My blood pressure was 165/116 yesterday.

[Renee in NC]

Let me give some background here (please bear with me, I know it is long, but I really need some help):

 

I have never had high blood pressure before April.

 

I didn't have high blood pressure before I lost 80 pounds (since last September.)

 

The only times I have had high blood pressure are at my current dr's office and yesterday at CVS.

 

When we moved, I had to find a new doctor. I had a hard time finding one that took my insurance, wasn't backed up for months, and didn't have a separate "facility fee" (hospital-based.) I found a physician assistant at an urgent care type of place to see me soon (I am on Vyvanse and have to get a new prescription every month.) The first visit I got stressed out because she wanted to do all these tests and I wasn't prepared for it (my dc were with me.) In addition, the office did not have a large blood pressure cuff. My bp was 140s/90s.

 

Then my dh went to her office and was also told that his bp was 140s/90s. He JUST had a very thorough physical for his job in February and there was no indication of high bp. He has very large muscular arms and the cuff was so small on him that the velcro on it scratched his arm!

 

The second time I went, my bp was high again - 140s/90s. I was also stressed that day because I argued with the receptionist about my copay. The PA prescribed bp meds. After that, I had my bp checked twice at the peds office (120s/80s) and checked it at multiple different machines/times/days over 6 weeks and did not get any 140s/90s at all (most were 120s/80s, even after exercise except one day when I was extremely hot, tired, mildly dehydrated, and stressed it was 130s/90s.)

 

I put off going back to the office because I don't like confrontation and I never filled the script for the bp meds. I finally had to and I stressed about it all day yesterday. In addition, I only got about 3 hours sleep the night before (because I couldn't sleep.) Finally, I have *not* been drinking enough water and drinking too much caffeine.:glare:

 

So, at the office, it was 165/114 with the too small cuff. I told her that it had never been that high and that the peds office had done it two different times with better results. She got another machine and got the same result (but the cuff became so tight it left marks on my arms!) The same thing with another cuff and then I had her test it on my forearm, which was also very high.

 

By this point, my bp probably WAS high - I developed a head ache, had a dull ache under my rib cage, and felt really bad. The PA decided that I had to come off the Vyvanse and gave me prescriptions to "step down" over the next 6 weeks. She does want me to see a psychiatrist to figure out what to do next, but I haven't been able to find one yet.

 

I am not convinced that the Vyvanse is giving me high blood pressure. I am not even convinced that I do have chronic high blood pressure! My blood work was fine - no abnormalities except that I have low vitamin D (which is connected to blood pressure.) I had an EKG in April (she insisted) and it was fine, too. There is no high blood pressure in my family history except my grandmother (and she is in her late 80s.)

 

So, what do I do? The Vyvanse helps me SO much that I am loathe to give it up unless I absolutely have to. Everything I am reading seems to say that stress+not enough water can cause it to be high (and that was definitely true yesterday!) I am especially not convinced because I am not getting high blood pressure readings any other time and Vyvanse makes me stress *less*!

 

HELP!

[Renee in NC]

OK, just did a google search on the blood pressure cuff issue and it *does* affect readings a lot (the PA insisted it would only make a few points difference.) In addition, forearm readings are only accurate if you do the systolic manually (so it doesn't work on the automatic machine.) Finally, high readings happen when the cuff gets pumped too high, which is what happened with the machine as well.

 

I am *really* not happy about this and I have to find a new doctor! However, she already has me stepping down and won't give me my full prescription. I have a call into my therapist to see if he can get me into the psychiatrist in his practice (they aren't taking new patients, but the receptionist said he might get me in through a "in-house referral.")

 

ETA: I want to emphasize that at my previous dr. in FL, I was on the same dose of Vyvanse and they had a large bp cuff - no high bp at all (even below 120s/80s.)

[LizzyBee]

Renee,

 

I know you're not real close to Wake Forest, but we love the doctors and PAs at Village Family Care on Rogers Road. If they are in your insurance network, you could try to get seen even if you don't stay with them long term. Tell them I referred you, since sometimes even offices that aren't taking new patients will take referrals. Some of the doctors you can look up for insurance are John Carson Rounds, Thomas Weber, and ?? Konopka (or something like that).

[Renee in NC]

Renee,

 

I know you're not real close to Wake Forest, but we love the doctors and PAs at Village Family Care on Rogers Road. If they are in your insurance network, you could try to get seen even if you don't stay with them long term. Tell them I referred you, since sometimes even offices that aren't taking new patients will take referrals. Some of the doctors you can look up for insurance are John Carson Rounds, Thomas Weber, and ?? Konopka (or something like that).

 

Thanks Elizabeth - I will look into it.

 

The more I research this, the madder I get.

 

Proper bp readings should be taken with a patient sitting in a chair with back support. They only take it there with me sitting on the exam table with my legs dangling down.

 

The cuff should not be over-inflated. The automatic machine they used pumped it up over 200 and held it there for a few seconds (this was the 165/115 reading!) The manual reading she did first with the too small cuff ws not that high even. It shouldn't hurt, but it did hurt and my fingers were tingling from no blood flow to them.:glare:

[Cindy in FL.]

