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Health care

Gaming the Mountain: YAHOO!

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In pursuit of a fine score on next week’s proposed stress test, it was off at the crack of dawn to climb Shaw Butte, a small “mountain” just to the north of the ‘hood. In most parts of the country, people would call these little mounds “hills.” But here, we think of them as key parts of the Phoenix Mountain Park.

Heh.

Well, the trail is billed as 4.4 miles, but I’m pretty sure that means the entire loop, from one end off Thunderbird Road, over the top of Shaw Butte and down the back of neighboring North Mountain; then out at Peoria Avenue or else back around the base of the hills to return to Thunderbird. The typical walk, though, is from the parking lot to the top and back. I’d guess this is about two miles.

Parts of the trail are somewhat steep — not as much so as the scrabbly uphill in behind North Mountain, but enough to provide a workout. Some guy’s dog had collapsed with exhaustion as I passed by — probably because the human had been too stupid to bring enough water for the animal. Most people don’t realize how much water domestic dogs need in this climate, or how vulnerable they are to heat exhaustion.

No heat today, though: at dawn it was fairly crisp up there.

Okay, now: here’s the amazing thing.

Bear in mind, it’s been years since I’ve walked on that trail.

I got all the way to the freaking top without stopping!!!!!!!

The last time I tried to hike to the top of Shaw Butte when I was out of shape, I had to stop three times to gasp for air.

How, you ask, did an old bat like me pull that off?

By gaming the mountain…

Actually, I used two techniques.

1) Diaphragmatic, deep breathing. You learn it in choir. And this is the device used to make blood pressure readings drop, too. Starting on the flat right off the parking lot, I started breathing steadily and deeply from the diaphragm. Continued all the way up the side of the hill.

2) On the steepest parts: the rest-step. Actually, I call this the rest-trudge… It’s something I learned while hiking in the bottom of the Grand Canyon with an Arizona Highways photographer, who was toting 50 pounds of large-format camera equipment. The rest-trudge entails stepping up-hill and then locking your knee and putting all your weight on that leg as you swing your other leg forward and upward. It creates a brief rest for each leg as you move up the hill, allowing you to go practically forever without feeling tired.

In the past, the rest-step alone was not enough to get me all the way to the top of that pile of rocks without having to stop, unless I was in pretty good shape. But combining it with the deep breathing, at no point did I feel I needed to stop. Nor at any point was I ever panting.

And when you consider how magnificently out of shape I happen to be just now, that’s pretty amazing.

It took about an hour and a half to get up there and back down. I wasn’t trying to beat any speed records…on the flat, it would take me about 25 minutes to walk two miles. Dog-free, that is.

Heh heh heh…. If it works on a mountain, it surely will work on a treadmill. You may be sure I’ll be using the deep breathing technique during that supposed stress test.

Images

Shaw Butte with paraglider: By Sonoradocent – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=49041534d
Banner image: North Mountain as seen from Shaw Butte trail: By Aznaturalist (Own work) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

How to Get Fit in Phoenix

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North Mountain in the springtime

So since I’ve been moping around thinking I was on the verge of a stroke ( 😉 ) — or more to the point, zombified by the meds the two cardiodocs prescribed — I’ve gone totally out of shape. This last drug they put me on knocked me so far into the middle of next week I could barely stir myself to crawl out to the kitchen and snare a meal out of the fridge.

Of course, I’m now a mound of Jell-O. The Mayo PA wants me to do a stress test a week from tomorrow.

{chortle!} Just imagine what the result of that is likely to be!

So I decided I’d better do a crash course in getting back in shape. The scheduling left me with exactly 8 days to restore my former glory.

Counted Friday’s traipsing around the Mayo Clinic’s spacious campus and running up and down the car park’s stairwells as Day 1, mostly because by the time I got home I was too tired and too psychologically dazed to do much else. Yesterday: one mile dog-free walk with stretches of running.

Now, though, it’s time to get back on the mountain. North Mountain’s back side is about a two-mile drive from the Funny Farm. If you go up the south side, you connect with the Shaw Butte trail, which runs about 4.4 miles. It’s convenient, relatively fast, and moderately challenging.

