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Kidney health

Lifestyle Changes

Diet

Some people we spoke to said that their diet was already healthy, so they hadn’t needed to make any changes. Others said that they had changed their diet, for example by reducing the amount of salt, fat or sugar they ate.
 

Jackie couldn’t recall anyone ever advising her to reduce her salt intake because of her kidney problem, but she did it herself as part of efforts to maintain a healthy lifestyle.

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Age at interview: 59
Sex: Female
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I have a low salt intake. I try to have low fat food but I do occasionally splash out on things [laughs]. But overall I think I have a really healthy diet and it is all about sort of trying to maintain a sort of healthy lifestyle.

Is that something you’ve discussed with any of your doctors over the years or have you just done it all off your own bat?

Surprisingly I haven’t discussed it with the doctor. It’s, even, when I think back, even though it was well known about having a low salt diet if you have a kidney problem, it was never actually mentioned to me. It was just something I did myself because I was aware of it. But I don’t recall anyone ever saying to me, “You should have…”, you know, “Restrict your salt intake”, which is quite interesting, because, whether someone just assumed that someone had said this at some point [laughs], you know, which, you know, is I guess, you know, could have been the case and they thought, ‘Oh well, she’, you know, ‘Someone will have said this’, but actually nobody did.

So has any health professional given you any advice about diet ever?

No. I don’t think so. Recently, the GP at, I see, it, but it was a kind of general, you know, about taking care of yourself generally. I think it was a, it wasn’t an in depth. It was just a, you know, low salt, healthy weight, you know, but not specifically, no.
 
Justine says she improved her diet after learning that she had high blood pressure. Eric’s had improved since retiring because he no longer ate fry-ups in his workplace canteen. Laura eats a largely vegetarian, home-cooked, organic diet. She had declined an offer of medicines to lower the levels of cholesterols in her blood, preferring to do this by dietary means. By contrast James eats whatever he likes but takes medicine to control his cholesterol.
 

Royston Y cut down on cheese after being advised by a nurse that his cholesterol level was raised. He was also given written information about healthy eating and is careful to stick to this.

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Age at interview: 82
Sex: Male
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Have any of your doctors talked to you about changing your lifestyle at all as regards kind of diet or exercise or anything like that?

Not recently, no.

But a while ago?

Yes, yes, I was given, before I moved here actually I was given a diet, you know, a diet sheet by a nurse who was about twice the size of me. But, [laugh] which rather amused me. But still. And I have tried to be careful what I eat.

Yes.

All right, I might go over the top occasionally, but basically I do try to be careful.

So what sorts of things do you eat?

Well, I mean I’m very partial to fish and white meat. I know I said I had sausages today but that, that’s, I don’t have that every day by any means. And usually with vegetables, and w-, sometimes fruit after, afterwards.

Sounds healthy enough to me.

Yes, yes, yes.

Yes. Do you cook for yourself?

Yes.

Good.

Well, unless I’m going out somewhere. But even if I go out, generally speaking I’ll, I’m usually quite careful what I choose, nothing too rich. And I don’t normally have puddings.

Oh, that’s very restrained of you.

Yes, as I say, I don’t normally [laugh].

[Laugh] You have to treat yourself sometimes.

Well, oh, yes, yes, just occasionally, yes.

Yes, yes. So why was this nurse worrying about your diet?

I can’t actually remember. I suppose I might have had a blood test and it might have been a bit high or something like, oh, the cholesterol, that’s what it was. The cholesterol was a bit high and I should, I shouldn’t eat so much cheese and this, that and the other.

So did you change your diet?

Yes, I did.

Oh.

I did.

Well done.

[mhm]

You’re a compliant sort of a chap?

Yes. I still like a bit of cheese.

Yes.

But, yes, no, but again, not to the level that I was. I was eating cheese every day.

Oh.

Which I don’t now.

Right. And did you lose any weight as a result?

Yes, a bit, yes.

 [mhm] Good, well done.

Yes, yes.
 
