Montreal health care woes – a lesson on asthma

NOTE: I took this post down yesterday when I was told I was mistaken about the number of refills for Bricanyl. I haven’t always been great about keeping records on my son’s asthma medication. He was well controlled for years and it looked like asthma was going dormant so I didn’t feel a need to keep track. Looking through my papers, I discovered a prescription from last year indicated more than six refills for Bricanyl. My information was correct. The doctor has lowered the number of refills she prescribes.

I don’t know what to say.

I have been trying for nearly two days to get my son’s asthma prescription corrected. There have been problems getting a fax message from the pharmacy to the doctor and then having a new prescription faxed back.

My 15-year-old son is a longtime patient of the Montreal Children’s Asthma Clinic. We used to regularly visit the Asthma Corner in the emergency department and he’s been hospitalised for asthma in the past. Recently things have been better. But he has a cold on board right now. It’s dangerous for someone with asthma to go days without access to their reliever medicine when a cold is affecting their breathing.

When his prescription was faxed to the pharmacy in September, I never saw it. This prescription was supposed to replace one he had lost. Going by what the doctor prescribed in 2011, it was supposed to say he had at least three refills for the Bricanyl, the reliever medicine since the medicine is supposed to get him through six months and when he saw the clinic once a year he was prescribed more than six refills for the Bricanyl.

For some bizarre reason the part listing the refill for the reliever medication only said one refill. We see the clinic only every six months and the pharmacy has received years of prescriptions that indicated  as many as six refills for both the preventer and reliever medications. If you have asthma, chances are when you are ill with a bad cold you will reach for your reliever medicine more often than your preventer medicine. But apparently pharmacists don’t flag inconsistencies in refills, only dosages and medications, and pharmacy staff explained that they “can’t read a doctor’s mind.” On Monday night I discovered my son was down to two puffs of his Bricanyl. The pharmacy informed me there were no more refills and said they were faxing the doctor to request another prescription.

The Asthma Clinic is friendly and the doctor has long said if we ever need to refill a prescription or there’s a problem, just call anytime. Yesterday I spent hours trying to reach someone at the Asthma Clinic before finally being transferred to a voice mail box where I left a message about the mistake with the prescription. I said they should have received a fax from the pharmacy. No callback. I wonder if anyone heard my message.

When I phoned today the Asthma Clinic’s voice mail was full. Phone line attendants were busy at the appointment centre that transferred me to the clinic’s voice mail yesterday. I phoned the emergency number on the Asthma Centre’s Web page to reach a doctor. I thought maybe someone could page my son’s doctor. I was taken seriously. They paged a resident. But she told me she couldn’t write a prescription for a patient she’d never seen.

The pharmacy tells me they had trouble transmitting their fax to the doctor and made their third attempt this morning. I ask them why they didn’t alert me when they had problems sending the fax. We’re talking about life-saving medicine for asthma, after all. I asked what number were they calling. They weren’t faxing the Asthma Clinic at all. So the clinic never saw the fax.

The pharmacy is giving my son another refill. It’s a one time deal.

I am disappointed in the doctor for making a mistake on the prescription (if that is what happened) for lowering the number of refills prescribed for Bricanyl without explaining to me they were doing this and with the pharmacy for not telling me they had trouble with the fax number. I used to have a good relationship with this pharmacy but they now have a policy of making us wait till one prescription is finished before we may bring in a new one. Months can pass before an old prescription ends and they accept the new one. My son used to see the Asthma Clinic only once a year. Now it’s every six months. It’s been all too easy to lose the paper prescriptions.

We desperately need to make prescriptions digital. And I need better access to my son’s doctor. The superhospital is bringing changes to the Montreal Children’s Asthma Clinic. I hope what I just experienced isn’t what we can expect in the future.

UPDATE, Nov. 29, 2012 : I was told today that the changes aren’t in effect yet. I usually have great experiences with the Montreal Children’s. I don’t know what happened here.

SECOND UPDATE: Was told my son’s asthma is out of control, that he used six month’s worth of medication in two months (!) and this means he needs to see the doctor more often (we’ll be seeing them soon). He has had colds and with a cold you can end up using your reliever puffer as many as six times a day.  When my son used to see the Asthma Clinic every three months, he never ran out of medicine. We always had plenty of refills.

LESSONS

  1. Keep records of prescriptions. Note medicine prescribed, dosage amounts and instructions, and the number of refills allowed
  2. Make sure the pharmacy has the correct fax number for the doctor (this problem may be rare but in Quebec maybe not)
  3. If you’re dealing with a specialist doctor at a hospital, ask for a phone number to reach them or their staff quickly just in case
  4. If you see any changes to a prescription, ask questions
  5. Bring a new prescription to the pharmacy right away, even if your pharmacy gives you grief
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Montreal health care woes – a lesson on asthma

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