Now this title may surprise you. You probably think I’m already going grey. Well, you’d be right.,. but what better way of hiding it than by dying your hair grey? The carer has dyed hers blonde, my sister has dyed hers sort of vaguely reddy sort of colour, but grey would hide it completely.
I am going to record here the story of the morphine. You may wish to skip it if you’re slightly headachy already or remarkably weak at maths or find it difficult keeping track of events. However I want to record it here as I’d like to be able to look back at it when times are trying and think to myself “If you survived that, you can survive anything”. But if you read it, you’ll need to concentrate.
Dad has slow release tablets for a constant supply of morphine, and additional top-up doses for breakthrough pain in medicine form. I have already told you the dilemma we have with the medicine needing to come both in bottles and in individual vials. That has been a trial, getting the doctor to prescribe both. But that was a minor detail by far in comparison with the story of the tablets.
These tablets come in 10mg, 30mg and 60mg capsules (and some higher doses, but luckily we don’t need those.) The most recent increase to Dad’s medication took him up from 90mg morning and night to 120mg, but it was soon discovered that the dose was not decreasing his pain but was making him very dopey and confused so it was almost immediately dropped back down to 90mg. This was fine – we gave him one 30mg and one 60mg morning and night, opened up onto a spoon and doused with honey. So it continued for several months. All was hunky dory.
Then a random doctor, we are not sure which, decided to tidy up Dad’s records and make sure all the medication on his repeat-prescription-request-slip was all relevant, a much needed task at the time as many things appeared there in duplicate and there were some tablets Dad was no longer taking listed on there. So, efficiently the doctor checked Dad’s records and saw that he was on 120mg of Zomorph twice a day. “Hmmm,” he thought,”120 can be made up with 2×60. I don’t need to prescribe any 30mg capsules” and so he removed them from the list, a fact that I only discovered when I had nearly run out of 30s and wanted to re-order. So I wrote on the top of the slip “Please can we have some 30mg capsules urgently”.
Our GP is great when it comes to bypassing the queue and hurrying Dad’s prescriptions through and I have, at this point, to say that I cannot sing the praises of the surgery highly enough – this business is only a blip and they have been incredibly apologetic about it. The doctor, trying to complete the prescription quickly, checked Dad’s records and could not understand why I wanted 30s when the dose was 120, so he rang up and spoke to the hospice visitor who was there at the time, looking after Dad while I was out for a few hours. She went into the kitchen to check what we normally have and confirmed that the only box there was for… wait for it… 60mg capsules. This was, of course, because we’d run out of 30s! So when I picked up the prescription and took it to the chemist’s, there were no 30mg capsules on there.
I rang the Mac nurse who contacted the surgery and explained the situation. I raced up there and collected a replacement prescription which the doctor (another one) had rushed through for me. But when I collected the tablets from the chemist she pointed out that a) they were a completely different brand (not a problem), b) the prescription said one a day (hmm… that would mean a reduced dose) and they released over 24 hours rather than twelve. By now it was Saturday morning, no chance of talking to anyone about it. I made an executive decision to give him two tablets as his pain was high and I didn’t want him getting morphine withdrawal symptoms. But with going into the respite centre it was important that the package was correctly labelled so on Monday I went into the surgery and left a message for the nurse or doctor to phone me.
When they did, they went ballistic that I was giving him two tablets when the box said only one. I should stop immediately and the dosage would be reviewed the following week. Unhappy, I rang the Mac nurse who explained that the problem was that they were right and I was right too, only I was slightly more right than they were. He did need two of the tablets and the way I was giving them was fine, it just wasn’t what it said on the packet. However, understanding the need to have it right for the respite centre, he contacted the doctor to get him to write another prescription, this time for the correct 12-hour release morphine, which would get us back to normal once Dad had finished these new ones.
Today I went to collect that prescription and take it to be made up, prior to packing his medicine bag for the respite centre. I get the bag of boxes home, take out one that looks unfamiliar, and what do I discover? One hour before the chemist closes I discover that the doc has got it wrong again. Yes it is 12-hour slow-release morphine at the right dosage, but it’s a tablet and not a capsule. If Dad goes into respite and they start giving him a tablet he doesn’t recognise and tell him it’s his morphine which it so obviously isn’t (in his eyes) as it’s not in honey then that’s a recipe for disaster, especially as he’s got a bit of mild paranoia as it is. Panic stations. I ring the Mac nurse, who rings the chemist. Can it be changed? No it can’t. I need a new prescription. (But they have got stocks in and will start labelling and bagging it up for me in advance, bless ’em). The Mac nurse then rings the doctor who promises to re-write the prescription immediately as I set out to walk up the increasingly steep hill to the surgery to collect it.
After a chat with the receptionist I leave the waiting room clutching the prescription in my hand. Suddenly a voice in my head says “look at the prescription and check it before you leave”. I do… and then rush back in because yet again it says “one 30mg capsule ONCE a day”. I eventually get to the front of the queue – they’re rushed off their feet in there with staff off sick – and the doctor apologises profusely and makes an alteration by hand to change it to TWICE a day. I set off post haste to the chemists.
I am greeted by an extremely apologetic and sympathetic pharmacist who exchanges my prescription for a package she has already prepared with exactly the right medication in it, we chat a bit and then I go to leave… whereupon she utters “Oh no!” No, it wasn’t that she was sorry to see me leave, though she did offer to get me a chair and a box of tissues before telling me that……….. the reason the prescription had said “once a day” was because it had been made out for 24-hour release tablets! It was the wrong prescription!!!!! And he’s going in tomorrow morning, and it was nearly 5pm already.
Thank God for such wonderful people – they got me to sit down while one of their assistants ran up that incredibly steep steep hill back to the doctor’s for the final time to get the prescription JUST RIGHT.
Thank you. Can he go now?