I was upset because my BP pressure was still high. I received encouragement from my wife who said even though my pressure was higher than I wanted it to be, imagine if I wasn’t focused on it.
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.
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.
Hang in their brother. I too have HBP controlled through meds. I had my annual physical (a must) yesterday and am back in the normal range. I am motivated by having spent too much time at a dialysis clinic with my mother-in-law, who never checked her BP until it was too late. Those clinics are the most depressing places you will ever visit.
When I found out I had an issue, I was still in my 20s. My reading was 180/110. Not quite as bad as you, but bad nonetheless. I think my weight was around 250 (eventually I would go on to a peak of 306 !) and the doc said “lose weight”. Lots of different diets, tried to lay odd salt, exercise…all the same ol’ stuff. I’ve been doing meds for the better part of 35+ years now and even when the weight was up, my BP has stayed pretty normal. I was diagnosed diabetic in 200, which meant different diets, but through it all, BP has stayed consistently good. So in my case, watching the diet, lay off the salt and keeping the weight down (around 200 these days). I wish I had a remedy for ya, but I don’t…and you probably wouldn’t want that from me anyway 😜. But I can see why you have little faith in the docs since they are showing no real sense of urgency, unless it was being done to keep you as calm as possible.
“While the federal law requires authorization for prescription refills, the law is silent regarding emergency or continuity of therapy refills. The states have their own statues and regulations regarding the pharmacist’s ability to dispense an emergency refill. In some states, when a patient’s prescription is out of refills and the pharmacist is unable to reach the prescriber to authorize the refill, the pharmacist may dispense an emergency refill to the patient. Some states allow emergency refills for a 72-hour, 30-day, or 90-day supply, while other states do not allow for any emergency refills or leave the quantity to the pharmacist’s discretion. Typically, emergency refills are allowed by law or regulation in a shorter duration, which is typically 72 hours, while continuation-of-therapy (“COT”) refills are allowed by law or regulation in a longer duration, which is typically 30 to 90 days.”
As a migrainer who at one time took a daily preventative, I understand. The side effects weren't worth it to me, so I have an injection for when I get a migraine. This also has side effects, but I choose to live with those.
I'm glad you commented here. Thank you. I shouldn't label all physicians as legalized drug dealers. The ones I have dealt with presented themselves that way. I eat healthy, exercise and take my meds when I have them. There's maybe too much information out there about other ways to control or lower BP. I have never had a BP that high and I would say it is because I didn't have my pills for too long. I understand your comment about the ER doctor. I wish my PCP would help me investigate why my BP is high and help me find ways to lower it or keep it low without pharmaceuticals. Even when I was running as was down to 180lbs, which was hard to get to and hard to stay at, my BP was high. 140ish over 90ish. I am currently 195, and looking at my gut, I could stand to lose about 7-10 lbs. I have a muscular build. If I could get a feel for what an acceptable BP is for a 64 yr old male, then I could plan accordingly. Again thanks for your input.
I am a physician. I understand your frustration that your prescription was not called in to the pharmacy as you had requested. That is bad customer service on the doctor's part. As for physicians being legalized drug dealers, that is a bit of hyperbole. The fact is, certain diseases need, and respond to, medications. Certain lifestyle changes can help, but there is not a chance that your level of hypertension can be brought down by diet, exercise and lifestyle changes alone. Also, your level of hypertension does not need to be accompanied by symptoms to be considered dangerous and in need of immediate attention. After all, your first symptom with this degree of blood pressure elevation could be massive stroke. And I won't make excuses for an ER physician's attitude, but I would say that these doctors see all sorts of far more serious things on a daily basis in the ER, and they don't get nearly as worked up at it as the patient does. They have the luxury of some time to deal with it, a luxury that is not afforded them in many of their daily encounters in the ER. Sort of like the person who calls the fire department because their cat is up in at tree....the firemen aren't nearly as worked up as the cat owner. It's a problem, and we'll deal with it, but there are priorities in any emergency situation where there are multiple people needing help.
Anyway, take your bp meds, don't smoke, lose weight, eat healthy and exercise. And enjoy life. Good luck!
I am sort of the same...blood pressure not coming down despite meds- and running kills the joints. I started back bike riding- have a gravel bike and biking with a friend...so crossing fingers.
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.
I appreciate this information. No one has ever explained this to me regarding the kidney function and kidney doctors.
