Legal and ethical dilemma

[sunshine080]

My job requires a professional registration in order to perform. My current registration expires shortly and I have been contacted to renew it. In order to renew I have to confirm that I am still fit to practice, and declare that there have been no changes to my health that would impact this. So I have two choices; lie and keep my job (because without a registration, I have no job), or declare my health issues, be unable to renew and lose my job - which subsequently means losing my house, being unable to support my family and child, etc. I am already in a high state of anxiety about this predicament and the closer it gets to the expiration date, the worse it's getting.

WWYD?

This is not an either/or situation, OP, and I expect that it’s your symptoms (and possibly your medication) that are making you feel like you have only two choices.

You need to make an appointment to see a new doctor, first of all.

Then inform your professional body that you will have a condition to declare when you register but you’re seeing a dr about it and will let them know more when you do.

Then depending on timing of the registration, either declare diagnosed depression (or whatever the first dr said) or symptoms of peri menopause (if the second dr says so).

PPs have helpful advice too. Don’t despair! This is a completely manageable situation and you have the skills to manage it.

£300 for an appointment with a meno GP at the BUPA menopause plan here
I saw an excellent Dr (after not being abje to get an appt with my own one and suffering increasingly intolerable symptoms). Called them, and got an online appt within days. HRT prescription sorted.

I don’t work for them BTW!

You're absolutely right. Although I wonder if the anxiety the OP is feeling about this issue might in itself be part of the peri menopause symptoms. I certainly found even simple setbacks as insurmountable for a while. That's definitely improved by some degree but is still not quite what it was.

Please go see a menopause specialist. GPs are often gatekeepers on this issue. Since I went on HRT (estrogen, progesterone and now just recently testosterone), it's been night and day in terms of my well being.

Re-register and take some time off - I think this is actually what you need and your situation could be rectified, but you need to be away from work in order for it to happen. Get tested for menopause and go from there, but ask for second opinions along the way if you're not happy.

If nothing changes and you don't feel you can be responsible, then consider the other route.

Sending lots of healing x

@porridgeisbae
I don't feel HRT will directly help (except maybe via placebo effect) - your doctor would probably have prescribed it nowadays if you were going through menopause and wanted it, as they are less worried about cancer risk etc than they once were.

They have to accept you're peri-menopausal first. One of the GPs at my surgery absolutely refuses to accept that I am despite the long list of symptoms and issues. She doesn't seem to believe peri-menopause is a thing and as I'm still having periods it's nothing to do with the menopause.

Talking to a different GP got me the Mirena which at least has sorted out the flooding.

Don’t just assume it is the menopause, I worked in the nhs for 36 yrs & felt ILL for a couple of years raised bp, ocular migraines everything was changing tasks took longer, hearing loss, eyes deteriorating put it down to advancing years & menopause. Started HRT did help with ‘ anxiety’ that I could not control, psychological release of adrenaline up to 50 times a day. Lucky I was able to retire at 55. The nhs were unsupportive, bullying. I since have found out I have multiple autoimmune conditions & kidney disease, I think it was triggered by the menopause. See your union or ACAS get some support. There are menopause clinics or well women clinics. I am shocked how easily we women are labelled as emotional, there is very little professional curiosity. With work you have to be honest your professional body will withdraw your pin if they find you have not being honest you know this. I did this you start to worrying about the future, losing your house all this effort thinking about this ( which may not happen) not enough maintaining your PIN & asking HR & OH for help. If the person who you say is your friend told you this not sure she is. What did she think it Was going to make you feel better remember management look after their own. Be proactive. Best of luck

I agree with PPs that if you feel so unwell you shouldn’t practice atm you should ask for a sick leave.

I know it sounds too simple but have you read Davina’s book about menopause? It helps to get your thoughts together for an appointment and give your language to describe the whole picture. Your anxiety about the situation is high and it looks like your GP is literally blinded by it and doesn’t go into other symptoms. Davina’s book gives your examples how to describe different symptoms without sounding too anxious.

Absolutely this!!!

This really has nothing to do with the registration. If your health changes are significant enough to cause the registration to be denied, they are significant enough for you to need to declare preemptively.

can you look into a moderate-term sick leave to allow you to focus on running down this issue

another option might be switching to a reduced schedule.

Even working 80% might give you the extra rest you need. Yes, it would mean a reduced income, but possibly not as reduced as changing careers.

