Author Topic: Re: Heart Disease  (Read 2257 times)

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Offline heather1957

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Re: Heart Disease
« Reply #15 on: 17 August 2016, 11:44:37 PM »
That's the one Patti.

I am hoping that if I start walking at a steady pace I won't need to use anything, I'll just have to see how it goes.
T2 since 8/12 HbA1c HIGH!!
Medication 4 x 500mg Metformin SR at tea time

Offline Pattidevans

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Re: Heart Disease
« Reply #16 on: 18 August 2016, 12:19:29 AM »
IIRC you only need to use it if you feel the pain.  Hope it helps anyway, must be horrid for you.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Avocado

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Re: Re: Heart Disease
« Reply #17 on: 18 August 2016, 07:26:04 AM »
I do support the NHS and will fight tooth and nail to keep it but it does need a bit more money and better financial management.
Me too. When I complain about the NHS I don't mean we shouldn't have it, I mean that government should be putting more moeny into it and it should be much better run. A huge amount of our taxes go to the NHS but a lot of that is wasted in admin (I used to work in NHS hospital admin, years ago and even then it was the most inefficient organisation - too many admin people, too poor organisation). The NHS never catches up with itself as a result. But also it's a mess - our GP surgery used to be one of the best in the whole area for miles, it had a fantastic reputation. Now it's one of the worst. Two of my consultantants have told me to leave it and go to another, but there isn't another locally that will accept new patients. Our surgery has over 20,000 patients and, supposedly, seven or eight GP's - I went there the other day, managed to get an appointment with the trainee GP - she was the only GP in the surgery, I ws the only patient. This was a regular week day afternoon. I popped into the inhouse pharmacy which is usually very busy and asked why it was so quiet "no doctors, no patients" the pharmacist said. Another day I went to deliver a letter, it was a weekday morning - I specifically enquired how many doctors were working that morning - the answer two. This is simply not on. The GPs work part time, many of them women with families. The partners won't take on new partners when the old ones retired (there are now just two partners), they employ salaried doctors who don't stay because they don't like the fact that they're just salaried and made to do all the work while the partners are just businessmen. It's a mess and sadly typical of many GP surgeries. Hospitals are badly run for other reasons - too many targets set by government which bear no resemblance to care for patients - and too much spent on inefficient admin rather than beds, nurses and doctors.


When I had heart surgery I was in a private hospital - the local huge NHS hospital had a contract with the private hospital - when their watiting lists got too long they paid the private hospital to do their work - as a result the private hospital was overloaded with work too - but they weren't going to say no to the lucrative contract so they employed agency nurses, put orthopaedic patients on the cardiac ward, and were rushed off their feet !  But worst of this is that instead of the NHS hospital admtting to the governernment that they couldn't keep up with 'targets' due to lack of beds, nurses and doctors, they make out they were on top of targets (get good Ofsted reports) by using NHS money to pay the private sector to do their work. I telephoned a couple of other local private hospitals and they also have contracts with that NHS hospital to do their work. I discovered this wasn't just the one NHS hospital, apparently lots do that. I don't think our NHS taxes should be used to pay the private sector, I think they should be used to pay for more NHS beds, nurses and doctors.
Anne

Atypical Type 2, thin, not insulin resistant, diagnosed March 2007. Very low carb (30 - 50g per day) Paleo diet and exercise - Prandin (Repaglinide) 0.5mg. Aortic Valve Replacement Jan 2014, Osteoporosis, Small airways disease, probable coeliac - Strontium Ranelate 2g/d, Omacor 2g/d, vitamin K2 300mcg/d, Aviticol (vit D3) 20,000 IU every week, Qvar 100 2/day.

Current HbA1c 33 Current total cholesterol 7, HDL 3.5, LDL 3.2, triglycerides 0.4

Offline Pattidevans

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Re: Heart Disease
« Reply #18 on: 18 August 2016, 09:48:40 AM »
Yet Jeremy Hunt plans to axe beds!  500 locally here and our hospital is buckling at the knees and can't keep up.


Anne, I thought you were on the patient panel of your surgery?

Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline heather1957

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Re: Heart Disease
« Reply #19 on: 18 August 2016, 10:13:25 AM »
Sadly we have also suffered by changes to our local GP services.

I was patient at a very small surgery, initially 2 GP's and in its latter years 1 GP and locums, it had a feel of a family doctors as it was owned by the main GP who was always called Doctor Gail. (her name was Gail Davies)

She retired last October and was unable to find a doctor to buy her out so all of her patients were assimilated into a much larger practice which has 5 surgeries and goodness knows how many doctors. The good news is that it can be a bit easier to get an 'on the day'  appointment as long as you don't mind traveling to one of the surgeries. The bad news is that none of the doctors 'know you' and just refer to case noted when you visit.

I say none of them 'know you' on my first visit with chest pains the doctor was the 'main man' and I used to go to church with him and his now wife (her and I were in school together) It was a little embarrassing to have to lift my top up so he could listen to my chest and I did say that I never thought I would be showing my bra to Geoff Lloyd when we used to go to church  ;D

I always now ask to see another doctor as I don't feel comfortable seeing him.
T2 since 8/12 HbA1c HIGH!!
Medication 4 x 500mg Metformin SR at tea time

Offline Avocado

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Re: Re: Heart Disease
« Reply #20 on: 18 August 2016, 12:01:07 PM »
Anne, I thought you were on the patient panel of your surgery?
I was but the last meeting was nearly two years ago. The senior partner in the practice decided to form a whole new patient participation group but it's not been formed yet. I have complained about it to the CCG because it is a statutory requirement for there to be a patient participation group and our surgery hasn't got one now. Thing is they have a nnotice up calling for patients to join one but when I asked to join there was no response - that was three months ago. The senior partner is making out that he is forming a group to get round the statutory requirement - another fiddle of the books to make it look like they're doing what they should. But they aren't and I shall be making another complaint soon and cc'd to NHS England as well as the CCG.
Anne

Atypical Type 2, thin, not insulin resistant, diagnosed March 2007. Very low carb (30 - 50g per day) Paleo diet and exercise - Prandin (Repaglinide) 0.5mg. Aortic Valve Replacement Jan 2014, Osteoporosis, Small airways disease, probable coeliac - Strontium Ranelate 2g/d, Omacor 2g/d, vitamin K2 300mcg/d, Aviticol (vit D3) 20,000 IU every week, Qvar 100 2/day.

Current HbA1c 33 Current total cholesterol 7, HDL 3.5, LDL 3.2, triglycerides 0.4

Offline Dr DeEath

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Re: Heart Disease
« Reply #21 on: 18 August 2016, 01:39:33 PM »
The delays and inefficiency within the NHS really frustrate me. In the last 10 -25 years they seem despite cuts to have crated a massive administration hierarchy. One clinic I went to had the consultant, a nurse assisting (although she seemed to be doing nothing) and two receptionists. With patients arriving once every 15 minutes I would have thought the consultant and nurse sufficient as the next appointment is always posted there was no need for the receptionists. The ophthalmology clinic I attend has just the consultant and a specialist nurse and runs fine.

The other day I talked with someone I met at the vascular clinic. He was a keen motorcyclist until he boke both legs when a car pulled out and he went over the roof catching his legs. Anyway in the spring he was referred to his local hospital as his GP felt a bespoke insole might reduce the pain he gets walking as one leg is shorter and out of line. After three months he saw a podiatrist who agreed, discharged him and wrote to his GP suggesting a referral to surgical appliances to be fitted with an insole. He has the initial appointment where he will have an initial assessment and be measured up but nothing else done in October. Podiatrist and insole seem to go together like horse and carriage yet with this mucking about his initial assessment will be over seven months from when he went to see his GP!
T1 for over 50 years.  MDI on Porcine insulin.  Lisinopril and Atorvastatin.

