To ask for an urgent second opinion ? Unwell 90 year old

[AnOnne]

My mum is 90, with a number of health issues (type 2 diabetes, under active thyroid, kidney disease, heart failure, obesity and more.) She has been on mounaro for her diabetes for over a year and has lost 6 stone and was generally feeling a lot better for it. Recently she has started suffering hot flushes, dizziness, agitation and generally feeling wrong/unwell. Her weight loss has suddenly accelerated to 6lbs a week which seems a bit alarming. I think it started to scare her (she is a long time GP avoider) since she checked her BP herself Thursday and noticed that her heart rate was in the 30s. She made a GP appointment, which was yesterday. The GP was apparently dismissive, disinterested and had little to say. He booked her bloods and an ECG for 10 days time, and when pushed by my 90 year old mum agreed that maybe she could reduce her thyroxine dose in the meantime. AIBU to ask to see another GP Monday? Surely there shoud be a bit more urgency when a 90 year old has a HR in the 30s? (He did take her HR which was 45 in clinic.) Any advice would be really welcome.

As an A&E nurse, I would say follow up with your GP again. This isn’t an A&E issue. Mounjaro can cause fluctuations in heart rate- although mostly palpitations- and underactive thyroid is also associated with lower heart rate although in the 30’s is too low and needs further investigation. If her heart rate is consistently >45 and she isn’t having further episodes of dizziness, I’d probably hang on as it might have been a vasovagal (I get them and my HR goes down to low 30’s). But she needs all her meds doses reviewing in light of the weight loss, (including the mounjaro dose) and also needs to make sure that she is eating and drinking plenty of the right things even if she doesn’t want it.

ECG and echo are completely different things - neither one is better...they are different. An ECG may be entirely enough to define what's going on.

No it isn't, an echo and ecg are needed.

Take her to emergency. GPs are not specialists.

I was being sarcastic…

@Lolalaboucheridesagain This is pretty much where we're at, several days later. Since Sunday she has been adamant everything is now fine and whilst I know she has had at least one further episode of HR in the 30's, I suspect more, she is totally and utterly not up for A&E. I feel negligent tbh, but Ive got flu myself so not in much of a fit state to do much, she doesnt need me breathing flu germs on her. She has the appointment for bloods and ecg Monday so at least thats in the bag. She has all her marbles fully intact so I guess I have to accept that even if I think its unwise, her decision is what it is.