Sunday, December 03, 2006

Hypertension 19: Meds vs. Meds vs. Dieting

There are many conflicts involved in being treated for Hypertension, and speaking of being treated I wish there were treats. Halloween candy would be very nice. But too often there are just tricks. Eggs on your windows, and the yolk is on you.

Generally, all doctors agree part of treating Hypertension is that you should lose weight and exercise. After that, agreements end. There can be conflicts between family doctors and specialists, between specialists, between different Western medicine and "alternative" treatments.

Many of these conflicts stem from differing opinons on the medications.

It isn't even just between different new meds. There are new meds and old meds, and every physician has his/her preferences. Some physicians listen well to patients, some think they know best and the patient should just lvie with it. A relative of mine has taken Western Hypertension medications for many years. He was concerned that his older medications created problems for him, compared with the newer stuff. His doctor thinks those meds are just fine, and won't change them. My relative is now in therapy for depression (one of the known side effects of those meds).

The side effects can have unexpected impacts. For example, on weight loss (dieting).

A previous post addressed dieting. Speaking of that, I wish I could really address dieting, preferably out of State. Or stamp it--out--or just plain stamp it and mail it somewhere else.

Where was I? Ah. The previous post looked at the less obvious problem--sodium in prepared foods. In writing that post, I figured that we all know about the truly awful "eating less" part of dieting, so why write about it?

But there was more. Losing weight is not as simple as getting your head around eating better foods (is there a better food? is a Hazlenut torte truly not as good as a whole wheat noodle that tastes like cardboard?), or eating less. There was an insidious side to losing weight in my situation.

By early October I was down to around 208 pounds, depending on where and how I was weighed.

Now, I really must stop here for a moment and talk about getting weighed, which is a weighty topic about the way to go in waiting to lower high blood pressure, as Tom Waits once sang. Ahem.

Have you ever weighed yourself on a scale in your bathroom, then later that day been weighed in the doctor's office and chugged in several pounds heavier? Feeling embarrassed as you tell the doctor's assistant you were lighter this morning, and she struggles not to roll her eyes? Then you say when you weighed yourself you were wearing, well, your birthday suit, and now you're wearing all these clothes, so that's why you are heavier, and she does roll her eyes?

I actually changed my bathroom scale, figuring that was the problem. It was not.

I can now state, based on my encounters with the superduper scale in my speciality gym, that being fully clothed can add three to five pounds to your weight. No doctor's assistant will believe this, but it is the truth.

Anyway. After I was put on a total of four prescription medications in early October, my weight began to go back up again. Right now, on December 2, it is up to 218 from the early October 208, which actually is down from 222 in November. Is that clear?

Here is what happened.

The new prescription medications lowered my blood pressure, indeed they did. At some points lately it has even been down to 110 systolic (I am still on four, but two of them are different, more on that eventually), and 110 for me similar to being embalmed. However, lowering my bp was not their only impact.

After waking at 7 am, driving my daughter to high school and then my wife to work, taking the meds, eating breakfast and spending a couple of hours reading or writing or watching some film I could never watch with in the presence of either my daughter or spouse (you have a dirty mind, I am talking, actually, of old Boris Karloff movies), by 11 am it was snooze time. That's right. Four hours of being awake and I would start feeling the need for a nap. Not just wanting a nap, or feeling tired. Needing a nap.

I do have sleep apnea, so I'm always ready for a snooze. But the CPAP machine I use each night generally gives me enough rest. This tiredness was different. I had experienced it at times before, as noted in earlier posts. It was not as bad as it had been. One medication left me unwilling to even get out of bed. These meds were better, but by 1 pm I had to nap because it was difficult to stay awake.

But I was tired of being tired. I wanted to stay awake.

Without really thinking it through, I began to eat more. Not ice cream, not chocolate. Just...more. The more I ate, the more energy I felt, and I could stay awake. Heck, even until 9 pm!

The medications created a vicious circle. They made me tired, I ate to feel energized, I then gained weight, for which I would end up needing more meds. Was this a plot of the military industrial medical pharmaceutical complex?

Although I would like to blame everyone else, including a paranoid X Files conspiracy directed against me, it was pretty simple: medications v. weight loss. The solution? Specialist number two (the first moved out of the province, I don't think it was anything I said) changed two of the meds. Now I feel less tired, and have started to lose weight again.

Took a while to figure out. No guide book. No advice. Had to be direct with the physician. As always, the responsibility lay on my shoulders. As it is for any patient navigating through the treatment maze. It is up to you to stay on top of it, make sure your doctor understands your issues, and make sure that your doctor acts on those issues.

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