My GP Appt - long post

[sleepygirl]

Well after waiting weeks, and having to miss appointments (they were running too late & I had to leave) I finally got to see a GP today, I'd never seen him before & I hope I never have to see him again. I've put on a significant amount of weight since my last GP visit, I still smoke too much & that is the cause of all my problems I explained my family history of nose breathing problems, he assumed I wanted surgery, I said the last thing I want is surgery, but at least a referal to ENT or a sleep clinic. He said I could see a dietician, because my diet is poor (WTF how does he know??) and the exercise I've been doing for the last 2 yrs isn't going to help because of my poor diet & comfort eating (again wtf ???). He also said there were drugs that could kick start weight loss, but all he was willing to do was refer me to a dietician, I said I know whats healthy & not etc & if he's not willing to refer me anywhere then I'm not willing to see a dietician. He said he's going to speak to my health visitor (my youngest is only 4 yrs old) & I hope he does, because at the moment she is speaking to me weekly & I'm seeing her tomorrow, she is very worried about me & knows I've had a lot of stress (including my sleep problems) and none of my family knows this (except my hubby), but in January I took an overdose because of various things that got too much & the sleep/being tired problem was a big contributor & that annoys me even more, surely he should be trying to help me more. Also the fact that I snored as a teen/child when I was normal weight & definately not smoking made no difference, its all caused by my weight & smoking, I left the surgery in tears & sooo angry. Anyway rant over, any help or suggestions?

sleepy girl

p.s I know its not healthy smoking, but I rarely eat take aways or fast food, I don't drink, I pay my monthly gym membership & I have my cigarettes,everything else I buy is for my family, I don't go out drinking or partying ar anything, I am always here for my hubby & kids, so surely I am allowed one luxury? and quite honestly I don't want to give up smoking, is that so wrong?

[puffin]

Hi Sleepygirl,
Sounds like a typical GP, first thing they see is an overweight person who smokes. They don't see the person behind the obvious problems. I've always made a point of seeing the same GP at our large surgery, that way you build up a relationship and trust with that GP.

As a non smoker myself, I don't see smoking as a luxury, it's an addiction, and is a legal one at the moment. If you can show that you are attempting to give it up, then the NHS would be more willing to help you. I know that is is easier to say then to do. I would give it some serious thought if I were you.

At this time of year, NHS money is short, end of budget etc. Wait until after the end of the month. Ask to see another GP at the surgery, say that you where unhappy with the negative response from the previous GP and insist that you want referral to a sleep clinic, the right is yours. Don't take no as an answer. Good luck.

[anneliz]

Hi Sleepy girl

Anyone who gets to the stage of OD with a child as young as 4 clearly needs more help than this GP has a chance of understanding.

I trotted to the doc a couple of times a year for a very long time and nothing seemed to get done, I was also very depressed ,a direct result of feeling dead on your feet most of the time, anyway last year I wrote a list of all the things I felt were wrong with me, and took it to the surgery then just told him I wamnted every single thing on the list dealt with. Once it was all written down he seemed to connect the tiredness, heavy legs, headaches, general feeling of not being able to cope.

He did loads of blood tests ect and yes said I needed to lose weight ( hasn't happened) but eventually he did to refer me to the sleep clinic.

So put it all on paper leve nothing out you don't make it clear if the doc knows about the OD? but he does need to.

I hope you get the help you need soon
take care
anneliz

[retsyo]

Hi Sleepygirl

Sorry to hear about your problems. You clearly need some help and support. Having not slept for donkeys years until quite recently I know how you must feel. However, as a non smoker I really think the smoking cannot help - OSA is a breathing disorder during sleep.

Have you tried the Epworth test - this can be done on line and you could then take a printed copy of the questions and your score along to a GP. I agree it is good to see the same person each time so they can get a consistent picture. Is there a Dr in the practice who is known to have a better manner. As many on the forums have said most GPs know very, very little about OSA.

The Epworth test can be done on line and the info can be found easily on internet. There is an additional test that can be done, it is the Berlin test. Both tests can be found on the internet at www.cpap.uk.co. The Berlin asks questions about your health - again I did not come out too well.

I had suffered with nasal problems all my life and had numerous surgical procedures done on my nose. It was only last summer when I returned to see my ENT specialist yet again that he made me do the Epworth test which gave me a score of 18. He suggested I made contact with a sleep clinic as soon as I returned to New Zealand where I am temporarily living. I had seen this UK specialist over many years and had suffered sleep problems for as long as I can remember. At the age of 66 I was finally diagnosed with OSA.

Be persistent and do not give up. I realise you are busy with a young family but if you are able to sit and wait patiently for your appointments it may be more advantageous. As the practice is clearly always running late try to organise an appointment time that wont clash with other arrangements even if you have to wait for ages. I know it is frustrating, I hate waiting and am the world's worst when it comes to time mismanagement by professionals. Are you able to get your husband to go along with you to the GP to put a little more pressure on him. I'm a great believer in fighting for your rights with the NHS and quite clearly you know you have a problem.

