Morphine

Part of my wife’s many medications included slow-release morphine capsules and morphine sulphate liquid, the latter of which she used when her pain became difficult for her to bear. Our GP had prescribed her 4 litres of morphine sulphate a month, and my wife was able to manage her pain levels with that amount.

However, in February of this year, the medical profession in all its wisdom decided that no-one should be on more than X mg of morphine a day (I can’t recall what the actual value was), because supposedly a person’s pain receptors didn’t react beyond X mg. Over a period of a few weeks, my wife’s morphine sulphate was reduced from 4 litres a month to 2 litres, and I could only watch helplessly as her pain levels increased to a point where she could no longer manage them. My wife began to hoard her morphine, keeping it only for use when her pain was excruciating, and I knew she was suffering so much more.

My wife said to me two or three times over the following months “Perhaps when I’m dead they’ll realise what they did to me.” I didn’t really think much about her comments at the time, I thought she was just trying to emphasise how much more pain she was in as a result. But perhaps she new more than she was telling me.

I was talking to a friend a few weeks ago, and she asked me if I thought the Covid situation had made matters worse. I hadn’t thought much about it up to that point, but the more I did think, the more I came to believe that my wife’s passing was hastened as a direct result of the government’s actions on Covid, and the medical profession’s action on reducing morphine availability. Our GP used to visit my wife at home every 2 or 3 weeks, but she hadn’t been able to see a GP since January of this year. I am so sad and angry about the circumstances of my wife’s passing because of these contributory factors, but I don’t have the energy to start raging about it. I just wish I could roll back the months and have done some things differently.

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Dear Alston56,
That must have been so hard for you and your wife, to be robbed of something that was helping to relief her pain which is so important. I can’t belief they halved the dose without providing an alternative to keep her pain at the same levels. Was your GP the only one who decided on her medication or did you get any advice or support on pain relief from other health care professionals? As you say, it is sad that her GP could not come out to see her as he or she may have realised that she needed more. I don’t think that the lower dosage of morphine would have hastened her death because it is not a treatment, it only relieves pain and sometimes helps improve breathing. I also don’t think there is anything you could have done differently,.
Jo

Dear @Alston56, I am so sorry that your lovely wife Nicki suffered so much towards the end of her life. There are, unfortunately, many idiots in the medical profession who are uncaring or think they know best, or both, and patients have to suffer. We all die, but at least let us die in a dignified manner with as little suffering as possible.

I dont understand why the GP couldn’t come out to a sick and dying patient. A face mask, gloves and an apron would have done. What are these drs doing. It has been months now that telephone is all you have and face to face only for emergencies. How many of those emergencies could have been averted by the patient being examined. My friend had stage one cancer in her uterus. The operation was a success. Her six week check up was on the phone. She started getting more symptoms and waited three weeks for an appt. she has another polyps in another place. The nurse in the clinic said to the dr. These telephone appts are not much use in these situations are they. Now waiting for results of biopsy again. I worked at a hospital for 10 years and still have contacts there. The girls tell me it is like the Marie Celeste. Consultants doing clinics from home and only coming in if they are on call. It is as though the NHS is holding its breath because of the virus just to be ready. Meanwhile people are dying of other things. Cancer is worse than Covid. How many people will be late to diagnose and will die because of it. Madness

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It isn’t as simple as that. A normal surgical mask doesn’t offer protection against the virus, you need a N95 mask for that. There was such a shortage of those in the early months of the virus - my dad was going to hospital three times a week for dialysis, and even the nurses in the hospital didn’t have the normal masks we now have in the shops, and the paramedics that came to take my dad away in an ambulance did not have N95 masks the first time they came. If we didn’t have a shortage of masks, my dad might be alive, but if I write more about this, people will accuse me of being “political” …

People are dying not from covid. Surgeries are failing basic care. Receptionists think theyre doctors. Doctors think its a holiday. My husband died not of covid. The doctor wrote to me and said with hindsight he should have seen my husband because he had many symptoms. Hindsight what a fool. Then another doctor wanting to do a zoom call the day befor he died. No was never going to happen. I explained you visit or you dont I dont care either way. They came out.
Covid is a poor excuse for people without covid dying.

