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Rant about diabetes review/ GP surgery madness

It just goes on and on. My "initial assessment upon diagnosis" is still ongoing nearly 4 months on, with the next instalment booked for 3rd September.

Most of my questions, including some quite urgent ones, get brushed off with "Save that for your next appointment, I don't have time". Latest ***** of a nurse got quite shirty, and, mysterious coincidence - lancets and test strips were missing when I went to order my repeat prescriptions on the NHS app today. Her petty revenge isn't helping me manage my diabetes or other health conditions I can tell you.

I've pretended I think it's just a mistake and requested them through the GP's e-consult instead.

I won't let the ******** grind me down, but I really could do with a break. This song seems appropriate

Agree with this song title


Edited by mods to remove a profanity
 
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The original thread is about my frustrations with my GP surgery. As OP I'm not too concerned by whether it drifts off topic, as it's not intended for anyone else to read for information about how to manage their own diabetes. If anyone wants to add a message of sympathy or practical suggestions for ways to overcome an obstacle, that's welcome. Otherwise it's just me having my say, with no-one else under any obligation to pay attention. I post here because my family don't want to listen, but there are things I want to get off my chest. That seems to me to fit the ethos of a soapbox.

Mod edit to comply with forum ethos
 
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I post here because my family don't want to listen, but there are things I want to get off my chest. That seems to me to fit the ethos of a soapbox.

Hi,

Has your family indicated why they don’t want to listen?

As a T1 I’ve been suggesting for a few years (with my “receipts.”) I need a pump as I actually need fractional insulin doses instead of adjustments in whole units? (At certain times of the day.)
I’ve just recently been prescribed half unit pens for basal & bolus..

lol, probably a step forward to that mirage of a pump, I suppose..

It takes a few mistakes & a certain tweak with method in language to convey the “pitch” on what one requires.?
 
Has your family indicated why they don’t want to listen?
They're under stress themselves and just don't have or aren't prepared to make enough time for me to have a moan.
As a T1 I’ve been suggesting for a few years (with my “receipts.”) I need a pump as I actually need fractional insulin doses instead of adjustments in whole units? (At certain times of the day.)
I’ve just recently been prescribed half unit pens for basal & bolus..

lol, probably a step forward to that mirage of a pump, I suppose..
Yay for small wins. I try to spot positives but I can't see any caused by removing testing supplies from my repeat prescription list. Except that it led me to discover a "request prescription" option on the surgery's econsult system. But I'd still rather not to have had to iyswim.

Just realised you meant talking to NHS prescription decision makers, not forum posts. Sorry. I'm not even going to try to argue with "Nurse 3". If whoever reads my request disagrees I'll try the one GP I trust, but she's semi-retired and very part-time. I need to book some bloods with her next month so will have an opening to bring it up.
Apparently I also have a "care coordinator" at the surgery but I have no idea yet what she does.

Mod edit to comply with forum ethos
 
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They're under stress themselves and just don't have or aren't prepared to make enough time for me to have a moan.
OK. My wife is a “swan.” Great woman. Paddles to keep afloat.. Neither I or my wife are getting any younger.. lovely woman. I do what I can to let her follow the river..

I have a mother with Alzheimer’s my sister is her primary carer?
I as a man “mumsit” on a regular basis (cook, take out, support, keep company engage in conversation.) & get a female carer in every day for the hygiene. This gives my sis a break..
She has her own issue theses days with her spouse’s serious potential health issues?

There is a rich English language you could use.. My (now deceased.) T2 father told me back in the day. “Swearing is a lack of vocabulary.”

He’s not far wrong.
I sing in 2 heavy metal rock bands..
I wrote songs. In my youth.. None of them were hits on radio one.

I’ve since taken the piercings out of my face & adjusted my image.
Lost the attitude & pushed my “game” a little further?

A change is actually not as good as a rest it can give you more credibility?
 