Happy to share. I’ve had a few patients that had obvious chronic kidney disease based on lab values and knew nothing about it.
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.
Hope and pray you get your BP down soon. I know it’s frustrating when you try things that are supposed to help but don’t.
Hang in their brother. I too have HBP controlled through meds. I had my annual physical (a must) yesterday and am back in the normal range. I am motivated by having spent too much time at a dialysis clinic with my mother-in-law, who never checked her BP until it was too late. Those clinics are the most depressing places you will ever visit.
When I found out I had an issue, I was still in my 20s. My reading was 180/110. Not quite as bad as you, but bad nonetheless. I think my weight was around 250 (eventually I would go on to a peak of 306 !) and the doc said “lose weight”. Lots of different diets, tried to lay odd salt, exercise…all the same ol’ stuff. I’ve been doing meds for the better part of 35+ years now and even when the weight was up, my BP has stayed pretty normal. I was diagnosed diabetic in 200, which meant different diets, but through it all, BP has stayed consistently good. So in my case, watching the diet, lay off the salt and keeping the weight down (around 200 these days). I wish I had a remedy for ya, but I don’t…and you probably wouldn’t want that from me anyway 😜. But I can see why you have little faith in the docs since they are showing no real sense of urgency, unless it was being done to keep you as calm as possible.
Also, many people may not know this but
“While the federal law requires authorization for prescription refills, the law is silent regarding emergency or continuity of therapy refills. The states have their own statues and regulations regarding the pharmacist’s ability to dispense an emergency refill. In some states, when a patient’s prescription is out of refills and the pharmacist is unable to reach the prescriber to authorize the refill, the pharmacist may dispense an emergency refill to the patient. Some states allow emergency refills for a 72-hour, 30-day, or 90-day supply, while other states do not allow for any emergency refills or leave the quantity to the pharmacist’s discretion. Typically, emergency refills are allowed by law or regulation in a shorter duration, which is typically 72 hours, while continuation-of-therapy (“COT”) refills are allowed by law or regulation in a longer duration, which is typically 30 to 90 days.”
Innovation in Pharmacy, 2021.
As a migrainer who at one time took a daily preventative, I understand. The side effects weren't worth it to me, so I have an injection for when I get a migraine. This also has side effects, but I choose to live with those.
I'm glad you commented here. Thank you. I shouldn't label all physicians as legalized drug dealers. The ones I have dealt with presented themselves that way. I eat healthy, exercise and take my meds when I have them. There's maybe too much information out there about other ways to control or lower BP. I have never had a BP that high and I would say it is because I didn't have my pills for too long. I understand your comment about the ER doctor. I wish my PCP would help me investigate why my BP is high and help me find ways to lower it or keep it low without pharmaceuticals. Even when I was running as was down to 180lbs, which was hard to get to and hard to stay at, my BP was high. 140ish over 90ish. I am currently 195, and looking at my gut, I could stand to lose about 7-10 lbs. I have a muscular build. If I could get a feel for what an acceptable BP is for a 64 yr old male, then I could plan accordingly. Again thanks for your input.
I am a physician. I understand your frustration that your prescription was not called in to the pharmacy as you had requested. That is bad customer service on the doctor's part. As for physicians being legalized drug dealers, that is a bit of hyperbole. The fact is, certain diseases need, and respond to, medications. Certain lifestyle changes can help, but there is not a chance that your level of hypertension can be brought down by diet, exercise and lifestyle changes alone. Also, your level of hypertension does not need to be accompanied by symptoms to be considered dangerous and in need of immediate attention. After all, your first symptom with this degree of blood pressure elevation could be massive stroke. And I won't make excuses for an ER physician's attitude, but I would say that these doctors see all sorts of far more serious things on a daily basis in the ER, and they don't get nearly as worked up at it as the patient does. They have the luxury of some time to deal with it, a luxury that is not afforded them in many of their daily encounters in the ER. Sort of like the person who calls the fire department because their cat is up in at tree....the firemen aren't nearly as worked up as the cat owner. It's a problem, and we'll deal with it, but there are priorities in any emergency situation where there are multiple people needing help.
Anyway, take your bp meds, don't smoke, lose weight, eat healthy and exercise. And enjoy life. Good luck!
I am sort of the same...blood pressure not coming down despite meds- and running kills the joints. I started back bike riding- have a gravel bike and biking with a friend...so crossing fingers.