GP initially refused to give me painkillers as she wanted me to use the pain as an incentive

[OvO]

to sort out my diabetes.

I have Type 2 diabetes, I know I need to do better and eat better etc. My last GP was really helping and I lost 2.5 stone so it’s not like I’m not trying. But still loads of room for improvement, I know that.

So I have had nerve damage pain in my foot for a few years (caused by poorly controlled diabetes) and I finally decided to see my new doctor (have moved house) to get painkillers.

The pains so bad I can’t sleep, I already have high dose co-codamol for back pain but it doesn’t do a thing for the pain in my foot.

But the GP said over and over again that she didn’t want to give me anything for the pain as it would just mask it and I needed to understand that it was a symptom I needed to pay attention to and I should use the pain as an incentive to get my diabetes under better control.

Then followed the Type 2 Diabetes Is Curable If You Try Lecture which is fair enough, it’s her job. But am I wrong to think that leaving me in pain is a pretty shitty way to try to force me to make the changes?

I honestly had to beg her before she’d prescribe gabapentin (so?). I explained over and over I was in agony and unable to sleep but she just kept saying to use it as an incentive.

I’m not sure if I’m being too sensitive. I’m pretty anxious about doctors and will go to great lengths to avoid them so can look for any excuse to not go back. I WILL go back as I know I need help with my diabetes but I’m NOT going back to see her.

So am I being too sensitive? Is she right and I should stay in pain as a way to incentivise myself? I can’t see how that works. I’m in agony and exhausted so hows that going to translate to making good choices?

This is my longest post ever, bloody hell. I’ll inderstand if you just skimmed it!

Sounds like a bloody good GP to me!

Have you got a diabetic nurse at this new surgery OP?

I find our GPs can be a bit abrupt but our specialist diabetes nurse is lovely and I've got a huge amount of support from her. She can change your medication etc, and is very encouraging with weight loss plans etc.

Wonder if that's worth a try for getting some more help?

God, I miss my old GP. I only saw her for a little while but she was great, really helped me. She was going to send me to a specialist as I’d stalled on my weight loss (stuck at 10.5 stone) and even when I put myself on a 800 calorie a day diet for 3 weeks I still couldn’t drop even 1lb.

I honestly AM trying.

But I moved house before I could be referred. I mentioned this all to new GP but she didn’t say she’d refer me herself?

I’m seeing a nurse at the GPs tomorrow so I’ll ask her about support/help. I’ve always found the nurses really great, supportive and easy to talk to.

Agree, try the nurse - hope the tablets help tonight

I think it's too harsh to leave you in that much pain. If it's affecting your sleep so badly I'd be worried about the impact on your mental health which will often just make you eat more rubbish anyway. Can you ask for a referral to a pain clinic, also consider going to another GP.

Also worth asking if there is a healthy weight management club/scheme they can refer you into.

I hope my comment wasn't harsh OP. You are doing really well and 10.5 stone doesn't sound very heavy at all subject to height/body shape etc (I am similar weight admittedly and do feel overweight as apple shaped). Hope you get some solid sleep

Do you have support at home? Is there someone you live with who is helping you regarding your pain and managing your disability? Have you enough money to eat properly?

If you want to come here and post every single day for support, I will keep coming back OP and I'll keep cheering you on. Others will too.x

She sounds a bit of a 'tough love' type - fine if you know your patient well but a bit much if you've only just met them. I hope the painkillers help you sleep.

I was reading some stuff recently about how a calorie-restricted diet doesn't aid with weight loss in the way you'd hope. Also can be a major factor in poor sleep (something about raising levels of cortisol in the brain?), which is partly why I found the articles, my bloody insomnia. Seemed to suggest a sensible, nutritious diet with mostly unprocessed foods was more effective than crash-diets for weight loss. Worth a look?

TAMS, I can’t see the GP referring me to a pain clinic.

I was also there to ask for different pain killers for my back as the co-codamol is rubbish. I only take it when I really REALLY need it (and I asked her to look up my prescriptions so she could see how little I order a new prescription) but when I really need it I need it to actually work. Which it doesn’t. She reeled of a list of painkillers but said they were all pretty much the same so there wasn’t much she could do. And that was that. Then we went on to the foot pain.

I can’t see her as a good gp even if you’re all right and she shouldn’t give me anything for the nerve damage pain. I don’t feel like we're a good fit.

Im not trying to be all drip-feedy about her. I’m not trying to paint her in a bad light so you’ll all suddenly agree with me (ha!) but just want to show that she’s not some amazing support I can trust when she dismissed my disability so easily.. Which might have coloured my feelings about her Diabetes decision.

But I am taking on board what’s been posted. I don’t want to be one of those posters who's all "yeah but no, I cant follow any that advice because reasons".

Im going to look up all the suggestions that've been posted!

Ajas, thank you! Even just posting this has helped. I went from cross, to crying to I Can Do This in this short thread!

I have help at home. And we're poor on paper but we're doing okay money wise so there’s always money for food.

Gabapentin has weight gain as a side effect OP...

I was on loads of tablets, including gaba for bipolar

I now manage almost solely on CrossFit every day and I’ve lost loads of weight

Is weight training something you think you could look into? It’s so so good for you

I have Spina Bifida, Camel. Can’t even tie my own shoe laces so weight training is not for me! I use a wheels walker thing to walk so exercise is difficult but I do try to walk as much as I can.

