Blood test or no meds

[TheSpiritofDarkandLonelyWater]

I have received a letter this week from my GP saying I need to book a blood test or my quetiapine prescription will be stopped. I have been on it for 15 years and had a blood test when I started it. None since.
Why are they asking for it now? I am also really needle phobic and reactive to people touching me. Last blood test took 5 appointments to do so with a lot of support from chaperone and family.
The letter was really stern and I feel that I can not give proper consent as I dont even know the reason why.
They have given me 4 weeks to book a test but the letter has turned up 2 weeks post the date on the letter.

To check the function of kidneys/liver and to test for blood sugars and cholesterol. (Just been for mine).

edit to add. It is important that these tests are done. Mine are every six months. No idea why you’ve been left so long without a test.

You should of been having them yearly but I do understand where your coming from

I could understand if it had said that but it literally said I need to have a blood test or they will stop the prescription.
How can I consent to something I do not understand?

Is it not responsible prescribing/dispensing? They need to make sure its still OK for you to take it.

After 15 years? All of a sudden? I do not understand to be honest.

So who other than mn have you asked? Who's the 'chaperone' you took last time?

Chaperone was a lady that worked in the surgery.

It’s probably a mass produced letter. Also they will likely expect that as you’ve been on the drug for so long you would expect to be aware of the protocols surrounding the prescribing of the drug. They’ve assumed you have information you don’t actually have.
you can always ring them make an appointment and ask, and then consent or refuse.

Yes I think I might have to speak to them. I have to change my phone number anyway.
But the letter was so stern and scared me. But gave me no info on the why I need to have blood tests. I know about informed consent.

You need to speak with your GP or psychiatrist in order to get a clearer understanding about this. Mumsnet is not the place for medical advice.

Um there are whole boards where people offer medical advice on MN.
I just felt a bit alone on this .

Medical letters do tend to robotic/terse. They stick to the plain facts - we want to see you for xyz asap. They also tend to stick to the same templates for basic tests so it’s easy and quick to just amend patient specific details such as name/address/nhs number. Also they want to see you they don’t want you to ignore the letter as being unimportant.
ring them, explain your nervous and make the appointment. They are there to help.

Thank you. It was very terse and in a huge font like it was shouting at me.

I suspect it’s been an oversight that you haven’t had regular blood tests until now when you should have regular monitoring. Something has made them suddenly realise that they’ve not done what they should, hence the letter. I get a similar letter if I don’t get my blood tests done for another medication that I’m on.

@TheSpiritofDarkandLonelyWater my mammogram letter was like that. It’s totally normal for nhs letters. They aren’t specifically shouting at you. Also some people find it hard to read, and the larger bolder font makes it easier for them to identify and read the really important bits of the letter quickly. (Eg may have poor eyesight/glaucoma etc).

Thank you. That has made me feel a bit better. I felt like I was getting told off!

I managed to get to the surgery today to sort this out. I said did not feel I could consent properly as I had no information. They said I need to have the blood test but my I can continue my meds for now as it is on a batch prescription until December anyway.
I got very overwhelmed though and the receptionists tried to keep me there as I was distressed but I just wanted to go home.
I was text an appointment when I got home but it clashes with a support group I go to so they will right away thinking I am trying to delay it.
I have no idea how I am going to do this. I cant even handle being in the building let alone having someone touch me and stick a needle in me.

I’m a mental health nurse. What dose of quetiapine are you on? As I hope your psychiatrist explained to you when he prescribed it, antipsychotics like quetiapine can be linked to problems with your liver and kidneys, as well as problems with blood sugar like diabetes. This is more likely at higher doses. Do you know exactly what you struggle with when it comes to blood tests? Do you think having some extra medication would help? Or maybe the blood could be taken by your CPN if you have one and trust them?

I was prescribed it when under section years ago. Didnt really have a choice about it and nothing was explained to me from what I remember. I had a blood test at the time and whenever I have been inpatient since I have had a blood test. But isnt that normal when you are admitted anyway? I was on a higher dose back then and on several other meds. Took a few years to come off some and reduce others as my psychiatrist said it was toxic.
I am not on a high dose. 100mg at night and 50mg twice a day.

I cant stand people touching me at all and I have always been very needle phobic. Last time I had a blood test at my GP I asked about some meds to help and they said no and I would basically have to deal with it. Said to use Emla cream which does not work on me. And it is not about the pain anyway. It took several failed appointments which is a waste of all our time.

200mg is a highish dose, high enough that I would want regular bloods doing. Have you tried propranolol before? Many people find that can take the edge off. Failing that, some psychiatrists might be happy to prescribe a tiny dose of diazepam if the alternative is not getting bloods at all, or have the bloods taken under waking sedation, but I wouldn’t bank on it. How do they get bloods from you when you’re on the ward?

I was given no choice. I was pretty much just nagged at a lot but they were patient but when you are on a ward there is the time for that. It is the same with all obs. I was there over a week before I let them do anything including BP and ECG.
I was in A&E this weekend just gone and I could not let anyone touch me to take my BP. Walked out and the police came and grabbed me and I had a huge meltdown. Was screaming and ended up curling up in a bush in the car park. I am still trying to wipe it from my memory as I am so mortified. I have EUPD and autism.
I will ask about propranolol. I no longer have a CPN. Just a support worker form a MH/autism charity but I do have a check in with the MH nurse at the surgery every couple of months and they make it clear I can book an appointment any time I feel the need but it is hard.

I don't know if they have recently redone the advice for quetiapine but I have been on it for 13 years and have been told at my last review that I should have been having annual ecgs due to being on quetiapine. With the annual blood tests I have had mixed experiences.
I had annual bloods at the first GP surgery but only after I had been discharged from secondary services back to the GP. When the early intervention team was managing my medication I didn't have them. The second gp surgery didn't do them this was for the next 4 years and since I have moved to the third town/gp and I get annual bloods for the last 3 years and now an ECG.
The things they are looking for are blood sugars as it increases the risk for diabetes, lipids as it increases your risk of high cholesterol, liver function, the ECG is due to an increased risk of prolonged qt syndrome

When my friend got pregnant, she was needle phobic the lovely nurse laid her down on the examination table saying it would be easier. And it was. She saw nothing, felt little and only sat up when she felt ready.

She always does it this way now.

@TheSpiritofDarkandLonelyWater Do you trust the mental health nurse at the surgery? If yes, ask if she can do your bloods. The worst they can say is no, and, speaking only for myself of course, I’d be perfectly happy to take a set if it meant a patient having a better experience. Do ask about the propranolol, it takes the physical edge of those feelings of panic and makes things a bit easier for lots of people.