Hot dayum!
I’m back from New CardioDoc, an “authority” picked from that bazaar of authorities in all genres, Angie’s List. Wanted a second opinion to original CardioDoc, who aggressively insists that I need to be on a drug that makes me sick and puts me and everyone around me at risk when I’m behind the driver’s wheel.
Old CardioDoc, having viewed what happens to my blood pressure when I suffer a stress attack in his goddamn office, refused to brook any questions and would not even listen to me when I tried to point out that if I fall and break a hip, I’m here alone in the house and could very well die on the floor before anyone notices and that the vertigo caused by his favored medicament was making it dangerous for me to drive my car. Neither would he take the slightest bit of notice of the fact that overall my average BP is in the normal range, even when one adds in the occasional spike engendered by this or that moment of hysteria.
So before I agreed to return to gulping down a med that does quite the number on me, I decided to pick another quack, any quack, and see what he thought. On Angie’s List, one cardiologist (count him, 1) was both highly recommended and within reasonable driving distance. Made an appointment with him.
Today, with vast trepidation, I slinked into his office, bearing a list of five questions and seven months’ worth of BP figures.
I happen to have, neatly registered in Excel, blood pressure figures going back to June 1. This is how I know what the averages look like. The anxiety-induced spikes are indeed alarming…but most of the time, when I’m not worrying about identity fraud or scared shitless from being in a goddamn doctor’s office, the figures average about 128/79. Not bad for an old bat.
You cannot imagine, especially if you’re a young pup, what it means to someone in my generation to question a doctor. Especially for a woman to question a doctor. Especially a male doctor. Here I was not only questioning a doctor, but questioning a freaking high-powered male specialist.
Sorry, but I just was not buying what CardioDoc1 said: he was telling me things that directly contradict what credible sources say; he was refusing to listen to me when I described the side effects of the crap he’d put me on; and he was blatantly trying to frighten me by way of manipulating me. I hate that kind of thing. All of those kinds of things.
But I was equally scared shitless of going to a new cardiologist and telling him I suspect his colleague is full of beans. So I’ve been racking my hot little brain for weeks trying to come up with a humble, tactful, boot-licking way to ask this new guy to give me a straight story.
And as you might imagine, I had myself mightily worked up by the time New Cardiodoc came wandering into his examining room. Blood pressure was through the stratosphere. However. I had the figures.
He actually believed that anxiety sends one’s blood pressure skyward. And he believed that was what was happening this morning. After he reviewed the figures I’d printed up, with their averages, he announced that he did not believe I need treatment with medication at this time.
Thank you, God!!!
It’s three hours later and I’m only just coming back down to earth. If I took the BP now, it would probably be pretty close to normal. From his office I went by the financial guy’s office to deal with the current stage of the Identity Fraud aftermath. And from there to Whole Paycheck, there to purchase one slice each of two exotic yuppie pizzas and a four-pack of Guinness. Figured I deserved it.
Pizza and two cans of stout ingested, I’m feeling a bit better. Have already had a mile-and-a-half walk today but think I’ll invite the dog out for another stroll by way of burning off some more nervous energy.
That was soooo hard! Soooo scary!!!! And sooooooo goddamn difficult!
But I did it. I questioned authority and came away with a sane answer.
Congrats…this is no small achievment. I have noticed with my folks that when the patient is “engaged” the care is much different than if you JUST “go along with the program”. My DM’s Doc has a similiar fight on his hands with a medicine she takes to control her BP. Her argument is it makes her feel funny…light headed….with episodes of vertigo…and therefore from time to time stops taking it. The Doc has a fit to which she replies…”bite me”….It’s a special time to be sure….But she is in control of her life and lets him know it. …and is treated accordingly….
Welp, high blood pressure is a life-threatening condition. If I believed I consistently had high BP most of the time, I would take the effing pills.
My question, though, is whether I have high blood pressure at all. Often at a doctor’s office — especially when the doctor is a specialist in a scary specialty (like cardiology!)–my numbers ARE high. However, overall, when taken two times a day and then averaged over time, the figures are in the normal range.
This new doc thinks that such spikes are not dangerous. I don’t know.
However, it is objectively true that many of these BP meds cause vertigo and faintness. For a person who lives alone, these also can be life-threatening.
