Wednesday, November 14, 2007

A doctor experience: High blood pressure and me

I haven't posted in a while, so I thought I'd write about a doctor experience.

A few years ago, I was scheduled to have surgery for breast reduction. My breasts had always been enormous; even when I was a twig, they ballooned outward because, for whatever reason, the glands just grew and grew. They maxed out at about an H cup when I was in college. Carrying them around for ten years took its toll on my back and neck, and I had grooves in my shoulders (now gone!) from bra straps.

About a month before the surgery, I had my family doctor checkup to get his seal of approval for the surgery. At that time, I was suffering from a headache that'd been going on for a couple of weeks (sinus infection), was going through finals at school, and was worried about a sick family member (who died later that year), and nervous as hell about surgery. My doctor came in and told me that my blood pressure was too high, and he didn't want me to have surgery unless I was able to get it down. It was 140/90. He also wanted to write me a scrip for blood pressure medication right then and there--which I most certainly did NOT want, considering the side effects. I was only 28.

I commented that it was usually NOT high, and in fact, was usually excellent. He flipped through my records and pointed out that it was high during two visits to the emergency room. Um, WHAT?

Let's see, the first visit was due to agonizing stabbing pain and unstoppable puking due to, oh, I don't know, my gall bladder being ready to explode. After the ultrasound, the ER doc (who, by the way, was AMAZING, and diagnosed it fifteen seconds after coming in) told me that I was going to have surgery, and I was being admitted right away. Being too drugged to even think about it, I didn't have the agony of anticipation, so I wasn't too nervous. The surgery was scheduled for 3pm the next day (I was admitted at about 4am). They got some blood tests back and rescheduled it for "right the heck now," which was 7:30am.

The second one was an incident where I felt something was trying to claw its way out of my face, and calling my doctor led to him telling me to go to the ER, where they weren't too busy that night, and they gave me some pain meds and antibiotics for a nasty sinus infection. I was weeping from the pain of it, and scared because I'd never felt anything like it before.

So, when I pointed out that high blood pressure is to be expected in cases of severe pain and fear, he flipped back through, noted that I averaged something like 110/70 or some such, and told me that if I were re-tested in three weeks and it was okay, he'd sign off on my surgery.

So, of course, eating disordered behavior kicked in. I switched to eating nothing but vegan fare, with zero salt, and nothing to drink but water. I ate as little as possible, just enough to stave off hunger, and nothing with many calories. Still anxiety-ridden about surgery, and still in pain from my undiagnosed sinus infection, I made sure to dose up on ibuprofen for my headache--which he had blamed on the "high" blood pressure, instead of realizing it was a sinus infection--and taught myself some relaxation skills. Even so, when I went in, it was something like 130/80, which he said was borderline, but improved enough that he'd sign off.

The morning of my surgery, I tested at 107/70 or something ridiculous like that, because the plastic surgeon was being very comforting and reassuring. He was awesome (if you EVER need plastic surgery in the Albany/Schenectady area, let me know, and I'll reveal his name to you), and the anesthesiologist was also very sweet and friendly. He looked and sounded like Woody Allen.

A week or so after my surgery, I had an appointment with my doctor. Finals were over. My surgery was completed. My headache was subjugated by pain medicine from the surgery. After pointing out that my headache did NOT improve with lower blood pressure, he finally diagnosed the sinus infection, gave me antibiotics, and it cleared right up. Imagine that.

Now, if I'd been thin, do you think I would have been excused as having situational anxiety? Do you think I would have had been offered blood pressure medication?

Meanwhile, on most recent trips to my current doc, my readings have been great, just a little elevated when I'm really hurting (123 over something). I'll also note that the office has correctly-sized cuffs, and the one time there wasn't the right size, the nurse apologized and noted in the chart that it was taken with the wrong size cuff (measured at 130/90 with the too-small cuff).

Also noteworthy is that, since I developed fibro, my upper arms are one giant tender zone, and even properly sized blood pressure cuffs are horribly painful; to me, they feel like they have been lined with thumbtacks over their entire surface. You'd think that it would raise the level--and it probably does, which tells me that my normal level is probably on the low side (which would be expected with thyroid problems, I suppose).

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6 comments:

Rachel said...

You should totally submit this story to First, Do No Harm at www.fathealth.org

JeanC said...

There are times docs really need to be hit up long side the head with a clue bat. SIGH!!!!!

Do you have the same kind of pain in your lower arms? If not maybe you can get your doctor's office to use a wrist BP monitor. I use one at home and it is nice not having someone try and cut your arm off pumping up the cuffs because they think you are going to have high blood pressure and want that blasted gauge above 150 :P

Andee said...

I can't believe doctors aren't taught about the phenomenon of "white coat hypertension," i.e. hypertension that only happens in a doctor's office. Or that blood pressure can be elevated due to physical distress. He must have learned about that stuff at some point, but forgot. Or was just on some jag to hand out pills like candy. Geesh. Anyway, I'm glad you finally got it resolved.

Andee (Meowser)

Harpy said...

There's also some useful information about getting a correct blood pressure reading at the Plus Size Preganacy website, useful for any fat person, not just pregnant women.
http://www.plus-size-pregnancy.org/

It mentions stuff like that even talking during a blood pressure reading can elevate the result, and that you should have your feet comfortably flat on the floor for a seated reading, correct arm angle, etc. And I think I've also read that for a lying-down reading your arms hould be on a pillow to make it parallel with the centre of your torso. And doctors often over-inflate the cuff on fat people!

Juri said...

How I solved my High Blood Pressure and Wight problems

Hi to all.

About 3 years ago I had problem with my blood pressure, caused by stress, wrong diet and low activity. And I was

only 25!! Wight, a little more than 100 kg.

The solution to this problem came to me accidentally. I 3 years ago I had to change my workplace. I had to walk to

and from my new Work every day about 3 kilometers (about 2 miles), thats made 6km (about 4 miles) a day and took

about 40 minutes. I did this a bit faster than normal walk and in 2 Months I lost 20 kg and my blood pressure went

to normal (and cholesterol too).

So this is my story. Hope this makes sense to You.

P.S I found some articles about High Blood Pressure, maybe You'll like them:
- Lifestyle Changes For High Blood Pressure – are they safe?
- Blood Pressure Variations Explained
- Understanding High Blood Pressure
- Causes of high blood pressure
- Do You Have High blood Pressure?
- Exercising vs High Blood Pressure

Enjoy,

To Your Health, Juri

RioIriri said...

That's great, Mr. Spammer, but nowhere did I say I really had a high blood pressure problem.

Also, I do not have high cholesterol.

This blog does not support the idea of weight loss, so your comment is particularly unwelcome. Nice try, though.