What to expect from your GP other than pain management?

Lollydogs

Hi all. I've decided to sign up for my Dad as I have seen a dramatic change in him physically and mentally and I am finding it heartbreaking to see. He no longer seems to be the energetic, funny and hard working man he once was and I'm wondering how you guys cope? He has RA and polymyalgia and so far his GP has only offered pain management which was initially codeine but he has since had his meds changed and is currently on steriods and morphine alongside others so he is taking 16 pills a day! As far as I am aware he has not been offered any referrals to a specialist such as a Rheumatologist or pain management so I guess I'm wondering if this is the norm and should he be pushing his GP for more help? I was also curious as to whether there are any holistic or alternative treatments that would help him? He is now struggling to get dressed and is in constant pain, he is so sad and fed up which is making him very irritated and snappy which is the polar opposite to his usual self. Any advice would be greatly appreciated. Thank you 😃

ajolly

Hi @Lollydogs,

Welcome to the forum, I'm glad you've found us! Your father is certainly very lucky to have you looking out for him. My mother had RA so I can understand how difficult it is to see a loved one suffering, and how helpless you can feel at times.

We cannot offer medical advice on the forum, but I can say from my own experience that I recommend asking the GP for a referral to a Rheumatologist. This is important to ensure your father is receiving the right treatment for his circumstances and to manage the disease progression.

I’ve included a link to our website with information on RA and the various treatment options. This may be a good starting point to help the conversation with your father’s doctor.

https://www.versusarthritis.org/about-arthritis/conditions/rheumatoid-arthritis/

Regarding your question about complementary therapies, different things work for different people. I’m sure our members will jump in and share their own experiences but in the meantime, I’ve provided a link from our website. It is important to speak to a doctor before trying any new treatments as they may interact medication your dad may already be taking.  

https://www.versusarthritis.org/about-arthritis/complementary-and-alternative-treatments/

I hope this information is of some help. Please check back in and let us know how your dad is getting on.

Best Wishes,

Alice

dreamdaisy

I am sorry, what a predicament for both of you. When it comes to my auto-immune arthritis (in my case, psoriatic) I expect nothing from my GP because it is not within his professional remit, it is my rheumatologist that deals with it. GPs do not have the knowledge to diagnose RA etc and are unable to presdribe the meds it requires so I wonder who diagnosed your father.

When it comes to my osteoarthritis then I do expect my GP to help and they do. They prescribe pain relief as in my case that is all that is available. I deal with the rest of the OA with exercise, adapting and adaptations and rest. My rheumatologist ignores my OA because that is not within her prpfessional remit.

If your father has not yet seen a rheumatologist then that is the next step. He may have RA or one of the other kinds of auto-immune inflammatory arthritis (there is a smorgasbord of auto-imjune inflammatory conditions available). I wish you both well. DD

N1gel

My GP assured me my OA was no more than 'tennis elbow', it took an Occupational Therapist to tell him otherwise :-/

Crookesey

I made the mistake of consulting my GP in respect of applying for a seat belt immunity as my shoulder had a habit of locking when I attempted to release it. She told me that she could see from looking at me that I had no signs of R/A and that I wasn’t going to use her as an excuse for breaking the law. I told her that my R/A had been carefully diagnosed by experts, she laughed and said “I think that you mean idiots”. I replied that the head of rheumatology, who was a professor, and his right hand person, who happened to be a consultant might take umbrage at this, she laughed again and said that she hadn’t heard of either of them, I replied to the effect that she would very likely be hearing from them, she in no longer with the practice as I hear that she was the target of a plethora of patient’s complaints.

GP’s have limited knowledge on dozens of medical matters, being lucky enough to find one who is an expert in the very unfashionable area of R/A would be very fortunate. Please don’t take this post as a broadside against good hard working GP’s, just the pig ignorant dinosaurs.

Lilymary

We often forget that GP stands for GENERAL practitioner. They have a very broad range of knowledge, but they are not specialists in specific conditions, although some may have developed an interest or more in depth training in some specific fields of medicine. If there are symptoms indicative of a specific condition, or range of conditions, that are outside their expertise, and where there are specialist consultants in that field, I would say their role is to refer you to the appropriate experts, to establish (or rule out) that condition and put you on the right path for treatment. If the consultant’s diagnosis is that you don’t have that particular condition, that too is helpful as you can be referred back to the GP who should then review future referrals or treatments.

sadly it’s too easy to throw prescriptions at the problem and hope it will do the job, for a whole variety of reasons, many unrelated to the GP’s abilities. Luckily that has mostly not been the experience in my family, but I put a lot of that down to remaining polite, engaged, and, where necessary, persistent and assertive (as well as being blessed with reasonably competent doctors and living in areas where the NHS isn’t on its knees. Chase up if referrals or appointments aren’t coming through, ask questions (including “what if”) take notes, if you have a lot to get through in a GP appointment, ask for a double appointment so the doc isn’t too rushed.

But sometimes it really is down to chance, and if you find a GP in your practice that you connect with, and who is really supportive, try to stick with them. I was lucky enough to end up with a new GP in our practice who has seen me through the most challenging few years I’ve been through health-wise, but sadly she has now moved out of our area, and I’m keeping my fingers crossed that I can now find another to fill her illustrious shoes.

Lollydogs

Thank you all so much for your responses you have been really helpful. I've asked my Mum to make an appointment for the GP and that she go a long this time and be more assertive so we can get some more help and a referral. 😃😘

JoeB

Arthritis in its varies forms is common as is pain. Consequently GPs have a fair amount of experience (and success) with both.

Steroids are the standard treatment for polymyalgia rheumatica. The codeine then progresing to morphine prescriptions suggest the GP is following long established prescribing protocols (and is sympathetic). All positive indications regarding his management.

The number of pills taken daily is largely irrelevent.

Having said all of this it does not (to me) appear unreasonable to discuss a rheumatology referral.

However, in the event he was referred it would be at least 16 weeks before he saw anybody and currently, as these NHS services are suspended in most areas, it will probably be considerably longer. Quite possibly next year.

Hence if it were me, and I was going to broach the subject with the GP, it would be in in the context of the wider and more long term (i.e > six months) management plan.

Arthur