Days and days and days go by in which no one speaks to me and I speak to no one other than the dog. My son does not call. My friends communicate by e-mail. SDXB calls rarely and when he does often gets the answering machine. If I fall and break a hip, I will end up laying on the floor until I die of shock or dehydration — as did the lady who lived in my house before me.
In a car, dizziness and faintness are extremely dangerous. One day on the way home from a business meeting I had to pull off a main drag (traffic moves at upwards of 45 mph throughout the city here) into a neighborhood and sit there until I felt I could continue without hurting someone. And even then, I didn’t feel safe. Ended up going into a Walgreen’s pharmacy where, on the pretext of getting the BP measured, I could sit quietly where there were some people around until the worst of it passed.
Doctors are human beings. They also are highly committed to their craft. These two facts predispose them to a) arrogance and b) error. Old CardioDoc is convinced that he’s right and he doesn’t want to brook any argument. New CardioDoc at least listened to me and did not discount the BP figures I had just because they came from a home monitor. It must be said, though, that even if you added 10 points to each of those figures, the average would still be below 150, which is the new standard for people over the age of 60.
Measuring BP is a tricky business, since the variables are many and it’s hard to establish a baseline of what is “normal”. Good on you for taking the old-fashioned approach – data, data, data.
I was once told that it’s not necessarily the systolic or diastolic measure that makes a big difference, but the average mean difference between the two. The greater the better, so 150/110 may be healthy, whereas 150/130 is definitely a danger sign. A high systolic/diastolic ratio indicates a good “compression ratio” in the heart and major arteries.
When my BP was dangerously high, it showed itself in screaming headaches at 5 AM (when BP is at its highest), and was intractably linked with sleep apnea and high alcohol intake, especially right before bed.
I don’t drink anymore, but miss Guinness once in a while. Although a good pour from a trusty barkeep is favorable to that tinned shite.
Slainte, anyway.
And a mighty happy New Year and best wishes of auld lang syne to you!
Yesh. Sleep apnea seems to be associated with elevated numbers, too. Losing 30 pounds pushed the average BP figures way down, AND after I hit about 135 lbs, it apparently began to allow me to sleep all night. Can you IMAGINE sleeping eight. full. freaking. HOURS?????? Even with the standard old-lady awakening at 4 a.m., instead of getting up and moving around at that hour (or laying there with eyes like saucers staring into the goddamn dark for the next hour or two), I now fall right back to sleep.
This week’s data-driven experiment in these parts seems to indicate that caffeine is a worse culprit than my favorite boozie-poo, Maker’s Mark. No coffee, two MM’s: 120/71, p. 81. Sumbiche! What is the explanation???
Here are the problems inherent to the entire blood pressure endeavor:
a) No question elevated BP is potentially life-threatening in itself or an indicator of a potentially life-threatening condition. (Understanding this factoid alone can elevate the BP of the most neurotic among us…)
b) No real consensus about what is a safe BP. Until just a couple of weeks ago, we were told we needed to keep our systolic figure to 120 or so. Then, what should come out but a study (got ahold of the JAMA publication of said study & will say it appears to be well designed) saying that the target figure for people over 60 should by 150 or less. Uh huh. That is a THIRTY-POINT spread, which is fuckin’ huge.
c) No way of being sure instrument A’s measurements jibe in any meaningful way with instrument B’s. By and large home BP devices register lower figures than the devices at the doc’s office that are hard-wired to the wall and require skill with a stethoscope. Naturally, the doc thinks the latter is the more reliable device — and she may be right. Or…maybe not. ????? About the best you can do is take your home device in to the doc’s office, waste her time by having her use her equipment to measure your BP, and then compare it, right then and there, with what your device says.
BUT…the very act of taking your blood pressure alters your measurable pressure! If you re-take your BP within five or ten minutes, it is likely to be lower than the first measurement. Sooooo….what does that say about the “calibration” you make in the doc’s office?
Argha.
It seems to me that if your BP is consistently high, you can safely assume you have a problem and should proceed accordingly. But if it’s not — if one hour or one day it’s 160/98 and on other days and at other hours it’s 132/80 or 120/71 — what exactly are you supposed to make of it? In that case, as CardioDoc2 suggests, about the best you can do is measure a couple of times a day over a substantial period and figure the average.
Thank god for Excel.
Good deal, FaM. Glad the BP is within tolerance, and that you got a new Doc that at least listens. Our own GP has a bit of a tin ear on a couple issues. Happy New Year!