[speaker001:] What shall I do with you then?
[speaker002:] Well I, do you mean for me?
[speaker001:] Yeah, yeah.
[speaker002:] Well I, I've come for b blood pressure. those
[speaker001:] Right, let's have a look, oh yes. That's right.
[speaker002:] tablets you gave me
[speaker001:] That's right.
[speaker002:] I, I don't want to see any more of them.
[speaker001:] Oh dear I'm sorry to hear that.
[speaker002:] After after a fortnight I couldn't walk up the street without stopping for a breather.
[speaker001:] They made you short of breath?
[speaker002:] Ooh terrible.
[speaker001:] Right, okay. Oh dear.
[speaker002:] And er I couldn't I mean I do a lot of gardening there were n no problems at all, so I took them t well you can see what's left.
[speaker001:] So you've stopped them?
[speaker002:] I took thirteen and I've got some of me old Diodide so went back on to them.
[speaker001:] I, I think that was entirely the right thing to do, entirely the right thing to do. Well I'm sorry about that.
[speaker002:] Every time I sat down I went to sleep.
[speaker001:] Oh well, that's no good then is it?
[speaker002:] And er, No.
[speaker001:] Okay, let me check what it is today. It, I mean it has been going up rather high, this has been
[speaker002:] Yeah.
[speaker001:] a problem of course. Let
[speaker002:] Yeah.
[speaker001:] me see what it is and there's a chance it's actually down
[speaker002:] Yeah,
[speaker001:] Because of the Etenalol but er
[speaker002:] [cough] But it's two
[speaker001:] Let's have a look.
[speaker002:] weeks since I took any of those.
[speaker001:] Well it's certainly right that you ought to stop anything that makes you feel worse. And
[speaker002:] Yeah.
[speaker001:] it's er
[speaker002:] No pain at all
[speaker001:] No.
[speaker002:] but you know, walking I've had to stop twice.
[speaker001:] Well that's no use is it? That's what?
[speaker002:] No apparent reason.
[speaker001:] Okay, this' ll squeeze your arm a bit
[speaker003:] [pumping]
[speaker001:] Any ankle swelling or palpitations?
[speaker002:] No I've nothing, any palpitations, nothing, I feel as fit as I did twenty years ago. I've got two great I do, I'm always cycling I never, very seldom ride anyway on buses and I ain't got no car, no car. And I feel as tip-top, I can eat, I've no bowel trouble or nothing.
[speaker001:] Yeah.
[speaker002:] I can sleep, eat.
[speaker001:] Good. [cough] Your blood pressure is still up,
[speaker002:] Yeah.
[speaker001:] a bit.
[speaker002:] Yeah.
[speaker001:] It's not up an awful lot but it is still up a bit. And I'm sure it'd be well worth er, er getting this down, no. Dies are you back on Diesiodinate doing the trick
[speaker002:] Well I've been taking them yeah,
[speaker001:] What I, what I suggest we do is we take this opportunity of having to review, to sort of have a complete overview and actually do, run a few er routine blood tests at this stage as well. Okay? I would erm... suggest what we do is we stop the Dieside and put in something else, you know, just to keep you on on I don't really want to have you on a combination of lots
[speaker002:] No.
[speaker001:] of drugs.
[speaker002:] No, no.
[speaker001:] I'd rather just have you on one preparation and then we see what happens. Now the question is, what is erm going to be the most suitable for you?... Hmm. I think what we'll do... is try this, which is called Doxazocin there you go, that's an instantly forgettable name for you.
[speaker002:] Yeah, yeah. Mm.
[speaker001:] Okay, but it does have the advantage in it, it's a has it's a very clean drug.
[speaker002:] Yeah.
[speaker001:] It's a very clean, so side effects are very very rare, that's right,... [writing] Now we, I'm going to give you two sizes, cos you need to start on the lower dose first.
[speaker002:] Yeah
[speaker001:] And what I would do, have you had your Dieside today?
[speaker002:] Yes.
[speaker001:] Okay, doesn't matter, your blood pressure's still up. What I should do is take the first one tonight.
[speaker002:] Yes.
[speaker001:] Because what new drugs can do is they can put your blood pressure down quite quickly. Which means if you're standing up, you
[speaker002:] Yeah.
[speaker001:] can get rather faint and wobbly.
[speaker002:] Yeah.
[speaker001:] So if you take the first one immediately before you go to bed, if your blood pressure does go down rather a lot, it doesn't matter cos you're lying down, you'll
[speaker002:] Yeah.
[speaker001:] be fine. And if you're okay, you can carry on taking one in the morning.
[speaker002:] One in the morning
[speaker001:] Okay? And the seven days at the low dose and then I'd like you to go onto the slightly higher dose, which is still a low dose,
[speaker002:] Yeah.
[speaker001:] for the rest of the time. And then we can bri check your blood pressure back. So, if that's okay, that's what we'll do.
[speaker002:] Yeah.
[speaker001:] Stop the Dieside
[speaker002:] Yes.
[speaker001:] take these back to the chemist,
[speaker002:] Yes.
[speaker001:] and if you can see our practice nurse in a few weeks
[speaker002:] Yes.
[speaker001:] okay, and then see me in about five weeks,
[speaker002:] Right, okay.
[speaker001:] something like that. Then we can
[speaker002:] How will
[speaker001:] have a look at the blood tests
[speaker002:] Yeah.
[speaker001:] I'll write down what I want her to do,
[speaker002:] Mm.
[speaker001:] we can have a look at the blood tests, we can see what the blood pressure is. If you have any side effects from the new ones, then you should come back straight
[speaker002:] Yes.
[speaker001:] away.
[speaker002:] Right.
[speaker001:] Okay?
[speaker002:] Yeah.
[speaker001:] But I think, I'd be very surprised if you do, so... so
[speaker002:] Shall I know which is which in the tablets,
[speaker001:] Yes they'll be clearly labelled.
[speaker002:] Yeah. Mhm....
[speaker001:] And I think I'll ask her to do an electrical tracing of your heart, just for completeness as well,
[speaker002:] Yeah.
[speaker001:] I think. Okay. Now then it's, isn't it??
[speaker002:] That's right, yeah. Well I've been on them Diodides for six year now.
[speaker001:] Yeah I know, but your blood pr I mean they did d they were doing you very well but blood pressure does tend to rise, as you get older
[speaker002:] Yeah yeah.
[speaker001:] and I think that's what
[speaker002:] Probably if it hadn't have been for Sister Helen and I would have never have been able to b catch the at all because I never came to see a doctor.
[speaker001:] You d then we, we'd have er we'd have summoned you by now, don't worry.
[speaker002:] You think so?
[speaker001:] Oh yes.
[speaker002:] Ah ah. I'm saying years ago my old dad, he, he were eighty nine and he never had a blood test in his life.
[speaker001:] Well
[speaker002:] Pressure or anything.
[speaker001:] if you go back even
[speaker002:] You think I could have some of that I pu i m Melorose or something, for dry eyes. I, I have got it on the prescription I had to get it Doctor sent me to the hospital,
[speaker001:] Yeah.
[speaker002:] and there's nothing wrong with my eyes at all, they said dry.
[speaker001:] Ju dry yeah I'll put one of those on for you.
[speaker002:] Cos they're a bit irritable at night.
[speaker001:] Yeah okay. If you only go back ten fifteen years, it wasn't realized fully how many problems are out there,
[speaker002:] Yeah,
[speaker001:] that don't cause people any symptoms until something happens and it's too late.
[speaker002:] That's right, yeah.
[speaker001:] Er that's becoming more recognized, which is why we do more routine things on people who appear fa yeah, it
[speaker002:] Yeah, that's right,. So as you say years at I'm
[speaker001:] No no, I mean
[speaker002:] so ill because I couldn't afford it
[speaker001:] No no.
[speaker002:] but I [LAUGHTER]
[speaker001:] Well sometimes we overdo I think, but anyway. So there's, there's two sixes.
[speaker002:] Yeah.
[speaker001:] The little ones there's only seven of and that's
[speaker002:] Yes.
[speaker001:] one a day.
[speaker002:] Yes.
[speaker001:] And I said, if you take the first dose tonight.
[speaker002:] Yes.
[speaker001:] I j write that, the first dose, dose tonight.
[speaker002:] Tonight, yeah.
[speaker001:] And then
[speaker002:] If I take if I take one at night
[speaker001:] after that, it's
[speaker002:] have I to take another one in the morning?
[speaker001:] If you're okay, yes, yeah. And if you feel completely weak and wobbly,
[speaker002:] Yes.
[speaker001:] then we better see you before you have any more. That has never happened [LAUGHTER] to me yet, first dose problems
[speaker002:] No, no no
[speaker001:] but it's something to be slightly aware of, so And if I can see, if you say you've had the blood test done in around, I dunno, two weeks, at your convenience and then if you see me in about five, which will be at the end of those, which
[speaker002:] So arrangements to have a blood test then,
[speaker001:] Mm.
[speaker002:] in about a fortnight?
[speaker001:] Please, yes. Yeah. Okey-doke.
[speaker002:] These, the chemist can have these back?
[speaker001:] Yes, please, he can then dispose of them.
[speaker002:] [LAUGHTER]
[speaker001:] I'm sorry about that but er is this yours?
[speaker002:] Well I, I wondered. Yes, I
[speaker001:] Yes, don't forget that.
[speaker002:] I wondered what was going on really, because I mean it just at least I can take them
[speaker001:] Yeah, yeah. It's
[speaker002:] got the wife worried,
[speaker001:] It's not a common it isn't a common problem at all that.
[speaker002:] No
[speaker001:] Okay?
[speaker002:] Yes,