Hello Uff-Da,

Hope that you are fine, I wonder if you still away from medication ? please tell me yes :). I hope so.
Thanks,
Michael

Hi Michael,

Yes, I'm still away from medication. I don't know how long that will last, though. I'm keeping pretty close tabs on my BP, as I know I'll have to discuss it with my doctor at my next physical, which I'll schedule sometime after I'm eligible for Medicare in about a month. (That's age 65.)

I've discovered that I have postprandial hypotension, which means that my SBP drops more than 20 points after a meal. By eating all day long, my body is almost always in a postprandial state, so I can keep my daytime pressure down most of the time. (Good thing I'm thin!) Sometimes it even drops lower than I like. For example, about a month ago I got readings of 100/56 and 93/65 after one meal. I just want to go to bed and sleep when that happens, but it usually only drops to somewhere between 110/60 to 125/75 at the lowest.

Of course, there are times it isn't convenient to eat every two hours, I forget, or I apparently don't eat the right things to keep my pressure down. There are occasional days when my systolic tends to run mostly in the 150s, with spikes higher and dips lower. But the majority of the time if I haven't eaten in many hours, my SPB is around 130 if I have rested quietly at least five minutes. But even the lightest activity, like getting up for a glass of water and sitting back down, sends my systolic to 140-145. So at this point, I don't know if I'm going to be able to stay away from the meds or not. If I could just behave myself and stay away from coffee and any commercially frozen products and eat my big homemade salads at least twice every day, I expect I could keep the pressure down. But when I get lazy and want quick meals and am stressed, that's when my pressure gets higher than it should. I'd say that overall, I'm right at the borderline of medicate or don't medicate right now.

Hello,

I remember you have said that you had no side effects on a medication you were on before, I guess it was ACEI?

I hope that best for you but you are really doing a good job for a long time. I'm on Diltiazim 120 SR and it's working like 60% but no side effects. In summer (now) my blood pressure runs between 130/120 on 90/80 :D most of the time no more than that.But the problem is the winter :(. Anyway, I will do my best to keep it that way without adding more medication.
Thanks and good luck,
Michael

Uff-da,

Are you having any problems with weight control from the endless meals?

No, Lenin, no problem with weight control at all. I still weigh 125. I'm 5'5", so that weight is just about perfect. Of course at this age, the weight could be distributed a little better, but it is going to take far more exercise than I will ever do to trim that accumulation off the abdomen.

Actually, I don't think I eat any more than I ever did. Instead of eating three big meals a day, I just distribute the same amount of food into six or eight times. Or more! Since I eat a lot of high fiber foods with all the fruits, veggies, nuts and whole grains, it seems a lot more food than it really is. I've really gone nuts over nuts, going through about a pound of almonds a week. But I think with all the high fiber, one can consume more calories before one starts gaining weight.

Today I caved. Back to meds, I guess.

It was just a week ago that I said I felt I was running just borderline then, and I thought I'd be able to wait another couple of months to discuss my BP with my doctor. Well, since then my BP has been running a little high almost every time I check it. This morning when systolic was 185 after just walking from the bed to the dining room, I decided enough was enough and I called for an appointment to discuss my BP with my doctor tomorrow. I'm going to tell her I probably either need to be back on BP meds or on a tranquilizer or something temporarily. And I'm going to emphasize that I am planning for it to be temporary. Unfortunately, "temporary" could be at least a year before I get this house sold and get settled in a new one.

I'm expect that much of the problem is stress related. (But it was also stress-related when I was on BP meds for five years previously when I was caring for my husband 24/7 and then after his death.) This time the stress may not be as severe and shouldn't last nearly as long. I've decided to sell my big house and downsize, so am getting all kinds of repairs done in preparation for listing it. Dealing with contractors literally seven days a week, when one never knows if and when they will show up, and dealing with their goofs is stressful. All the big more reliable contractors are busy building new houses locally, so at this point I'm forced to deal with those who just do this as a side to their usual work or with those whose skills may not be quite up to what one might expect. It will probably take the rest of the summer to get all the house repairs and painting done. Then I'll have the job of trying to sort through the accumulations of 18 years since I've lived in this house with the thought that I'll probably move to something about half the square footage. And I've been a collector! More stress! In addition, it looks as though my stepdaughter is going to have to go on disability, as she's tried going back to work after her respiratory arrest, and she just is not going to be able to do it. So that adds to the stress.

