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When would you go to ER?


Scarlett
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This thread is raising my blood pressure.

 

BP that high causes damage. Period. It increases the risk of heart attack and stroke.

 

It sounds like your hospital choices are limited...time means tissue. So if it is a heart attack, the longer the trip to the ER to get care, the more damage is done.

 

I'd get my ducks in a row about which ER, as a general life plan.

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The issue is not only whether he had a (most likely minor) heart attack. The issue includes what caused the high blood pressure to begin with. Numbers like that are not some kind of benign side effect of sitting down. And the issue is what blood pressures like that can do to the blood vessels and the heart. That is why people are put on blood pressure medications. To lower the blood pressure so that you don't have a potential heart attack or damage.

:iagree:

 

Untreated high blood pressure can also lead to strokes.

 

If the doctor said your dh could wait a month to see him, it is time to find a new doctor -- today.

 

Please don't let this go. My brother died at 56 because he didn't take proper care of his blood pressure. He looked and acted like he was in great shape and you never would have guessed that there was anything wrong with him... until the day he had a cerebral hemorrhage. :(

 

I'm sorry if it sounds like I'm trying to scare you -- it's just that I wish someone could have scared my brother and SIL into taking his health more seriously and not just assuming that everything would always be okay because he was feeling fine.

 

It's not like a visit to the cardiologist is painful or traumatic. Your dh will probably be prescribed a medication and then monitor his blood pressure at home. No big deal at all.

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This thread is raising my blood pressure.

 

BP that high causes damage. Period. It increases the risk of heart attack and stroke.

 

It sounds like your hospital choices are limited...time means tissue. So if it is a heart attack, the longer the trip to the ER to get care, the more damage is done.

 

I'd get my ducks in a row about which ER, as a general life plan.

:iagree: :iagree: :iagree:

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I just got a call from the nurse. She told me the doctor responded to my email and she wanted to be sure I read it. Basically doc says it is too late to determine anything but he absolutely should have gone to ER last night.

 

He has a follow up visit with that doc in a month....and I will keep a close eye on dh until then.

Is this your prospective new Small Town family practice doctor? I'd get a second opinion right away. Direct to a cardiologist, if possible.

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:iagree:

 

Untreated high blood pressure can also lead to strokes.

 

If the doctor said your dh could wait a month to see him, it is time to find a new doctor -- today.

 

Please don't let this go. My brother died at 56 because he didn't take proper care of his blood pressure. He looked and acted like he was in great shape and you never would have guessed that there was anything wrong with him... until the day he had a cerebral hemorrhage. :(

 

I'm sorry if it sounds like I'm trying to scare you -- it's just that I wish someone could have scared my brother and SIL into taking his health more seriously and not just assuming that everything would always be okay because he was feeling fine.

 

It's not like a visit to the cardiologist is painful or traumatic. Your dh will probably be prescribed a medication and then monitor his blood pressure at home. No big deal at all.

Oh, Cat. :crying:

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Cat that is terrible. I am so sorry.

 

Ok, I read the email and the doctor does want to see him in the office asap.

 

But I do,want to clarify that dh has never had high BP. He isn't on BP medicine. And he was just in for a check up 2 weeks ago. We have a big issue we are dealing with right now with his esophagus. He is on a strict diet for 6 weeks and medicine for the reflux.....but it is a potentially very serious problem. And I have considered that the esophagus issue is causing the other symptoms he had last night.

 

The doctor said if he has a repeat of those symptoms take 325 mg of aspirin and head straight to ER.

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Ok, I will say that pain can cause high blood pressure to some extent, and the esophogus could cause the back pain and abdominal pressure. In fact, esophogeal spasms present almost identically to a heart attack. And are oddly treated with the same meds. Hope it is that, but yes, get him rechecked. 

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Cat that is terrible. I am so sorry.

 

Ok, I read the email and the doctor does want to see him in the office asap.

