Office visit: testing for sodium, BB report, uric acid, Triglycercides - High & Low Blood Pressure Message Board

famnd · 09-21-2007, 08:15 PM

Great visit except for my b/p (179/80) spiking up but my nurse & Dr were cool about it since they are used to my erratic b/p. My Dr. has always been okay with my b/p spikes but she has been through several nurses during the past 4 yrs who would get hyper & I know run into her office. My Dr. doesn't say ANYTHING about my b/p unless it is low. This is good psychology. I think she has laid down the law to the nurses

. She knows that I take my meds & take extra pills when needed so that's all we can do. Getting all excited will just drive my b/p up higher.

Of course, she always checks to make sure I am feeling okay & don't have any symptoms of a stroke or heart attack. I have always felt really great when my b/p is high so I might as my husband thinks be one of those whose b/p is meant to be high. I'm not going to test that theory!!!

I had three questions for her. Here are the answers. She uses blood sodium levels to determine if a patient is or is not getting too much sodium intake. Dr. Oz was on TV the other night with a experiement regarding sodium & he too used blood sodium level to determine the effectiveness of the low sodium diet on the group. She said to keep doing what I'm doing because my sodium level is fine. I'm on HCTZ so she said I shouldn't go salt free.

My triglycerides were up 100 points. She said Tri's are very subject to what one has eaten a few days before. That's fine unless your eating had been out of the ordinary for you. For example, she said after a holiday almost everyone will come back with high blood values . So she advises patients to avoid having routine blood tests after these holiday splurges. Since my tri's have been high but okay she isn't worried at the moment with one blood test.

Pleased that my uric acid levels are at the lower so I guess my 9-10 glasses of fluid are working to get rid of the uric acid. Read some more on uric acid-apparently the concensus is that uric acid tests are somewhat unreliable but that it is best to keep the levels at the lowest possible with diet, fluid intake, or meds if one needs too.

Finally, we discussed the recent Beta Blocker report. She agreed that taking Lebatalol (an alpha/beta blocker) gives me some protection from the negative effects of a pure beta blocker plus the fact that I'm taking HCTZ which balances everything as much as we can given my resistent HBP.

Now I can relax since my next appointment won't be until March

Oh for the days when I only had one Dr's appointment for a pap once a year!!! Fam

flowergirl2day · 09-21-2007, 10:12 PM

Hi Fam,

thank you for sharing that. The kidneys should regulate our sodium levels, so that the sodium levels remain unchanged. What your doctor said makes sense. That's why they are always checking our electrolyte levels. I couldn't figure out why my sodium level remained constant, in spite of my adherance to the dietary salt restriction. I would have expected it to drop. That is not how our regulatory system works. I looked into that extensively. My sodium level went down. I think my diuretics are to blame. It's barely within acceptable limits (just by one point). Now I have to figure out how to make it better without stopping the diuretics, which is not an option.
I think you mentioned that your blood pressure readings at home were excellent. At least for a time. You also mentioned having the white coat at the doctors' office and taking extra Labetalol before your doctor's appointments. Do you think that's what might have happened today? A bit of a white coat? Or has your BP started to fluctuate again? I hope not! I know only too well how unpredictable our blood pressure can be. There are no guarantees. My blood pressure has been excellent for the most part - a HUGE spike just last night at bedtime for NO reason. I just don't understand it at all! Seeing high numbers is always like a big slap in the face. Just when one begins to think things are perfect.... I know you know exactly what that feels like. So do others.
I guess since your diet has not changed in any way, there must be a non-dietary reason for the increase in triglycerides. I am starting to worry about my cholesterol levels. I was told that Lipitor combined with Aspirin should give enough protection against the accumulation of plaque. I take anti-inflammatory supplements which should also help. How's your HDL? Mine is too low. I hope it doesn't get any lower. My other numbers are excellent. The HDL is the most important one though, as is takes the lipids back to the liver for removal, after they were transported to the bloodstream by the LDL. I guess low LDL and high HDL are what we aim for. Easier said than done.

You are right about the uric acid levels not reflecting anything. We can't really tell if anything is wrong, even with normal levels of uric acid. I did a LOT of reading about uric acid when researching gout and renal tubular acidosis. It seemed so hopeless! The more I read the worse it got.
I am glad your doctor gave you a green light for staying on the Labetalol! I happen to think it's a great and very effective medication. Maybe I'll go back on it some day.

flowergirl

famnd · 09-23-2007, 07:42 PM

Finally got time to sit down. I should be cleaning my kitchen up but the smell of my husband's spagetti is still there & makes me feel like eating even though I'm not physically hungry. Tomrrow is another day & I don't want to be up all night with acid reflux

.

On the issue of our sodium levels. I'm told there is a margin of error either positive or negative for each blood test so your low sodium level may not mean much especially if you have no symptoms. I guess when you think about it if there was more sodium in the body then t he blood levels would be higher. When I read about this issue before I was looking for someway to measure how much sodium was excreted via urine so I could get some feedback for decreasing my sodium intake.

I hope to be able to decrease my HCTZ to 12.5 without getting my b/p out of control. I don't have perfect b/p control but it usually doesn't go off the charts unless "cuff anxiety" is involved. During the past 6 months my systolic has ranged from 114 to 230. The diastolic from 48-90. Usually the diastolic is in the 50-60 range. I worry about that low number thinking it may be encourage clot formation in the heart. Need to ask my Dr. But it is nice to have a low number when the systolic goes up to 200 plus range.

