GP review

[Pilgrim1956]

Next week I have my first clinical review of any sort since my HA 2 weeks ago wit my GP. What if anything should I expect from the review?

[Karenpr]

Our GP checks cholesterol levels and sugar levels annually. Discusses diet, exercise and meds.

This is an opportunity for you to ask questions, don’t expect too much as this is not your cardiologist. So ask what the GP recommends you can and can’t do, when you can return to your previous regime ie work if you work. If the local hospital runs a cardio rehab course who do you call. How often you need to get blood work done and a pill review. Basically you want to know what support your surgery offers.

[Pilgrim1956 in reply to Karenpr]

Ok thanks. I think that's what I was thinking. It'll be good to find out my cholesterol count.

Rehab dates in place so that's good.

[Karenpr in reply to Pilgrim1956]

Get your blood pressure checked and ask what all the pills are for and if and when you can drop any or when doses should be changed, are there symptoms you should watch out for that tell you drugs are wrong. Some like Ramipril give you a dry cough, some people struggle with statins. Bisoprol gives some people problems. So you want to know what to look out for, what is normal and what should be reported to initiate a change

[Pilgrim1956 in reply to Karenpr]

Thanks that again is helpful. I'm on several of those medications and I have notice a bit of a dry cough in the evenings. Will ask more - time for a list I think! I have my own BP monitor so keep an eye on that already.

Several people seem to refer to diabetes checks as well.

[Karenpr in reply to Pilgrim1956]

Diabetes can sometimes be a common dominator in heart problems. Even if you are not diabetic it’s worth getting the GP to check your bloods for any signs

[Dickyticker26]

I presented at Kingston Hospital A&E with chest pain on 31 July last and had 5 hours in the Resuscitation Unit

Currently after tests at 5 different London Hospitals I await a quadruple bypass at St Thomas' on the recommendation of a Joint Cardiology Conference and on the strength of Images from scans which have never been shown to me

On August 2 last I had a "discharge" appointment with one of the younger doctors at the surgery

I was with him for nearly and hour whilst he said he had 3 patients waiting

He said that I should never had been discharged and was all for calling an ambulance to take me back-all because my heart rate was so high 120 and jumping all over the place and lack of oxygen to part of my heart

Originally the hospital were going to keep me in overnight to see a cardiologist in the morning but that had been dropped

After the gp had phoned a cardiologist a return to hospital was ruled out

I saw the same doctor the next day He upped my betablockers (Bisoporol) to 7.5 mg once a day and left the other prescription of blood-thinners (Apixaban) at 5mg twice a day

The young gp had an even younger looking "colleague" with him He said he was about to go away on holiday (not with her) and advised me against going on my own planned holiday to Malaga a week later

In fact I went with my 3 adult children and it was fine

I renewed my prescriptions from time to time and never had a return of the chest pain nor of the supra ventricular tachycardia which I had had for some years but which had not been recognised by me or anyone else until I read about it on this forum a month or so ago and which left me when I gave up caffeine after the visit to A&E

In December 2018 after an angiogram my prescription was extended to include nitrates, statins and clopidogrel

All January and February I had terrible diarrhoea which I put down to the change in prescription

I saw another doctor at the surgery and he insisted on referring me back to the hospital for a charming procedure called colonoscopy The hospital gave me a 60 second interview and I had to go back to collect a large bottle which the nurse explained confidentially was a very strong laxative and advised me to stay close to a toilet the day before the procedure

This was exactly what I wanted after 2 months non-stop diarrhoea!

By chance on the very day of the procedure I already had an appointment to see a surgeon at St George's

I explained my predicament to him and I had actually taken with me in a Tesco bag a pair of soiled underpants which had been a constant feature of the diarrhoea together with complaints from my wife about the smell in the toilet

The consultant/surgeon/registrar at St George's declined to inspect the exhibit and with a dismissive wave of his hand suggested that I simply drop the nitrates/statins/clopidogrel part of the prescription

It worked like magic or a miracle and from the next day I could record in my diary like Samuel Pepys "excellent stools!"

Just recently I felt duty bound to report back to the original doctor on my visits to St George's, Guy's,Royal Brompton, St Thomas' and Kingston Hospitals

After waiting 2 weeks for a specific appointment he said that he had only just got back from holiday, it was an emergency session only and he was behind with the mythical "3 patients waiting"

On the way out the look from the receptionist said it all "Oh dear we have been busy haven't we and what bad luck we have had!"

[Pilgrim1956]

Thank you

[Qualipop]

ALl I got was a nurse appt for blood tests; nothing at all from the GP. I had to specifically ask for an appointment . I took in a list of questions I wanted answering but he didn't volunteer anything except to say "Ring if you are worried". Advice on diet, exercise etc was left to the cardiac rehab nurse who was worse than useless.

[Shoshov in reply to Qualipop]

same here qualipop. defo a ostcode lottery on treatment❤️

[Pilgrim1956]

Had my GP review this morning (HA +16d). No bloods or tests done but answered questions well and reassuringly. Some good explanations and interesting his view was do what you can without pushing hard but definately avoid being sedantry as that's not a good way forward.

Cardiac rehab next in a couple of weeks sounds a positive step to.