To not expect dh's dr to threaten to stop prescribing his meds?(143 Posts)
DH has received 2 letters from doctors surgery, one dated 2 weeks ago and one dated last week. First one from nurse asking him to contact nurse as he missed his INR check/blood test, saying she'd left messages asking him to call. She didn't call our home number, only his mobile. She didn't leave number for him to call her back. DH, being a man, doesn't have the surgery phone number stored on his mobile. I asked him to call surgery after receiving first letter but he forgot - he's been working long hours and away from home (hence missing his appointment).
In second letter, from our dr, dr says he's writing because they've tried to contact him several times. Dr says he remembers dh telling him he often works away from home through the week. He goes on to say he will stop prescribing his medication if he does not make an appointment within the next month as its not safe for him (dr) to prescribe the meds (warfarin). INR clinic is once a week, between 9-5. DH leaves for work at 730, home at 7pm.
(We have recently moved & changed drs. Previous surgery tested dh every 6 weeks, sometimes dh couldn't make the appointment so there were times over past few years where he wasn't tested for 2, maybe 3 months. It was never a problem as his INR is pretty regular now.)
AIBU to think this is a bit out of order (stopping dh's meds)? Yes, i appreciate that the surgery tried to contact dh, but they didn't try our home number - in which case I would have explained and this situation could easily have been avoided.
No it's not out of order.
It could kill him, cause a stroke etc if the INR is not checked.
Your GP would be negligent if he continued to prescribe without getting this checked.
The correct thing to do is discuss your difficulties regarding opening hours and see if he can get his INR checked another way. Would the GP let him do his own in between GP check. You can buy machines yourself?
Warfarin has to be closely monitored, my dad had to go ever week, for years, and the dose changed ever time by a few grams.
Your DH has to take leave to see the doctor. It's either that or be dead.
I think YABU too, I'm afraid.
I am on meds that are not available on repeat prescription & that have to be reviewed periodically. It's a pita but that's the way it is. If I need & want the meds, I have to make arrangements to attend a clinic.
So he's at less risk from becoming ill without his meds than with them? His last appt was just over a month ago when his levels were fine/well within range :&
But his meds ARE on repeat prescription!
Are you his mother? All this "oh he's a man so he doesn't know the phone number" and "he's got to work long hours" is bull. Men are able to use google to find out a phone number surely? Maybe if you stop babying him, he can start taking responsibility for his own health? He'll probably know his diary better than you to decide when he can best take some time off to have these tests done?
The doctor is acting responsibly.
Unfortunately the surgery cannot speak to you due to patient confidentiality likewise many surgeries will not leave messages.
Holly, dh's levels have rarely changed over the last 3 years he's been on it. As I said earlier, he's gone max 3 months without check and still been on same dosage. Admittedly that's only happened once ...
Cabbage, dh has thought about buying one of those machines. Will be calling surgery to find out if he can be tested somewhere else or at other times of day.
Your husband needs to grow up and take responsibility for his own health.
he needs to make an appointment to have his blood test done as soon as possible.
The GP is right not to prescribe without knowing everything is right first
What else can the doctor do if your husband is too lazy/entitled to make a simple phone call and get his appt sorted. These are strong and potentially dangerous drugs.
Nobody is "too busy" to do this.
No not necessarily less dangerous to stop the meds but maybe but there is a big difference in who takes responsibility. He maybe needs to book appt with GP take in his book and discuss his problems with appointments. The Dr can explain the risks of irregular monitoring and maybe they can come up with a solution with dh taking responsibility for his actions
Widow. DH is not allowed to use Internet at work nor does he have it on his phone. I'm not babying him so please stop accusing me of such.
I'm happy to accept IABU, I'm just surprised a doctor would threaten to stop prescribing warfarin. Why has he been taking it if dr feels he can stop prescribing it?
YABU!! His doctor would be irresponsible if he kept prescribing without knowing his INR levels. Life is busy but it's NOT difficult to arrange a doctors appt
YABU, but I see your point.
You (and your husband) know that your DH's INR has been stable for years.
Your knew Dr may not.
He is acting responsibly, but pointing out he may have to stop his meds unless an up to date INR is available to him.
He did not just stop anything at all.
And yes, your DH needs to take his own health on as his problem. It is not difficult to store the surgery's number on his phone .
Oh gawd, your new dr, sorry - no coffee yet
Ok. I KNOW dh needs to make an appt. he knows this too. He's not lazy or entitled AF, he's working very hard long hours ATM which is far from ideal but that's how it is. Your comments are rude & unhelpful, but if it makes you feel better to be abusive towards my dh, fill yer boots!