Offline Quantum Learning

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Re: Heart Disease
« Reply #22 on: 18 August 2016, 06:42:42 PM »
It almost seems to me to be deliberate delaying tactics, hoping you'll die/get fed up and give up wanting treatment so they won't have to do anything thereby saving them money. Things are getting so much worse so much more quickly I find it actually quite scary. I do believe there is probably an adequate amount of money given to the NHS but the sheer inefficiency/time and money wasting is breathtaking. I can't think of any other 'business' that would allow this to happen.  :(
Type 2 dx Nov 2012 with fasting BG 14%/129.5
HbA1c Jan 2013 79/9.3%
April 2013 50/6.7%
July 2013 39/5.7%
Oct 2013 39/5.7% Chol 5.9
July 2014 45/6.3% Chol 5.5
Aug 2015 61/7.7% Chol 5.9
May 2016 84/9.7% Chol 6.9
Oct 2016 53/7%  Chol 6.3
Dec 2016 41/5.9% Chol 6.0
June 2017 51/6.8% Chol 6.1
Oct 2017 52/6.9% Chol
Metformin SR 2000mg, Candesarten Cilexetil 4mg Omeprazole 20mg, Fexofenadine 180mg Co-Codamol 30/500g when needed. Amitriptyline 20mg
Toujeo/NovoRapid, Allergic to Levemir.

Offline Pattidevans

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Re: Re: Heart Disease
« Reply #23 on: 18 August 2016, 07:21:56 PM »
Anne, I thought you were on the patient panel of your surgery?
I was but the last meeting was nearly two years ago. The senior partner in the practice decided to form a whole new patient participation group but it's not been formed yet. I have complained about it to the CCG because it is a statutory requirement for there to be a patient participation group and our surgery hasn't got one now. Thing is they have a nnotice up calling for patients to join one but when I asked to join there was no response - that was three months ago. The senior partner is making out that he is forming a group to get round the statutory requirement - another fiddle of the books to make it look like they're doing what they should. But they aren't and I shall be making another complaint soon and cc'd to NHS England as well as the CCG.
Draws in breath!  Bl**dy scandalous!  Yes, I agree Anne you need to complain and make sure NHS England and the CCG know about the situation.  I have always felt that ours was a bit of a tick box exercise to say they actually have a patient panel, but the old Practice Manager has gone and a new broom sweepeth, I think we might have more say from now on, having attended the first meeting during the new regime.

I actually think the problems with the NHS come more from inefficiency than any deliberate attempts to foil patients into giving up.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Alan

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Re: Heart Disease
« Reply #24 on: 19 August 2016, 01:06:38 AM »
Well I am back having been away for a few years and they have not been good years!

My Blood/glucose readings are back where they were on diagnosis even though I am now taking 4 x 500 mg Metformin and lately I have been prescribed 1 tablet a day Januvi?
G'day again Heather

I've only just read your post, please forgive me if I repeat questions you have already answered. Would you mind posting your typical current fasting and peak post-meal numbers please? What Januvia dose are you on?

You probably read this years ago, but maybe it will still help with some ideas (click on it): Getting Started

Quote
What makes it worse is that I have booked a 2 month trip to Australia starting in February next year flying business class

Wow! I'm envious of business class :)

Where are you planning to go? I wander the eastern areas of this land fairly widely and would be happy to help with tips for Oz and also for long flights.
Cheers, Alan, T2, Australia.
--
Everything in Moderation - Except Laughter.
There is nothing I could eat I like more than my eyes.
Type 2 Diabetes - A Personal Journey (latest: Small New York Baked Low Carb Cheesecake)
Born Under a Wandering Star (Latest:Dambulla, Sigiriya and Polonuwarra, Sri Lanka)

Offline heather1957

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Re: Heart Disease
« Reply #25 on: 19 August 2016, 03:41:39 PM »
Hi Alan, I had the fasting bloods taken on 4th July and got the result a week later. To be honest I have been more concerned about my heart so really can't remember exactly what the results were but think they were about 18 or 19 mmol/L  :eek: I have been taking Metformin 2000mg & 100 mg of Januvia, goodness knows what they would have been without them.