 

But I do,want to clarify that dh has never had high BP. He isn't on BP medicine. And he was just in for a check up 2 weeks ago. We have a big issue we are dealing with right now with his esophagus. He is on a strict diet for 6 weeks and medicine for the reflux.....but it is a potentially very serious problem. And I have considered that the esophagus issue is causing the other symptoms he had last night.

 

The doctor said if he has a repeat of those symptoms take 325 mg of aspirin and head straight to ER.

Scarlett, here's the thing. Not every ER can definitively deal with a heart attack. You need to figure out which hospital near you does stat caths. Usually, if you go to an ER at a hospital which does not perform stat caths, the ER will transfer you to a hospital which does. Although the hospital which doesn't perform stat caths can start some therapy, for most patients with either STEMIs (meaning you can "see" the heart attack on the 12-lead ECG) or NSTEMIs (meaning the 12-lead does not show the stereotypical pattern of a heart attack, but cardiac enzymes are elevated) the gold standard treatment is a heart cath, many times with one or more stents placed.

 

Remember, time is muscle and re-profusion of the coronary arteries is what saves the cardiac muscle.

 

I have attended patients who had low ejection fractions because of damage to the heart muscle or cardiomyopathy. They would tell you that their quality of life has markedly decreased because of the low EFs. (Basically, the ejection fraction is a measure of how much blood the heart pumps outs each beat. There's more to it than that, of course.)

 

It might not be a bad idea to ask his doctor (assuming the doctor is a primary doc, not a cardiologist) about a referral to a cardiologist for an echo and an ECG stress test.

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Scarlett, here's the thing. Not every ER can definitively deal with a heart attack. You need to figure out which hospital near you does stat caths. Usually, if you go to an ER at a hospital which does not perform stat caths, the ER will transfer you to a hospital which does. Although the hospital which doesn't perform stat caths can start some therapy, for most patients with either STEMIs (meaning you can "see" the heart attack on the 12-lead ECG) or NSTEMIs (meaning the 12-lead does not show the stereotypical pattern of a heart attack, but cardiac enzymes are elevated) the gold standard treatment is a heart cath, many times with one or more stents placed.

 

Remember, time is muscle and re-profusion of the coronary arteries is what saves the cardiac muscle.

 

I have attended patients who had low ejection fractions because of damage to the heart muscle or cardiomyopathy. They would tell you that their quality of life has markedly decreased because of the low EFs. (Basically, the ejection fraction is a measure of how much blood the heart pumps outs each beat. There's more to it than that, of course.)

 

It might not be a bad idea to ask his doctor (assuming the doctor is a primary doc, not a cardiologist) about a referral to a cardiologist for an echo and an ECG stress test.

Dh said he will ask for a stress test.

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Scarlett, here's the thing. Not every ER can definitively deal with a heart attack. You need to figure out which hospital near you does stat caths. Usually, if you go to an ER at a hospital which does not perform stat caths, the ER will transfer you to a hospital which does. Although the hospital which doesn't perform stat caths can start some therapy, for most patients with either STEMIs (meaning you can "see" the heart attack on the 12-lead ECG) or NSTEMIs (meaning the 12-lead does not show the stereotypical pattern of a heart attack, but cardiac enzymes are elevated) the gold standard treatment is a heart cath, many times with one or more stents placed.

 

Remember, time is muscle and re-profusion of the coronary arteries is what saves the cardiac muscle.

 

I have attended patients who had low ejection fractions because of damage to the heart muscle or cardiomyopathy. They would tell you that their quality of life has markedly decreased because of the low EFs. (Basically, the ejection fraction is a measure of how much blood the heart pumps outs each beat. There's more to it than that, of course.)

 

It might not be a bad idea to ask his doctor (assuming the doctor is a primary doc, not a cardiologist) about a referral to a cardiologist for an echo and an ECG stress test.

