Hello all. First of all, thanks to anyone reading or replying to this message.
I am a 39 year old white male, 5'11" and 215 lbs. Four weeks ago today, I went to the hospital in an ambulance for the first time. I had an episode with my vision, which the ER said was possibly an ocular migraine. The real problem (to me) was that, after the alleged migraine had subsided, the paramedics took my blood pressure and it was 170/110. In the ER, it hovered around 150/89 and really didn't go back down until later that afternoon. My blood pressure has always been normal and my normal resting heart rate is around 55-60.
I was discharged and happened to be sharing this story with a client, who holds a PhD in neurology and pharmacology and he said it was a TIA. Sounded plausible to me. I followed up with my PCP and he doubted it was a TIA, but said that my blood pressure was elevated and we needed to deal with it. I began taking Lisinopril (just 10mg). Long story short, my blood pressure spiked on several occasions, one time landing me in the ER and I am now taking 30 mg of Lisinopril. The spikes are averaging in the 168/96 range and my resting heart rate at times has been as much as 78. I can tell when my BP is going up because I feel like I am being stuck with needles all over my body. I have tremendous anxiety, my heart feels like it's doing flip-flops and my pulse rate soars. My doctor was concerned that the Lisinopril was not controlling the BP and prescribed me a beta blocker, which has usually worked wonders.
Not convinced that I just all of a sudden had high BP, I asked my Dr. to think about running some tests. We got a test back showing high catacholamines and he suspected pheochromocytoma. During this time, I was still having BP spikes occasionally. I have seen a heart specialist and they did echocardiogram and stress test and my heart is solid. After some other testing, today I had a CT scan of my abdomen and my PCP's office called and said there is no tumor on my adrenal gland.
Finally - my question. Something is just not right. My mother has high BP and she can only tell when hers is through the roof. I believe they call hypertension the silent killer, because it's not usually felt until it really gets out of control. My hypertension seems to accompanied by the same exact symptoms as an adrenaline burst, which is a hallmark of pheochromocytoma, yet there's no sign of that near my adrenal glands. Additionally, I have come kidney pain in my right kidney area. The spikes are not due to stress or physical exersion - I have stopped exercising completely over the past 4 weeks, because I am scared to continue. There is no rhyme or reason to the spikes - I have had a spike while sleeping, watching television, driving, etc....
Do I really have hypertension or could this be something else? Has anyone had these type of symptoms with BP which is only 155/95? Would it worth continuing to check for a pheochromocytoma somewhere else (I think they can occur in other parts of the body)? I am married and I have a 4 and 1 year old and I just don't think I can live every day wondering if my BP will spike or not. It really scares me when it happens and I feel like I have dumped the care of the house and children on my wonderful wife. Something just feels out of place, but so far, nothing is turning up as a cause.
My question revolves around your statement that you added a beta blocker "which has usually worked wonders". Have you been on beta blocker therapy for a while? ever? or is this a new pill for you?
I feel like I'm a broken record on this site sometimes, but I had such a bad experience with Atenolol (a beta blocker), with very similar adrenaline bursts, anxiety and quickly elevating blood pressure, that I have to ask you about it.
In some people, especially ones with poor peripheral circulation, the elevated BP will be caused by beta blockers because they restrict peripheral circulation as part of their action. And most of the time the BP is OK, but bam! out of the blue comes the adrenaline burst (high catacholamines), headache, ringing in the ears and racing heart.
So if I were you, I'd do some research on the beta blocker you are taking and see it's side effects and go from there.
...Would it worth continuing to check for a pheochromocytoma somewhere else (I think they can occur in other parts of the body)?
I definitely think that is worth investigating, and yes, they do occur in other parts of the body. As far as I know, no one has recently posted on pheo, and the most recent posts weren't as helpful as the older posts, so I would encourage you to do an advanced search of the high/low blood pressure boards for more info. If I recall correctly, there are only a couple of labs in the country that have good tests for this, so again, I would do a thorough search for those who has some solid info on the identification and treatment of this condition.
Also, I agree wholeheartedly with ms58's post! And I might even question the 30 mg of lisinopri, especially if started you on 30 mg without trying a lower dose first.
Wow, thanks for the quick responses. As a matter of fact, I had another spike this afternoon...tingling (more like needle pricks than tingling), chest pain, etc.... I haven't ruled out just a plain old anxiety problem, but I do have a relatively stress-free life (other than being an attorney and having the afore-mentioned 1 and 4 year old girls).
As for the Lisinopril, we started out with 5mg, which one Dr told me was nothing. After a couple spikes they raised it to 20 and then 30mg.
The beta blocker I am taking is Propranolol. I have only been on that med for about a week. The first few days of taking it, I felt better than I had since the problem began, I assumed because it got my heart rate down to where I was used to having it. I did just start taking an antibiotic for a sinus infection, and in the two days I have taken it, I have had trouble keeping my BP down. I check the antibiotic out and see if there is some sort of issue with taking it with this other stuff going on. I was really down this afternoon when I posted, because I was just so certain this whole thing was the Pheochromocytoma and it would go away once they removed the thing.
I am going to an endocrinologist and a hypertension specialist (my Dr. has set this up this afternoon), so maybe a different perspective will yield some results. Also, have a sleep apnea study lined up. I have never been sick with anything other than a cold in my life and this is just hard so hard to stomach.
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