Type 2 In need of some advice slightly confused

[Jenny15]

Hi Jenny15

I have never known any doc surgery that I have attended offer blood pressure tests to people who come in and ask the receptionist for appointments. It just doesn't happen. Nor are receptionists qualified to look at test results and say 'this person needs to have their bp checked NOW.'

Making a phone or doc/nurse appt is about all that we can expect from a receptionist - which is fair enough. They aren't qualified to do more, and on the few occasions where receptionists do step in to make decisions, then people get pretty vocal about how they should leave medical stuff to qualified staff. Expecting them to do blood pressure tests when someone drops in to speak to them over the reception desk isn't really practical.

@Stesmithy83
I totally agree with @AtkinsMo that you need to stop worriting about this, and wait for more information.
And getting your own blood pressure machine is a brilliant idea. I got an OMRON one from Amazon when I was having high blood pressure. Was a great decision. I was able to test myself in the relaxed comfort of my armchair and discovered that the silly-high readings I had got in the surgery were White Coat Syndrome (triggered by my Doc doing his omnipotent 'my decision is FINAL' act 2 mins before taking my bp - which sent my bp through the roof. At home, my blood pressure is perfectly normal.

I think my suggestion may have been misunderstood. I wasn't talking about receptionists making clinical decisions. that's the last thing any of us need. If I tell the receptionist I want to discuss something with a nurse they ask the nurse if he or she wants to see me, phone me to discuss, or wait a week. The receptionist acts as merely a messenger.

I've said in other posts but I can't say it in every post that NZ is different to the UK. I sympathize with my British peers who struggle to get basic healthcare at times. Over here the government has focused a lot on the basics like BP and diabetes in primary care, putting more money into it. It's an approach I'm sure would be welcome in the UK. I think being a smaller country helps make it possible for us here.

In post #6, the OP said this:

"Yeah the last 3 weeks I have had my blood pressure checked 3 times it first started at 200 now it’s 167 (can’t remember the second number) they said they was likely to put the medication up after I had finished the first course."

That's why the severity of the BP results has caught my attention. I am not sure the HCPs are giving this enough focus. And telling a patient they will be contacted about a GP appointment on a certain day, but not that the clinic will be closed that day, isn't a comforting sign. Maybe that's just me.

 

[Jenny15]

So, you went to the doctor's and no one asked you to sit down for a BP check? That's not a good sign IMO. If I were you I would phone and ask for a BP check today or tomorrow and if they say no, ask to speak to a nurse. Surely a nurse would want to check it? Are you able to remember when it was last checked and what the result was? thanks.

I realize now that this post wasn't very clear. I rushed it.

Here's what I meant:
At my clinic I can phone to book an appointment for a BP check with a nurse. A BP check is very quick so it's usually easy to get an appointment. By "if they say no," I didn't mean the receptionist would make a clinical decision. I meant that if no appointments were available, they would say no (for however many days). At that point I would ask to speak to a nurse if one was available in the next couple of hours for a 2 minute chat. A nurse might decide to squeeze me in if the problem is clinically urgent.

At my local A&E, you arrive, fill in a form, wait, and are called into a room for a triage assessment, this includes BP. Sometimes the nurse comes out into the waiting room to check a person's BP. They need to monitor people for deterioration.

If you say there's some urgent medical context when you arrive, they check your BP and other obs very quickly. That was the situation I had in mind when I wrote the above post. I was a little muddled in the way I wrote it.

I wouldn't have suggested treating mildly elevated BP with urgency but this person's BP is highly elevated.

 

[Stesmithy83]

Last blood pressure reading was 167/100 last Wednesday and that was the lowest it's been in 4 weeks I first got it checked it was something insane like 200/130 was told I was in danger of stroke or heart attack

Weight loss happened by itself done nothing different

Decided to take your advice and tryied to stop worrying at this very moment I'm sitting in the park looking at the baby swans lol

Will have a look at getting bp monitor I was meant to be given one

 

[AtkinsMo]

Jenny, most of us in the UK think that we have an excellent Health Service. As in the rest of the world, we have, unfortunately, a generation of Doctor’s who are misinformed about diet and in particular about diabetes, but I don’t think that’s any different to anywhere else.

When I was first diagnosed with High Blood Pressure mine was 230/160 and it was so high because I was very poorly for other reasons, as my illness subsided, my BP lowered naturally. If the lady had gone to, say, a Well Woman clinic, that sort of BP would be far more alarming than going because of a series of acute, painful illnesses.

