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Old 07-30-2007, 07:20 PM   #1
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Unhappy Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Let me first appologize, this will be a bit long.

Please, provide any assistance or guidance of you can.
about mid june '07, i had been experiencing a bit more stress with work and home life than usual.

I had also been slowly developing a loss of appetite and neusea when eating. I began losing weight. I had also been experiencing swelling salival glands and slight vertigo and some heartburn.

I had attributed to bad food, so I stopped nightime sleep aid and caffiene.
June 28th 2007, I visited my general physician and had explained to him my symptoms. I had my bp checked and it was 125/79. Normal as usual. I have never had blood pressure problems. I would soon find out that this would be the last normal reading i would recieve.

The doc said I had swelling behind the ears and "cobblestone" appearance to the throat. He attributed to allergies and prescribed allegra and rhonocort.
June 29th was a typical day, went to work then had to pick up niece approx 40 miles away. My wife was driving and we had stopped to get some food at Taco bell. I had eaten my food an thought it was odd that I didnt feel neuseated. We he just ate and headed home.

On the way home, I recall feeling a slight pinch in the left side of my neck, then my heart rate shot up. I was feeling very irritable. I couldnt calm down. I began having palpitations. We got home and I had my wife run me up to the store so I could use their bloood pressure monitor. I was really anxious and couldnt calm down. the blood pressure read 175/105.

I said we need to go to the er. We went and I couldnt calm down. They finally got me in and my bp had reached 215/120. they took urine, blood and ekg test then just monitored me not doing anything to assist with blood pressure.

i was in er bed for 5 hours and they said that all tests were fine. The doc said that i had GERD and it just triggered my problems. he prescribed protonix and sent me on my way.

Since this day, my blood pressure never came back down. I had to go to the ER two days later with same issues and they just said that I need to see a cardiologist.

I visited a cardiologist and my blood pressure remained about the 140/90 range. He didnt want to give me blood pressure meds as he was thinking that i have seconary hypertension and he wanted me to come back for some more tests.

I went back for general physician and he prescribed ativan thinking i just had anxiety. It did help somewhat, but my blood pressure never came back down.
throughout this ordeal, i had ached in my gut and difficult to eat.

I ended up in the ER about a week after the last ER visi with hogh blood pressure and palpitations. I went to a different hospital. They did blood test, urine test, and chest and back xrays which apperently were normal. i had pretty bad stomache aches and they decided that i needed off the protonix and take pepcid.
The ER doc recommend i get an endoscopy.
I made an appt and had the procedure done and they diagnosed me with duodenitis and gastritis. i was prescribed prevacid and sucralfate.

meanwhile, i went back to the cardiologist as i have been irritable, lethargic and uneasy feeling. my blood preeure was 170/100. he gave me diovan and said take that. he also requested a 24hr urinalysis. Items out of range are:

Creatinine 3.41 g/24h -normal: 0.63-2.50
Metanephrine 289 mcg/24h - normal: 25-222
normetanephrine 443 mcg/24h - normal: 40-412
metanephrines total 732 mcg/24h - normal: 96-604

these results let the cardiologist to believe that i may have adrenal tumors. i had CT scan performed that appeared to be negative for adrenal masses.
i raised concern about my kidneys or blockages to the cardiologist and he said thats not the problem and "you're too young".

Throughout this whole ordeal, I have lost 40 lbs, i dont feel well at all, i have been taking the most prescription drugs in my life. I cant walk for long periods of time, i spend most of my time in my bed and i have missed so many days from work and i cant keep up with m wife and kids. I am so depressed and nobody knows whats wrong with me or why the sudden onset of hypertension.. At this point, i am so desperate and i wish someone could help me or figure out whats wrong with all these supposed "advances in medical technology".

My cardiologist gave me Lotrel too replace the Diovan 160mg. I have been afraid to take the Lotrel from all of the side-affects i have read about.

I have a colonoscopy scheduled for the upcoming week.
I am concerned about the Phospho soda that is required to prep for the colonoscopy. Being that I'm questioning my kidney function, theres has been rare cases of causing permanent renal failure. I talked to my gastro doc, and he seemed to not have any concern.

The other day, i experienced a similar strange pinch in my neck that raised my heart rate and took me to the er the fist time. It seemed that my gland on the left side swelled up for a couple hours after that.I am wondering if i need to see a nephrologist or endocrinologist.

Please, anyone with any advice, please help. Thanks

 
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Old 07-30-2007, 07:51 PM   #2
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Ok... your 24 hour urine shows a possibility of something called 'pheochromocytoma' (these adrenaline secreting tumors are usually found on the adrenal glands BUT NOT ALWAYS!!!!!)

