NHS Health Check

[Wowbagger]

I had one this morning. I'm generally quite pleased. The adiposity I knew about because, well, mostly it's in front of me all the time so it's quite difficult not to notice it.

Blood pressure: 140/78 (happy with that).

Cholesterol: 5.1, so a bit too high - they like it to be below 5. Must get out and cycle more. Also reduce the cheese and ice cream intake.

Waist measurement: 50". Blood ridiculous, you fat bastard.

With my family history taken into account the probability of me suffering from a heart attack in the next 10 years is 9%, which is the same figure I was given 5 years ago, the last time I had it done. Then my cholesterol was 4.3.

The nurse who saw me was absolutely lovely - nice smile, heavily pregnant, chatty. I told her that we spent a lot of time looking after grand children, that it was very tiring and that was one of the main reasons that my cycling mileage has taken a considerable downturn.

So, no blood pressure tablets, no statins, just "keep up the good work and cut down on the cheese and ice cream. Come back in 5 years and I'll have a look at a new streamlined you!" I thanked her for her the time and wished her a happy baby.

[mrcharly-YHT]

The total cholesterol figure really isn't that important, it is the ratio that is crucial.

My total at last measurement was 6.5 with LDL of 4 and HDL 1.2

Looking at that now, it is still pretty shit (despite being a huge improvement). You look wonderfully healthy compared to me, Wowbagger.

[adenough]

My cholesterol was 6.2 and GP was not bothered as blood pressure was fine and resting pulse was 52. I don't think it is all cut and dried with these figures. My wifes Cholestrol is 5.2 and her blood pressure is off the scale, she's on permanent meds for it.
I don't think that current medical guidlines take into account the fact that we are all different animals. I'm a big animal and she's a small one. I'm in my 60s and take nothing. Why should we have the same results?
I think it should be more about how you feel and what you can do. My cat died recently [sniff], he was only 7 years old. Just died, but he was always a lazy slowpoke. never played much, stayed inthe garden or house. My other cat died at 19. Always  out roaming about. Two weeks before he died he was turning somersaults in the garden over a moth or something.
The younger one may always have felt crap.

[Wowbagger]

I had another one of these today. I thought they were supposed to be every 5 years, but I changed docs in the intervening period and I suspect that they haven't had all the info.

Anyway, it was a bit of a bugger because my BP was 170ish over something. I have a wrist monitor with a 30-odd memory and the highest I have been within its memory is 144/nn. I took it with me and showed the nurse. My monitor said 151/nn.

My glucose level measured from the fasting blood test was 5.8 - they don't like to to get above 6. I thought my cholesterol was OK, but the nurse was talking about statins. A couple of weeks ago I had a big dip in BP one morning for no obvious reason (88/48) so I'm going back tomorrow to have a 24-hour BP monitor fitted and I have an appointment with the doctor on Friday morning.

Puzzled by the BP as it's pretty well back to the normal 130ish over 80ish now. I can't think that a half-mile walk to the doctor's would have made that much difference.

[hellymedic]

These checks seems to be stressful for no good reason IME and this is reflected in the blood pressure. (see yesterday's Pub 'You know you're middle aged' posts.

Just leaving the house and being punctual, followed by a wait, tend to wind ME up.

GPs are incentivised to keep patients' cholesterol down, with the result that most middle-aged folk are 'encouraged' to take statins.

My spidey senses would not jump at putting you on statins; I would avoid within reason.

[Nelson Longflap]

Perhaps also be a bit suspicious of the instrumentation; wrist monitors are less reliable than the traditional sort using a cuff round the upper arm.  The wide variation you are seeing may be down to the occasional flaky reading ...

[hellymedic]

Wrist monitors are not very reliable. Upper arm monitors are cheap now. Get one and buy a large cuff cos the standard cuffs are fairly small.

[Wowbagger]

I wore a 24 hour monitor up to 9.30 this morning. The person who fitted it clearly wasn't that familiar with the process as she fitted the cuff inside out at first which gave her terrible Velcro problems. The upshot of it all is that my BP is slightly elevated, an average over the 24 hours of 140ish/something. I have a prescription for losartan, 50mg dose daily. Had a very productive chat with the doc. I hadn't met her before. Lovely lady. Mrs. Wow came in to help me remember things. Doc was quite happy with my pulse rate, glucose level and cholesterol, as well as my diet and exercise regime. I was able to say, quite truthfully, that my weight this morning of 115kg is the lightest I have been for two or three years - possibly more.

I'm relieved that Something is being Done.

[Wowbagger]

The hole in the ozone layer over the antarctic was 'thinning' rather than an absolute hole and extended as far as Australia at times.

