Some doctors are good.

Anyone who has read my blog over time will know I have an overall, pretty low opinion of doctors (especially neurologists) but there are some good ones out there. My GP is a very good doctor and I respect him a lot for that.

Even so I avoid going even to him if I can avoid it. I phoned for an appointment before Easter and was told there were none until mid april unless it was an emergency and so I didn’t go. Yesterday, I went because by that point I really had to.

The oncall doc was one of the regulars at the group practice I attend. I’ve only met her a couple of times when she tried to help sort out some post c-section problems I had after Heleyna was born.

She didn’t keep me waiting but came out as soon as she had finished with her patient and took me straight through to the nebuliser room. She asked me first what I thought was happening and whether I thought I had an infection. I told her no infection and no full on asthma attack as it was mostly URT wheezing and breathlessness. She had a listen and agreed with me.

She plugged up the machine and left me to it.

I was really taken with the fact she trusted me to know what my own body was up to.

Afterwards she took us through to her room and allowed me time to recover and talk to her. It was because she was allowing the breathless-voicless middle aged biddy to speak that I felt able to tell her the whole truth; first that I’d taken myself off the Ivabradine to see if it was a side effect – but nothing changed so I assume it isn’t the Ivabradine. And that I’d had a nasty TIA last month and I showed her the rather startling BP/HR/pulse pressure chart.

Then she was cross with me. I hadn’t made an appt after the TIA (to be honest, although I didn’t tell her this – I just didn’t feel well enough to go)  She looked at my nice neat print out and asked what I’d done about a reading of 175/150 and I had to admit I hadn’t done anything.

Now then, she could have given me a right lecture, but she didn’t. She was cross with me, but respectfully and anyway, I knew she was right. She demanded to know why I hadn’t raised this with the Prof Cardio. But he was in a rush, so although I had taken the chart in with me I didn’t get the chance to ask him about it.

She’s raised the Candasarten by 4 mg to try and drop the diastolic without dropping the systolic too far.  I have to go back in two weeks for bloods. I hope they will do B-type Natriuretic peptide (BNP) but I’ll ask when I get there. (I’d like ANA done as well but one thing at a time)

Ooh and she gave me steroids which always make me feel so much better. I wish i could have them all the time – only of course I can’t because of their nasty side effects. But oh, while they last they are so good.

And I’m back on the Ivabradine for the inappropriate sinus tachy.

Thanks to my breathlessness and voice problems it can be difficult to get things said quickly. It is so important for a doctor to be willing to give you the chance to speak, even if it does take a little longer.

chartI do think having a “proof” helps as well. So if you can do take BP charts or photographs of rashes and weirdness.I am using iLOWER BP which is free and easy to use. It also records pulse pressure which is important, although it’s a rare doctor that actually knows this. You might also find the ABCD score  useful if you’ve had a TIA.

I even have that horrible neuro wanting a film of my next seizure. The neater and clearer the information the better as it looks like you’ve done it properly.

Couple of things to note for stroke risk; fluctuating BP is more indicative of risk than constant hypertension. A pulse pressure of between 60 to 70 isn’t good but it isn’t too bad if you are over 60. Research on people in their 40s to 50s however suggests that a high pulse pressure is indicative of stroke risk.

Low pulse pressure (less than 10 to 20) is indicative of low blood volume.

A lot of this is just part of the joys of dysautonomia.

On to the next tests…

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