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Two weeks ago I had BP of 220/180 a.k.a doctors are fucking useless...

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So you went to see some doctors and they couldn't figure it out but you went to another doctor and he did but doctors are useless?

That's kind of how medicine works.

Nobody figured out the cause of the hypertension. They called it "intractable hypertension" and said about 5% of population has this type that they can't pin down the cause.

The medication combo was figured out by current doctor, but that's because I kept record of all the meds I tried and so he simply noticed that I didn't try any beta blockers. Nothing amazeballs. If anything, that doctor I saw after hospital stay was a totally useless chump. He has 4 months to find me something. Got me down to 170/110. Useless.
 

poppabk

Cheeks Spread for Digital Only Future
Are you trying to defend BMI? I don't want to sound like I'm on the offense, but if you think BMI is an accurate obesity meter then you ought to take a couple of minutes and do a little researching. Trust me, it'll only take a couple of minutes.
For the general population it is a reasonable measure. There is probably a stronger correlation between BMI and body fat percentage than there is between body fat percentage and weight related health problems.
 

Smellycat

Member
Dude beta blockers are no joke, and they are not even first or second line treatment for hypertension.

Have you tried ACEI? ARBs? Diuretics?
 

Flo_Evans

Member
Damn that is crazy high blood pressure.

I'm on 50mg of metoprolol and 20mg of lisinopril a day, that gets me 120/80 every time.

Take care of yourself!
 
While doctors can be good or bad or everything in between like regular people, you have to accept that they do know more about medicine than you. What they don't have is the same investment in your health, which is why you need to constantly advocate for your own health, monitor it, and make as much effort as possible in your lifestyle choices. Change your doctor if you feel you need to, but don't start self medicating when your understanding of the medication is just something you read from a Google search.
This is by far the best comment I have read yet. Very true about the investment of time in other people's health.
 

wrowa

Member
Doctors are just humans as well, it's always good to keep that in mind. They can and will do mistakes.

My gf nearly died of a sepsis some years ago, because several doctors just didn't take her seriously until it was almost too late. That definitely helped me form a more realistic picture of doctors.
 

Flo_Evans

Member
Time is the doctors friend too though.

I was kind of under the impression a doctor could look at a single test result, diagnose the problem and know the correct dosage to fix it.

It's more like a stock broker, just seeing one day of quotes doesn't really give you a good picture of the market.
 

Ra\/en

Member
I'd probably get your electrolytes checked again.

Have you tried spironolactone? Sometimes that is required to get this under control.
I assume they did a check for secondary causes of hypertension.


To be honest, you strike me as one of those patients that expects a fix without actually putting in the hard work to lose weight etc. 2012 was a long time ago.
do you drink a lot of alcohol?
are you overweight/obese?
salt intake?
etc
 

Ultrabum

Member
This is a venting thread.

AKA doctors and useless.

Back in 2012 I went into emergency room with extreme blood pressure reading of 220/190.

I could have totally had a fucking stroke two weeks ago. And this fucking doctor just kept charging me for each visit and new prescription. I want my fucking money back. The only reason I need him now is to write me prescriptions every few months. He gonna act all grumpy when I bring this up probably. He does that when I question him about anything. Fuck this guy. I guess I'm ordering meds off internet.

I think Google should start working. on doctor.google.com and save us from shitty doctors.

My heart rate reading for the last 2 weeks are still in normal range. (69~70 bpm). I will keep my eye on that. I need to find a new doctor though.

Doctors are useless. I need to find a new doctor.

Go find a doctor you like. No need to disparage an entire group.
 

FreezeSSC

Member
Kinda went through a similar thing, went to a CVS minute clinic for strep throat, and the nurse freaks out over my blood pressure being to high and makes me make an appointment with a cardiologist. I go they do all these crazy tests and then tell me they have no idea why its so high so now I take a 20mg lisinopril tablet every morning. The only upside is its free at publix.
 
I'm with you OP Doctors are mostly useless. I had a terrible pain in my leg and they couldn't figure it out. Wouldn't give me pain meds and sent me on my way with a bill for a couple of hundred dollars. Fucking useless.
 
I'd probably get your electrolytes checked again.

Have you tried spironolactone? Sometimes that is required to get this under control.
I assume they did a check for secondary causes of hypertension.