Thanks for the input.
The GP doesn't want to stop it. However if his patients won't undertake the required monitoring needed to know its safe then the GP has no choice but to stop it.
If he carried on giving it knowing he hasn't been correctly monitored then if something happens then it is on the GPs head.
If he stops it then it is clearly on record that your husband has been contacted on numerous occasions and he was warned in advance and still didn't do anything therefore protecting the GP who is only doing what he has to given the fact the patient isn't willing to take responsibility for themselves
The doctor can't keep prescribing it without your DH having regular checks. That would be dangerous and negligent.
I am looking at it from the POV of the doctor's surgery
He has already wasted their time with an appt he failed to attend. That slot could have been given to someone else, and he didn't cancel it did he ?
He is wasting NHS time and money. I don't make excuses for that. The organisation is on it's knees and one of the reasons is because people take it for granted and abuse the system. Every phone call to chase/letter they send you is the end of a time consuming process. That is what your H is doing when he is "too busy" to sort a simple appointment out.
He has been taking it to reduce his risk of DVT/PTE/stroke or whatever. That risk is reduced IF his INR is between 2-3 or whatever level is appropriate for his condition (can be up to 4.5 for certain things).
This means his blood takes 2-3 times the amount of time to clot than the next person's.
If his INR is too low, he is at risk or whatever he is taking it for in the first place. If it is too high, he is at risk of bleeding including brain haemorrhage.
It is the doctor's responsibility to ensure appropriate monitoring. If a pt does not have their INR monitored, something bad happens, the prescribing dr (the person who has signed the relevant prescription) is accountable.
With both phone call and letter being used as a reminder, and as doctors' numbers are published and readily available, then DH has no reason for not contacting thr surgery to make his appointment.
If he does not give this enough attention/priority to use/store the phone number, then that's his business, not the fault of the surgery.
YABVU. If the INR is not checked then the warfarin should not be prescribed. How would you feel if he had a massive bleed because the INR was too high, or a stroke because it was too low? Would you still be happy then that the GP had prescribed, just because it's been stable in the past? I don't think so. GPs should never give in to unreasonable demands when they know it's not safe, if it all goes wrong you can bet the patient won't be defending the doctor to the GMC saying they were only trying to help and make things more convenient. No they'll be suing them and writing into the Mail. He has a month to get the INR checked, thats plenty of notice and unfortunately if you're on warfarin then your health needs to be prioritised.
And how much chasing do you expect the surgery to do? You've had 2 letters, a call to his mobile and yet you're not happy they didn't call your home phone!! And how hard is it to google the surgery number? The GP shouldn't have to keep chasing you, your husband needs to take some responsibility for himself. And if he knew he was working away why did he 'miss' the appointment? Surely he should have cancelled it? There are lots of areas where patients are able to check their own INR at home though, so you could enquire about that.
I am not being "abusive" towards your DH, don't be ridiculous. (btw, you have just reinforced the idea that you baby your delicate flower of an overworked and busy man that is just too important to deal with the little details if someone else will do it for him)
Not only are you being U you're being stupid too.
His INR can be up or down - so his current dose can be either too high or too low. The dose he is taking right now could be wrong and leaving him in harms way - of course your doctor doesn't want to keep prescribing it - it's as likely what he's taking right now could kill him as it is that taking none could kill him. That's why it's supposed to be checked every week.
It's all to do with legal responsibilities I'm guessing.
Your dh has been stable for years however what if it changes? What if he is given the wrong dosage? It's his gp that would be legally, ethically, and personally responsible.
If your dh had called then the gp would not have to have resorted to scare tactics. It's done now, and it can't be changed.
Your dh just needs to call the surgery today and arrange an appt. He needs to put a monthly appt in his diary. Done.
If he can't make an appt then he needs to call and explain.
Hope everything works out.
If the first letter was two weeks ago about a missed appointment and the GP has told DH to make an appointment within a month, then there is six weeks between checks, isn't there?
What else can the GP do? Seriously?
his is to do with INR levels. ..they may hardly have changed in three years but occasionally they can swing and meds can need adjustment. The doctor would be negligent to continue prescribing the current dose without an accurate measurement of the INR.
Whether the letter has been worded badly is another issue
Definitely aak if there are other places he cqn go for testing.
Yabu. And I'm afraid your dh does rather need to take more responsibility for his own health. Busy or not!
The doc says action will need to be taken if DH doesn't make an appointment within the next month.
If he ends up stopping the meds then it is entirely your DH's fault for not taking responsibility for his own health. A month! How is that unreasonable?
