Healthcare in The Netherlands

[[cs...]]

Yes I do the same. Doc said always listen to my body and not him. I'm still waiting for you to write your signature.

 

 

Lorazepam, potentiated with ambien and lunesta, potentiated with hydrocortisone and fludrocortisone.  Talk about being kindled to a crisp.  .  I don't think they could have prescribed worse.  Single dosed for several years , except hydrocortisone, which was spread throughout the day.    Rx'ed for sleep.

 

To everyone, please don't single dose short acting benzos, and please don't potentiate with PAMs....

[[...]]

 

Unfortunately, we don't pick our doctors here. I wonder if that board is going to support his stupid ideas 'clonazepam is safe because it is prescribed by a doctor' ' I didn't see anything'.

 

You're not able to choose your own doctors there, Liberty?  Curious how it works there?  You're assigned a doctor, or what?

[[li...]]

Yes I do the same. Doc said always listen to my body and not him. I'm still waiting for you to write your signature.

 

 

Lorazepam, potentiated with ambien and lunesta, potentiated with hydrocortisone and fludrocortisone.  Talk about being kindled to a crisp.  . I don't think they could have prescribed worse.  Single dosed for several years , except hydrocortisone, which was spread throughout the day.    Rx'ed for sleep.

 

To everyone, please don't single dose short acting benzos, and please don't potentiate with PAMs....

 

What about clonazepam, lorazepam, solifenacin (off label!), mebeverine (both antimuscarinic drugs) with a near full block on ´normal´ (first world) somatic healthcare ?

 

And with respect ´To everyone, please don't single dose short acting benzos´: double dosing may increase physical dependence, as a general rule I would suggest to get off ASAP rather than messing with doses, not everyone does well on double dosing. I recall that Australian outfit advising to accept interdose withdrawal. Sorry, I don´t remember the name (edit: or maybe I do : http://www.reconnexion.org.au/ )

[[li...]]

 

Unfortunately, we don't pick our doctors here. I wonder if that board is going to support his stupid ideas 'clonazepam is safe because it is prescribed by a doctor' ' I didn't see anything'.

 

You're not able to choose your own doctors there, Liberty?  Curious how it works there?  You're assigned a doctor, or what?

 

According to the law, we are. But then there is the real world.

In many places you need to ask permission before you are allowing to switch GPs in the same town/city. Even if that does not apply, then what ? You can´t change GPs like a pair of socks. Maybe once, twice, thrice. But (according to rules, docs) they need to be in charge of all healthcare. You never know what you get till have have handed over (note: always check files, it´s usually done electronically) your medical files and have completed the switch. Then you know what it means when they are in charge ... Or not yet, but a bit later ...

There is the formal 15 minutes rule, they have to be able to arrive at your house within 15 minutes so that´s a geographical constraint.

 

GPs are gatekeepers, you need their referrals to see a specialist. I get that some HMOs may do something that seems similar, but they are not nearly as strict as the Dutch.

 

Move to a different town or city ? Easy when you´re rich. But Dutch laws/regulations re: renting and mortgages limit that option for a great part of the population.

 

And as far as referrals go: you usally don´t get to select a specific specialist, you get a card by mail that tells when when and at what date you are expected to appear at the appointment with the specialist who took up your case. If you´re very ´street wise´and know how to play the game, you may be able to pick a doctor/time/place, but don´t forget the waiting list ! I once had to wait 9 weeks to see an internist. The appointment was a waste of time, btw.

 

GPs are responsible for managing all care, and for deciding who needs what care. How well does that go with complicated and severe cases of benzodiazepine withdrawal/rare health problems, do you think ?

[[cs...]]

Yes I do the same. Doc said always listen to my body and not him. I'm still waiting for you to write your signature.

 

 

Lorazepam, potentiated with ambien and lunesta, potentiated with hydrocortisone and fludrocortisone.  Talk about being kindled to a crisp.  . I don't think they could have prescribed worse.  Single dosed for several years , except hydrocortisone, which was spread throughout the day.    Rx'ed for sleep.