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I hope that one positive from this awful pandemic will be a long overdue review of GP contracts. Who are doctors there for?
Becoming a GP is a choice. No one is requisitioned. It’s a vocation not a job. UK GPs are some of the highest paid in Europe and with the privileges they enjoy comes great responsibility , or it should.
Some patients have a great relationship with their GP but too often it’s down to chance as to who is allocated. It shouldn’t be like that in primary care. A&E departments were overflowing at weekends long before covid.
Of course telephone appointments may be appropriate for some people with more minor ailments but when it comes to the seriously ill patient nearing the end of life I think that to refuse a visit is reprehensible. The onus should not be on a relative having to negotiate a visit. The same goes for patients and relatives managing complex care plans and medication. When is it a more appropriate time to see a doctor?
If it’s acceptable for community nurses and carers to visit patients then it should be ok for a doctor to do so. My daughter in law is an ultrasound radiographer and every day receives referrals from GPs to see not just the patient but also has to allow a partner in with the patient if required. She wears full PPE all day five days a week. Doctors also have access to the appropriate PPE which they would only have to wear for visiting the seriously ill. It is possible to provide care safely if the will is there.
For those GPs who do honour the oath they took on qualifying they must also view some of their colleagues actions with disbelief.
In a time of national emergency everyone has to step up to the mark and to argue about or deny visiting the sick and dying is not a choice a doctor should have. Patients should always come first.
Reading some of the posts describing how people have struggled on in the most emotionally and physically draining circumstances is heartbreaking. Care, compassion and dignity cannot be given remotely. Never has been possible and never will be.

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That echoes exactly how I feel. People say they didn’t have the right equipment and it was the governments fault. We have never dealt with anything like this. I worked in a hospital and I worked in ICU and doctors in hospital just get on with what they have. It is primary care that is failing people. Complex regimes for people at end of life being cared for at home change sometimes daily and paramedics always turn up masks or not. As the other person said my niece is a community care nurse. They had only paper masks but she still went in to her elderly patients who would have died if she hadn’t. Let’s not sweep the GP scandal under the carpet

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Unfortunatley covid has just shown our gp for what they are an already poor service now beyond repair. I have found in the course of my life that it is no longer a vocation. Sad times ahead.

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People say they didn’t have the right equipment and it was the governments fault. We have never dealt with anything like this.

Viruses have been around for millions of years. They are nothing new. We have known for years that there could be a pandemic that kills huge number of people - it is the government’s job to plan and prepare for such a pandemic. When we had Exercise Cygnus in 2016, to see how the UK would cope if there was a flu pandemic which hit the country, it showed that the health system would be overwhelmed and lots of people will die. Why then did the government not do anything?

The UK, Germany, and France have similar populations and similar economies. In Germany their excess deaths is 10 per 100,000 people. In France it is 54. In the UK, it is 95. Our excess deaths for this year are 9 times that of Germany. Why should we not hold the government to account?

My dad died. He caught the virus in March. He couldn’t self isolate as he had to go hospital three times a week for dialysis. Our idiotic Prime Minister was going around joking that he is shaking hands with people in hospital whilst the WHO were recommending that the UK needs to go into lockdown. We did not go into lockdown till three weeks later. When the paramedics first came to take my dad away, they did not even have the correct protective equipment. The woman told me that the mask they are wearing doesn’t protect them. And yet people somehow say we shouldn’t blame the government for their abject incompetence?

As the other person said my niece is a community care nurse. They had only paper masks but she still went in to her elderly patients who would have died if she hadn’t.

And how many people died because medical staff, who went in to see patients in a care home with just a paper mask, caught the virus, were asymptomatic, went to see other patients wearing just a face mask who did not have the virus, and accidentally ended up giving them the virus? Because paper masks do not stop the spread of a virus. We are the 6th largest economy in the world, we did not even have basic PPE equipment. That is totally unacceptable.

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