One of my best friend's husband stubbornly refused to go to the hospital until about 12 hours after symptoms starts. Because his wife didn't answer her phone at work because she was at lunch and well,anyway it spiraled out of control....his wife tried all evening to get him to go to ER. Finally at midnight he woke her up and said he needed to go ther. He was throwing up on the way to the hospital. They rushed him back....someone came to her and said, m'am your husband is having a widow maker heart attack and it is doubtful he will survive it.

 

He suvived. But the damage to his heart was extensive....most which could have been prevented had he only gone to the ER at noon that day.

 

So that story is in my mind.

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I didn't feel that bad once I met a fellow patient who was an MD while we were pushing our IV's around.  He didn't know his appendix had burst either and he was a medical doctor,  so how was I supposed to know?  We both thought we had the flu. 

 

I was chatting with dudeling's ND.  she'd been out biking with two other dr's and one fell.  NONE of them realized he'd broken his leg! (or maybe his arm.  it was a long bone.)

 

(and yes, they all felt stupid.)

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Cat that is terrible. I am so sorry.

 

Ok, I read the email and the doctor does want to see him in the office asap.

 

But I do,want to clarify that dh has never had high BP. He isn't on BP medicine. And he was just in for a check up 2 weeks ago. We have a big issue we are dealing with right now with his esophagus. He is on a strict diet for 6 weeks and medicine for the reflux.....but it is a potentially very serious problem. And I have considered that the esophagus issue is causing the other symptoms he had last night.

 

The doctor said if he has a repeat of those symptoms take 325 mg of aspirin and head straight to ER.

 

 

better to head to the ER and let them decide if it's the rx or not.  and if it was the rx - it needs to be changed.

 

aspirin can help break up a clot and reduce damage - same thing for stroke symptoms.  take aspirin and make haste to an ER.

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I was chatting with dudeling's ND. she'd been out biking with two other dr's and one fell. NONE of them realized he'd broken his leg! (or maybe his arm. it was a long bone.)

 

(and yes, they all felt stupid.)

Oh I don't think it is the med. it is just an antacid. I think it is the esophagus itself that might be causing him pain/ pressure. thus high BP. He was very tender to the touch during his exam two,weeks ago.

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Oh my. My little brother had the same thing happen, he was 49.

Scarlett- please go to the ER if you suspect a heart attack. If you are worried about cost( totally understandable) then clearly state he is having chest pain, arm pain, etc, and these key words will be enough to have it covered.

My husband complained of arm pain. No sweating, no shoulder pain, nothing but tight arms and a horrible pain in his pinkie fingers. It was a heart attack, but luckily not a big one. Two days later he had a quadruple bypass.

Please have him ask the doctor for a carotid and heart ultrasound. Treating clogged arteries now, perhaps even needing a stent, is so much less scary than needing a bypass.

It pisses me off to no end that dh's doctor gave him a carotid ultrasound, said he was blocked a bit but " not so bad for his age", and didn't even do a damn heart ultrasound. 6 months before his heart attack-- if we'd known the level of blockage we could have possibly treated it. I'm sorry I'm rambling, but this upsets me so much. PLEASE don't take this episode lightly.

(((Hugs))))

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Which suggests to me that this has actually been going on for awhile. High Blood Pressure is called the "silent killer" precisely because it can be present with no visible symptoms.

Yikes. So......now for a TMI question that I am really worried about. Can tEA be harmful or actually cause him to have a heart attack?

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Yikes. So......now for a TMI question that I am really worried about. Can tEA be harmful or actually cause him to have a heart attack?

According to blood pressure charts, his recent readings are in stage 1 hypertension.  (There is a stage 2 which is a real emergency).  So he definitely needs to be seen and treated and monitored.  But I probably wouldn't worry about a heart attack from tEA.  (OK - I might actually worry but it wouldn't be something a doctor would be worried about.)  

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We took it just twice last night.

11:00 150/87

11:30 150/95

 

He said he felt fine. No pressure anywhere. No pain.

