To wish my GP practice had told me about this upward trend earlier?

[polarband]

I have used a blood pressure medication to treat migraines for several years now. As a result I need to go for blood tests and a BP check every 6 months as my BP tends to be low on this medication. The blood tests are mainly to check my kidneys but they do other checks as well, after each test I just call and they tell me everything's fine and I go again in another 6 months.

This time after my check I got called back in to speak to the doctor and was told I have high cholesterol and prediabetes. I asked him what could have caused the problem so suddenly and he said it hadn't been sudden and that if he looked at my blood test results over the past 6 years he could see that my cholesterol and blood glucose levels had been creeping up but its only now just crossed over into clinical diagnosis. I am fit, a healthy weight, a non smoking, non drinking, active woman with ideal blood pressure who eats a healthy whole food diet so when I was told my results were normal I thought that meant I was healthy not that things were getting worse.

I'm not mad that it's happened because these things do happen of course, I'm 50 now and there is type 2 diabetes in my family but I just wish they had told me earlier when this upward trend was noticed and I could have made some changes to prevent getting to this level. My GP just said they don't treat at anything below clinical diagnosis level and anything below that is in the healthy range and therefore normal.

Is it so unreasonable to think that they should flag up something like this to patients?

I think this highlights the difference in standards of care by doctors surgery. My old surgery before I moved house automatically provided a printout that I could either go in and collect when the results were ready or I would receive through the post a week or so later. The numbers on the sheet meant absolutely nothing to me and I would go by the doctor saying everything is fine, but as someone regularly tested this would have benefitted you.

Primary care medic here.
We have hundreds of blood tests to check and report on daily.
If its within normal limits.... that's it. Its normal. Until its not normal... at which point you will be notified.
We have no time to be looking backwards and checking trends when things are within normal limits.
If you want to take ownership of your health then you are entitled to have your blood results printed out for you to monitor the trend.
(PS sometimes things are out of range but have no clinical significance.... which is why what you perceive to be abnormal is marked otherwise)

I'm sorry you've had this shock, best wishes to you for the future.

My friend is 75 and had no idea that her high blood pressure could affect her kidneys. She had a kidney 'stone' which was causing her great pain and she went in for surgery - and was told that she had stage 3 kidney disease. Apparently her kidneys are now full of tiny stones - which could meld together to become another large one. Unfortunately the dietician/nutritionist? was unavailable before discharge, and she didn't really understand what she could or couldn't eat. I managed to get her a renal diet printed off from the web, and then a book from Amazon but she was frightened and ended up just eating salads.

Health is devolved in Scotland to ensure that you get a better service. Apparently.

You know now so can make some changes, but it really doesn't sound significant if it's just been creeping up. You can try some dietary changes over the next 6-12 months or try medication, but at such an early stage it really makes very little difference to whether you started a couple of years ago or not. It may be worth getting your GP to print a full copy of all your blood test results however, as if your lifestyle is healthy there could be an underlying cause to consider. You may want to consider stopping birth control pills, or advocating for more kidney or thyroid tests.

I don’t think the GPs have time to look at everyone’s test results other than making sure they are in the normal range and nothing has been flagged. I have had results many times when the receptionist has told me they were normal, however when I have checked myself of the app or Drs website I can clearly see that some are creeping up and just sitting under the radar.

Because once I was just over the limit they were keen to point out how it was clear I was headed here all along.

@Emma6cat It would be good to have the option to be able to check them online myself and I would have but unfortunately we do not have that access in Scotland as a matter of course.

Why don't you just get the app?

Kidding, sorry 😂

Seriously OP, this is frustrating. I has some medication (infused over a week in hospital) which required me to have monthly blood tests for 5 years after and although it was sometimes met with a lot of objections, I felt I needed the results to reassure myself of what was going on. I'm not blaming you, it's not unreasonable to think this trend would have been flagged but my personal experience is that you can't rely on the NHS to necessarily do everything it should. You can't turn back time so I would just focus on doing what you need to going forward. Good luck.

If you're worried about cholesterol it's well worth reading 'the great cholesterol con' by dr malcolm kendrick so that you are fully informed before you make any decisions.

This is a great result, congratulations! How much legumerie (?!) do you eat each day?

@Salome61 How awful for your friend, and yes it would have been useful for her to know that and for some feedback about her diet when she left hospital. I hope she is doing better now! When I was in hospital for a burst appendix a few years ago it my care was amazing, I don't think I could have had better care anywhere in the world. Until the day after my surgery when I was being discharged all the nurses and staff changed that day and they just told me to leave, the day before the nurse in charge had told me everything that would happen on my discharge, that I'd have my wounds checked and be given compression socks and medication to take home but none of that happened, it was fine but very disconcerting when I was already in a very vulnerable state and it just happened because of the rota switch and there being no communications between one team or the other.

I feel your pain. I'm also in Scotland and I've also been fobbed off with " results are normal" , rather than being told they are steadily rising. I only know this because I asked for a print out of results, which seemed to really throw the reception staff as they didn't know how to deal with the request and a few days later called to say that if I really wanted them they'd need to request the practice nurse to authorise it. So no, in Scotland it's definitely not usual for patients to be able to easily access their own results.