UV can penetrate light clothing.
UVA can penetrate most glass, so you get a lot of Australians develop skin cancer on one side of their face (cars with aircon, keeps them cool, but the UVA comes through the driver-side window and does the damage to their face).
UV can also penetrate water, so you can be swimming, feel cooled but still be getting skin damage. Hence the Aussie limb-covering swimsuits (it was an aussie who invented the burkini and that's just a slight extension of what is quite common there anyway). Those didn't exist when I lived there, we swam in budgie-smugglers.

It is scary stuff. My brother and his wife have had multiple minor skin cancers removed and their generation regard that as normal. Ditto for my parents when they were still alive. We grew up being relatively careful, wearing hats most of the time, slathering ourselves with 'pink zinc' sunblock when working outside on the farm.

I have a high degree of hypochondria/paranoia about skin cancer. I'm in that demographic your daughter is mentioning (high rates).

That's interesting.

I mentioned in the same conversation that I had just had an NHS health check and, for the first time, had been put on blood pressure tablets. To my considerable surprise, my daughter went off on a rant which was clearly a result of considerable frustration. She considers, as a result of her several years as a manager at CRUK, that the priamry reason for health checks is not to improve patient health, but to enlarge the market for drugs companies. She had been in a meeting only this week in which the general consensus was that Aus should introduce health checks. She is against. She reckoned that, because the Aus health sysyem is even more commerce-oriented tan ours is, that there are a hell of a lot of operations carried out that are just not necessary, and might actuslly put the patient at unnecessary risk. She specifically mentioned the removal of non-malignant skin lesions, which is commonplace. In a previous conversation a couple of months ago she mentioned the very high number of endoscopies that are carried out in Aus - far more per head of population than in the UK (I don't have the figures - I just took her word for it). Shoving cameras up people's bums is mot without risk to the patient, and she reckoned that te high levels were because an insurance-based system was prepared to pay for it. I pointed out that, in the case of my bp prescription, I felt that in the general scheme of tjings, as a seriously overweight 62 year old, I felt I had done pretty well to keep off the bloody things for as long as I had, and to be honest the decision had given me some peace of mind. "Dad," she retorted, "drugs only give you peace of mind if you are the 'worried well'. Drugs are meant to be prescribed as a necessity to help cure the genuinely sick. The best thing you can do is lose more weight. Were you offered any help with that, for example by referring you to a dietitian?" When I said I wasn't she reolied "That's because there's no money to be made for Big Pharma from that outcome, but it would have been much better for you."

I could not help thinking yhat she had a very good point.

[hellymedic]

I mentioned in the same conversation that I had just had an NHS health check and, for the first time, had been put on blood pressure tablets. To my considerable surprise, my daughter went off on a rant which was clearly a result of considerable frustration. She considers, as a result of her several years as a manager at CRUK, that the priamry reason for health checks is not to improve patient health, but to enlarge the market for drugs companies.

... scheme of things, as a seriously overweight 62 year old, I felt I had done pretty well to keep off the bloody things for as long as I had, and to be honest the decision had given me some peace of mind. "Dad," she retorted, "drugs only give you peace of mind if you are the 'worried well'. Drugs are meant to be prescribed as a necessity to help cure the genuinely sick. The best thing you can do is lose more weight. Were you offered any help with that, for example by referring you to a dietitian?" When I said I wasn't she reolied "That's because there's no money to be made for Big Pharma from that outcome, but it would have been much better for you."

I could not help thinking that she had a very good point.

I don't completely disagree with your daughter but even a modestly raised BP seems to be correlated with strokes and I might think medication might be wise until you can get your weight down.

There is a drive to get most >50s on a polypill, which I really despise.

[Jaded]

Risk to the patient through procedure has to be balanced against risk to the patient through no procedure.

Bowel cancer screening is having a marked effect on bowel cancer death rates. Risks from the endoscopy procedure can be mitigated by well designed up to date endoscopy suites and good training and monitoring for those carrying out endoscopy.

[chrisbainbridge]

But there is increasing evidence that Breast and prostate screening is leading to increased surgery and no real benefit  in terms of better outcomes.

To simplistically improve life expectancy you simply diagnose non life threatening disease earlier!

[Wowbagger]

Admin comment: bit of a cross-threading here, I think! OK, threads tend to go off at tangents, but this one seems to have jumped from one to another and found itself with a different title!

[De Sisti]

Bowel cancer screening is having a marked effect on bowel cancer death rates....

I'm having one next month.

[hellymedic]

Bowel cancer screening is having a marked effect on bowel cancer death rates....

