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Doctor being difficult

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AlanLiv

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I spoke to my doctor on Monday 13th March. She asked what my blood sugar reading was and I said it was always between 5.5 and 6 and had been for two years. (I was admitted to hospital in June 2020 after having a seizure. It was then they found I had type 2 diabetes)

She said that my blood sugar was too low and I should stop taking Gliclazide. She ended the conversation by saying she'd get back to me. I ordered the testing strips and lancets the same day.
When I checked on the NHS app the next day the Gliclazide had been "ended" ón the 13th.
I checked again on Friday 17th and discovered the testing strips, lancets and statin had been "ended" on Thursday 16th.
I submitted an e-consult that morning to try and find out why these items had been "ended" and received a call back Friday afternoon from a locum at the surgery. He asked me if I needed help from the Mental Health team to get over my fear of catching Covid by coming to the surgery for a blood test. He asked me to think "long and hard." No explanation about the ended medication. He said that my doctor would send me a letter.

The letter arrived yesterday:
"You have declined any monitoring of your medications or your blood pressure. Unfortunately that poses a risk to your treatment for needing statins and your treatment of diabetes. Untreated diabetes poses the risk of severe complications, sight loss, peripheral neuropathy and will likely significantly affect you.

I have discussed your case with the other GPs in the surgery and unfortunately none of us feel safe to continue prescribing your medications without the appropriate monitoring. For this reason I have discontinued your diabetic medications and your statin. I would strongly like to encourage you to uptake the monitoring of your medication. We have also stopped prescribing your testing strips and the lancets as you are not on any medications that require daily sugar monitoring.

If you change your mind, please contact the surgery. We will be more than happy to arrange the necessary tests and restart medications as needed."

So, I believe it all comes down to me refusing to go to the surgery for a blood test because I don't want to risk catching Covid. It's the first one I've been invited to since I left hospital.
I feel like I've been put on the "naughty step".

So I don't have diabetes any more? Apparently I don't need the testing strips because the diabetes medication has been stopped?

I pride myself on never being a strain on the NHS I didn't even register with a GP until I was 70.

Sorry it's so long but I think I've covered all the salient points.

Any help would be much appreciated. If I've posted this in the wrong forum, I apologize and perhaps it could be moved?
 
I mean, they are clearly hoping that this *enormous* pressure being put on you will mean that you change your mind and agree to blood tests, because they cannot realistically medically claim that leaving your diabetes untreated is safer for you than treating it. So they’re hoping that it doesn’t come to that.

Should you change your mind? Well I suppose that’s up to you in the end. Personally I would be more fearful of uncontrolled blood sugar and the consequences of that than I would be of catching Covid, but that’s probably because I’ve had Covid and it was fine, a minor sniffle for three days and that was it. I know not everyone is as fortunate (although of course the VAST majority are).
 
Random finger prick readings that you take will not give the doctor enough information to judge your HBA1c reading which is what they need in order to determine suitable treatment. It also doesn’t allow them to check your blood pressure and cholesterol levels and determine what treatment is necessary. It’s understandable that they don’t want to give you pills which might cause you significant harm if they guess the wrong dose.

I guess the question is why you feel you will catch Covid if you go in the doctors surgery? Are you considered clinically vulnerable in which case I would expect the doctors to put appropriate procedures in place for you. Is it just the surgery which makes you feel anxious? Or all contact with other people? No need to actually answer any of these here if you don’t want to share more info. A chat with a mental health expert may well be the best way to explore these feelings and whether they are due to a real risk, or the result of heightened anxieties over the last three years.
 
I am clinically vulnerable, but I do go in for my blood tests. How else can my doctor and myself decide what treatment I need?
It is a risk for you to stop medication and testing for diabetes and the complications that come with it (eg kidney failure), but it is a professional risk for a doctor to treat you without the tests.
What can you do to reduce the risk of catching covid at the surgery - wear a good quality mask, use hand sanitiser after you touch doors or chars?
 
I have had similar treatment from my GP too. Did not get my annual checkups since 2020 due to Covid and GP availability. Then suddenly a telecon saying he as stopping my medications until I had a review. That was 2 months ago, and my meds did indeed stop. I have just had my bloods taken, and I get my review in a fortnight. He did remove the stop on my meds, and I collected them on Friday.

My heart team also discharged me from care saying I was unresponsive. When I queried it they said they had tried many times to call me but I did not pick up the phone. I replied that I ignored all call centre and unrecognised calls since I get around 10 scammer calls a day. I finally got a letter from them and I go to see them tomorrow,

As someone who also worries about Covid I empaphise with you. But my surgery is reasonably well self distanced and we do not sit long in a crowded waiting room like we used to.
 
They always do my drugs review over the phone.
 
I'd suggest you talk to the GP about what options there are regarding support for you, what measures are in place to protect you for taking the blood sample and if there is anything which can be done to reduce risk further if you are still concerned after the discussion.
 
Maybe ask the surgery if a district nurse could call and take the blood? In my area you have to be registered bedbound for that but its a postode thing. My Pandoras medicine chest of strokes, heart attacks, heart surgery, heart failure, kidney failure, and diabetes does not qualify me for home visits.

PS despite these comorbidities, in Jan this year my carer rang me one day and told me she and her partner were down with covid, which would explain why I had a sleepness night with a hacking cough and the shivers. Only one night of it then it cleared up like it had been switched off. My LFT was negative, and follow up tests were also negative. So it seems my covid booster did a splendid job in routing the enemy before it took hold. Are you inoculated?
 
They must be on some sort of “drive?”

