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Russell

Age at interview: 84
Brief Outline: In 2009, Russell developed prostate cancer which was successfully treated with radiotherapy. He has regular blood tests to check his PSA levels and kidney function. He also has atrial fibrillation but considers himself in good health overall.
Background: Russell is a retired carpenter and joiner. He has been married to his wife for 60 years. They have 3 children and 7 grandchildren. Ethnic background: White British.

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In 2006, Russell consulted his GP about his problems with passing urine. He was referred to the local hospital for a water flow test. The hospital doctors suspected that he might have kidney stones and decided to do a nephroscopy - a visual examination of the kidney which involves sending a small camera up the urinary tract into the kidney. Russell received a local anaesthetic before the procedure was performed and did not experience any discomfort from it during or after. He was told that the nephroscopy had shown up ‘a bit of grit’ in the bladder which was likely to be passed out naturally, that his kidneys were clear and that his problems were likely to be due to his enlarged prostate.

In 2009, Russell put his heart ‘out of rhythm’ after some heavy lifting. His GP referred him to hospital, where he was diagnosed with atrial fibrillation and a heart murmur. He was given a cardioversion under general anaesthetic to put the heart back into rhythm. Investigations whilst at hospital found that Russell also had developed prostate cancer. He was offered radiotherapy in combination with an experimental treatment of 3-monthly implants. The cancer was shrunk successfully but Russell still receives the 3-monthly implants. Russell also takes beta-blockers (bisoprolol), atorvastatin, ramipril, ranitidine and furosemide. He experiences no problematic side effects from his medications apart from occasional hot flushes. Most recently, Russell was in hospital in December 2013 to have a vein transplanted from one leg onto the other to treat an aneurysm. He has recovered well from the operation and thinks the healthcare he has received over the last nine years has been excellent.

Russell knows that the six-monthly blood tests he has at his GP surgery check his kidney function along with his PSA levels and other vital signs. His understanding is that the purpose of the kidney checks is to make sure the cancer has not spread to his kidneys. He has complete trust in the doctors at his surgery, where he has been registered for almost 50 years. He likes the fact that his GP is straight-talking and ‘wouldn’t pull any punches’ if he had to deliver bad news. His GP has told him that he can phone him whenever he needs to, and when Russell has had more serious problems in the past, he has been referred to secondary care very promptly.

Russell has enjoyed very good health for most of his life and does not believe in ‘self-analysing’ his health. The only lifestyle advice Russell has received from health professionals has been to drink plenty of fluid. He drinks lots of tea during the day and describes his lifestyle as fairly healthy. He no longer smokes, only drinks alcohol very occasionally and keeps very active, leading a busy social life and growing vegetables on his allotment.
 

Russell says he doesn’t expect his doctor to tell him his test results if there is nothing to adjust; he takes it for granted that all is well.

Russell says he doesn’t expect his doctor to tell him his test results if there is nothing to adjust; he takes it for granted that all is well.

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So and I've already asked you, you don’t get actually any detailed feedback on the results of your tests like your kidney function, your cholesterol, your blood pressure, you don’t talk about the exact values that your tests are showing?

Well I don’t need to ask because… if… he does… if he takes a check and he does a test and there is nothing… to, you know, adjust then he doesn’t have to tell me does he? So… I take it for granted that as long as he isn’t saying anything everything's going along nicely.
 
 

Russell’s GP usually tells him that his kidney test results are ‘all clear’ and doesn’t discuss them in detail with him.

Russell’s GP usually tells him that his kidney test results are ‘all clear’ and doesn’t discuss them in detail with him.

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I'm particularly interested in what kind of information you got from your GP… about your kidneys. Can you remember when you have your check-ups how do you get told about your test results?

He just says that it's either… if it was anything wrong he would tell me but he normally he says it's all clear.

But apart from that we don’t really discuss it too much we just… because if there's anything wrong he just does a referral.

And has he explained to you how your kidney function compares to other people’s?

No never no. No we haven’t had that information at all.

Now you’ve explained to me very well that you really trust your doctor and you're very happy with the medical team.

Mm

What we'd like to understand is, at what point would you want to be told about say specifically your kidney function, because I think I explained to you, it goes down with age anyway. When would you want to, your GP to tell you in more detail what was going on?

I haven’t got any qualms about that because what I- what I do know is that if there was anything going wrong he would tell me immediately.

My doctor would tell me immediately, he wouldn’t pull any punches about it, he'd just tell me and I don’t think that he would hold back on it.
 
 

Russell believes his lifestyle is healthy so has not discussed it with a doctor; he has been advised to keep his fluid intake up, which he does naturally by drinking lots of tea.

Russell believes his lifestyle is healthy so has not discussed it with a doctor; he has been advised to keep his fluid intake up, which he does naturally by drinking lots of tea.

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And do you ask your doctor or does he tell you about ways of keeping yourself healthy and well?

Well I don’t do anything that… I don’t do anything that would, really entail needing to do that because I don’t think that I do anything that is derogatory to health.

Yeah

I try not to, put it that way, and so I wouldn’t have to ask the doctor about that.

But you did get told about keeping your fluid levels up. That was…

Yes because I think that… because down the road that if you drink plenty of liquids you're flushing the kidneys all the time aren’t you, you're keeping them clean.

And so it is… everybody emphasises, most of the medical profession and even you're told on… things on the television that drinking liquids when you're getting a hot day is essential, so we all understand that; if we've got any common sense we understand the fact that you should drink plenty of liquids anyway.

Every time you go and they say take… drink plenty of fluids but [coughs]…

And is that something that you make a conscious effort of doing?

Well no because I drink quite a lot tea anyway [laughs].

You think you'll be alright with that?

I don’t drink cups of tea; I drink pints of it [laughs]. It's, I suppose it stems from the fact that I did work for the… in the tea industry for seven and a half years on a break from normal job.
 
 

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

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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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.
 
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