this post was submitted on 09 Feb 2025
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Comradeship // Freechat
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You've nailed the cause-effect-outcome writing style, nice!
You're probably right, it is cheaper to give you 2x the $20 cream than $20 cream + a hospital visit and associated follow-up but imo that detracts from the focus of your healthcare outcomes. If you elect to follow my advice to ignore costs in your appeal, then noting the comparative cost to the NHS doesn't align with that line of reasoning.
I misunderstood, I thought thought the GP and pharmacist were aligned on the cost being problematic. But I would probably still avoid discussion costs. The comparative cost of giving you adequate supplies vs the cost of a potential hospital stay multiplied odds that, for example, the eczema flares up and becomes infected gives you an expected value to compare costs. And you might have noticed these are hard to quantify even if you had pricing info and it takes the argument to a weird what-if place where you probably won't win against a doctor.
Your metaphorical high ground is the higher allocation of pills and supplies has better outcomes for you and mitigates specific health risks of yours. You want to stay within that as much as possible.
How about something like:
Dear Dr R,
I have noticed that lately I have been prescribed only half the amount of Dermol 500 cream and e45 eczema repair cream I used to receive. I was previously prescribed two bottles of each a month but now receive only one. I am unsure whether this is an oversight or intentional. I would like to ask that my future prescriptions are for two bottles each rather than just one. I need to use Dermol 500 as a soap substitute daily over my entire body, followed by e45 eczema repair cream as a mosituriser and one bottle simply doesn't last for a month. Prior to being prescribed these items, I was using ordinary soaps and body washes, and it aggravated my eczema to the point that I had open sores that regularly got infected. This resulted in frequent trips to both hospital and the GP surgery and regular treatment with both antibiotic tablets and antibiotic creams. Since switching to these items, the eczema has remained in remission and I have not had any skin infections from it nor needed antibiotic treatment for it.
I have also previously written to the surgery about my rimegapant prescription, but have received no response. Previously I was taking rizatriptan for migraines, but since I had a stroke, the neurologist prescribed rimegapant because, rizatriptan is contraindicated in stroke patients. I have tried all the other migraine treatments including nerve blocking injections in my head, none of which worked. Rimegapant, along with topiramate, are now the only things I can take that give any relief, and rimegapant can be taken daily as a preventative. However as the GP surgery won't prescribe more than 8 tablets a month, I am unable to take it daily as a preventative, and so still suffer migraines. Migraine with aura, which I suffer from, doubles the risk of stroke, and as I have had one stroke already I would like to do everything possible to prevent another. The neurologist originally prescribed 8 tablets for me to try to see if they worked, but said I can increase them to daily if they help. They do usually work for me by ending a migraine, but as I don't receive enough to take daily I still get migraines. Would you please therefore increase the number of rimegapant tablets I am prescribed?
I also previously wrote to the surgery about my topiramate prescription but have not received any response. I received a letter saying that all female patients taking this medication must take birth control too, as topiramate can cause birth defects. However, I am not sexually active nor have any intentions to be, and I also appear to be going through the menopause. I do not need birth control and am unwilling to take it under any circumstances. Please confirm that i will continue to receive my topiramate prescription.
Hi, simply wanted to ask if you had also tried Valproat as prophylaxis. It off-label use status for this where I live. Sadly I don't have something, were I could ask for the medication you take - my doc prescribes me almost everything and its for free anyway - but Valproat would not be a problem at all. I could ship it to you then (sealed and not opened package)
Thank you for the offer but I'm on so many meds already with so many side effects i don't want to take another one. It's one of the reasons I don't want to be put on birth control.
OK. I know the pain of headaches and I am taking now opiates for few months now - it is not migraine but still sometimes with a weird feeling like aura or my right eye starts to tear. Strong Headaches, migraines included, can literally disable one person for a time and it is cruel pain. I wish you the very best and sincerely hope you'll get the medicine you need. Shitty ppl behave like its their own money, if the don't want to prescribe more expensive medication.
Thanks. if you're getting extra symptoms like aura, then it's migraine you're having. You can even get a migraine without a headache at all, sometimes I just get the aura without the pain. You might want to see if you can try something like rizatriptan or rimegapant, as I believe taking opiates can make headaches and migraines worse if used too much.
You should state that in your letter's last paragraph "I would like to avoid taking birth control medication, for fear of how its side effects might interact with my fragile health and the other medication I receive".