I see you've mentioned CGMs, I liked the Dexcom one. You may also find it useful to listed to Ben Bikman - he explains that by the time our blood glucose has breeched the diagnostic levels, we're already insulin resistant. He also has videos about how to use your Cgm data.
Good luck

https://m.youtube.com/@benbikman

Do you?? I’m 53 and have never heard of this (I’m in England). I moved house 2 years ago, meaning a change of GP surgery, and it wasn’t mentioned. So you just phone up and request it? I speak to my GP a couple of times a year re my HRT and she’s never mentioned it either. I wonder if it’s area-specific?

Lol, you almost had me there!

Yeah like I said I did try to get the results and was told no, this was during covid times and the last thing I wanted to do was make things harder for doctors. I think in other circumstances I would have pushed harder. I suppose I did get off lightly when you consider those that missed a crucial window of diagnosis for cancer at that time.

Slightly in the defence of you gp - they would have looked at the results in isolation, he/she wouldn’t pull up your blood result history unless there was a reason to do so. So they wouldn’t have seen anything amiss in your long term trend.

It was only when you asked why this came all of a sudden/ they got the outside of healthy range results they would have looked at the history.

It is frustrating, write to your mp and push for the NHS app.

@SeaGreenSeaGlass Thank you so much for this, that is exactly it and what I think people aren't getting! The culture is really quite different it seems and access to results aren't always the norm. I had a relative quite a few years ago now ask for some information from their records to make a DLA or PIP claim and their GP practice made such a fuss about the request she ended up going ahead with the claim without it as the practice was saying she had to put her request in writing, pay a fee (fair enough) but also that it could take up to 3 months to get the information. Hopefully it isn't as bad as that now but again the culture is different it seems.

Thank you for the info on CGM I will be getting one. Unfortunately many people in my family seem to get type 2 as they age even if they are fit and not overweight so I am not sure sure I will dodge that one but I will try to delay any escalation for as long as possible.

@JamesWebbSpaceTelescope I do understand that I suppose my complaint is that I wish they had told me sooner and if they don't do this as a matter of course then perhaps they should? Hopefully in future they will be able to use AI to flag this kind of progression up. My GP was actually using AI to write his notes when I spoke to him so it can't be far off!

Are you taking betablockers for the migraines?

Can you say what legumes and what portions etc as that sounds really useful

Hi Thanks for responding, I think as has been discussed before the culture around detailed results seems to vary across the UK and someone else from Scotland has confirmed that it can be very difficult to get your hands on the results up here, no doubt it may vary from practice to practice. However I generally find staff quite hostile to requests for my results beyond normal or abnormal. People rely on the practice for help and good care and nobody wants to foster a difficult relationship with their GP's or their staff fighting them over this.

I just think that an early warning system would perhaps save the NHS and GP's work and money over time. When I saw my GP he was using AI to type his notes so perhaps in time AI could be used to flag these upward trends to patients?

https://www.nhs.uk/tests-and-treatments/nhs-health-check/ - it is from age 40 and it looks like it is national. Maybe some areas are better than others at offering it.

No its an angiotensin receptor blocker, so quite different. It is used primarily to treat high blood pressure but is used off label for migraine. I previously used betablockers but they didn't help me much.

I agree with you, OP. An upward trend over time is certainly something that in an ideal world, you should be made aware of.

those saying ‘your body, your responsibility’ have no idea how hard it can be/has historically been to get detailed data.

i hope that as surgeries become more and more digitised, this sort of important tracking information will be routinely available.

OP you are completely right to be annoyed and infuriated.

The NHS babies you as though you are 3 years old and unable to interpret any data or anything at all really and should just 'wait to be told what to do' and never ask any questions.

Thank God for the app because without it, I wouldn't have discovered that I had a life-altering disease that NHS trusts locally to me had actually moved the goal posts on, but the app still had the old measures.

You are 100% correct you need to take your health into your own hands as the NHS will literally have you crawling on the floor before they take any action or allow you any kind of proactive interventions at all.

I've found since the age of 45 I've had to become my own doctor because they won't take any of my health issues seriously. Having seen my own DM die of complications, it's driven me to be far more proactive.

I'd ask for all your data, as legally provided for by whatever NHS act provides for it. Ask ChatGPT. What else are they hiding from you?

On another note, with regards to migraines, you could look at the scientific data on vitamin B2 - high dose - to see if this helps you at all. It's not for everyone, only those with MTHFR gene and a certain type but if it works, it's life-changing and you could come off the drug.

Additionally I really recommend the Zoe Nutrition program for lowering cholestrol.

I've been repeatedly fobbed off. Just recently I've had an operation which has cured my condition which would have literally robbed me of good health but on the NHS it's a condition where you 'watch and wait'. I've watched numerous women crumble in a Facebook group waiting for help and they are repeatedly pushed back on again and again and again.

I really don't trust the NHS unless it's for acute issues or terminal diagnosis.

Even then A&E is a shocker and terminal help is also a complete shocker too. It's made me consider moving abroad, the healthcare here is so woefully underfunded.

This is why you go privately for an annual check up. It cost a few hundred pounds but it’s so useful.