To not expect dh's dr to threaten to stop prescribing his meds?

[mrssmooth]

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.

[mrssmooth]

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?

[Sirzy]

So who is phoning up today to sort the problem then?

[mrssmooth]

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.

[Freddiemisagreatshag]

He can get a private gp. Anywhere.

You just have excuse after excuse.

[mrssmooth]

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?

[mrssmooth]

FFS I'VE SAID I ACCEPT I'M BEING UNREASONABLE. PLEASE READ THOSE PARTICULAR POSTS ON THE THREAD.

[Freddiemisagreatshag]

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?

[Freddiemisagreatshag]

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.

[3littlefrogs]

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.

[crashdoll]

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.

[sashh]

but because we dont' live in the same borough where he works, he's not allowed to do that unfortunately.

wtf?

No one questioned me using a drop in clinic 60 miles from home.

[YoothaJoist]

It's not us you should be ranting at, OP.

But I think you know that.

[Theas18]

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.

[jeee]

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.

[PrettyFlyForAWifi]

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.

[3littlefrogs]

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.

[PrettyFlyForAWifi]

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.

[Fleecyslippers]

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.

[wonkylegs]

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.

[LazyMonkeyButler]

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).

[QuintEggSensuality]

"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.

[Pandemoniaa]

Your husband is being unreasonable. But you can't blame the surgery for not wanting to condone his disinterest in his own health.