Tuesday, 18 September 2012


Tamoxifen is the daily drug in tablet form that keeps my hormones at bay and stops them collaborating with cancer cells to produce something nasty. Along with my Herceptin treatment, I have been on Tamoxifen for seven years, but whereas I have never missed a single cycle of Herceptin  in all that time, I have, on a couple of occasions, forgotten to take Tamoxifen. This freaked me out two years ago, when I forgot to take the tablets on holiday to Budapest. In fact, I was so concerned about withdrawal symptoms after such a long time on the drug,  I nearly didn't board the plane, but could see that this would have been a considerable disappointment to my teenage daughter. The following morning, however, I felt just the same as usual and  enjoyed a week's break  - and a break from Tamoxifen - in one of my favourite cities. Budapest spas are good for the soul (see posts in the early years of this blog to see just how good those hot springs are...).

Anyway, because I'd missed a week's Tamoxifen before and lived to tell the tale, I wasn't too bothered when I went to Boots Pharmacy this morning to collect my tablets and was told they weren't there. My Tamoxifen scripts are on repeat, meaning that Boots take responsibility for contacting the GP Practice when the prescription is due  and collecting it for filling. They used to deliver the tablets to me at home when I was really ill from the brain treatment, and they got my emergency steroids to me within an hour of the consultant instructing them. All in all, I have been very impressed with Boots, so was surprised when I couldn't get through on the phone to the pharmacy all day yesterday, nor this morning when I rang again to check that the script had been filled and was ready for collection.

All became clear when I arrived at the pharmacy counter in person just before lunchtime. A gang of numpties (all women, I'm sorry to say, and of the species unhelpfulus unsympatheticus  GP receptionistae) had replaced the old reliable staff, like the South African lady who always showed patience, sympathy and forbearance to the endless line of sick people queuing for their scripts. I have to say, though, that even with the old regime, there was never a time when I went to collect my Tamoxifen tabs that I didn't witness some poor bugger (as Dr Wheatley would say) upset by the news their medication was missing: Boots always blame the doctors; the doctors blame Boots. Today, Boots tried to blame me by implying that I hadn't requested a repeat script -  but, I countered,  it was their pharmacist who set up the automatic repeat scripts process several months ago; in fact, she urged me to subscribe to it to save me the bother of ringing the GP practice (always a challenge) myself. When I pointed this out,  also mentioning that the drug in question was a cancer drug, the most helpful one of the gang began searching the computer screen and then a series of logbooks. This confirmed that the repeat had indeed been set up, although last time I went there to collect the tablets, on 15 August, the holiday girl had failed to log the next due date. I said I was going away on Thursday for six days and had run out of Tamoxifen on Sunday, so it was sort of imperative now that they find and fill a script before I left for London. I said it should have been ready on 13 August and I had called them several times yesterday, and again this morning, to check it was there, but no one in the pharmacy had picked up the phone. In fact, I did get what sounded like a pick up this morning, but whoever answered hung up straightaway - dare I say with exasperation, which is the way I hang up when badgered by telesales people to take out unnecessary insurance policies or demand that I give them my log in details because my computer is broken. (A friend of mine fell for this last one and they cleared out his bank account, but I work with Mac, not Windows, so I told them to sod off.)

And then came a supremely numptyish remark from one young numpty on the pharmacy counter.  I hope Boots haven't just taken her onto the permanent staff:

'The phones are old,' she said. 'They don't always work.'

This asinine response reminded me of the truly numptyish English teacher at Penair School in Truro who assured me at parents' evening that she did indeed correct my daughter's homework. The policy was to correct five mistakes at a time.

All this may sound funny, trivial even, but it isn't funny for patients waiting for essential drugs, only to find they either haven't been signed off by the GPs (let's not forget the £100K plus annual salaries for writing scripts...), or have gone AWOL in the pharmacy, lost amongst the munchkins.  And it kind of vindicates my decision not to come off Herceptin, administered at home to me still by a super-efficient private health care agency with their own pharmacy, in regular three weekly cycles. The drill there is that their receptionist-  pleasant, helpful Dawn, rings me a week before the treatment is due to make sure I am all right before she orders the dose to be made up. Would it were so within the NHS. I wonder how diabetics fare, or people with chronic heart disease, people who need stettins, steroids, morphine substitutes, all the helpless parade of sick supplicants who rely on community medicine - GPs and pharmacies, for the prescriptions that keep them well.
anne morgellyn