Changing one’s diet can be very hard, particularly for people with other health problems that limit what they can eat, such as diabetes, or gastrointestinal conditions such as diverticulitis, hiatus hernia, colitis or Crohn’s disease. Fortunately, almost all health conditions can be helped by eating a healthy balanced diet that is low in salt, fat and sugar and includes lots of fruit and vegetables. Some foods must be avoided when taking certain medicines. For instance Simon had to avoid grapefruit, cranberry and foods rich in vitamin K (such as green vegetables) because they reduce the effectiveness of warfarin. Grapefruit can also interact with some types of blood pressure lowering medicines, and with statins used to control cholesterol.
 

Anne recalls a GP suggesting she should not eat too much fruit and vegetables because of her colitis. She describes her daily diet, which is also limited by diabetes.

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Age at interview: 71
Sex: Female
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Tell me about your diet because I imagine it’s a bit restricted; both because of the diabetes and the colitis.

It is a bit restricted. But I’m fortunate in that I like what I like.

I have Cheerio’s each morning and I think ‘well, they’re probably a good thing, whole wheat cereals and so on’. And I tend not to have much round about lunch time, might have a couple of digestives to keep the carbohydrates going. And I’m fortunate that, although I don’t cook, there’s a family member who will cook most days. So I have things like chicken, rice; I like ham. I tend to not have many vegetables. I understand why five a day is recommended for most people. But I remember the GP a long time ago, saying, “Yes, I realise that a lot of vegetables is not going to be a good thing for somebody with colitis.” So I perhaps have a lot less fruit and vegetables than most people. And supper time, I usually have something like, sort of, cheese and biscuits. And I tend to have quite small quantities and to eat quite slowly because that’s the way I eat anyway.
 
Lesley found that certain foods or drinks gave her symptoms that she attributed to her kidney condition but could also have been caused by other things; she had found it helpful to follow dietary advice aimed at people with more advanced kidney disease. Symptoms don’t usually occur until kidney performance reaches stage 4 or 5; Jim B had adopted a special kidney diet when his condition reached stage 5.

Some people had been advised or had read that they should keep their fluid intake up. While drinking a healthy amount of fluid will prevent dehydration, it is not known whether drinking a larger volume of fluid than normal can slow down the progression of kidney disease.
 

A GP considered David’s diet to be healthy but advised him to keep his fluid intake up. This was easy for David as he frequently went to the tap for a cup of water anyway.

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Age at interview: 78
Sex: Male
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And did you have any questions that you wanted to ask about maybe things that you could do to help your kidneys – anything like that?

I was advised… I didn’t ask questions, I was advised to keep my liquid intake up with them and in particular water.

So did you make any changes or ?

Well I couldn’t make many changes because I've always been a big drinker of water. I was always up to my- what they recommend your daily intake of liquid was and I was forever going to the tap and a mugful of water, it's never been a problem drinking water.

Did your GP give you any other advice on food or was it just drinking water?

Just the drinking of the water because she'd asked me what my diet was and she was happy with my diet.

And what is your diet?

Well much and varied. I like all food – plenty of veg. Even now I'm by myself I'm cooking… cooking meat, potato and three veg every day for myself.
And sugar is, hardly ever use sugar at all. If I do a bit of cooking – baking which I do sometimes – I use sugar then but a bag of sugar lasts me for months and months and months.
 
Other factors affecting how easy it was to change dietary habits included having to cook food for other people or if arthritic pain or poor mobility limited the amount of time they could stand up to cook meals. Elizabeth pointed out that living alone meant there was less incentive to cook proper meals. Simon was just getting over a cold and said he wanted to eat more healthily but that, ‘when you’re feeling like absolute rubbish you want to eat rubbish’.
 

Betty likes cooking for herself but doesn’t do it much these days because of pain from a back problem when she stands for any length of time.

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Age at interview: 89
Sex: Female
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Then I had the trouble, as I say, with my spine, and that was, that was about, can I say six years ago, about six years ago. And I had to have an operation and, oh I can’t say, can’t say the name of the doctor. I was operated on by a neurosurgeon and he removed all the pressure from my, from two of the lobes of my spine and he hid a lot of nerves and things like that. But it, I was told it wouldn’t last forever and he couldn’t do any more. But it has been very good but now it’s starting to feel really bad again. I can’t, if I stand for a while, I can’t, I used to like making cooking and doing cakes, if I stand for more than like, I get this terrible pain and I have to, it’s like , it’s like somebody jabs your teeth when you’ve got a bad tooth, somebody jabbed. I have to suddenly go like that and sit down. It goes. It does go and then it’s okay again, so it’s that sort of thing I’ve got. I have good days and bad days with all of those sort of things.