Tell your DH to stop wasting NHS time and resources btw. Reminders and letters and missed appointments cost the rest of us money.
Wow beckandcall thanks for that. I'm being stupid. I was asking a question, IABU as I have stated previously. Not necessary for you to be so rude.
Gotta luv an AIBU first thing in morning, that'll teach me ...
People who don't turn up for appointments and who don't bother to cancel really annoy me - that is time that could have been used for someone else. It is so selfish.
He is home at 7, so could have googled the number then, phoned and left a message on the answerphone that he wouldn't attend and the slot could have gone to someone else - how hard is that?
You can bet if we didn't have an NHS and you had to pay for private medicine, he wouldn't be missing appointments and ignoring phonecalls and letters.
Your DH is no more busy and important than anyone else in the system and the system would collapse if everyone was as selfish as him.
Just read your other comment expressing surprise that the GP would threaten to stop prescribing it, as if it's safe for your husband not to take it. It's not safe at all, he would be at risk of blood clots or strokes but that would be his decision to take that risk. Hence all the communication attempts by the practice and the fact they've given a months warning. This is a dangerous drug. The deal is that the GP prescribes it if the patient attends monitoring. If the patient doesn't keep their part of the deal then the GP can't either. The GP is perfectly right to stop prescribing despite the risks this would cause, as long as they've made attempts to get the patient to have their INR checked. They would not be blamed if anything were to happen as a result. They would however be negligent to keep prescribing without an INR if the patient then came to harm.
My DH is in same position (different drug). He's out the house similar hours to your DH. He sorts it out though the odd reminder call from surgery is necessary.
Perhaps you have misunderstood/underestimated the potency of these drugs and that is why you are happy for him to continue taking them unmonitored regardless of any serious health implications?
Jesus he missed an appointment to see the nurse to have his INR checked. The next person in the queue will have taken his place. He didn't miss the appointment deliberately, it was a genuine mistake on his part. He's not selfish, lazy, entitled or any other words you care to throw at him. He's a human being (one who is more than grateful to the NHL after they saved his life!) and he made a mistake!!
Perhaps the Dr thinks if DH cannot be arsed to look after his own health why should we waste time and money chasing him?
Stop looking for other people to blame for your husbands stupidity.
Missed appointments is an inconvenience for the NHS and a waste of their resources. Making them have to write to him twice before he takes action is a waste of resources.
He needs to take responsibility for his own health.
OP, I think it was your comment: 'DH, being a man, doesn't have the surgery phone number stored on his mobile' that has set a lot of posters off.
If he's been so ill that he's recently had to have life saving treatment, how about he stopped dicking about and starts to take responsibility, instead of leaving it all to wifey?
Well, when he realised he'd made a mistake and telephoned to apologise for that he could also have rearranged the appointment.
Where have I said he "cannot be arsed" to look after his own health ffs? He made a genuine mistake.
Surely the surgery number comes up as a missed call on your husband's phone?
I agree with everyone else I'm afraid. If I were in your shoes, the only person I'd be annoyed with would be my husband for being so cavalier with his health and other people's time.
Oh, and stop with the 'he can't access the internet' rot. He can - he just tells you he can't so that you'll do all the errands. Wake up.
If my husband had genuinely forgotten an appt, he would be mortified, phone to apologise and then make a new appt asap. Not then ignore letters, forget to ring them back and not bother to look up the surgery numbef.
Incidentally, as your GP has a note that your DH works away during the week, calling his mobile seems pretty reasonable.
In what way is he "leaving it all to wifey"? All I was doing was asking a question, dh didn't ask me to ask the question. He knows himself what he's done and what he needs to do, I don't do it for him, he's a grown man.
You aren't saying much to suggest your husband cares about his health he seems to expect everyone else to do things for him and can't even remember a simple appointment
my mum has to have her inr checked every 2 weeks. if she doesn't do this her, the medication can kill her.
the medication could kill your husband.
but if you think that is less important than his freedom to miss appointments hen so be it.
ok-to answer your question in the way you seem to want it answered.
yes you are being unreasonable .
'Yes you are!'
'NO I'm not!' (Excuses,excuses)
'You are still BU'
THREE attempts to contact your husband have been ignored - what else do you expect them to do?
Whether it's meds or phones/gas/electric etc the best way to get a patient/customer to contact you is to stop their service.
As is clear from your OP (and my many years experience chasing customers) it WORKS.
No it shouldn't have come to this - because no matter what hours he works your DH should have met HIS responsibilities in relation to HIS health.
FWIW my DH works similar hours (often longer) and has monitored meds. If this situation happened in our house I wouldn't be blaming the Dr or making excuses for DH not taking responsibility for his own health.
