Hypertension 49: Where are we at now?

It's been a long while since I have posted anything on this blog about Hypertension? Why the delay? The basic reason is that through multiple postings I was able to write down my history. Once I got that far, there seemed to be nothing particularly new.

Right now, I am waiting for a followup with my third specialist. The first specialist moved to Alberta. The second generally only saw people once as he worked out of a hospital cardiology ward. So I've now hooked up with a third specialist.

Seeing the third specialist meant going through a new battery of various tests & bloodwork. In particular, I wore a blood pressure arm cuff for twenty four hours. It is just like the home cuff I use, but it's attached to a battery pack and a an electronic data gathering device. Every half hour, it would pump up, no matter what I was doing. Kinda cool, actually.

I have no idea what the readings ended up being. I was out late that night as it was the first night, at midnight, that the last Harry Potter book went public. My 18 year old daughter had to pick up her pre-ordered copy asap, so we went down to the bookstore together. It was a marvelous experience, seeing a bookstore mobbed with eager readers! I like the Potter series, although I've only read the first two--I was partway through the third when my daughter lent it to a friend, & I've never seen it again. Tributes to Rowling for writing so well that she has brought millions of readers into bookstores!!

My blood pressure remains unstable, but is generally below 140 systolic and hovers around 80 diastolic. I gather the diastolic readings are still not good, but often my systolic readings are in the normal range. At times, though--as when I started this morning--the readings are still too high (this morning, 151/88), especially given the multiple prescription medications I take.

Life remains draggy, meds-wise. One would think that if those doctors who insist that it just takes a little time to adjust to the meds are correct, that by now I would have adjusted--it has been over two years, after all. Whether the feels of weakness and tiredness are due to low blood pressure, the side effects of the medications, or some combination of both--who knows?

But the end result is that while I can work, I can only work successfully with a reduced work load. I can still produce the right amount of completed work, provided I do not have to juggle too much. The more work, the less gets done. It is as if concentrating and focussing uses up so much energy that, if I work very hard in the morning, it is almost impossible to stay awake in the afternoon. I have yet to find a way around this.

I did stop exercising for a while after my mom was in and out of hospital due to heart attacks. She also had to move into a nursing home. I'll try restarting the gym shortly--but, interestingly, it appears to have had no special impact on either my blood pressure or my weight.

The best advice for weight loss came from my third specialist. He did not bother with calorie counting, he just told me to get used to being hungry. Believe it or not, that worked--I just don't eat when I get hungry. That approach must be combined with sensible eating, of course. I find an ice cream cone today adds a pound or more within two days. Simple as that. Gotta avoid the ice cream, the chocolate, the pizza--all that stuff. I lost the most weight when for a few days I simply ate canteloupe and cottage cheese. That was filling, but very low in calories.

Some decisions are coming up--do I keep working full time, do I retire on a small pension & find other work, do I go to part time work? At 62 I don't feel like retiring, although I would find plenty to do. We are all too much tied into our paid work ethic, I guess.

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.

Hypertension 18: Die-eting

To eat is to live. To diet is to, well, die-et.

Critical to reducing high blood pressure is dieting--especially reducing salt intake and the amount of calories and fat you chow down. Medical professionals can tell you better than I why both are necessary. I gather salt increases the amount of water you retain, which increases blood volume. Losing weight in general helps your heart.

Reducing salt would appear easy--just sprinkle less on your food. Hahahahhaha. Not so fast (fast--diet--get it?)! In our easy-out society, we love our prepared foods. We eat a lot of eats someone else has gotten ready for us. When I started to read the nutrition levels on the processed foods I ate, though: Ooops.

Sure, potato chips are a no brainer. Plenty of salt and fat, too. But what about Lean Cuisine and other 'healthy' frozen dinners? They are a 'healthy' choice in many ways--low in fat, good on fibre, limited portions, and so on. Tasty, too. However, each such meal can give you close to half your sodium intake per day--700 mg of sodium. And they are not very big. So you end up, when it's all added up, eating too much sodium.

A simple can of peas? Even that is close to 600 mg of sodium, sometimes more. And remember, the nutrition label's 'portion' size is about half the can of peas. Normally you eat the whole can--so you have to double what is on the label! And that is just one part of what you eat each day. When you add up an entire day's pigging out: watch out!

I learned, reading labels, the sad truth. What should be health, canned vegetables, have a big drawback: too much sodium. I found only a single brand of canned corn--Del Monte--which contained no sodium at all. The manufacturers claim they must add sodium to improve taste, but for me the saltless corn tasted just fine.

And I thought I was safe with processed cheese food. Okay, it is not even cheese, but it is 'no fat' and low in calories. But on checking the label, each slice had around 320 mg of sodium. With two or three slices of cheese per sandwich, or on an extra lean cheeseburger, that was, again, close to or more than half my sodium intake--just with the one meal!

And while eating the 'no fat' stuff seemed to be better, lemme tell you: it may have no fat, momma, but it still got them ol' calories.

Again, with processed food, the 'portion' on the label is often not the portion you actually eat. No one eats just one slice of cheese. No one eats half that can of beans. Who eats the 'portion' of 30 grams for most cold cereals? Usually you put double that in a bowl!

Sigh. Reading labels became very depressing. It was like water drop torture. One by one my favourite foods--and not the obvious stuff, like ice cream, chocolate or other no-nos--had to be dumped.

Yes...I'm coming to it...are you ready?...the WORST part of dieting was having to eat...sigh...real food!!

This is so unfair! North American culture does not raise us to eat real food!