Well, that was unpleasant!

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IrvineHimself

IrvineHimself

Well-Known Member
Relationship to Diabetes
Type 2
So, there I was working away on my latest project when, around 4 am, I decided to take a cat-nap. As soon as my head hit the pillow, for the next two or three minutes, it was like I was being turned inside out. Although the feeling subsided, unsure of what was going on, I spent a very uneasy 45 minutes before deciding to get up and check things out: Whoa! Head rush! .... If it hadn't been for a heavy chair I keep near my bed solely for grabbing purposes, I would have hit the floor hard. As it was, I was so unstable, I had to use a wheeled computer chair to reach the toilet.

I wasn't sure what was going on, but, by focusing on potential side effects from the Metformin or Empagliflozin. I managed to reach a totally erroneous conclusion. Luckily, since I wasn't 100% sure about it being a side effect, I decided to cover all bases by eating a couple of sachets of oatcakes [carby, but with a low GI]; drink a couple of gallons of water, and toddle off to the A&E.

My squat is on one of the main hospital bus routes, with a major commuter stop literally just across the road. I had improvised a walking stick, but was still staggering so much, everybody thought I was drunk [as you know, I don't drink]. Only one old woman realised the truth and, after helping me to sit on some traffic furniture, offered me a few pieces chocolate. 🙂

To cut a long story short, the hospital ordered a full battery of tests, including blood-work and an MRI. Of interest, were:
  • My initial pinprick BG was 11 mmols/l [I hope this was because of the oatcakes and chocolate]
  • My initial systolic BP was a 156 mmHg, which had fallen to 123 mmHg after two hours.
The final diagnosis was a mini-stroke, with the following preliminary treatment plan:
  • A loading dose of 300 mg of Clopidogrel, followed by a daily 75 mg maintenance dose of same.
  • Register with the stroke clinic, [If the waiting list is similar to the diabetic clinic, then I'm in trouble 😉]
  • Consult with my GP, I already had an appointment with her for next Friday, so at least we will have something to talk about.
Ah man, the adventures of old age.

To finish on a brighter note: After over three months, a bank has finally acknowledged that I have a pre-existing, de-activated account from the 1980's which they are prepared to reactivate. Having said that, while they have said this in front of witnesses and given me the sort-code/acc-number to enable me to proceed with my pension application, they have not yet put anything in writing. However, it was enough for me to proceed to the next bureaucratic hurdle in my Sisyphean battle for the state pension.

Irvine

Edited to correct typo in Clopidogrel dosage. (Wrote 30 and 7.5 mg, when the correct dosage is 300 and 75 mg)
 
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Oh my. It's hard to say whether you were lucky or unlucky in your experience.

So glad you were seen and treatments given. Hopefully your mini-stroke will transpire to be transient.

I hope the Stroke Clinic are prompt in seeing you.

(Edited to say, lucky you realised something was very wrong and did something about it, not lucky having a stroke, however mini!)
 
AndBreathe said:
(Edited to say, lucky you realised something was very wrong and did something about it, not lucky having a stroke, however mini!)
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I feel I have been lucky both ways. Noting that:
  • Cash-wise, the weekend is very important for my budget.
  • The high probability that Friday night's walking wounded would still be lurking around the A&E.
  • Dr Google seemed to confirm my initial suspicion of it being a hypo or some other side-effect of my meds.
  • I already had an appointment with the Doc this Friday
I was very, very tempted to just stop taking my meds until I next saw the Doc. So yes, I do feel lucky I chose to take my chances with the spillover from a Friday night A&E department, [shudder]. I really was tempted to give it another couple of hours before making a definitive decision.

In a perverse kind of logic, I also feel weirdly lucky in both having had a mini-stroke and finding out I have type-2 diabetes. To explain: Over the last four or five years, my friends, enemies and frenemies have started to drop like flies. I am talking about people my age, usually respectable, wealthy, careerists who I have known since uni. Causes of death have been from a variety of factors: Cancer, brain tumours, heart attacks, strokes .... etc, etc.

Since the mini-stroke and the diabetes can largely be controlled with life-style changes and quality medical care, (which I am lucky enough to be receiving,) rather than a burden which will define my twilight years, I view them more as a wake-up call from the Last Chance Saloon to get my sh*t together.
 