This stub of the North Mountain trail is pretty steep, so if you go up that, connect with the main trail, and then go all the way to the top of Shaw Butte, you get a very nice uphill walk. The problem is the steep access via this little trail is rocky and difficult to get down: it’s strewn with roller-bearing rock. For reasons that escape me, the City and the County maintain their trails by dumping loose scree all over them — apparently this is thought to reduce erosion. The stuff will slide right out from under your boots, especially when you’re traveling downhill.

Three times this afternoon I almost fell coming down from the junction with the Shaw Butte trail. So that was annoying. It looks like I’ll have to drive all the way into Moon Valley and access the trail from the north side — which is a huge PITA, because the parking lot is a) in a residential neighborhood; b) highly unwelcome amongst the people who live there; and c) way too small to accommodate the number of hikers who want to use the trail. I do have a crip space hanger, but it’s illegal to use it unless you’re visibly crippled up…and…heh…if you bounce out of your car and charge up a mountain trail, you make yourself pretty suspect.

At any rate, the plan for the next seven days is to take off at the crack of dawn, shoot into Moon Valley, steal the crip space, and fly onto the 4.4-mile paved pathway up the north side of Shaw Butte.

By the time the stress test comes around, I should be in halfway decent shape to trudge on a treadmill for 15 0r 20 minutes. In years past when I’ve let myself get completely out of shape, it has taken about four days (i.e, four consecutive trips up the mountain) to be able to get all the way to the top without stopping. Since I’m older now, I expect it’ll take a little longer…but seven days should be plenty of time to begin to revive some.

Naturally, this throws a monkey wrench in the other self-improvement plan I’d dreamed up. Since I’m not making much progress on the Ella story — because I put off doing that kind of writing until all the day’s other activities are done, by which time not a helluva lot is left of the day — I was going to opt the early-morning wake-me-up news reading and blog scribbling and sit down, first thing out of the barrel, to write the story. But…well…that ain’t a-gunna happen. Doubtful that I’ll get any writing of any kind done on this schedule.

Oh well.

Money, Medical Practice, and the Patient

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So you’re no doubt all on the edge of your seats: WHAT did the Mayo say about the endless blood-pressure conundrum, in the wake of the Affair of the Phantom Heart Attack?

Mwa ha ha!

Friday morning I stock up the covered wagon, yoke the oxen, climb into the seat, snap the bull-whip, and head across-country to that fine organization’s doctor’s offices — from my house, about halfway to Payson. Traffic isn’t bad, for a change — it’s the tail end of rush hour — and I get there in less than an hour.

That notwithstanding, they call me right in. I present the current three months’ worth of twice-daily blood-pressure measures called up by my cardiologist “in the wild” (this is what we call doctors who practice outside the coveted Mayo system), explain why I thought I needed to make a fast run on the ER at 2 a.m. the other morning, and fork over a long list of questions and observations:

The main question/proposal: We need to treat the causes of this supposed elevated BP, not the results.

Factors: There appears to be a correlation between what I tag “annoyance” (comprising annoyance, frustration, anger, and related negative emotions) and higher numbers. A correlation also exists with hot flashes. And another factor appears to be pain: headache, musculo-skeletal, dental, etc.

  1. Hot flashes: These episodes occurred before I started on the amlopidine & they continue, but it wasn’t until after I started taking it that they began happening with some frequency. Whatever is causing them, they clearly are directly connected to BP spikes. BP is elevated every time I test during or shortly after a flash.

What is causing these hot flashes? Could there be an ovarian problem? Can we address this issue?

  1. “Annoyance”: I seem to have developed a problem coping with minor (and major) daily aggravations, such as computer hassles, urban driving, work stress, bureaucratic bullshit, & the dog yapping. Unclear whether a causal relation exists between mild anger or irritation and spikes: the “annoyance” tag also appears many times in the absence of a spike — often when numbers are in the low 120s and 110s.

Some of these issues cannot easily be dispensed with:

  • To live in the city, I have to drive.
  • My business partner declines to fire the infuriating client.
  • I can’t do business or function socially without dealing w/ a computer.
  • I am not getting rid of the dog.

What can be done to address a physiological reaction to frustration, annoyance, and anger?

