Are you given appointments you can actually keep?

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Are you given appointments you can actually keep?

Post  pen on Sun Feb 14, 2010 1:07 pm

My neuro only does morning appointments, and I dont do mornings....not at all, and certainly not to do a 90 minute car journey.
This defeats me. There are patients who although sufferers still manage to function. I was one of those people years ago.
Why dont they ask you when you can manage to go. I have had to cancel 3 appointments....someone else could have had them, and instead I got the guilt.
He is a nice fella and did eventually give me an afternoon when he only see his new patients.

I have just been sent an appointment with him. Its for 12.30 monday morning a month from now.
I will have to call them and go through the embarrassment of being "difficult". I hate it.

Whilst I am bitching. Is it fair that the people like me who cant travel don't get to see anyone.
All the specialists see to be in London, and I have no chance of getting there, not even in the afternoon.
BUT I can talk, and I dont see why I cant have a telephone consultation. Then, when hopefully they have got me a bit better I can go see them like a normal person.

Is this just england or is it the same elsewhere.?

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Re: Are you given appointments you can actually keep?

Post  moominamy on Sun Feb 14, 2010 1:11 pm

Our posts just crossed! See my post to you and I will be back later if I can.

Amy

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Re: Are you given appointments you can actually keep?

Post  AuntieBubbs on Sun Feb 14, 2010 1:57 pm

Well, Pen, I don't know about elsewhere in the states, but my experience here in CA has been that doctors don't really do phone consultations. I hate a doctor once talk to me on the phone, then prescribe a new medication based on what I told him, but it was an emergency situation. (And the medication he prescribed was not one I wanted - he prescribed vicodin, which I knew would not help my headache, and sure enough, it didn't.)
But in general, I have never had, nor heard of, having the option to have a phone conversation in lieu of a dr. appt. I don't know that I'd be comfortable with doing that, either.

I would think there would be ethical concerns involved as well. If something happened to you, the dr. could be sued because he prescribed medication sight unseen. Of course that's a US perspective, and everyone in the US is sue-happy, but I can understand a doctor not wanting to treat a patient sight unseen, especially a chronic pain patient. Our medications are pretty strong.

It might be different in the UK though. I don't know.
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Re: Are you given appointments you can actually keep?

Post  pen on Sun Feb 14, 2010 2:54 pm

Sorry Bubbs, I didnt explain myself that well. I didn't mean in the first instance I meant subsequently.
All we do is talk. I can do that on the phone just as well.
He did it because I just missed several appointments. It was good, I got some advice and felt a bit reassured.
Next time he gave me an afternoon and i got there. This time I doubt I can.

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Re: Are you given appointments you can actually keep?

Post  TeriRobert on Sun Feb 14, 2010 3:56 pm

Pen,

I feel for you. For four years, I had to travel eight hours each direction to see my Migraine specialist. I wasn't able to drive for the first several visits, so my husband had to take time off from work. With the doctor eight hours away, the only way to handle it was to drive up, spend the night at a nearby hotel, see the doctor in the early morning, then drive the eight hours home. Not the easiest way to get care, and it really stretched our budget.

There aren't enough Migraine and headache specialists. You're 90 minutes from London and the specialist there? It's no better in the US. Most of the people I know have to travel at least that far, if not farther, to see a specialist. Most want to see their patients at least every three months, but may help them through one of their nurses between those appointments. In the US, by law, a doctor must see you in person once a year if they're going to prescribe medications.

I know this is beyond frustrating. Wish I knew more to suggest to you.

Teri

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Re: Are you given appointments you can actually keep?

Post  HeelerLady on Sun Feb 14, 2010 5:11 pm

Well I seem to be a fortunate one. My neuro (who is a headache specialist) is a 20 minute drive away. Granted I live near a major city with a university medical school so I'm probably fortunate. If I lived farther north, I'd face the same problem.

I can get to the appointments however getting one....yikes! For my first consult, I had to wait almost 4 months. When I went in in January due to my meds not playing nice, he wanted to see me in 3 months...first free slot was in May. Not horrible, but if he'd have wanted to see me sooner - wasn't going to happen. The problem is they seem to be a rare breed and book up insanely fast.
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Re: Are you given appointments you can actually keep?