I'm having one next month.

Enjoy!

[De Sisti]

Squeaky bum time?

[TPMB12]

Didn't know NHS does health checks. Thought it was see a doc if you're ill if you can get in?

[hellymedic]

I think health checks are done on over 45s or 50s, I can't remember which.

They are not done by the doctors, but results are brought to their attention. AIUI they check:
BMI¹
BP
Fasting Blood Sugar
Fasting Cholesterol
Bad Habits²

1) Silly sausage (who, by eyeball had BMI>30) told partner he was underweight and should GAIN 7kg. At 62kg and 175 cm he was slim but NOT underweight! He was not impressed.
2) Their tick boxes don't cope very well with people like me; I told nurse I had about one unit of alcohol per month - I don't pretend to be teetotal, I just don't drink much. Printout stated I drank one unit per week...

Other routine screening I have had:
Cervical smears
Mammography
Bowel screening

[Legs]

1) Silly sausage (who, by eyeball had BMI>30) told partner he was underweight and should GAIN 7kg. At 62kg and 175 cm he was slim but NOT underweight! He was not impressed.

Does not compute.  I'd agree that 62kg @ 175cm is slim but not necessarily underweight, but this doesn't tie up with BMI>30...   69kg @ 175kg is, similarly, fine.

[mrcharly-YHT]

1) Silly sausage (who, by eyeball had BMI>30) told partner he was underweight and should GAIN 7kg. At 62kg and 175 cm he was slim but NOT underweight! He was not impressed.

Does not compute.  I'd agree that 62kg @ 175cm is slim but not necessarily underweight, but this doesn't tie up with BMI>30...   69kg @ 175kg is, similarly, fine.

I think helly meant the doctor was clearly overweight. Beam in thine eye and all that.

[barakta]

My sister was once ordered to give up smoking by a Maxillofacial consultant (excellent skillz, known to be an utter twat in terms of bedside manner) who himself REEKED of cigarettes.

[hellymedic]

Helly did indeed mean nurse/HCA telling David that he was underweight was a chubby person.
Being told to gain weight by a fat person is normalising obesity.

David has a fairly light frame and really doesn't need to weigh more  than 62kg.

He's 65kg right now and thinks that he is fat. While it's not overweight, there's enough to cuddle/pinch an inch etc.

[Wowbagger]

I think health checks are done on over 45s or 50s, I can't remember which.

They are not done by the doctors, but results are brought to their attention. AIUI they check:
BMI¹
BP
Fasting Blood Sugar
Fasting Cholesterol
Bad Habits²

1) Silly sausage (who, by eyeball had BMI>30) told partner he was underweight and should GAIN 7kg. At 62kg and 175 cm he was slim but NOT underweight! He was not impressed.
2) Their tick boxes don't cope very well with people like me; I told nurse I had about one unit of alcohol per month - I don't pretend to be teetotal, I just don't drink much. Printout stated I drank one unit per week...

Other routine screening I have had:
Cervical smears
Mammography
Bowel screening

I think it must be over 50s - or possibly more. I think I've had 2. maybe it's over 60s, like the bowel cancer screening.

*googles*

However http://www.nhs.uk/Conditions/nhs-health-check/Pages/NHS-Health-Check.aspx says over 40s.

They also ask about family history. Given that my parents and their brothers & sisters had ages of death along the lines of: 86, 89, 93, 86, 92 and that two of my dad's sisters are still breathing at 98 and 92, as long as I can keep on top of the other factors I ought to be OK for a while, mishaps apart.

[mrcharly-YHT]

family history
Grandparents 53 (heart), 62(heart), 69(cancer), 63(heart)
Uncles, 45 (heart), 53 (MS), 70 (heart)
Mother and father, both passed at 72 (cancer), but dad needed quadruple bypass at 61

Aunts still going at over 80. One should have had a bypass but is too fat to have the operation, and too stubborn to give in.

There is a theme here and a sensible system should be giving me closer monitoring. But I'm a non-smoking 'slim-ish' person who regularly exercises so they  put me in the 'low risk' category. It's rather stupid.

[Legs]

1) Silly sausage (who, by eyeball had BMI>30) told partner he was underweight and should GAIN 7kg. At 62kg and 175 cm he was slim but NOT underweight! He was not impressed.

Does not compute.  I'd agree that 62kg @ 175cm is slim but not necessarily underweight, but this doesn't tie up with BMI>30...   69kg @ 175kg is, similarly, fine.

I think helly meant the doctor was clearly overweight. Beam in thine eye and all that.

  I put two and two together and got something like 3±i, assuming it was an anecdote from helly's practice.