The only person in the wrong here is your DH, and your 'reasons' for him not taking responsibility for his own stuff are just excuses. He should have done it. He didn't. His fault - not the Dr.
Yootha. I didn't say he couldn't access Internet at al, I said he can't when he's at work. His work is sometimes residential which means there's no Internet access at all during the week. His phone doesn't have Internet. Unless he goes specifically to a library/Internet cafe he cannot google anything. He doesn't have time to do that when he's at work. May be difficult for people to understand but that's the truth of it, no need for you to insinuate I'm a pier!
I would imagine that they are desperate to get your husband to respond! I doubt they will actually stop his meds, they just want him to get his arse into gear.
SEVERAL TIMES I HAVE SAID I ACCEPT IABU.
Thanks again for all the input.
Yabvvvu! Well done for coming back and taking that opinion on board.
The fact that you came on here and posted this, obviously thinking you had a good point, is indicative of the insane way the british public treat the health service. The sense of entitlement contained in your op is mad. It's unclear what you are actually suggesting - that the health service should be available for routine, scheduled care 24 hours a day? That everyone else who manages to attend outpatient clinics/gp surgeries/mw appts/day case are all less busy or hard working than your dh? That your gp is somehow obliged to prescribe meds agsinst his professional judgement, because you think it will be ok?
The wonder of our nhs means that it is very likely that he could have his inr monitored at a practice or clinic near his work while he's away - it would just mean him (a man!) coping with arranging that. I'd have thought that someone - even a male - employed to work so hard probably had a basic skill set that could cover looking up numbers and making phone calls.
Could he not have text you and said "do me a favour and send me a text with the doctors phone number on?" Or found a phone book at work?
You may have said you accept your being unreasonable but the fact that you persist in trying to defend your husbands actions shows you don't really accept that at all
If I could star LaCucina's post I would. This is precisely why the NHS is currently dying a slow undignified death, and one day in the not too distant future you will have to pay for appointments and blood tests. A large part of the British public will have no idea how good they had it until it's gone.
I didn't insinuate you were a liar. I insinuated you were a bit dim.
The vet won't fill a repeat prescription for our CAT without seeing her every few months, so its hardly unreasonable that a doctor will expect to see as person regularly re life saving medication!
IME GPs and their staff give short shrift to people who put their work before their health. This can feel unfair as we need to be employed for financial reasons of course, and often employers are not generous in allow time for appts. However, GPs are right to insist on prioritising health over work, however awkward and stressful that might be for the employed person.
Your dh obviously has a serious medical condition, and he needs to take it seriously and make his healthcare a priority.
Why, given the amount of medical appointments he must need, doesn't he have the doctors number on his phone?
You ARE making excuses for him. And enabling his uselessness and making him out to be so awfully more important than anyone else.
I did it too when I was married to my ex. He has had an interesting and steep learning curve since we split (ladies and gentlemen may I give you him not reading the letter properly and turning up to the wrong hospital. Sitting down and waiting to be called. Waiting for nearly 2 hours. Then going to the desk with his letter. To be told he should have handed it in when he arrived and that he was at the wrong hospital. I would have loved to have been a fly on the wall)
I've just read the whole thread and can't see a single place where you 'accept' you're being unreasonable. For an AIBU thread this was pretty mild tbh - it is irresponsible for your DH not to have rearranged. I work long hours on top of a hideous commute and I forget to do stuff too. For a week perhaps, not longer and certainly not when it's such a serious matter.
I suspect the issue might be that you know your DH is being somewhat irresponsible and you're scared, like you must have been scared when he needed the life saving treatment. That's natural. But please, get your hubby to make the appt, check levels and adjust dosage accordingly.
Kiri .. No, comes up as private number otherwise he would have called back.
Yootha, thanks for clarifying, appreciate it.
Freddie, he doesn't need any other check ups other than inr, I'm confused why you'd think otherwise .. I've not suggested he needs any other medical appointments ..?
I AM concerned that he's not rearranged his appointment but other than reminding him to make another appointment there's not really much else I can do.
yabu , repeat prescriptions need reviewing in case the underlying problem has changed. It can be risky not to and then who would you blame ? Missing appointments happens but most people realise , apologise and remake it . His slot won't have been taken unless the next person was running early etc so 10 minutes will have been wasted during the day - someone else could have used it if they'd known. DH works similar hours but still fits in the occasional dr/dentist appointment. If he doesn't face up to this soon eh could find himself with no GP at all.
