Sunday, June 02, 2013

My blood pressure may not be as high as previously suspected

Since the beginning of the year, I have been following my blood pressure and taking medication to reduce it. In the morning, it is always comparatively low (ie normal) - around the 120/80 mark so beloved of doctors. But sometime during the day it takes off to high levels, and when I measure in the evening, I see values of 155/95 or even higher.

At times, I measure my blood pressure every morning and evening, religiously noting down the values (one doctor told me to report only the average of three readings and not all three) for a fortnight. I've been measuring the blood pressure with my personal sphygmomanometer (a word which I know how to copy and paste from Internet sites but don't know how to pronounce) although every time that I visit the kibbutz clinic, I have my bp measured with the devices there.

During one of my recent visits, the nurse suggested that I bring my machine it so that we could check its accuracy against the clinic's machine. So the other evening, when I had an appointment with my doctor, we also measured my bp with both machines.

Whilst the diastolic value (that's the lower number) was virtually the same with both machines, the systolic value varied widely - my machine reported a value like 155/93 whereas the clinic's machine reported 135/91. It makes one wonder when a diagnosis of hypertension is based on my machine's readings. Today we repeated the experiment: my machine reported 166/93 (I was very agitated at the time of the reading) whereas the clinic's machine showed 148/91.

Unfortunately there seems to be no way to calibrate a sphygmomanometer's readings (although I will look in the owner's manual) which means that my machine is worthless. I will replace the batteries to see if that makes a difference, although I know that I replaced them at the beginning of the year.

Regarding medication: I started off on a minimal dose of 5mg <something> at the beginning of the year. This was increased to 5mg in the morning and 5mg at night, but this doubling had no effect. For the last two months, I've been on 10mg twice a day, which also has had little effect, so now I am going to try 20mg in the morning (to try and prevent the increase during the day) and 10mg at night.

One possible effect of the increased blood pressure is headaches. About a month and a half ago, I went through a terrible phase of daily headaches. Taking an analgesic after a headache had started had virtually no effect. As an experiment, I started taking an analgesic pill at breakfast - this prevented any headache! When I reported this to my doctor, he started me on a daily dose of 100mg aspirin - this is only 20% of one normal aspirin pill which one takes for headaches or fevers. During the past month, I had only three headache days: one time I took no extra analgesia and suffered badly; one day I was quick enough to take a pill as soon as I felt the headache start - the pain disappeared after three hours; one day I took a pill slightly too late - I suffered all day but not excessively.

I asked the doctor what was causing these headaches: he answered that the current diagnosis is migraine,  meaning that he doesn't know what starts them. The diagnosis is based partially on the fact that I reacted favourably to the drug sumatripan (which is specific for migraines but not other types of headache). Unfortunately, taking this drug is normally out of the question as it knocks me out for several hours. The pain comes from the expansion of blood vessels in the brain which leads to them causing pressure on nerves. 

I don't know whether I mentioned it here but about six weeks ago I had my first migraine with aura: I could see flashing lights and zig-zagging lines in my right eye. This episode lasted about fifteen minutes, followed by about three hours of stomach pain. I had my eyes checked a week later but there was no organic damage which could explain the attack (hence the diagnosis of migraine).

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