Re: High Blood Pressure (again)

[Guest guest]

Great story of poor training in Scotland of those who do the most important

thing that is done when you go to the Dr: Measure the BP.

I am forwarding this to one of the nurses who has been involved in these

issues.

In a message dated 1/3/08 1:00:29 PM, helenmpearson@... writes:

> >

> > I'm really disappointed - just got back from the hypertension

> clinic...

> > BP is 213/125 using the machine. The technician thried to get

> a " normal

> > reading " several times and then said I had " funny shaped " arms! She

> > then used the manual mercury machine and got 160/110 but said she

> was

> > not great at using it as she had received only minimal training in

> the

> > use of it.

> >

> > Top and bottom is I have to go back next week..... I hope it will

> be to

> > see someone else as she was next to useless.

>

There is actually a Hypertension Nursing Society in England and they have a

training program on how to do it right which can be seen at the British Society

of Hypertension Web site or at dableducational.com

I have had troube viewing their videos let me know if you can view them

May your pressure be low!

Clarence E. Grim, BS, MS, MD

Senior Consultant to Shared Care Research and Consulting, Inc.

(sharedcareinc.com)

Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI

Clinical Professor of Nursing, Univ. of WI, Milwaukee

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

**************

Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

[Guest guest]

In a message dated 1/3/08 1:00:29 PM, helenmpearson@... writes:

> >

> > quick summary of past history: left unilateral adrenalectomy in

> 2002.

> > Excellent results for a year or two following that but more health

> > problems have since followed.

> >

> > Helen in Scotland

> >

>

Suspect you have hyperplasia-but dont recall what your pathology showed.

What meds for BP are you taking now and list any other meds as somemay be

aggregavting BP?

May your pressure be low!

Clarence E. Grim, BS, MS, MD

Senior Consultant to Shared Care Research and Consulting, Inc.

(sharedcareinc.com)

Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI

Clinical Professor of Nursing, Univ. of WI, Milwaukee

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

**************

Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

[Guest guest]

I should also have said that even if I had been sent straight to the

hospital I could not have got as we have heavy snow and all the roads

are closed as well as the ferries not running. Airstrip has also been

shut. It took me 4 hours to get home from the clinic and at one point

I thought we would not make it!!!!

>

> I'm really disappointed - just got back from the hypertension

clinic...

> BP is 213/125 using the machine. The technician thried to get

a " normal

> reading " several times and then said I had " funny shaped " arms! She

> then used the manual mercury machine and got 160/110 but said she

was

> not great at using it as she had received only minimal training in

the

> use of it.

>

> Top and bottom is I have to go back next week..... I hope it will

be to

> see someone else as she was next to useless.

>

> quick summary of past history: left unilateral adrenalectomy in

2002.

> Excellent results for a year or two following that but more health

> problems have since followed.

>

> Helen in Scotland

>

[Guest guest]

Oh dear, Helen. I imagine you measure your own pressure - does this

seem accurate or close to what readings you obtained? What will you do

if so? Things like clonodine can rebound. . .

I'd say she has a " funny shaped sphygo, " because they should be able to

accommodate human arms.

Dave

Helen wrote:

>

> I should also have said that even if I had been sent straight to the

> hospital I could not have got as we have heavy snow and all the roads

> are closed as well as the ferries not running. Airstrip has also been

> shut. It took me 4 hours to get home from the clinic and at one point

> I thought we would not make it!!!!

>

>

> >

> > I'm really disappointed - just got back from the hypertension

> clinic...

> > BP is 213/125 using the machine. The technician thried to get

> a " normal

> > reading " several times and then said I had " funny shaped " arms! She

> > then used the manual mercury machine and got 160/110 but said she

> was

> > not great at using it as she had received only minimal training in

> the

> > use of it.

> >

> > Top and bottom is I have to go back next week..... I hope it will

> be to

> > see someone else as she was next to useless.

> >

> > quick summary of past history: left unilateral adrenalectomy in

> 2002.

> > Excellent results for a year or two following that but more health

> > problems have since followed.

> >

> > Helen in Scotland

>

[Guest guest]

In a message dated 1/4/08 5:27:55 AM, helenmpearson@... writes:

>

> We don't get the path report. Just givn a pat on the head and told to

> go home. In my case I didn't see the surgeon after the op as he had

> come from another hospital especially to perform my op. I saw a

> medical student 6 weeks after the op who told me all had gone very

> well and they didn't expect any further complications. I saw the endo

> again just once when he asked my local hopsital to follow up if they

> could (they haven't as they don't have the facilities) so I have had

> no follow up at all since 2003 except when I ask for my K to be

> checked. I was called to the hypertension clinic in Jan 2006 for a

> review and then yesterday. The Jan 2006 vist was much like yesterday

> except my BP was only 145/112.