I am now self testing about 3 times a day and am averaging 8.5 mmol/L although for some reason I had a reading of 12. 4 mmol/L early this week, but it dropped within a few hours, so slowly dropping and I have decided to drop the Januvia, my reasoning is that when I was first diagnosed 4 years ago I was only on 1000 mg of Metformin and within 6 months and a diet change I had a HbA1c reading of 5.5 mmol/L so want to try and manage with just the Metformin, I am still unhappy with being on 2000 a day so will drop 500 mg when I start getting into the 6 mmol/L

As for our trip to Australia we fly into Brisbane on the 9th Feb and will drive North to Hervey Bay, have visited there a few years ago but for a whale watch and didn't stay, so this time we've rented a lovely little house (with pool) for a 1 week stay it'll be a week of relaxation. It's out of whale watching season so the place should be quite quiet. I am also a huge fan of 'My Kitchen Rules' and was a supporter of Dan & Steph who won series 13 and have opened a cafe in Hervey Bay so we plan to visit there too.

From there we drive down to Main Beach and stay at Xanadu in an ocean front apartment, we stayed there in 2014 and loved the place, it is a bit expensive but we decided too 'go for it'.

A long drive to Forster for a 5 night stay and then another 5 nights in Lake Macquarie with a day (or 2) visiting the Hunters for a few tasters and no doubt buy a few bottles of wine!  ;)

We will the drive to North Shore where my friend's uncle lives and we will be staying with them for 3 days then off to Tasmania for a week. I have visited Australia about 6 times but have yet to visit Tasmania so it will be a bit of a whistle stop taster and I am really looking forward to that week.

Then flying to Christchurch and South Island for 10 days, it started as a quick trip to visit my nephew who is working in Queenstown but we decided to extend it a little. I was in NZ in 2010 for a Wales rugby tour but my friend hasn't been for a few years so we decided just to stick with the South Island which is my favourite of the 2.

We then fly to Perth for 2 weeks, our last stop before coming home. We are staying in the City for 3 nights then travelling South with a couple of stopovers including 4 nights at Margaret River for some more wine tasting.

So looking forward to the trip, I have been fortunate to have visited Australia and NZ several times in the past but never tire of my trips.

Sorry if I have bored everyone blame Alan...... he did ask!  ;) ;D
T2 since 8/12 HbA1c HIGH!!
Medication 4 x 500mg Metformin SR at tea time

Offline Pattidevans

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Re: Heart Disease
« Reply #26 on: 19 August 2016, 05:09:26 PM »
Hi Heather

Quote
I am now self testing about 3 times a day and am averaging 8.5 mmol/L although for some reason I had a reading of 12. 4 mmol/L early this week, but it dropped within a few hours, so slowly dropping and I have decided to drop the Januvia, my reasoning is that when I was first diagnosed 4 years ago I was only on 1000 mg of Metformin and within 6 months and a diet change I had a HbA1c reading of 5.5 mmol/L so want to try and manage with just the Metformin, I am still unhappy with being on 2000 a day so will drop 500 mg when I start getting into the 6 mmol/L

At what times are you testing (and in what relation to meals time wise)?  I would caution you on dropping meds too soon and too drastically.  Be cautious.  I was on 2000mg met as well as insulin, but after several years dropped the Met altogether about 10 days ago because of appalling stomach problems.  Now I don't know if it was a flare up of diverticulitis or whether it was Metformin and I have been taking the Fybogel Mebeverine for Diverticulitis, but stopping the metformin has calmed my tummy problems.  However dropping Met has had a truly devastating effect on my BGs.  Now bear in mind I am on an insulin pump which gives me more opportunity to adjust things, I have been seeing high teens rather than the 5 - 7 mmol/l I am used to.  I have just adjusted my basals accordingly, you do not have that luxury.
Patti


Type 1.  Mis-diagnosed T2 May 2003, finally had CPeptide test 15/7/11 and proper diagnosis 1/9/11.  Now pumping Apidra with Roche Spirit Combo pump. Hba1c 6.1 April 2016.


