Margaret

Margaret has rheumatoid arthritis, asthma and high blood pressure. After having a hip replacement in 2012 she is more mobile, has lost weight and feels much better. She was unaware of her kidney impairment until it was mentioned during a routine check-up.

Margaret has a life-long history of high blood pressure which was first diagnosed 45 years ago when she was pregnant with her oldest child. She also has rheumatoid arthritis and asthma.

Since 2000, Margaret has been taking blood-pressure lowering medication. She was attending six-monthly check-up appointments at her GP surgery, but assumed that this was due to being on tablets and did not know that the check-ups also involved tests of her kidney function. Margaret was unaware that she had decreased kidney function until a nurse, during one of the routine check-ups, mentioned as an aside that the kidney impairment is not bad at all. The nurse explained that her kidney impairment was the reason why she was having regular blood and urine tests. She also told Margaret that her kidneys might have been damaged by one of the blood-pressure lowering tablets Margaret had been taking. Shortly after, the GP advised her to stop that drug. Margaret is now only taking the ACE inhibitor lisinopril, which she has been told will protect her kidneys from further decline.

When Margaret was in her thirties, she developed rheumatoid arthritis. Over the years she had to put up with considerable pain and increased problems of moving about. However, in 2012, Margaret had a hip replacement in her left hip. This has greatly improved her mobility and has also helped with the pain she had been having in her right hip. She now only needs to take half the amount of painkillers that she was taking previously, though she still uses paracetamol and tramadol twice a day. Occasionally she also uses a TENS machine. For her asthma, Margaret takes Ventolin (albuterol) and Clenil Modulite (beclometasone) but feels that the asthma does not affect her as much as it used to since she lost some weight and has improved her overall fitness.

Margaret describes herself as a very obedient’ patient who will do as the doctor tells her and not ask any questions, even though sometimes she does not understand the reasons behind particular recommendations. She reads prescription leaflets carefully and is not interested in complementary treatments, though her daughter is very keen on them. Taking her medication as prescribed is straightforward and she has not experienced negative side effects.

Margaret has a good relationship with the nurses at her GP surgery and rarely ever sees a doctor. She actually jokes that doctors are bad for your health. She has 6-monthly blood and urine tests with the nurse and once a year gets a letter inviting her to attend the Vascular Clinic run at her surgery. She can phone up for her tests results and is happy to be told that everything is fine. She thinks being given more detailed feedback might just confuse her. As far as she knows her kidney function has remained stable over the last five or six years (a figure of 48 was mentioned to her) and she is not at all worried about her kidney health.

A few months ago the nurse advised Margaret that it would help with lowering her blood pressure if she could lose some weight. The nurse referred her to Slimming World, which has taught her a different way of eating that she found easy to fit in with her personal food likes. She enjoys the course and has already lost two stone, but is keen to continue and lose more weight. She now goes every day for a walk in a nearby park and also goes swimming a couple of times a week. Margaret enjoys socialising with friends or family and pursuing her hobby; making stained glass objects. Recently, she has also started going to a local aqua aerobics class.

Margaret feels well supported by health professionals, friends and family and thinks there is no point worrying about how her kidneys impairment might progress in future. Her main health concern remains her arthritis: she struggles to bend over (e.g. for cleaning) and worries about not being able to get up again after a fall. However, one of the wardens in her supported accommodation recently reassured her that they now have a new device to help lift up people if they should have a fall in their homes.

Margaret thinks that at the age 72, things are bound to get a bit more difficult health-wise and her attitude is very much that you’ve got to die of something. Nevertheless, she hopes to be around for a while to see her grandchildren grow up and she is proud of her recent achievements of losing weight and becoming more physically active again.

Margaret had been given vouchers from the NHS towards slimming classes and said she now felt healthier as a result of losing weight.

Age at interview 72

Gender Female

And I went to see the nurse last August. And she said that my blood pressure was raised. I had put on weight and she gave me vouchers to go to Slimming World and so far I’ve lost two stone two pound, and I can walk a lot further than I used to. So it’s actually doing me quite good. So, at the moment, I’m pretty healthy.

