Latest treatment info from my surgery - Wales

Daibell · Jan 19, 2017

Hi. Many pharmacies will do a test for around £15. My wife had hers done at the local Lloyds. It was a fasting one and had a breakdown. Also, for your HBa1C get the bloods taken early'ish in the morning having fasted and you will have a fasting test whether or not the surgery asked for it. Do ask the surgery to include a lipids breakdown in the test. I thought that happened anyway when a lipids blood test was requested. Are you sure your surgery doesn't have the breakdown on their computer? I now have online access to my blood test results which is really useful.

dbr10 · Jan 19, 2017

serenity648 said:
I was diagnosed just over a year ago, had fasting bloods done for cholesterol and they came back with a proper breakdown listed. This time I wasnt given the choice of a fasting blood test, and no breakdown of LDC etc available.

I rang the surgery for more information and the doctor rang me back today.

They only do a fasting blood test on diagnosis. Every other test in non-fasting, with no breakdown. I asked how I can get a fasting cholesterol test and was told I cant have one. I only get my H1Ac done once a year as well.

How am I supposed to monitor my condition?

Doctor said that nothing much would change over a year, and all I have to do is get my weight down, following the eatwell diet, and I have nothing to worry about.

I am not comfortable with this, but dont know if i am being unreasonable to expect anything further from the HCP's? Is this the usual NHS level of care? Do I need any further input from them? I feel so confused about all this. On the one hand the doctor tells me it is a serious condition, and on the other hand I am supposed to be unmonitored for a year at a time.

I didnt dare tell him I have a meter. But a meter wont check my cholesterol, will it.

I am in Wales, dont know if that makes a different.

All too familiar to a lot of us, I'm afraid. It's not care; it's lack of care. Try a new Doctor. You couldn't possibly monitor your condition with that advice.

Johnjoe13 · Jan 19, 2017

I think we can all agree sadly that the three letters NHS means different things in different places all over the UK. Personally I think most people in the UK have lost all confidence in this institution because of it's diversity of treatment. The whole wording 'National' and Health and Service' is an absolute sham at the moment, but the gut wrenching thing for me is we are paying for this!! and who the hell in the NHS listens? What with CCG's NHS England,Scotland,Wales, N.Ireland the department of health and whatever they have outside of England. Oh and then you have the GP's each doing there own thing as well, and you then have all of these trusts that are run by god know who and answerable to nobody it seems? not you and me the people who are paying for this freakin three lettered mess, is there any wonder we can't even agree when discussing this.

Rant almost over, I do think as individuals the only thing we can do to vent our personal anguish, and certainly my policy from now on, is everytime anybody in any of these institutions P us off and don't listen to us or treat us with respect to remind them and tell them straight '**** you' I pay your wages. Rant over ' god save the queen' and probably subject to moderator edit I should think.

douglas99 · Jan 19, 2017

I prefer to work with mine.
I checked my results from last year

8 liver function results
7 serum lipids from a fasting test
1 serum TSH
1T3
1T4
1 HbA1c
6 Urea and electrolytes
1 urine microalbumin
1 urine creatinine

I think I get enough tests to make me happy, without any confrontation.
But that's a list of what is available here annually either way.

serenity648 · Jan 19, 2017

Daibell said:
Hi. Many pharmacies will do a test for around £15. My wife had hers done at the local Lloyds. It was a fasting one and had a breakdown. Also, for your HBa1C get the bloods taken early'ish in the morning having fasted and you will have a fasting test whether or not the surgery asked for it. Do ask the surgery to include a lipids breakdown in the test. I thought that happened anyway when a lipids blood test was requested. Are you sure your surgery doesn't have the breakdown on their computer? I now have online access to my blood test results which is really useful.

even though I fasted before my test, the breakdown wasnt done by the lab. The surgery no longer requests this service. And they dont do online blood tests results either, I asked yesterday : (

serenity648 · Jan 19, 2017

dbr10 said:
All too familiar to a lot of us, I'm afraid. It's not care; it's lack of care. Try a new Doctor. You couldn't possibly monitor your condition with that advice.

not an option, it is the only surgery for many miles, and this is surgery policy.

BrianTheElder · Jan 19, 2017

Daibell said:
Hi. Many pharmacies will do a test for around £15. My wife had hers done at the local Lloyds. It was a fasting one and had a breakdown. Also, for your HBa1C get the bloods taken early'ish in the morning having fasted and you will have a fasting test whether or not the surgery asked for it. Do ask the surgery to include a lipids breakdown in the test. I thought that happened anyway when a lipids blood test was requested. Are you sure your surgery doesn't have the breakdown on their computer? I now have online access to my blood test results which is really useful.

I think for a HbA1C test it doesn't matter whether it's fasting or not as it measures fat accumulation on your haemoglobin over 120 days.

serenity648 · Jan 19, 2017

BrianTheElder said:
I think for a HbA1C test it doesn't matter whether it's fasting or not as it measures fat accumulation on your haemoglobin over 120 days.

I think you are right, but if it means getting a fasting cholesterol test its worth fasting anyway, in my view.

