Urgent: NHS METABOLIC clinic questions?

[52andblue]

I've been offered a short notice telephone appt today at 3pm with an NHS 'Metabolic' clinic. I've been waiting a year so I said 'yes'.

Background: age 58, now post meno & on HRT.
Overweight. BMI is 38. I had roux en y surgery 8 years ago. Effective in first year but slow regain since to almost my original weight despite following guidelines. GP says: 'no further help avail'. Afaik not tested for diabetes or cortisol.

Last summer I found my BP was consistently 200+/100+. I was told I had Pericarditis & a heart murmer. 6 weeks later told both resolved. Due to family history of CAD I was started on Felodipine (currently 10mg) & Ramipril (currently 5mg) plus Atorvastatin 80mg (which I couldnt tolerate and had to stop).

I still have regular chest pressure & some pain, giddiness & pins & needles/pain in shoulders & arms. I had a CT Angio which I was told was 'ok' so 'can't be Angina must be 'anxiety' (it's not) or 'mobility' (reduced but has been for 20 years) or 'windy weather' (!)

My phone appt is with 'Metabolic'. I had a clear Famial hypercholesteramia test last summer(v happy) My Cholesterol is 7.8, HDL 1, LDL 5, triglycerides 3.8.

I cannot alter my diet any further. I cannot exercise more (see mobility)
I am exhausted & I find the chest issues painful & a bit worrying as getting worse.

Sorry for essay - what should I ask today in the circumstances please?

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I think you almost read your post to them in its entirety so they get the full picture and then ask for advice and take it from there. I totally get that you are stressed about it, but they are in place to help you and you can absolutely let them lead the questions. Anything you need to ask will come up naturally through the conversation and have a pad and pen handy to write down anything you need to remember. The only question I think you definitely need to ask is at the end of the call and about the next steps in terms of contact with the service. I wish you lots of luck, I've had health issues recently and am awaiting a referral.

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What do you want to achieve from the appointment? Is there a chance you’ll be prescribed WL injections? Is there anything you are sure you don’t want? Just write a summary as you did in your OP of points you want to mention and what you would like to achieve. Let them do the taking and see what they can offer and just make sure to get the points you have recorded across.

@Arlanymorsorry I didn’t see your reply. Thank you, I will do this. I have found on the past that GP & various specialists just don't communicate, except telling me to 'ask the other one' which is frustrating. I've only seen this Metabolic' person once before - I waited over 13m & was in & out in less than 10mins.

@ShrinkholeGP refuses to refer for WL injections. Cardiologist says: 'not sure, probably anxiety'. This Metabolic person was not interested after FH test was negative. I had my original R-en-Y op as I wanted to improve my health. I still do, but after it failed (it seems a high % do, over a 10 year period) everything is now looked at through that prism or of course 'post menopausal anxiety'.
I'd like to improve my cholesterol figures so I don't develop CAD, in addition to my 'angina' type symptoms (which GTN does help, tbf)

No worries lovely - health stuff is hard, I really do sympathise. I think you are very sensible in wanting to prepare as best you can. Fingers crossed that it is a good phone call and will move you forward.

You should try another statin. Your cholesterol especially LDL are high. Have you discussed this. I would try simvastatin and if you don't tolerate that then rosuvastatin is a more potent drug that can sometimes only be needed three times a week. There are also newer drugs for cholesterol now as second line but I was retiring as they came in so not really looked at them.

@Musicaltheatremum - thanks.

I just had the phone appt: 6mins.
Latest results:
Total 7.7, HDL 1.5, LDL: 3.5, Triglycerides 1.98 (so, all better)
Not diabetic (glucose 4.9) & 'thyroid normal'. All good news & helpful to know.

I did ask if gut transit could be an issue (seeing a specialist re bowel probs who has asked me to ask GP for gut transit test): 'No'. I asked about weight: 'see GP'

Advice: 'work with GP' (have been trying...) as being discharged now.
Try Rosavastatin at 5mg for 3m then GP will test. If ok then annual test.
If not, try a 3rd statin before they will offer 'acetimide' (I think, strong accent)

Ezetimebe, perhaps ?