>

Recommend you keep asking for path report as the BP seems to have returned

and you should have it for your records.

>

> At home my BP is nothing like that high but they tell me the home

> devices are inaccurate and don't recommend their use.

>

They need to read the literature on home BP monitoring and the British

Hypertension Society recommendations. You can find these at their web site.

As you know, but apparantly they do not, some home devices are very accurate

and some are not. Take your home device with you next time so the can check

it out. It is important to follow our guidelines on how to do it at home.

>

> I take no medication at all. Nothing for anything, otc or prescribed.

> I have SJS and no one wants to take any chances after the last

> episode which was the most serious so far.

>

> Last U & Es done a year ago. K was 3.2 then (lab normal 3.1 - 5.0 I

> think, not sure of the top number) that sample was taken at the local

> clinic and the blood would have sat overnight before going to the

> hospital.

>

The low K means the primary aldo is back unless they had another good

explanation.

> All other levels normal. FBC - iron levels taken 4 weeks

> ago and were 16.2 (above lab normal) and haemocrit was 52%. I'd had a

> double phlebotomy 6 weeks prior to that when my iron was 18.3. I go

> back to see the haemo mid February but it is mostly a watch and wait

> situation.

>

Do they think you have polycythemia rubra vera?

>

> Helen in Scotland

>

>

> >

> >

> > In a message dated 1/3/08 1:00:29 PM, helenmpearson@ In a messa

> >

> >

> > > >

> > > > quick summary of past history: left unilateral adrenalectomy in

> > > 2002.

> > > > Excellent results for a year or two following that but more

> health

> > > > problems have since followed.

> > > >

> > > > Helen in Scotland

> > > >

> > >

> >

> > Suspect you have hyperplasia- Suspect you have hyperplasia-<wbr>b

> showed.

> >

> > What meds for BP are you taking now and list any other meds as

> somemay be

> > aggregavting BP?

> >

> >

> >

> > May your pressure be low!

> >

> > Clarence E. Grim, BS, MS, MD

> > Senior Consultant to Shared Care Research and Consulting, Inc.

> > (sharedcareinc. (sh

> > Clinical Professor of Internal Medicine and Epidemiology Med. Col.

> WI

> > Clinical Professor of Nursing, Univ. of WI, Milwaukee

> >

> > Specializing in Difficult to Control High Blood Pressure

> > and the Physiology and History of Survival During

> > Hard Times and Heart Disease today.

> >

> >

> >

> > ************ *

> > Start the year off right. Easy ways to stay in shape.

> >

> > http://body.http://body.<wbrhttp://body.<wbr

> NCID=aolcmp00300000 NCID=

> >

> >

> >

[Guest guest]

In a message dated 1/4/08 5:12:34 AM, helenmpearson@... writes:

>

> I am in Scotland, not England. They are two seperate countries.

>

Sorry I keep forgetting this major fact.

> Our

> health systems, legal systems, education systems and parliaments are

> different.

>

Perhaps the best place for PA in Scotland in in Glasgow and I know the folks

there. Maybe I could ask them if they would be interested in seeing you in

consultation? Or they may know the best person for you to see closer to home?

>

> The training nurses get in England is different to Scotland. When I

> was living in England I was a tax consultant working for many well

> known individuals and companies. In Scotland my qualifications are

> not valid and I am unable to work in that field here. My English

> teaching qualifications are also not valid in Scotland and I would

> have to go back to school for a further 6 years to gain the ish

> qualification that would allow me to teach in state schools.

>

> Go figure......

>

> Thanks for the website details. I don't think our surgery nurses are

> that technically savvy though. They have problems working the

> computer in their room and I have often had to help out when they

> mess up.

>

> I couldn't get to any videos at all.

>

You need high speed I think.

>

> Helen in Scotland

>

>

>

May your pressure be low!

Clarence E. Grim, BS, MS, MD

Senior Consultant to Shared Care Research and Consulting, Inc.

(sharedcareinc.com)

Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI

Clinical Professor of Nursing, Univ. of WI, Milwaukee

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

**************

Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

[Guest guest]

I am in Scotland, not England. They are two seperate countries. Our

health systems, legal systems, education systems and parliaments are

different.