I’m glad you got sorted in A&E, @IrvineHimself . When my husband ended up in the TIA or mini stroke clinic, after a retinal artery occlusion (treated the same) they were having an initiative whereby everyone had to be seen within 3 days. Hopefully they’ve continued that practice, and it’s the same in Scotland.
 
Robin said:
.... they were having an initiative whereby everyone had to be seen within 3 days.
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That sounds promising. I think the problem with the diabetic clinic is the backlog caused by the high mortality rate for diabetics with COVID. I have no idea what the situation is with people at high risk of strokes.

To change the subject slightly, this clopidogrel seems to be really nasty stuff. My painkiller of choice is normally aspirin, which I think I had better make a point of avoiding from now on. Even more alarming, is that, having recently got an HC-1 exemption certificate, I have some major dental work in the pipeline.

On a, possibly, lighter note: The Wikipedia page for anti-platelet meds [not the page for clopidogrel] says that garlic may increase the anti-coagulant effects. (It gives as a source a dead link to the Scottish Dental Clinical Effectiveness Programme, which seems to be a legitimate NHS project by Scottish Dental. frustratingly, the updated 2022 advice on anti-coagulants returns a compilation error.)
 
Sorry to hear about your nasty experience @IrvineHimself

Hope your repair work goes smoothly and you are able to bounce back speedily.
 
IrvineHimself said:
A loading dose of 300 mg of Clopidogrel, followed by a daily 75 mg maintenance dose of same.
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IrvineHimself said:
To change the subject slightly, this clopidogrel seems to be really nasty stuff. My painkiller of choice is normally aspirin, which I think I had better make a point of avoiding from now on
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Husband has been on Clopidogrel since his 'event'. I don’t think he had the big loading dose at the start, though. His 75mg maintenance dose doesn’t seem to cause him any problems, apart from bleeding a little bit more if he catches himself on a bramble when we’re out walking. I think you’re right about avoiding aspirin, as it also has a blood thinning effect.
 
When my OH had a TIA he was put on an experimental regime of Clopidogrel, aspirin 75mg and simvastatin for a few months. Then the aspirin was dropped but the others continued, he was then changed to apixaban
For any planned procedure that might cause bleeding be stopped the anticoagulant 2 days before and 1 day afterwards.
He did get a few nosebleeds and bleeds a bit more from a cut.
He had no follow up at any stroke clinic.
 
Robin said:
When my husband ended up in the TIA or mini stroke clinic, after a retinal artery occlusion (treated the same) they were having an initiative whereby everyone had to be seen within 3 days.
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At midday, I had just sat down for lunch when I got a phone call asking me if I could make it out to Little France for 1:45 pm!

Depending on what bus you get, normally it can take over an hour from Leith, but, with all the road works, you can easily add half an hour to that. Then, you need another half hour because the workmen like to play hide-n-seek with the bus stops..... But, I made it on time, and, as a bonus, despite rushing around on the hottest day of the year [so far] my BP was only a 123/83 mm-Hg 😎

I jumped straight to the head of queue to see the Vascular Neurologist, who, after reviewing my records, confirmed a mini-stroke, and was back to finish my lunch by 3pm.

Along with continuing the clopidogrel, he has prescribed a 20 day course of aspirin and is writing to my Doc to recommend statins. He also wants my Doc to kit me out with a portable ECG to get a weeks worth of data on my heart activity.

The last time I saw my GP was three weeks ago when she suggested that on my next appointment [Friday] she would like to start me on ace-inhibitors. I don't know how the clopidogrel and statins will affect that decision?

Now if I could just get some action from the Diabetic Clinic. (Or maybe not! The way they are triaging, getting some action on that front would probably mean I was in really serious trouble.)
 
I’m glad things are moving in at least one branch of the health service!
 
Robin said:
I’m glad things are moving in at least one branch of the health service!
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Noting the Guardian's coverage of the current state of the NHS, which is backed up by some genuine horror stories I have read on these boards from new members, I think I have been incredibly lucky with regard to my primary care team. The real irony is that it's not a swanky practice, but rather an outreach practice for the local indigents, junkies and illegal immigrants.

