Saw a locum GP today. All I can say is sorry to patients waiting after me. She spent best part of half an hour checking how I was and going over options for a medication plan. She concluded that she can’t get me to a full dose of pregabalin before I see Mr Casey, but got me as close as she can without risk of hitting a downer or being left without sufficient pain/nerve relief. However, I’m going to have a couple of weeks of less relief than I’m used to.
I explained that the amitriptyline is making me groggy, and with having such a complex job, I really can’t be doing with taking any more, and I haven’t seen any improvement in symptom since increasing the dose. Given that I have had amitriptyline before and come off it ok, she feels I can reduce the dose fairly quickly and be off it in a week. I then need to reduce the gabapentin for a week before I start to introduce the pregabalin. Hopefully I’ll know whether it’s doing any better before my appointment, even if I’m not up to full whack. She has also prescribed me some more diazepam and morphine for the scan, but said I can also use either on occasions if the pain gets too bad or I can’t get enough sleep.
I asked about a referral to the pain team, but she said it would be a waste of my time and the appointment until I’ve been on the full dose of pregabalin long enough to know if it is going to work. They will just tell me to come back when the meds options have been exhausted.
A bit frustrating in a way that I could have started the pregabalin by now if I hadn’t been told to increase the amitriptyline again. That said, I really can’t fault the consideration she gave me, having read my notes before she called me in, and looking at all options for me.