Part of the BP problem is, no doubt, diet related, too. From past experience, I know that strictly home cooking with a diet very high in vegetables gives me the best BP readings. But that's time consuming to prepare, and with all this chaos in the house, it is so easy to try to get by with prepared foods or at least very easy to prepare ones that aren't necessarily the best for my BP.

So we will see what the doc says tomorrow.

I saw the doctor today. It may be back to meds - but not to blood pressure meds yet.

My systolic was as high as 195 last night. And this morning after breakfast it was down to 108! Then at the doctor's office it was 166. At first my doctor tried to tell me that that kind of range was typical of all of us. But when I showed her my records indicating postprandial hypotension and explained my extreme reaction to stress, she backtracked. She located a place that will do ambulatory BP testing. In fact, she made an appointment for me for Monday morning, though I might change that since it would come out of pocket now, but might be covered by Medicare if I can postpone it until after I'm eligible for Medicare the first of August. After she gets the results from that, she plans to refer me to a cardiologist to sort out the postprandial stuff and make sure there is nothing more serious at the root of it. She admitted that she didn't know a whole lot about postprandial hypotension, except that it was sometimes associated with atrial fibrillation, so felt a specialist should look into it.

In the meantime, my doctor gave me a prescription for Zoloft, to help me deal with the stresses that send my BP into orbit. At least that won't lower my postprandial lows in BP, which I was concerned about if she took the BP med approach. I'll let you know what happens after my ambulatory BP test.

Well, Me too...
I can't ignore too many readings above 140 and the ENDLESS advertising about the dangers of hypertension. I;m playing catchup on OZ (HBO series from several years back) and a main character refused his med and had a heart attack! :D:D:D So it's back on the Lasix-Cozaar combo.
My stress level is banging against the overheat point because I have just embarked on some EXTENSIVE dentristry which has me white-knuckled with fear!:dizzy:

Anyhoo,
In the midst of the mania caused by rebuilding a house, I think the last thing you need is a drug like Zoloft that is QUITE likely to make you manic...AND raise your blood pressure. I really, really really think its a bad choice for you.
I think an occasional benzodiazopine like diazepam might be a FAR better choice for dealing wiith recalcitrant builders, plumbers, carpenters, electricians, gardeners, gazebo-builders etc.

August 1 for Medicare, eh...time does sneak up on us. I have less than 2 years myself and I'll be glad to see the backside of my $600 monthly insurance payments. (I'm asssuming this current Congress and president won't get their wish to dismantle all social programs by then, :D)

Actually, I was on Zoloft for almost a year back in 1999-2000 while caring for my husband 24/7. The main side effect for me then was sleepiness. I'd fall asleep at the wheel a dozen times just between here and his doctor's office 20 miles away - and another dozen times on the way home. Usually woke up as soon as my chin "bounced off my chest." But finally I drove off the road and at that point I decided the Zoloft had to go. However, back then I was getting so very little sleep that I was hoping this time would be better.

I do recall after taking Zoloft just a few times and feeling much more relaxed that my reaction was, "So this is what it is like to feel normal?" I took the first 25 mg tablet last night, and I sure don't feel "normal" yet! (Yeah, I know it may take four weeks to build up the effect.) At the moment, I feel very faintly nauseated and like my upper body is flushing. I don't know if it is from the Zoloft or because I'm ticked about what the builder did yesterday.

The doctor mentioned that my thyroid had been just a tad high with the last blood test. I neglected to ask her for a number. How would that likely affect blood pressure - or anything for that matter? It has been two months since the last test and she suggested she might want to re-test after getting the results of the ambulatory BP.

Hello,

Uff-Da I'm sorry that you might be back on medication again :(, Hyper-Thyroid can has effect on your blood pressure and your heart rate too. About Zoloft, after 4 days my blood pressure went up to something like 160/120. I felt that I'm going to die so I had to stop it.

The problem about High Blood Pressure that it's something you need to care about for the rest of your life, I think about it all the time since I was 14. Hope that you get better soon and please keep us up to date.
Good luck,
Michael

Well, my blood pressure didn't go up last time I was on Zoloft, so I'm hoping it won't this time. But I was also already on BP meds by the time I took the Zoloft last time, too. I did have a bit of a headache this morning which might have been from Zoloft. I'm just not a headache-type person. I could easily count on my fingers and toes the number of times I've had one in my life. But the headache could also have been from the construction screw-ups, too, and might have had nothing to do with Zoloft side-effects.