I've had something similar in that for the past 15 years or so I've had blood and urine samples taken and then when the results are at the surgery I would be called for review. However this year I was asked to attend the review without any tests so I refused on the grounds that it is illogical, how can you discuss anything before knowing what the data is? Anyway I insisted on having the tests first then the review and that was accepted. Unfortunately the HbA1c came back at 65 when it has been in the 50's for years.
In the review we discussed how the Hb1A1c is skewed towards the latter month or even a week and as I had been on holiday immediately prior to the tests I had slipped into some bad eating and drinking habits. We booked another blood test after 3 months; this was last Friday and I am awaiting the results before my next holiday this Friday. I hope that I did not stray from the straight and narrow too much and my readings are down to my normal.
 
Oh and apparently I can no longer use the home phlebotomy service because I left the house when the surgery *insisted* I come in immediately, back at diagnosis. It's like living in a novel cowritten by Orwell, Heller and Monty Python.
Sorry you are going through this, but I had to laugh at the "novel cowritten by Orwell, Heller and Monty Python" as my surgery is unfortunately the same! Had to fight to get my Triglycerides result. Onwards and upwards xxx
 
Reading this thread brings it home to me how simillar the situations are to my own and I have every sympathy to the OP. I tend to find that we are treated by my GP practice as self inflicted sufferers draining their budgets. I had never seen the inside of a Drs surgery for 30 years yet when I went in and was told at 50 purely for an old age MoT I was diabetic it was apparently all my fault for not coming in earlier when I was healthy. Can't quite work that one out. Perhaps that is why we struggle to get mythical GP appointments as there is a queue of healthy people being seen.
I had major issues with metformin when first prescribed, without going into too much detail it created major urgency with no mercy down below and when you've got to go, you really have to go. I worked as a data engineer in data centres around the country and security is a nightmare with finger print scans, iris scans and such like. Getting inside data halls is a bit of a bind but acceptable however the same restrictions apply getting out and having to find a loo before the volcano erupts was more of a challenge believe me. When I politely tried to explain this to my DN she just told me to "ask your boss for alternative work as metformin is the most cost effective drug for people in your position."
I lost even more faith when after an annual blood test and I had a much reduced Hba1c together with lipid results all in the "green" for once I actually got the call from my GP practice and was told that they were glad my Hba1c had come down a bit but I really need to do something about my cholesterol. Thankfully I had all of my results direct from the hospital so queried which cholesterol result she was worried about. When I told her I was looking at the same results and in fact they were better than usual and "could I be reading or misinterpreting them wrongly?" she promptly said "I'm sorry I must have the wrong patient" and promptly ended the call. So much for individual patient care and maybe a lot to be said for reading off a script.
That was when I made up my mind to go it alone, ignore the "eat more porridge and weetabix, it's good for you as it's slow release." Or "change your job in order you can get to the loo quicker" and laughably "inform the DVLA that you are Type 2 diabetic."
Unfortunately I do find my annual reviews just to be a box ticking exercise, it is a one way street regarding questions with no opportunity for me to ask. I get the impression that it is a case of "we know best so put up and shut up" or " I haven't a clue what you are talking about." When I mention low carb diet they look at me as if I had just committed murder and when I now purposely ask to also have my lipid profile included in the tests in order that I can see how a LCHF diet is affecting my body they mysteriously omit those figures from the GP practice summary but thankfully I can get them from the full and comprehensive hospital results. I am with @debs248 in that there is a bit of "getting your own back" at play which is not very professional or certainly not helpful.

Maybe one day all practices will become more aligned to individual patient needs but as more and more people succumb to diabetes through no fault of their own or self inflictions I wonder if I will ever see that day.

Still onwards and upwards, keep smiling, keep testing and keep experimenting to find what is truly best for you as an
individual and not one of those moaning, money draining diabetics. (Certainly not my opinion by the way but how I see it perceived by those who should know better.)
 