You need to see an Endocrinologist and to ask for a Plasma Free Metanephrine test (it is more conclusive) and since you seem to have that neck issue I would be willing to bet that they will find it on your neck (this is not uncommon for a 'pheo')

Pheochromocytoma is sometimes called the 10% disease... 10% are not in the adrenal glands... 10% are hereditary... 10% are malignant...

Pheochromocytoma is a cause for high BP that can be cured!!!

Push, yell, kick and scream to get to an Endocrinologist ASAP and do some looking on your own to learn more about this very rare condition.

(I am in the testing phase for this condition myself... my normetanephrines are 819)

Good luck and please let us know how things go!!!
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Last edited by Administrator; 07-17-2010 at 09:26 AM.

 
Old 07-30-2007, 08:07 PM   #3
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Your story caught my eye and I can feel your frustration and concern. I am not a medical doctor, but let me share this with you. I have an adult daughter who has some chronic illnesses that turned her life upside down (nothing similiar to your case). It took over a year for her to get diagnosed. My suggestion is that you get copies of all your test result and go to a teaching hospital.

I see that you are from Utah...there is a highly regarded medical center there...[removed]. Usually teaching hospitals have more knowledgable doctors. You might want to take all your test results and start with an internist there.

I would also say that doctors love to tell peolple they are too young or to this or that to worry about certain things. Don't buy into that. The main point is to be persistant and if you can't find your answer from the next doctor, sometimes you have to move on to another one.

Also, there is medication for palpitations, you could ask your cardiologist about this.

Don't give up.

Last edited by mod-anon; 07-31-2007 at 01:42 AM. Reason: do not post info on how to find websites

 
Old 07-30-2007, 08:09 PM   #4
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

BigJim,

Am sorry to learn that you're having problems...it must be scary to have those experiences and not know anyone with similar symptoms.

Given your young age, it is most likely that your hypertension is secondary in nature meaning that it is caused by an identifiable condition. The good news is that if this indeed is the case, it may be possible to "cure" your high blood pressure and other symptoms.

I would suggest reading about secondary hypertension and the conditions that cause it.

One condition that comes to mind immediately is pheochromocytoma....this is a list of some of the symptoms that people with this condition may have. Keep in mind that one doesn't have to have ALL of the symptoms to have pheo...

Headaches (severe)
Excess sweating (generalized)
Racing heart (tachycardia and palpitations)
Anxiety / nervousness (feelings of impending death)
Nervous shaking (tremors)
Pain in the lower chest or upper abdomen
Nausea (with or without nausea)
Weight loss
Heat intolerance

But again, I would recommend reading as much as you can about all of the secondary hypertension conditions. Learn as much as you can...and don't assume your doctors know everything...ask lots of questions and do lots of research.

A cardiologist who suspects secondary hypertension, has done a 24 hour urninalysis and suspects an adrenal tumor is definitely someone I'd want to see again. It sounds like s/he knows what s/he's doing.

Bethsheba

You might want to check out the pheo posts on this board...we recently had someone diagnosed with this conditon but she hasn't posted in the last few days. Penybobeny just posted...read and reread her post...and ask her lots of questions.

Last edited by bethsheba; 07-30-2007 at 08:11 PM.

 
Old 07-30-2007, 08:13 PM   #5
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Thanks for the response.

Out of all of the ailments, that is what myself and docs are hoping is the cause. (pheo)

I did have a CT scan on my adrenals, and we were dissappointed to find out that there were no Pheo's. Apparently there is a nuclear test that can pinpoint them even if the CT fails to show anything.

Being that they are able to grow in the neck, that sheds some new light.

My hope is that i have that, they cut it out, and no more medications. This has been so hard on me mentally, physically, and emotionally.

I get mad at watching TV seeing actors that do stuff i want to do and used to be able to do. Maybe i need stronger BP meds? I cant even exercise.

Can allergies cause sudden onsets of hypertension?

Thanks for the response and i will keep you posted of all findings.

i have condsidered looking for an endocrinologist at university hospital hoping they would be more motivated.

Thanks

Last edited by kerry4; 07-30-2007 at 08:16 PM.

 
Old 07-30-2007, 08:21 PM   #6
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

penybobeny:

What blood pressure meds or any other meds do you currently use if you dont mind my asking.

 
Old 07-30-2007, 08:30 PM   #7
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

There is a test called a MiBG that is used to locate adrenal and extra-adrenal pheochromocytomas...