The training nurses get in England is different to Scotland. When I

was living in England I was a tax consultant working for many well

known individuals and companies. In Scotland my qualifications are

not valid and I am unable to work in that field here. My English

teaching qualifications are also not valid in Scotland and I would

have to go back to school for a further 6 years to gain the ish

qualification that would allow me to teach in state schools.

Go figure.......

Thanks for the website details. I don't think our surgery nurses are

that technically savvy though. They have problems working the

computer in their room and I have often had to help out when they

mess up.

I couldn't get to any videos at all.

Helen in Scotland

[Guest guest]

We don't get the path report. Just givn a pat on the head and told to

go home. In my case I didn't see the surgeon after the op as he had

come from another hospital especially to perform my op. I saw a

medical student 6 weeks after the op who told me all had gone very

well and they didn't expect any further complications. I saw the endo

again just once when he asked my local hopsital to follow up if they

could (they haven't as they don't have the facilities) so I have had

no follow up at all since 2003 except when I ask for my K to be

checked. I was called to the hypertension clinic in Jan 2006 for a

review and then yesterday. The Jan 2006 vist was much like yesterday

except my BP was only 145/112.

At home my BP is nothing like that high but they tell me the home

devices are inaccurate and don't recommend their use.

I take no medication at all. Nothing for anything, otc or prescribed.

I have SJS and no one wants to take any chances after the last

episode which was the most serious so far.

Last U & Es done a year ago. K was 3.2 then (lab normal 3.1 - 5.0 I

think, not sure of the top number) that sample was taken at the local

clinic and the blood would have sat overnight before going to the

hospital. All other levels normal. FBC - iron levels taken 4 weeks

ago and were 16.2 (above lab normal) and haemocrit was 52%. I'd had a

double phlebotomy 6 weeks prior to that when my iron was 18.3. I go

back to see the haemo mid February but it is mostly a watch and wait

situation.

Helen in Scotland

>

>

> In a message dated 1/3/08 1:00:29 PM, helenmpearson@... writes:

>

>

> > >

> > > quick summary of past history: left unilateral adrenalectomy in

> > 2002.

> > > Excellent results for a year or two following that but more

health

> > > problems have since followed.

> > >

> > > Helen in Scotland

> > >

> >

>

> Suspect you have hyperplasia-but dont recall what your pathology

showed.

>

> What meds for BP are you taking now and list any other meds as

somemay be

> aggregavting BP?

>

>

>

> May your pressure be low!

>

> Clarence E. Grim, BS, MS, MD

> Senior Consultant to Shared Care Research and Consulting, Inc.

> (sharedcareinc.com)

> Clinical Professor of Internal Medicine and Epidemiology Med. Col.

WI

> Clinical Professor of Nursing, Univ. of WI, Milwaukee

>

> Specializing in Difficult to Control High Blood Pressure

> and the Physiology and History of Survival During

> Hard Times and Heart Disease today.

>

>

>

> **************

> Start the year off right. Easy ways to stay in shape.

>

> http://body.aol.com/fitness/winter-exercise?

NCID=aolcmp00300000002489

>

>

>

[Guest guest]

In a message dated 1/5/08 1:24:52 PM, helenmpearson@... writes:

>

> In Scotland the path reports are the property of the health board not

> the patient and the patient has no right to a copy to them (or to

> actually see them). We also do not keep our own medical notes - they

> reside with the hospital or the primary care team. If a patient wants

> a copy of their notes it is a long and complex process. Very

> different to the US system. I doubt very much if I will get a copy of

> the path report, if indeed there was one. In our local hospital there

> is no path lab so samples are sent elsewhere for reports only if the

> surgeon thinks it necessary.

>

My guess is that Dr. Connel in Glasgow could get them and give them to you.

I will be happy to ask.

> Again very different to the US. I have

> to really fight to get my BP readings and the results of my blood

> tests. Usually the screens are turned away from the patient so one

> can't see the scores.

>

> Last time I went to the hypertension clinic I took my home device but

> they just laughed at me. Said I was wasting my time taking BP at home

> as it was worthless to them. They have suggested I have a 24 hour

> monitor fitted from 10 am to 3 pm and I have to ring on Monday to see

> if they will have a device available within the next month.

>

So they want to take a single days readings to test rather than a year of

your BPs? They don't understand the problem.