What would you say, what is it down to that you managed to do that because I have to be honest, I find it quite amazing that you managed to lose all this weight.

Probably because she said that the blood pressure had gone up because I thought, you know, although I say, you know, if your time is up, your time is up. I actually would like to sort of live long enough to see the grandchildren and, of course, I do worry about my son that is disabled but so I want to carry on as long as I can. So I was quite happy to sort of go on the diet and, well, it’s not really a diet. It’s more a way, a different way of eating and I’m never hungry. I’m going to have a massive great, I’m even having chips for my tea but they’re Slimming World chips. So they’re done with one spray of oil, you know?

That approach really works for you, the Slimming World approach.

Yeah, I like it. You get loads of stuff you can do.

Have you been dieting at other times of your life?

In two thousand and nine, I did lose two and a half stone in six months and did I try? I did actually try, years and years ago, but I didn’t get on very well. I don’t really know what, I can’t remember what that one was. We used to have to sit there doing all these silly exercises as well. So, no it wasn’t for me.

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Margaret didn’t know the medicine she had been prescribed had affected her kidneys until a nurse commented on her kidney impairment a couple of years ago.

Age at interview 72

Gender Female

So I’ve had high blood pressure problems for a long time and then, when it was in about 2000, the doctor, the GP I was with then prescribed tablets, which is the ones that damaged the kidneys a bit, apparently, but I didn’t know at the time that it had damaged the kidneys until a couple of years ago one of the nurses at the practice said about the kidney damage and I said I didn’t realise. And she said, that’s partly why you have the blood tests twice a year.

Yeah, well, ever since I’ve been taking the blood pressure tablets, I go to the doctor, I go to the nurse twice a year for blood tests. And I didn’t actually know that there was anything wrong with my kidneys until a few years ago one of the nurses said, she said, Oh, the kidney impairment is not bad at all. And I said, What do you mean? And she said, Oh well. She said, Haven’t you been told? She said, You’ve got a, you know, your kidneys aren’t functioning a hundred per cent. But she said, They’re quite good. And I said, No, I didn’t know and I never thought I had any problems, so So because I mean, up until then, I didn’t even know that they were impaired. I thought I was just having the blood tests because I was taking tablets. But, apparently, they can cause a bit of damage but- now I’m fine.

So when you, do you remember back to when she mentioned that and talked about your kidney impairment isn’t that bad

Yeah.

what went through your mind and what questions did you ask?

I thought, well, they give you tablets to cure one thing and it gives you something else. But then I’ve got friends that have had chemo for cancer and that causes even worse problems, so it’s just, you know, your kidneys don’t work a hundred per cent, fine. But they’re still working, so it doesn’t bother me.

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Margaret explains that because the bottles provided for urine specimens have such a narrow neck she first urinates into an old beaker and then transfers it into the small bottle.

Age at interview 72

Gender Female

That’s fine. I mean they give you the little phial to take. So I’ve got, in the bathroom, I’ve got a bright pink beaker and so the night before, I always wash it out, put it on top of the cistern so that I remember as soon as I go in in the morning, because it’s a mid-stream sample they want and it works fine.

So you’ve got, so that’s like a bigger one to get it into the small one.

Yeah. Yeah because I mean the phials are very tiny. Really, yeah.

Where did you get that from?

What the phial.

The beaker.

Oh, it’s one I had for the grandchildren, when they were younger, and they didn’t like them because they were bright pink.

And the boys said, the boy, because and that, I’m not drinking that. That’s a girl’s colour. So fine, so they never got used [laughs]. I’ve got one, actually, in the cupboard at the back out in the kitchen, which has got turps in it and the other one is in the bathroom. I don’t know what happened to the other two.

Okay. No, I thought it was like a special device.

Oh, no, no, no. No, it’s just that it, you can’t, these phials are so tiny.

And so I’ve found it’s quite easy.

Yeah

And I just put it on the top of the cistern. So that I think, must go. And I put a big note. I do, just for that, I put, wee sample, so that I don’t forget because first thing in the morning my head is a bit, you know, not [blinks her eyes].

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