But he needs that check up regularly. And if he was being a big boy and sorting it out himself and not missing appointments then he'd have the number on his phone and deal with it.
Don't remind him. Stop reminding him. He's a grown up
who puts in requests and collects his repeat prescriptions?
118118? Yellow Pages?
Or would expect the Drs to check his blood levels by text message, somehow?
Unfortunately, even in this world of technology, some things require a person to be physically present.
Your basic tone is that your DH's time is too precious for this inconvenience. The truth is that his medication is highly dangerous and the results of a wrong dose can be catastrophic.
LIZS, I think you already know the answer to that question!
Mrssmooth - you need to stop babying him. He's a grown man. It's up to him to sort out. Seriously.
I am guessing the doctor only rang your DH mobile as they know he works away and wouldn't be available on the home phone? Looks like they were using some logic and common sense.
I think yabu. If your husband has a condition serious enough to warrant needing warfarin then he needs to start taking his health seriously and making time to go for his INR check.
And being a man does not render him incapable of googling the surgery number.
I apologise if I'm giving everyone the impression dh is too precious/ important.
I genuinely am not making excuses for him, I'm very peed off with him for missing it then not rearranging it in the first place.
Yes, that may well have been the case tulip, but the doctor knows he's not away from home every week, so I do think that they should have tried the home phone number to be sure. But that's only my personal opinion, obviously.
Yabu and your dh is being lax, and quite honestly lazy.
Warfarin has to be closely monitored. My dm has been on it for well over 5 years and get blood tests every fortnight to determine if her medication needs changing. She has had a clot on her lung while having surgery on removing half her liver after the cancer spread.
It is your dh's responsibility as an adult to ensure ALL appointments are attended, and not for the nurse or doc to chase him. The NHS has better things to do!
Yes, YABU. I had a similar letter regarding an Asthma Review. I wasn't in any hurry to book it, they sent me another letter saying "If you don't, we might..."
It made me hurry up and book it for sure.
I was not impressed with the tone - but it worked! No doubt it will work for your DH too.
You need to stop making it your responsibility.
He's a man he doesn't have the number. Wtf?
You organise his meds and repeat scripts. Wtf?
Ring the house not his Mobile so you can explain. Wtf?
They shouldn't be discussing him with you, that would be a breach of confidentiality. So they have to talk to him. And they know he works away and rang his mobile. And wrote. More than once. The doc can't keep prescribing without checking - the doc would be leaving themselves open to a negligence suit if anything went wrong.
He is a big boy. He needs to take responsibility for his own health. And man up and sort it.
How about ... Emmmmmmm .... Get him a phone with Internet? Or can't he use directory enquiries? Or, you know, a phone book?
He has wasted NHL time and resources.
NHS. fat fingers. Plus autocorrect.
I bloomin hope so Maggie. I guess that's what the letter is aiming for - a kick up the bum to get it sorted. Have to say it did scare me as I've no idea what would happen to him (or at least, I don't want to think about what might happen) if his meds were stopped.
Haha, OP you sound like quite a feisty type - good luck. Your husband's health is his problem, you know - you can't make it your own.
So DH dies because Dr prescribes medicine without doing regular regulation checks?
Do you think Drs, nurses and NHS admin have all the time in the world to chase up patients who can't be arsed to ring and book an appointment?
No Freddie, I put in the repeat prescriptions. Because I have the time to do it and he doesn't. Docs dont have late night surgeries/weekend surgeries otherwise this situation wouldn't have cropped up!
And FFS are you seriously saying he can't get number when home in the evening and ring on way to/home from work or during lunch break next day to make an appointment?
If he dropped dead tomorrow after being gayley handed out meds that killed him because checks weren't carried out would you be so blasé about it, blaming him being a busy, inept MAN, or would you be on here asking if it is possible that you could sue bastard doctor for not following procedure?
He needs to sort it. Not you.
Can't you see that?
It's a sad state of affairs when that's what a doctor has to do to actually get your/your DHs attention re his meds.
Wow madamec! Am speechless, I really am
Do you actually think a GP should do late night weekend surgeries just to convenience your husband? Your level of entitlement is staggers.
If your hubby is that busy and that important then I suggest he finds a private gp who will charge him plenty but accommodate his oh so busy work schedule.
418000 appointments not attended in nhs in Eastern Region last year. Cost a whopping 43 million spondulies!
OK. I am fully aware that it DH's health is HIS responsbility. I'm not trying to take responsibility for his health. I asked a question. I got the answers, LOUD and CLEAR. I don't think its appropriate for anyone to start calling my DH entitled/precious/too important/lazy (irresponsible, yes, I agree with that one). However, I understand that that's what happens in most threads in AIBU. Thank you.
