Ivy is over 80. She is tiny, both short and incredibly thin, but really very well. Except that she worries. Lots. All the time. Six or seven years ago she was found to have high blood pressure. Every treatmnet we offered her made her ankles swell, gave her dizzy turns, made her cough.... if there was a published side effect she got it within the frst few doses. And yes she really did get them, because she was very worried about her blood pressure and very keen to take medication to control it.
In the end we settled for very low dose diuretics as the lesser of several evils. Then her blood sugar crept into the diabetic range. Never high enough to require insulin. Never quite normal enough not to worry, and so we have done the same dance with tablets for diabetes, again settling for the lowest dose of the mildest medication to keep her sugars on an even keel.
Next came the high cholesterol..... and so we go on. She is tormented by side effects to pills she feels she must take, or tormented by "abnormal" results where she cannot tolerate the "treatment". He life is now dominated by sugar and cholesterol levels and BP values and frequent attendances to our Diabetes Clinic.
Neil is stolid and phlegmatic. His breatlessness has been getting worse for a couple of years, resulting in a diagnosis of "Heart Failure". He has been started on all the right med's and has his breathing back under control, but now whenever he tries to stand up his blood pressure drops and he falls over! After a month of this he came in for a chat today, and we have decided the side effect of his postural hypotension might be best managed by reducing his meds a little! "But if you tell me to take the tablets that's what I do!" he says. Despite seemingly catastrophic side effects he isn't at all worried.
This blind faith in our profession is very touching. Still I am left wondering just how much better Ivy and Neil have been made by our interventions?