Friday, November 17, 2023

Adventures with blood pressure

 

As regular readers will know, last week we suffered water damage to our home when our dishwasher decided to fill itself late on Thursday night . . . and kept on filling itself.  Our insurers called in ServiceMaster within an hour of our lodging a claim, and they spent Friday testing for water contamination, cutting and boring holes in a couple of walls to aid air circulation, removing wet insulation, and preparing to dry out our home.  By Friday night there were more than a dozen big roaring fans and dehumidifiers at work, and they stayed in place until Tuesday.  Fortunately, all went well, and we're now into the process of getting quotes to replace flooring and repair the damage.

Unfortunately, the stress of dealing with all that, and the non-stop 24/7 noise of all those roaring fans, affected my health.  I hadn't expected that, but I'm no longer as young as I was, and the doctors tell me that stresses like that do hit harder as we get older.  I woke up early on Sunday morning feeling very uncomfortable, with chest pains and some referred pain in my left arm.  Having survived two heart attacks already, you can imagine that those warning signs were not welcome at all.  It didn't take long before I was on a gurney in the local emergency room, with nurses measuring my vital signs.

Fortunately, I wasn't having a heart attack:  my EKG was normal.  However, my blood pressure was very dangerously high, at seriously life-threatening levels.  That came as a complete surprise.  The ER doctor said it was almost certainly a physical reaction to the noise and stress of the previous 48 hours.  When I shook my head in disbelief, commenting that I didn't feel stressed, he reminded me (rolling his eyes) that I wasn't 21 any more, and that as one gets older, one's body reacts to stress a lot more than it used to - and it won't necessarily warn us about it with obvious symptoms.  I can see now why they call high blood pressure the "silent killer"!

I was discharged after a few hours with instructions to monitor my blood pressure several times a day, and to return to the ER at once if it spiked at all.  I haven't previously bothered to check my blood pressure routinely, but after this episode, you can bet I'm going to be doing so, probably more than once per day!  I ordered a blood pressure monitor off Amazon, one recommended by the doctor.  It's very simple to use, and gives me peace of mind.  I'll also be checking my post-heart-attack prescriptions with my health care provider, to see whether I need an increased dose of any of them, or a new medication to add to the mix.

The purpose of telling you all this isn't to make you go "Ooh!  Aah!" at my medical misadventures, but in the hope that some of you will consider checking your own blood pressure more regularly.  If you're older, or a heart attack survivor, or in poor health due to other conditions (all of which apply to me), I've just learned the hard way that it's very worthwhile to invest in your own blood pressure monitor and use it regularly.  (One word of warning:  it seems that small wrist-size blood pressure monitors are notorious for not giving very accurate results, irrespective of the model.  I had one for some years as a result of my earlier heart problems, but found that when comparing its readings to those obtained by my health care provider, the former were very inaccurate;  so I stopped using it.  My new blood pressure monitor, which reads from upper arm or forearm, is much more accurate.)

Fortunately, my blood pressure has been within normal limits (for me, anyway) for the past several days.  Long may it remain so!

Peter


20 comments:

  1. I have been using a blood pressure monitor for maybe 15 years now. Take a reading everyday just before going to sleep. Also take a reading every third day at a different time of the day while sitting at rest. These reading I keep as a permanent record to show my health care provider, the VA, to prevent them from putting me back on blood pressure meds.

    Over the past 18 weeks I have been averaging 114-116/69-71 with HR of 52-57 bpm. I think I'm doing well for an old fart.

    Wishing you good health and regular use of you monitor!

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  2. oh, yeah. doesn't old age suck ? and to think I used to do a 2 mile run in boots, in the sand in 13 flat too. but that was 50 years ago now and just doing the damn shopping run kicks my ass these days. BTW, I also have a blood pressure cuff
    here and other items to keep a eye on things.
    and the Doc says I need to push myself these days.
    right.

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  3. That Omron BP reader is excellent. But a word of warning for others who may decide to try ordering one. If you search on Amazon for it you may discover pages of chinesium knockoffs before you get to the genuine article. It is very easy to accidentally click on one of the knockoffs instead of the real thing.