Yes and she weighed me and I eat, as I say, very little and I can’t cut down on what I eat because I really choose what I eat, you know, and I always have porridge in the morning. I must admit I have a little brown sugar on it, I mean I know that. I have, try and, midday I have, I used to have it in the evening but it’s, I couldn’t cope with it in the evening, after a while, so I have it at lunchtime, you know, and I always have something. A lot of chicken. I have fish. I like those packs, do you know, do you know the ones? They’ve got all the chopped up green stuff and everything in.

You know, I have that. I like that with perhaps some chicken or something like that. If I make, I make a soup, I do it, I make my own soup, like, you know, I just shove everything in. I do like cooking and everything, you know, but, as I say, with my back, I have to have to keep sitting down, so I don’t do much these days.
 
 
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Since Elizabeth has been widowed she hasn’t bothered to cook elaborate meals for herself but has a roast dinner at her daughter’s house on Sundays.

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Age at interview: 74
Sex: Female
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I suppose diet's got a lot to do with it, because I don’t eat like I used to, because there's no point in cooking like I used to. I mean I've had a family and cooked, and I just eat what I like now, which half the time it isn’t, I suppose it isn’t a good diet, but I have a bit of everything – you know cheese, milk – because they want to know how much milk I drink. Well I don’t literally drink milk but I have it in coffee. Only have weak milky coffee, so average half a pint a day, and cheese a couple of days a week. But other than that I mean it could all be down to diet I'm sure. I've never been a fruit eater but I have tried to start eating a bit more fruit. But you know, when you’ve got a family you cook, don’t you, and then… I mean my husband was a big eater, as ill as he was, he still loved his food.

So what sort of things do you have for your meals these days? You were saying you don’t bother cooking like you used to.

I prefer fish to meat. I do eat quite a bit of fish. I don’t know, I mean jacket potatoes and cold meats and pickles and things like that I like. I go up to my daughters every week and have a roast dinner on a Sunday, so [coughs] at least I get vegetables there.

But, and I cook for my little granddaughter two or three days a week but she only wants chicken dippers and chips and things…
Some said they would like more advice and information about how they could change their diet to help their kidneys. Others had seen a dietitian, usually for conditions such as diabetes, or had received dietary advice at cardiac rehabilitation classes.
 

When Gordon attended rehabilitation sessions after a heart operation, as well as doing exercises he was advised on how to eat healthily to protect his heart.

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Age at interview: 72
Sex: Male
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And then as part of your rehabilitation after the heart operation you’ve been given advice on eating and obviously you’ve been going to the exercise class?

Yeah

Can you remember what kind of things you’ve been taught in the classes, what was helpful to you, what do you remember? …Especially around diet?

Well it's all …oh God that’s a job to think about that. I mean they told us we've got to eat; you need fish, oily fish at least three times a week. …Brown bread, not so much white but I'm not a keen lover of brown bread. …Cereals …do eat lot of cereals and all that so… and there's a lot of things that I can't remember now, they were to, they were pretty good with us …you know?

Well you don’t bring… you know you can't remember them all. I look after myself and I mean I'm the right weight. So I'm happy.
 
Weight loss

Some of the people we spoke to wanted to lose weight but found it very difficult. Donald said he had failed to lose weight despite changing his diet because of his diabetes. Flo said she was too old to bother at age 70.
 

A nurse told Betty that she is overweight, but as she is relatively inactive because of mobility problems and already eats healthy food in small quantities, Betty doesn’t know what else she can do.

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Age at interview: 89
Sex: Female
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Let me ask you…

Yeah.

…when the doctor said to you recently that you were overweight…

Yes.

Was she suggesting…

No, it wasn’t a doctor. It was the nurse.

Oh was it?

She said, “You you’re getting quite obese.”

She used that word?

Yes.

Really?