I would invest the money going to a private menopause clinic asap. Speak with your employer about menopause support also.
My symptoms resolved within 3 weeks of starting treatment and your professional body will have some leeway for payment timing. Your employer should support you whilst you start treatment, even it it means reduced caseload for that time.

I found it helpful to print of a copy of the NICE guidelines for perimenopause/menopause diagnosis and take it with me to the GP demanding to know why they weren’t following them when I was suffering but kept getting fobbed off.

https://www.nice.org.uk/guidance/ng23/chapter/Recommendations#diagnosis-of-perimenopause-and-menopause

i was initially prescribed synthetic HRT but after reading on here, asked for bio identical HRT and was again fobbed of so again asked why they weren’t following NICE guidelines for prescribing it and got it without a murmur.

Please go back to your GP and do the above, then take a a few weeks off work to let HRT kick in (night sweats and brain fog cleared pretty quickly for me). Tell GP it is affecting your work so you get signed off.

I do think if you're not fit to practice and may harm someone, you have to declare it. However, since this seems to be a case of severe menopause related symptoms, I think you should consult a menopause specialist, as has been suggested. I know it makes things harder and can be awful to live through, but there is help available. If you haven't consulted a menopause specialist, you haven't tried all avenues yet.

As long as the menopause drugs do the trick just write on the form you have the menopause and presumably the medication you are on thats required
However if drugs are not sorting your symptoms out it is unethical to carry on working in a clinical environment dealing with people.
What if something dreadful happened and it was found you had lied. The registration will include insurance so if a claim is made it will be investigated.

No offence OP but I wouldn’t want someone with brain fog, forgetting things etc dealing with me or my family.

You say you could, in your job, kill someone. If you lied and someone one died or was hurt you’d end up in jail.

You need to find a way to become healthy enough to practise.
I would lie and then make sure I were healthy and fit to meet regulations.
Seek professional help in getting well as quickly as you can.

Generous sick leave policy? For real?

Hahaha

Perimenopause as awful as it can be, isn’t a declarable Illness it’s a life stage all women go through and it is something that can be managed effectively with HRT and if necessary antidepressants. It also sounds like counselling might also be beneficial to you.

Unless you have an actual serious illness that affects fitness to practice then re-register and take the time to try to fix the peri-m symptoms. Speak to your occupationsm health department for support and advice and consider taking some sick leave to properly care for yourself.

Menstruation is a life stage women go through, yet I was with Dsis when she collapsed fainting with pain on a railway station platform.

The symptoms are the problem, illness or not.

What kind of health issues do you have? I think a lot depends on just what your job is and how the health issues affect that.
It never seems to end well when people lie. It might work at first, but it's difficult to live a lie and remember it each and every single day.

Okay, finished reading the thread. Perimenopause is not a life-changing medical issue. It's one that needs some medical help to get sorted but it will improve with either HRT, decent anti-depressants and getting rid of your anxiety. Honestly, it sounds like your symptoms are making you anxious and panicky. That's normal. Get to the menopause clinic (sounds wonderful and very worth it to me). They will help you, as will your work if you are just honest with them. I hope you soon find relief.

You need to ask your medical team their opinion I have chronic health conditions and I'm FTP. I take medical advice , medication and reasonable adjustments if needed. It depends what the condition is could you change job role to something less physically demanding?

What was the amitryptiline prescribed for? It's usually used for nerve pain

One gp would not give HRT despite my symptoms. I went back and saw another gp and I lied and said my periods had been erratic (thank you Covid😂). Prescribed immediately. It stopped my anxiety, insomnia, increased libido etc within 2 weeks. My (generally good) gp said HRT was for women who hadn’t had a period for 1 year - this was a female gp in 2022. I gave her literature to read. I hope she read it for the sake of other women.

Put in a complaint. See another gp. Say you take the anti depressants but they haven’t worked. See a private gp via video link, you may have this with your life insurance policy. Pay to see a private gp today. Or visit the menopause clinic.

You can purchase HRT abroad. Get a mirena coil fitted and buy gel abroad. Women on here may be able to advise what to ask for.

Women’s healthcare in the U.K. is terrible and has been for a long time.

That BUPA link looks good - I wish I’d known about that last year when I was faffing around educating my GP and stressing I wouldn’t be believed. The newson clinic had long wait times.
2 weeks of a low dose patch and anxiety gone, insomnia gone - life changing for me. I felt normal again.

Op book with them today.