Why

[smfadmin (OP)]

My email to my doctor:

GP Treatment Ultimatum / Treatment Plan Request

To Dorothy,

I want a direct and serious review of my pain management.

I have severe chronic venous insufficiency (CVI) causing the problems in my left foot, including significant pain, burning and other symptoms that are interfering with sleep, walking and standing. My arthritis has also deteriorated substantially.

My current treatment is not adequately controlling my pain.

I am asking you to consider whether a substantial increase in my current medication is medically appropriate, including the doses I am requesting of 80 mg oxycodone and 150 mg pregabalin.

I understand that you are the prescriber and that you must make the clinical decision. I am not asking you to prescribe something you consider unsafe. I am asking for a proper assessment and a treatment plan that has a realistic prospect of controlling the pain caused by my CVI and arthritis.

I also want to be completely frank: inadequate pain control has contributed to my obtaining heroin outside the medical system. I would much rather have my pain and medication managed openly and medically.

Therefore, if you do not consider the doses I am requesting appropriate, I want you to give me a specific alternative plan, including:

- what medication and doses you recommend;
- how and when those doses will be adjusted;
- what other treatments for the CVI-related pain should be considered;
- what monitoring you require; and
- when we will review whether the treatment is actually working.

I am prepared to work within a sensible treatment and monitoring arrangement.

What I am not prepared to do is continue indefinitely on treatment that isn't adequately controlling the pain without a credible alternative being offered.

If you cannot provide a treatment approach that you believe is appropriate for me, please tell me plainly. I will then seek another GP who is prepared to take responsibility for managing my pain and underlying condition.

I want a treatment decision and a workable plan — not another indefinite continuation of inadequate treatment so fuck my heart issues, I don't care bc it doesn't hurt !

- Andrew at the end of his tether, seeking compassion.



Why not ?