To be honest, you strike me as one of those patients that expects a fix without actually putting in the hard work to lose weight etc. 2012 was a long time ago.
do you drink a lot of alcohol?
are you overweight/obese?
salt intake?
etc

Back in 2008 I was over 220lbs. I had BP of 160/90. then I worked out and cut out carbs and brought my weight down to 180lbs in 2010. BP was still 160/90. Then in 2012, it shot up to 220/180 and I had to go to ER. I weighed 185lbs at the time.

My weight isn't the issue. Neither is my diet. I'm no longer doing low carb (hence my weight gain over the last 5 years). And I cut out Korean food back in 2010 to do low carb, so I don't overdo salt either. And I was never a drinker. I don't smoke, I don't drink soda either. I'm pretty much a prude when it comes to vices,
 

jdstorm

Banned
OP since you came on GAF looking for a Completely Unqualified Oppinion - that should in no way be seen as a substitute for seeing a qualified medical professional who you deem trustworthy

You seem stressed and angry. Remember to relax and do things that you enjoy. or if you need to just expel that anger physically, talk to your new physician about getting cleared for a new hobby that is geared towards physical movement. IE Boxing/Martial Arts, Baseball, Wood work, cooking ect.
 
OP since you came on GAF looking for a Completely Unqualified Oppinion - that should in no way be seen as a substitute for seeing a qualified medical professional who you deem trustworthy

You seem stressed and angry. Remember to relax and do things that you enjoy. or if you need to just expel that anger physically, talk to your new physician about getting cleared for a new hobby that is geared towards physical movement. IE Boxing/Martial Arts, Baseball, Wood work, cooking ect.

I can't work out after 2012 BP spike. When I get my heart rate over 150 my head feels like its going to explode. But I walk 5~6 miles per day. I got rid of my car when uber came out. I'm not sedentary.

Maybe now that my BP is near normal with new dosage, I can start working out again without risking aneurysm.
 

KoopaTheCasual

Junior Member
4 years @ 100mg/d only got me down to about 140/90. With this new dosage now I'm at normal-ish range of 116/82. Shouldn't he have upped my dosage after a while seeing that it's still kinda high?
As others have said, your body (in reaction to any substance) will build a tolerance, and your doses will always increase.

I'm assuming you're a pretty young guy. You don't want to shoot up the scale so early, when you'll potentially need those higher doses to just keep you at 140/90. It sounds shitty but welcome to the world of pre-disposed hypertension! Population: us.

Find a physician at a smaller practice to help you manage lifestyle changes that will provide results without upping your dosages. That's the best shot you got.

For me, it was cutting out egg yolk and salt almost completely ):
My experience has been that the majority of doctors are quacks.

Don't listen to patients, and I swear they use a dartboard or roll the dice on whatever treatment to try. If it doesn't work, it doesn't matter they get to bill you anyway.

Results and care would improve if they don't get paid when they don't help you.
This post is garbage, and OP please don't let this mentality sink in.

Anti-physician hatred is the most baffling thing in the world to me, second only to people who are anti-vaccines.
 
As others have said, your body (in reaction to any substance) will build a tolerance, and your doses will always increase.

I'm assuming you're a pretty young guy. You don't want to shoot up the scale so early, when you'll potentially need those higher doses to just keep you at 140/90. It sounds shitty but welcome to the world of pre-disposed hypertension! Population: us.

Find a physician at a smaller practice to help you manage lifestyle changes that will provide results without upping your dosages. That's the best shot you got.

For me, it was cutting out egg yolk and salt almost completely ):

This post is garbage, and OP please don't let this mentality sink in.

Anti-physician hatred is the most baffling thing in the world to me, second only to people who are anti-vaccines.

I'm almost 47. I think 200mg out of 450mg recommended limit should be OK. I will find a better doctor make sure that 200mg per day isn't a problem.
 

jdstorm

Banned
I can't work out after 2012 BP spike. When I get my heart rate over 150 my head feels like its going to explode. But I walk 5~6 miles per day. I got rid of my car when uber came out. I'm not sedentary.

Maybe now that my BP is near normal with new dosage, I can start working out again without risking aneurysm.