OP if getting to the doctors is such a problem for him, can he not go see a doctor closer to where he works?
YABU. no sympathies for anyone who fails to cancel an appointment.
Wow madam that's quite shocking.
I don't understand why people find it so hard to cancel appointments they can't attend.
oh FFS freddie HOW the hell have you got that idea? Some surgeries in the country do hold late night/early morning/weekend surgeries. I didn't say I expect surgeries to hold them for my dh. Holy moly.
Mrssmoorh it is your posts which have given a very clear picture your husband is like that. Perhaps your head is buried in the sand or your too used to having to do everything for him
Well done for accepting YABU. Not only is your GP doing whats best for your DH, he is also protecting himself.
This has come about because everyone nowadays are so quick to blame and accuse someone of being negligent. I wonder how quick you would be to complain if he didnt have his bloods checked and had a massive bleed and died. I can just see the AIBU now " my GP didnt "bother" to chase my DH up and now he's dead, can I sue/complain/strike them off etc".
And the coroner and GMC would not be happy with the GP either.
Am afraid we have to protect ourselves now as well. My medical protection fees have gone up another 10% this year, and are now only slightly less than my mortgage.
Westie, I asked him that, there's a hospital round the corner from where he works which has a drop in clinic he used to go to, but because we dont' live in the same borough where he works, he's not allowed to do that unfortunately.
Then stop whining that its their fault because they don'tdo them. If you don't like it, move to a different surgery that will accommodate your needs better.
What's who's fault Freddie? I'm not actually blaming anyone for anything!
You are blaming the GP for saying he can't keep prescribing the medication without seeing rour DH.
You said he can't go because they don't do evening weekend apptmts.
So get a different gp. Or a private one. My DP attends a private gp so he can go at night and on the weekends. It costs him £70 a pop though.
Sorry, it would cost him - he has private health insurance.
Sirzy. My posts have given the indication that DH has missed one appointment, that he works away from home and that whilst he's away from home he's got no internet access. Yes, he should have found out the number and called them - I've called him up on that. I genuinely am confused as to why you are saying I do "everything" for him ... what is this "everything" that I'm doing for him exactly?
Everyone: yes, you are.
OP: no, I'm not!
Aww, poor ickle incapable man.
So who is phoning up today to sort the problem then?
Where we live, you can only register at a surgery which is within a certain area, and this is where we have registered. When DH is not working away from home, he does attend his appointments. It's just that atm, and over the last few weeks, he HAS been working away from home.
He can get a private gp. Anywhere.
You just have excuse after excuse.
OK, Sirzy, hands up, yes I will try to find out if there is anywhere else he can have his blood tested. I'm sorry that I have the free time to do it and he doesn't. Happy now?
FFS I'VE SAID I ACCEPT I'M BEING UNREASONABLE. PLEASE READ THOSE PARTICULAR POSTS ON THE THREAD.
Could someone please tell me why you need Internet to make a phone call? Can't he use 118118 or any of the other directory enquiry services? Or a phone book?
While you keep doing this for him he will not take responsibility and you will get more and more situations like this.
His health is up to him to make a priority. If he chooses not to then he should face the consequences of that.
The doctor and the nurse are following the National Patient Safety Agency guidelines.
If the GP prescribes warfarin without ensuring that the patient has had an INR check within the last 12 weeks, the GP will be held responsible for any untoward events suck as bleeding or stroke, both of which can result in serious illness or death.
Warfarin is a very dangerous drug. When patients are put on warfarin they have to have counselling that covers all the reasons why regular testing and personal responsibility are central to safe treatment.
Anticoagulation is the second highest area of litigation in the NHS.
The INR is only as safe as the most recent test.
Your DH needs to get his act together and take responsibility for ensuring he gets regular monitoring.
I take a medication that can suddenly affect your liver. I am meant to have regular blood tests. A couple of years ago, I got busy with work and got behind with them. I had a couple of letters and then a phone call. At first, I was angry, I felt chased up and bothered. I was resentful of the way my illness restricts my life and this was the last straw. I did go back with my tail between my legs and I keep on top of my bloods now. With hindsight, I think I saw it as a massive irritation but liver failure would have been much worse. Thankfully, I had (and your DH has) GPs that is on the ball and gives a shit if their patients drop dead. He needs to take responsibility for his own health, as did I. It can be a bitter pill to swallow but he has no one else to blame but himself.
but because we dont' live in the same borough where he works, he's not allowed to do that unfortunately.
No one questioned me using a drop in clinic 60 miles from home.