 

To everyone, please don't single dose short acting benzos, and please don't potentiate with PAMs....

 

What about clonazepam, lorazepam, solifenacin (off label!), mebeverine (both antimuscarinic drugs) with a near full block on ´normal´ (first world) somatic healthcare ?

 

And with respect ´To everyone, please don't single dose short acting benzos´: double dosing may increase physical dependence, as a general rule I would suggest to get off ASAP rather than messing with doses, not everyone does well on double dosing. I recall that Australian outfit advising to accept interdose withdrawal. Sorry, I don´t remember the name (edit: or maybe I do : http://www.reconnexion.org.au/ )

 

Were you on clonazepam at the same time (as in concurrently)as lorazepam?  If so, were they both taken literally at the same time each day?  And if so, why 2 benzos?

 

I was rx'ed all of the above concurrently, and taken  literally at the same time each night.

 

You know I have a special place in my heart for those short acting benzodiazaphines 

 

My doc has been doing this for several decades.  He's worked with Ashton.  In short, he told me that I would would have been far better off not only splitting up the lorazepam, but also titrating up to stop the kindling.  I initially didn't like what he to say and took offense.  Looking back, he was right, and i crossed over......

 

I was dependent long before i was kindled.  I agree on getting off ASAP, but if you are kindled you are like a caged animal.  You will seize  if  you do an ASAP.  There's only one way out if you want to minimize collateral damage,  You have to smooth out the serum levels.

 

I did go to another place prior and talked to them.  They don't advise cross overs, but they would have kept me on lorazapm and split the dose, and titrated up if required.  I did not want to stay on the junk and chose the earlier approach above,

 

At no point did anyone advise to continue dosing all at once , the same time each day. 

 

We are all unique physiologically, and perhaps that's why some of us can tolerate single dosing short benzos with z drugs for years and some cannot,...but it's asking for trouble.

 

[[li...]]

No, never on lorazepam and clonazepam at the same time.

 

But solifenacin and mebeverine with the clonazepam ...

 

Oh, I once did get midazolam with the clonazepam but I didn't take it daily.

 

Hey, exercise produces glucocorticoids ...

 

This isn't really 'The Netherlands/healthcare' kind of stuff.

[[cs...]]

No, never on lorazepam and clonazepam at the same time.

 

But solifenacin and mebeverine with the clonazepam ...

 

Oh, I once did get midazolam with the clonazepam but I didn't take it daily.

 

Hey, exercise produces glucocorticoids ...

 

This isn't really 'The Netherlands/healthcare' kind of stuff.

 

Yes, I agree, not Netherlands.  I'll stop on this subject.

[[li...]]

There is a criterium that is followed by the ´Medisch Tuchtcollege´ (´medical board´) that is more or less formulated as ´exercising meticulousness/care that could be expected from a collegue in the same circumstances´ Really crappy translation, but both I and google translate have difficulty with this. Anyway, I wonder if this trumps the law ! Or vice versa.

 

Multiple choice: what do you do when you have discovered you made a medical error ?

 

A) get angry with the patient

B) deny everything

C) admit the error ASAP and offer whatever help you can.

A) and B) are old style.

 

Anyway, the average success rate with that ´board´ is 14 % And I´m not even dead yet !

[[...]]

 

Unfortunately, we don't pick our doctors here. I wonder if that board is going to support his stupid ideas 'clonazepam is safe because it is prescribed by a doctor' ' I didn't see anything'.

 

You're not able to choose your own doctors there, Liberty?  Curious how it works there?  You're assigned a doctor, or what?

 

According to the law, we are. But then there is the real world.

In many places you need to ask permission before you are allowing to switch GPs in the same town/city. Even if that does not apply, then what ? You can´t change GPs like a pair of socks. Maybe once, twice, thrice. But (according to rules, docs) they need to be in charge of all healthcare. You never know what you get till have have handed over (note: always check files, it´s usually done electronically) your medical files and have completed the switch. Then you know what it means when they are in charge ... Or not yet, but a bit later ...

There is the formal 15 minutes rule, they have to be able to arrive at your house within 15 minutes so that´s a geographical constraint.