>

> My K was within normal limits at the last testing so they are not

> concerned but I will ask if they will test again as it is a year

> since it was last done. They said last time that I was the only PA

> patient they had seen at that primary care practice and that it was

> so rare I would be extraordinarily unlucky to have it again.

>

I bet you are the first one they have recognized. There are many in their

practice that they have missed.

> As my BP

> was okay at that time I did not press matters.

>

Agree as long as the BP is OK that is a good sign.

>

> They don't know what is causing the high iron levels. I am JAK2

> negative which the haematologist said was 100% negative for

> polycythemia rubra vera. They also tested for erythroproietin levels

> which were right on the mid-point of lab normal so I don't have an

> erythropoietin producing tumour. It is " watch and wait and treat when

> levels get too high in the specialist's opinion " .

>

Sounds like a reasonable approach. Will forward to my son who is a

hematologist for his comments if that is OK with you?

>

> I have seen 15 specilaists in the last 2 years and no one has been

> able to do anything for me. Each says something needs to be done but

> it is not their area and sends me off to see a colleague... and so it

> goes. Now I have doen the full circle and am back with the first man

> I saw who still doesn't know what to do!

>

Ah yes the specialist who can see past their nose. This is the reason we

stress here that you need to find a good internist who is very knowledgeable

about high blood pressure. Indeed we now have HTN boards and I think the

British HTN Society is working on this too.

>

> In Scotland one has to be referred to a specialist and that

> specialist will be at the local hospital. I specifically wished NOT

> to see a certain specialist but was told that if that was the case I

> would see no one. I will be treated at Borders General Hospital and

> will have no choice in the matter - if my primary care team do

> actually refer me which is far from a done deal. Glasgow would be too

> far for me to get in any case as we have no public transport and it

> is too far for me to drive the way I am feeling right now it would

> not be safe.

>

> When I was diagnosed with PA in 2002 it was because I collapsed in

> Newcastle upon Tyne City Centre and the ambulance took me to

> hospital. Luckily the hospital was a major teaching hospital and the

> medical student who was working on A & E did a very complete workup.

> She remembered about low K and high BP so called for specialist back-

> up. My primart care team had completely missed the connection for

> several years. I no longer have the same primary care team.

>

> Helen in Scotland

>

>

May your pressure be low!

Clarence E. Grim, BS, MS, MD

Senior Consultant to Shared Care Research and Consulting, Inc.

(sharedcareinc.com)

Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI

Clinical Professor of Nursing, Univ. of WI, Milwaukee

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

**************

Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

[Guest guest]

In Scotland the path reports are the property of the health board not

the patient and the patient has no right to a copy to them (or to

actually see them). We also do not keep our own medical notes - they

reside with the hospital or the primary care team. If a patient wants

a copy of their notes it is a long and complex process. Very

different to the US system. I doubt very much if I will get a copy of

the path report, if indeed there was one. In our local hospital there

is no path lab so samples are sent elsewhere for reports only if the

surgeon thinks it necessary. Again very different to the US. I have

to really fight to get my BP readings and the results of my blood

tests. Usually the screens are turned away from the patient so one

can't see the scores.

Last time I went to the hypertension clinic I took my home device but

they just laughed at me. Said I was wasting my time taking BP at home

as it was worthless to them. They have suggested I have a 24 hour

monitor fitted from 10 am to 3 pm and I have to ring on Monday to see

if they will have a device available within the next month.

My K was within normal limits at the last testing so they are not

concerned but I will ask if they will test again as it is a year

since it was last done. They said last time that I was the only PA

patient they had seen at that primary care practice and that it was

so rare I would be extraordinarily unlucky to have it again. As my BP

was okay at that time I did not press matters.

They don't know what is causing the high iron levels. I am JAK2

negative which the haematologist said was 100% negative for

polycythemia rubra vera. They also tested for erythroproietin levels

which were right on the mid-point of lab normal so I don't have an

erythropoietin producing tumour. It is " watch and wait and treat when

levels get too high in the specialist's opinion " .

I have seen 15 specilaists in the last 2 years and no one has been

able to do anything for me. Each says something needs to be done but

it is not their area and sends me off to see a colleague... and so it

goes. Now I have doen the full circle and am back with the first man

I saw who still doesn't know what to do!

In Scotland one has to be referred to a specialist and that

specialist will be at the local hospital. I specifically wished NOT

to see a certain specialist but was told that if that was the case I

would see no one. I will be treated at Borders General Hospital and

will have no choice in the matter - if my primary care team do

actually refer me which is far from a done deal. Glasgow would be too

far for me to get in any case as we have no public transport and it

is too far for me to drive the way I am feeling right now it would

not be safe.