Yes and I said to her, “I’m very sorry but it isn’t what I eat.” I said, “It’s because I can’t walk or do anything.” I’ve always been so active, you see, and I’ve always walked and walked and walked. Well, of course, stopping that and, as I say, I just can’t cut down any more on my food. Sometimes I, as I say, I’ll have some lunch and then afterwards I won’t , sometimes I don’t even have anything else. I might have just a , sometimes I have a small sandwich about tea time but sometimes I just have a sort of small slice of cake, and that’s it. That that’s what I eat, you know…

…it’s well, my carer, when, you know, when she comes and, she knows what I eat, you know, so it’s no good me trying to bluff because, and say I don’t eat this and that and the other, she knows exactly what I eat and she said to me, “Betty, you can’t cut you can’t cut down anymore.” So….

Was the practice nurse suggesting that you should change your diet in some way?

No, she didn’t say. She just said I was overweight and getting on towards being obese.

So, but she wasn’t suggesting you should do anything?

No, no. Well, I, but the food I eat is the healthy food.

Chicken, you see. Make my, sometimes I have soup. I buy a tin of soup for an emergency. I have a couple of tins in the cupboard. But usually, I make my own soup and, as I say, it’s a lot of, I like green stuff and I like, well, I do have potatoes, I must admit, I do have potatoes, but I don’t know what else I, you know, I can do.
 
 

Donald has diabetes and receives dietary advice from a dietitian but has not lost weight. He often eats out because he lives alone and finds it tempting to snack to keep his blood sugar level up.

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Age at interview: 60
Sex: Male
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Those changes you've made to your diet and stuff, was that… have you done that off your own bat or was that suggested by your GP?

Well no it's been suggested by a dietitian, I've seen a dietitian from time to time – gives me a sheet of what I should drink, what I should eat and what I shouldn't eat, and I largely try and stick to, but ‘cause if you live on your own it's not, you haven't got anyone else sort of pressuring you, have you, so you tend to go for fast food anyway. It's easiest to go out and have something to eat rather than, you know, stay in. Well I like to get out in the evening, I'm not working, I like to get out the evening anyway rather than staying at home watching some stupid soap opera [laughs]. So , you know, so I think your lifestyle a little bit, when you're on your own you just tend to be a little bit different from someone who has a partner or married or have children for instance.

So when you first got to see a dietitian was that something the GP organised or…?

Yeah it was organised through the GP, yeah. I've been seeing a dietitian on and off for several years. In fact I saw one, first time I saw a dietitian was back in 1989, so that’s going back some time. So I've seen dietitians over that time, different ones.

And do you think you've benefitted from the changes…?

Well I think it helps, I mean I haven't generally lost a lot of weight but I think it helps in education – it gives you an idea of what to… you know, it gives you a good indication of what level of portion sizes and everything else, that's always very important when it comes to eating; it’s not just how much you eat, it's… well it's not so much how often you eat, it's portion sizes.

Because with diabetic… with being a diabetic you tend to possibly eat a bit more because the fact the high… the possibility of going hypo, there is a tendency to snack a bit more, you know, just boost up the sugar level, there is that tendency.

So, I'm sorry, did you say you had or you hadn't lost weight?

No I haven't lost weight no, no – if anything I've put it on. But, you know, it varies, sometimes it goes up then sometimes it goes down, you know, so it's round about the sort of… it's not the highest... At the moment I'm about two stone less than I… the highest I've been but several stone more than I used to be when I was about fifteen years younger, you know, so. But of course your metabolism slows down the older you get as well so. And there’s a lot of people I know I haven't seen for years, suddenly I felt, “Good lord”, I hardly recognise the person who’s put a little weight on around the face and that sort of thing, because obviously the older you get you slow down, don't you don't burn as many calories. Mm.
 
Many of those who had lost weight had done so by attending slimming classes such as Slimming World or Weight Watchers. After attending classes Justine found she lost weight not just by cutting out certain foods but also by eating more vegetables. Not everyone who had lost weight managed to keep it off. People who are taking diuretic medicines (water tablets) may find their weight changes according to how much fluid they are retaining at any particular time.
 

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

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Age at interview: 72
Sex: Female
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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.
 