I'm not making any suggestions about working out or not working out. That is something to see a medical professional about. I am just suggesting that you remember to relax. For some thats a massage or meditation or laughing at a TV comedy. For others it might require something more physical like Sawing and Hammering wood, hitting a ball with a stick, agressively chopping vegetables ect. Only you know what will work for you.
 

sturmdogg

Member
Back in 2008 I was over 220lbs. I had BP of 160/90. then I worked out and cut out carbs and brought my weight down to 180lbs in 2010. BP was still 160/90. Then in 2012, it shot up to 220/180 and I had to go to ER. I weighed 185lbs at the time.

My weight isn't the issue. Neither is my diet. I'm no longer doing low carb (hence my weight gain over the last 5 years). And I cut out Korean food back in 2010 to do low carb, so I don't overdo salt either. And I was never a drinker. I don't smoke, I don't drink soda either. I'm pretty much a prude when it comes to vices,

Are you under stress? Do you live in a hot / humid environment? I have hypertension and sometimes the trigger (in my case) is either stress or heat/humidity.
 

Cyframe

Member
Don't be afraid to change doctors, question the methods or seek second or even third opinions. You should be empowered to do so.

US healthcare debt is a problem but there are repayment plans that can be negotiated.

I haven't liked quite a few doctors over the years, but I tallied that up to their individual faults, rather than take a confrontation stance on medicine and PCPs.
 

pestul

Member
I'm about to start the process. I had tingling down the left side of my body so I went to see the doctor and he's got me on a barrage of tests. My blood pressure was 161/107. I also had to get a cervical vertebrae x-ray because he believes the tingling/buzzing is more than likely a pinched nerve in my neck.. man getting older sucks. And you just hope health care puts you on the right path.

I was under a lot of stress the past week though with having to put our cat down on Wednesday so I'm sure that didn't help too much.
 

Dr.Acula

Banned
Why are numbers of 220/190 bad but 116/82 good? How can a machine even measure numbers?

And don't tell me some kind of "doctor" defines what blood pressure is, or how it's measured, they're useless.


Sorry for the sarcasm, but OP has some respect for the medical community if they're measuring themselves on medical standards.
 

pestul

Member
Those BP machines aren't accurate. Especially the ones at a drugstore
Yes, and some of the portable units are not great either. The cuff often doesn't fit if you have larger arms which tends to lead to artificially elevated numbers. If the doctor takes it, it should be quite accurate though.
 
Ok, I could see why you'd be mad. Let me explain.

The most important question here is how often you went for checkups. The protocol is NOT to increase your meds without reason. Metoprolol is a beta-blocker and does not require tapering to a high dose. If 100mg of Metoprolol gave you good control for 4 years, there was no reason to increase the dosage while it was effective. Higher doses ALWAYS have their own set of risks. Beta-blockers slow your heart rate down, and too high a dose could result in fainting or even a deadly arrhythmia. What happened was your body's tolerance to the medication changed. That's not uncommon whatsoever. People have this notion that our bodies are static vessels but that's not true at all. Our bodies are ever changing. The exact opposite of what happened here could have occurred where the metoprolol becomes TOO effective at 100mg and your blood pressure gets dangerously low. I know because I've had that happen to my patients.

You should be at least seeing your doctor once a year at the bare minimum, especially when you know you have a potentially life threatening condition. Your body's tolerance can change over the span of several months, which is likely what happened here. Or you started taking something else that interacts with the drugs you're already on. It's very possible that the issue isn't with the metoprolol at all but rather with another BP medication to which you're no longer responding. What you should have done was schedule an appointment with your doctor after your symptoms persisted for a few days.

Shhhh, let the uninformed rage continue
 

NervousXtian

Thought Emoji Movie was good. Take that as you will.
My doctor will prescribe things over e-mail for things I've already had diagnosis for.

I just e-mail her through the system and she get's back to me. I see her once a year for a check-up.

...but... didn't they check your BP each visit? If they did and it was within normal for you... why would they up the dose until it wasn't working?

It's like your mad that you have a weird issue, and that they didn't respond after helping you with said issue for not having the ability to read the future.

The same site that says you should up those meds probably says the other meds you originally were prescribed should have reduced your BP... right? We pick and choose when we want to believe something on the internet.
 

