I wonder if anyone has any info on possible reasons or instances when medication for longstanding (and quite significant) hypertension has been stopped by a GP "because when they took the blood pressure it was fine!"
Sorry this is a bit long..
Mum was seen by a different GP to usual (she is in Care) as I had raised the query whether a) she was having TIAs as she had had episodes of slurred speech and one carer said at one point she did seem to be leaning more to one side - no idea if related to the speech issue and b) I had queried if she had had a recent Full Blood Count as she has a long term history of anaemia and no cause found but previous GPs had said that she was likely to need to stay on some form of iron supplement for the greater part of the time. When talking to the CH Manager I asked how her BP was (prior to the Dr being asked to visit) and said I wondered if it was still being controlled OK as it had been quite difficult to get to an acceptable level previously. I was told they don't do Blood pressure checks as they arent trained but she would ask the GP.
I know that, on occasion, medication needs to be adjusted either up or down and in rareish cases it can be stopped. However, I asked what review and blood pressure checks would be done and was told there was no plan to review and maybe they could ask the GP to check it in 3/12 or so if I was really bothered...
The Dr said Mum looked fine, doubted she was anaemic and so wasn't going to bother with a FBC.
There were other issues too but these are my main queries. I was told I could speak to the doctor if I wasn't happy (and I have put in a request for a call) and I left it at that for that conversation as I wanted to check my facts although I didn't think that type of good practice guideline would have changed since I was actively nursing (plus I still read online journals etc)
I phoned and spoke to a Cardiac Nurse at the BHF who was amazed and said as I did - if her blood pressure is good, then its the medication working. She went into further medical detail but suggested I needed to ask the GP what the rationale is as, with the information I had shared she could see no logical reason. I then told her Mums age and she went a bit quiet and said hopefully they don't have any ulterior motive. Mum is a 103 - she still has a fairly good quality of life in some areas - she can hold a conversation, sing songs, enjoy music and has a good sense of humour and pretty good recall for longer term issues in some areas. However, some of the home staff say "Well...she is 103... " and then tail off into this dismissive little laugh. I accept she is 103 but as I said, as long as it doesn't cause her distress, then whatever age someone is - the emphasis should be on maintaining their abilities and health and not writing them off because of their age. Mostly she gets good care I feel and a lot of the staff are very kind and caring with Mum but they obviously don't like any intervention and I was basically told if you don't like it then look for another placement. I think it was said in the heat of the moment by the manager as she wasn't happy that, although I was very polite, I said I wasn't happy with the decisions made. But its an implied threat - if you comment/ disagree or complain about any aspect or decision about your Mums care then the sanction of removal is there!
So sorry this is so long (and believe me I have edited it down several times!) but I want to get armed with any info I can re the medications and so am asking here in case there is something unusual that I haven't been able to find out although I would have expected the Cardiac Nurse would know and she did look up things whilst we were talking and obviously didn't find a reason.
Thanks for reading this far ...
Sorry this is a bit long..
Mum was seen by a different GP to usual (she is in Care) as I had raised the query whether a) she was having TIAs as she had had episodes of slurred speech and one carer said at one point she did seem to be leaning more to one side - no idea if related to the speech issue and b) I had queried if she had had a recent Full Blood Count as she has a long term history of anaemia and no cause found but previous GPs had said that she was likely to need to stay on some form of iron supplement for the greater part of the time. When talking to the CH Manager I asked how her BP was (prior to the Dr being asked to visit) and said I wondered if it was still being controlled OK as it had been quite difficult to get to an acceptable level previously. I was told they don't do Blood pressure checks as they arent trained but she would ask the GP.
I know that, on occasion, medication needs to be adjusted either up or down and in rareish cases it can be stopped. However, I asked what review and blood pressure checks would be done and was told there was no plan to review and maybe they could ask the GP to check it in 3/12 or so if I was really bothered...
The Dr said Mum looked fine, doubted she was anaemic and so wasn't going to bother with a FBC.
There were other issues too but these are my main queries. I was told I could speak to the doctor if I wasn't happy (and I have put in a request for a call) and I left it at that for that conversation as I wanted to check my facts although I didn't think that type of good practice guideline would have changed since I was actively nursing (plus I still read online journals etc)
I phoned and spoke to a Cardiac Nurse at the BHF who was amazed and said as I did - if her blood pressure is good, then its the medication working. She went into further medical detail but suggested I needed to ask the GP what the rationale is as, with the information I had shared she could see no logical reason. I then told her Mums age and she went a bit quiet and said hopefully they don't have any ulterior motive. Mum is a 103 - she still has a fairly good quality of life in some areas - she can hold a conversation, sing songs, enjoy music and has a good sense of humour and pretty good recall for longer term issues in some areas. However, some of the home staff say "Well...she is 103... " and then tail off into this dismissive little laugh. I accept she is 103 but as I said, as long as it doesn't cause her distress, then whatever age someone is - the emphasis should be on maintaining their abilities and health and not writing them off because of their age. Mostly she gets good care I feel and a lot of the staff are very kind and caring with Mum but they obviously don't like any intervention and I was basically told if you don't like it then look for another placement. I think it was said in the heat of the moment by the manager as she wasn't happy that, although I was very polite, I said I wasn't happy with the decisions made. But its an implied threat - if you comment/ disagree or complain about any aspect or decision about your Mums care then the sanction of removal is there!
So sorry this is so long (and believe me I have edited it down several times!) but I want to get armed with any info I can re the medications and so am asking here in case there is something unusual that I haven't been able to find out although I would have expected the Cardiac Nurse would know and she did look up things whilst we were talking and obviously didn't find a reason.
Thanks for reading this far ...