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Roy and Janet

Age at interview: 57
Brief Outline: Roy has ongoing problems with his eyesight and has had a series of corneal transplants. He attends regular check-ups for his blood pressure but didn’t know that his kidney function was ‘low’ until his GP invited him to take part in this study.
Background: Roy is a retired hospital porter and carer for his wife Janet, who is disabled. They have been married for 35 years, have 5 children and live in a bungalow together with one of their sons. Ethnic background: White British.

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Roy used to work as a hospital porter until he developed problems with his eyesight 12 years ago. He had six corneal transplants in his left eye and more recently, also had a cataract removed from the right eye. But he still has trouble seeing clearly and his eyes can sometimes feel quite itchy. Around the same time when Roy developed his eye problems, his wife Janet, who he has been married to for 35 years and who had worked at the same hospital as a dinner lady, became disabled due to a lifelong problem with her legs bending outward. Roy took early retirement and now is a full-time carer for his wife.

Roy’s main current health concerns are his failing eyesight and chronic back pain stemming from a slipped disc some years ago. He manages the pain by taking paracetamol twice a day. For the last fifteen years, Roy has been taking medication to help control his high blood pressure and cholesterol. He also takes medication to settle his stomach as he is prone to bouts of gastroenteritis. The initial blood-pressure lowering drug he was prescribed made him feel dizzy, tired, hot and sweaty, but after the GP changed his prescription he has not experienced any other medication side-effects.

Roy and Janet attend the same GP practice and usually will go to appointments together. They like to see the same GP who has known them for all their lives and ‘tells it straight’. However, the appointment system can make it difficult to get an appointment quickly.

When Roy was first diagnosed with high blood pressure, his GP gave him leaflets and advice on leading a healthier lifestyle and things he could do to help himself. Roy says the diagnosis was ‘a wake-up call’ and since then he has become more active, has managed to keep his weight down and eats a very healthy diet with lots of salad and fresh fruit. However, he really struggles to give up smoking, though he has managed to cut down to 10 cigarettes a day. His wife Janet also smokes, though neither of them will smoke in the house anymore. They both find that if they go out for the day they tend to smoke a lot less.

Roy has been attending regular bimonthly check-ups at his GP surgery ever since he has been taking statins and blood pressure tablets. However, until he was invited to take part in this study, he had been unaware that his kidney function was mildly impaired. After speaking to the researcher, he made an appointment with his GP and was told that his kidneys were ‘a bit low’. He did not ask any further questions at the time but still is a bit worried as he is not sure just how ‘low’ his kidneys are and whether they are likely to get any worse. One of Roy’s brothers died of a kidney bleed as a young man, so Roy wonders whether his own kidney impairment might have a genetic cause.

A few years back, Roy consulted his GP because he thought he was passing blood in his urine. He was referred for a kidney scan at the hospital, but eventually it turned out that the red colour of his urine had been caused by eating beetroot the day before.

Roy finds it reassuring to attend regular check-ups every two months. His wife Janet, who has diabetes, attends check-ups every six weeks. They both think it’s important to having regular checks for all vital organs and that GPs should tell their patients “the full story”. This may cause some people to worry when they needn’t worry, but health professionals should take the time to explain.
 

Roy was quite worried despite his GP’s reassurances, because his brother had died of kidney disease. He felt embarrassed to ask questions in the consultation.

Roy was quite worried despite his GP’s reassurances, because his brother had died of kidney disease. He felt embarrassed to ask questions in the consultation.

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Roy: It was really yes because me brother, as I said, died of it in that late sixties, he had kidney problems, unfortunately he died. And so obviously it's probably genetic somewhere in the family, isn’t it?

Is that what you think that?

Roy: I think probably, maybe… I don’t know because a lot of people have got… all my family seems to get a problem with high blood pressure, cholesterol and my oldest brother's had heart surgery of the valves three times, replacements… and me as well and probably with my kidneys are slightly a bit low but nothing to worry about so I feel it- well could it be genetic.

So when you got a letter to invite you on a study on kidneys that kind of alarmed you a bit because you were worried that your brother’s…

Roy: That’s right yeah.

And but you did go and see your GP afterwards?

Roy: I did see my GP and I did spoke to him about you and… I did ask for another blood test but he said it's up to me if I want to but he said, "Really," he said, "you’ve only just had a blood test in the summer," he said , "your cholesterol was low… sugars not too bad, but if he was…slightly a bit worried, he said “your kidneys are slightly a bit lower," he said.

Yeh but you didn’t ask more about the “low”… what does it mean “low”?

Janet: No because I think Roy felt a bit embarrassed because there was a student there.

Oh, OK.

Janet: And I was the one what was asking questions, Roy was just sit back and… but he was… he is worried about that and he is. I'm not like that; because I love him… he is worried about it. Like I’ve known him or a long time and he does worry very quickly.

Yeh

Janet: And he does, and he did ask, “how low was it”. He said, "Just it's OK and if it gets worse, but you will be coming down again to have some more tests and it means that". So I just left it at that because I thought, 'Well it's not my… keep on- my place, keep on butting in,' is it?
 
 

Roy often feels flustered when attending for a check-up and worries while waiting for his test results in case they are not good.

Roy often feels flustered when attending for a check-up and worries while waiting for his test results in case they are not good.

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And how do you feel about going for the check-ups – what's it like for you?

Well it can be a bit frightening of course, you know? No we don’t want to go down and find you got bad results, you want good results… It can be a bit nervous sometimes yeah.

So in between doing the test and getting the result is that like a worrying time for you?

It is, actually until you… you’ve got to wait say a week or two weeks then you’ve got to book up to see your GP… and it can be a bit worrying, yeah.

Do you ever forget to get a test result?

No I don’t no, no.

So it's really quite at the front of your mind?

Yeah, yeah.

To get it checked out.

Mm.

And what about the actual going there and having the test – do you feel OK about it or is it…?

Sometimes when you get there and anxiety a bit, you know sort of flustered and worried about it yeah can do, you know just got… take a grip of yourself and get down there [slight laugh].
 
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