It's not us you should be ranting at, OP.
But I think you know that.
YABU GP is responsible for the safety of the medication and monitoring is part of that. He has no " track record" with this GP as it's all new.
everytime a script is issued the ultimate responsibility lies with the person who signs it.
Your DH needs to be nice and smile at the GP not foul and rude and " can't do" and get his back up.... then when a good relationship is established, and the GP is on side, find out about newer anticoagulants and "near patient testing for INR" and ask if either could be made to work for him as they seem a better choice given his working arrangements. However they are both semi specialist/specialist stuff so he may have to actually attend a few hospital appointments... (and are very £££) . However either of these mean ultimately less GP visits either because you check and adjust your own wafarin ,or the newer meds don't need monitoring.
Another thread where the op asks a question, is given an answer, doesn't like it so resorts to name-calling posters who have given helpful advice.
He can probably get his blood tested privately, at great expense, in some clinic somewhere.
These threads remind me of how much people in the UK take the NHS for granted. If you were paying per visit, per blood test, per prescription and for all the medication he wouldn't miss visits because he was working. And he would make sure he picked up the phone - I presume he gets a lunch hour?
OP - you ABU.
But your husband will be able to have his bloods taken where he's working. My mother is on warfarin, and has had her bloods taken all over the country when she's been away and needed this. She's just gone to a local surgery - no fuss and issue dealt with.
I work in a GP surgery. Several of my warfarin patients who lead busy lives attend outpatients phlebotomy at the local hospital for their monitoring, as they are open much earlier than the practice is. I provide the forms and off they go. Could your dh consider this? Alternatively if you are able to book in advance then phlebotomy appointments at the GPs generally start at 8.30 which is do-able for most.
Of course the GP will have to stop the warfarin if your dh cannot comply with the testing. Frankly I have little to no patience with people who have their lives saved and then refuse to do the bare minimum to maintain their health but still expect the NHS to patch them up when they inevitably become ill.
Every person on warfarin has either a yellow book or a record folder that contains all the advice and contact numbers they need should they require advice about INR tests or warfarin dosing. This is also a NPSA requirement.
They are also given a medicalert card to keep in their wallet. This also contains contact details for the warfarin clinic.
Thea18 makes a good point - you can buy INR testing kits which might suit your husband's needs better. May be worth discussing with the GP.
YABU. The reality is that if your DH continues to be prescribed warfarin without having his blood clotting factors monitored, he is at risk of a serious internal bleed (e.g a brain haemorrhage) which could be fatal. If he was involved in a car crash or fell off a ladder or sliced his hand with a carving knife he could bleed so severely that he could die. This is serious shit.
I'm on a different drug that also requires regular monitoring. I am not allowed to order a prescription without telling them my monitoring results. I then have to also give my results at the pharmacy before they will give me the drug. This is because it is a very dangerous drug and too many people like your husband forgot
didn't take it seriously enough so they won't prescribe to anyone without results now.
It's inconvenient when you have a high pressure /time job but I've managed to juggle 2wk - 6wk monitoring with my job for 15 years now. Your husband just needs to pull his finger out. He needs to have a chat with the GP as to how he copes with monitoring and working away. I've managed to sort it despite working away at the other end of the country and abroad. It's like childcare you just have to sort it out and make it work you don't get a choice.
sashh - not for an INR test you wouldn't have. Unfortunately, they do have to test the blood at your local hospital (the GP surgery will have all the blood couriered there) - so that they can compare the current result to your last one and decide whether to increase/decrease warfarin.
I also don't think an evening/weekend appointment would be OK anyway as the blood has to get to the hospital for testing same day (while it's fresh).
"Jesus he missed an appointment to see the nurse to have his INR checked. The next person in the queue will have taken his place." Bit dim that. And at the end of the queue there was nobody to fill the last slot, because somebody did not bother turning up, and another person wanting an appointment were turned away. Every missed appointment cost the NHS money.
Why cold you not google the number and text it to him?
You are full of excuses. Like him, I suspect.
My local dentist has started charging for appointments up front.
If people dont make a conscious effort to not waste NHS money on missed appointments, I guess this government will revamp the NHS too, and start charging for appointments. Maybe a private health system for all would be on the cards, one way or another.
Your husband is being unreasonable. But you can't blame the surgery for not wanting to condone his disinterest in his own health.
I hate to be dull and organised but I have School, Doctors, Dentists and the AA all programmed in to my phone.
Suggest that, both my Doctors and Dentists have signs up saying how many hours appointments have been missed, as did the local physiotherapy dept I had to attend. The Doctors surgery is a big practice with about 12 Doctors and Nurses but it was about 144 hours of missed appointments over a couple of months the last time I noticed the sign.
