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  1. That a real shame, I loved him in Goodfellas. What a fantastic film! Here is the prison 'Dinner' scene. It took me a bit finding a clip without any swearing in it. I think throughout the whole film there is hardly any footage longer than a few minutes without any swearing!
  2. Hi Old'un The prescribing of a course of prednisalone that can be completed without any reduction, or conversely a dosing regime that will require it to be gradually reduce is made taking into account several factors among others. The condition which the drug is aiming to treat, the duration of the treatment and the likelihood of a relapse of the condition. Prednisalone can be stopped at the end a non tapered prescribed course dose for certain presentations that only require a short course and are indicated in a condition that is unlikey to relapse. There are risks to abruptly stopping a long term dose which can result in what is known as 'acute adrenal insufficiency' which is a condition in which your adrenal cortices stop producing certain hormones that have been replaced by the synthetic man made prednisalone. Abruptly stopping the pred after long term use can lead to symptoms of acute renal insuffiency, these symptoms may present as fever, malaise, pain in joints, abdominal pain, fluid retention, confusuion, low bp among other symptoms, thankfully and very extremely rarely cases of mortality. This is what your gp may have been alluding to, gradually reducing the prednisalone over a period allows the adrenal cortices to start producing hormones again thus reducing the risk of 'acute renal insufficiency'. Some dosing regimes may allow for the addition of 'stat' doses such as a additional doses above the daily prescribed maintenance dose in the event of a flare of the condition being treated in order to reduce the risk of the condition turning into a full blown excacerbation. These are formulated between the clinician and the patient and communicated to the patient as part of a clinical management plan as which may have been predetermined in Bruno's case. Considerations firstly taken into account are allergies to the medication, contra indications, renal, liver function, interaction with other drugs that the pt is taking, other systems and conditions which may be impacted and also how concordant the patient is likely to be. I prescribe prednisalone on a daily basis for quite a few different conditions, like many drugs it has benefits and risks and that is the play off between quality of life and pharmacology. Prednisalone when prescribed correctly and taken correctly is a very beneficial drug, it accounts for millions of prescriptions a year in the UK alone improves quality of life for many and also saves lives. Drugs certainly are wonderful thing and if it was not for modern medicine and pharmacology I fear we would all be in the ground or the long hot oven a lot sooner. Hopefully, not too soon! Hope this helps. Atb 7diaw
  3. I do not see your request as being 'difficult', simply raising a 'concern' with the practice through the internal concerns/compalint process or formalising a complaint through exteranl PALS, duty of candour process. As is your legal right, and it would appear not unreasonable in the given time frames. Patients are removed from the register for a few different reasons, cannot see this being one of them and If in this case that this did result in a unlikely removal, the practice would have some difficult questions to answer if challenged. I could not see how they could dodge that from a litigious aspect. It can be difficult to remove individuals who persistently exhibit some of the most toxic and challenging of behaviours at the best of times. This clearly is not one of them.
  4. Hi Steve Have they said that they are now getting them out to you ASAP?? Hopefully they have and told you they will be with you in a day or so?? Under the FOI act the right for a subject access request for medical records legally compels the provider (in your case the gp) to respond within 20 working days, however under certain circumstances they can delay the request for up to no longer than 40 days. Also under some circumstances the provider can refuse a foi request if it is of the opinion that the request is: “manifestly unfounded or excessive”. For example, a largely repetitive request for information which has already been provided, or a information request which would be deemed too complex to aggregate and have a impact to the trusts hr resources that would impact service provision. Other reasons may be that it could deemed that the information would increase the risk of harm due to sensitive data for the individual among several others. In my experience, individual requests for FOI SAR are not 'excessive' and would be completed no later than 30 days, 20 days to 'respond' and/or complete the request fully, or respond within 20 and complete within the following 10/11 days so 30/31 days a month in total. I would ring the surgery and inform them of their obligations, if there is a delay in the FOI SAR (Non excessive) which it appears there is, as it has now breached 31 days you can request a internal review as to why this has happened. If you are not satisfied with the response of a internal review you can then ask the information commissioners office (ICO) for a review. Inappropriate delay for a response can and do result in fines of around the £1000 mark. EDIT P.S Just seen other posters and your reply Steve after I had just posted, I hope you get sorted. Hope you get sorted.
  5. Excellent stuff! I also like roe and prefer it over a red. I am finishing off the end of a my last red. Hopefully be replenishing my freezer soon.
  6. Nice beast that Rimfire, is it destined for your own freezer? A good bit of venison there. Good man for taking the opportunity to get out. 👍
  7. I enjoyed that Al 👍 That rust didn't take long to shake off!
  8. You made me a little confused for a second bob I read the account of Trafalgar when I was younger and things did not add up. Thank you John for the information, I did not know that.
  9. Ahh! Thought it was port. Thanks for the correction.
  10. Wasn't Nelson was pickled in a barrel of port wine, he was by accounts perfectly preserved. If it was good enough for 'pickling' our Lord Nelson it be good enough for drinking I would say.
  11. A fine arsenal walked up and it would appear you have all bases from a experience point of view well covered. The little 22 as has probably accounted for tens of thousands of foxes over the years from the mid 80's and 90's, I would surely think that would be quite a bit less so now as the advent of the hmr and other superseding calibres allowing for fox control over more varying different terrains and distances. As you point out they still have their place. 👍
  12. Good on you Bunny Blaster From my own efforts that 24 is a great day, especially with a 410 and all! The views are certainly nice.
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