 

GPs are gatekeepers, you need their referrals to see a specialist. I get that some HMOs may do something that seems similar, but they are not nearly as strict as the Dutch.

 

Move to a different town or city ? Easy when you´re rich. But Dutch laws/regulations re: renting and mortgages limit that option for a great part of the population.

 

And as far as referrals go: you usally don´t get to select a specific specialist, you get a card by mail that tells when when and at what date you are expected to appear at the appointment with the specialist who took up your case. If you´re very ´street wise´and know how to play the game, you may be able to pick a doctor/time/place, but don´t forget the waiting list ! I once had to wait 9 weeks to see an internist. The appointment was a waste of time, btw.

 

GPs are responsible for managing all care, and for deciding who needs what care. How well does that go with complicated and severe cases of benzodiazepine withdrawal/rare health problems, do you think ?

 

Interesting, not in a good way, I can understand your frustration.  Seems every country has their own set of problems, I haven't looked it up but it would be interesting to know which country presently supposedly has the best healthcare system and what makes it so.  Patient satisfaction, I guess, would be the overriding criterion.

[[li...]]

Difficult to compare patient satisfaction between different countries ! People usually only know 'their' system.

 

Generally, MDs in this country have almost free reign as long as they don't kill anyone. As a rule, if you're a victim of medical errors, the errors are not admitted, you won't find any other doc willing to help you. Completely different from the USA.

 

I would have been better off in Ghana or Zimbabwe.

 

[[...]]

Difficult to compare patient satisfaction between different countries ! People usually only know 'their' system.

 

True, good point.  It would still be interesting to see a survey on patient satisfaction per country.  Here, a quick Google search, you'll love this one, Liberty. 

 

https://www.happy-or-not.com/en/2016/05/uk-ranked-amongst-top-10-countries-in-patient-satisfaction/

[[be...]]

USA number 3?  :2funny:

[[li...]]

Remember the adjective and nouns: the Dutch, Dutch courage, Dutchman, Dutchwoman, country The Netherlands.

 

As far as GPs are concerned, no GPs anywhere are as strict as the Dutch. About referrals, prescribing drugs. Specialists are strict in some ways too, limited diagnostics, with an eye on money and their time.

 

Here is a little gem:

 

https://resource.wur.nl/en/show/Blog-Getting-medical-treatment-is-a-pain.htm

 

´Health care in Netherlands is different than healthcare in other countries. Our healthcare is based on saving money instead of providing people service. That means that the GP will send you away with your complaints for a few weeks/day in hope that your symptoms and illness will disappear on its own. There are a lot of infections that will disappear on their own. A lot of doctors are also pro natural healing. Not only because it will save money, but because it's more healthier for your body.´

 

How well do you think that will work if you have two different health problems at the same time, while the doc doesn´t know what specifically is going on and the doc doesn´t recognize the need to take action ? Like something that could happen easily while  taking or withdrawing from a high dose of a benzodiazepine, (not even taking into account that clonazepam is only licensed for treating epilepsy) ?

That´s not even including aversion to prescribing drugs, referrals. And note ´pro natural healing´. There is little that is ´natural´ durign benzo withdrawal.

And then there is their preference for giving lifestyle advice !

 

I know a little bit of everything=´you know enough to be dangerous´

 

I know I suffered from medical abuse, but doctors are so well protected ... I filed a complaint ... not expecting much since the national average success rate is 14 %.

 

And the beauty of this system ... forget about appealing to a different doc´s sense of moral or medical responsibility ... if he doesn´t see it as him immediate job, he´ll think that the ´huisarts´ (GP) will take care of you. Your stuck with that guy whereever you go ... everything is so well organized, isn´t it ? They all think that the system is so great, and GPs are so full of themselves ... ´opinion based healthcare´

[[li...]]

A little update, although a bit blog like:

 

That ******* of a GP got two weeks extra time for his reply. It looks like he hired an expensive, specialized lawyer for his case. Not that I have that kind of money, certainly for a ´judgement by his peers´. Who needs healthcare while on a benzo, right ?

