David

Age at interview: 63

Brief Outline: He had a minor stroke in 2001 and spent 3 days in hospital. He is allergic to aspirin and it took time after the stroke to find a blood thinning drug that he could tolerate. He asked to be tested for diabetes because of his family history; he started on insulin 2 years ago.

Background: David is widowed with one child. He is a retired tax specialist. Ethnic Background: White.

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Because of his family history, David asked to be tested for diabetes:

“I asked to be tested and I was substantially diabetic and the clinic ummed and aarhed and eventually decided that I must be type two, rather than type one, though I’ve never been convinced they were doing anything other than following the easiest path”.

David feels fit enough to be as active as he wants, although having to remember to take insulin and associated gear with him wherever he goes is seen as a “tie”. David sees his diabetes and the stroke as unconnected. He thinks that the reason why he had a stroke is “an unknown”.

In David’s account we find a description of how different medical professionals have to collaborate and how they prioritise, e.g. sort the blood pressure first, then the diabetes. Most of his interaction is with a diabetic clinic, but prescribing is controlled by his GP. In his view, it would be better if the person he was seeing had the power to prescribe. However, whilst preferring “one port of call” he does not see his GP as being expert in either condition.

David’s advice for patients is: “keep taking the tablets etcetera [laughs]. And if you have a side effect, go to your doctor [laughs] and come off, and hopefully come off the one that’s causing the problem.”

Over the years David’s diabetes got worse and the drugs he was being given stopped working. He was then put on insulin.

You mentioned that after a bit of discussion, you were diagnosed with type two diabetes?

[mm] Yeah.

But I’ve written here, you’re not sure whether they were just sort of…

Well, the age I was and am expect, you’d expect it to be type two rather than type one, I think is a total breakdown of the system, and just treating it with tablets worked fine for controlling it for some time. But, over the years, the tablets have less effect, which is why they pushed to put me onto insulin, which I really didn’t fancy the idea at all and had to be talked into it. But it’s actually, turns out to be a lot easier than it sounds. 

David spent an extra night in hospital after the first alternative drug to aspirin they tried made him feel faint. Clinicians did not want him to take a beta-blocker as it would block the symptoms of a diabetic hypo.

And you mentioned that following the stroke you reacted to a medication?

[mm]

But are now on a blood thinner.

Yeah.

That you’re okay with.

Yes. Yes, the first one they tried, instead of aspirin, I felt faint and very light-headed while I was waiting to be sent home. So I ended up with an extra night in hospital with that one. Yeah, but, apart from that, the medications have had very little in the way of side effects. 

Okay and I’ve jotted here that your GP added medication for your blood pressure.

Yes. Yes the hospital sent me home with one tablet, with instructions to go to my GP, and she added, one, two, two immediately, fairly immediately. One was a beta-blocker, which I’ve been taken off because the diabetic staff say that it, the effect of it is to shield symptoms of a hypo and they don’t they don’t, they want you to be aware you’re going hypo for fairly obvious reasons. But I don’t think it did affect me because I was conscious of being hypo on occasion, while I was still taking it, and since then, incidence hasn’t changed. So I had to be weaned off it. 

I think I was on fifty milligram a day and it was reduced to alternate days and then a half dose, alternate days and eventually, nothing at all. And taking me off it, actually didn’t affect my blood pressure readings at all, which makes you wonder what the hell it was doing in the first place [laughs]. But I suppose that could be true of any long term medication. You either, it stops having an effect or it’s you’ve got so much in your system that it doesn’t matter.

David urges people to follow medical advice until a side effect is encountered, at which point you should tell your doctor. David’s experience is that things can be sorted out when a problem is raised.

Do you have any messages that you might give to people living with more than one condition, any advice or messages for them?

I think the answer is probably keep taking the tablets etcetera [laughs]. And if you have a side effect, go to your doctor [laughs] and come off, and hopefully come off the one that’s causing the problem.

Okay.

Even if it’s their favourite one for treating that condition [laughs].

Do you feel that’s it’s been responded to well, if you’ve ever raised that or?

Yes, thinking about it, when the dosages for the blood pressure on its own have been dealt with, one of the tablets was upped and it did have a side effect on me. I complained. We went back to the original dosage, which sorted it. 

So by pointing out that there’s a problem, you can get something done.