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.
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.
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
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.
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.
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.
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?
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.
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.
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 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.
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?
Have you considered INR self testing ?
Gives much better control as you can test weekly.
because she was still justifying her and her dh's behaviour
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??
Your husband is being unreasonable. But you can't blame the surgery for not wanting to condone his disinterest in his own health.
"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.
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).
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.
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.
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.
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.
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