After finding another major goof this morning, I've just decided I'm going to have to fire one of the workers. He is obviously way over his head on this job, and enough is enough. After I actually fire him, I'm sure my BP will go down -- at least until I get bids from someone else to straighten out his messes.

I called the doctor's office today and got the number on my thyroid test. It was 4.32. Reference range was 0.35 to 5.5, so I am within range, but on the high end of it. I have no idea if anyone thinks being on the high end of "normal" could still be bad.

Hello Uff-Da,

I hope you will finish your house issue soon so you can relax. About Thyroid test, was it T.S.H ? I guess. It's within normal range but you have to make sure that your FT4 and FT3 are in normal ranges too.

Someone told me that the solution to the blood pressure problem is to eat regarding your blood type, have you tried this before?
Thanks and good luck,
Michael

Apparently the sudden rise of my blood pressure is more than just the stress of the workers here. I finally remembered to take my BP monitor to bed with me, so I didn't have to walk 30 feet or more (which usually raises the SBP about 20 points) into another room to take the first reading. Even supine within five minutes of awakening my BP was 162/81, almost the same identical BP I had while I was up during the night. That doesn't jibe with my previous history of blood pressure rising just after a stressful event or thinking of something stressful, but at least subsiding during the night.

I was able to get my systolic down to 125 a couple of times when I was awake during the night, but instead of staying down or taking at least a couple of hours to pop back up, it popped back up within minutes. Part of it, I know, is that I'm just not breathing right. I tend to hold my breath. Perhaps I can manage to take a long walk today to get my breathing back to more normal and relax more at least for a while. I know that I have not been getting adequare exercise the past few weeks.

Michael - I've never heard of eating according to your blood type. You'll have to tell us more about that one.

Uff-Da,

Now I really believe that our bodies are very different and each one has his/her own mechanism. My blood pressure never gets 20 points higher when I walk 30 feets, anyway you need to research what's going on. I think that eating according to your blood type is a good step, although I can't do it in Egypt because food here is like 10 times expensive as in the US (relative to salaries of course).

I don't know much about it but you can read more about that online or get the book Eat Right 4 Your Type.
Thanks,
Michael

Yes, I've checked it many times. Compared to a seated, resting position, my BP after getting up and moving around, even as little as seven feet to the refrigerator, getting a glass of water, and going back to the table, increases my SBP anywhere from 5-20 points, most usually close to 20. Just moving at all increases my pressure just about the same amount as much more active movement, like climbing one or two flights of stairs or vacuuming. That's one reason it really ticks me off that the nurse at my doctor's office will never let me sit quietly for even a minute before she slaps the BP cuff on me. From the waiting room, it is a walk of 30-40 feet, so I know my BP would show considerably lower if she would ever allow me a few minutes resting time. Since I spend the majority of my time at home seated (at my desk, at the sewing machine, reading, etc.) I'd think that would be closer to my usual BP than the "immediately after light exercise" pressure.

I'll have to look into that book. I think there is a lot of truth that individuals have different dietary needs because their systems are different. I don't know if we have enough knowledge yet to identify what the diets should be, but it may be worth seeing what someone has to say about it.

VENT TIME! I'm really ticked off!

I'm having the ambulatory BP monitoring done today. I was having enough problems that I decided not to wait until I'm covered by Medicare in 15 days, so it is going to cost me $260 out of pocket. And I don't think the thing is working properly.

The nurse who fitted the monitor on me gave me almost no instructions at all. She didn't say if one could exercise or not (I assume so from my reading on the web, but surely that should have been included in instructions), that one should hold the arm still while it takes the pressure, if one could lay on it if you sleep on that side. She didn't even know how often the thing takes one's pressure. She said every 30 minutes during the day (it is actually every 20 minutes) and every hour at night. She didn't tell me there was a button to push to take extra readings until I asked her. She didn't recommend making a written journal of activities. (How would one determine BP during sleep or postprandial hypotension if they couldn't coordinate the readings to activities?)