*wheely walker, like older folk use. (Stupid fat fingers!)

How awful. It’s so hard to diet and exercise when sleep-deprived and in pain!

The NHS is rubbish with diabetes - my son has type 1 and we meet so many doctors and nurses with apallingly little knowledge of it.

I also take gabapentin (for nerve pain caused by spinal problems) - it’s great but you can’t dip in and out - you have to build up,to the right dose and then keep it up.

I hope the nurse is helpful and supportive. I don’t know how much you’ve learnt about controlling blood sugars - do you know that a small amount of exercise straight after meals (as in, going for a walk) can help massively? I imagine you know that it’s all carbs that affect you, not just sugar. But different carbs affect people in different ways - it’s really individual. Could you afford a Libre sensor for a few weeks? It would show you how different foods and exercise affect you, and what small changes will help most.

I'm with your gp on this one. I've had loads of experience in this area. The trouble with taking painkillers is that the brain adapts quite rapidly and the brain's experience of gabapentin becomes the new 'baseline' so that before long, even that won't be enough. A new even stronger narcotic is needed - all the while the original cause of pain isn't addressed rigorously enough. Gaba can have some awful side effects too that may outweigh the pain relief. Withdrawal from Gaba can be horrendous in some people. I've also seen many, many people lose their feet and legs to DB2. It's very common.

I appreciate the pain is very real & hideous to live with. I've suffered neuropathy myself in the past. What got me through was a complete & permanent lifestyle change, which meant gritting my teeth and getting on with it. I found out through my experience there are 4 stages to actually turning around and making the change:

1. being 'ordered to' by doctors (which doesn't work), then:
2. agreeing to change to avoid criticism & shaming, which still doesn't work, then:
3. beginning to get intellectually curious & starting to listen, before:
4. being so pissed off & fed up that it's unbearable to stay with our current behaviour & we actually genuinely start to enact real purposeful long term change.

What made the most difference to me was counselling - to look at why I behaved the way I did. With the support of a therapist I changed everything.

Aside from weight gain gabapentin can have horrific side effects. DF once took them for arthritic pain and after 6 weeks DM was almost divorcing him - the memory problems genuinely made it seem like he was gaslighting. They changed his personality overnight. She took him to the doctor because she thought he was getting dementia. Watch out for them!

Jelly, I asked my go today for a monitor so I can really see what’s happening and what affects me the most. She did agree to that so hopefully the nurse tomorrow will be able to give me one.

Gp didn’t mention any side effects of gabapentin. Not a thing. So that’s not very helpful either. Now I don’t know what to do.

I don’t agree with the GP. If you need pain relief, you should be able to have it.
If you are in that much pain, it will stop you trying to walk around which won’t help you lose weight. It will also make you depressed which also won’t help you lose weight. Please see a different GP and ask if they can refer you to their well-being or weight management program. Good luck as you have done well to lose some weight so far.

I feel your pain op. I broke my foot (and tore a bunch of ligaments) and as I live in an area with high opiate abuse the doctor gave me ONE co-codamol for that evening and that was it.

I didnt get a wink of sleep for almost a week when I desperately tried a weed edible. Not suggesting you do that obviously as it's not legal in the UK.

It truly sucks. I do think they're trying to help you though. I think you're getting a rough time on this thread. 

Take them, just be aware.

Gabapentin also made my joints and bones ache, like I had the flu and seriously affected my hypermobility. They were like a gateway to disability that I am thankful I ran away from

It sucks but I agree with your gp on this one. You don't want to mask the damage as other posters have said. Its not about leaving you in pain, its ensuring you don't do further damage without realising it.

I'm type 1 and regularly get the tough love treatment and over time it does work. They tend to use scare tactics on me and as horrible as it is, it forces me to listen.

Also a lot of medications can affect your blood sugars and control so they have to be careful when prescribing.

You've done really well to lose the weight you have so far so keep it up! Maybe you'll have the opportunity I will never have and be diabetes free!

You've mentioned spina bifida and mobility issues - have you been referred for physio? They can show you exercises that will help and tailor them to your condition.

I completely empathise with you here. The pain from nerve damage is intense but you need to follow advice - they are qualified professionals and know much more about these things than strangers on the internet whi don't know your full medical history. By all means get a second opinion if it makes you feel better but this gp isn't masking things. Shes trying to help.

Can't believe the responses on here, completely inhumane. How long does the jury of Mumsnet think op should be made to suffer for her sins? I'm guessing most of you aren't doctors so you really have no business dispensing medical advice, and I doubt your armchair diagnosis (sounds like "it's all her own fault") has any bearing on reality.

Please see another GP if you can, this isn't the middle ages. Medical personnel have no business torturing people.

Unbelievable.

Catlady3 no one is being inhumane and offering diagnoses. They are backing up the medical professional that does have the qualifications and the knowledge and suggesting the op follows her advice.

If you have spina bifida your pain should be investigated further. It may not be 'just' diabetes pain, though that will be painful enough. Your nerves will already be affected by the spina bifida and you may well be in more pain than you would be if you didnt have sb.
The gp IS being cruel and inhumane. Its 2018 and people should not have to struggle and suffer with pain if it can be eased or relieved.
Go back and see another gp., preferably one who understands about spina bifida. Good luck.