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    Old 03-25-2008, 09:43 PM   #1
    cmpgirl
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    Newly Diagnosed Hypertension & have many ??

    Hi everyone: I am a chronic pain patient and have been for several years. I was recently diagnosed with HBP (it's been averageing around 185/123. Until very recently my BP was usually around 120's/low70's. I had gone to a regular doctor's appointment and have never had "white coat" syndrome, but when the nurse took my BP it was 185/123. I made an appointment to see my family physician immediately and it was still as high. He prescribed Toprol or Metoprolol lx 25mg. 1x/day. I have been taking it for 2 days now.

    Now for the questions....I purchased a home BP kit and have been checking 3x per day. It hasn't changed any yet, but I know it takes time for the meds to start working. Can anybody give me an idea of how long?

    Also, I do take class II Narcotics. I have for many years and I am completely compliant with my physician's prescribing. I see a pain management specialist and I have never abused these meds. Does anyone else here have experience with taking these types of meds with BP meds?

    It's not that I don't trust my docs, but I know many times the docs don't know all of the possible interactions, etc. I've tried looking on the on-line drug reaction checkers and haven't gotten much useful info.

    I would appreciate any help understanding this disease and the meds that go along with it. I have been quite nervous since that first doc visit and I know that can't be helping. Thanks in advance and God Bless, cmpgirl

     
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    Old 03-26-2008, 06:57 AM   #2
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    Re: Newly Diagnosed Hypertension & have many ??

    I can relate to your situation. Don't have a lot of time @ the moment but I don't think it is safe to wait until Toprol kicks in which maybe a few weeks. When I went in with a higher b/p than yours this is what my Dr. said. Are you taking aspirin? Check with your Dr. about this. She said it was very important to help prevent a clot from forming which might cause a stroke or heart attack with my b/p being so high. I found Lebetalol which is used in the ER worked better than a plain beta blocker like you are taking.

    The lower number (diastolic) is the main concern here. If you haven't already had blood tests done ask that they be done to rule out immediate concerns such as thyroid problems.

    Fam

     
    Old 03-26-2008, 10:16 AM   #3
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    Re: Newly Diagnosed Hypertension & have many ??

    Thanks Fam: The doc I was seeing the day I found out my BP was up was a Rheumatologist that my pain doc hed referred me to, and he ran some tests. Bloodwork only. When I saw my primary he had requested the report from the Rheumy and had not received anything yet, but is going to run the whole gammit himself.

    He wants to check my kidney function as well as other things (including Thyroid). I must admit I had very little knowledge of hypertension and it's a little scary that it can cause so many other problems.

    Today is only day 3 on the metoprolol, and I know it takes a while to kick in. I have checked my BP with the home kit that I bought and it's still about the same. Last night my systolic was a little higher...196, but the diastolic was still 122. What a crazy viscious cycle this is. I make it a point to take my BP when I'm feeling the most relaxed, but at the same time, taking it makes me nervous!

    I generally don't take aspirin, due to stomach irritation. My primary didn't mention it to me, but I will see him soon and I will ask about it.

    It has bothered me that he put me on a med that takes a while to kick in. I guess I didn't realize there were meds that work faster and now I wonder if I should ask for something different. This is so confusing. I've learned in recent days that while my BP is elevated, it is not as high as some people experience, but where is that line exactly? Obviously, any elevation should be taken care of, but how high does it have to be, to be "dangerous" as opposed to "a concern"?

    Thank you for the reply Fam. I'm looking forward to learning more. Take care and God Bless, cmpgirl

     
    Old 03-26-2008, 09:14 PM   #4
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    Re: Newly Diagnosed Hypertension & have many ??

    Hi CMP,

    Yes, it is very scary to be in your position. At the same time you have to calm down as much as possible given your pain & diagnosis. Eliminate any stressors that are possible. If you are working, I would take a leave of absence until your b/p is stabilized. Avoid any heavy lifting or physical stress which would further stress your heart & blood vessels. A relaxing walk is okay.

    Make sure your b/p monitor has been checked against your Dr's equipment. If that is not possible you can always drop in a fire station or even the ER for a free check. I had to do that at times.

