I hate ordering repeat prescriptions. It’s mostly annoying more than anything else, but it should be really simple. In most cases, you tick the boxes of the things you need, hand it in to the reception at your GP or your local pharmacy and then pick it up from your pharmacy 48 hours later. I’ve had problems ordering prescriptions pretty much since I was diagnosed with Adrenal Insufficiency, mostly because of ‘computer says no’ scenarios.
I have 19 items on repeat every month, which don’t all run out at the same time, meaning at one point I was having to work out which things ran out when, which was confusing for everyone. The GP computer says no to lots of things, for example, it won’t issue cocodamol and tramadol on the same day but will if you put them in on separate days, and it nearly always refuses Hydrocortisone. But the receptionists can’t override the computer because they’re not medically trained. So my GP sorted it so that I ring the surgery for a telephone appointment whenever I need a repeat prescription, so that I can talk to a doctor and they can issue them.
This works well, except for Hydrocortisone. Sometimes I need to double my dose, which I can do myself without talking to my GP, but obviously the tablets run out quicker, so I have to ring and ask for more more frequently. If I talk to my GP, it’s fine because she knows me really well. If I talk to anyone else, the conversation usually goes like this, even if I’ve seen them before. (note that I appreciate the doctor is just doing their job and being cautious, but I’ve been having this conversation twice a month at least for a year now).
Why do you need more hydrocortisone? You only had some recently. Because I doubled my dose when I had a virus/was sick/admitted to hospital…
Why did you double your dose? Because that’s what you do when you’re sick, you have to stress dose.
What’s stress dosing? Click the link if you want an explanation 😉
Who told you to stress dose? No one/hospital if I’ve been admitted
Aren’t you supposed to check first? No, not for a double dose.
What dose are you on now? I tell them what numbers e.g. 20/10/5
Hang on, when do you take that? 20 at 8.30, 10 at 12.30, 5 at 17.30
That’s not what the computer says you take. Yes because I’m tapering
So what should you be taking? My baseline is 15/7.5/5
Depending on who it is, when will you come off hydrocortisone? Never, I’ve been told I’m taking it for the rest of my life.
When will you be back at your baseline? I tell them an estimated day. There’s usually a pause while they try to work out the maths of how many to give me
Do you only take 10mg tablets? Yes because 5mg aren’t available on the NHS. Another pause
ok well I’ll give you 90 tablets to cover the double dosing and then you need to put in your normal repeat as usual. Because 5mg tablets aren’t available, the maths is way to hard to work out 2.5 and 5 multiples quickly to give me the right amount, especially as it’s a taper dose. So they usually issue my normal prescription amount anyway.
Except when I go to put in my normal prescription a couple of weeks later, I have the same conversation again… The GP is nice. They’re just doing their job. They have to make sure that I’m taking my medication properly, I do appreciate that. But they’re also supposed to know about my care, and I talk to them twice a month minimum and go to the surgery at least once a month, so I’m ‘known’. This particular doctor has also admitted me to hospital twice because of my AI, so definitely knows my case. It also makes me feel like I ‘know more’ than they do about my condition, which makes me wary when I do need advice because I’m not sure if they understand it fully if they don’t know about baselines and stress dosing.
Like I said, it’s a minor irritant and not really a big deal. But when I have to explain my condition over and over to every healthcare practitioner I meet, even the ones who speak to me or see me regularly, it gets a bit frustrating and lonely as a patient. I just want someone to understand without me having to justify myself every time!