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645800 tn?1466864555

my BP in chart form

Lulu had asked in the "what up this week" post about my BP so I thought I would share what is happening with it. I could have just posted all the readings, but this graph of them shows it a lot better.

Dennis
10 Responses
739070 tn?1338607002
What BP meds are you on? Your readings mirror mine except  mine without meds are constant at 180/110.

Who handles your BP at the VA?

As my doc says you need to eliminate the extremes and find a happy medium.

Ren
645800 tn?1466864555
I'm on Losartan 25mg, Metoprolol 12.5mg 2x, and Amlodipine 10mg. Prior to my latest flare mine was almost constantly at 134/76.

My PCP handles my BP at the VA usually. But I don't think the PCP at the VA know anything about BP meds.  It was a LPN in the walk-in clinic that switch me to taking the meto twice a day as that is how it is suppose to be taken. I have been going to the VA since June of 2008 and they have yet to schedule me to see a cardiologist. I have one assigned to me but have never seen the doctor for an office visit.

Dennis
739070 tn?1338607002
Actually, I have a neurologist/internal med guy AND a cardiologist following y BP. Of course the two don't agree on the meds as on approaches it from a kidney stand-point and one from a cardiology standpoint.

I do like the kidney guy's efforts to save my kidney function after having BP issues since I was 22 and was under the impression that I had  a rheumatic condition., not a neurological one. But, the cardiologist does provide some important input and keeps tabs on my cardiac function and arrhythmias.

So, I feel comfortable with the two of them settling it among themselves. They do keep in contact with each other.

The kidney guy is concerned about my WBCs dropping and sent me a copy of the labs is calling my MS neuro tomorrow about this event. I can honestly say I DO have confidence in my docs.

I wish the VA would take care of their vets like they should, since you offered the ultimate sacrifice , your life, to defend our rights and freedoms.

Take care,
Ren
645800 tn?1466864555
I think one of the main problems at least with the VA I go to is the doctors are very territorial in their approach to medicine. They just don't want to intervene or make changes to something another doctor should be covering.

For instance I had some fluid on my left elbow one day when I had an appointment with my PC. When I mentioned it to my PC his response was we don't do that here. I had to go over to the ER to have the fluid drained as that was their job. All the ER did was stick a sering in my elbow and draw out the fluid.

The one exception to this is the Shrinks. If you talk to your shrink about something they will usually get it handled for you in no time flat. Probably is that way because of all the vets that have lost it over the years from lousy care. So the shrinks are the kings of the roost. It was by talking to my shrink about my symptoms that the VA got me in to see a neurologist right away. I suspect that is also why they sent me to Vanderbilt when the Neuro at the VA could not figure out what is going on. There is probably some note somewhere in my file about my shrink saying I needed to get this figured out. :)

I am hoping that my new shrink ( another of the flaws with the VA) will be as good as the last one. Every year I have to get a disability form filled out by my doctor to say I'm still disabled for my LTD.  Last year it was a nightmare getting this done. Each of my doctors would fill out their section of the form, but none of them wanted to fill out the overall section as that was not part of their area. I finally got one of them to fill out that section by yelling at him in a hallway. Anyway I am hoping that when I see my shrink tomorrow that he will get it filled out for me so I don't have to go through that again.

Dennis


739070 tn?1338607002
Sending good luck thoughts for your way for LTD certification.

Ren
751951 tn?1406636463
Very nice & clear graph, Dennis.  Is that simply drawn, or did that come from a spreadsheet?  If it's a spreadsheet, you could probably also have it plot a rolling average for each number over the same time frame.  Somebody with some skill obviously produced the graph, but that idea might require you to bring in our old friend Algebra.

Do your vertical lines represent midnight?  If so, it looks like you're spiking in the mornings, calming down mid-day, and bumping up a bit before bedtime.  (Never asked & nunna my bizness; you live alone?)

Also, if you discount the three highest spikes, it looks to me as though the average probably isn't super high, although I admit I didn't do the math.

Anyway, we ditto ren's thoughts on the VA and add an exclamation point.  Same with the LTD.  God bless.
572651 tn?1531002957
Hi Dennis,

cool graph - I am guessing it might be the BP tracker here on MH.  Am I right?  If so, do I win a prize?  :-)

The missing info to go with this type of graph is what were you doing at each of these BP readings?  That could be useful to understand the spikes.

I still say your BP should be managed - it is running too high and that is an increased risk for stroke, heart attack, and/or long term damage.  The recommended BP is 120/80 as the top end. That said, I don't see anything in these numbers that would cause a doctor to keep you for observation.  But then again, I may be totally wrong about that.  