OP as acknowledged she was being unreasonable and accepts that she should be annoyed with her DH rather than the GP - why is everyone going on at her??
because she was still justifying her and her dh's behaviour
Have you considered INR self testing ?
Gives much better control as you can test weekly.
I feel a bit sorry for you now, op
You have certainly been given the message loud and clear
Show your h this thread. How would he react, do you think?
YABU to ignore requests for check-ups. The doctor would be negligent if he continued prescribing without doing the required check-ups. He could be in trouble.
You've accepted that yabu and that's good. Now you have to give your husband a massive fucking boot up the backside to sort this out. I know you say his levels have been stable for years, but excess warfarin essentially killed my mum when I was 18 - she bled out on the operating table for a heart op. She may, just may, have survived if her clotting was better, but it was so bad she'd probably have died from a serious cut, let alone an op. Uncontrolled drugs are killers OP, please give your h the rocket he deserves.
YABU - But I have to admit there are some GP surgeries which make it really difficult to get to them. Have a look around, and see if you can find another surgery which is more flexible with testing times, etc.
It's easy to become blase with a medicine which is regularly given. But it is still a dangerous drug, and needs constant monitoring. It doesn't take much for the warfarin levels to change, and if they do, the consequences are very serious.
OP you have had a bit of a bashing here!
I think people ranting over one missed appointment is a little OTT. I am fairly sure that most people, at some point, have had that 'Oh shit' moment where they realise they're supposed to be somewhere right now. I have missed a nurse appointment before, and I am quite an organised person.
But... you then ring up and say sorry right away!
I also think YANBU about wishing the surgery had extended opening hours. It's perfectly true that people need to take responsibility for their own health, but the NHS is a taxpayer funded service and where possible, I think it's good if surgeries can make it easier for the working people who fund the service to take advantage of it.
That said, your DH does sound a bit of an organisational nightmare and you sound at best naive to think that the GP would be right to continue prescribing meds like this without regular testing.
As a general point, not just to the OP and her DH, nobody should receive more than one reminder letter or call (we all make the odd mistake and can forget the odd appointment) from a medical facility. It's your body and up to you to make sure you make and go to the appointments you need to look after it.
If you CBA why should stretched resources be used on you?
Sorry about your mum sparkle
He doesn't need the internet, a phone book or anything else to have the number of the surgery. It will be on one of the 2 letters surely? If he had done something about the appointment at the time he got the letter, he could have just slipped the letter in his pocket with the phone and made the call any time, any place. No need to go looking for a number at all. A lack of the number is no excuse.
OP, I can imagine you are worried about your DH's lackadaisical approach to his serious health problems and you probably only posted in the hope that somebody would say don't worry, it isn't so bad but they can't, can they? You need to stop defending your DH. Actually he is being unkind and selfish leaving you to worry for this long too. He could do with a boot up the backside by the sounds of it and a few words to make him realise this isn't just affecting him but you too.
Longer opening hours wouldn't help with blood tests, would they? Last test at my Health Centre is 5.30pm because that is the latest time they can send them up to the lab.
Count yourself and your DH lucky, OP. My Dad was on warfarin and had to go to the clinic at the hospital weekly. He was a double amputee with heart failure yet still managed to not miss an appointment.
sparkle - I am so sorry to hear about your mum. That is dreadful.
Nobody should ever have surgery while on warfarin. It should be stopped 5 days before the operation, or if an emergency, it should be reversed with vitamin K.
If the person is at risk of clotting, they should be put on short acting injections in the days leading up to, and following, the op. then put back on warfarin when safe to do so.
Unreasonable and fuckwitted IMO
Aw mrssmooth you've had a bashing here. As I said in my first post it's worth talking to the GP (will mean he needs to make one appt!) to discuss the difficulties with working. Many will be sympathetic and try and help him cooperate by offering alternatives.
FWIW I think people don't quite realise the significance of a long term condition on someone who has a job which makes GP apps tricky. YES your health is important but when a) you perceive the checks are just routine and b)work is pressured it can be hard to justify so much time off work and you want to be normal and healthy.... Not ruled by GP appts. Nothing wrong in desiring that. You can't demand it though
Thanks ladies. I've posted about it many times before I suppose - it was a massive op and needed badly enough that the surgical team decided to go ahead despite the warfarin issues. Her odds were never great tbh, but she'd have had a damn sight better chance if the clotting could have been promoted.
OP I hope you've been able to talk with you dh and that he understands why it's so very important that he make the effort to get to his gp.
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