When I was diagnosed with PA in 2002 it was because I collapsed in

Newcastle upon Tyne City Centre and the ambulance took me to

hospital. Luckily the hospital was a major teaching hospital and the

medical student who was working on A & E did a very complete workup.

She remembered about low K and high BP so called for specialist back-

up. My primart care team had completely missed the connection for

several years. I no longer have the same primary care team.

Helen in Scotland

[Guest guest]

Yes it is.

May your pressure be low!

Clarence E. Grim, BS, MS, MD

Senior Consultant to Shared Care Research and Consulting, Inc.

(sharedcareinc.com)

Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI

Clinical Professor of Nursing, Univ. of WI, Milwaukee

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

**************

Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

[Guest guest]

Again I think I could refer you to Dr. Conell as a favor but looks like it

would be hard to get there.

I will see him in May.

May your pressure be low!

Clarence E. Grim, BS, MS, MD

Senior Consultant to Shared Care Research and Consulting, Inc.

(sharedcareinc.com)

Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI

Clinical Professor of Nursing, Univ. of WI, Milwaukee

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

**************

Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

[Guest guest]

Yes it is but as I have heard only for CHF.

May your pressure be low!

Clarence E. Grim, BS, MS, MD

Senior Consultant to Shared Care Research and Consulting, Inc.

(sharedcareinc.com)

Clinical Professor of Internal Medicine and Epidemiology Med. Col. WI

Clinical Professor of Nursing, Univ. of WI, Milwaukee

Specializing in Difficult to Control High Blood Pressure

and the Physiology and History of Survival During

Hard Times and Heart Disease today.

**************

Start the year off right. Easy ways to stay in shape.

http://body.aol.com/fitness/winter-exercise?NCID=aolcmp00300000002489

[Guest guest]

Do you know if Inspra (eplerenone)is available in the British Isles

yet?

>

>

> In a message dated 1/5/08 1:24:52 PM, helenmpearson@... writes:

>

>

> >

> > In Scotland the path reports are the property of the health

board not

> > the patient and the patient has no right to a copy to them (or to

> > actually see them). We also do not keep our own medical notes -

they

> > reside with the hospital or the primary care team. If a patient

wants

> > a copy of their notes it is a long and complex process. Very

> > different to the US system. I doubt very much if I will get a

copy of

> > the path report, if indeed there was one. In our local hospital

there

> > is no path lab so samples are sent elsewhere for reports only if

the

> > surgeon thinks it necessary.

> >

> My guess is that Dr. Connel in Glasgow could get them and give

them to you.

> I will be happy to ask.

>

> > Again very different to the US. I have

> > to really fight to get my BP readings and the results of my blood

> > tests. Usually the screens are turned away from the patient so

one

> > can't see the scores.

> >

> > Last time I went to the hypertension clinic I took my home

device but

> > they just laughed at me. Said I was wasting my time taking BP at

home

> > as it was worthless to them. They have suggested I have a 24 hour

> > monitor fitted from 10 am to 3 pm and I have to ring on Monday

to see

> > if they will have a device available within the next month.

> >

> So they want to take a single days readings to test rather than a

year of

> your BPs? They don't understand the problem.

> >

> > My K was within normal limits at the last testing so they are not

> > concerned but I will ask if they will test again as it is a year

> > since it was last done. They said last time that I was the only

PA

> > patient they had seen at that primary care practice and that it

was

> > so rare I would be extraordinarily unlucky to have it again.

> >

> I bet you are the first one they have recognized. There are many

in their

> practice that they have missed.

>

> > As my BP

> > was okay at that time I did not press matters.

> >

> Agree as long as the BP is OK that is a good sign.

>

> >

> > They don't know what is causing the high iron levels. I am JAK2

> > negative which the haematologist said was 100% negative for

> > polycythemia rubra vera. They also tested for erythroproietin

levels

> > which were right on the mid-point of lab normal so I don't have

an

> > erythropoietin producing tumour. It is " watch and wait and treat

when

> > levels get too high in the specialist's opinion " .

> >

> Sounds like a reasonable approach. Will forward to my son who

is a

> hematologist for his comments if that is OK with you?

