Thought this might be a good place to start before I have words with the doctor. GP surgeries seem to be a bit like politicians, you can’t get near them if you need to, but if they want you they won’t leave you alone.
About 3 weeks ago out of the blue the receptionist had phoned me and asked me to send them some BP readings. Something to do with the Stroke team discharging me. Not that I’ve seen much of them since Christmas, but I digress. So I shrugged and said ok, took some readings for a week and emailed them in.
At the moment I’m run ragged doing my best to double up as a disabled carer for my wife who had a new hip last week. It isn’t easy but there’s nobody else to do it. Friday out of the blue the phone rings and a man I’ve never met introduced himself as a clinical pharmacist at the surgery. He says he’s not happy with the BP readings I sent in. Apparently they are a little higher than (and I quote) “the target figure we’d like to see” He didn’t say who “we” are. No mention of a doctor. So then he begins to cross examine me about lifestyle, diet etc…you all know what the questions are…and concludes by saying he wants me to begin medication to lower my BP. So I pointed out that I’m on the meds assessed and prescribed by the hospital stroke consultant and I’m not changing that without first discussing it thoroughly with a doctor. So now he’s sent me a no-reply email telling me he wants to “get me in” for blood tests to check whether the high blood pressure has ‘impacted my organs’. We are talking about an average reading in the 140s. I’ve not had the 135 he wants since I was young and fit 40 years ago. So he wants me to start taking Amlodipine or Ramipril.
What’s my concern? That the medication may affect the essential meds I’m already on (Clopidogrel, Atorvastatin, or even have side effects more dangerous or unwelcome to my stroke recovery and condition than his perceived benefits. I’ve never had any heart problems btw.
Anybody have any experience or advice please? I have to admit his general attitude got up my nose a bit, so I’m trying to be calm and logical in my approach to dealing with it.
Thank you dear people.
It mighy be worth going in for the appointment and Explaining the added pressure you are under at the moment as that might account for higher readings. Many people take BP meds alongside stroke meds as very high BP can be a stroke cause.
I was given a 130/80 target when i was discharged from hospital & told to see GP if my BP went higher than this. I’ve had an odd reading above this but mainly my BP is on the lower side.
There are ways of bringing BP down if only slightly raised so might be worth a discussion with the dr about trying those first.
Hope you find the best solution for you.
@Mrs5K I don’t have a blood test appointment yet, I’m expecting he will have passed that back to the receptionist. When she calls, which will probably be tomorrow, I was going to tell her I want an appointment with the doctor first. If after discussing it he decides I should take BP medication, fair enough I’ll do it. I don’t think the nurses or pharmacist consult the doctors before approaching patients, they wanted me in for blood tests and an MOT just weeks after leaving hospital stroke and vascular surgery units. The GP said it was unnecessary and he cancelled it. I doubt at that time there was much blood left.
Not to stir up any wasp nests, but with all these data leaks from hospitals, I would be a little wary of cold contact, prescribing medication, and check in with your regular GP to get to the bottom of it.
If it is anything like my surgery the nurses & pharmacists are taking on these things to free up GPs for other appointments. I’ve had a good experience with the pharmacists in my surgery & find they are very knowledgeable & probably understand med interractions better than the GPs. If we want to see a GP instead then they will book us in with one we just have to wait longer for an appointment.
I’m on both Amlodipine and Ramapril, so’s hubby. I’m also taking the other meds you mention.
The thing is Mick you do not want another stroke, do you? As we all know, or should by now, high blood pressure can lead to strokes, bleeds on the brain from burst blood vessels, etc etc. Don’t mess around with this one Mick! This guy is trying to buy you more years of life, not less, meet with him, meet with your gp, but do whatever needs to be done to bring your bp down…not raise it!
It’s as @Mrs5K says, the nurse’s and pharmacists are taking on a lot of the routine stuff, to free up gp’s for the more urgent cases. The pharmacist is just as qualified, maybe more so, than the gp in what medications are best suited to you. And they will probably have access to all your history of medications and allergies, medical history too probably. Even the ambulance crew who took my mother-in-law to hospital the other day had her full medical history on their tablet. It saves time and saves lives…though not all.
I would certainly echo @EmeraldEyes - GP’s know a little about a lot but they know bugger all about things at the deeper levels- they’re just signposters whereas the pharmacist really will know the medications.
I’ve recently started taking amlodipine because the BP with the other medication which was candesartan and that was replaced by lisinopril which wasn’t enough on its own. I’m also taking clopidogrel etc. all these things potentially stress liver and kidney so blood tests after you start are a precaution. I have some coming up to test if the amlodipine is causing problems. I’m not having side effects from it but swollen ankles is fairly common.
I definitely agree with you that you can’t get hold of them and then they seem to decide that they need to get hold of you. The move to be proactive on your behalf should maybe be welcomed though 
High blood pressure does not just bring that the risk of a dissection it also damages the interior of small blood vessels which then promotes clot formation which when they detach or build up to a large extent cause problems. Years of high blood pressure has a cumulative effect 
if folk like the joke association were serious in an efficacious aim of reducing strokes they would publicise this sort of information ditto how to spot a TIA etc
Caio
Simon
@SimonInEdinburgh
I think the blood tests are to decide which flavour they’ll put me on. I’ve had blood tests galore since I collapsed prior to my stroke up to almost daily in the hospital stroke and surgical units. None of them showed any problems but of course I’ve now been on Cloppy and Stats for a year. So I’ve no idea what that might have done.
