Showing posts with label my consultant. Show all posts
Showing posts with label my consultant. Show all posts

Wednesday 23 December 2015

Another Annual Check

Well, another year has gone by.  Actually, it's more than a year as the annual appointment was slipped by three weeks by the Churchill, and I attended there on Tuesday this week for my "MoT".  I was very impressed by the fact that the results were posted on PatientView at 6pm after being done at 1130am that same day!

The only slight worry I've had this year is that my creatinine went up at the six month point in June.  I think this was for two reasons: firstly, Tim and I reckon that creatinine varies through the day; you need to be well hydrated and, for a consistent comparison, have the sample taken at the same sort of time of day each time.  Annoyingly I forgot this when I made the appointment with my new GP's surgery in June and so it was not surprising that, at 8.50am, after just a bowl of cereal and a single cup of tea in the previous 10 hours, the reading was quite high, at 140. (They also did a cholesterol test even though I had not been fasting, so that was unsurprisingly very high.)

Secondly, the hospital's message about drinking more somehow seemed (to me) to be directed at the recipient more than the donor, and also it seemed to be "for a period of time" as opposed to "for ever"; I guess I was consuming only 1.5 to 2 litres per day in the form of tea and coffee.  So in late September I discussed fluid intake with the transplant nurse at the Churchill (as lovely and helpful as ever!) and we decided that I just need to drink more.  Since then, I have made a concerted effort to drink water, and also now I monitor how much I drink every day; I now have more like 1 to 1.5 litres as tea/coffee, and about the same in pure water, so my daily total is about 2.5 litres.  I discussed this with the consultant and he was happy with only 2 litres as a target, comprising half tea or coffee and half water or cordial.  He was clear on the need to avoid any drinks with salt (like what - Bovril or Tequila?), and even agreed that beer can count to the total, so long as you are staying within a limit of three units of alcohol per day on average - I reckon I average two units, although I admit to the occasional day in the summer when I had a couple of treble G&Ts or a couple of beers in the evening sunshine!

Having realized this in October and changed my habits for liquid intake, I have been hoping to see a decent improvement in things and I was pleased at a reading of 127 which is only 1 more than a year ago.  If I'm honest I would say that I was hoping for an even lower figure, having been so conscientious about my hydration; perhaps my focus on that is too late?

At least my worries about aches, pains and tiredness do now seem to be a function of age - I was worried that some of them were sounding a bit like Tim's symptoms before the transplant!

My blood pressure was good at 120/79 - the consultant expressed envy of that! Everything else was in the range apart from cholesterol.  He asked what I had done about this after last year's promise to see my GP about that; the answer was I had forgotten but my record showed that I had seen the GP in February - then I remembered that I had declined statins (as I reckon they make me sleep badly from a previous trial) and instead had made a few changes to my diet - less sugar, more skimmed milk, cutting fat off meat etc.  However, he thinks I should see the GP again as it's still a bit high.  Apart from that, hopefully that's it for another year.

http://www.heyfordhoofers.org.uk/

Monday 1 April 2013

Small Consolation

I had a surprise the other day: "my" consultant nephrologist telephoned me at home at 5.30pm!

The purpose of his call was to tell me that, contrary to previous advice, there is nothing that needs any further tests on me.  When the transplant nurse told me of the postponement, she had said that there were two things which the meeting had wanted investigated, but one of them was simply not true (presumably someone mis-read the CT scan or something).  The other one was to do with my gall bladder which the transplant nurse had said was the possibility of gallstones, but the neph said it was actually the possibility of an enlarged tube.  (Why do different people tell me different things?).  The neph told me that he had just looked at the scan with a radiologist; they had decided that there was actually nothing out of the ordinary and so no further test is required.

So, while I consider the probability of an extended wait for the operation, at least officially I am 100% fit, provided I ignore the muscular and joint issues with my back, neck and knees.  OK, so let's say that my systems are fine, it's my structure which might have a few bad signs for the future.

Saturday 2 March 2013

Progress At Last

Yesterday I finally had my first appointments at the hospital where my brother has been treated.  This is near to my parents' house and so we had plans to go and see them for lunch and dinner before returning home; it all made for a long day.

Being nice, I will only say that at this hospital, the general approach to patients is not quite as good as my local transplant centre, but perhaps I've just been lucky.  We arrived early, not wanting to risk the London traffic, and found our way around this slightly out off date building to the Renal Dept.  Eventually I met one of the transplant nurses (although the one looking after me was on holiday) and asked for the obligatory blood and urine samples; I was much amused by the phlebotomist's tourniquet having Dracula and vampires on it!  Then I was off  for an echocardiogram at the ECG Dept which is where I shall also have the treadmill test in a couple of weeks (the day when I see the surgeon); I was told yesterday that actually I couldn't have that test on that day - it was a mistake.  Happily whilst I was being seen, my wife spoke with them and I now have a 9.00am appointment for that same day (as I really wouldn't want to travel all that way for such a frankly trivial test).

The actual echocardiogram was fine, it seems, but I found the posture adopted was a bit difficult.  I was asked to lie on my left side with the display behind me (are they still afraid of the patient seeing his own data on the screen?).  The table was canted up as well so I was bent sideways at my waist, and then I was asked to bring my left arm up over my head!  Try doing this at home, add in a sometimes bad back and neck, and see if you could hold this for 25 minutes!  A large pillow to support my head would have been a good start, and if they wanted my left arm out of the way, I would have preferred to put it on the end of the table.  I actually used it to support my head, but then my elbow started complaining... This procedure did not finish until at least 20 minutes after my consultant appointment, so there was another long walk back to Renal and another wait, before seeing the consultant almost an hour late.

On the phone, the transplant nurse had said that the consultant was "my" consultant, and his job was to protect my interests.  I had not quite appreciated this aspect before; he is required to be (and is) totally independent of the team looking after my brother, to ensure that there is no conflict of interest.  He went through a lot of my history using his PC but, to my surprise, there was no data on it from the tests last year.  It seems that the CD with all that information is still with the absent transplant nurse - I know it was sent because I posted it myself last August, and she had confirmed that she has it.

[Slight drift off topic - I used to work in IT, and I have always thought that the story of the NHS IT system under the last Labour Govt was scandalous.  They wasted well over £10 billion on this project and kept on giving more cash to the useless people (principally Accenture, formerly Andersen Consulting) who kept on getting it wrong.  Eventually it was gently terminated by the new government in 2011. The first aim of such a national project should not be to try to design and implement one new system for the whole country, but to make it possible to link the existing systems together so that data can be passed to another hospital, as in this case.  To do this you have to define a common standard for the data and define the export file that you need to send; then the only expensive bit of new software is a process to import the datafile into each individual system.  This they clearly failed to achieve if they cannot import data from a CD from a different hospital trust; can I please have £1m for showing them the way?]

Back to the topic: after lots of warnings about the risks, my consultant declared himself happy that I was fit to donate, and then thanked me for doing so.  He followed that up by saying that of course I can still change my mind right up to the actual removal of my kidney - there has to be a point of no return somewhere, after all.

We left this old hospital with its difficult signage, dated and tired decoration, multiple levels and silly (and expensive) car park, and spoke of the hospitals back home.  In several different departments of three separate hospitals in the same group near where we live, I have had such consistently wonderful service from helpful and lovely people in the last year.  What is it that makes hospitals so different?  When you go somewhere else, the different culture is most noticeable, and it really affects the patient's experience.  The actual operation will be done at another larger and more well known hospital so we're not too worried about this; however I couldn't help wondering whether Gordon Brown would have been better off investing all that cash in better facilities rather than believing those *** IT consultants!