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  #26  
Old 02-10-2017, 10:10 PM
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Default Re: Do NOT skip your yearly check-ups ...

Best wishes, TLR.
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Old 02-10-2017, 10:29 PM
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Default Re: Do NOT skip your yearly check-ups ...

I had already made up my mind to go in for my check-up this year. You've just made certain I won't blow it off.
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  #28  
Old 02-12-2017, 11:19 AM
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Default Re: Do NOT skip your yearly check-ups ...

My insurance won't pay for yearly check ups. I get them every three years at best. But yes any bleeding is serious and those nifty blood pressure machines are now way more accurate and cheap then they were 10 years ago. Never turn down a free blood pressure check, it's a silent killer.
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  #29  
Old 02-12-2017, 11:49 AM
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Default Re: Do NOT skip your yearly check-ups ...

Oddly, nor will mine. The NHS offers them every five years for 40-75 year olds. But you seem to get a blood pressure check whatever you visit the GP for.
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Old 02-12-2017, 03:10 PM
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Default Re: Do NOT skip your yearly check-ups ...

Okay, Lone...Welcome to my world. I am a victim of the 'dread triad': hypertension, diabetes, and hypercholesterolemia.

I've never seen quite as high of BP readings as you are describing, but I've been close. I was diagnosed more than 20 years ago and the physicians have never been successful in completely lowering my BP to 'normal' levels. The diastolic is now near where it 'should be', while the systolic remains modestly elevated.

They will probably give you meds to reduce the BP and those are not always safe, nor particularly effective. One medication I was on made it exceeding difficult to walk even a modest incline without becoming physically exhausted in short order, while another (Norvasc) engendered raging periodontal inflammation....without having much effect upon my BP. In the years since my diagnosis, I have been shuffled through several sets of medications, seeking one that will accomplish the purpose without engendering other problems.

My recommendation is to make sure that you have an idea of what possible adverse events might occur with each prescribed medication and make sure your physician is apprised of those events ASAP. The Cochrane Library online is a pretty good source on medication effectiveness.

And...There are ideologues within the medical profession who are questioning the 'need' for annual medical check-ups (I believe this is coming out of the Geisel School of Medicine at Dartmouth, which provides much of the lead in Evidence-Based Clinical Medicine). I suspect the 'annual check-up' came about because so many patients never came to see their physician unless they were exhibiting serious conditions and preventive intervention might well have been more effective. However, with all the 'preventive scanning' occurring these days in medical clinics and hospitals, 'preventive care' has taken on some malevolent aspects of pushing unnecessary over-medication and over-treatment (like, say, the PSA and prostatic treatment). I believe that the cost, or perceived cost, of medical treatment has generated the reluctance to see a physician when one needs one. Universal single-payer coverage would end that.

All that said, take care of yourself, man. I hope you have a more positive response to medical intervention than have I, and you are back to near normal soon.
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  #31  
Old 02-12-2017, 08:58 PM
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Default Re: Do NOT skip your yearly check-ups ...

Quote:
Originally Posted by godfry n. glad View Post
Universal single-payer coverage would end that.
The difference between:
Weird, I should see my doctor.
And
Weird, would the benefit exceed the cost of seeing my doctor?
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  #32  
Old 02-12-2017, 09:14 PM
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Default Re: Do NOT skip your yearly check-ups ...

I am also very fond of you, TLR. Wishing you the best.
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  #33  
Old 02-14-2017, 07:33 PM
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Default Re: Do NOT skip your yearly check-ups ...

Well, I'm just back from my first follow-up visit. As it happens, the physician who admitted me wasn't in today (he's out with the flu), so I saw another physician. That's not such a bad thing, really, since there's value to a second opinion.

I had some more blood drawn and tested, and then he went over the results of all the tests I've had over the past week and a half.


The real issue, it seems, is diet. The campus cafeteria serves 3 meals a day, and faculty eat for free. (This is part of the deal; part of the reason this college pays its faculty so little is because all of our meals are -- supposedly -- free.) The downside to that is that the food served in the campus cafeteria is very high in salt, saturated fat, and other unhealthy stuff.