Renee,

 

Is there any way you can buy your own bp machine (mine is automatic and cost around $100). That way you can track your bp at home for a period of time and get a better idea of what your numbers are. I did this after getting high readings every time I went to the endocrinologist. It turned out to be situational and I didn't need bp meds.

 

Hope you get it figured out!

 

Cindy

[stripe]

I am pretty sure your readings are also affected by factors from the office. I get high readings when they measure me just after I come in, but they go quickly back to normal range. I read you're supposed to sit quietly for five min before and not talk during. It's good you're investigating your medicine.

[Renee in NC]

I am pretty sure your readings are also affected by factors from the office. I get high readings when they measure me just after I come in, but they go quickly back to normal range. I read you're supposed to sit quietly for five min before and not talk during. It's good you're investigating your medicine.

 

This office stresses me out every time I go. In addition, my mother called right before she did the reading - she *never* calls me on Thursdays (she works double shifts at her restaurant on Thursdays.) So, I was worried about why she was calling about *and* was stressed by the whole situation.

 

We were talking during the readings and my arm was hanging down (because there was nothing to support it.)

 

I am looking at blood pressure machines and cuffs (my arm is still large depsite losing weight, so I want to make sure I have one that fits.)

[Perry]

You need some good, accurate readings. I know many fire stations do free BP checks on a walk-in basis. Maybe you could call your neighborhood fire station and ask if they have a large cuff?

[EKS]

You need some good, accurate readings. I know many fire stations do free BP checks on a walk-in basis. Maybe you could call your neighborhood fire station and ask if they have a large cuff?

 

Yes--I was going to suggest this as well. My husband, who is a firefighter/EMT, takes people's blood pressure all the time.

[twoforjoy]

Is there any way you can buy your own bp machine (mine is automatic and cost around $100). That way you can track your bp at home for a period of time and get a better idea of what your numbers are. I did this after getting high readings every time I went to the endocrinologist. It turned out to be situational and I didn't need bp meds.

 

This. I have a home BP machine that I inflate manually but that does the reading automatically. I got it because I get really, really nervous in the doctor's office, and this caused all sorts of problems in my first pregnancy.

 

With my second pregnancy, I asked my OB if I could track my BP at home. She wanted me to bring my cuff in so that we could make sure it was reading accurately, and once we did that, she was fine with that. For the first few months I was seeing her, my BP in her office would be much, much higher than my BP at home. I'd have readings of 160 or 170 systolic (my bottom number never went past the 80s), while at home it would be in the 110s or 120s or lower. She accepted my home readings, especially since we did a 24-hour urine catch that was fine, and within a few months, I'd gotten used to her and the office, and my BP readings were always below 120/80 in her office. I'm seeing her for another pregnancy now, and I've had no BP issues at all.

 

If you can get your own machine, or have a friend you know who's a nurse or doctor take your BP, or otherwise get some calm, accurate readings, that would probably help a lot.

[amo_mea_filiis.]

You could learn to palpate your BP with just a proper fitting cuff. It would only give you the top number, but would be god for tracking. BP cuffs are not that expensive.

 

The very first thing I learn about when taking BP is that a proper fitting cuff is vital! I can't believe they'd use a too small cuff, and think those numbers are accurate!

[stripe]

This office stresses me out every time I go.

 

Exactly. I was sitting in the waiting room for an HOUR one time, with steam coming out of my ears, so how could my BP possibly be normal?

 

Funny thing is, I went to another doctor -- whom I really like! -- and my BP was very normal/ low. The next day I got a massively high reading from the other office after coming in from the parking lot, frantic, etc., and I rejected it and told them to do it again, and loand behold it went down. I also told them I'd had two low BP readings in the last month at another office!

 

Made me want to get my own BP machine.

[Renee in NC]

Exactly. I was sitting in the waiting room for an HOUR one time, with steam coming out of my ears, so how could my BP possibly be normal?

 

Funny thing is, I went to another doctor -- whom I really like! -- and my BP was very normal/ low. The next day I got a massively high reading from the other office after coming in from the parking lot, frantic, etc., and I rejected it and told them to do it again, and loand behold it went down. I also told them I'd had two low BP readings in the last month at another office!

 

Made me want to get my own BP machine.

 

I had normal readings at the peds office - I don't get stressed there because they are nice and competent!

 

I am working on finding a new doctor now.

[Paz]

Can you get one more prescription from your old doctor's office? Just explain that you're having trouble getting a new doctor. The pharmacy may even call him to get you one. Ours often does.

[Twilight Woods]

This office stresses me out every time I go. In addition, my mother called right before she did the reading - she *never* calls me on Thursdays (she works double shifts at her restaurant on Thursdays.) So, I was worried about why she was calling about *and* was stressed by the whole situation.

 

We were talking during the readings and my arm was hanging down (because there was nothing to support it.)