[[be...]]

Perhaps it will be in his file so even if he wins it can haunt him. That's what they do here. once sued no matter what its in the file just like an HR file.

[[ne...]]

Thanks for keeping us updated, liberty. I'm so proud you are going through with this. 

[[be...]]

Yep way to go Liberty  👌🏿😎

[[li...]]

Today I received a copy of his reply.

 

He stated that I didn't have a full copy of my medical records because of *lame ass excuse*. A few pages with rebuttals. Some half truths, dancing around the subject.

And a high degree of 'I'm the craftsman, I did learn my job a certain way'.

 

That he didn't learn what benzodiazepines really do, that he most certainly didn't learn what clonazepam can do is obvious.

 

GP culture in this country is awful. You'd better be very healthy, and not have more than one problem at a time, and above all: everything has to be normal.

 

Most other docs wouldn't have done what he did. Yet, almost all are equally ignorant. He will be judged based by the standards of his profession (GPs). And here, it's quite often opinion based medicine. Referring people is too expensive. Will the 'standards of his profession' trump the law (WGBO) ?

 

Well, the national success rate is 14 %. And I'm not even dead yet. I have a feeling I'm not going to win, but that remains to be seen.

[[ne...]]

Liberty, even if you aren't going to win, it's important that someone raises the issue and increase awareness of these awful dangerous drugs. I do believe that GPs are not informed.

 

I'm keeping you in my prayers and thoughts! Good luck! xoxo

[[be...]]

Sorry to hear that Liberty. No matter what the outcome, you are doing the right thing. Maybe he will be different with another patient because of this. Keep going!

[[li...]]

Thanks for the encouragement.

 

It's awful to be excluded from medical care. Everywhere I'd go, docs would say that I have to visit the GP first. Maybe with a few exceptions, but not many.

Some of the rules for visiting a GP: have one problem at a time, the GP must know how to handle the problem himself or know of a common way to refer for the problem in question, be careful about their ego (they think they are so great and are so proud to refer as few people as possible). Above all: you have to be able to live normally. So no funny stuff !

 

And I'm getting older. I guess I have to get better first before I can receive medical care. Get off the clonazepam first or 'it's mental' ? I wish he had told me that from the start !

 

Actually, this guy is going to retire. So, not that much of a learning experience for him.

[[ma...]]

Some of the rules for visiting a GP: have one problem at a time, the GP must know how to handle the problem himself or know of a common way to refer for the problem in question, be careful about their ego (they think they are so great and are so proud to refer as few people as possible). Above all: you have to be able to live normally. So no funny stuff !

 

Yes

 

I hope things improve to you, liberty

[[ne...]]

I'm so sorry for all of this, liberty. It's ABSURD that you have to get BETTER before you can recieve medical care!?    :o

 

I hope you can figure this out, eventually. I managed to get my GP to admit that I AM in withdrawal, even though he didn't offer any helpful advice, other than to continue prescribing me the pills I need to finish my taper.

 

Sending my love. xoxo

[[be...]]

That's a strange health care system Liberty. I wonder if ours is worse?

[[li...]]

I get the feeling that this will potentially take a lot of time and energy.

 

Those who would judge asked for his copy of the medical records.  Different from what he gave me. I want to see those first before I consent.  Part of his defence rests on ignorance and the standard excuses of 'underlying issues'.

Slept horribly last night. Not good. Chances, not good. I tend to get my hopes up, and I have my experiences.

 

He's such a lying, manipulative and self righteous bastard.

 

And I'm completely excluded from medical care. Aside from the local equivalent of 911. There is nowhere else to go. I mean, present a Dutch GP with two major problems that are strange or not so obvious ... usually, they don't refer for diagnostics. Then, there is the effect of the clonazepam. You can't expect anything good. And they are oh so loyal to their collegues. Then, there is the 'continuity of care' the last thing I need !

 

I guess I have to try to dismiss what's going on, but that's easier said than done, especially since someone told me she would call back ... What did I start ... I did write a few new things, but I'll try to put it aside. I don't think there is a local equivalent to 'medical abuse'.