Good luck and keep trying to get them to listen.

as always, L
645800 tn?1466864555
OK you all lose on the source of the graph. It was done by the website 360heart of the American heart association. This is a site that allows you to keep track of things like BP, Glucose, Exercise, weight. It works in conjunction with Microsoft's Health Vault site. Another benefit of the site ( and others too) is that it accepts data directly from some medical devices like the new BP monitor I just ordered.

Yes I agree that it should have also graphed the pulse ( and it might in another mode ) but this one gave me the shortest printout. They include an entry for each reading for comments about what you were doing at the time. This only shows up in the table data which I didn't include as I haven't figured out yet how to get two pages of data into one picture.

I'll report about todays happenings in a different post. See Ya There!

Dennis
147426 tn?1317269232
Hi!  I think you are far too worried about your blood pressure.  It is not as grave as you seem to think.  Also, remember that I am not an Internal Medicine specialist.  You would need to become acutely younger for me to be totally comfortable.

Yes, your systolic blood pressure often shoots up into a pretty high range.  But, just as often it is pretty close to normal.  It is what is often called "labile" (quickly changing) hypertension.  Labile blood pressure is a very common thing.   But, the overall patterns of pressures in your graph reassure me quite a bit.  It looks to me like your meds are the problem and shooting you up and down.

A lot of people don't completely understand what the "systolic" and the "diastolic" readings refer to.  I think of it this way.  When the heart beats it sends a wave or pulse of blood into the arterial system.  When you take someone's pulse you can actually feel the highest amplitude of this wave pass beneath your finger.  That "pulse" or wave corresponds to the systolic pressure.  It is the highest pressure that is exerted on the interior walls of the arteries at any given time.

With your finger on the pulse you feel the beats or pulses separated by a time of feeling nothing.  This is the time between the waves or pulses of blood.  If you could see it happening it would be like the troughs between waves in the ocean.  The lowest point of this period between pulses is the time of "diastole".  It actually corresponds to the time after a heartbeat when the heart rests and passively fills up with blood, preparing for the next heartbeat.  During diastole (between pulses) is the lowest pressure the walls of the arteries experience.  This is the diastolic pressure.

In many ways your constantly normal diastolic pressure is reassuring, as I said above.  This is why.  All tissues in our bodies depend on the constant supply of blood and nutrients brought by the tiny arteries (called arterioles and arterial capillaries).  This is just as true for the walls of our arteries as it is for our brains and muscles.  All the larger arteries have tiny, little nourishing vessels that supply them with O2 and glucose.  This is how they stay alive and healthy.

But, in the case of areteries and the heart, the arteries do not get a constant in/out supply of blood-carrying oxygen.  During systole (during the highest point of the pulse) the walls of the heart and the larger arteries are under pressure - you could say they are being squesszed from the inside out.  The little nourishing arteries can't fill with blood during the short time the pulse from the heartbeat is passing through.  This is okay.  That is the way we are made.  

It is during the resting period, diastole, that the little nourishing arteries fill with blood and supply the tissues of the vessel wall with the oxygen they need.  So, the systolic blood pressure can spike high, but if the diastolic pressure is low enough (in the normal range) the little arteries can fill with blood and do their job.

Dennis, your diastolic pressures are nicely low, so that affords some protection to your vessels.  The damage that high blood pressure does depends on the length of time that your vessels are under the strain of increased pressures.  Your blood pressure does need some management because if the spiking is very high, then it has to take some time to fall to the normal resting (diastolic) pressure and this can shorten the time it has to get replenish the walls.  So, we would like to see those spikes even out.  We worry most about those people whose pressures never let up and we know that the vessel walls will eventually become damaged and lose their normal elasticity.  I don't see that pattern in you.

But, even with your spikes in systolic pressure we see plenty of time when it is near or at the normal range.  This is very reassuring.  

I don't see that this indicates a severe problem with the Autonomic Nervous System.  Perhaps it is due to ANS fluccuations, but as I mentioned, it is a common problem.  So common, in fact, that I see no reason why any Internist would even blink at taking you on as a patient.

I hope this helps.  If I missed the mark, let me know.

Quix
645800 tn?1466864555
Quix,

  Thanks again for you excellent explanation.  

My main concern has been those spikes as they have been very high at times, and when they happen I know it without even taking my BP. On the chart I posted the highest reading was 179, but I had gotten a few that were around 192 before I started keeping track of them and I know that is not good at all. I have been taking the multiple reading during the day in order to show my doctors at the VA what is going on with my BP.

Today I saw the LPN in the same day clinic at the VA and she did adjust my BP medication by adding a water pill to try and get those high numbers lower. She also got to see me having a vertigo attack while there. I had been sitting in a chair and she asked me to get up on the exam table and when I did I had to quickly grab a hold of the table before I fell down. She is also hoping the water pill will help with that as well.

It is so nice to see you posting here again tonight. I hope this means you are feeling better.

Dennis
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