Tony

Age at interview: 74

Brief Outline: Tony’s kidney impairment was picked up on a routine blood test. He was referred to a consultant at first but is now monitored monthly by his GP with whom he has a good relationship. He takes pills to control his blood pressure and cholesterol levels.

Background: Tony is single and works as a volunteer driver for the Red Cross, having retired from his main occupation as a hotel duty manager. Ethnicity: White British.

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Tony’s kidney impairment was first picked up on a routine test. He was referred to a specialist who considered inserting a plastic tube (stent) to widen the drainage tube (ureter) from one of his kidneys, but in discussion with the GP decided to treat the problem with medication instead. Tony takes aspirin and simvastatin and has tried a succession of different tablets to control his blood pressure, some of which disagreed with him. He had an adverse reaction to one drug, which made him feel dizzy and caused his kidney function to drop from 56 to 36 percent. Another drug gave him a dry mouth, which prevented him enjoying his food and drink. He now takes indapamide for his blood pressure and his kidney function has risen to 44 percent, which his GP is happy with. Tony is not expecting any further improvement and will be content for it to remain at its current level.

Tony has tests done every month. The GP tests his urine and blood pressure, and Tony goes to the pharmacy department of his local ASDA supermarket to have a blood sample taken, which he finds convenient as there is no need to book an appointment in advance and the waiting time is usually short. Tony obtains the results from the GP next time he goes to the surgery, or if something needs attention the GP will contact him sooner. The GP provides him with a graph showing changes in the level of his kidney function over time. He has a good, trusting relationship with the GP and all the staff he comes into contact with.

Tony was completely well until he reached age 70, after which he developed several health problems in a short space of time. In addition to his high blood pressure and kidney impairment, he has been treated for bowel cancer and an aneurysm and is currently having three-monthly injections for prostate cancer. He feels well at present and doesn’t mind taking his medications or having regular check-ups. Tony feels he knows as much as he needs to about his various health problems and doesn’t seek out additional information. He is happy to talk openly about his health to friends and family, and his brother and sister-in-law are his main sources of support. He adopts a positive attitude to life and doesn’t dwell on his problems.

Tony finds it convenient to have his blood samples taken at a phlebotomy clinic in his local ASDA store when he happens to be passing it; he doesn’t need an appointment and never waits long.

It’s just in the clothes section.

Really?

In George in ASDA, yes. I mean you just go ups-, up the travelator into ASDA, the George section, you’re looking in the clothes, and, oh, it’s in the corner. That’s all it is, it’s…

And you have your blood test done there?

…and you’d, oh, yes. And a lot of people in [city], it saves going to the hospital or other, very quick.

Really?

Yes.

That’s good.

Yes. Oh, aye, you go down there, blood pre-, coat, jacket off, sleeves rolled up. And there’s four, four people from the hospital in a morning and three in the afternoon. And they get through some, they get through some people.

So you don’t need a specific appointment, you just turn up?

No, you just turn up, no. The doctor gives you the thing, or the consultant at the hospital, and they give you the form and you go when it’s, when, when you’re free to go. You don’t have to make an appointment. I just go when I’m passing.

That sounds really good.

Oh, it is, it’s excellent.

And how long do you have to wait usually?

Well, Mondays is the worst day but, oh, about a quarter of an hour maximum.

Really?

[mhm]

That’s fantastic.

Oh, yes, yes. They aren’t long once they get started, they’re away, yes.

Mm. Gosh.

Yes, and everybody knows the drill when you go in. There’s five si-, because we play mu-, say it’s musical chairs. You sit, you sit on the chairs and move down and then, “Next, next, next”, and so forth, you know, yes. So you aren’t there, you aren’t there long.
 

Tony has complete faith that his GP has his wellbeing at heart and would therefore go along with whatever changes she suggested.

And if your doctor wanted to change the way you were monitored, for instance, how often she checked up on you or the type of tests, how would you feel about that?

I trust the doctor. I always have trusted all this time that I’m in good hands and whatever she said it’s for the better for my health, or the consultant, it’s better for me.
 

The first blood pressure medicine that Tony took made him feel dizzy. The second one he tried gave him a dry mouth. He is now taking a medicine that does agree with him.

Yes, the symptom was, the first tablet I took [nifedipine], I took it half past seven in the morning, I did a morning’s work, came back home, walked into town and then came back home. And the whole of, in my city, one of the ancient [gatehouses] started going round and round. I then managed to walk back home, sat down on the settee and, to put it in generalisation, you would just think you’d been on the beer all night because the room was going round and up and down and everything. I was then told by the GP not to go to bed, lay down, but sit, relax and the tablet would go through, go through the process, and by 5 o’clock of the same day I would be able to read the paper, watch the television. And so that is eventually what happened.

Persevered with this tablet for a fortnight. Then a review between the consultant and the GP it was established that this was not the right tablet for me. I then went on to another tablet, which did agree with me, and taken that for quite some time. I then went on to another tablet [felodipine], again very short tablet, didn’t agree with me, which gave me a very dry mouth and any food or drink I took I couldn’t say I was getting any enjoyment out of taking even a simple thing like a cup of tea, it felt like poison. I stopped those tablets, told the GP, and from there we went on to a tablet that has agreed with me [indapamide]. And we are now in the process of going on to a further tablet which will even bring the blood pressure down more.