  1. Pain. This is a constant: at my age, you just hurt as part of life. Chronic sources of pain:
  • Headache. Probably sinus; occasionally migraine. Sometimes stress.
  • Hip pain. Undoubtedly related to osteoporosis.
  • Mastectomy scars.
  • Dental pain of unknown etiology.

Recently learned that pouring cool or cold water over your head can stop a stress or migraine headache, and this drops BP reading rapidly. Otherwise: I can’t take acetominophen, ibuprofen, or aspirin.

Got any other ideas? Is there a way to determine whether I actually am allergic to OTC pain-killers? Or to desensitize me to at least one of them?

  1. “Supposed” elevated BP. There appears to be a great deal of controversy over what is dangerous and what is not.
  • Mayo’s ER doc called me, three times, a “very low-risk patient.”
  • British NHS guidelines differ from US guidelines.
  • HALO-3 researchers (Lonn et al.) found BP-lowering drugs led to no change in mortality & morbidity after 5 years.
  • New AHA guidelines have been criticized on several grounds.
  • Pharmaceutical companies fund the American Heart Assn., confounding the issue with an obvious financial motive
  • Other studies (e.g., Diaou et al, BMJ) suggest guidelines are too low and many people are overtreated

What, really, is the science-based, proven significance of BP spikes that occur in response to external stimuli? Is an average BP in the mid-120s/high-70s to mid-80s something that needs to be treated? Show me the science that proves it!

To my astonishment, the woman they assigned to me — a P.A. who specializes in cardiology — actually sat down and read all this bullshit! Instead of just glancing at the figures I’d compiled for the cardiologist (which is what he does: gives a cursory glance at the overall average), she sat there and studied the spreadsheet. She read my questions and thought about them. (I hafta ask you: when have YOU had a doctor behave like this?)

After I’d had time to calm down (nothing makes me more miserable or more nervous than going into a doctor’s office or a hospital, except possibly a face-to-face encounter with a home invader), she took my blood pressure and pronounced it non-alarming. She was familiar with the HOPE-3 study and knew about its five-year finding that blood-pressure-lowering drugs had exactly zero effect on mortality and morbidity among its large sample population.

And finally she opined:

• 108/75 is too low for me. This is why I have been feeling so dragged out I can barely haul myself down to the bathroom.
• The occasional spikes into the 140s are not very out of the ordinary, nor are they anything to get hysterical about.
• I should quit taking the drug ASAP. (Beat her to that one!)
• I should knock off tracking my blood pressure every damn day, for godsake.
• She was ordering a stress test and a full blood panel. Go downstairs now, please, to get the latter done.
• Make an appointment, please, for the stress test. Seeya soon!

It was pretty clear that she did not think I needed to be on a $125/bottle calcium-channel blocker — or anything else. Nor did she think there was really much of a problem. The average BP compiled over the past three months of 123.4/81.9 struck her as within the safe range.

Wow.

When I staggered out of her office and bounded down the fire-escape to my car, I felt more like crying than celebrating.

Sumbiche. I’ve been through two years of this torture, with doctors in the wild trying to pressure me onto these drugs by repeatedly telling me that if I don’t take them I’m going to drop dead of a stroke or heart attack.

One hesitates to state the obvious: that I was gratified when her opinion echoed my own. But yes: I was gratified that her opinion echoed my own. But that is because my opinion is grounded fairly solidly in science: I do know how to read a research report, and I certainly can distinguish between science and woo-woo. Those traits follow naturally on several years as a technical editor.

* * *

Some years ago, my beloved, long-time, and much trusted GP, Tim Daley, quit his private practice and went to work for the Mayo. He had done his residency at the Mayo in Minnesota and was delighted when they opened for business here in Arizona. Despite the pleading and dismay of his partners, LIKE A ROCKET he shot out of downtown Phoenix and off to Outer Scottsdale.

Naturally, I followed him. One does not easily let go of a competent, intelligent doctor imbued with experience and common sense. Getting insurance that would cover the Mayo was sometimes challenging, but in the occasional years that My Beloved Employer dropped the ball, I would go out on the open market and buy my own.

Eventually, Tim retired.