At the office visit I think I got too hot waiting for the Dr.
even outside in the car. I read that beta blockers do cause some heat intolerance which I have always had any ways.
I don't sweat much at all so my skin gets so hot. I often wonder if this contributes to my b/p increases. I know my b/p goes way down after soaking in the tub.

Next time I will ask the nurse to take my b/p right away even though I have to wait. Also, it is rare to have a b/p done correctly at a office visit as you know. My arm was way above heart level.

My lipids are okay but in the high range. Actually my cholesterol has gone down since 2001 before I got on meds etc. My HDL used to be in the 60's before menopause, now it is 40-45.

Asked the Dr. about how much I should push my heart to get to the target heart rate. She said just to exercise & not to be concerned about target heart rates. Dr. Donohue said that it could be dangerous to try to get to the target rate while on beta blockers. I guess one never know whether or not he or she has a diseased heart that could be fatally stressed by that exertion when the beta blockers are preventing the heart from increasing the heart rate.

Are you treating your acid reflux? Are you sure you have AR cause not all people with hiatal hernia have AR?

Fam

flowergirl2day · 09-23-2007, 09:00 PM

Hi,

Quote:

I hope to be able to decrease my HCTZ to 12.5 without getting my b/p out of control.

I'll see if I can do the same, depending on what my BP does. I certainly don't want it to get too low and start getting the dizzy spells again. Because my dose of beta blockers increased, I'll probably have to decrease the Hctz.

Thank you for mentioning the heat intolerance the beta blockers cause. I completely forgot about that. I am still getting used to mine and actually physically feel it affecting my heart. There's this tightness and a dull, achy type of a feeling. I've quite forgotten what the beta blockers feel like. I was off of them for almost four months.
It's so good you mentioned the target heart rate. I will not worry about mine. Things are a little different for us. I believe that it might be impossible for us to achieve our target heart rates anyway while on the beta blockers. Not to mention UNSAFE. My shortness of breath/exercise intolerance does not help. It's better to play it safe. If I find I can't keep up at work (and I should know after a couple of days), I'll ask for another position. It's not like I can ever expect to be the same as before. I am not. I know several people who had been through various hardships that returned to work. (Part time, but that's another issue). They encourage me to do the same.

Quote:

Are you treating your acid reflux? Are you sure you have AR cause not all people with hiatal hernia have AR?

Well, that's what the doctor at the hospital who did the tests put in his report. He said my swallowing reflex was fine (I have this lump in the throat type of a feeling and swallow a lot -it does not help). My stomach is fine except for the reflux. It's now being treated with Nexium for three months to start. The Nexium has made my constant nausea all but disappear. And my breathing is better now. I wonder if the SOB is caused by the hernia. I started getting these painful, weird muscle spasms in the abdomen under the left ribs. There's a bulge I push back with my hands. I think I might have another hernia, unless it's the actual muscle. I'll have to wait until I see another doctor sometime. My GP dismissed my concern without bothering to check or feel the area where they happen. He says everybody gets muscle spasms (he does too, of course!!!) and that they are harmless. He also said my problems stem from anxiety. That's a new one! I got all my prescriptions and won't go back to him for 3 months. He does nothing for me anyway.
I am leaving tomorrow morning to visit my son & family. It's such a LONG drive. Will be back in a few days.

flowergirl

bethsheba · 09-24-2007, 05:44 AM

Quote:

Originally Posted by famnd

Great visit ...

Am happy to know that things went well...I chuckle about your nurses and your doctor...ah, there's something to be said for life experience, or lack of it!

Quote:

...I'm not going to test that theory!!!

I wouldn't either,

.

Quote:

I had three questions for her. Here are the answers. She uses blood sodium levels to determine if a patient is or is not getting too much sodium intake. Dr. Oz was on TV the other night with a experiement regarding sodium & he too used blood sodium level to determine the effectiveness of the low sodium diet on the group. She said to keep doing what I'm doing because my sodium level is fine. I'm on HCTZ so she said I shouldn't go salt free.

This was interesting...as was the info on blood tests and trigycerides. Again, we assume because we had such and such tested, that the tests are accurate measurement of what's what when some are simply a snapshot of a temporary situation.

Quote:

Pleased that my uric acid levels are at the lower so I guess my 9-10 glasses of fluid are working to get rid of the uric acid. Read some more on uric acid-apparently the concensus is that uric acid tests are somewhat unreliable but that it is best to keep the levels at the lowest possible with diet, fluid intake, or meds if one needs too.

Famnd, I've GOT to start drinking more water...I swear the knob on my thumb is growing!

Quote:

Finally, we discussed the recent Beta Blocker report. She agreed that taking Lebatalol (an alpha/beta blocker) gives me some protection from the negative effects of a pure beta blocker plus the fact that I'm taking HCTZ which balances everything as much as we can given my resistent HBP.

Synergy...nice to know that meds aren't just a bunch of side effects and that they CAN make a difference.

Quote:

Now I can relax since my next appointment won't be until March

Oh for the days when I only had one Dr's appointment for a pap once a year!!! Fam

Boy, can I identify with that statement,

.

Bethsheba