The first Dr that I saw about my possible Pheo did no more than a CT of my adrenals and decided that it was not a pheo... he then ignored the 24 hour urine that was obviously positive... when told that not all adrenaline secreting tumors are located on the adrenal gland he just rolled his eyes. He admitted that he knew nothing about pheo's (they are very rare...) and said "they are very rare, so you don't have one"... Rare means just that... rare... if it was impossible for anyone to get one they would be called impossible.

Check to see what Endocrinologists accept your insurance then start calling... be sure to ask if they have experience with Pheochromocytoma... not all Dr's do and your chances of getting the tests and understanding that you need depends on a Dr that not only is familure with this condition but has treated patients with it.
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Last edited by penybobeny; 07-30-2007 at 08:33 PM. Reason: sneezed, hit post... what can I say I am bloooonde

 
Old 07-30-2007, 08:41 PM   #8
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

I am currently on DiovanHCT 160/25 and Varapamil 240 for my BP and tachycardia (racing heart). These do not stop 'break through' episodes of BP in the 220/130 range or a heart rate of 160 for no reason though. Topomax did not work for me.

You need to get a good BP monitor and keep a dairy of your BP at odd times during the day, writing down what you were doing and anything that might have set it off.

You will probably be put on a holter monitor... a 24 hour one might not be long enough to 'catch' enough episodes to get a clear idea of what is going on.

you can go to [url]http://www.nih.gov/[/url] to find more information
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Old 07-30-2007, 11:23 PM   #9
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Hi BJ,

I have some idea of how scary your situation is. I developed Thyroiditis in 03' which send my b/p soaring & gave me severe thyroid pain for several months. Anyhow I also had tests for Pheo because my b/p continued to be eratic even with meds. One test show a possibility for Pheo but the others were normal. But my medication Lebetalol interferred with the results of the urine & blood tests so the results were almost useless. Make sure that the Dr. is aware of any meds you are taking that may interfere with the tests.

Lebetalol is a apha/beta blocker that is often used in the ER. It keeps my heart rate down but it won't prevent extreme "breakthrough systolic b/p" increases in certain situations. However, it is a drug one can take more of during these increases. It works faster than other beta blockers. I've found it easier on the stomach than other beta blockers.

I've found it easier take tablets rather than capsules etc. One reason being I have a swallowing problem. Tablets usually can be diluted with about 1-2 oz of water (room temperature). So when the med reaches the stomach it is spread over a larger area & is less irritating to the stomach lining. I always eat some food then take the med. Then eat some more. Eating an egg (fried with a 1 tsp of Fleishman margarine) is my secret weapon against gastitis caused by meds. The idea is to coat your stomach & throat with a little fat & protein from the egg. I also take HCTZ (diuretic).

Make sure the Dr. has checked your thyroid (your wt loss & swelling in neck plus the twinge, irritability are a few symptoms that bring that to mind. If he hasn't, he should be fired!!!

I've found Endocrinologists the best DR's at diagnosing, being empathtic & caring. In fact it was such a Dr. who suggested my going on Lebetalol when my regular Dr. was at a loss.

In the meantime, keep copies of all lab results, Dr's visits etc. You never know when your will need them especially going to other Dr's. Keep telling yourself that a solution will be found because this will motivate you to keep seeking info & not give up even when others do.

I kept & still keep journal (ntebook will do) as it helped with the frustration and anger of dealing with a overwhelming illness with no apparent cure. Just write whatever comes into your head. It is not a term paper so don't pay attention to correct grammar etc. Until you do this, you don't realize how much putting your feelings down on paper helps.

Come here for support & any answers to your questions that we can give you.
Fam

 
Old 07-31-2007, 02:35 AM   #10
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

I am sorry to hear about your problem. I know it is very scary. I too was a reasonably healthy person one day, and the next day I started having episodic bouts of hypertension. This then triggered anxiety about the hypertension, which increased the frequency of hypertension,and eventually gave me primary hypertension.

I was having stress and anxiety in my personal life,and my BP shot up every time I was anxious and worried,and finally my BP remained high all the time. Alot of people start off this way.

It will get better. It takes a while to work through all this.I see you are very worried,and maybe some valium can help relax you a bit or at least help the anxiety part, while investigations are being done. You have to try to stay sane as best you can. I know you are probably very stressed right now, but that may just increase your BP, which will only make things worse.