I get on well with my receptionists, and the practice manager was a great help recently with an issue unrelated to diabetes. I also get on well with my doctors. Its the system thats the problem, and they seem just as frustrated by it as the patients : (

Salvia · Jan 20, 2017

I have met the problem of cholesterol testing breakdowns recently. In my own area, West Midlands, they no longer carry out the full breakdown of cholesterol; apparently this is a better marker, but I have to wonder if finance comes into it somewhere.

I found out a bit about it on the NHS Choices website, here: http://www.nhs.uk/Conditions/Cholesterol/Pages/Diagnosis.aspx
(4th para down). Perhaps the same approach applies in Wales too.

zand · Jan 20, 2017

If the only cholesterol test that is done is TC then it is meaningless, so they may as well save more money and not test for cholesterol at all. Of course then they wouldn't be able to push statins onto so many unsuspecting patients would they?

Bluetit1802 · Jan 20, 2017

Salvia said:
I have met the problem of cholesterol testing breakdowns recently. In my own area, West Midlands, they no longer carry out the full breakdown of cholesterol; apparently this is a better marker, but I have to wonder if finance comes into it somewhere.

I found out a bit about it on the NHS Choices website, here: http://www.nhs.uk/Conditions/Cholesterol/Pages/Diagnosis.aspx
(4th para down). Perhaps the same approach applies in Wales too.

What the NHS is saying in that link is they do Total and HDL, which then produces the Non-HDL amount. This non-HDL amount is the total of the LDL and triglycerides, so you can calculate that. I always get a "non-HDL" figure on my breakdown reports. When I was first diagnosed 3 years ago I did some research on cholesterol and came across this. Sorry but I've lost the actual link.

Here you can see how non-HDL-C levels are generally looked at in terms of risk:
Non-HDL Cholesterol = Total Cholesterol – HDL cholesterol
above 220 mg/dL (5.7 mmol/L) is considered very high
190 – 219 mg/dL (4.9 – 5.6 mmol/L) is considered high
160– 189 mg/dL (4.1 – 4.8 mmol/L) is considered borderline high
130 – 159 mg/dL (3.4 – 4.0 mmol/L) is considered near ideal
below 130 mg/dL (below 3.4 mmol/L) is considered ideal for people at risk of heart disease
below 100 mg/dL (below 2.6 mmol/L) is considered ideal for people at very high risk of heart disease

Salvia · Jan 20, 2017

Bluetit1802 said:
What the NHS is saying in that link is they do Total and HDL, which then produces the Non-HDL amount. This non-HDL amount is the total of the LDL and triglycerides, so you can calculate that. I always get a "non-HDL" figure on my breakdown reports. When I was first diagnosed 3 years ago I did some research on cholesterol and came across this. Sorry but I've lost the actual link.

Here you can see how non-HDL-C levels are generally looked at in terms of risk:
Non-HDL Cholesterol = Total Cholesterol – HDL cholesterol
above 220 mg/dL (5.7 mmol/L) is considered very high
190 – 219 mg/dL (4.9 – 5.6 mmol/L) is considered high
160– 189 mg/dL (4.1 – 4.8 mmol/L) is considered borderline high
130 – 159 mg/dL (3.4 – 4.0 mmol/L) is considered near ideal
below 130 mg/dL (below 3.4 mmol/L) is considered ideal for people at risk of heart disease
below 100 mg/dL (below 2.6 mmol/L) is considered ideal for people at very high risk of heart disease

Thanks BT, all I can say is that in my case, if they do have that detail, then they keep the info to themselves ('they' being the testing labs, I assume). There was only one figure sent in the bloods report to my GP, and I had a copy of that (printed off from my on-line patient record). I wasn't able to calculate anything with just one piece of the jigsaw.

Daibell · Jan 20, 2017

serenity648 said:
even though I fasted before my test, the breakdown wasnt done by the lab. The surgery no longer requests this service. And they dont do online blood tests results either, I asked yesterday : (

Hi. Your surgery obviously isn't the best. I think you need to 'insist' next time that they ask for a lipids breakdown which mine always does. I also think you need to talk to the Practice Manager why you can't view your Patient record online as it's an NHS requirement and they MUST offer this now. You can always complain to the local CCG group but this may annoy the surgery.

Daibell · Jan 20, 2017

BrianTheElder said:
I think for a HbA1C test it doesn't matter whether it's fasting or not as it measures fat accumulation on your haemoglobin over 120 days.

Hi. The HBa1c is not fasting as you say, but if you want a lipids breakdown as well and the bloods form adds this then that needs to be fasting to get the most reliable breakdown.

DavidGrahamJones · Jan 20, 2017

serenity648 said:
Its the system that's the problem

Did you sign the petition? Or did I see that somewhere else? There's a petition going around to ask for additional funding for the NHS (I don't think it differentiates between Wales/England/Scotland/N.Ireland).

There's also a petition for using the £350 million as Brexiters, Farage, Gove, Johnson, Gallaway et al, suggested on their bus (can't see that little gem happening, but you never know these days).

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