Opinios on my BP and Pulse readings

[Sailorsong]

My BP and pulse seem very irratic during a typical day. In fact on one site where I keep track of my BP it says I should see my doctor because of the significant changes in my BP over a short period of time. Here is a sample of my pulse & BP readings for just 1 day.

23:30 68 146/80  before bed
21:30 71 150/77  After dinner
17:00 67 124/72  after eating ice cream
13:30 59 145/80  Vertigo
12:00 65 116/82 After breakfast
10:30 62 168/81 just after waking up

The columns are time, pulse, BP and conditions at time of reading.

Any opinions are welcome and appreciated.

Dennis

[Sailorsong]

Thanks! I really do appreciate this post. I didn't get my new BP monitor in the mail today but did print out these instructions so that I will have them handy when it does get here.

Dennis

PS My doctor added a water pill in the hope that it will bring down my BP and maybe help my vertigo.

[AMO]

dear heiferly,

HA! just brilliantly put :)
the part about aborting and not  damage the lil b.p. unit .... yup, heaven forbid it gets hurt LOL

maybe this helps, for standing,  if your chest of drawers is the right heeight, open the top drawer to  rest your arm.

thankf sor this  perfect instructions! amo

[Heiferly]

Dennis,

To take your BP/HR lying down:

Put the cuff on your arm and position the button on the machine near your hand so that you won't have to move hardly at all to push it when it comes time to take the reading.  Lie down flat, with both your feet and your head down (i.e. nothing elevated) for several minutes before taking the reading.  During this time, remain as motionless as possible and try not to talk either.  Surprisingly enough, talking can cause sometimes dramatic changes in HR and/or BP for some dysauto patients (we get occasional funny stories about this here on the forum).  

Five minutes is probably sufficient; I always figure my MOST accurate readings in this position are taken when I've been flat for much longer.  So if possible I have someone bring me my machine and help me get the cuff on without me moving around much (which would potentially muck up the numbers) if I think of it and realize I'm due for a lying down reading anyways and just woke up from a nap/in the morning or have just been lying down watching tv for a long time, etc.  (For reference, a protocol for a tilt table test might call for a patient to be lying down for two HOURS to get the baseline values before tilting the patient up.)  Oh, as with sitting up BPs, you want your arm relaxed and approx. level with your heart, so keep it flat on the bed/couch.


When you sit up to take your sitting orthostatic pressure:

Wait about 2-3 minutes after sitting upright (both feet flat on floor, legs and arms uncrossed) before taking the pressure.  It takes time for things to "settle" into that position, and even healthy people would get readings that looked like dysauto if they took them in the first 30 seconds after quick position changes because the body doesn't adjust to position changes instantaneously.  It's the failure to adjust even after allowing for the normal adjustment period that makes us "weird."  Err ... special.  ;-)  Again, a special note for we "dysautonomiacs" (I'll make up words as I see fit, oh yes I will!) is to try to remain speechless to get the most accurate readings as many may see spikes in HR or other anomalies if we engage in conversation while taking BP/HR.  Keep the arm with the cuff about level with your heart but at rest (e.g. lying on a firm surface like a table top), yadda yadda yadda.  I think these are the ones we've all done a billion times, LOL.



Standing BP:

Before I say anything else, allow me to state the obvious:  if you, like myself, are a frequent fainter BE CAREFUL taking standing BPs and always always always take your lying and/or sitting BPs first to get an idea of how you're doing.  KNOW THYSELF.  Over time, you should have a pretty good idea of how far your systolic and diastolic generally drop from one position to the next (within a certain margin of error, accounting for "good days" vs. "bad days").  It may help you (consider we aren't always so "with it" when the brain fog rolls in) and those who help to care for you and monitor your BP along with you if you put some masking tape on your BP machine and mark it with your GOOD range of BPs in green sharpie, your mediocre range of BPs in orange sharpie (yellow is hard to see) and your "oh no, do NOT even TRY to stand up or else fainting will be imminent--it's a bedridden day!!!" < or = BP in red sharpie.  