On first blush, most people would rather avoid the place: It has security doors that require patients to be buzzed in, and, first thing in the morning or just after lunch, they often have a genial, albeit unobtrusive security guard to keep the junkies from storming the place. Yet, the attention and quality of care I have been recieving is beyond first class. (The same applies to my pharmacist, podiatrist and the rest of my specialist health team, who have been absolutely brilliant.)
 
IrvineHimself said:
Noting the Guardian's coverage of the current state of the NHS, which is backed up by some genuine horror stories I have read on these boards from new members, I think I have been incredibly lucky with regard to my primary care team. The real irony is that it's not a swanky practice, but rather an outreach practice for the local indigents, junkies and illegal immigrants.

On first blush, most people would rather avoid the place: It has security doors that require patients to be buzzed in, and, first thing in the morning or just after lunch, they often have a genial, albeit unobtrusive security guard to keep the junkies from storming the place. Yet, the attention and quality of care I have been recieving is beyond first class. (The same applies to my pharmacist, podiatrist and the rest of my specialist health team, who have been absolutely brilliant.)
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I had brilliant care, (still do) from my local surgery, I think it also reflects your personal attitude to the care team as well.
As to new members, possibility it's not actually their horror stories, it's a selection of overstretched practices recently, but enhanced by some (the same) posters who disagreed with the advice and care they were given, hence "all NHS are bad" seems to be a repeating theme from a very small minority, but frequently in new members posts.
 
I agree, there is a bias in posts from new members. In many cases, people have joined the forum because, sub-consciously or not, they are dissatisfied with the care they are receiving.

The key point being that they are dissatisfied with the care they are receiving. One has to read that in the context of the large body of evidence from other sources which makes plain that, in many parts of the country, the NHS is failing to live up to its founding core principle of: "Meeting the clinical needs of everyone, regardless of ability to pay,"

travellor said:
... "all NHS are bad" seems to be a repeating theme from a very small minority, but frequently in new members posts.
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But it's not just a small minority of new members posts. Every day I read in the papers about:
  • People having to go "private" in order to get basic care,
  • NHS Trusts failing to provide basic medications and services
  • NHS Trusts having to outsource basic care to for profit hospitals
  • US health chains taking over surgeries and prioritising profits over patient care
  • Patients being seen by Doctor Assistants rather than qualified GP's
  • Patients being dumped on a drug regime without any follow up or personal care plan
  • Much, much more. The list of reported scandals is quite extensive
So, yes you and I are satisfied with the care we are receiving, but that does not mean that over 40 years of cut backs and reform has not had a deleterious effect on the quality of care many people are receiving.

As a result, when I read these horror stories, rather than dismissing them as moaning minnies who have a personnel issue with their care team, I read them in the context of an NHS that is widely acknowledged to be seriously underfunded, understaffed and close to fracturing beyond repair.
 
IrvineHimself said:
I agree, there is a bias in posts from new members. In many cases, people have joined the forum because, sub-consciously or not, they are dissatisfied with the care they are receiving.

The key point being that they are dissatisfied with the care they are receiving. One has to read that in the context of the large body of evidence from other sources which makes plain that, in many parts of the country, the NHS is failing to live up to its founding core principle of: "Meeting the clinical needs of everyone, regardless of ability to pay,"


But it's not just a small minority of new members posts. Every day I read in the papers about:
  • People having to go "private" in order to get basic care,
  • NHS Trusts failing to provide basic medications and services
  • NHS Trusts having to outsource basic care to for profit hospitals
  • US health chains taking over surgeries and prioritising profits over patient care
  • Patients being seen by Doctor Assistants rather than qualified GP's
  • Patients being dumped on a drug regime without any follow up or personal care plan
  • Much, much more. The list of reported scandals is quite extensive
So, yes you and I are satisfied with the care we are receiving, but that does not mean that over 40 years of cut backs and reform has not had a deleterious effect on the quality of care many people are receiving.