His parting shot to me was this: Never hire a doctor who relies on a private practice to make a living. Get yourself a doctor who is paid a salary. All other doctors are motivated to “discover” reasons that you need treatment and medications that will keep you coming back to their office for endless consultations and further rounds of treatment.

“Holy shit!” said I. “Where does one find a doc who gets paid a salary, this side of Luke Air Force Base?”

“In Arizona? Your only choice is the Mayo. Or,” he added, “doctors who have ’boutique’ practices, whereby you pay a stiff annual fee for the privilege of becoming one of the limited number of patients they see.”

Toward the end of my tenure at The Great Desert University, the state offered PPO coverage that included the Mayo, so I was able to stay on their rolls that way. (Wander off, and the Mayo will dump you: especially if you’re on Medicare, whose bureaucracy they prefer not to deal with). Once I got on Medicare, I was a legacy patient and so they could not gracefully boot me out.

I hadn’t thought much about Tim’s advice in recent years. But now on reflection it comes back to me. Get a patient with BP in the 120s or low 130s believing she has “high blood pressure,” slap her on the smallest dose of BP meds you can prescribe, and you’ll get her locked in to coming back every three months for a consultation, now and forever. And that will be a consultation for which you can charge Medicare and her Medigap insurance, to the max. She will, in a word, represent your bread-and-butter.

So, my friends. Bear in mind that medical practice is not a religious calling. It is a business. You are a cash cow, no less for doctors and hospitals than for vendors of televisions, communication systems, real estate, and cans of beans. In America, you have to be an alert and aware consumer of medical treatments, same as you need to be an alert and aware consumer of anything else.

And good luck to you…

It Lives! It Moves!

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Holy mackerel! She’s HEALED! It’s a miracle…

Seriously: woke up this morning, for the first time in living memory, completely pain-free: no back pain, no hip pain, no headache. It’s been weeks since I’ve felt this well.

To what to attribute the Divine Generosity?

Well, we had a gentle rain spread over two days. It probably washed a lot of the dust and pollen out of the air. Spring is sproinging here, meaning the bermudagrass lawns and a lot of similar weeds have already leapt to life. I’ve had a nonstop headache for day after day after unending day, accompanied by a stubbornly stuffy head.

Add to the air-laundering job the fact that two days ago I sought recourse in the Flonase bottle. I don’t like to use it, because one of its side-effects is glaucoma. Thanks: the Adventures in Medical Science have been fun, but now it’s time for someone else to enjoy them. 😉 But I figured a few days or couple weeks on the stuff isn’t going to blind me right this minute.

And, probably more to the point: on the ninth, I decided to knock off the blood pressure pills. Over the following three days, as the stuff has worked itself out of my system, I’ve felt better and better — and today I’m pretty much back to normal.

Three factors in that decision:

1) In the month since I started the amlopidine regimen, I’ve felt just completely, utterly dragged out. Immobile. Literally, I’ve felt so wrung out that I’ve stopped walking the dogs (wasn’t that brisk one-mile walk what we were supposed to be doing to treat the blood pressure???), stopped caring for the yard, stopped doing the laundry, stopped writing…you name it, I’ve stopped it. Some days I have sat in an easy chair or in bed with the computer on my lap and done…exactly nothing. I haven’t finished the current chapter of Ella’s Story because I haven’t had enough strength to dream up what comes next.

Interestingly, among amlopidine’s side effects are fatigue, exhaustion, and lethargy…

2) I suspect the surprising new hot flashes — which themselves drive up the blood pressure — have something to do with the side effect of amolipdine described as “warmth.” Obviously, if the manufacturer described this phenomenon as what it is — a fuckin’ hot flash — no woman over the age of 50 would agree to swallow the stuff. That of course would be counterproductive to the goal of getting every Baby Boomer in the land on blood pressure meds.

3) The stuff in fact is doing nothing to stop the spikes in blood pressure. Although it indeed has driven the moments of normal BP down into the 110/70s, nevertheless, the jumps into the 130s and 140s persist. One particularly annoying and stressful day, after I’d squirted the nose with Afrin (well known for jacking up your blood pressure), the numbers hit 141/93, an alarming state of affairs. Two hours later, though, the average of six readings was 107.2/65.8, and by dinnertime (when readings are normally at their highest) another set of measures averaged 116.7/74.7 — hardly indicative of the stroke that I’m told is imminent.