Post  AuntieBubbs on Sun Feb 14, 2010 5:18 pm

Pen, I understood what you meant. I still stand by my answer. I don't think there are many doctors here in the states that would do a phone consultation instead of actually seeing the patient. But, please, if anyone on the board has had a different experience, let us know. I personally have never heard of this practice being common. And I stand by my reasons for not thinking it's a good idea, for the patient or the doctor. Too many unknowns, too many variables, and the doctor will get sued, no question, if/when something goes wrong with the patient that he didn't see personally, but still diagnosed and prescribed medication to.
It's like the mechanic trying to diagnose your engine trouble based on your description of the problem over the phone, then telling you what to buy to fix it, and hoping you can do the work yourself. Not a good idea IMO.

Oh, and I've always had to travel at least an hour - driving myself in my car on CA freeways - to get to my nuero appts. I don't have a hubby to take me. I drive 45 minutes to get to the GP too. Of course, I'm able to manage the drive as I don't suffer the severity of pain Pen describes, but I think quite alot of us are in similar situations, US or UK or Canada or where ever. It's rare to find a good nuero or GP in your own back yard - sad and strange, but true.
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Re: Are you given appointments you can actually keep?

Post  LG on Sun Feb 14, 2010 6:03 pm

I hate mornings. I despise them. I have a bit of insomnia, I usually stay up till around 3am-4am. When a doctor wants to see me at 9am, it is extremely difficult especially since I need to make arrangements for my baby, get her ready and myself ready as well. That and my husband and I share a car. That means it takes an average of about 2 1/2 hours in the morning to get everyone together and drop her off at grandma and grandpa's, plus an additional 15-30 minutes to get to the appointment. That usually leaves me with 2-3 hours sleep. Crying or Very sad If I ask for another appointment, I may run out of medication and be stuck as they wont prescribe the type of meds I get over the phone unless I have been seen during that month. Stinky. I am forced to go to the early appointment sometimes.

I make it, but it is one h3!! of a difficult day for me. Close to impossible, actually. Since I have medication that works it is more of an incentive for me to go to the appointment. I believe if you found a doctor that actually helped you, it would probably get you up and going to make it to the appointments you schedule. I hope this helps you out in the long run Smile Best wishes, Pennie!
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Re: Are you given appointments that you can actually keep?

Post  Cindy*W on Mon Feb 15, 2010 2:25 pm

I truly understand how difficult it is to keep apointments.

There are many times when I just have to drag myself in there because I feel like crap.


There is a reason I don't miss appointments though, because at my MD's clinic, if you miss three appointments, they dump you as a patient.

Seems like I have changed an appt on a couple of occassions, but I gave them a couple of days notice when I did.

As far as phone consultations. I think doctors in the States don't do that because of liability.

There are lots of people who will sue at the drop of a hat, so I think they are just protecting themselves.

I know that it is rare that doctors in the clinic I go to will even change meds without seeing you.

I do understand your problem though. Hope you can find a solution.

Take care,

Cindy
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Re: Are you given appointments you can actually keep?

Post  theresae on Mon Feb 15, 2010 2:57 pm

on the occasions that i have had appointments to keep i always get hubby to drive me in or my mum so i dont have the stress of parking etc, i always take a triptan b4 bedtime so i dont wake up with a migraine, and other than that i just keep my fingers crossed!! To be honest even if i get there with no M i usually have one by time i get home, but i can say the same for the opticians, dentist, travelling to and from holiday, travelling to visit realitives, cinema,full day in shopping mall, busy day at work, you all know what i mean!!
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Re: Are you given appointments you can actually keep?

Post  pen on Mon Feb 15, 2010 3:09 pm

Before Bed Theresa?? As a preventative. I could try that. I never have. I could try couldnt I??
If it works for you.....
See what I find is that if I sleep after taking one they dont work much....
No idea why...but still I could try.
Thanks

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Re: Are you given appointments you can actually keep?

Post  sailingmuffin on Mon Feb 15, 2010 4:52 pm

Hi All,

Most doctors despise practicing medicine via telephone. (Both my parents are doctors, and both hate telephone medicine.) In an emergency situation, it may be the best bet, but more doctors like to see the patients and judge from there. It might work if you are very ill and far way from the doctor or specialist.

The only other idea I can think of is this. Do you think your specialist would be willing for work with your GP or a dr near you. This way, you can see a dr and have the input of the specialist without trave. My cardiologist is in another state- so if there is a change to be made, medication or otherwise, I will talk to both my cardiologist and internist. The cardiologist works with my internist and my internist prescribes the medication and does some monitoring. This may nor work, but it an option. The other option is to ask for afternoon appintments, and explain the problem to yout dr.

I know it may be hard to get there, but is there anyone who can go with you? Maybe going up the day before might be good. I really hope you get some much needed relief. If this doctor can help you, I'd try to make the appointment. If nothing else, you need better treatment, or at least comething to get this horrible cycle under control.