> >

> > I have seen 15 specilaists in the last 2 years and no one has

been

> > able to do anything for me. Each says something needs to be done

but

> > it is not their area and sends me off to see a colleague... and

so it

> > goes. Now I have doen the full circle and am back with the first

man

> > I saw who still doesn't know what to do!

> >

> Ah yes the specialist who can see past their nose. This is the

reason we

> stress here that you need to find a good internist who is very

knowledgeable

> about high blood pressure. Indeed we now have HTN boards and I

think the

> British HTN Society is working on this too.

> >

> > In Scotland one has to be referred to a specialist and that

> > specialist will be at the local hospital. I specifically wished

NOT

> > to see a certain specialist but was told that if that was the

case I

> > would see no one. I will be treated at Borders General Hospital

and

> > will have no choice in the matter - if my primary care team do

> > actually refer me which is far from a done deal. Glasgow would

be too

> > far for me to get in any case as we have no public transport and

it

> > is too far for me to drive the way I am feeling right now it

would

> > not be safe.

> >

> > When I was diagnosed with PA in 2002 it was because I collapsed

in

> > Newcastle upon Tyne City Centre and the ambulance took me to

> > hospital. Luckily the hospital was a major teaching hospital and

the

> > medical student who was working on A & E did a very complete

workup.

> > She remembered about low K and high BP so called for specialist

back-

> > up. My primart care team had completely missed the connection for

> > several years. I no longer have the same primary care team.

> >

> > Helen in Scotland

> >

> >

>

>

>

>

>

>

> May your pressure be low!

>

> Clarence E. Grim, BS, MS, MD

> Senior Consultant to Shared Care Research and Consulting, Inc.

> (sharedcareinc.com)

> Clinical Professor of Internal Medicine and Epidemiology Med. Col.

WI

> Clinical Professor of Nursing, Univ. of WI, Milwaukee

>

> Specializing in Difficult to Control High Blood Pressure

> and the Physiology and History of Survival During

> Hard Times and Heart Disease today.

>

>

>

> **************

> Start the year off right. Easy ways to stay in shape.

>

> http://body.aol.com/fitness/winter-exercise?

NCID=aolcmp00300000002489

>

>

>

[Guest guest]

As I am not Dr Connel's patient it would not be ethical for him to

ask for the notes. We (You) tried that route before and got nowhere.

I just have a feeling that there was no path report or that it has

not been kept.

Because we have no path lab here it is difficult. I had minor breast

surgery (for a lump) in November. Samples were sent to Edinburgh to

the path lab there but there was not enough tissue in the samples

sent so they could not give any opinion. The rest of the excised lump

was destroyed immediatley after the surgery so I am left

wondering..... I see the breast surgeon again at the end of the month

and will be asking a few questions then.

We are lucky to have more than 10 minutes with a specialist so I

often end up witing with all the questions I want to ask. Sometimes I

get answers and sometimes I don't. Sometimes I get a letter

cancelling my next appointment and discharging me to the care of my

GP.

You have already asked your son about the high iron etc.

The big problem is that I live in a remote and sparsly populated

area. Specialists come here either because they can't get a job in a

leading hospital (ie they are not top of the class so to speak) or

they are looking to retire. To see any specialist (NHS or private)

one has to be referred by your GP. GP's refer to the nearest hospital

that has a consultant in that field as that is the way the system

works.

Yes it will be just 5 hours of readings. The machine is a real

nuisance as it is quite bulky and noisy. Last time I had to switch it

off while I was at work as it was annoying everyone in my workplace.

I've changed job and employer since then. As I can't have the d***

thing going off every 20 minutes at work I may have to take the day

off work which will be a pian in the purse!

Helen in Scotland

[Guest guest]

>

> > Ah yes the specialist who can see past their nose. This is the

reason we

> stress here that you need to find a good internist who is very

knowledgeable

> about high blood pressure. Indeed we now have HTN boards and I

think the

> British HTN Society is working on this too.

> >

Yes they are.

There is not one within reasonable travelling distance of me. There are

centres in the central belt but nothing for us country bumpkins. We

have a bus on Wednesday. By the time it gets to Edinburgh it is too

late for the hospital. The bus back is the following Wednesday. We have

no railroad here at all. Sorry but we don't all live in populated areas!

Helen in Hume

[Guest guest]

>

>

> Do you know if Inspra (eplerenone)is available in the British Isles

> yet?

>

In some areas for CHF only. Some specialist clinics prescribe it for PA

but it isn't gluten free so would be no good for me in anycase.

Helen

>

>