Losing faith in HCPs.

One reason I trust Metformin so much, is that onone makes much money from it, and the Accord study was not funded by anyone who benfits from Metformin sales.....

The book “How to Lie with Statistics” is the best education I have had to spot when someone is trying to mislead me. It was a recommended book on my university first year stats course. (And no it had not just been published when I was at university!)

Guzzler said:

When I said 'What about peripheral neuropathy?' she answered 'Yes, head and neck'.

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My understanding (google) is that neuropathy affecting the head is cranial neuropathy, neck neuropathy is called cervical radiculopathy. although if you look at cervical radiculopathy that says "pinched nerve" or "dysfunction of a nerve root of the cervical spine". So arguably not peripheral.

Obviously doesn't know what peripheral means. Like you, I would not want to be considered non compliant, and I'm at a loss to make a useful suggestion. Maybe a straight "may I respectfully suggest that you google neuropathy". Then if you want to be a bit sarky you can add "because you quite clearly haven't got a clue".

The more I think about it, the more I think that she quite clearly isn't in a position to teach you anything. If your GP referred you, would you be able to ask your GP for advice, because as you say this person doesn't instill confidence.

Good luck.

ringi said:

One reason I trust Metformin so much, is that onone makes much money from it,

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I know Metformin is relatively benign, and also not the most expensive drug around, but the bill to the NHS must still be enormous, as there are probably millions (?) of people on it in the UK. Seems to me that loads of people on this forum have been able to reduce/come off Metformin and other medication by adopting an LCHF diet - personally speaking, I've also been able to stop taking antihypertensives. So the cumulative savings for the NHS could be enormous if everyone with diabetes was told about the possibility of controlling T2 through LCHF, and supported to try it if they want to. One more reason to have very little faith in HCP's.

I suffer form nerve damage all over my body and it was only after a double transplant that how much damage there was. I take strong medication and have lidocaine infusions every 4-6 weeks, but they make the pain a bit better for around 2 weeks and i no how it can effect daily life. I have never seen a DNS for it but am under a pain management team who look after me, I also have lidocaine patches that i can yous for 12 hours a day. I also look at the medication i take and they all interact with each other, This can cause other problems and i feel that the NHS is under that much pressure that you have to fight to get the best care you need. With everything that is going on it effected my mental health as well so another problem to add to a growing list. You can also ask to see another HCP if you are not happy or you do not have faith in the people who are looking after you now. It is like the consultant told me having a pancreas is not a cure and we cannot reverse everything that the diabetes has done we can only hope to find a better quality of life for you but we cannot put a time frame on it. I wish you all the best and remember you live with the pain and there is only you who can fight for your right to get the treatment you want.

KathyCP said:

I know Metformin is relatively benign, and also not the most expensive drug around, but the bill to the NHS must still be enormous, as there are probably millions (?) of people on it in the UK. Seems to me that loads of people on this forum have been able to reduce/come off Metformin and other medication by adopting an LCHF diet - personally speaking, I've also been able to stop taking antihypertensives. So the cumulative savings for the NHS could be enormous if everyone with diabetes was told about the possibility of controlling T2 through LCHF, and supported to try it if they want to. One more reason to have very little faith in HCP's.

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Metformin is easy to make and is made by lots of companies, therefore it is cheap.

If I recall correctly (and I have not looked this up for some time) Metformin costs the NHS about £30 a year, most other Type2 drugs cost over £300 a year. (And lots of people are on 3 type2 drugs!) Therefore the big savings are from people keeping under an AC1 of 52 while not using any drugs other than Metformin.

A lot of the cost of Type2 to the NHS is from complications not directly from Type2 drugs, hence keeping AC1 low without using drugs that result in complications is key to the savings.

One day someone may do some research on the benefits (or not) of Metformin for people with diet-controlled Type2, until then I take my lead from Stephen D. Phinney who is the leading low carb researcher. He thinks Metformin still of benefit even when BG is well controlled with low carb, but he has not done a study on it.

Guzzler said:

After more thought about what I heard on the above video I'm wondering whether I have been a little harsh on HCPs. One can only work with the information one is given. The true fault lies then with that very data that leads clinical practice IRL. I am feeling a little like a guinea pig at the moment.
It should be made very clear to GPs especially that reporting of side effects is extremely important but I know that this is coming at the problem from the wrong end. All data must be easily accessible and conflict of interest should be stated as mandatory. Big Food, Big Pharma I can understand but Big Academia? That is something I am struggling to reconcile.

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We are all living guinea pigs... we are all teally the generation to have a wide range of Big Pharma and big meds and ops available....

The strange thing to me is that there is no real large database that consuktants feed back to, or GPs. None of my GOs have fed back my intolerances of a lot of drugs to MHRA/Yellow card scheme. When I had cannula problems with a pump and reported them, alot of people said I was wrong here.. but the cannulas did get withdrawn worldwide, so others patients must have talen time to complain somewhere to FDA in USA..

It worries me that patients and doctors can have varying aspects to thinking about pain. I have been on 6 session pain management ACT therapy course and found it brilliant. Helped me enormously.

However, if a doctor had chronic toothache he would do his/her damndest to get rid of it.. even if it meant extracting the tooth. They would not accept being told "alter your thinking/activity and it will go!!"

I do believe that some pain is beyond meds, and not just toothache. My friend has chronic dystonia, and catherised and with po bag too. Totally wheelchair bound. Carers and a nurse at 2-4am each morning.. that is chronic, chronic pain from dystonia and opsrations that went badly wrong... however through good thinking and good syringe driver meds and more she is a beautiful, beautiful, lovely, kind laughing, caring lady.... she has a balance of both...mindfulness, thinking of nature, thinking of others AND relatively good pain management control.

I know I found out for myself that other ladies had lidocaine patches helping them with mastectomy pain relief. I was not offered it. It wasnt until I asked my consuktant when he said "you dont tolerate any pain meds, so I cant help anymore" that I asked about lidocaine patches. He said "I'mglad you mentioned as I could not tell you about these as our CCG will not pay for them"... so I could not even be told about something that would help unless I had found out for myself.. even my GP could not help when I had asked them previously... yes, I have to pay £108 for 28 days of 12 hourly pain relief -but I could not even be told about it!! My GP now prescibes on a private prescription for me to purchase.

I have no trust in HCPs, totally knocked out of me when 2 hospitals let me go hypo pre two mastectomy operations.
Only getting a Professor for my breast care has given me some trust back.

We are guinea pigs...

ringi said:

Metformin is easy to make and is made by lots of companies, therefore it is cheap.

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Add to that the patent expired years ago. The sustained release variety is slightly different because those patents are more recent and in fact some of the later patents are for a Metformin/Statin combo, god forbid. Certain brands with later patent dates will be more expensive because they will be made under license or by the patent holder. A patent lasts 20 years after initial filing, but as clinical trials are part of that 20 years you might be looking at only 14 years after availability.

As soon as a "good enough" sustained release comes out of patent that is easy for other companies to make, the price of all the sustain release versions of Metformin will be forced down, as NICE makes GPs choose the cheapest option unless the GPs can provide very good reasons to use another option.