Monday, 31 March 2014

Currently I feel totally unsupported - maybe it's my fault

I started taking Nifedipress MR10 tablets on Friday night. I was told I should start taking them now to ensure there wasn't any adverse reactions before going to Iceland for my holiday.

They are supposed to alleviate my Raynauds symptoms and they have caused a few side effects.

I got a constant headache, it started on the Friday night and (thankfully!) went away on the Sunday. Friday night was a restless night but that too has settled down. Only one side effect remains - the impact on my blood glucose control.

My blood glucose readings have gone in to double digits and it takes a lot of correction doses to bring them back into range.

Having read the PIL (Patient Information Leaflet) that came with the drugs I had a few concerns too.

Despite the questions I asked beforehand about impacts on my diabetes control (which were dismissed) the PIL states that it should be prescribed with special care/not at all if the patient has diabetes. It also mentions that urine tests can be affected - I don't know if that includes ketone testing.

Sunday night I had my usual #hurtyhands or more precisely painful fingers and I decided I should ring my GP in the morning for advice.

Monday morning and on-route to work my Raynauds triggered again and I spent the morning trying to stop the pain. So I rang up with some questions.

My GP surgery has an interesting method of booking appointments. You ring up, explain your issue to the secretary and they decide if the GP will ring you back or not later that day. If the GP then decides you need to come into the surgery they will book you in to see them that day.
After explaining my situation it was agreed that the GP would ring me back.

The GP rang and so I explained the situation again.

I wanted to know if I should wait longer for the drug to take effect, in which case I would increase my insulin doses to deal with the higher readings and give it time to make a difference. If the drug should already be working then I was going to stop taking it and ask what the alternative option suggested by my consultant was (oh to be able to read that letter!).

Unfortunately my GP said (paraphrased) the following:
"Well these are just for when you are on holiday so, if you like, reduce the dose to once a day and when you are on holiday increase it back to twice a day. Don't worry about your blood glucose readings being in double digits because it's only for a couple of weeks"

I re-iterated that the dose wasn't helping with my Rayaunds currently but, if I needed to give them more time to work then I'd work out my insulin doses to better control my blood glucose... and the GP reiterated that I could reduce my dose to one a day until going on holiday, take two from that point and if I felt it wasn't working stop taking them. I tried one more time and then gave up.

I put the phone down not really knowing what to do. I didn't bother asking about the impact on ketone urine tests because I couldn't get a sensible conversation on the first question.

My choices

1. Do as the GP says:
  • Reduce my current dose to one tablet per day - I'm not sure why. I think maybe my GP believes this will reduce the increase on my blood glucose readings.
  • Increase my dose back to twice a day whilst on holiday and accept the double digit blood glucose readings that follow - I'm not happy with that idea.
  • If the drug fails to work then stop taking them and suffer the pain whilst on holiday.
2. Just stop taking them now and suffer the pain whilst on holiday.

3. Carry on taking the current dose in the hope they "kick in" at some point and adjust my insulin dose to bring my blood glucose levels under control. If they do "kick in" then I can enjoy my holiday.

I hate flying solo and if I'm going to be in pain on my holiday then I'm not sure I really want to go!