Eric

Eric was diagnosed with chronic kidney disease stage 3A in 2008 while having investigations for anaemia. His GP has reassured him that it is not life-threatening, so he doesn’t worry about it. He is treated for hypertension, high cholesterol and gout.

In 2008 Eric learned in a letter from a consultant that he had chronic kidney disease (CKD) stage 3A after having an ultrasound scan in the course of investigating possible causes of his anaemia. His kidney condition doesn’t cause him any symptoms and he wouldn’t have known he had it if he hadn’t been told. He has a good relationship with his GP, who explained the condition to him and reassured him that no treatment is necessary as it isn’t serious in his case. He feels he knows as much as he needs to about his kidney condition and does not worry about it. He feels it is important to see the same GP all the time and is prepared to wait a few days for an available appointment either in person or on the phone rather than seeing a different doctor.

Eric has a blood test every six months to check his kidney function; he usually waits about a week for the results and asks to be told the numbers. His most recent test result showed better kidney performance than the test before it, so he is shortly going to have a repeat test to check if this is a genuine improvement or whether something went wrong in the testing. He doesn’t mind having these tests or waiting a week for results; he appreciates having regular monitoring because it shows that someone is looking after him. He has had urine tests done on occasion but these are not done routinely. His blood pressure is checked whenever he sees his GP or practice nurse.

Eric is being treated with medication for high blood pressure, high cholesterol and gout. He suffers from breathlessness and has pain on walking due to an arterial blockage in one of his legs which cannot be operated on. He also lives with arthritic pain in his back and has had some bone removed from his shoulder. Eric is unsure why he has developed CKD but knows it can happen as a result of increasing age. Since retiring from the RAF he has been more in control of his diet, which has as a consequence become healthier, consisting of his home grown vegetables, fruit, nuts, meat and fish. He also drinks less alcohol than before.

Eric accepts his GP’s explanation that kidney function may decrease as you get older, because he is aware that other aspects of bodily function also decline with age.

Age at interview 79

Gender Male

When you first saw the GP about your chronic kidney disease do you remember the explanation that she gave you?

No I don’t think I do.

Don’t worry it’s not a test [laughs].

No it’s a I think when I see my GP weve got a very good relationship and we tend to sit and discuss things rather than her telling me or me telling her what I want to do, although I’m quite forceful if I think something should be done I will try and convince my GP to have it done for me, but weve got a very good relationship.

So how do you feelsorry, carry on.

But as far as an explanation of why the kidneys aren’t working perfectly, she did, most recently, tell me that kidney function decreases as you get older, and I accept that as being the case like everything else. You get older you lose your memory and things, but no, as far as someone saying it is because you have done something wrong in your past or something else is going wrong at the same time which is affecting your kidneys, I don’t know, I don’t know. But as I said before, if somebody hadn’t told me I wouldn’t know. I don’t think I would know now.

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Having only recently learned of his kidney disease, Eric finds it hard to understand how it can be referred to as chronic. This term also makes it sound more serious than it is.

Age at interview 79

Gender Male

So do you remember how you felt when you read that in the letter about having chronic kidney disease?

I couldn’t understand how I could be described as having chronic kidney disease when it had only just been discovered. Chronic’ to me means well maybe mistakenly that I’ve had it for a long, long time. But I’ve noticed that chronic’ seems to be a word that a lot of medics use quite frequently and I’m not sure it actually applies in all circumstances, because other conditions I’ve had and got have been referred to as chronic’ anaemia. I’ve never had any treatment for anaemia, like I’ve never had any treatment for kidneys, but they keep using this work chronic’ and I think the word chronic’ makes it sound worse that what it is, to me anyhow. My interpretation of chronic’ is that it’s bad and you’ve had it a long time, but I don’t think that’s the case.

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Eric’s kidney impairment was detected through a kidney scan as part of hospital investigations into the cause of his anaemia. He found out about it when he received a copy of the consultant’s letter to his GP.

Age at interview 79

Gender Male

Whilst being investigated for anaemia I had an ultrasound scan of my kidneys in June 2008. As a result of that scan whilst seeing a specialist at the chest clinic in his report indicated that I had chronic kidney disease stage 3A. My GP obviously picked this up when the report was sent to her and since then I’ve had six-monthly blood tests and the results have varied, not considerably, but there has been some variations in the readings which indicate how my kidneys are working. I have never had any problem with my waterworks and if somebody hadn’t told me that I’d got chronic kidney disease I wouldn’t know – I get no effects at all of what is happening to my kidneys.

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Eric wonders whether heavy drinking during his time in the military may have contributed to the development of a mild kidney impairment. He hardly drinks at all now.

Age at interview 79

Gender Male

Do you have any thoughts about why you might have developed this problem with your kidneys?

I used to be a party animal. Being in the military it’s very easy to be a party animal. The drinking may have had something to do with it but I’m not sure. I think drinking would more likely affect your liver than your kidneys. I think this is just something with my kidneys which is that they’re not functioning as they should do, but at seventy-nine years of age I accept that.

Has your GP ever offered you any lifestyle advice?

No [laughs]. I was a party animal long before I knew my GP.

Do you still drink a lot now?

No, no I hardly drink at all now. See I’ve gone from I stopped my drinking heavily in when I was fifty-five – twenty-four years ago and now I don’t even go out to pubs. I go out to pubs to have a meal but I don’t physically say, “I’m going down the pub to drink”. But I’m not sure whether drinking had anything to do with my kidneys; as I say, I think if my liver had failed I would say, “Yeah I know what caused it”, but I’m not sure what caused the kidney problem. You know, if doctors can’t tell me how can I fathom it out?

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Eric thinks it’s unforgivable for doctors not to inform their patients of a condition they have diagnosed, even if it is mild. However, current appointment systems can make it harder for GPs to know their patients well.

Age at interview 79

Gender Male

I can’t imagine why someone would be a doctor if they can’t tell their patient what’s wrong with them. You know, surely it’s part of the thing, that you discover something about somebody, you tell them what it is. It’s unforgiveable really to think that a doctor would know and not tell you. Well I have heard in the past of people not being told when they’ve got serious things, but I think it’s a very bad thing if it happens.

The thing is I think it’s not as black and white as that, because it’s not a serious thing, this is the point, it’s a relatively, I can’t think of the right word, but it’s not usually serious and so for that reason they don’t like to worry people about

But then if they don’t want to worry people really do they know that patient all that well? If they think by telling them something will worry them surely they don’t know the patient.

If they don’t this is a problem of seeing too many GPs in a surgery; they don’t know you. So I can understand if a GP doesn’t know how somebody’s going to react to being told something, that they wouldn’t tell them, but I still think it’s wrong. They should be able to extract enough information from a patient’s notes to know a bit of the psyche of that person and how they’re going to react to something like that.

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Eric was confident that any changes his GP wanted to make to his monitoring regime would be discussed with him.

Age at interview 79

Gender Male

How would you feel if your doctor wanted to change the way you were monitored, like the frequency or how it was done?

It wouldn’t be done without a lot of discussion. We would have to agree on it and I’m sure my doctor would not just ring me up and say, “I’m going to change your blood testing regime”, we would discuss it before she even got before she picked the phone up shed know that really we should discuss it.

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