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  4. Hey Peter,

    Glad you are ok, What brand do you use? so I can look for it on amazon.

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  5. @MrGarabaldi: https://www.amazon.com/dp/B07RYBKNC2

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  6. My health plan offers free blood pressure monitors. There are about a half dozen to choose from. Not only do I not know which one to select, I wouldn't know how to read it if I did have one.

    Is there a tutorial out there somewhere? Maybe a you tube video recommendation (overwhelming).

    If it was just one number, it would be easy. But there are two numbers. This number, over that number, . . . who knows when it is a concern, and when it is not?

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  7. I keep a note in my billfold to give to nurses. Don't use automatic cuffs. When they put it on me nurses run for the doc's and they come flying in because my blood pressure is 231/187. Doc's office take it with the hand model and it's 121/70. I had so many nitro pills shoved in me and other med's till we figured this one out. Glad your OK.

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  8. My GP asked me to set up an excel sheet (rather than storing the readings in the machine) and email it to him every two weeks. BP and sugar first thing every morning - even before coffee.

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  9. Thanks for a timely post. Having passed the big seven-oh, I'm officially an old geezer now. I retired a year earlier that I had wanted to simply because I was no longer as resilient as I used to be, and the stress of the job at Big City Medical Center was starting to seriously affect my health. Even then I didn't realize just how MUCH stress I was under until it was GONE. The relief was astounding, and while a local doctor has tried to hire me for our small hospital, I just can't bring myself to do it.
    A couple years ago I was deferred from donating blood because of an "irregular heartbeat". I didn't even know that was a criteria in the pre-donation testing. Well, after much further testing, including an echocardiogram and a coronary calcium CAT scan, I have had consults with a cardiologist and an internist. My irregular heartbeat is entirely benign at this point, and apparently quite common. The only thing that either of them could find to recommend for me was to lose some weight (which I have done; an ongoing project of a low carb diet).
    Thanks again for the link to your physician recommended BP monitor. I knew the little wrist ones are notoriously inaccurate, it's nice to have an alternative recommendation.

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  10. Negative stress is weird. Low-level single negative stressor can slowly build up until it is very bad.

    But multiple negative stressors act geometrically in increasing stress-induced effects.

    What you, Peter, experienced is what gets people dying after hurricanes or other severe weather conditions.

    This is a good warning for the upcoming holiday season, too. Family and family obligations are major negative stressors, and all of that builds and builds.

    Y'all need to watch your stress levels out there. Find something safe that will lower your stress, like petting your dog or cat (petting alligators, on the other hand, might increase stress and cause your hand to be lost.)

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  11. I have an old style manual sphygmomanometer, but those are not good for self checking. I guess I need to get newer one.

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  12. I did see a medical study article that said to take your blood pressure laying down flat! They found that way to be way more accurate! Might want to check into that!

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  13. ALCON

    1) Most home BP machines have some amount of inaccuracy.
    The good ones are always inaccurate the same way, i.e. they may read 10 points high (or low), but they won't alternate high readings and low ones on different days.

    2) Check you BP first thing when you get up. The best reading you're ever going to get is before the cares and worries of the day get you good and pissed off and worked up.

    3) Write the numbers in a notebook, which you take to your semi-annual or annual Doc visit. One reading a day is plenty, until your MD specifically tells you to do more.

    4) No one - NO ONE - cares if your BP shoots up 20 or more points on one day.
    If it's been normal, and creeps up, and stays high for several days, and you've been taking your meds as directed, it's probably time to see your doc and have your BP meds adjusted. Your body gets habituated to them over time, so expect this; don't freak out about it.

    5) If your BP spikes over 200 systolic (the first number)
    and/or you have physical symptoms like chest pain, dizziness, blurry vision, weakness, unusual fatigue, nausea, vomiting, blurry vision or loss of vision, slurred speech, facial droop on one side, or one-sided decrease of function to arm, leg, etc., call 9-1-1 and get to the ER, immedately.