Hycran

Banned
Did you ever try proper diet and excerise? I'm assuming your pretty young with a shitty diet

This was the first thing I thought as well. Blood pressure problems are almost solely attributable to poor physical conditioning, especially in the young. Unless OP is a flight traffic Controller.
 

sphinx

the piano man
my BP spikes when I am anxious and nervous which is every time I have to do any kind of health check up. the most I've shown is 160

since I know I am prone to this, I try to do everything on my part to keep it stable and avoid visiting doctors, I do more cardio than before, eat much less salt and have potasium,also a lot less sugar.

I also used to have some headaches on the back of my head but disappeared since I had less stress in life and changed my eating habits some months ago.

in my case, BP has an incredibly strong relation to how my soul and mind feel, if I am happy and just about "ok", not expecting anything, neither good or bad things to happen, then I am ok.
 

Miker

Member
Grow some thicker skin, this is nothing. And think about focusing your career on acute/emergency care, regardless of specialty. If patients are literally dying in front of you, they tend to be a little more grateful compared to the outpatient stuff.

This post sucks. The guy said he's working in the ICU, where most patients are literally on their deathbed. As for emergency care, I'm an ED doc and this isn't true at all. Some people aren't grateful no matter what you do for them, including saving their lives.
 

numble

Member
Back in 2008 I was over 220lbs. I had BP of 160/90. then I worked out and cut out carbs and brought my weight down to 180lbs in 2010. BP was still 160/90. Then in 2012, it shot up to 220/180 and I had to go to ER. I weighed 185lbs at the time.

My weight isn't the issue. Neither is my diet. I'm no longer doing low carb (hence my weight gain over the last 5 years). And I cut out Korean food back in 2010 to do low carb, so I don't overdo salt either. And I was never a drinker. I don't smoke, I don't drink soda either. I'm pretty much a prude when it comes to vices,
210 at 5'9 is considered "obese". And though you had dropped it down to "heavily overweight" in some other years due to low carb diets, I doubt it made much of a difference.
 

Maxim726X

Member
Are your potassium levels ok? When you were in the hospital did they evaluate for hyperaldo / pheochromocytoma in your battery of tests?

Listen to this man.

I've seen pheo lead to intractable malignant hypertension before, and once the underlying cause is found patients are usually good to go.
 

Nivash

Member
This post sucks. The guy said he's working in the ICU, where most patients are literally on their deathbed. As for emergency care, I'm an ED doc and this isn't true at all. Some people aren't grateful no matter what you do for them, including saving their lives.

Yeah, in my experience ED patients in general are either terrified, too sick to really remember you or pissed because they're there for something trivial and had to wait for six hours to see a doctor at all. My most rewarding experience was in GP. The clinic I worked at gave us 40 minutes per consultation. A third of the time there wasn't even a need for any major intervention, but people were just so grateful for having someone finally listen to them that I got praise from patients almost every single day. Especially the older ladies who were used to people brushing them aside.

YMMV obviously, it depends a lot on both personal preference and organisational structure. Either way, finding your place in medicine is one of the most important things a doctor needs to do in mind. GP isn't for everyone, but I don't think the high-pressure advanced hospitalist disciplines are either.

Listen to this man.

I've seen pheo lead to intractable malignant hypertension before, and once the underlying cause is found patients are usually good to go.

Pheochromocytoma? That's rare to the point that I've seen even endocrinologists call it a "textbook disease" because it practically doesn't exist in the real world.
 
This is my daily regiment.

75mg of Apo-Metoprolol
6mg of Coversyl
25mg Hydrochlorothiazide
10mg Sandoz-Felodipine

18mnths now since I was admitted to the hospital with a BP 240/120.

Those Hypertension headaches were the worst.

Hopefully I continue to lose fat and get off some of these if that's even possible.
 
210 at 5'9 is considered "obese". And though you had dropped it down to "heavily overweight" in some other years due to low carb diets, I doubt it made much of a difference.

Dude, how the hell is 180 lbs "heavily overweight" at 5'9"? Are you like a pencil? I stopped my low carb when my GF at the time was telling me I looked too damn thin at 180.

My current 210 is fat, no doubt. But funny enough I look totally different than when I weighed 220. Back then I had a huge Buddha belly and several chins. Now I have a bit of spare tire and no double chin. That can't be 10 lbs difference. I've basically traded visceral fat of subcutaneous fat pretty much.
 