    HBP can cause a lot of problems in the body as well as be a result of damage to the kidneys, adrenal glands etc.

    You need to call your DR. tomorrow morning first thing to ask about taking aspirin. This is extremely important. You could have a stroke or a heart attack with a diastolic of 129!!! I don't know where your Dr. is coming from!!!

    I, too, have a very sensitive stomach, but have found a way to take mega doses of aspirin during episodes of my thyroiditis. Dilute aspirin in water & take it half way through your meal so there is a coating of food in your throat & stomach to protect it. I also take it with yogurt & pumpkin plus raspberry jam to coverup the taste. Fam

     
    Old 03-27-2008, 09:01 AM   #5
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    Re: Newly Diagnosed Hypertension & have many ??

    Hey Fam: I went in for labs this a.m. and my BP was a little better. 178/110. When I got home, I checked it myself with my home kit and it was 177/110, so I think my kit is pretty accurate.

    My doc wasn't there this morning, but the nurse said she would have him call me about the aspirin. I bought a bottle of low dose (81mg) on my way home, so I could at least try that until I hear back from him. Thank you for that bit of advice. I am surprised he didn't say anything about it when I saw him on the weekend. They did an EKG that day and it was fine, so maybe that is why.

    I also told the nurse I was concerned that it was taking so long and is only going down a little at a time. So she said she would make sure he knew about this as soon as he came in.

    I know that the labs he ordered were extensive and include a full thyroid panel, so he is definitely checking that and also BUN, Creat, blood sugar etc. They were fasting labs.

    Thanks again for all of the info. It's so nice of you to take the time to answer my questions. My psychiatrist also okay'd a slight bump in my Xanax, to help keep my stress/anxiety down and I think it has definitely helped. I will let you know what the doc says, when I speak to him. God Bless, cmpgirl

     
    Old 03-27-2008, 11:10 AM   #6
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    Re: Newly Diagnosed Hypertension & have many ??

    Just a quick update.....my doc called and told me to double my dose of metoprolol. He said even though it was coming down, it wasn't fast enough for his liking. He also said to go ahead and take the 81mg aspirin every day and if it was causing me any stomach upset, he would prescribe something for it as well. Doesn't want me starting everything all at once.

    I'll definitely take it with food to be safe. Thanks and I'll let you know when the labs are back, cmpgirl

     
    Old 03-27-2008, 06:42 PM   #7
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    Re: Newly Diagnosed Hypertension & have many ??

    Since your b/p started to come down, he probably wants to stay with the same drug so if you have side effects it would be easier to know which drug is causing it. Doubling the dose will probably help. 110 is a lot better than 123 diastolic. Fam

     
    Old 03-28-2008, 04:08 PM   #8
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    Re: Newly Diagnosed Hypertension & have many ??

    Hi Fam and everyone: I am now on day 2 of the double dose (50mg) of metoprolol lx and my systolic seems to be coming down more steadily than my diastolic. At my last reading (about 6:30 p.m.) it was 148/113. Is this normal when you first start taking a Beta? or any other BP med?

    I am really laying low, as I no longer work due to my chronic pain. I also have felt pretty lathargic and light-headed since I started the meds. I've been really careful not to let myself get stressed. Is there anything else I should be doing? Also, do you think a short acting med would have been better to start with?

    Thank you so much for all of your advice. I hope I'm not being a pain, asking so many questions. cmpgirl

     
    Old 03-28-2008, 09:34 PM   #9
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    Re: Newly Diagnosed Hypertension & have many ??

    Hi Cmp,

    From my experience & others that I have read about the diastolic seems to come down rather fast & the systolic takes much longer. Most of us have had to go to another drug to get the systolic down far enough. If it were me I would want to be on Lebetalol cause I'm pretty sure it will bring the diastolic down faster.

    Lebetalol does have one very potential serious side effect that you should be aware of. In very rare cases, it will cause a fatal liver failure. I wouldn't take this drug if I had liver problems already or I liked to drink alcohol a lot. You must make sure you get your liver function tests done at least every 6 months after you are stabolized on a dose. I haven't had any problems with liver issues in the 4 yrs I'm been on it.