Physical activity

Some people we spoke to considered themselves reasonably fit or said they were on their feet all day so didn’t feel they needed to increase their levels of physical activity. Health or mobility problems limited other people’s ability to be active, but most tried to do some level of activity. Walking was popular although Ian said his Chronic Obstructive Pulmonary Disease limited the distance he could walk on cold days. Other forms of activity included gym exercises, gardening, golf, cycling and swimming.
 

Flo has multiple health problems and finds that the exercise advice offered to her by health professionals is often unrealistic for her circumstances.

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Age at interview: 70
Sex: Female
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What about lifestyle such as diet and exercise – is that something that was discussed by the GP or your nurse or the hospital consultant in relation to your kidneys in particular?

When you go for your yearly… MOT the nurse says to you "Your cholesterol level's high or it's low." If it's high she'll discuss, you know, are you taking… do you eat…(whispers) cheese is my downfall.

And it's, you know, sort of, "Less of the cheese if you don’t mind or less of this so you know, sort of take that steady, you're not too bad but you're just creeping up again." When it comes to exercise she says to me, "Do you do twenty five minutes brisk walking every day?" Now, I can't even walk to the bottom of the street. How on earth do they think I'm going to do a brisk walk of twenty five minutes every day? So then I got told, "Well no well we appreciate that; how about …walk nice and steady," and I'm using a walking stick mind, "Nice and steady, don t worry about it. Walk until you're tired then turn round and walk back." Now if you walk that way until you're tired there's no point in trying to turn round and walk back again because you're too tired!

So when you explain that they say, "Yes alright then; now how many times do you go up and down stairs in the day?" That’s enough [laughs]. Because all of a sudden they can see that it's silly, there's no point.
 
 

Barbara cannot walk as much as she used to but does walk every day when taking her grandchildren to school and back or to the shops.

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Age at interview: 69
Sex: Female
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And have you also had discussions about your lifestyle – you know diet and exercise and those kinds of things? Is that something you've discussed with your GP?

No because I do walk quite a bit. I mean I take my grandchildren to school and then go and fetch them and I do that three times a day or I'll walk to the shops and walk, you know, walk back and everything else like you know? so…

So you feel you're getting quite a good bit of exercise?

Well I don't walk… I'm saying I walk but I do not walk so much as I used to. I mean when they were small I used to walk from here right down to [name] Road and I used to walk from here right down to [city area]. Down by [city area] and walk all the way back home. I mean I don't do that now, that is a bit too much for me now like you know? But I do try and walk quite a bit.
 
 

Following an operation on her spine, Jackie Z has had exercise on prescription from her GP, which she gets at her local gym, in addition to regular physiotherapy at hospital.

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Age at interview: 70
Sex: Female
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So what are you doing at the moment? Have you got some rehabilitation programme still going on?

Yeah I've got a programme of physiotherapy exercises from [small local hospital], physiotherapy department, and I also go to the local authority gym in [suburb] here on the Exercise… Exercise on Prescription it's called.

Which is great. I asked for that because I'd heard about it and the GP said, "Ooh yes we can put you on to that," and that’s been great. Because you go to the local gym; all your medical details that the gym needs to know are there on the computer for them and there is a person there who is actually employed by the NHS to look after all the people referred and make sure you don’t do anything to damage whatever's wrong with you.

Which is great, it's very reassuring and I was building up beautifully before I fell and broke my hip [pulls a face].
 
Smoking

Among the people we spoke to were those who had never smoked, those who had smoked in the past and successfully quit or were trying to quit (either with professional help or going it alone), those who had cut down or were trying to do so, as well as current smokers.
 

Russell gave up smoking 22 years ago after finding the smell of a friend’s cigarette revolting when he was recovering from the flu.

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Age at interview: 84
Sex: Male
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And have you been given any advice on your lifestyle, so by that I mean diet, exercise, smoking, drinking…

I don’t smoke. I haven’t smoked for… I haven’t smoked cigarettes for about twenty two years and I gave up just like that [shrugs] and that was it.

The only time that I ever felt ill was when I had flu at Christmas and I gave up smoking. And I was… I came home on the Christmas… I came home and I was absolutely shot for about a week before Christmas and I went through this week and the flu was terrible. I could not even drink a cup of tea could I? And I… got through the flu and decided to go out to a game of skittles and I got there and my friend said, "Oh I'll come and mark up on the board with you," and he put his cigarette in a wet ashtray; …he put his cigarette down in a wet ashtray and this cigarette burnt out in a wet ashtray and it burnt out right the way up to me. And the smoke that came out of it was absolutely revolting smell.

