Laura
Laura has had high blood pressure and kidney disease for 17 years and, although told her risk of kidney failure was high, her function has declined very little since diagnosis. As well as taking blood pressure medications, she uses complementary therapies and has changed her diet in a bid to stay well.
Seventeen years ago, aged in her early forties, Laura learned that she had high blood pressure and kidney impairment after having investigations for headaches that she had suffered with for about a year. She was shocked to be told that she had only 50% kidney function and that the chances of her kidneys failing within ten years was about one in three. She felt scared and was depressed for about a year after her diagnosis and felt that the doctors didn’t give her enough support to come to terms with what she viewed as a life-threatening condition. She asked for psychotherapy on the NHS but was offered a peer support group, which she chose not to join because she didn’t want to meet people whose kidneys had failed as she didn’t want to think that might be her future. She obtained psychotherapy privately, which helped her to overcome feelings of nervousness that had troubled her in the past and which she believed might have contributed to her health problems. She still feels scared by the thought of dialysis because she perceives it would complicate and limit her life, and she is needle-phobic.
Immediately after diagnosis, Laura was prescribed blood pressure medications: amlodipine at first, with lisinopril added later. She is keen on natural and complementary remedies and doesn’t like the idea of taking tablets but accepted that controlling her blood pressure with drugs was the right thing to do. She once declined a GP’s suggestion that she should take a statin to lower her cholesterol, preferring to try to control it with diet. She also decided not to have a kidney biopsy unless her kidney impairment became severe.
Since her diagnosis Laura has obtained information about kidney disease from books and the kidney charities to find out what, if anything, she could do to prevent her condition worsening, and in particular whether any complementary approaches might help. She likes to feel well informed about kidney disease so that if her kidneys failed she could act quickly to get on the transplant list and choose which type of dialysis to have.
Laura has made changes to her lifestyle in a bid to keep healthy and is surprised that her GPs have never talked to her about diet. Off her own bat she has reduced her salt intake and assumes that cutting down her alcohol consumption would also help her kidneys. She eats mostly organic, home-cooked, vegetarian food. During her menopause she swapped dairy milk for soya milk and wonders whether her kidney condition or the blood pressure treatment made her more prone to hot flushes. Since being diagnosed she has needed to go to the toilet about twice a night; she consumes nettles because she has heard that they are good for the urinary system. She went on a weight loss course and lost a stone and has recently obtained discounted sports centre membership through her GP. In the early days of her kidney disease Laura used homeopathy and herbal remedies. Nowadays she has acupuncture regularly and practices Reiki with visualisation.
For the first few years after diagnosis Laura’s condition was managed by a hospital specialist but she was later transferred to the GP for monitoring. She has moved area, and therefore changed GP, several times since her diagnosis and has experienced variation between the different GPs in the level of support provided to her and the way that check-ups are organised. At some practices she had to ask for tests whereas at her current surgery they call her in. She has blood and urine tests every six months, as well as using a home blood pressure monitor from time to time. Because of her needle phobia she doesn’t like having blood tests and has to consciously relax to allow the blood to flow. She is glad that the tests are not required more often. She phones the practice for the results and keeps a printout for her records.
Laura considers it lucky that her kidney condition was identified early. Her kidney function is only a little bit worse now (about 44% with a little bit of protein in her urine) than it was at diagnosis. She would like to know which, if any, of the things she is doing (medication, complementary therapies, lifestyle changes) is preventing further decline. She likes to think that the complementary approaches have helped but accepts that this cannot be proved.