The monitor worked properly, I think, for six readings. Then it would seem to be taking my pressure - and maybe it still is - but instead of numbers while it is pumping up, all I get is a series of dashes. And it no longer shows what the BP reading was after it gets done. It just makes a beep, gives an error code, and shuts off. So if it is working, I can't see what the readings are. I WANT TO KNOW! LOL!

I called the office and asked what the codes EC01 and EC02 meant. The nurse said it probably means it isn't working properly. Brilliant remark! I'd think she could have looked it up to see if the errors would indicate something where the readings just aren't showing up or if the thing is not recording, either.

So guess I have to go back in after lunch. It is an hour and a half round trip. Grrrrrrrrrrrrrrr! If they want some BP readings that show reaction to stress, they will get them, if that thing is actually still recording.

Edited to add: I took my BP on the other arm shortly after the last "reading" on the ABP monitor. It was 178/84.

Goodness,
I would have waited the 15 days come Hell or high water.

Probably the EC01 and EC02 just mean "error computing #1" and "error computing #2" and the next would probably be EC03.

THe whole process sounds tedious...to pick an uncensorable word :D

Probably the EC01 and EC02 just mean "error computing #1" and "error computing #2" and the next would probably be EC03.Oh, I'm sure it did, but if they are using the equipment, they should either know what the error codes mean or have the instruction book available to look them up. EC01, for example, might mean that the patient moved the arm, so an accurate reading could not be taken. EC02 might have meant the cuff got twisted and was not properly located on the artery, or some such thing. Maybe there was an EC03 that meant the battery was going dead. If I knew the meaning of the codes, I could have probably been able to figure out whether the thing was still recording or if it was just that I wasn't able to see the results without having to make another 90 minute round trip.

As it was, the nurse really couldn't tell for sure, either, but she thinks it is just that I can't see the results. She couldn't take it off me to check or what results we did have would be invalidated, so I came back home with machine still not showing me any results. And we just hope it is recording.

I seriously considered waiting the 15 days, but this has been a rather sudden onset of increased BP, plus I've started having some strange sensations in my chest (which are probably just gastric problems, which I rarely have) but it does make me nervous. Plus, I'm now getting suspicious that it isn't just stress related, but could well be some secondary cause. I'll probably wait until after I'm on Medicare to see the cardiologist, though. He may well order some additional expensive tests.

Oh, I'm sure it did, but if they are using the equipment, they should either know what the error codes mean or have the instruction book available to look them up. EC01, for example, might mean that the patient moved the arm, so an accurate reading could not be taken. EC02 might have meant the cuff got twisted and was not properly located on the artery, or some such thing. Maybe there was an EC03 that meant the battery was going dead. If I knew the meaning of the codes, I could have probably been able to figure out whether the thing was still recording or if it was just that I wasn't able to see the results without having to make another 90 minute round trip.



Uff-da,
You missed my point which was that perhaps the error codes might have NO meaning and the affixed number merely served to differentiate the events as in "the first error", "the second error," "the third error," etc., with no indication as to the type of error. If they came in order, this would be likely.
Just one step removed from my digital tester which says "ERR" no matter what the problem! :D (Except for the SINGLE understandable one, "BATT")

Make sure you take your daily aspirin for the next 2 weeks.

Do you think there might be a connection between your normal mild-mannerdness and VENT TIME...3 days after you mentioned the antidepressant.:D:D I think, though I know that I am repeating myself, that the Zoloft is a singularly awful idea for you.

Uff-da,
You missed my point which was that perhaps the error codes might have NO meaning and the affixed number merely served to differentiate the events as in "the first error", "the second error," "the third error," etc., with no indication as to the type of error. If they came in order, this would be likely.Oh, I see what you were saying. No, it didn't happen that way. EC01 and EC02, whatever they mean, keep repeating themselves, so they must have some specific meaning.

Make sure you take your daily aspirin for the next 2 weeks.Thanks for the reminder. Yesterday when I was leaving the town where the hospital is and started having weird chest sensations, I actually turned the car around and started back toward the hospital, so I'd be close to the ER if I reached the conclusion that the pains might be heart related. But I saw a store and stopped to buy a bottle of aspirin, thinking that the 81 mg one I'd taken that morning might not be enough. Maybe I'll up my dose to a full aspirin for the next few weeks. Anyway, I waited in the store parking lot until I reached the conclusion that the problem wasn't heart related. They say women's symptoms of heart attack are much less clear than in men, so I really don't know what to expect.