Is it really even driving normal, un-spiked blood pressure down? Well, consider: this morning’s set of blood pressure readings, after feeding and hassling with the dogs, banging around the house, brushing teeth, washing face, and all that routine Brownian motion, average out to 112.7/79.2. The highest in this set of six readings was 122/83. The lowest was 107/78, though the lowest diastolic reading was 69.

Given that before I started taking this drug, I regularly had readings in the 120s and occasionally in the 110s… I suspect this stuff isn’t doing enough good to make it worth feeling like sh!t all the time.

So…what is the explanation for the spikes into the 140s and even occasionally the 150s?

Welp, I believe the issue is a combination of chronic allergies that produce a nonstop headache and passing episodes of vertigo plus what can only be described as excessive sensitivity to stress.

Ever since cardiodoc demanded that I test my BP several times a day, I’ve kept a spreadsheet. In it, I’ve recorded what was going on around me…so whatever progress was happening at any given time is enshrined in Excel.

Think of that. 😉

Sooo…. What I did was build a set of categories of stressful circumstances that seem to occur regularly around the Funny Farm:

  • Headache
  • Pain, chest (mastectomy scars tend to ache; not cardiac-related)
  • Pain, other (like, say, the hip and the back)
  • Hot flash
  • Annoyance (including work stress)
  • Anxiety
  • Alarm (startling events)
  • Excessive salt consumption
  • Light-headedness
  • Drugs, other (i.e., Claritin, Afrin, Flonase)

This produced data for another spreadsheet: one that lists the dates of all the spikes, the highest reading for each event, and the average reading for each event.

Twenty-one such events have occurred since January 9. Of them, 15 have been associated with pain and 16 with annoyance, anxiety, or alarm.

Obviously, there’s some overlap — since I was in pain for several weeks after having hurt a hip in the frenzy to exercise by way of bringing BP down with “lifestyle changes,” any of the other circumstances can occur with it. At one point, the pain from the hip injury/bursitis was so intense I could barely walk up the hall from the bedroom to the kitchen.

Looks suspiciously like causality to me…

So what are the sources of “annoyance/anxiety”?

{chortle!} When you have the personality of a hummingbird, lemme tellya: everything annoys and enrages you. We have the following most common causes:

  • barking dogs
  • jangling phones
  • computer hassles
  • Cox’s interminable fuckup of my phones and computer system
  • polemic disguised as scholarship
  • time pressure
  • worry over health issues (i.e., over the BP matter)
  • having to take these time-consuming, nervous-making BP measures twice a day

I do not know when I have flown into a rage so soaring as the one engendered by Cox Communication. I’m still mad…but there’s nothing I can do about it, so have given up fulminating.

Pain is a form of stress. So are anxiety (nagging worry; 30-minute low-flying cop helicopter buzz-overs, reading or listening to the national news) and alarm (jangling phones and doorbells, potential cardiac symptoms at two in the morning). So what we’re really looking at here is 31 instances of stress associated with 21 blood-pressure spikes.

Admittedly: sometimes normal and low BP readings occur in the presence of one or more of these circumstances. Apparently, not all pain causes a spike; not all aggravation causes a spike. But that notwithstanding, every spike is associated with one or more of the listed factors. And every hot flash is associated with elevated numbers.

Maybe what I need is not blood-pressure meds but a tranquilizer.

Bourbon, anyone?

 

Morning at the Mayo…

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So along about 2 a.m. I woke (again!) with a hot flash and the dim sensation of chest pain and, when I checked the numbers, totally soaring blood pressure.

Usually these wee-hours chest aches appear to be pain from the mastectomy scars. If I shift position, it goes away.

Not so this morning. Indeed, before long the pain migrated into the left armpit and down the arm. Lovely.

The nearest hospital is not one with the greatest of all possible reputations. And indeed, I’ve had less than perfect experience in its ER — granted, it was a long time ago…but still…

If you call 911, they will not take you to the Mayo. They will give you the choice of said nearby hospital, St. Joe’s, or Good Samaritan (whatever they’re calling themselves these days).