Interestingly the full set they did when I originally collapsed indicated nothing was wrong. Both the pharmacist and GP had access to those and there was no suggestion I might just have had a TIA, which I clearly had. At that time despite me telling the doctor of weakness and wobbly legs I was told the blood tests are good so just carry on and ‘see how you go’ It just makes me sceptical about their latest course of action.
hi Strings,
Firstly, don’t take my post too seriously (it’s just my opinion) but here goes;
what you say about surgery ; spot on. Your BP in the 140s ; pretty good, really. You don’t mention the diastolic number (which is more to the point). BUT the hassle, bother and worries he is cramming into you does way more harm than good to your BP. Please look at the big picture, and do things at your own pace so you stay calm (essential right now) and get through this difficult period as smoothly as possible. Eat some celery / or juice it to lower your BP, and put some soothing music on, and your feet up, for today. (In time, you’ll keep BP in check)
Just my opinion, ciao, Roland
@pando @Nigelglos
Thanks for the comments guys, much appreciated. Roland, diastolic average is 79.
Mick,
I’m impressed 79 is great. I really would put your feet up and stop fretting about it. But even if you do fret about it, it’s so good, you won’t spike it, IMHO. Of course, nobody wants to risk it, so nobody will endorse my point of view. What is important is that it doesn’t become a constant worry… put your feet up !! I stand by my first post, and in your own time you’ll keep an eye on it, I’m sure.
Bravo, Roland
Hi Nigel,
thanks for the challenge. (I will reply on the public forum, if you don’t mind, just in case anyone else might benefit). I agree with you that a cold limb can set off paraesthesia… any sensation that is received but not understood by the brain will. In fact, a few months ago I went for a walk, got half way so had a rest, and noticed my foot was full of paraesthesia… almost in a throbbing way. I thought, and compared my feet, and noticed with my good foot that I could feel the circulation racing around. Therefore, I concluded that the paraesthesia spike I was feeling in my bad foot was because I was not able to explain it as circulation . That understanding was a revelation, and became the way I moved forward with new understanding, or at least a new way to be inquisitive and mindful of my difficulties.
Eventually, fuzzy pain, buzzing, paraesthesia, numbness will settle, one little step at a time. I might have to be aware of the 3 “P” s in the meantime.
Ciao, Roland
@pando TBH this particular wind up has come at the worst possible time for me. My wife is in awful pain from her hip operation and can just about get to the bathroom and I’ve reversed roles as her carer for as long as it takes, so I’m having to do everything for both of us. Now this BP and blood test crap lands on my table. You speak wisely my friend, believe me I’m doing my best to relax but it’s hard right now. There’s a beer in the fridge for later, Cheers.
Mick,
Exactly what I’m talking about. Allow nothing and nobody to wind you up, especially not now. Try meditation (not medication) or getting in touch with your vagus nerve, at least (rest & digest). Easy to look up on youTube… some work / some don’t. I can imagine you’re under pressure, and now is not the time for any wind ups.
good luck, you’re doing great, Roland
Hi
Something similar happened to me recently when I was called in by a new doctor at the surgery for some sort of lifestyle evaluation.
Blood pressure,blood test .weight etc.
All eventually summarised in a follow up appointment with some recommendations .
The doctor has your best interests at heart so no harm in taking a few tests and listening to their advice.
Doctors are more expert on some things than we patients and we would be well advised to at least listen to their advice before deciding to take it or not.
For example I am on similar neds to yourself and my cholesterol reading was a little high .
I decided to make some lifestyle changes rather than move to a higher dose or different statin.This decision can be reviewed a few months hence.
We are all a little anxious after a stroke but I am now 13 years and counting since I suffered mine ,and no further stroke.
Good luck on your journey
Tony
Having been a doctors’ receptionist and before that an administrator who assisted with sending out letters, texts etc (I was sliding down the NHS career ladder long before the stroke) I do understand the logic behind their contacting you. They really are trying to be helpful even if their efforts are a bit of a pain. One job involved sharing an office with the practice pharmacists and although that has given me a biassed view I did find these people very understanding and helpful both in what they were trying to do for the patients and as workplace colleages. They can’t force you to take anything, only advise, and as with any advice you can take it or leave it. I hope that the other stresses in your life lessen soon.
I’ve been on Cloppy Doggerel as I called it to the nurses amusement and Atorvastatin for two years now. A couple of months ago I suddenly saw double. I checked with my optician who checked with our local eye hospital ( Princess Alexandra Eye Pavilion) who did a double take at the BP and confirmed it must have been a TIA hitting the optic nerve. Pressure then was 170+. GP prescribed Amlodipine. At the end of the month BP was down to 120-130 but I’d had morning nausea, a painful knee at night and a swollen ankle. Same GP ( not often I get the same one twice but I booked it online) says lets try Lercanidipine but have a blood test (kidney function) after a fortnight. OK for a week and then I am peeing every 1 1/2 hours. Next day hardly peed at all, darker colour so obviously affecting kidneys. I stopped taking it at that point. Settled down after a couple of days, when I had the blood test, spoke to one of the older hand GPs and when he head that BP was a steady 140/80 ish for a fortnight sais" that’s acceptable, we could try x but what do you think" and we agreed I would stop taking anything for BP but keep regular check on it.
I think the statin is affecting my voice and making for sore muscles, especially if I try to straighten a leg in bed, and I have another appointment ahead to discuss this, hopefully with one of the older hands with more experience than the workshop manual following younger staff.
Hope this helps!