Daily Archives: November 30, 2006

Goodness, I’m impressed.

Now either you’re a very efficient lot or that last post took me too too long to type. Well, it was a bit of a long story, I know. (My feet and worry-lines seem to know it too, somehow… to say nothing of my dermographia which is working overtime at the moment!) But four comments before I’d even closed the admin screen… that IS impressive.

😀

I am thinking of dying my hair grey.

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?

Bleugh

Ever been run over by a steamroller?

It’s been a bit of a… a bit of a day? It’s been a lot of a day. I have rarely been as exhausted, emotionally and surprisingly physically too. Indeed, the idea of going into the respite centre myself for a week is highly appealing, and I think anyone able to see inside my head today would have been seriously concerned about the fact that I have access to both morphine and sedatives, not to mention a bottle of sherry in my cupboard (yes, I am teetotal!). But I seem to have survived intact .. so far at least.

The first source of perpetual anxiety is Dad. He is so determined not to go for respite that he is currently unable to bring himself to speak to me. He seems really quite ill, and it is hard to tell how much is his actual illness and how much is a deliberate ploy to a) try to weasel out of going and b) make me feel guilty and c) make me work ten times as hard to pay me back for putting him in there for the week. I have my suspicions it’s a bit of both, which makes it all the harder as you cannot call his bluff so easily. It’s had one good effect, I no longer feel quite so guilty for him going as the exhaustion combined with the irritation (nay, near anger!) at being emotionally blackmailed mean that I need this week of battery-recharging more than anything.

I found myself with a dilemma this morning, however. The respite is intended to give me some time with my children and I found myself not actually wanting to spend any time whatsoever with my eldest, in fact I found myself looking for ways to get rid of him too for a while. I think we have cracked it today, but yesterday I was mother to the teenager from Hell and things were looking bad at his school too. Those of you who know him will know how alien it is to his character to be determined to break up the family and be expelled from school. But God is good and sent him the migraine to end all migraines today, which resulted in him spending a couple of hours in the medical room (I was just getting into a much needed bath when they rang me and, not wanting to see him yet, I asked if they could keep him for just a little longer, explaining the circumstances… but omitting to mention that my bathwater was getting cold and so was I!) and then breaking down in my arms when I went to collect him. Teenage stuff, of course, but all wrapped up in worries not only about Grandad but about me and about what would happen when it’s all over. Textbook stuff really, trying to disrupt the relationships deliberately to preempt it all falling apart around him beyond his control. I don’t suppose we’ve heard the last of it, but several heartfelt conversations, and him starting to share some of his worries and allow himself to be comforted and reassured have definitely been a positive step forward… even if he doesn’t quite understand that the punishment given yesterday still has to be served!

The biggest headache this week has been Dad’s medication. More of that in another post.

The saving grace today was meeting R in the chemist. She is the most wonderful old lady I have ever met. She is soft and gentle, angel-like in voice, demeanour, appearance and attitude. She’s one of those people whose glow of loveliness seems to radiate out and touch your heart even before she speaks. Totally crippled with arthritis, but never grumbling. A lady who, when she says “I am praying for you every day”, you know she actually is, you can feel the prayers almost tangibly. Who better to meet when feeling world-weary?