To expect my GP to care just a tiny bit how unwell I am??

[TiredOfCovid]

I’m mid 30s and have been suffering with long covid / b12 issues and now possibly fibromyalgia for 2 years.

The GPs just don’t seem to care.

I cried in the room today saying how much pain I am in, that I’m going to lose my job if I take any more time off sick, that I’ve got children I need to look after and there must be something that can be done - medication, anything?

She told me she had a stressful morning as couldn’t get her computer to work, said sometimes antidepressants help with long covid, offered no explanation of why my body isn’t absorbing b12 normally and said I’ll have to have injections monthly for the rest of my life and sent me on my way.

NO compassion at all - surely they should care just a tiny bit / pretend to?

Rheumatology specialist nurse here. Fibro is not in itself an autoimmune condition but our patients with autoimmune arthritis often have fibro alongside their rheumatological condition. It used to be a diagnosis of exclusion but evidence is suggesting more and more that it is to do with exaggerated pain pathways in the brain. The current treatment is amitriptyline/pregablin and a pain team referral. Some patients feel that is useful, others don't. I can see the effect it has on our patients and feel bad I only have a limited time with them in clinic.

Chronic conditions caused/contributed to largely by lifestyle choices, "mental health", health tourism, lacking any ounce of common sense or decency... to name a few.

Before I am pounced on for daring to say the above, it is a specific subset of people that I am referring to, who use the healthcare system inappropriately. If one does not use the healthcare system inappropriately, then they are not among the people I refer to.

N this is why when people see me in the pain clinic they cry at how empathetic I am.and how I listen. Take it steady love.

So ask for referral to long covid centre alot are doing acupuncture now which you cannot get for fibro as it isn't in the guidelines.

Your in a flare up be kind to yourself it will pass I promise. You can cope you cope everyday.

Duloxetine works OK for a lot of ppl it works on both mood and pain. Xx

@florizel13 pregabalin is not recommended!!!!!!! Amitriptyline /nortriptyline is, duloxetine etc

What do you want from your GP? Practically you’ve probably reached the limit of what’s in the scope of a GP (antidepressants, B12 injections, exercise, time etc is what the guidelines suggest). Or is it the emotional support / feeling heard you’re looking for? To be fair they are mostly seriously burnt out, have no specialist training in this area and a 10 minute appointment to see you and document etc. It is great there are exceptions to this, a GP with a special interest, or one who isn’t overwhelmed and burnt out, or one with such an amazing beside manner that they still are able to support you, but otherwise by crystal clear what you want from the consultation.
I’m sorry it’s rubbish - I’m leaving because I don’t have enough to give the job anymore, I hope you have a GP at the practice who can do more.

Exactly this. GPs show care by offering appropriate treatment (if such a thing is available) and a professional service. It is NOT their job to offer sympathy, which would come across as patronising or gushing.

https://www.kcl.ac.uk/news/new-study-shows-fibromyalgia-likely-the-result-of-autoimmune-problems
Just leaving this here for the less well-read, who still consider they are experts in the field.

Why is mental health in “ marks? It reads like you don’t think mental illness is real?

Mental illness is real; that doesn't mean everyone has a mental illness.

I was unofficially "diagnosed" with MS but sent away as there was no treatment and the neuro didn't want to "put me through" a lumbar puncture. My MRI didn't show brain damage but my spine wasn't imaged.

22 years later and after many, many appointments with different GPs I finally paid to go private to see a neuro. She did a scan of my spine and discovered that my MS-type symptoms were due to Transverse Myelitis.

My notes state I'm a "nuisance" for returning time and time again with TM symptoms. None of them had read the notes from my original neuro appointment.

I also have been diagnosed with Fibro.

I have terrible nerve pain that all kinds of medication like Tramadol, Gabapentin and Pregabalin haven't really touched. Careful use of Ibuprofen along with good old Paracetamol works best for me. I was taken off Co-Codamol and put on Tramadol but it's not a patch on it.

I take a PPI for stomach problems which the last GP I saw has said wants me off. I've been on them for years but only now have been told they interfere with B12 and can lead to anaemia - which I've had for decades.

Honestly, OP, pay to see a GP privately. It IS awful that the NHS is failing us all but it's a fact of life. You may be able to get heard and offered something different.

Could your B12 issues be linked to PPI use?

As Trailing says, GPs look for behaviour that may indicate opiate addiction. I know they thought that of me but I'm VERY careful with my medications. I tapered off Tramadol myself. It was an absolute nightmare as I was on the slow-release version and couldn't lower the dose, just miss it. At least with Co-Codamol I could use it as needed and not as regularly as prescribed. I'd go a month or two not requesting them on my repeat. I'd have thought that would have demonstrated that I wasn't addicted but there you go.

They just don't have the time to go through each patient's notes. It's something that could technically be avoided if appointments with a regular GP were made instead of seeing whoever you got on the day. Maybe when a few patients end up dead because of this wasteful, idiotic system it'll be changed.