So anyway, the test results: the problem wasn't with my kidneys, heart, or renal arteries. There are no signs of pituitary or adrenal disorders that would explain the very high blood pressure. In short, he said, there was no physical cause, so far as they can tell -- it's just a combination of genetic susceptibility and a high-salt diet.

He also reiterated what I'd already been told: the blood in the urine may have been dismaying, but it was probably the best thing that could have happened to me -- because if it hadn't convinced me to come in for a check-up, I might well have died of a stroke or a heart attack.



That also explains why it took several days before I finally started responding to the medications and my blood pressure went down: we had to wait for the excess sodium to clear my system. But my b.p. is staying down now, fortunately.

My body mass index is good; he said that it wouldn't hurt to lose a little weight, but that it isn't really necessary. He also gave me the green light to start going back to the gym. [The first few days on the medication, I felt ... well, awful ... but I seem to have pretty-much adjusted by now. I'm currently feeling about 1,000% better than I did just a couple of days ago.]

So, he said, if I continue on a low-sodium, low-fat diet, then moderate levels of exercise should suffice to keep my blood pressure under control. Indeed, he thinks that a good exercise regime and proper diet may well let me get off the pills entirely.



Ironically, because one of the pills I'm now taking is a diuretic, my blood magnesium levels are too low. (That's not a surprise; many diuretics work by causing increased excretion of sodium, potassium, magnesium, and other ions.) So, I'm to take a magnesium supplement daily, to keep my magnesium levels up.

But that, too, should be a problem that takes care of itself if I can get myself off the pills. Yet another incentive to hit the gym after class.


I have a meeting with a nephrologist in a couple of weeks, just to make sure there are no kidney issues, and another follow-up appointment after that, to make sure that my blood pressure is staying down. But all in all, the results of today's follow-up exam were most encouraging.
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  #34  
Old 02-14-2017, 08:18 PM
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Default Re: Do NOT skip your yearly check-ups ...

Quote:
Originally Posted by The Lone Ranger View Post
Ironically, because one of the pills I'm now taking is a diuretic, my blood magnesium levels are too low. (That's not a surprise; many diuretics work by causing increased excretion of sodium, potassium, magnesium, and other ions.) So, I'm to take a magnesium supplement daily, to keep my magnesium levels up.
No mention of covering up in the sun? My doctor was semi-strident about that when I was on diuretics. Maybe bounce that off your next doctor and then your GP.
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  #35  
Old 02-14-2017, 10:00 PM
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Default Re: Do NOT skip your yearly check-ups ...

Yeah, I'm not supposed to be spending too much time in direct sunlight.

I'm going to make a point of eating foods that are rich in antioxidants, to hopefully help counteract that. [As if I need an excuse to eat more blueberries and drink more grape juice.]
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  #36  
Old 02-15-2017, 03:35 AM
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Default Re: Do NOT skip your yearly check-ups ...

Did they check Vitamin D levels? :nosy: May need to watch that as well, especially with the reduced sun. I'm chronically low and one doc told me that such deficiency is usually lifelong. Luckily it's an easy pill to take.
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  #37  
Old 02-15-2017, 03:44 AM
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Default Re: Do NOT skip your yearly check-ups ...

Yeah, couple years ago I got diagnosed with the Vitamin D deficiency. And B-12.

Remedy: take my vitamins.
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  #38  
Old 02-15-2017, 05:29 AM
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Default Re: Do NOT skip your yearly check-ups ...

Oddly enough, when I was being treated for hypertension my sodium levels were always in the normal range. They were just about the only numbers that were. Go figure.
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  #39  
Old 02-15-2017, 07:06 AM
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Default Re: Do NOT skip your yearly check-ups ...

Magnesium is best at night, it also helps you relax and fall asleep. Too much of that causes diarrhea, so back off if you have those symptoms.
I would also consider low carbs, because all the research I've seen about lowering fats is not as compelling as lowering carbs. Any excess calories turn into cholesterol in your system, to be stored (if you're an efficient member of our species), but fats may be slower to be broken down by your digestive system.
Prostaglandins have some interesting and variable effects on our bodies. I am not going to recommend anything, but that with your scientific back ground look into research about prostaglandins and their effects on the human body. My friends who have done way more research than I recommend certain things (grass raised dairy fats, no nitrate treated proteins). I hope you are well. And you can come visit some time!
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  #40  
Old 02-15-2017, 07:08 AM
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Default Re: Do NOT skip your yearly check-ups ...

a fair amount of high blood pressure has nothing to do with high sodium levels, but it's not insignificant that there is a correlation with about 1/3rd of people who have high blood pressure.
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  #41  
Old 02-19-2017, 05:30 AM
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Default Re: Do NOT skip your yearly check-ups ...