I hope this helps.

Pain free days,
sailingm
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appointments i can keep

Post  dizzyflower on Tue Feb 16, 2010 5:16 am

I live near Plymouth. My apointments in London are in the morning because they don't have an afternoon clinic. I have to book a train ticked a month in advance to afford the ticket, and I have to stay overnight in order to make it. I have to go on my own because we can't afford anyone to go with me. I have to change from one station to the other by going on the underground surrounded by every trigger that i have and how on earth I make it i don't know.

The journey there for me starts at 10 am and I get to where i stay at 8pm, i then have to get out at 7am the next day to get a commute train to the hospital. I then set off again at 2 no matter what ests thay have done across London, arriving home at 11pm. I find it frightenning, but have to convince myself that there is the same amount of help available as there would be if I was just going to Plymouth. The most frightenning thing for me is getting dizzy and being unable to speak properly just before vision starts to go bad with people rushing round me. I have found the staff on the underground very kind though.

I don't know what else to do other than turn up for these apointments as nothing is actually working for me. Not that there are many apointments anyway, it takes months to get one. Soon I will be having to go more regualrly and I bet it won't be long before this goes wrong, there are too many potential areas for things going wrong on the journey, it is just too long.

But this is the problem with migraine, it is unpredicatable so for me the only apointments I make for anyhting are with specialists, I don't make an apointment to go out anywhere, I just go when I can, whiuch doesn't fit with hospital routines.

best wishes

Di

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Re: Are you given appointments you can actually keep?

Post  moominamy on Tue Feb 16, 2010 6:51 am

Sounds like we go to the same place Di. My commute to specialist appointments isn't quite as bad as yours as I live a bit closer.

When I have an appointment (invariably 9am!) I don't book anything in for a couple of days before and after it to both prepare and recover. I usually set off about 6am and get a local bus to where the coach to London goes from. I could take the train in and it would be a bit quicker, but it puts me in the wrong part of London with more travelling at that end. When I get to London I can either take the underground train (quicker, but very busy rush hour so packed with migraine triggers and makes me feel horrific), get a taxi (nicest option, but expensive, so only if I really must eg when having a bad hemiplegic episode), or walk for about 45 minutes to get to the hospital.

I usually walk and plan in a few rest breaks. I know every place that has a bathroom/toilet on the way, which really helps when I am vomiting. Usually I have enough time to have a proper break when I get to the hospital to recuperate a bit and mentally prepare myself for the appointment.

Then the journey in reverse, and home. And straight to bed usually to recover. But these appointments are the best chance of help I'll ever get and I'm proud to say I've never missed one. I waited 13 months to get onto their lists about 7 years ago and I'm pretty sure the wait is slightly longer now. I've seen more local specialists too before and during that time, and have to say they just aren't quite as good for my degree of migraine and all the things I've already tried. They are much more experimental at the National and really worth the effort of travelling. I think you get back what you put in (including preparation for the appointment etc).

Amy

Just forgot to mention phone consultations - my feeling is that even if a dr might be prepared to do this (and they probably wouldn't be as they cannot examine you etc and would be wary about making an error of judgement), most drs are so overworked with clinics, inpatients, paperwork, meetings, etc etc that they physically wouldn't be able to offer this service alongside. Neurology is a vastly understaffed area of medicine, it's just not as 'sexy' as, say, cardiology. They just don't get such a high number of drs wanting to specialise in it. So every neuro has a LOT of patients to see. Then factor in specialising in headache, even more 'unpopular', and the numbers with headaches that want to see them...... it's also the reason appointments may not be as frequent as we may want.

That's why every appiontment is precious and we should make every effort to attend and have an active part in our treatment.

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Re: Are you given appointments you can actually keep?

Post  pen on Tue Feb 16, 2010 6:31 pm

Amy,
Just quick response, I must sleep.
Re phone appointment, this was the neuro, whom I have seen twice before.
He did this for me because I had missed two appointments.
I thought it was nice of him and no prescribing took place.

I cant imagine anyone be would do this as a first appointment no..

I actually think his availability is quite good, I see him every 6 months, but first time was only 3.

P

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Re: Are you given appointments you can actually keep?

Post  pen on Wed Feb 17, 2010 6:01 am

Adendum.
I am going to try to reschedule the appointment to later if I can.
If not I am going to take the suggestion and take a Triptan the night before and if I miss it I miss it.
Only downside is I shall have to wait some time for another apppointment, and I feel bad wasting one someone else could have had. But this is the plan. Good advice.

P

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