MEDICAL MATTERS

[Wendyf]

Is Febby OK Maz?

[PanBiker]

My machine is the same as those used at our surgery. The instructions state that you should elevate the arm from which the reading is being taken using a cushion if necessary to ensure the CUFF is level with your heart. Cuff placement is dependent on which arm you are taking the reading from (diagrams on the cuff). I do mine on the left and Sally's on the right as she has no lymph nodes at her left. Instructions go on to say that you should sit upright and relaxed, no talking during the measurement. It does not say that the machine should be higher than your heart just that the cuff is level or higher. This is exactly the same practice if you go to the nurse to have it done, sat relaxed in chair, reading arm elevated with pillow, machine on table.

Taking a reading before or after a meal or a drink or after visiting the toilet can alter the results, so random readings and averages are better than any individual reading. When you have it done at the surgery there is such a thing as surgery anxiety for some folk which can slew the results.

I put our results on a spreadsheet so you can see all the figures for each reading and then have a line displaying the average. I print it for the doc so he can see the whole picture.

[Marilyn]

If that is the case,Panbiker, then the cuff will always be level with your heart! Seeing as your upper arm is always level with your heart no matter if you are standing or laying down! But, a good enough instruction for home monitoring I suppose, because it will give a consistent reading over time.
If you were collapsed on the floor Panbiker, the cuff will still be level with your heart, but the reading would not be true if the unit was on a table.

[PanBiker]

I think that's the point. The machine is only displaying the result. Position of arm and cuff is the important bit. If your arms are down by your sides you could put the cuff lower than your heart hence the advice about the pillow.

[Marilyn]

Mmmmm...I'm not arguing with you.
But you don't need a pillow. Your cuff and heart are at the same level.

[PanBiker]

I'm not arguing either Maz just stating what it says in the instructions for my BP monitor. It is also the practice adopted by our surgery nurses in my experience.

[PanBiker]

Here's the relevant section of my instruction manual, the equipment is Omron same as used at our local surgery.

[PanBiker]

On a different matter, I went to the docs last week with a peculiar problem. I have a dodgy leg or I should say I have dodgy leg after vigorous exercise such as a good walk. I develop weakness in my right leg after about 3-4 miles into a walk depending on terrain, I can sometimes go further on the flat before any change. This manifests itself as clumsiness or being more likely to trip with my right leg, I adopt a different stance (probably subconsciously trying to compensate), friends have asked why I am limping on occasion. It does not seem to manifest itself when riding my bike, (I can go 20 or 30 miles and have never noticed the same). If I rest for 5 or 10 minutes during my walks the effect will temporary ease as it does fully after a few hours rest after returning home.

My doctor did basic neurological test and manipulated my leg at the hip and knee. I don't have any pain and there does not seem to be any clicking or grinding in the joints. He has given me a ticket to get a pelvic X-Ray as a first check to rule out any physical degeneration. Open sessions at Airedale during the week or I can ring if I want to switch it to Skipton where I will need an appointment. I then have to make a follow up appointment with him a couple of weeks after I have had the X-Ray. Been busy last week so I'll probably go tomorrow.

[Sue]

I think the cushion/pillow is a comfort thing to help make people feel more relaxed. I have always just placed my arm on the table next to the machine, whilst sitting.

[Sue]

All this discussion stems from a referral by my GP for a drifting 2nd and 3 rd toes on my left foot, drifting towards my big toes. It was thought it was a neuriloma or rheumatoid arthritis. I have had scans and blood tests that are negative so there appears to be no reason for it. It was the rheumatoid consultant who got all the information wrong. Discussed the Wrong toes, the wrong symptoms, the wrong previous procedures, and listed hypertension as one of my existing conditions, including taking drugs for it. I am not inspired with confidence as to whether the results to the blood tests carried out are actually mine.

[PanBiker]

I was once mixed up with a namesake at our local surgery we both had the same doctor. I had not been to see him for probably 10 years at the time and he pulled the wrong notes, or may have been given the wrong notes by reception. It was back when everything was manual and all your notes were in a brown paper envelope. Easily sorted when he opened the consultation by asking if I was still experiencing completely different symptoms from what I had gone to see him for.

The pillow is mentioned in the instructions for my BP machine for the correct posture in my other post Sue. Seems fairly obvious to me, if your seating position ends up with the cuff below your heart level (and it is possible), elevate the arm with a pillow.

[Stanley]

All very interesting..... No I haven't got the instruction book, I threw it away. Yes I do know about the correct placement, level compared with heart, positioning the pressure pad etc. Occasionally I take my machine with me to the surgery and compare it with theirs, it's always read exactly the same. P is right about batteries, they are OK as long as they get the cuff pressure up to the max before the reading and yes I do change them.... I am not interested in the actual reading, just the comparison with the previous ones, it's the spikes and trends that are important. That's why I always do the reading in the same chair, same position and just after morning walk. The little book I keep with the readings noted gives a far better indication the actual state of affairs than a random reading at the surgery especially if like me you have white coat syndrome. The surgery reading is always higher than at home.
Wendy, I am taking your advice about cutting down on apples. Like Col, my tinnitus has improved of late as has my old war wound pain in my right shoulder. I hadn't connected them with sugar levels. I shall keep an eye on it!

[PanBiker]

Had my pelvic X-Ray done today at Airedale. Very efficient and speedy through the system. No appointment as it's open access just the referral, in and out in less than half an hour.

[Sue]

The same system is used at Rochdale Infirmary, always works well.

[Big Kev]

hbA1c 39.

[Wendyf]

Brilliant Kev, you must be well pleased!

[PanBiker]

[Big Kev]

I am quite pleased, a reduction in medication too. I was also given a new meter today, the testing strips for it are a lot cheaper than the current one apparently.

[Wendyf]

Col got the new meter too.

[Stanley]

My blood sugar is slightly up but the nurse agreed with me about stress and being careless over the last three months. It will be down in six months!

[Moh]

Got a 'phone call yesterday to go to the eye clinic on Monday - they finally have decided to add more clinics!

[Stanley]

Is that for cataract Moh?

[Tizer]

On a different OG topic Stanley has asked `Can someone please cheer me up by highlighting an area of society where things are improving?' Well here it is...
I recommend anyone who supports the NHS to listen to this recent Radio 4 programme which is available on iPlayer. It discusses some brilliant initiatives by doctors to make the NHS more efficient and shows that it can be done and will save a lot of money. The only thing getting in the way is the difficulty of propagating these new ideas through the organisation and that's down to better management.

In Business
The NHS and Productivity
"The NHS is facing a sustained squeeze. An ageing population, the rising cost of new treatments and increasing patient demand on the one hand, and the impact of continued austerity on the other. What can it do? One answer might lie in improving productivity. In the first of two programmes on the NHS, Louise Cooper explores its productivity puzzle. What does increased productivity look like in the health service? She meets clinicians, across the country, who are trying to do more for less. Can their efforts be replicated across the NHS? And, if so, will it ever be enough?" LINK

There's a second programme, titled `The NHS: The Recruitment Dilemma' and this can be accessed via a link from the web page of the first.

[Moh]

Is that for cataract Moh?

No, I had both eyes done for cataracts a few years ago - it is for laser treatment on what was originally my 'good' eye. They have both been good since having the cataracts done but one has got scars on due to the op. so the optitian recommended laser trearment. My appointment is at the clinic so when I get the treatment is anyones' guess.

[Stanley]

Thanks Tiz.....

That sounds like the treatment they gave me Moh. Mine did the same. It took 5 minutes, no pain and return of 100% eyesight. I hope it is, you'll love it, it's a miracle. Mine have been OK ever since.