I'm just going to add my *small rant to the thread. Despite the fact I see my sensible DN every 3 months and we review my meds and progress, my GP surgery won't issue any more meds until I've had a review with their Pharmacist. What a waste of both my time and their's (and NHS funds) GRRRRRRRRRRRR
 
I have had this with a GP withholding medication because they hadn’t seen results. I moved hospital clinics for that condition at about the same time, and the hospital now provide the medication instead.
Metformin is recognised for causing gastrointestinal issues. If one already has GI issues (e.g. IBS) then it wouldn’t be prescribed.
My surgery keep trying to get me to engage with them for diabetes reviews. My view (and that of one of their team) is that it’s a waste of time, as they won’t be able to do much as I’m type 1, on an insulin pump, and any assistance that I need will either be at hospital annual reviews or by contacting the pump specialist nurses.
The last GP review that I had the nurse asked me how much insulin I take and didn’t understand basal/bolus. My then diabetes consultant explained that she probably had 1000 type 2 diabetics on her books and maybe two type 1s - it would be better for her to spend time where it’s needed and me to concentrate on the hospital reviews and liaising with the hospital DSNs. That’s what I have done ever since.
Partha Kar wants more routine diabetes care in the community, but that requires significant training. Also, it’s never good to be Patient 1 for a new diabetes team unless they have a proven track record.
 
One option that used to be available in some of the circumstances discussed would be to change your local gp/surgery. Unfortunately most surgeries near me are part of a primary care network (PCN) and diabetes care is harmonised locally so you no longer have the choice to change surgery (unless you can go private). In my practice my GP never discusses my diabetes care which is the responsibility of a surgery nurse with diabetes training or a regional diabetic nurse (this regional service was put on hold for the past two years due to GP funding issues within my PCN, which have only been reinstated in the last month). I try to manage things through the nhs app and looking at my own data, but its very patchy especially when you have a range of conditions that are looked after by your gp/nurse/hospital consultant.
 
Not had a rant here for a while about my "special" GP surgery but hubby is sick of me complaining so I'll post here.

My first diabetic review since diagnosis in late April is apparently due on 17th July. Not sure how they figure that out as I still haven't had an initial assessment.

Anyway, having read up for myself about diabetes, here and elsewhere on the Internet, about what they should have provided/ told me, I asked if I needed to arrange blood tests beforehand or take a urine sample with me.

Yes, they want the urine sample, but they will draw blood *at the review* for testing. Unless they've got one of those fancy fridge-sized instant HbA1c testing machines in every surgery, what's the @#*&% point of doing it then?

My FBG is almost always in double digits and i'm on the maximum dosage of Metformin, so I'm pretty sure another medication is needed, but it'll be pure guesswork on everybody's part.

I'm not asking for special treatment or even anything particularly difficult, but really, is it too much to ask for basic common sense?
Does your surgery have an active Patient Participation Group? All surgeries should have one but some are more active than others. The system at your surgery does sound inefficient. Do look into the PPG and tell them what you’ve just said here. It’s the sort of situation that the PPG should take up with the surgery.
 
Not had a rant here for a while about my "special" GP surgery but hubby is sick of me complaining so I'll post here.

My first diabetic review since diagnosis in late April is apparently due on 17th July. Not sure how they figure that out as I still haven't had an initial assessment.

Anyway, having read up for myself about diabetes, here and elsewhere on the Internet, about what they should have provided/ told me, I asked if I needed to arrange blood tests beforehand or take a urine sample with me.

Yes, they want the urine sample, but they will draw blood *at the review* for testing. Unless they've got one of those fancy fridge-sized instant HbA1c testing machines in every surgery, what's the @#*&% point of doing it then?

My FBG is almost always in double digits and i'm on the maximum dosage of Metformin, so I'm pretty sure another medication is needed, but it'll be pure guesswork on everybody's part.

I'm not asking for special treatment or even anything particularly difficult, but really, is it too much to ask for basic common sense?
The system at your surgery does sound inefficient. Do check your see if they have an active Patient Participation Group. All surgeries are obliged to have one but some are more active than others. It’s amazing how few patients know about these Groups. Do tell them what you have said here and they should then take it up with the surgery. My PPG, of which I am Secretary, meets bi-monthly with a GP, Practice Manager and other surgery admin staff present so we are able to discuss any issues raised.
 
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