I have a pre-cancerous condition called "Barrett's Esophagus".

I have an A1C of 5.8 and that makes me pre-diabetic.

So, while I don't have either cancer or diabetes I am both pre-cancerous and pre-diabetic. Those are not good things.

However, the other day it occured to me that while I am both pre-cancerous and pre-diabetic I am also pre-deceased.

That, in my opinion, is a good thing.
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  #42  
Old 02-20-2017, 07:40 PM
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Default Re: Do NOT skip your yearly check-ups ...

Quote:
Originally Posted by The Lone Ranger View Post
Ironically, because one of the pills I'm now taking is a diuretic, my blood magnesium levels are too low. (That's not a surprise; many diuretics work by causing increased excretion of sodium, potassium, magnesium, and other ions.) So, I'm to take a magnesium supplement daily, to keep my magnesium levels up.
Potassium, very important, critical even. Unless your bp meds cause potassium retention like Valsartangeneric (Diovan™) does, which is why it is usually coupled with the diuretic Hydrochlorothiazide.

Quote:
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a fair amount of high blood pressure has nothing to do with high sodium levels, but it's not insignificant that there is a correlation with about 1/3rd of people who have high blood pressure.
Unless you're one of the people who are salt sensitive, reducing salt intake is not very effective. I cut out all snack foods and eat only fresh foods from the perimeter of the grocery store, and only occasionally sprinkle a little table salt on some meats, and it didn't make a bit of difference to my blood pressure. In fact, my sodium levels were so low I was getting muscle cramps. Low sodium and high potassium levels, not good. Hated it. Bad.
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  #43  
Old 02-23-2017, 05:48 PM
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Default Re: Do NOT skip your yearly check-ups ...

Just back from my visit with a nephrologist. He confirms that none of the tests show anything inherently wrong with my kidneys, renal arteries, etc. Nor are there any signs of pituitary or adrenal problems that might have caused the spike in blood pressure.

He said what the G.P. had said: my body mass index is good, so while it wouldn't hurt to lose a bit of weight, that's probably not too much of an issue. Still, if I lose a few pounds and get back into a regular exercise routine, it's possible I could wean myself off the pills.

He took me off the magnesium pills, but left the remainder of my prescription alone, pending a follow-up exam in a couple of weeks.


His diagnosis is the same that I had gotten from the general practitioner: There's no obvious physical cause for the hypertension, so it is probably a combination of genetics and poor diet. (No more eating the high-salt, high-fat foods at the campus cafeteria.) So, I seem to be responding well to the medication and to a low-sodium diet, and we'll see how things look in a couple of weeks.
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  #44  
Old 02-23-2017, 09:47 PM
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Default Re: Do NOT skip your yearly check-ups ...

Good.

I just came from my neprologist, and despite my BP being slightly elevated in the systolic, she was content to stay the course on the present med...minoxidil. It's actually the best response so far, and I'm on a couple of others, including the diuretic furosimide. Hey...I might get hairier out of the deal. Woot!

I'm a Type II insulin dependent diabetic. My A1C was pegged at 5.7 and considered great.

My big improvement was with the cholesterol. Last time, I'd finally gotten my cholesterol count down to 212 with the minimal statin dosage, which my physician had talked me in to continuing to keep me on the statin (he thinks it may reduce any arterial plaque buildup). But, with the statin presciption came the emphatic instruction to NOT eat grapefruit or drink grapefruit juice. The reason? Adverse reaction. So, I was dropping the med for the duration of the peak of Texas ruby grapefruit season and then restarting in the off-season. I told my physician, and he looks up why it is that grapefruit is contraindicated....because it has a 'synergystic' effect upon the statin, intensifying the effects (and thus unwanted side-effects - muscle aches and lethargy). So, physician says at lowest dose, eat with as much grapefruit as you want, deal with muscles aches with CoQ-10. I, of course binged on grapefruit. Good stuff, too. Sometimes two whole grapefruit a day. For three months. I haven't needed the CoQ-10 supplement.

