The Pain Trilogy – Part 3

After a weekend en famille I return home a day early on account of feeling a tad underpar (as I mentioned last week). Following a day in my own company I rally and am ready for the next appointment (I am looking forward to a week when my routine is not punctuated with medical intervention requiring an in person presentation). Arriving a few (10 minutes) early I manage to shatter the quiet of the reception atrium as I knock over my crutches as I lower my puppet-like frame onto the seat. Certainly shook a couple of people out of the stupor that descends whilst waiting!

 I am intrigued by the number of people fixated on their respective tiny screens; the well thumbed magazines largely ignored these days – who reads the back copies of Readers Digest these days I wonder? Today the hot one looks tense as he is running late; popularity comes at a cost (for patient and doctor alike). The elderly gentleman two slots before me shuffles to the lift after his appointment, catching my eye he winks at me! Oh a heaven to Betsy was that appropriate? I smother a smile as to laugh would risk offending when he was only being kind to the afflicted (this response is one I have become accustomed to although it still bemuses me – like aging becoming ‘disabled’ doesn’t change how one feels inside).

 Eventually it’s my turn and I unfold my legs that I have entwined in my sticks (I find it comfortable although it looks odd I confess). Bunny hopping I follow the doctor at a respectful distance (ideal for maximising the viewing experience). He has this cute habit of turning his head as he reaches the door, somehow looking down with eyes up at you at the same time resulting in a little leap of a spinster’s tummy!  OK I need to get out more I know and I would if I wasn’t spending so much time attending appointments at this Surgery!

The Hot One arranges himself in his wheeled office chair. For illustrative purposes only I will venture to describe the process:

  • Reach chair (initially facing the window as the act of getting out means the chair moves to the left),
  • Lower body with hands on arms – (the rolling up of the sleeves to the almost elbow can look tacky but this guy can carry it off superbly),
  • Buttocks down right leg crossed over left in one smooth movement – (the right over left discretely protecting the vulnerable patient from a potentially embarrassing glimpse of one of the forbidden five a day),
  • And finally turn towards the patient raising head to make eye contact (as if to say ‘coming ready or not’ – brace yerself).

 Swooning metaphorically whilst choking back a giggle (my tendency to over analyse human behaviour means I am too often running a conversation in my head to see if there per chance might be a (slight) deviation from previous encounters; details ladies details!

 ‘So what can I do for you today?’ he asks – ha ha ha you may well ask laddie! Is that Hugo Boss you’re wearing today? Enough already; calm down lady! ‘I understand you are the pain specialist’ I begin; ‘Oh not you as well’ he replies disarmingly. ‘Yes, the doctor I saw last week, young female new one whose name escapes me booked this appointment so we could discuss the new drug’ I continue. Consulting the computer records he identifies the doctor in question and tells me he deals with palliative care that’s where the pain specialist thing comes from. ‘Ah well I would like to discuss this new drug that was mentioned’ I say. I shan’t continue the conversation word for word as it’s tedious but I shall summarise the pertinent points.

Hot Doctor has not come across the new drug but recalls a drug rep talking to the Practice about it. He then pointlessly consults his 2008 version of a drug manual to find details of a drug licenced in 2011 noting he must get a more up to date version! Really?  What the first doctor had failed to mention was that at the point he was made aware of this new drug the health body responsible for prescribing had not decided whether to fund patients to receive it. The difference being the context within which the term ‘available’ is used i.e. literally in existence or funded enabling doctors to prescribe it.  Apparently the health body with jurisdiction for the area I live in is scrutinising the prescribing of medication with a particular focus on pain relief. Just when I thought we might be able to make progress; how utterly naive of me!

 Unable to give me answers the doctor says he will telephone the appropriate person to ascertain the current position with a view to prescribing it for me. However, didn’t you just know there would be a catch, it is very expensive he says but you use Fentanyl and those are REALLY expensive! In a nutshell it will be a trade off and a net saving will strengthen the case for my receiving the new drug. Turning to his computer he says ‘let me add it to my list so I don’t forget’ and he agrees to phone me later that day. Off I go with his parting shot – ‘if you haven’t heard from us by the end of the week chase us up’ – ringing in my ears!

 Chwarae teg (fair play) the doctor does telephone me (twice) with an update. The drug can be prescribed but only by a Consultant for patients who have tried everything else. So now I wait for the GP to contact the Pain Consultant (pleasant man I discuss opera with) to request a prescription for me so the GP can order the drug via the pharmacist who won’t have it in stock in order for me to receive the drug. In the mean time I will attempt to pat my head whilst rubbing my tummy i.e. continue to wean myself off the existing expensive drugs! Fingers crossed that I can continue to function without being had up for aggravated (verbal) assault when a random stranger irritates me (in a state of more pain than I can really cope with)! And so I wait.

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