© 2015 Patti Evans

Offline Avocado

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Re: Re: Heart Disease
« Reply #27 on: 19 August 2016, 05:17:41 PM »
When I had heart surgery I was in a private hospital - the local huge NHS hospital had a contract with the private hospital - when their watiting lists got too long they paid the private hospital to do their work
Well just look at this from the GP online magazine Pulse just popped in:

GPs in Hertfordshire have been told to refer patients to private hospitals in a bid to control soaring waiting times at the local NHS trust, Pulse has learned.

NHS Herts Valley CCG has told GPs to refrain from referring patients to West Hertfordshire NHS Trust (WHHT) for non-urgent appointments wherever possible, and has put a bar on all referrals for certain specialties, including cardiology, ENT, urology, pain, and general surgery.

Instead GPs have been told to refer patients to alternative hospitals, including local private providers, while the Trust is in the process transferring existing referrals to the private hospitals. The referrals will be funded by the NHS.

This is in a bid to cut waiting times at the trust, which has failed to meet national 18-week referral to treatment targets.

http://www.pulsetoday.co.uk/news/commissioning/gps-told-to-refer-patients-to-private-sector-in-bid-to-cut-local-trusts-waiting-times/20032543.article

So it’s not just hospitals doing this now !
Anne

Atypical Type 2, thin, not insulin resistant, diagnosed March 2007. Very low carb (30 - 50g per day) Paleo diet and exercise - Prandin (Repaglinide) 0.5mg. Aortic Valve Replacement Jan 2014, Osteoporosis, Small airways disease, probable coeliac - Strontium Ranelate 2g/d, Omacor 2g/d, vitamin K2 300mcg/d, Aviticol (vit D3) 20,000 IU every week, Qvar 100 2/day.

Current HbA1c 33 Current total cholesterol 7, HDL 3.5, LDL 3.2, triglycerides 0.4

Offline heather1957

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Re: Heart Disease
« Reply #28 on: 19 August 2016, 11:44:07 PM »
Hi Patti, unfortunately I don't have the luxury of getting the testing strips on the NHS so have to buy them off E-Bay, not ideal I know but it makes my life so much easier to be honest. It does mean that I cannot test as often as I would like so am testing around about 3 times a day but I do vary when I take them.

I always do a test just as I go to bed though just to see what the reading is before I go to sleep.

On testing pre meal and post meal I am not finding much of a difference and the reading can be higher when I wake up than after a meal. Obviously when I have my next HbA1c it will give a more accurate average reading than I am getting with my random tests, the good news is that I am seeing a drop now I have cut right back on carbs.

I know what you are saying about not dropping the medication too quickly, but as I said earlier when diagnosed my initial HbA1C was very high, I think something like 23 mmol/L and I was initially prescribed 2 x 500 mg Metformin a day and within 6 months I had a HbA1c of 5.5 mmol/L. I am making the same diet changes apart from probably eating a little too much fruit so am hoping that I don't need to much Metformin. I am lucky that although I get the occasional upset stomach I cope with the Metformin quite well, I am on the slow release though.

I won't do anything too quickly though as obviously I don't want to stop a quick drop in my B/G levels.

I have to admit with the change in my GP I do feel that more responsibility lays with me to control my health and where possible I will make every effort to do that where I can.
T2 since 8/12 HbA1c HIGH!!
Medication 4 x 500mg Metformin SR at tea time

Offline Avocado

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Re: Re: Heart Disease
« Reply #29 on: 20 August 2016, 07:16:58 AM »
unfortunately I don't have the luxury of getting the testing strips on the NHS
Why can't you get testing strips from your GP ?
Anne

Atypical Type 2, thin, not insulin resistant, diagnosed March 2007. Very low carb (30 - 50g per day) Paleo diet and exercise - Prandin (Repaglinide) 0.5mg. Aortic Valve Replacement Jan 2014, Osteoporosis, Small airways disease, probable coeliac - Strontium Ranelate 2g/d, Omacor 2g/d, vitamin K2 300mcg/d, Aviticol (vit D3) 20,000 IU every week, Qvar 100 2/day.

Current HbA1c 33 Current total cholesterol 7, HDL 3.5, LDL 3.2, triglycerides 0.4