Several years ago I worked in the NHS and saw the decline in service when new and frankly nonsensical systems were put in place just to get more patients seen over a period of time. It's very wrong as even the GPs that would pass through our department would mention that they hated seeing some types of patients or enjoyed seeing some with certain conditions or characteristics. It would be easier and better for both patient and doctor to see one that specialised in mental health/geriatric/dermatological etc., conditions.

I could go on and on but I'd just like to say that I hope everyone here eventually gets sorted and no longer has to suffer pain or fatigue.

I have pernicious anemia and only get 12 weekly B12 injections. I can't absorb B12 through food. As others have said you are very, very luckly to get them monthly.

I have Long Covid and have been taking Low Dose Naltrexone for a few months which has helped me get back to work. Not cured but it has helped with some of the symptoms.

Ok, but given the state of mental health care in the NHS where there are almost daily inquests into the suicides of people wrongly thought to not be that badly suffering from mental illness, the issue today is too many mentally ill people being turned away, or discharged too soon. There is no evidence of anyone thinking they are mentally ill or faking a mental illness and exploiting the health system because they aren’t taking responsibility for their own health ?

I’ve not long been diagnosed with PA/b12 deficiency and not even seen or spoken to a dr. Initially had phone consult with nurse, blood tests with phlebotomist, receptionist phoned me to tell me the results and what dr had said, and prescribed b12 to be administered other than my own surgery. Bonkers. Hope the b12 helps and you feel better soon

Have you not been prescribed folate as well?

I am 8 weekly because I have neurological symptoms x

Yes this is correct- GPs have 10 minute slots to see patients/diagnose/treat & prescribe...and then do it all again with the next patient, all day

But you can't deal with someone's mental health in (less than) ten minutes. It's takes a long time and expertise to unpack someone's mental health. Whenever someone is depressed they are always told to go and see the GP but quite honestly they'd be better going to see a counsellor, especially if they are someone who doesn't believe in taking antidepressants. They are likely to be offered antidepressants in the first instance and then group CBT.

Going to a counsellor for a couple of sessions they are likely to get the support and validation they need to start to be able to look at what is going on for them and then see a medical professional if they need a prescription.

CBT, which is what many people are offered as talking therapy through the NHS, can be lifechanging for some or not very effective for others who need a different kind of therapy, particularly if their poor mental health arises from negative childhood experiences.

Since so many people access the GP for poor mental health, I think it would be better to have a mental health professional attached to the GP centre triaging people either direct to different psychological services or to the GP if this is indicated.

Yes, I recognise the type of patient you describe.

Amitriptyline may have been the antidepressant the GP was offering. And they have also offered a solution to the b12. Yes ideally they should appear compassionate and also proper explanations really help patients and reduce repeat attendance for same things. but as pp said they have less than 10mins to rule out anything life threatening, diagnose, prescribed, refer if required and write notes…repeat up to 40 times per day and read and file 50 letters or blood results between clinics…the system is unfortunately set up for holistic care

having said that OP some GPs have better communication skills and you will hopefully be able to find one who understands you more and can give you a bit more of the time and compassion you need.

As someone with pernicious anaemia, fibro and mixed connective tissue I do think when you have autoimmune disease you do have to become what one GP called a 'patient expert' you have to read papers and studies research pain relief and consider alternative therapies. Autoimmune disease is a complex area and GPs generally have only had a small amount of teaching in this area.
I read bathe KCL paper on fibromyalgia and I think it is interesting, but a lot more work needs to be done.
Why you have this almost certainly Covid has triggered your immune system ( in a similar way to many post viral syndromes) and you are developing autoimmune conditions.
As the eminent no longer with us veterinary immunologist who taught me my post grad immunology said ' autoimmune disease is an ice berg the ones you can currently see are only one third of the problem'.
Living with autoimmune disease is about managing your life as summed up with the spoons theory and you have to take care of yourself eat well, get plenty of rest and take moderate exercise.

GPs don't have the time or the emotional bandwidth to be emotionally connected to everyone they see to be honest. Sorry if that sounds harsh, but you reach the point where for your own wellbeing you have to take a step back. 10 min appointments are ridiculous as it is, and during a day you see such a range of people, lots with lifelong and some with life shortening illnesses that it's tough going.

OOOh, you're brave! Sadly, too many people are very gullible - Fabricated illness is, in itself, an illness!
https://www.nhs.uk/mental-health/conditions/munchausen-syndrome/overview/

With the greatest of respect, I am assuming you don't/haven't worked in front line healthcare for any length of time. I can understand from the outside, if all you've ever seen is people you know struggling to get help/how difficult it can be to get help yourself/what the media say, that it can be difficult to believe there are people taking advantage of how easy the system is to access, but there are.

I didn't mention or refer to Munchausen's.