And I thought, 'Blow me I've been pushing all that rubbish down my neck all these years I ‘ve been smoking?'

And that’s when you gave up?

And I gave up smoking that day.
 
 

Liban stopped smoking about 12 years ago immediately after learning that he had diabetes.

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Age at interview: 73
Sex: Male
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And smoking – I was smoking before. But no more.

When did you stop?

When did I stop? [looks to ceiling]…about 12 years, I think so.

Yeah. Was it hard to give up?

Just [makes hand throw over shoulder gesture] I stop.

Just one day?

Yeah when I know anyway I have diabetes.

Mm okay

It’s not so good. Diabetes and smoking is not so good together. I stop before something is happening. Otherwise, something is happening - when something is happening it’s too late.

Yeah

Because it stops all the blood, this one. [points to his fingers?] And then it was late, you see?. So I stop it.
 
 
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Mike was referred for professional help to quit smoking. For four months he sucked a nicotine lozenge whenever he craved a cigarette. He hasn’t smoked since.

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Age at interview: 36
Sex: Male
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Have you had any lifestyle advice about diet or exercise or anything like that as part of your consultations with the GP or nurse?

Yeah, yeah. I got told to lose some weight and I got told to stop smoking and . So I stopped smoking and that was a year ago and , but I haven’t lost any weight [laughs]. I just haven’t…

It's a bit much both at the same time I guess [laughs].

Yeah, yeah, yeah. My job is fairly sedentary so it doesn’t really… it's not conducive to being a, you know, a fit and active person, but you know, I fully intend to- to look at that and do something you know. But…

Was that…when did that happen? Was that right at the start in 2009 when you had the diagnosis or?

No, no that was, well it was a year ago – I went to see the nurse and it was about this time.

For the kidney and the blood test and she weighed me and… and she asked about smoking and , from then she gave me an appointment with the 'stop smoking' lady and I went to see her and then… following that I've given up smoking, and she gave me a booklet about a healthier diet, you know, so that was… but I haven’t read it so… [laughs]. Yeah so I did the smoking thing but I didn’t do the diet thing.

Well done on giving up the smoking.

Thank you.

How was that – did you find that helpful, the 'stop smoking' lady? How does that work?

Yeah the- the lady… well I don’t know , I don’t know what her sort of remit is but you basically go in and talk about your habit and you blow into a carbon monoxide machine which registers the amount of carbon monoxide that you're breathing out, and she records that. She prescribes you some stop smoking aids, in my case I had lozenge mints, and then… you go away really. She gives you some information, some generic information that you can read up. You go away and then use the- use the stop smoking aids when you feel like smoking, and then go back to see her at a pre-prescribed time, like a month later, and the same process happens again – you blow into the machine and then she gives you a bit more of the stop smoking aids if you want, and I'm pretty sure I took… it was… four months to stop using the stop smoking aids. So it took that long a time to…

You did it quite gradually.

Yeah I stopped smoking on the…in February last…the last day was the fourth, and then I was using these pill things, the little mints. Every time I felt like smoking I'd suck a mint and then it would stop me feeling like it, and I was just using those for a while and she said it's better to keep using the mints rather than smoke cigarettes so, you know, that’s why it took four months to stop. But then, since then that’s, you know, I've not smoked in, you know, on the…yeah I'm very happy about that.

Yeah. I don’t know whether that’s improved my health, I don’t know. Well I'm sure it's improved it but I don’t know whether it's improved my condition that we're talking about here.

Yeah mm

But it's definitely, you know, definitely a good… yeah I'm happy I've done it you know.
 
Roy had declined professional help in his efforts to cut down. He found it difficult to cut down as his wife still smoked. John X had been advised to quit smoking and reduce his alcohol consumption. He found it too difficult to do both at the same time, but has succeeded in cutting down the number of cigarettes he smokes. Lesley enjoyed smoking and had not tried to quit because she was afraid to fail in her attempts.
 