 
Old 07-31-2007, 04:16 AM   #11
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

jim,

Let me toss in one thought probably apropos of nothing : the major BP sensor in the body is located in the carotid artery of the neck. Perhaps it's not coincidence that you feel that "neck pinch" just at the time your BP spikes. Perhaps it's also tied to that "cobbly throat."

It sounds like you need Dr. House, aka an expert diagnostician...your condition is definitely not run-of-the mill.

(Replace the Ativan with some Valium (diazapam)...Ativan is the worst tranquilizer ever made. It is supposed to cure panic but CAUSES it when it quickly wears off. A TERRIBLE drug. It's probably adding to your problems.)

Last edited by Lenin; 07-31-2007 at 04:25 AM.

 
Old 07-31-2007, 07:05 AM   #12
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

[QUOTE]I always eat some food then take the med. Then eat some more. Eating an egg (fried with a 1 tsp of Fleishman margarine) is my secret

Thanks for the tip! It's in my notebook now.

For those watching their cholesterol, Harvard investigators determined in one of their studies that adding one egg a day to one's diet (in healthy adults) does not increase their risk of heart disease and stroke. These findings encouraged the AHA to revise its dietary guidelines to include one egg a day.

A teaspoon of honey taken five minutes before the meds also works well for esophagal/stomach sensitivity.

flowergirl

 
Old 08-02-2007, 10:04 AM   #13
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Just a follow up...

I had a colonoscopy and they found all sorts of erosions. Not sure of the causes.

I now have another drug called Lialda that should help remedy this and hopyfully my guts will be fixed.

As for the hypertension... i did a search for a doctor that had decent reviews in my area. To my surprise, i found a doc that my wife has been to before that had been able to help her.

I was able to get an appt with him yesterday. So far, he has shown a ton more care that any other doctor i have visited. I showed him my results from my 24urinalisys. As he saw that my epinephrine, norepinephrine, metanephrine and creatinine levels we way above normal, he asked me "So, when you show the other docs this, what did they do or say?"
All i could tell him was that they exclaimed at how abnormally high those levels are and thats about it. Also i told him that I did have a CT scan ordered by my cardiologist, however that doc seemed to drop the ball after the results were negative.

This doctor that i visited yesterday was dumbfounded that nobody did anything else to persue my case. He took my information and immediately said "ill be right back, i gotta go make some calls"

Apparently he had to consult a few other docs and he came back saying he wanted to do another CT scan, however this time it wouldnt be on the entire abdomen, it would be with strict emphasis on the kidneys and adrenal glands.

He mentioned that it sounded as I may have a Pheo or another issue of a carcinoma within the kidney creating pressure causing the abnormal release of hormones. They took more blood to test for this issue.

I was so suprised at this doctors proactivism. He seems so motivated to get me taken care of.

I have a CT scan August 6th and he said he should have the results from the blood tests and scan on August 7th. He hopes that we will have an answer.

I am so excited to have found a doc that cares.

Apparently, if these prove to be negative, then we may need some scanning of my brain for pituitary masses. I think that it would be great, as there is progress being made.

Thanks everyone, I will post any findings that I recieve.

 
Old 08-02-2007, 12:20 PM   #14
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Hi,

Quote:
I was so suprised at this doctors proactivism. He seems so motivated to get me taken care of.
What a story! Unforturnatelly, not too uncommon. Our doctors are expected to care for more patients than can be fitted into their already extended workdays. This results in patients not getting the care and attention they need. The overbooking of patients leaves too much room for error and omission of testing and referrals to specialists. As a result, many patients' health deteriorates and medical conditions go undiagnosed.

I asked my doctor about his coffee breaks when he seemed ready to fall asleep during my very rare afternoon appointment. (I always get the first ones of the day, except in an emergency). He never gets any coffee breaks and manages to eat his lunch (a sandwich) between appointments at his desk. How sad. They often work well past the appointed hours. As we all know, their compensation reflects these inconveniencies.

How wonderful for you to have found a doctor who takes the time to run all the necessary tests and really cares about the state of your health. We should all be so lucky!

Good luck with your treatment.

Flowergirl

 
Old 08-02-2007, 12:50 PM   #15
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Re: Desperate 26yr Male - Sudden onset of Hypertension 1 month ago.

Hi,

Finally things are rolling along. Your story emphasizes the important point that patients must get their lab studies, learn what they need about their symptoms&,diseases, & be a partner with their Dr. If the patient is too ill or not capable of doing what needs to be done then they need to enlist the help of a friend or relative. The days of depending on one's Dr. to followup on everything is over for most of us. These health boards are an invaluable help for those of us coping with symptoms etc. that we don't understand. Fam

 
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