    Another thing you must take this drug with about the same amount of food each time in order to get the maximum therapeutic effect from the drug. I get muscle weakness in my calfs for about 3-4 hrs after taking my am dose so I plan to do my walking for exercise before taking the dose. This is most noticeable when going & up stairs & inclines. You'll find b/p drugs in general have some side effects that you have to live with to prevent a stroke from HBP.

    One side effect that can be good or bad depending on how you look at it is the blunting of one's taste buds. Food just doesn't taste as good as it did before taking b/p meds. Sweets are the only food that come close to tasting the same. But of course sweets contribute to weight gain. While we're on that subject, many of us gain about 20 or more lbs after going on beta blocker type drugs in particular even though we have maintained a certain weight for many yrs. It's a bummer but the price we have to pay to keep from having a stroke or heart attack.

    I am on the highest dose so I may have more problem side effects than most people. Fam

    Ask all the questions you want. Most of us are happy to try to find answers for you if we can. I wish I had someone to answer my many questions when I was going through what you are now. And yes the tiredness & some dizzyness are normal when you first start. There is always a certain degree of fatigue but you learn to work around it. I choose just to take my meds & go back to sleep for a few hrs. Others keep pushing through the tireness. I do the same some days when I have to but it takes so much longer to get anything done. Exercising before taking meds helps somewhat with the tireness. You sound like you are doing everything you can at this point.

    I found it very helpful to write in a journal everyday just to get the feelings out as your family & friends get tired of hearing the same story over & over. I use a double spaced spiral cheap notebook. Fam

    Last edited by famnd; 03-28-2008 at 09:47 PM.

     
    Old 03-28-2008, 10:09 PM   #10
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    Re: Newly Diagnosed Hypertension & have many ??

    Thanks Fam: I appreciate the info very much. I'm not concerned about alcohol because I don't drink. i have regular liver enzymes because my meds I take for pain have a lot of tylenol in them. Not over the daily max, but I've been a chronic pain patient for 8 years and like to keep a close eye on that.
    So far I've never had any problems with my liver. Thank God.

    I'm not sure if it has anything to do with the choice of med my doc made (toprol), but we found out just before this happened (HBP) that I have some thyroid problems. I had lost 20 lbs. in the last couple of months and had not been dieting, nor had I been exercising. It's been hard for me to walk much of a distance these last years as my pain is from a neuro-muscular condition. I sure do miss it. My husband and I used to walk 5 miles every evening before I became ill. My doc re-ran all of the thyroid panel again this week and a whole host of others including kidney function, so I guess we'll see.

    This has scared me more than I had expected it to. I guess with being sick all these years I had become used to not feeling well, and I've had lots of added joint pain and other symptoms like flushing, forgetfulness, anxiety, etc. but I was assuming it was part of my peri-menopause. HBP never crossed my mind.......I sure wish it had. Maybe we could have caught it earlier.

    I do feel somewhat better tonight. I'm trying not to get stressed. My doc prescribed low dose Xanax and it is helping.

    Thanks again for being there for me and I will keep you updated. cmpgirl

     
    Old 03-28-2008, 11:27 PM   #11
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    Re: Newly Diagnosed Hypertension & have many ??

    Quote:
    Originally Posted by cmpgirl View Post
    ... Is there anything else I should be doing? Also, do you think a short acting med would have been better to start with?

    Thank you so much for all of your advice. I hope I'm not being a pain, asking so many questions. cmpgirl
    Hello cmpgirl,

    Welcome to the boards! I don't have much time (I really need to get to bed) but I will tell you that my systolic was much easier to get down than the old diastolic. I went from 200/100 to a normal range and am currently med free.

    One way you may be able to reduce your pressures is through the DASH food plan, which is a government developed, government studied, government endorsed meal plan. Although I thought I was eating well (no added salt, more fruits and veggies), the DASH plan has dropped my systolic over 20 points...with a noticable difference in the first week. Please note that DASH eating is more than low sodium eating...you might want to do some reading about it.