My cholesterol went from 212 to 124.
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  #45  
Old 02-23-2017, 11:07 PM
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Default Re: Do NOT skip your yearly check-ups ...

Oh, I forgot to mention: the nephrologist told me the same thing that both of the g.p.s had suggested. He said that the blood in the urine that convinced me to go to get checked out was probably due to a spike in my already-too-high blood pressure rupturing glomerular vessels. "And," he pointed out, "the reason you're alive right now is because vessels in the kidney ruptured, instead of vessels in the brain or heart."


So yeah, that's really good incentive to keep up a regime of proper diet and exercise, and to keep a close eye on the blood pressure.
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Old 02-24-2017, 02:12 PM
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Default Re: Do NOT skip your yearly check-ups ...

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Old 03-04-2017, 09:12 PM
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Default Re: Do NOT skip your yearly check-ups ...

So, the nephrologist took me off the magnesium pills; he says my Mg levels are fine now.


I'm thinking I may have to schedule another appointment soon. My blood pressure has remained low, but now it may be heading toward too low. I've managed to lose a few pounds, and I'm getting more exercise, and now my b.p. consistently reads around 110/70 or lower.

I'm thinking if this trend continues, it may soon be time to lose one of the pills, or at least switch to a lower dosage.
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Old 03-05-2017, 06:12 AM
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Default Re: Do NOT skip your yearly check-ups ...

Quote:
Originally Posted by The Lone Ranger View Post
So, the nephrologist took me off the magnesium pills; he says my Mg levels are fine now.

I'm thinking I may have to schedule another appointment soon. My blood pressure has remained low, but now it may be heading toward too low. I've managed to lose a few pounds, and I'm getting more exercise, and now my b.p. consistently reads around 110/70 or lower.

I'm thinking if this trend continues, it may soon be time to lose one of the pills, or at least switch to a lower dosage.
Be careful of arrhythmia, my medication was for that and not high blood pressure, and during one stay in the hospital, for an other condition, the medical staff withheld my medication because my blood pressure was too low. They didn't consider that my medication was not for high blood pressure, and didn't take that into account. As a result my defibrillator went off after I was released. My cardiologist and I figured it out, and I wasn't restricted from driving for 30 days.
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  #49  
Old 03-05-2017, 11:19 PM
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Default Re: Do NOT skip your yearly check-ups ...

Yep, definitely calling the doctor tomorrow morning.

Today, my blood pressure has been consistently staying at around 90/60 or lower. I've fallen down twice in the past two days after standing up too fast. I'm definitely suffering from hypotension now, and I have to be very careful when standing up.

Maybe my body will adjust after a few days, but right now it sucks, because just standing up for more than a few minutes at a time makes me dizzy.

Oh, the irony.
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Old 03-06-2017, 02:27 AM
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thedoc thedoc is offline
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Default Re: Do NOT skip your yearly check-ups ...

Quote:
Originally Posted by The Lone Ranger View Post
Yep, definitely calling the doctor tomorrow morning.

Today, my blood pressure has been consistently staying at around 90/60 or lower. I've fallen down twice in the past two days after standing up too fast. I'm definitely suffering from hypotension now, and I have to be very careful when standing up.

Maybe my body will adjust after a few days, but right now it sucks, because just standing up for more than a few minutes at a time makes me dizzy.

Oh, the irony.
Damn, and I thought getting dizzy when standing too fast was just from age, seriously I believe the body tends to compensate for things like this, in time I have learned to stand up slowly and not be in a hurry. That can be a real problem with diets, if you lower your caloric intake, your body automatically does the same thing but more efficiently so you think you are doing just as much but you are actually doing less to match the calorie intake.

BTW when I was in the hospital my BP was below 90 on the top number and the hospital had a policy of withholding BP medication when the BP got that low. I had given them the names of all my doctors and assumed that they were in contact with them. I won't make that mistake again.
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Angakuk (03-06-2017), The Lone Ranger (03-06-2017)
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