Do you think there might be a connection between your normal mild-mannerdness and VENT TIME...3 days after you mentioned the antidepressant.:D:D I think, though I know that I am repeating myself, that the Zoloft is a singularly awful idea for you.You mean I have fooled you all this time? LOL! Actually, I can be a blow top. I tend to keep it all in for a while, just letting my BP rise and camouflaging my feelings. Finally I BLOW, antidepressant or not. When I took Zoloft back in 1999 and 2000, it calmed me down a lot and I felt normal for the first time in my life. But this time so far it just seems to be doing nothing. I don't feel any calmer, or any more agitated, either. I'm still on just the 25 mg, so thought I'd wait until I go to the 50 mg a few days before calling my doctor and telling her it isn't helping. But as I recall, it started helping right away last time even on the lower dose. My memory is bad, though, so I thought I'd give it a shot a few more days.

The nurse at the doctor's office that had the ABP machine called today to let me know that the readings did take, even though I wasn't able to see what they were. As I mentioned above, though, I did take my own pressure on the right arm with my home BP machine shortly after the ABP machine took it on my left arm most of the waking hours, so I have a good idea of what the record will show.

:D Wait until my own doctor sees my activity record! The second highest reading of the day, 175/95, has the activity notation, "Thinking about Dr. (name) not believing my BP readings." LOL! What is even funnier is that this was during the postprandial time, when my pressure should have already started going down. My BP 14 minutes earlier, with the note "just before starting breakfast" was 149/84. That's quite a jump for just a stressful thought! I was afraid when I saw that jump that it would totally mess up that I was trying to show my doctor that I had postprandial hypotension. So I very deliberately changed my thoughts and my PPH definitely showed up. My BP was down to 122/71 46 minutes after thinking about my doctor.

I made an appointment to see my doctor to evaluate all this Thursday afternoon. I fear that at this point I am definitely in "medication" territory. Without taking the time to add up the readings I got, a quick look leads me to believe the average daytime systolic is in the neighborhood of 155. That's about 20 points higher than my average was just a month or two ago. How much of it is from the recent stress of the construction and all, I don't know, but I'm still suspicious that there is more to the big jump than just that.

I'm back on meds. Just a very small dose, though, 5 mg Lisinopril. When I was on meds before, it was 30 mg for four years, then 10 mg the last year. I've been off meds for about a year and a half. Because I have problems of both too high and too low readings, she doesn't want me to drop too low. My systolic during the test dropped to 110 twice, once during my daytime nap and early in the night time sleep cycle.

Much to my surprise, my average systolic reading was only 138. And that was a high-stress day. Though I had 63.1% of systolic readings "above limits," my sleeping and postprandial readings were low enough to make up for it. Since the few times I'd taken readings immediately upon awakening, the readings were 145 or so, I'd been concerned that my BP during sleep might not dip, which would increase the 24-hour pressure average by a lot.

Though I did learn some things from the test, I was frankly disappointed. They did not ask for an activity log. The nurse said I could just give the log I made to my doctor. My doctor didn't even look at it. The interpretation was done by the doctor who had the machine, and he didn't have my activity record. So naturally there was no interpretation of postprandial hypotension, which was my primary concern. They also used an arbitrary time period, 10 pm to 6 am as "sleep period." My actual sleep periods were 6:30-7:15 pm and 11:30 pm to 4:30 am. Obviously, such a difference would have changed the sleep and awake averages a lot.

One notation in the interpretation should interest many of you. "Suggestive of White Coat HTN."

The doctor is going to hold off on referring me to a cardiologist until we see what happens with the low dose Lisinopril.

I finally got around to getting my prescription for Lisinopril filled and took the first one yesterday afternoon. (My last reading before I took it was 173/81.) I didn't think that a mere 5 mg was going to do anything, but I had a before breakfast reading of 124/75 and a postprandial reading of 96/68 about 45 minutes later. I wouldn't want it to go much lower than that. After a reading like that, I am enjoying a cup of coffee!

We'll see what happens to my BP when the painters return this afternoon.

Hello,

You know I'm worry about you having that range of readings in that short time. I hope that you will get it under control soon.
Stay healthy and good luck,
Michael