Maxim726X

Member
Yeah, in my experience ED patients in general are either terrified, too sick to really remember you or pissed because they're there for something trivial and had to wait for six hours to see a doctor at all. My most rewarding experience was in GP. The clinic I worked at gave us 40 minutes per consultation. A third of the time there wasn't even a need for any major intervention, but people were just so grateful for having someone finally listen to them that I got praise from patients almost every single day. Especially the older ladies who were used to people brushing them aside.

YMMV obviously, it depends a lot on both personal preference and organisational structure. Either way, finding your place in medicine is one of the most important things a doctor needs to do in mind. GP isn't for everyone, but I don't think the high-pressure advanced hospitalise disciplines are either.

At least most EDs give a printout of the diagnosis, causes, and treatment plans... Because as you say, most people aren't going to retain what they hear for a myriad of reasons.

Patient education is of course important, but compliance will always be an issue.

Pheochromocytoma? That's rare to the point that I've seen even endocrinologists call it a "textbook disease" because it practically doesn't exist in the real world.

Yes, pheochromocytoma. I did see a case in the ED during my rotations, believe it or not.
 

numble

Member
Dude, how the hell is 180 lbs "heavily overweight" at 5'9"? Are you like a pencil? I stopped my low carb when my GF at the time was telling my I looked too damn thin at 180.

My current 210 is fat, no doubt. But funny enough I look totally different than when I weighed 220. Back then I had a huge Buddha belly and several chins. Now I have a bit of spare tire and no double chin. That can't be 10 lbs difference. I've basically traded visceral fat of subcutaneous fat pretty much.

BMI. Since you are Asian, check out Asian BMI calculators, like this one: https://aadi.joslin.org/en/am-i-at-risk/asian-bmi-calculator
 
This is my daily regiment.

75mg of Apo-Metoprolol
6mg of Coversyl
25mg Hydrochlorothiazide
10mg Sandoz-Felodipine

18mnths now since I was admitted to the hospital with a BP 240/120.

Those Hypertension headaches were the worst.

Hopefully I continue to lose fat and get off some of these if that's even possible.

4 different meds! that's a new hypertension treatment record. What are your BP readings now?
 

Nivash

Member
Yes, pheochromocytoma. I did see a case in the ED during my rotations, believe it or not.

Huh, what are the odds. Then again, I did see a possible case of Miller-Fisher syndrome during my rotations. Guess we all stumble onto something super rare eventually.
 

numble

Member

It is more accurate when they adjust by race:
VbThlJYl.jpg


At 185 pounds, you have a BMI of 27.3 which puts you into Class I obesity.
At 210 pounds, you have a BMI of 31.

If you want to use a better metric of obesity, please indicate what measure you want to use.
 

Maxim726X

Member
Huh, what are the odds. Then again, I did see a possible case of Miller-Fisher syndrome during my rotations. Guess we all stumble onto something super rare eventually.

Very low. My attending said it was only the second time he'd seen it in his life... But after the first, it's something he would always keep in his pocket as a differential. Assuming the patient fit the profile, of course.

And I don't even remember learning about Miller-Fisher syndrome. I need to brush up on weird ass illnesses as my recert is coming in a year or two.
 

Reynx

Member
Huh, what are the odds. Then again, I did see a possible case of Miller-Fisher syndrome during my rotations. Guess we all stumble onto something super rare eventually.

My first patient as a fresh medical student starting a neuro rotation had Miller-Fisher and the next had CJD. My consultant told me it would most likely be the last one I encountered throughout my medical career. Weird how these super rare things tend to crop up as a student.
 
It is more accurate when they adjust by race:
VbThlJYl.jpg


At 185 pounds, you have a BMI of 27.3 which puts you into Class I obesity.
At 210 pounds, you have a BMI of 31.

If you want to use a better metric of obesity, please indicate what measure you want to use.
How about we use actual body fat percentage instead? When Lambert Adolphe Jacques Quetelet concocted BMI formula back in 19th century, there were no reliable ways to measure actual body fat percentage. Now we do in 21 century. He squared height to come up with a formula that fit his collected numbers. Its 19th century mathematical hack. It's nonsense.
 
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