Anyway very good luck and I certainly look forward to hearing you have had a more positive experience with your GP.

[sleepygirl]

Thanks for the replies. I don't think I mentioned that he even said it sounds like I have sleep apnea. Anyway to update, I saw my health visitor today & the Dr had spoken to her yesterday & she clued him in, with various things that are going on at the moment & she said he was very sorry, he realised that he came across as rude & didn't handle "it" well at all etc etc. She suggested another appointment with him, as he is very nice/good (her opinion) and that if I see him again, we meet each other half way. So seeing as I know my HV very well & trust her opinion, I shall make another appointment & see him again. As for meeting him halfway, thats what annoyed me most, he wasn't willing at all yesterday, if he'd said I'll refer you to ENT or sleep clinic if you see the dietician & lose x amount of weight, or pretty much anything that didn't blame everything on my "poor diet & comfort eating" without even knowing me, then I wouldn't have got so upset & angry. My HV also spoke to me about my diet & although she doesn't know exactly what or how much I eat, she seemed to think that my diet is pretty healthy. Just in case you're wondering, I eat 3 meals a day (took a lot of getting used to over past few yrs, as I used to skip meals a LOT), I'm not into chocs, sweets, fizzy drinks, alcohol. If I snack, its usually fruit or yogurt, or sometimes a bag of crisps. I rarely buy/cook burgers or fish fingers (mostly for the kids anyway) & if I make things like spag bol etc, I make them from scratch, I hate ready made sauces, I mainly eat chicken (skinless breast) or prawns, or good quality mince & apart from fried eggs, nothing is cooked in oil in my house, oh and occasionally we have takeaway ...... so maybe not 100% healthy, but not a poor diet IMO

sleepygirl

[puffin]

Sounds like the GP was having a bad day, perhaps he needs CPAP himself.

Sounds like you do eat a fairly balanced diet, sometimes there can be other factors that can influence body weight and mental heath, such as thyroid problems. Have you ever been check for this, simple blood test. Mrs Puffin has had depression and weight problems for many years. Turned out to be under active thyroid, once she went onto pills for it, her quality of life changed for the better. The other benefit is free prescriptions for life.

[Dopey Plumber]

Hi SLeepygirl
you have my sympathy. Have been on the wrong end of more psychie treatment than is good for me, a doctor who says "what's the use of coming to see me when you have a high BMI", and finds excuses not to look at things.
I went through a long period of the big D, when I think OSA was getting started with me, 20+ years ago. It's damned annoying when you see someone else, who says you're a textbook case but your own doc never made the connection.
"WTF" is something like I feel too!
The most switched-on doc I saw was one who couldn't have been more than about 25, what a breath of fresh air he was.
Dealing with depression can be a long and difficult process, but you're obviously bright, which according to the evidence, does help. I'm through it now, and do wonder how much of the feeling of not being able to cope was to do with being half asleep. ECT didn't help, (not surprisingly!!) but other therapies did, Stick with them.
Good luck.

[sleepygirl]

Thanks again everyone, like I said I'll try again with the Dr & maybe he'll be a bit more sympathetic. I don't know if anyone else has noticed this, but when I'm stressed etc, my sleep problems become even worse, I had a few weeks of "good" sleep, but the last week all my crazy sleeping positions & stuff have been happening again, I know what the main source of my stress/anxiety is & unfortunately there's not a lot I can do about it :-(

sleepygirl

[anneliz]

Hi sleepygirl

If you can identify the source of your stress you are 1/2 way to dealing with it. you say there is nothing that you can do about it? if that is truly the case then allow yourself to accept that the problem is outside your control and you can begin to put it to one side. It won't go away but not feeling responsible for it/ or responsible for doing nothing about it will ease the stress.
You have alot on your plate with a young family to take care of so don't think you have to be super woman.

[EssexBoy]

You're not alone. I've just got back from my GP. Started telling him all the symptoms (gasping for breath during sleep, constant tiredness, etc), and he interrupted me and said "you're obese (15.5st, and 5'10) and you smoke. Until you fix both of these things these things there is nothing that anyone can do for you". I explained that losing weight was a necessarily slow process, made harder by the constant tiredness, and that smoking cessation therapy had no guarantee of success.

He said he would give me a prescription for a nasal spray. I said I wanted a referral to a private sleep clinic. He said OK. If I wasn't lucky enough to have private health care through my employer, nothing would have been done.

[Dopey Plumber]

That's appalling. "Obesity" atarts with BMI over 30, yours is 30.8 So your GP idiot is saying that disallows you from NHS treatment? Who the hell does he think he is? He needs reporting to the BMA, GMC, or whoever it is who regulates GPs' behaviour.
Presumably he hasn't heard of the guy on the news recently who lost 6 stone AFTER getting his CPAP machine.