It is very common for BP to be overdiagnosed and over treated, resulting in people having too low BP, resulting in falls, etc, especially in the elderly.

I was not suggesting that a very high BP is not to be taken seriously, I check my BP every day and probably always will, it’s part of my routine and I find it reassuring. I have been BP medication free for some 6 years, thankfully, due entirely to a Low Carb Diet and weight loss. Sometimes it is useful to consider ‘self help’ strategies whilst waiting for appointments etc. That is all that I was saying.

 

[Jenny15]

Last blood pressure reading was 167/100 last Wednesday and that was the lowest it's been in 4 weeks I first got it checked it was something insane like 200/130 was told I was in danger of stroke or heart attack

Weight loss happened by itself done nothing different

Decided to take your advice and tryied to stop worrying at this very moment I'm sitting in the park looking at the baby swans lol

Will have a look at getting bp monitor I was meant to be given one

Good to hear you are sitting in the park. It can work wonders, can't it?

The fact your BP has moved so much in a short time is a really good sign. Your latest BP result is almost out of the danger zone, according to the guidelines I've read (and posted above).

I always hate spending money on something I believe the clinic/system should provide for free but if you don't mind spending the money, a home BP monitor would be really helpful, I am sure. The prices have come down since the time of my diagnosis 14 years ago.

And you will also be able to offer a BP check to friends and family, LOL. I've had more success offering that than a BG test (obviously using a single use lancet device, in case anyone is alarmed by that). My clinic is so keen on screening that they give out lancet devices for free.

Enjoying your day in the warm weather, it's absolutely freezing down here in NZ.

 

[Jenny15]

Jenny, most of us in the UK think that we have an excellent Health Service. As in the rest of the world, we have, unfortunately, a generation of Doctor’s who are misinformed about diet and in particular about diabetes, but I don’t think that’s any different to anywhere else.

When I was first diagnosed with High Blood Pressure mine was 230/160 and it was so high because I was very poorly for other reasons, as my illness subsided, my BP lowered naturally. If the lady had gone to, say, a Well Woman clinic, that sort of BP would be far more alarming than going because of a series of acute, painful illnesses.

It is very common for BP to be overdiagnosed and over treated, resulting in people having too low BP, resulting in falls, etc, especially in the elderly.

I was not suggesting that a very high BP is not to be taken seriously, I check my BP every day and probably always will, it’s part of my routine and I find it reassuring. I have been BP medication free for some 6 years, thankfully, due entirely to a Low Carb Diet and weight loss. Sometimes it is useful to consider ‘self help’ strategies whilst waiting for appointments etc. That is all that I was saying.

I based my comment about the UK system only on what I've read on this forum about wait times and difficulty getting all kinds of things funded. The NHS is a great system. I was just trying to show empathy so I don't get accused of boasting. Can't seem to win either way.

Glad the OP is doing better now, that's the main thing.

 

[AtkinsMo]

Last blood pressure reading was 167/100 last Wednesday and that was the lowest it's been in 4 weeks I first got it checked it was something insane like 200/130 was told I was in danger of stroke or heart attack

Weight loss happened by itself done nothing different

Decided to take your advice and tryied to stop worrying at this very moment I'm sitting in the park looking at the baby swans lol

Will have a look at getting bp monitor I was meant to be given one

Enjoy the wildlife, a walk in the park does wonders for me, enjoy!

 

[AtkinsMo]

I based my comment about the UK system only on what I've read on this forum about wait times and difficulty getting all kinds of things funded. The NHS is a great system. I was just trying to show empathy so I don't get accused of boasting. Can't seem to win either way.

Glad the OP is doing better now, that's the main thing.

That’s okay, my son lives in NZ so I’m happy it has a good system.

I agree that there are problems sometimes with wait times, funding of expensive tests / equipment, particularly when the ‘powers that be’ don’t think they are cost effective - in the UK treatment priorities are judged by cost / benefit. The vast majority of doctors and even endocrinologists believe that self testing for T2s, for instance, will not prevent the inevitable ‘slow progression’, we can only hope that we win them over with our success stories. Diabetes.co.uk is leading the way with this, and brilliant people like David Unwin and others are shining examples of good practice.

We can always move over to private health care if we want to, it runs in a parallel system to the NHS, but for most people with a chronic condition it would be unaffordable.

