Q for our Doctors, NHS preventative testing?
Discussion
A quick question for our Doctors please...
Does the NHS do ANY preventative testing as relatives have been refused this?
Case in hand, had an infarctus, cause probably extremely high (150mg) Lipoprotein a which according to my heart clinic is genetic and thus wanted to get rest of my family checked... their local GPs (2 to date) have refused to do any tests as they say it is not acute. How can they judge this on the telephone and without a bloodtest, and is preventative testing now not allowed? Do they know about LPa?
Your opinions appreciated (also off-forum if necessary) as I'm worried for the family. Thanks
Does the NHS do ANY preventative testing as relatives have been refused this?
Case in hand, had an infarctus, cause probably extremely high (150mg) Lipoprotein a which according to my heart clinic is genetic and thus wanted to get rest of my family checked... their local GPs (2 to date) have refused to do any tests as they say it is not acute. How can they judge this on the telephone and without a bloodtest, and is preventative testing now not allowed? Do they know about LPa?
Your opinions appreciated (also off-forum if necessary) as I'm worried for the family. Thanks
JMGS4 said:
A quick question for our Doctors please...
Does the NHS do ANY preventative testing as relatives have been refused this?
Case in hand, had an infarctus, cause probably extremely high (150mg) Lipoprotein a which according to my heart clinic is genetic and thus wanted to get rest of my family checked... their local GPs (2 to date) have refused to do any tests as they say it is not acute. How can they judge this on the telephone and without a bloodtest, and is preventative testing now not allowed? Do they know about LPa?
Your opinions appreciated (also off-forum if necessary) as I'm worried for the family. Thanks
I am not a GP, and I am sure that Julian will no doubt point that out, but if you have a condition which is thought to be a genetic disease and your family is at risk, then they should be screened for the disease, if they wish.
In my field, there is a familial tendency for glaucoma, and any patient with a diagnosis of glaucoma is told to advise their children and relatives to get screened at their next eye test (people over 40 years old). I don't see why your case should be any different. It might be worth asking the Cardiologists who are looking after you to write a letter to remind your GP that this disease is genetic, and its consequences can be prevented quite easily.
968, thanks, my problem is that I'm in Germany with an excellent medical service, the rest of the family is in GB subject to the whims of the NHS, so I doubt if they'd understand a german cardiologist's letter. I was also surprised that their GPs said what they did...perhaps I'll get a letter in English for them...
JMGS4 said:
968, thanks, my problem is that I'm in Germany with an excellent medical service, the rest of the family is in GB subject to the whims of the NHS, so I doubt if they'd understand a german cardiologist's letter. I was also surprised that their GPs said what they did...perhaps I'll get a letter in English for them...
They should be able to write them a letter in English, outlining your problem, and its aetiology, ie genetic disease. That aside, the GP shouldn't refuse them from getting their lipid profile checked, if someone in the familiy has been found to have a familial lipoproteinaemia.
When in 1997 my wife was found to have a genetic duplication(46X dup(q13-q26)for all you genetists(sp)out there) the whole family ,mainly her side,were offered and given genetic tests just so they could try and trace its origin etc.It,in her case,only effects the male offspring(50:50 chance)so our daughters are unaffected but may be carriers also and on this subject they have offered to test them when in their early teens.This service was offered by the Guys and St Thomas(sp)hospital so perhaps its regional and due to funding.BTW my wifes duplication was 'de novo' or new in otherwords it started with her.We only found out because the daughter she was expecting was affected by a heart condition and she was tested as routine.
Andy
Andy
slightly o/t, but there in a bacterial infection called group b strep which 30% of adults carry in their stomachs, and about a quarter of women carry in their vagina. While harmless to adults, it is potentially fatal if a baby picks it up from the mother during birth. Carriers are given IV antibiotics during labour, or the baby is given them immediately after birth if the mother was not administered them.
The NHS do not routinely test for GBS, as the cheap test they do is not accurate enough - it can fail to detect GBS in some cases, though it never gives a falsely positive reading. A much more accurate test is available, costing £18.
Through pure coincidence, it was discovered that I had GBS, and so I was able to be given antibiotics during labour meaning that Alex was born fit and healthy - others are not so lucky.
Considering that GBS causes meningitis and septicemia in newborns, does it not make sense that even if they aren't prepared to test women on the NHS, they should at least make them aware of the availability of the other test, and indeed the existence of GBS? The first that was mentioned to us by the midwife was when she arrived on my doorstep on my due-date to let me know they had found I had it!
Surely to save lives, giving women some information wouldn't be that great a cost for them?!
The NHS do not routinely test for GBS, as the cheap test they do is not accurate enough - it can fail to detect GBS in some cases, though it never gives a falsely positive reading. A much more accurate test is available, costing £18.
Through pure coincidence, it was discovered that I had GBS, and so I was able to be given antibiotics during labour meaning that Alex was born fit and healthy - others are not so lucky.