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Elizabeth is trying to cut down from 20 cigarettes a day to 10. She feels that health professionals have little patience or sympathy with smokers.

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Age at interview: 74
Sex: Female
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You mentioned that you still smoke. Have you…how much do you smoke?

Well I'm trying to cut it down to about ten a day. Some days I'm good and another day I'm bad, it all depends how I feel really.

How much do you smoke on a bad day?

Twenty. Yeah well that’s… in twenty four hours, I mean, because if I'm up in the night you see that’s the trouble but…

You'll have one in the night if you're awake?

Yeah I get up and have a cup of… I did it at half past three this morning – have a cup of coffee and a biscuit and a cigarette, and then I read for a while and then I go back. I went back at five o'clock. I've been like that since my husband died.

Not every night [coughs] but most nights.

Mm. How long's that then?

Seven years, be eight… yeah, seven years in February.

So what have you done to try and give up your smoking?

I've got inhalator. I had patches last time – they did help – but I'm not mind-set to give it up that’s the trouble.

I'm not determined to give it up and that is the worst thing, isn’t it?

Yeah, yeah. And see my husband he had to give up drinking and smoking overnight. He had cirrhosis of the liver and a lung thing and heart trouble, and he gave up smoking and drinking overnight. But the doctor told me at the hospital not to give up straight away like that – gradually cut it down. So, mm, that is my sin, is smoking and I don’t think anybody has any patience with you when you smoke, they seem to have more patience with people that drink, don’t they? Drink and drugs they seem to have patience with, they don’t seem to have patience with people who smoke, you know.

What makes you say that? How do you get treated by the health professionals when you say you smoke?

Well it's your own fault really isn’t it? You brought it on yourself.

Is that what they say to you?

They don’t but that’s what, you know what they mean. They don’t literally say it but you know what they mean. I know a lot of people who drink a lot and get help, and they seem to sympathise with them like it's an illness, but I suppose smoking is a drug isn’t it? I've been on it for all these years.
 
Alcohol reduction

The people we spoke to drank different amounts. Liban drank no alcohol at all because of religious reasons, Margaret didn’t drink because she didn’t enjoy it, Peter and Bernard had given it up for health reasons. Others drank alcohol only occasionally, or regularly but within recommended limits (current guidance is no more than 14 units a week for both men and women - NHS Choices 2016). Some drank more than this and were worried about the effects on their health.

Eric said he had reduced his consumption since retiring from work; Simon cut down because too much alcohol can interfere with the warfarin he now takes for his heart condition. Laura believes she drinks too much but is surprised that her GP has not advised her to cut down because of her kidney condition.
 

John X sought help with reducing his alcohol consumption after learning he had a liver problem. He rarely drinks nowadays.

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Age at interview: 66
Sex: Male
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I think they said there was an enzyme up in the liver you know, which means to say… which the doctor told me it means it's just working harder. You know so, you know so that makes you think, “Well, I don’t want it to have to work harder”, you know so I'm going to cut back down if it's the drink that’s doing that then… you know, if it's something you can change, change it you know but if it's something you can't change you’ve just got to live with it, I suppose but…

Did the GP offer you any help with that? Did you discuss the drinking with your GP?

I did yes. I did go somewhere to see about the drinking, yeah. And that helped a little bit, one of these places you know that you go and…you know, talk to people and just…

Was that in the GP practice or was it like a specialist alcohol services?

There was another alcohol service; I can't remember the name of them now. But I think it was suggested that I go there… which I did, but you know. But then I decided to do it myself anyway so, you know to cut down, not…you know… not sort of drink every day and, you know, cut the amount down with a reasonable amount. And… but I don’t go out to the pub at all now so I might just have a couple of cans in or something, you know so. Very rare I go to the pub, and if I do I just have a soft drink and have something to eat usually and that’s all I do now.

Was it hard making those changes?

Not really. I think it was because of the problem at the time.

Mm… going through the divorce?

Yeah and through that and a few things back through life you know and I decided I… I hit the drink a bit but I just don’t see the need for it now and I… you know.
 
For detailed healthy lifestyle advice see the NHS Choices website.

Last reviewed August 2017.
Last updated August 2017.
 
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