St Joe’s is the fine institution whose pathologist called me at 7:00 in the evening, said “I’m sorry: you have cancer,” and hung up. So as you can imagine, I’d prefer to go somewhere else. Good Sam is another inner-city hospital, crowded and over-worked.

The only hospital in the Phoenix area that is consistently rated “Excellent” is the Mayo. If you live in North Central and you want to go there, you either get a friend or spouse to drive you or you drive yourself.

Lacking friends or spouses at 2 in the morning, it was into the Toyota and off in a cloud of dust.

Did you know that when there’s no traffic on the Phoenix streets, you can run a red light with no risk of killing anyone or of getting arrested? Did it twice. 😉

Interesting. I’ve never run a red light on purpose before. Nothing happened.

Ripped up the freeway, flying like a bat out of Hell. A six-banger will do that for you, especially when it’s installed in a rather flimsy late-model vehicle. But the guy who’d hit the on-ramp with me (two lanes) was damned if he’d let some woman get in front of him. Before long he disappeared in the distance. Before much longer, I saw the cop lights flashing: caught the poor schmuck.

Thanks, buster: if you hadn’t been going 90, that would’ve been me, even though I was only going 85. 😀

Four hours later, it was clear

a) I was not having a heart attack;
b) I had not had a heart attack;
c) I was not about to have a heart attack (“a very low-risk patient,” said the Mayo’s cardiologist);
d) yep, the blood pressure was very high when I showed up, and
e) yep, the blood pressure dropped down into the normal range well before I keeled over and died.

When I remarked that I’d like to know what the chest aches are if they aren’t a cardiac problem, especially when they seem always to be associated with high blood pressure and/or hot flashes, the Mayo’s ER doc said high blood pressure itself can give you chest pain.

Holy sh!t.

Thus one theory in the offing is hot flash > jacked-up BP > chest pain. But, ER Doc said, she did not believe it was a heart attack. After a slew of tests, she could find no evidence that I’d had a heart attack or that anything was out of whack with the heart itself. She approved of Cardiodoc’s choice of meds and said to keep taking it.

So that was a fine way to spend the night.

Missed the pup’s appointment with the vet to have her teeth cleaned. Missed about five hours of sleep. Missed some peace of mind.

The Mayo, though, is first-rate. They were exceptionally nice to me and kicked into gear the minute I walked in the door. One can’t say that about my experience with other hospital ERs here…

{moan} Life in the Land of Old Age..

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So….yesterday along came what appeared to be another migraine. This, during rehearsal for Sunday’s service; in addition to that, I was also looking forward to singing along at last night’s Evensong service.

Better get on the road while I can still drive without picking off any of my fellow homicidal drivers, think I. That thought thunk, I excuse myself from the service and slink away.

Back at the Funny Farm…holy ESS AITCH AI! The damn tattling Omron informs me that I’ve spiked a blood pressure reading of 165/105!!

Obviously, I soon will be leaping off the edge of this hole in the ground here and pulling the dirt in after me.

Now I’m wondering…is this really a migraine? Or am I having a stroke? Or…WTF?

Last major spike — which was nowhere near that high on either side of the slash mark — came when I was having a fine hot flash. (Can you imagine? Damn near 73 years old and having hot goddamn flashes again?)

After some recourse to the Hypochondriac’s Treasure Chest, I discover that a headache can be associated with high blood pressure. But such headaches are not migraines. Elevated BP, interestingly, is not associated with true migraine.

Uh huh. Are you saying, dear Google, that I am having a stroke?

These antics proceed through an irritable, headachey, cranky day. I do, however, get through the current Chinese math paper by about 9 p.m., which is…something. I guess. My head still hurts, which, one imagines, could be caused either by detailed discussion of F-tests and p-functions as they apply comparatively to the evolution of state-owned and privately-owned corporate boards or…by an impending stroke.

Stroke. Definitely a stroke.

Meditating this thought, of course, is not conducive to sleep. Not only does the headache proceed, I’m enjoying palpitations and vertigo, too….just like the ones that initially drove me to the cardiodocs.