    Doctors often do not tell us about this option but according to the government guidelines, it should be discussed before trying drugs providing the pressures aren't to high...and tried with med if the pressures are too high to do without meds. Unfortunately, for whatever reason, doctors do not mention this very effective "treatment"....

    Good luck with your pressures.

    Take care.

    Bethsheba

     
    Old 03-29-2008, 12:26 AM   #12
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    Re: Newly Diagnosed Hypertension & have many ??

    Thanks Bethsheba: I will definitely look into the DASH program. I am a little better tonight. As of midnight when I took my BP it was 144/102. So, I guess even though it is gradual the meds seem to be helping. I don't mind the light-headed feeling and the sleepiness for now, and I've been assured that should go away after a little bit, but it's this dull headache that is kind of lingering around that has become quite annoying. Is this also a common side effect when you first start meds?

    Thank you again for the info and support. I will update when I can.

    God Bless, cmpgirl

     
    Old 03-29-2008, 05:56 AM   #13
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    Re: Newly Diagnosed Hypertension & have many ??

    Quote:
    Originally Posted by cmpgirl View Post
    ... I don't mind the light-headed feeling and the sleepiness for now, and I've been assured that should go away after a little bit, but it's this dull headache that is kind of lingering around that has become quite annoying. Is this also a common side effect when you first start meds?...
    Cmpgirl,

    One side effect of many meds, including toprol, is a headache. Although some side effects go away, many do not, and some get worse. Keep your doctor informed of your side effects and do not assume he knows what he should know about them. If you ever find that you must stop taking the toprol, you must do it gradually as stopping it suddenly could possibly cause stroke, heart attack, or death.

    You mention a psychiatrist? Besides the xanax, are you on other medications that could possibly elevate bp? And again, don't assume your doctors have considered this possibility.

    Hope you will find some answers when your lab/other tests come back. And hope your side effects have waned.

    Take care!

    Bethsheba

    Last edited by bethsheba; 03-29-2008 at 05:57 AM.

     
    Old 03-29-2008, 09:36 AM   #14
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    Re: Newly Diagnosed Hypertension & have many ??

    Hi Bethsheba: Because of my chronic pain, I do take some narcotic meds, but I have checked with not just my docs, but my pharmacist about those meds and the HBP. Both said that in some cases, long term use can lead to slightly elevated BP, but right now they are looking more at my elevated thyroid levels as being behind this, because both of these seem to have popped up at the same time.

    My primary is very open to exploring possible causes and so is my Pain Management doc. I'm currently working with my pain doc to re-evaluate my meds and make sure they are not causing or creating any other health problems. I actually take very little, compared to many with my pain levels. Personally, I'd be thrilled if I didn't have to take any of them, but I also need to have some quality of life. Taking care of my home and family is the most important thing to me. These meds have been the only treatment modality in my years with chronic pain that have allowed me to do that.

    It is a relief to know that the dull headache is a possible side effect of the toprol, and I will definitely speak with my doc about that. Hopefully it is one that will ease up once my system gets used to the toprol.

    Thank you again for your advice and support. cmpgirl

     
    Old 03-29-2008, 10:15 AM   #15
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    Re: Newly Diagnosed Hypertension & have many ??

    Quote:
    Originally Posted by cmpgirl View Post
    .... I have checked with not just my docs, but my pharmacist about those meds and the HBP. Both said that in some cases, long term use can lead to slightly elevated BP, but right now they are looking more at my elevated thyroid levels as being behind this, because both of these seem to have popped up at the same time.
    Great! You're many steps ahead of the average person, and healthier for that! Yes, it is very likely that the thyroid is the problem but I thought I might add the med thing just in case.

    Quote:
    ... Taking care of my home and family is the most important thing to me. These meds have been the only treatment modality in my years with chronic pain that have allowed me to do that.
    Thank goodness the meds have allowed you to do that...it sounds like you have your priorities in the right places!! I admire your tenacity, and your courage.

    Hopefully, that headache will fade..take care,

    Bethsheba

     
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