 

[Stesmithy83]

Been given the run around again no call so went around all I got was your not on the call list despite asking them 2 times this morning if they would definitely call.

Asked them about my blood pressure medication despite not having none won't get them till Monday asked them for them to do a blood pressure test can't be done until 7th June....

Don't think I can be bothered anymore

 

[AtkinsMo]

Just googled Lloyd’s Pharmacy BPMonitor, they have a fully automatic one with 60 day memory and detects irregular heartbeat, has to be a bargain at £19.99 with excellent reviews. Buy one, end your frustration and put your mind at rest.

 

[Stesmithy83]

went to tesco near but they never had any in stock but the nice pharmacy lady offered to do it for me there and then 175/120 at the moment

i was able to buy a cheap blood glugose monitor tho 7.2 at the moment i should check again 2 hours after ive eaten right?

 

[bulkbiker]

Hi Jenny15

I have never known any doc surgery that I have attended offer blood pressure tests to people who come in and ask the receptionist for appointments. It just doesn't happen. Nor are receptionists qualified to look at test results and say 'this person needs to have their bp checked NOW.'

Making a phone or doc/nurse appt is about all that we can expect from a receptionist - which is fair enough. They aren't qualified to do more, and on the few occasions where receptionists do step in to make decisions, then people get pretty vocal about how they should leave medical stuff to qualified staff. Expecting them to do blood pressure tests when someone drops in to speak to them over the reception desk isn't really practical.

@Stesmithy83
I totally agree with @AtkinsMo that you need to stop worriting about this, and wait for more information.
And getting your own blood pressure machine is a brilliant idea. I got an OMRON one from Amazon when I was having high blood pressure. Was a great decision. I was able to test myself in the relaxed comfort of my armchair and discovered that the silly-high readings I had got in the surgery were White Coat Syndrome (triggered by my Doc doing his omnipotent 'my decision is FINAL' act 2 mins before taking my bp - which sent my bp through the roof. At home, my blood pressure is perfectly normal.

Interestingly our surgery has 2 blood pressure machines out the back of the waiting room that they ask you to use after sitting still for 10 minutes. They give small print outs of the results that you are asked to give to the receptionist to record the readings. I kind of thought this would be the case in all/most surgeries.. obviously not.

 

[Resurgam]

Just googled Lloyd’s Pharmacy BPMonitor, they have a fully automatic one with 60 day memory and detects irregular heartbeat, has to be a bargain at £19.99 with excellent reviews. Buy one, end your frustration and put your mind at rest.

I have had a Lloyds pharmacy BP monitor for ages - you can get different sized cuffs for it, and it seems to be accurate when compared with the nurses ones. I believe I got it when they were on half price offer so the cost was ludicrously low.

 

[AtkinsMo]

My lowest readings are about half an hour after I get back from a walk, when I’ve had a nice cup of tea and I’m chilling out.

Here’s the records and graph I keep for my doctor. He is very happy to refer to my readings. I can still get an odd ‘glitch’, in March and April my husband was ill and had a stretch in hospital, and look what it did to my BP, just anxiety and maybe loss of sleep! This app is called IBP and it is very good.

Try not to worry too much, it was 2010 when my BP was off the scale and I know that worrying made it worse, I am a worrier! I also know that within a week or two of going seriously low carb (20 to 30g a day) my BP plummeted, long before I had lost significant weight (I’ve lost about 27kg now) and I had to come off the medication.

 

[Stesmithy83]

hello again sorry for all the posts

i decided to go back to the doctors and to go in abit more determined lucky i was greeted by a very helpful receptionist who was able sort out everything i have my blood pressure medication

and now the important bit i asked if she could print out my blood test results and i got them

i beleave this is the one that is most important

HbA1c IFCC standardised 75 IFCCmol/mol <41

(cd1) - Abnormal this would confirm needs tci has family history but note age

i do have some other results but that seems to be the one that people seem talk about the most here

i have also retested using my blood gloucose montor it was 7.2 before eating about 2 hours later now 12.7

 

[Jenny15]

hello again sorry for all the posts

i decided to go back to the doctors and to go in abit more determined lucky i was greeted by a very helpful receptionist who was able sort out everything i have my blood pressure medication

and now the important bit i asked if she could print out my blood test results and i got them

i beleave this is the one that is most important

HbA1c IFCC standardised 75 IFCCmol/mol <41

(cd1) - Abnormal this would confirm needs tci has family history but note age

i do have some other results but that seems to be the one that people seem talk about the most here

i have also retested using my blood gloucose montor it was 7.2 before eating about 2 hours later now 12.7

Good on you. Not having BP medication at the moment, given your high BP readings is a real problem and suggests that this surgery is not meeting the basic standards set for them.

Like I said before, you should treat your HbA1c as meaningless until your iron has been tested and found to be normal.

Low iron throws HbA1c results way out.

There is a test they can order called the Glucose Tolerance Test but in my opinion this is not urgent for you, especially since your surgery seems to struggle with the basics of high blood pressure, which is far more of a risk to your short term health than your mildly elevated blood sugars.

Yes people do talk about HbA1c the most here BUT when the person has low iron it should be ignored.

You reported a blood sugar of 6.1. The target range for fasting blood sugar is 4 -7. That is why I am not worried for you at the moment about diabetes.

You have enough BP meds to keep going, and your BP is coming down, so I am not worried about that now.

Did the receptionist make an appointment for you?

Feel free to ask as many questions as you like, it gives us the info we need to be able to help you better.

 

[Jenny15]

went to tesco near but they never had any in stock but the nice pharmacy lady offered to do it for me there and then 175/120 at the moment

i was able to buy a cheap blood glugose monitor tho 7.2 at the moment i should check again 2 hours after ive eaten right?

The pharmacy lady did the right thing. All health professionals in medical surgeries and pharmacies should know how important it is to check BP. Many pharmacies offer free BP checks, mainly as a screening tool, and they then refer people to a doctor if its too high.

If you end up making lifestyle changes that bring your BP down, you can always decide to slowly go off the meds, while having regular checks at home and at the surgery. But based on your results at this time I think any doctor would say it is prudent to be on meds. It's what the national guidelines say, too.

 

[Jenny15]

Interestingly our surgery has 2 blood pressure machines out the back of the waiting room that they ask you to use after sitting still for 10 minutes. They give small print outs of the results that you are asked to give to the receptionist to record the readings. I kind of thought this would be the case in all/most surgeries.. obviously not.

It *should* be the case with all surgeries. A receptionist is capable of recording a BP reading for a nurse to review. In the past, GPs weren't as proactive with BP treatment but the guidelines have gotten tighter over the years because of research showing the benefits of early treatment in preventing strokes and heart disease. Moderate to severe hypertension is far more of a short term risk than prediabetes, or most cases of newly diagnosed T2 will ever be.

 

[Jenny15]

View attachment 26795 My lowest readings are about half an hour after I get back from a walk, when I’ve had a nice cup of tea and I’m chilling out.

Here’s the records and graph I keep for my doctor. He is very happy to refer to my readings. I can still get an odd ‘glitch’, in March and April my husband was ill and had a stretch in hospital, and look what it did to my BP, just anxiety and maybe loss of sleep! This app is called IBP and it is very good.

Try not to worry too much, it was 2010 when my BP was off the scale and I know that worrying made it worse, I am a worrier! I also know that within a week or two of going seriously low carb (20 to 30g a day) my BP plummeted, long before I had lost significant weight (I’ve lost about 27kg now) and I had to come off the medication.

Well done, that is great that you've had such success. Many people can bring their BP down without meds but current guidelines for doctors and nurses are tighter than they were in 2010. A person using meds to bring their BP down can always go off them later if they're not needed.

Everyone is different, too. For example, stress doesn't affect my BP much. Even when my BGs and weight were at their best a few years ago, I tried going off my BP med (with GP supervision) and I couldn't do it without raising my BP. Hypertension has several types, just like diabetes does. One size does not fit all.

 

[AtkinsMo]

Trust me, in 2010 it was serious stuff, still have my records from then, too! Can see how many weeks it took to get my BP down into acceptable range, have records of all the medications, when they were introduced, how effective they were, what the side effects were, etc etc. So glad that I managed to get it controlled by natural means, eventually, and got weaned off the medications.

And anxiety does have big impacts on my BP, and I’m probably not alone, and because I test it and record it so regularly, I can see the patterns.

Some guidelines just get tighter and tighter under the influence of pharmaceutical companies, in my honest opinion, who are in the business of generating profits, not the wellbeing of people. A patient cured is a customer lost.

Should a 70 year old really have the same BP as a 20 year old, do you think? I think probably not. But we’ll probably have to agree to differ.