At 1 in the morning, I get up and go back into the office and lash myself back up in the damn Omron. Still spiking at a mere 146/93 on the initial reading. This figure falls to 123/89 in the course of the full testing maneuver (which entails wasting about 15 minutes with repeated measures between resting periods — it really is an amazingly annoying procedure). But 146 is still not at all a good systolic reading. And 93 on the diastolic side? Pushing 90 at the lowest ebb? Remarkably not good.

So finally I throw in the towel and decide to swallow the first of the blood pressure pills dispensed by cardiodoc.

Here’s the problem with that. See these here?

Those are pretty typical figures over the past week. Every number in blue is a figure in the “safe” range.  Black: not great, but not life-threatening, either.

If average blood pressure is in the low 120s or the the mid-teens, then a medication that pushes it down still further will cause severe, dangerous vertigo. That’s dizziness of the fall-down-and-break-your-hip variety. Dizziness of the you-dare-not-drive-your-car variety.

This, we already experienced with the previous cardiodoc: the stuff he gave me made me nonfunctional. And believe me: with all my heart (heh!), I do not want to do that again!

New Cardiodoc was concerned enough about the occasional spikes — which usually go into the 140s but can go as high as 155 or so — that he pressed a new variety of pill on me. I’ve been resisting, because when I’m not in his office and not surrounded by strangers prodding me and yakking at me and making me take my clothes off, my average BP over the course of a typical week is about 128/83 — and that includes the spikes. Over the past week, though, as I’ve lost weight the blood pressure has lost elevation. Even with the batsh!t 165/105 spike and a couple other spikes in the 140s, this week’s average has been 125.4/84.2.

Push that down very far, and I’m gonna be falling down every time I try to stand up from a chair or the toilet.

Reassured by the Mayo’s PA, who had the common sense to observe that I’m not required to stay on these pills, and if they have an untoward side effect, I can just…well…you know: stop taking it, I decided I’d better try the damn stuff. Despite the lovely low figures of late, these spikes are damn scary, especially so because we do not know what is causing them.

The figures are routinely low in the morning — though you can see that over the past few days (except for yesterday…) they’ve been surprisingly low in the evenings, too. Normally, the BP rises late in the day. So what would make sense, if anything in this makes sense at all, would be to take the daily dose around 4 or 5 p.m., when I won’t be driving anywhere (except for Wednesdays…)

As for the headache:

Well, it’s still in the offing, and as we scribble the morning’s average BP is 121/84. Higher than it has been over the past few days, but still: not suicidal. Whether the pill pushed the figures down or whether the pressure just dropped on its own, as it always does in the morning, is now unknown.

But whatever: it is surely NOT high enough to cause my head to hurt. Which it decidedly still does.

This suggests some other headache etiology, hm?

Well, you’ll recall the fine respiratory flap that started last March and went all the way to the end of October before it cleared up?

Yes, that may have been a cold or flu (and that is why I’m trying with all my wiliness to avoid the flu this spring). But between Cardiodoc 2 and the young Mayo doc, we suspect the issue was not an infection — or at least, not one that lasted the entire 8 months — but probably allergies. Or allergies complicated by an infection. That theory advanced, Mayo Doc recommended that I double up on the 10-mg doses of plain, unadulterated Claritin (hold the pseudoephedrine), gulping down one pill in the morning and one at night.

And damned if this didn’t work! Within a few days, the head congestion started to clear up, and within a month it was gone.

Also gone? The dizzy spells and palpitations!

Turns out that in old bats Eustachian tube and sinus congestion can cause both dizziness (this is pretty common) and presyncope. In other words: I wasn’t enjoying near-fainting spells and crazy world-spinning because of the blood pressure. Those must have been caused by head congestion…which went away when the Claritin kicked in.

Past couple of weeks, I’ve been forgetting to swallow a daily Claritin. The pill-a-day lifestyle, really, is not for me. And in the absence of the antihistamine, my head has slowly been gooping up again. It is almost March again: right when the head thing started last year. Right when things start to grow in the low desert.

And so…very likely what feels like a sinus headache is a sinus headache. And it, along with the vertigo, is coming back because I quit treating it. 😮

Imagine that.