Just remember that high BP is a silent symptom. Unless one is having a hypertensive crisis (think BPs 180+/110+) a high BP won't usually cause pain or discomfort. And your dh's doctor should be concerned about these readings as they are by definition high (technically stage 1 hypertension). The latest guidelines for hypertension is 140+ systolic or 90+ diastolic. Hypertension is called the silent killer for a very good reason.

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The doctor is concerned about the readings. He told me to call and get an appt asap. I just sent another email asking doc if we should wait for the follow up appt that is already scheduled ( less than 4 weeks from now) or come in sooner. I would like to monitor it for a few weeks. He was just seen two weeks ago and no high BP then.

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But the point is your dh has had high BP SINCE then. I strongly encourage a sooner appointment.

Yes your dh will be thinking you're fussing for nothing but better to fuss for nothing than to not fuss when it is SOMEthing!

 

I'm convinced God gives wives to men partly so that men will actually go to the doctor once in awhile! :-P

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But the point is your dh has had high BP SINCE then. I strongly encourage a sooner appointment.

Yes your dh will be thinking you're fussing for nothing but better to fuss for nothing than to not fuss when it is SOMEthing!

 

I'm convinced God gives wives to men partly so that men will actually go to the doctor once in awhile! :-P

Yes I agree with that for sure.

 

Dh thinks it might have something to do with the strict diet he was put on two weeks ago....his body just adjusting etc.

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Oh and we did make a plan for what ER. We are almost 45 min to a good hospital. 15 min to crap hospital but that is on the way to good hospital. So if he is having a heart attack we will call 911 and hope the rural fire department shows up quickly.....if he is having signs but able to get in the car we will head toward good hospital and only stop at bad hospital if he gets worse on the way.

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Yes I agree with that for sure.

 

Dh thinks it might have something to do with the strict diet he was put on two weeks ago....his body just adjusting etc.

Well, as Mark Twain said, "Denial isn't just a river in Egypt." ;) <referencing your dh, not you>

 

I can't imagine what kind of diet would cause your dh's BP to suddenly go into stage 1 hypertension and remain there, unless he's eating a high salt diet or something. I think I'd set up an appointment for sooner than mid-November and continue monitoring and recording his readings.

 

By the by, AHA's web page (www.heart.org) has a section on how to get the most accurate home BP readings. I'd link it for you; but, I'm technically challenged.

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If anything caused this to come on, it could be the reflux meds.  If he's on omeprazole, high blood pressure is listed as a rare side effect.  But it is rare, so emphasize the "could" and don't automatically decide that this is it.  It could be that he has had slow building up of plaque in his arteries and it is only just now affecting his blood pressure.  It's also possible that as he's aged (as we all do!) that this has now just happened to develop at this point in time.  It happens.  

 

He shouldn't  go off any meds unless the doc says to.  It may be that the doc just needs to give another med for the high blood pressure in addition to the reflux med.  As I mentioned up thread, my doctors started with a very safe diuretic first for me.  Treating high blood pressure is not usually a big deal.  He may need to watch his salt intake.  They may need to do some cardiac tests to make sure that there aren't blockages causing this.  If not, great.  If there are, then those need to be treated.  

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If anything caused this to come on, it could be the reflux meds. If he's on omeprazole, high blood pressure is listed as a rare side effect. But it is rare, so emphasize the "could" and don't automatically decide that this is it. It could be that he has had slow building up of plaque in his arteries and it is only just now affecting his blood pressure. It's also possible that as he's aged (as we all do!) that this has now just happened to develop at this point in time. It happens.

 

He shouldn't go off any meds unless the doc says to. It may be that the doc just needs to give another med for the high blood pressure in addition to the reflux med. As I mentioned up thread, my doctors started with a very safe diuretic first for me. Treating high blood pressure is not usually a big deal. He may need to watch his salt intake. They may need to do some cardiac tests to make sure that there aren't blockages causing this. If not, great. If there are, then those need to be treated.

That is what he is taking Jean and I didn't know it could be a side effect.