Considering that GBS causes meningitis and septicemia in newborns, does it not make sense that even if they aren't prepared to test women on the NHS, they should at least make them aware of the availability of the other test, and indeed the existence of GBS? The first that was mentioned to us by the midwife was when she arrived on my doorstep on my due-date to let me know they had found I had it!
Surely to save lives, giving women some information wouldn't be that great a cost for them?!
Hi John
Cholesterol testing is largely age dependent, and because the reference tables used to determine cardiovascular risk are of little use below age 50, that could be one explanation. The risk calculation depends on a number of factors, high cholesterol being only one of them. Smoking is by far the greatest risk factor, and high blood pressure and diabetes are also big risk "increasers".
However, strong family history of CVD (cardiovascular disease) is one indicator for lipid tesing of immediate family members.
I think it is reasonable for a GP to send off a lipid screen if close relatives are having heart attacks and strokes - I would certainly do a test.
Cholesterol testing is largely age dependent, and because the reference tables used to determine cardiovascular risk are of little use below age 50, that could be one explanation. The risk calculation depends on a number of factors, high cholesterol being only one of them. Smoking is by far the greatest risk factor, and high blood pressure and diabetes are also big risk "increasers".
However, strong family history of CVD (cardiovascular disease) is one indicator for lipid tesing of immediate family members.
I think it is reasonable for a GP to send off a lipid screen if close relatives are having heart attacks and strokes - I would certainly do a test.
nubbin said:
Hi John
Cholesterol testing is largely age dependent, and because the reference tables used to determine cardiovascular risk are of little use below age 50, that could be one explanation. The risk calculation depends on a number of factors, high cholesterol being only one of them. Smoking is by far the greatest risk factor, and high blood pressure and diabetes are also big risk "increasers".
However, strong family history of CVD (cardiovascular disease) is one indicator for lipid tesing of immediate family members.
I think it is reasonable for a GP to send off a lipid screen if close relatives are having heart attacks and strokes - I would certainly do a test.
I thought in the case of familial hyperlipidaemia, it was advised to carry out tests?
JMGS4.... if your GP gives you grief, produce this web page for him/her....
www.bhf.org.uk/hearthealth/index.asp?secID=1&secondlevel=78&thirdlevel=166&artID=447
In particular, quote this paragraph "If you have been told you have FH, it is important to tell other members of your family to tell their doctor and have their blood cholesterol levels measured. Many people with FH are not obese and may not have any other risk factors for coronary heart disease. If you are related to someone with FH, don’t put off asking for a blood cholesterol test just because you feel you are fit and well at the moment. Anyone with FH who has a child should find out as early as possible if their child has inherited FH. It is important to find out at least by the time the child is five because even at this age, healthy eating is important. As the child gets older it is particularly important that he or she does not start to smoke."
Hope it helps.
www.bhf.org.uk/hearthealth/index.asp?secID=1&secondlevel=78&thirdlevel=166&artID=447
In particular, quote this paragraph "If you have been told you have FH, it is important to tell other members of your family to tell their doctor and have their blood cholesterol levels measured. Many people with FH are not obese and may not have any other risk factors for coronary heart disease. If you are related to someone with FH, don’t put off asking for a blood cholesterol test just because you feel you are fit and well at the moment. Anyone with FH who has a child should find out as early as possible if their child has inherited FH. It is important to find out at least by the time the child is five because even at this age, healthy eating is important. As the child gets older it is particularly important that he or she does not start to smoke."
Hope it helps.
968 said:
nubbin said:
Hi John
Cholesterol testing is largely age dependent, and because the reference tables used to determine cardiovascular risk are of little use below age 50, that could be one explanation. The risk calculation depends on a number of factors, high cholesterol being only one of them. Smoking is by far the greatest risk factor, and high blood pressure and diabetes are also big risk "increasers".
However, strong family history of CVD (cardiovascular disease) is one indicator for lipid tesing of immediate family members.
I think it is reasonable for a GP to send off a lipid screen if close relatives are having heart attacks and strokes - I would certainly do a test.
I thought in the case of familial hyperlipidaemia, it was advised to carry out tests?
Absolutely - if the lipid profile definitely indicates a familial pattern - and there's usually a strong family history of CVD events at relatively young ages which helps to highlight the genetic problem. As I said, I would certainly do a test based on this story.
JMGS4 probably just frightened himself driving his Porsche too fast!
Get well soon, John!
>> Edited by nubbin on Thursday 31st March 15:47
nubbin said:
JMGS4 probably just frightened himself driving his Porsche too fast!
Thanks all.... esp 968..... will send the page to my sister for passing on to GP...thanks again!
nubbin, I get scared more of being killed by numpties than of fast driving.....
thanks for the good wishes...JohnGassing Station | The Pie & Piston Archive | Top of Page | What's New | My Stuff