I had usual tests done with a DSN twix last Christmas & new year. She arranged to ring me at a certain time a couple of days later. Then an appointment t endo & another nurse team a week later in the new year 23.
Then some mysterious phone calls? (I don’t answer hidden numbers either.) I was also working in a noisy environment. No answerphone message left. So, 3 maybe 4 missed calls over a 2 day period & a problem regarding a script for insulin that should have been processed at my chemist?

Then I had a text from the surgery. So I rang. & was quickly put through to the locum trying to contact me…

Basically, she was asking if I still needed my insulin.. I explained my position (T1.) & that I did.
She went on to add. So you are still using it then.? I can’t understand this she went on, you’ve had recent satisfactory checkups. Been for the eye scan..
But is been a little while since you last ordered insulin.

I then went on to point out my insulin requirements on a daily basis & due to the amount prescribed on any given request I had built up a stash & had been working my way through it.

I tend not to rock the boat with my surgery, They are on the whole pretty good. Satisfied she processed the script.

All this happening after a cluster of motivational checkups so I can renew my driving licence.

If I didn’t know any better, the ease & early appointments must be due to wary patients with covid which I empathise with.

Sometimes, you just have to hold a candle to the devil. In order to get things “done.” (In my case, keep driving.)
 
Blood tests can be done by appointment at the hospital and GP's normally. I find you wait less time and in a less crowded room (often empty) at the hospital. Alternatively choose a time of appointment so that queues from over running can be avoided., e.g. first appointment of the day or first appointment after lunch or last appointment of the day.

I find that Gliclazide has a strong and immediate effect on me so I swopped to slow release Glicizide 30mg. This trickle release was just right for my diabetes variety. Perhaps discuss changing as this avoids the peaks and troughs of the standard Gliclazide.

Blood pressure machines can be purchased for around £20 (Boots Argos etc)my GP and diabetic nurse accept these figures as true and accurate.
 
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Right or wrong this is what some GP's are doing nowadays. But let's be honest here, I'm guessing you've refused the test for quite a while and that's why they've pulled the plug on your medication etc.

You have conditions that need treatment and monitoring.
 
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HarveyD said:
Right or wrong this is what some GP's are doing nowadays. But let's be honest here, I'm guessing you've refused the test for quite a while and that's why they've pulled the plug on your medication etc.
Click to expand...

HarveyD said:
You have conditions that need treatment and monitoring.
Click to expand...
That's a bit harsh to be honest. It is not always a case of swallowing your pride and get things done. I arrange for the earliest appointment first one of the day. I have to be masked up to the hilt and sit there shaking with sheer panic and doom, ocd running into overdrive! Please don't think its JUST a case of "swallow your pride and get the test done" it is not always that easy when you have health anxieties on top of other mental health issues which can physically stop you. I know I have been there, still am and although I have had my tests, I have cancelled them and re-scheduled that many times I have lost count. I have also on many occasions bolted, run out of the surgery explaining that I cannot cope! This has been marked down on my records that I walked out which was not the case and vehemently fought to get it changed on my notes. Covid is still out there and for some people the safety of our safe space is all we want despite the tests etc we need to take.
 
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And your point is?
 
I am classified as clinically vulnerable but have always gone to my medical appointments including blood tests and eye checks. I wear a mask, take sanitiser and if I felt the waiting room was too full I waited in the corridor. I feel the risk of covid is less than diabetes complications . I dont get any test strips etc on the NHS and have always bought my own. I only use mine finger pricks to check if I eat a new food etc. I think you really need to reconsider going in for the tests. Maybe ask for an appointment at a quiet time? Consider asking if you can stand outside until its your turn and asking if someone could call you or come and fetch you when its your turn. My brother used to do that because he had MH issues and the surgery always obliged
 
OK. Putting my recent tests & wot not into context. My surgery & ophthalmologist stuff still minimises contact with others either in the hospital or surgery. Due to the nature of the appointment you will see an HCP whilst wearing PPE on both sides.

Folks. Please express empathy for the concerns our member has regarding the topic.

Thanx.
 
Hi @AlanLiv. My sympathy, indeed.

I like @filly's surgery as indicataed above, who calls the person with diabetes, re their prescription. So reasonable.

I agree with you - your surgery seems to be behaving in a punitive manner, rather than negotiating with you re your care and treatment.

My own medical centre explained that I had to have a review to make sure that if I died, they would know what I had died of. I laughed with the practice nurse about that one! got my prescription for metformin filled, and then cancelled the review appointment. Lol. (I had not one but two awful review appointments as I was checking out new GPs last year, six months ago and did not want a repeat any time soon, of a review appointment at any rate, with the same GPs I do not want to be paying for their lazy treatment via tick boxes and not what I was saying to them.) I am in the midst of a life change, I hope, and hope also to have a better GP than the ghastly ones at that medical practice. But as we know - that is not so easy - changing doctors for standard care.

My understanding is, medical care is still a service industry, albeit a highly educated and professional-standards led one. You are, still, the customer! In my own country (Aotearoa/New Zealand), the university which makes suggestions to medical professionals on standard of care to people with diabetes is that it be one of partnership. Not an authoritarian model. I completely get this, as so much of type two diabetes care and treatment is generated and determined hugely by the patient themselves, which medical professionals will be the first to agree with. And this forum is a huge testament to.

I think the referral to a Mental Health professional could be construed as nasty. It is not mentally ill to be nervous about what can be a deadly disease.

I'm sorry you experienced this. I hope there is someone at your medical centre that you can relate to better? At least to have a laugh with, if it comes to it. Or, is it possible to change doctors and centres? (I do know - easier said than done!)
 
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