    6) "If you never check a temperature, you'll never find a fever." - Rules of The House Of God
    And if you never check your BP, you'll never find out you have hypertension. Until you have a heart attack or stroke, and then it may be too late.
    Your doc wants you below 140/90.
    Walking around with a high pressure is like driving your car 95MPH from stop light to stop light: something's going to blow.
    The best heart attacks or strokes are the ones you never have.


    Peter,

    Best wishes going forward. Glad things are getting back to normal.

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  14. I check my blood pressure every morning with an upper arm cuff unit. I use a "OMRON Silver Blood Pressure Monitor, Upper Arm Cuff, Digital Bluetooth Blood Pressure Machine, Stores Up To 80 Readings". As Jerry Pournelle used to say, good enough.
    https://www.amazon.com/gp/product/B07RYBKNC2/

    I have had two heart incidents. The first was caused by high blood pressure in 2009 at age 49. I walked into the Port Lavaca ER on turkey day with a bp of 210/110. It took them five hours to get my blood pressure down. Incredible chest and left arm pain. My second incident was atrial fibrillation with tachycardia in 2013 with a heart rate of 200 to 250. I had an heart double ablation in 2018 to fix that after the drugs quit working.

    I don't want to have a third incident, I have enough heart damage from the first two. Yes, heart damage. I lost the back side of my heart muscle from the first incident due to a congenital problem with my right coronary artery.

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  15. Hypertension is a major contributor to having a stroke. Trust me. You do NOT want to have a stroke.

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  16. Timely post. I was in Urgent care on Monday for something not BP related, but not having a regular doctor I have never had my BP checked. I wasn't happy to see 132/88. I've got to work on that since I am in my early 40s. Maybe the new job come January? Anyway, thanks for the link.

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  17. Are there ANY good BP wrist monitors? Not having to strip lots of winter type clothing to access the upper arm would be a very useful item. I had one that I spent some time comparing to an upper arm version, and it was consistently close in readings. That changed about the time the first batteries got tossed. Then it started under-reporting in an inconsistent fashion.

    Peter, do you use a finger cott/pulse oxymeter? I've got an Ankovo brand one, and discovered that it has irregular heart beat warning alarms. It warned me about my second heart attack, another PVC (premature ventricular contraction) attack. I was taking a break from cleaning a large RV, feeling a bit worn, sat down in my car and plugged my finger in, since it was sitting right there. Lots of flashing and beeping to get my attention.

    Doesn't do any damage, I'm told, but quite scary with the high "G" forces simulation (vision reduces to a tunnel effect, just like a fighter pilot graying out).

    Since it seems to have a map to compare your pulse to, I think it might be a useful tool for early heart problems manifesting.

    One of the big takeaways for me was that I could not wear a mask anymore. More than 5-10 minutes, and my oxy level drops. That is also seen in DRs in the OR, according to studies.

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  18. I forgot that that I have logged my daily blood pressure, weight, and time of taking on several stenographer pads since my first heart incident in 2009. There is nothing like a good record of possible changes.

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  19. I've been looking at the Garmin Index BPM "Smart" Blood Pressure Monitor ( https://www.garmin.com/en-US/p/716808 ).
    Pros:
    * **Optional** syncing with Garmin Connect -- I'll note that the binary format that Garmin uses is fairly well documented on the _base_ level. I could _probably_ figure out what the decoded data maps to in an afternoon or so (for https://www.gadgetbridge.org/ ).
    * Claims to be "clinically validated" by the FDA. I don't know if I trust the FDA to do a good job validating stuff though.
    * FSA/HSA eligible, probably due to being "clinically validated" by the FDA.
    * Privacy: Mozilla has looked at Garmin's privacy policy in the past ( https://foundation.mozilla.org/en/privacynotincluded/garmin-fenix/ ) and thinks it was *pretty* good.

    Cons:
    * Price. $150.

    I'm kind of hoping that it goes on sale somewhere on Black Friday, but I'm not holding my breath on that one.

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  20. Good to hear all is now well. Take care of yourself.

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