As a result, when I read these horror stories, rather than dismissing them as moaning minnies who have a personnel issue with their care team, I read them in the context of an NHS that is widely acknowledged to be seriously underfunded, understaffed and close to fracturing beyond repair.
Click to expand...
I both work in the NHS and am a patient. I appreciate your comment, Irvine, because even though we are horrendously overstretched, patients deserve good quality care. And it is rarely not wilful low care quality that people are experiencing, but the result of utterly untenable conditions. We are not 'NHS Superheroes'. Our staff need to eat, sleep, go to their kids' parent evenings etc. Sadly, there are not enough people or resources, and we should never become accepting of that. Newly diagnosed individuals like myself are likely to feel unsupported if they don't have enough support and education. It's not moaning, and I think it's maybe easy to forget that everyone's circumstances are different. In my case, I was in hospital with a DKA for 5 days and no diabetic specialist nurse or doctor was available as it was bank holiday. I was discharged as a new insulin user with incomplete notes (caused by the ward having no staff other than bank and agency) and no follow up appointments. It took over a week (and getting down to my last 10 units of NR) before I finally got a GP to prescribe my insulin. It took a further week and a half to get them to refer me to a diabetic nurse. Despite understanding the reasons for this poor quality of care, it was still poor and at a time I was particularly stressed and vulnerable.

Irvine, I'm glad you're being seen and treated well, and I really hope they get anything going on in the background under control so you don't have to worry so much about a recurrence. Take care.
 
IrvineHimself said:
I agree, there is a bias in posts from new members. In many cases, people have joined the forum because, sub-consciously or not, they are dissatisfied with the care they are receiving.

The key point being that they are dissatisfied with the care they are receiving. One has to read that in the context of the large body of evidence from other sources which makes plain that, in many parts of the country, the NHS is failing to live up to its founding core principle of: "Meeting the clinical needs of everyone, regardless of ability to pay,"


But it's not just a small minority of new members posts. Every day I read in the papers about:
  • People having to go "private" in order to get basic care,
  • NHS Trusts failing to provide basic medications and services
  • NHS Trusts having to outsource basic care to for profit hospitals
  • US health chains taking over surgeries and prioritising profits over patient care
  • Patients being seen by Doctor Assistants rather than qualified GP's
  • Patients being dumped on a drug regime without any follow up or personal care plan
  • Much, much more. The list of reported scandals is quite extensive
So, yes you and I are satisfied with the care we are receiving, but that does not mean that over 40 years of cut backs and reform has not had a deleterious effect on the quality of care many people are receiving.

As a result, when I read these horror stories, rather than dismissing them as moaning minnies who have a personnel issue with their care team, I read them in the context of an NHS that is widely acknowledged to be seriously underfunded, understaffed and close to fracturing beyond repair.
Click to expand...

I don't read papers.
It's never my experience they write cheerful news, that's just the donkey story at the end.
And usually dropped for something more eye catching.

I just go on experience.

(No need for the embedded links, there isn't a cat in hells chance I'd ever click on them)
 
So, I went to my scheduled appointment with the Docs on Friday afternoon and she prescribed 40mg a day of Atorvastatin, to be increased to 80 mg a day after 4 weeks. Taken in conjunction with the Clopidogrel, this seems to be a really nasty [potentially dangerous] combination!

The danger is so high, because of the risk of stomach ulcers, I've been prescribed Lansoprazole, as a prophylactic. Which is pretty nasty in it's own right, All in all, I am starting to get moderately worried about all the possible complications and wondering whether [in case of accident] I should be carrying some kind of medication alert?
 
IrvineHimself said:
So, I went to my scheduled appointment with the Docs on Friday afternoon and she prescribed 40mg a day of Atorvastatin, to be increased to 80 mg a day after 4 weeks. Taken in conjunction with the Clopidogrel, this seems to be a really nasty [potentially dangerous] combination!

The danger is so high, because of the risk of stomach ulcers, I've been prescribed Lansoprazole, as a prophylactic. Which is pretty nasty in it's own right, All in all, I am starting to get moderately worried about all the possible complications and wondering whether [in case of accident] I should be carrying some kind of medication alert?
Click to expand...

Have you considered having a chat with your pharmacist about your recipe of medications and your concerns. I generally find them better than most medics for that sort of thing.

He/she might also have an opinion on the need or otherwise of a medicalert bracelet/necklace/card or whatever.

I understand there are also places in cell phones, or relevant apps that could help paramedics if you are incapacitated.
 
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