Note to Doctor

[eredien]

Dear Doctor's Office and Doctor:

You saw me really quickly last week, which was awesome, because I had thrush and it was bothering me, and I had to pay out of pocket.
You gave me a prescription, and I picked it up last week, the day after it was filled.

The instructions clearly stated to use the medicine four times a day, but failed to tell me how much medicine I should be taking for each dose. After calling the pharmacy and your office and getting two calls from two different nurse practitioners within five minutes of each other, I then waited nearly 4 hours to be told that I should take 5 milliliters of medicine for each dose.

Let's do some basic math:
5 ml/dose * 4 times/day = 20 ml/day.

The bottle contains 60 ml of medicine.
60 ml/bottle 20 ml/day = 3 days' worth of medicine (even though it turned out to be a little more than that because I only took one dose, before bed, the day I picked up the medicine, and one day only took three doses by accident).

When I called your office today asking for a refill because the thrush is not gone yet, why were you surprised that the medicine was all gone already? Why didn't you give me two or three refills, for, say, a weeks' worth of medicine, instead of requiring authorization for the next refill? And why did you set that next permissible refill date to be a month away, causing you and your staff annoyance to refill my prescription?

You said that you would let me know in 2-3 days when the next refill is ready, but I am not sure if you are supposed to call me or if the pharmacy is supposed to call. I bet that bottle will be gone in three days too. Since I cannot treat my thrush with medicine for the next three days as I have already run out of medicine, I hope that the next three days' worth of medicine, when I get it, had better kill the damn stuff off so I can stop going to and calling your office!

Now I am going to eat yogurt and probiotic fruit juice, as the tub of yogurt and carton of juice last for more than 3 days, and do not require a refill, and I want to do something to stop the thrush from coming back, and that is all I can do.

Comments

[tiamat360.livejournal.com]

It is a very good idea to eat yogurt after taking an antibiotic, even if you didn't get the full course of the antibiotic (or were trying to help the thrush by eating it). Go you!

I hope the doctor gets back to you soon!

[thomasyan.livejournal.com]

One concern I've heard raised about eating/taking yogurt and probiotics is replacing the depleted fauna and flora with a monoculture, but I don't know how serious a concern that is, nor if there's a recommended way to avoid that.

[tiamat360.livejournal.com]

Well let's see. Possible lactobacillus monoculture, or possible C. diff monoculture? I know which I'd pick...

[gallian.livejournal.com]

There are also some very effective gerbil remedies for thrush as well. My brain is dead and can't find them off the top of my head but googling thrush or Candida should do it. The thing about the anti fungals is that if you take them too long you just end up with a more persistent infection.

[gallian.livejournal.com]

Herbal remedies, Herbal.

Ah, autocorrect......

[nightengalesknd.livejournal.com]

I was trying to figure out how rodents were going to help here. . .

They don't teach liquid dosing common sense in medical training programs. When I prescribe a liquid medication, I calculate the amount needed plus a small margin of spillage/stick to the side of the bottleage error. But I'm a pediatrician and most of our meds are liquids. And I'd rather do the math at the outset than field the phone calls later.

Your letter should truly be sent to this clinic so they can pin it up as a practical lesson - "here's why we made you take arithmethic"

[wherdragon.livejournal.com]

I, too, was trying to understand how gerbils, or the remedies for when gerbils get thrush (do they get thrush?) would help E. :)

I know that at my program they do teach you to do the math about dose x doses per day = how much you need to prescribe (if we were prescribing... this is a nursing program, not practitioner), and that I've heard from my instructors on the floors about the problems re: liquid meds (you get them a lot on GI units and oncology), but it's not specifically in the program.

I am certainly going to relay it to my classmates and instructors for our education!

[ab3nd.livejournal.com]

I worry that I immediately wrote it off as "Oh, gerbils get thrush too, and medicine that works for them works for people too", despite the fact that I know not all animal drugs work for people or vice versa.

[thomasyan.livejournal.com]

*laughs and laughs*

[wherdragon.livejournal.com]

Also, I share some rage about not specifying dose amount. That is a crucial and required part of ANY 'script!

>:( Only emoticons can express my feelings.

...I may be feeling kinda silly. But I do hope the thrush goes away and stays away.