John

John has high blood pressure and osteoarthritis. He has had surgery for spinal stenosis and three knee replacements. His decrease in kidney function was discovered during a routine blood test.

John has high blood pressure, osteoarthritis and a hiatus hernia which he has managed to control for the last 20 years. He has had knee replacements in both his legs, which themselves are now in need of replacement. He has had one knee done and is awaiting the operation for the other one.

In 2011, John developed pins and needles in his toes. An MRI scan showed that his osteoarthritis had caused spinal stenosis (nerve compression due to a narrowing of the spinal canal). An operation on his back helped to alleviate the problem and John feels generally in pretty good health for his age now. He is able to take longer walks again and he plays golf twice a week.

However, as part of the checks for the operation on his back, it was found that John had a reduced platelet count. This was a very anxious time, as there was a suggestion that he could have leukaemia. John decided to use his private health cover to have further investigations as he wanted to have an answer as quickly as possible. Luckily leukaemia was ruled out but there was no conclusive explanation for the drop in platelets, so John requested to be monitored every six months for his own peace of mind.

More recently, John has started taking medication to help control his high blood pressure and cholesterol. He is taking an ACE inhibitor (perindopril) and simvastatin. He was not keen on taking medication at first as he saw it as a sign of weakness. Also, John’s mother had developed kidney damage from the drugs she had been prescribed for her rheumatoid arthritis, so John was very aware of the negative side effects medication can have. However, he was able to discuss his concerns with his GP and was glad that the GP did not try to force him into it. In the end, he decided taking the medication was better than risking a heart attack. He now finds taking his tablets straightforward, though he sometimes forgets a dose.

John’s decrease in kidney function was detected only recently during one of the routine blood tests that also checked for his platelet count. His GP asked him to repeat the test to make sure that it was not a rogue reading’. He then explained to John that he had early stage Chronic Kidney Disease but that it was unlikely to cause him any problems for another 30 years which at the age of 74 did not overly concern him. His GP also explained that his kidney function was negatively affected by his high blood pressure. John bought a home blood pressure monitor and started using an App, BP Monitor, to record his readings and managed to bring down his blood pressure with medication, diet and exercise At a recent GP appointment, John was told that his blood pressure is now under control’. When John suggested that he might use his private health insurance to see a consultant for a second opinion about his kidney function, he was told that his last two tests were normal’ though his GP did not tell him any specific test results. John now feels sufficiently reassured and no longer considers himself to have a kidney problem’.

John is pleased that his GP has organised for all his regular tests kidney, liver, and platelets – to be rolled into one visit to the nurse in future. John is glad that his GP told him openly about his decrease in kidney function. He thinks GPs should be sensitive enough to know how much information each individual patient can cope with. Also, GP surgeries should be more proactive in encouraging patients to have check-ups, though he acknowledges that they operate under financial constraints.

John had three tests in a row that showed his kidney function was dropping, so he was diagnosed with chronic kidney disease; his kidney function has since improved through controlling his blood pressure.

Age at interview 75

Gender Male

John only uses reputable websites to look up health information. He was reassured by the information he found about kidney impairment.

Age at interview 75

Gender Male

John had been reluctant to take medicines at first and talked to his GP about possible side effects and the risks of refusing treatment. He has now become used to taking his tablets.

Age at interview 75

Gender Male

John believes that at age 75 he is over the hill’ and his health will only decline, meaning that his kidney performance will not get any better.

Age at interview 75

Gender Male

John appreciated his GP taking a direct approach and telling him he had CKD. But doctors need to be flexible in how they communicate a diagnosis to individual patients.

Age at interview 75

Gender Male

John has started taking an ACE inhibitor to lower his blood pressure and will be monitored to ensure this drug does not adversely affect his kidney function; in future all his health conditions will be monitored through a single blood test.

Age at interview 75

Gender Male

John thinks of his kidney impairment as a normal part of getting older. His GP assured him it was unlikely to become a problem for 30 years.

Age at interview 75

Gender Male