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Eric Coppala's avatar

Cecil, I’m a CRNA, the person you often meet when being put to sleep. The physicians have explained it better than I would as primary care/ internal medicine isn’t my specialty. I’m also on triple meds for HTH. Mine is genetic( my dad had HTN from probably 45 YOA til death) and also related to a non functional kidney d/t corrective surgery at age 12 that caused essentially a kink in the blood supply 40 years later. You know kidneys are directly involved in BP management and when the BP is chronically high, kidney damage will result. Other organs are negatively impacted as well. I see patients daily with HTN and many are black. Also disproportionately in black men diabetes and kidney disease often d/t poorly controlled BP and diabetes. Not knowing the rest of your health history, if I were you, I would want to know my kidney function. Your PCP can tell you that info based on lab results and depending on the results, I would consider consulting a nephrologist. I see one every 6 months and he has my BP dialed in. Kidney docs are thorough, IME, getting BP in line. PCPs are good but specialists are sometimes what you need to better manage an issue.

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Dan Daniels's avatar

Abrupt stoppage of BP meds seems to have some refractory increase in BP that wouldn't normally be there if you were weaned off. Obviously not your fault for the abrupt stoppage, and good for you for addressing it directly and quickly. Regarding the ER, asymptomatic patients rarely will get much attention until an opportunity arises based on acuity. Wasn't there, but I bet a candid conversation by the doctor to you directly would have gone a long way in your assessment of their level of care. I try to tell my patients that if it bothers you, it bothers me. Regarding the "legalized drug dealer" comment, I think we deserve the heat. I'm truly bothered how complicit we've been in the very real issue of what we call "polypharmacy". There needs to be more accountability across the board between patients and providers. To be honest I truly believe it's the system's problem as we have let government and public health initiatives become priority over positive transactional interactions with providers and individual patients. We can all do better.

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