 

He must be worried about himself because he called the doc office and got an appt for Monday.

 

He said he feels fine and is watching for any sign of heart attack. I made a believer out of him that the squeezing in his arms and stomach is definitely a symptom. He didn't believe me at first. Thank God for Google.

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Well, as Mark Twain said, "Denial isn't just a river in Egypt." ;) <referencing your dh, not you>

 

I can't imagine what kind of diet would cause your dh's BP to suddenly go into stage 1 hypertension and remain there, unless he's eating a high salt diet or something. I think I'd set up an appointment for sooner than mid-November and continue monitoring and recording his readings.

 

By the by, AHA's web page (www.heart.org) has a section on how to get the most accurate home BP readings. I'd link it for you; but, I'm technically challenged.

I found it. We have the wrist monitor which isn't recommended. Hmm.....it is reading mine accurately though. I just took it and mine is 100/72 heart of 53.

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I was chatting with dudeling's ND.  she'd been out biking with two other dr's and one fell.  NONE of them realized he'd broken his leg! (or maybe his arm.  it was a long bone.)

 

(and yes, they all felt stupid.)

Yeah.  Even doctors don't know everything.  And I assume some of them are under-responders, like some of the rest of us. 

 

I have a friend who is an over-responder.  She once talked me into going to the emergency room because my belly-button area was bluish (which could indicate strangulated hernia).  I had nothing of the kind.  It was completely reducible, and even worse, the DOCTOR couldn't find it.  I had to show him where it was.   For that privilege of instructing him, I got to pay $1000 for that ER visit.

 

I am careful what I tell her about health.

 

We both got swine flu back in 2008, before it hit the media.  She went to the emergency room for IV fluids.  I stayed home. It did knock me on my butt for a month though. 

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Oh my. My little brother had the same thing happen, he was 49.

Scarlett- please go to the ER if you suspect a heart attack. If you are worried about cost( totally understandable) then clearly state he is having chest pain, arm pain, etc, and these key words will be enough to have it covered.

My husband complained of arm pain. No sweating, no shoulder pain, nothing but tight arms and a horrible pain in his pinkie fingers. It was a heart attack, but luckily not a big one. Two days later he had a quadruple bypass.

Please have him ask the doctor for a carotid and heart ultrasound. Treating clogged arteries now, perhaps even needing a stent, is so much less scary than needing a bypass.

It pisses me off to no end that dh's doctor gave him a carotid ultrasound, said he was blocked a bit but " not so bad for his age", and didn't even do a damn heart ultrasound. 6 months before his heart attack-- if we'd known the level of blockage we could have possibly treated it. I'm sorry I'm rambling, but this upsets me so much. PLEASE don't take this episode lightly.

:grouphug: :grouphug: :grouphug: :grouphug:

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That is what he is taking Jean and I didn't know it could be a side effect.

 

He must be worried about himself because he called the doc office and got an appt for Monday.

 

He said he feels fine and is watching for any sign of heart attack. I made a believer out of him that the squeezing in his arms and stomach is definitely a symptom. He didn't believe me at first. Thank God for Google.

I'm relieved to hear he is going to the doctor on Monday. His bp readings seem to be consistently high, and although he doesn't have a history of high blood pressure, let's face it -- nobody has a history of high blood pressure until they get high blood pressure, so his history really doesn't matter right now. His current symptoms are what matter.

 

Tell him not to worry about it, though, because the good news is that he knows about it and is going to get it treated, probably with a pill or two a day. The bad news would be if he ignored it and hoped it would go away on its own. He is doing the right thing.

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BP in doctors office was normal. Doc still concerned because of the symptoms last Wednesday night. He gave him BP med and nitroglycerin. Did ekg and chest X Ray and more labs in office. No results from those yet. He did more labs because dhs white blood count is very low. I remembered it was low 3 years ago when dh was so sick. So doc getting copies of those labs to compare.

 

Dh is being sent for a stress test. Waiting for the scheduler to call.

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