 

I am looking at blood pressure machines and cuffs (my arm is still large depsite losing weight, so I want to make sure I have one that fits.)

 

you can go to the local firehouse and request they take your blood pressure, same with an urgent care or ER.

[stripe]

A lot of stores have them by the pharmacy, like Target or WalMart, for free. My husband asked the pharmacist at one of those and he said it's calibrated often.

[The Governess]

Have you tried taking it in the morning before you have any caffeine? When I have coffee before going to the Dr. my reading is 10 or so points higher. Now I wait and have my coffee after I go in so I don't get a "your blood pressure seems a bit higher than normal" comment.

[brehon]

You've received good information about the BP cuff issue: (1) it must be properly fitted and (2) NIBPs are notoriously inaccurate even in the best of circumstances, regardless how often they are calibrated. If you can get a manual (aka regular manual pump-it-up) BP cuff and a stethoscope you can teach your dh or older kids to take a BP. It's easy-peasy. I wouldn't try to take your own palpated BP - again too much chance for inaccurate readings.

 

Alternately, go to a fire station and ask one of FF/EMTs or paramedics to take your BP. Make sure the cuff fits correctly. It is very important. I'm constantly getting on my firefighters to ensure they use a properly sized cuff. I used to have an elderly gentleman walk to the station every day for a BP reading. Nice man.

 

Also be very mindful of your water and caffeine intake. You know what you need to do. If you have any questions, don't hesitate to ask or PM.

[Renee in NC]

Can you get one more prescription from your old doctor's office? Just explain that you're having trouble getting a new doctor. The pharmacy may even call him to get you one. Ours often does.

 

It is a Class II, so my old doctor can't call it in or even send me a scrip.

 

Have you tried taking it in the morning before you have any caffeine? When I have coffee before going to the Dr. my reading is 10 or so points higher. Now I wait and have my coffee after I go in so I don't get a "your blood pressure seems a bit higher than normal" comment.

 

Caffeine could be an issue, as could water consumption. However, I didn't have anything unusual yesterday and I haven't gotten abnormal readings other days.

 

You've received good information about the BP cuff issue: (1) it must be properly fitted and (2) NIBPs are notoriously inaccurate even in the best of circumstances, regardless how often they are calibrated. If you can get a manual (aka regular manual pump-it-up) BP cuff and a stethoscope you can teach your dh or older kids to take a BP. It's easy-peasy. I wouldn't try to take your own palpated BP - again too much chance for inaccurate readings.

 

Alternately, go to a fire station and ask one of FF/EMTs or paramedics to take your BP. Make sure the cuff fits correctly. It is very important. I'm constantly getting on my firefighters to ensure they use a properly sized cuff. I used to have an elderly gentleman walk to the station every day for a BP reading. Nice man.

 

Also be very mindful of your water and caffeine intake. You know what you need to do. If you have any questions, don't hesitate to ask or PM.

 

I might have to learn to do it myself and teach someone here. I'm not particularly worried about the bp because I am not convinced it is correct anyway. When I find a new doc I'll discuss it with him or her - until then I am stuck. Not only that, but because of the way she wrote the prescriptions, I will have to pay 3 copays over the next 6 weeks at $50 a piece.:glare:

[brehon]

It is a Class II, so my old doctor can't call it in or even send me a scrip.

 

 

 

Caffeine could be an issue, as could water consumption. However, I didn't have anything unusual yesterday and I haven't gotten abnormal readings other days.

 

 

 

I might have to learn to do it myself and teach someone here. I'm not particularly worried about the bp because I am not convinced it is correct anyway. When I find a new doc I'll discuss it with him or her - until then I am stuck. Not only that, but because of the way she wrote the prescriptions, I will have to pay 3 copays over the next 6 weeks at $50 a piece.:glare:

 

Yeah, that really bites, huh.

 

Well, I will say that having at least a week's worth of auscultated BP readings, especially if you take at least 2/day (morning and night) [and, really 3/day -- morning, afternoon, night], would be great information for a half-way "with-it" doc. Also, up your water intake and decrease your caffeine intake and see if that helps. If you need any help learning how to take a good manual BP, just let me know.

[~Kirsten~]

:grouphug: One other thing...they should have waited at least 5 minutes between readings and alternated arms. There's no way the readings yesterday remained accurate after the second one from that alone!

 

I have serious anxiety over BP readings and at new doctor's offices in general, and with my first pregnancy, ultimately I was borderline preeclamptic and BP wouldn't come down even after birth, so now I'm even more paranoid. My new OB was using the wrist monitor and I had an absolutely outrageous reading at my first appointment. Thankfully, the doctor was very kind and soothing, and it was only as we were leaving that the nurse mentioned he was ready to send me directly to the hospital! But they rechecked it at the end with a manual cuff, and it was much better...still high, but reasonable.

 

At that point, I bought my own automatic cuff on Amazon. I use it right before every appointment, and my OB office now knows to just use the manual cuff on me. :D But I'm reassured because I've measured myself first, and that calms me.

 

I hope you can find a new doctor quickly! :grouphug: