Anything else? - Update

AndBreathe said:

So, this morning I had my scheduled call with the GP to discuss my recent bloods. I hadn't been looking forward to it, but like any meeting I consider important, I had done my prep a couple of objectives I wanted to achieve.

On balance, it went really well, if you were me. The points of discussion and outcomes were:

I had queried unfamiliar acronyms, and a “?hypothyroidism” note on my blood results. Apparently these notes are added by the lab these days. The acronyms were explained and she stated they have no concerns for my thyroid, with the TSH bang on mid range.

Doc's conclusion about my cholesterol is that the current levels are probably my body's endogenous levels, and that any further reductions, due to any dietary modifications would be very modest.

I challenged the focus on total cholesterol, so we moved onto the underlying components and the Qrisk profiling. The GP's initial profile was based on my weight in February, and the last recorded BP reading taken at the surgery, despite the nurse accepting my home readings when she reviewed my machine at my review. There was no way she could know I had lost weight since then. With the new numbers the qrisk score was more better.

She was then at pains to explain the amended scores still sat above the population average. Smarty-pants that I am I then challenged the binary application of the T2 flag, bearing in mind my HbA1c scores, which have all been non-diabetic, aside from the diagnostic test. I asked at which point they (i.e. the medics) would begin discounting the T2 weighting. In this context I meant discounting on a potentially sliding scale, rather than disregarding it. She agreed this to be a fair challenge, and suggested that to all intents and purposes my diabetes has gone/resolved/in remission, but stated that knocking it off the record is trickier. (I wasn't asking her to do that.) I suggested if we even halved the weighting, I would feel the assessment to be fairer (but I already knew what that meant in terms of score). So, we settled on that qrisk score. )

So, having established I had done some reading, she confirmed I realised NICE guidelines for diabetics is for a routine recommendation for statins. I asked if she is aware of any empirical research or evidence focusing on women of my age without current CVD, or even on women per se.

She admitted she didn't know of anything compelling. I asked her to help me to understand the true benefits, to me, of filling a prescription for a long term drug, for which there is no empirical evidence of efficacy for my sort of person, and which could give me unwanted side-effects, including raising the HbA1c I have worked so hard to reduce. She admitted it, based on our discussion, it wasn't a a recommendation she was willing to push.

We agreed to look at the numbers again in a few months. The period of 3 months was set by me.

I get the impression she was going to head for the kettle after our little chat. I know I did, and at least one of us had a smile on their face.

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AndBreathe said:

The reason I shared was because I know I'm not the only woman of a certain age who is unconvinced by the flimsy statin arguments, and it's good to share.

The only blot on my copy book was when I almost lost it when she summarised confirming no strong recommendation for statins was being made and that she completely understood my standpoint and rational arguments. However, where I almost lost my cool was when she said (probably to save a bit of face) that she wanted to be sure I didn't think I was missing out on any medication available to me to manage my health......

My response started something like, "Well, as you've brought it up. The only thing I really feel I have been denied are the tools to self manage my diabetes; meaning meter and strips."

I could almost hear her thoughts screaming "Oh no. What have I said!?!?!"

We had a bit of a chat about that, and clearly she suggested with my current levels there would be absolutely no way they could support testing for someone with serial non-diabetic blood results, Of course, I knew that, and I had no intention of bringing it up, but her statement begged me. It goaded me into it.

We had a decent chat around that, and the recommended low fat diet for diabetes management, and how that would work out. I thanked her for the first honest and adult conversation I'd had on the subject.

I liked her. She'll never last. But, I would like it of she did.

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