Some find that going by systolic alone is sufficient, some have ranges for both systolic and diastolic; it really depends on what the trends are with YOUR numbers and what your body seems to tolerate and not tolerate (i.e. what seems to correlate with "body, meet floor").  If narrow pulse pressure also has a strong correlation with your faints, you may want to put "warning" levels for that on your machine or on a nearby post-it as well.  The bottom line is this:  if you know that you faint 50% of the time when your systolic drops below 70, and you know that your systolic usually drops about 20 mmHg from what it is lying down to what it is standing, AND you just took a lying BP of 88 systolic, then do the math and be reasonable.  From 88 lying down, with a predicted 20 mmHg drop, you're likely to go below your threshold of 70, which puts you at considerable risk of fainting.  Do you have any business standing up?  No!!  It's not worth it just to be able to chart your standing BP for the day.  Even at the doc's office on days when I'm that bad off, if they **really** want to get the standing orthostatic pressure they still have whoever brought me to the office plus the doc and one nurse (i.e. THREE people) spotting me so if/when I go down, I won't get hurt and they can quickly/safely get me up on the examining table with my feet up.  

While I'm up on my soapbox, I should also say, this is one benefit of keeping a [wheelchair/rollator walker/wheeled office chair/whatever works for you and fits into your budget and through your house's door frames] by your bedside if you're a fainter.  You just never know when you're going to wake up in the midst of a dysauto flare and be unsafe to stand up; having a safe mode of locomotion at these times can literally be a lifesaver and it doesn't have to be fancy, it just has to work!

Okay, done lecturing, back to standing BP:  again, you need to stand still for 2-3 minutes before taking the reading.  Try not to shift you weight around back and forth on your feet a lot (blah blah skeletal muscle pump blah blah yadda yadda ... ask me if you want that spiel, LOL), try to remain relatively motionless, as said twice before zip your lips hehehe.  You may have to be a bit more creative to keep your arm relaxed and at heart level when standing (most of my tables, at least, are a bit low for this--and I'm probably shorter than most of you).  Unless of course you call upon your lovely personal BP assistant to hold up your hand for you, but if they fidget too much while the cuff is trying to do the reading, you may get an error so probably better to let Vanna off the hook on this one.  What works well for me is just stacking up some books on a table on which to rest my arm (and the machine so it's not out of reach).  

This should also go without saying, but if you start to feel faint whilst standing to take your orthostatic pressure, ABORT THE MISSION, SOLDIER!!!  :-p  Not that any of us have ever fainted with a BP cuff on, too stubborn or silly to just sit down before we hurt ourselves (or the machine) ... no, not US!!  ;-)  "You too can prevent blood pressure machine destruction!!"  (Did I sound like Smokey the Bear??)

Happy BP/HR taking!!
:-)  Hope everyone enjoyed the holiday weekend!
-Heiferly.

[Sailorsong]

Thanks for the response. All of the reading were done while sitting in a chair in the proper way. My current BP monitor needs to be pluged into an outlet so not veryt easy to move around. I have ordered a new BP monitor that is more portable ( can run off of batteries) so that I can use it in my bedroom. It also allows me to directly upload the readings to my PC.I should get itiin the mail the beginning of next week.

I have not been train in how to take the laying down BP so any instructions would be great.

Dennis

[Heiferly]

Dennis,

Can you repost that same list, but next to where you put "before bed," "vertigo," etc., can you also label each one as "lying down," "sitting upright," or "standing" if you indeed ever take your BP in different positions.  If you always only take your blood pressure whilst sitting upright, it may be very helpful for you to collect some "orthostatic" (or in those three different positions) blood pressure data for us to look over in case there are useful patterns there.  

If you have not been trained in how to properly take orthostatic pressures, please reply back and I'll post a response with a description of how to get accurate measurements for those (there are some particular details that if not done properly can cause "false" results--much like the rules for taking a standard sitting BP that the arm should be resting and at heart level and the legs should be uncrossed).

Thanks!
-Heiferly.