued. At 5.58pm I had to cycle round to the surgery and bang on the door to get them to sort it out.

I say "alleged doctor" because there was a mistake on the prescription too. I'd asked for Flixotide aerosol inhaler 250 micrograms, and had been issued not only that, but also 2 x Flixotide powder inhalers 100 micrograms. Which is a bit of an administrative-type mistake, really. It's true that I have had the same drug in multiple administration methods in the past (e.g. sodium cromoglicate in both eye drops and nose spray), and it's also true that you can get fluticasone both for asthma and for nasal allergies - but these were both asthma inhalers, and surely no one would want the same drug for the same condition in two different types of inhaler? In fact, I have a vague feeling now that I might have crossed out the Flixotide powder inhaler 100 micrograms and written alongside "Please remove this from the repeat".

I am totally and utterly pissed off. If I need a fucking blood pressure check before issuing a medication, then someone at the surgery should fucking well phone me. You have my home number and mobile number. The prescription goes straight to the pharmacy, how was I supposed to see the note? And you, the doctors' surgery, get annoyed if patients order a repeat prescription too far in advance of running out of pills, because "we're not supposed to stockpile". Surely it was pretty obvious that I only had a few days' worth of pills left on Tuesday? A brief check through my medical record would show that I have been depressed on and off for a very long time, and that it's likely not safe to have me manage without even over a weekend.

And then! To top it off - the fucking doctor who I spoke to decided from nowhere to hassle me about the dose of Efexor that I'm on, because "it's very high". Once upon a time, 225 mg of Efexor XL (the extended release form) was the highest recommended safe dose, but that was years ago. Nowadays people can take up to 375 mg in situations of severe depression. Rather shocked to be randomly hassled, I said "actually, it's not that high - I know people on 300 mg and 375 mg, and this is the extended release version". Bear in mind that I didn't even know she was a doctor at this point. She said "Never mind them, you should reduce the dose for the sake of your health. It comes in 32.5 mg capsules". I just... stared. I said "I've been on this dose for about 10 years and haven't had any problems with it". And she replied "Oh, that's a very long time to be on such a high dose. Reducing it even by 32.5 mg is better for your health".

I said "The overall plan is for me to increase the dose of my mood stabiliser and then gradually reduce the dose of the Efexor. But I am not well enough to reduce the dose of the Efexor yet". And she said "Not even by 32.5 mg?". And I said "NO. Actually I've spent quite a lot of the past couple of weeks wanting to be dead, I don't think my depression is controlled enough to come off it." And then I walked out of the surgery without challenging her because I was already in tears, and cycled round to the pharmacy and cried there (which was ok because I know everyone in the pharmacy).

(She is also wrong - the smallest capsule is 37.5 mg, and you can't get those in the UK to my knowledge. Efexor non-extended release pills can be obtained in 37.5 mg, but they also give me terrifying ultra-rapid mood cycling.)

I was just fucking flabberghasted because she had literally met me under 5 minutes ago and knew NOTHING about my mental health. She said she has 30 years experience as a GP. If she has 30 fucking years experience as a GP then she should KNOW that you can't FUCKING change a patient's dosage of medication without knowing what their health is like! And I didn't understand this generic reference to "health" anyway. Efexor is a strong and evil drug, sure, we know this - but my health is a combination of my physical and mental health, and I am willing to endure a fair number of side-effects for improved mental health. Having me able to think and function and work and study is worth the possibility of a medication, say, lowering my life expectancy by a few years. I see it as a tradeoff between having a shorter life that is worth living and a longer life that isn't.

Funnily enough, my blood pressure has been absolutely boring for years, but it's now through the roof. I can't think why.

I need to write an official complaint. If anyone can help with that please do so in comments, I feel too sick right now to deal with it. Random hugs are also okay.
Tags: medical phobia, mental health, people are stupid

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