Re: Drastic Times, Drastic Measures

[Guest guest]

In a message dated 1/7/06 3:50:49 AM, spirlhelix@... writes:

HI, Dr. Grim

Thanks for reminding me!

I have been on spironolactone, which does not bother

me, but eventually my blood pressure rose again.

How much did you go up to? I often go to 400 mg a day.

I have also been on nitroglycerine, but I was taken

off it again so I'm guessing the effects were not as

desired.

I have also been on Catapres, but it makes me very

sleepy and disoriented (no shock there) and I can't

stay on it, so there is risk of rebound when I stop

taking it.

Ah yes..this is the reason I love to see pts come to me on

Catapres. They feel like I am a savior when I stop it. I call it the Shadow--it clouds mens minds but you may not be old enough to know what that refers to.

I have also been on Norvasc; I don't recall the side

effects if any, but I know I was taken off it, so it

seems it either was not effective or not tolerable or

both.

Diuretics seem to lower the blood pressure only for a

short time.

Again was this increased?

I haven't done the DASH 14 day challenge, but I intend

to use DASH after the fast--so I will let you know how

it goes.

I had a 14 hour BP reading and my nephrologist and my

cardiologist disagreed on how to interpret the

results.  My cardiologist said my BP was "too

variable", while my nephrologist said the variations

were normal.

The B12 was low (not an official deficiency, but

enough to cause symptoms--I think around 419, if

memory serves).  It caused memory loss, dizziness, and

tingling arms and hands.  It was diagnosed by a

neruologist.

And did you have aneima as well? If not it is not likely that taking it helps.

I don't recall how much HCTZ I was on, but I think it

was a high dose by the time they titrated it up three

or four times.

Thanks for your remarks!

Once again were you one Norvasc and diuretics and sprio at the same time. Many require 3-4-5 different meds to get to gaol--at least by the time I see them.

Warmly,

Pam

--- lowerbp2@... wrote:

> You have been through the gamut.

>

> There are still some drugs you have not been tried

> on:

>

> Reserpine a good old timer

> Spironolactone or Inspra

> nitroglycerine.

> Aldomet

> Ismelin

> Catapres

>

>

> But here is what I would do if you came to me:

>

> Diovan HCTZ lowest dose bid.

> Norvasc 2.5 bid

> Reserpine 1.25 per day

>

> Adding each slowly and treating your home BP not

> your office BP.

>

>

> In a message dated 1/6/06 3:43:13 AM,

> spirlhelix@... writes:

>

>

> > Hi, Dr. Grim

> >

> > I tried to get the article you named last night,

> but I

> > was not able to access it since I'm not a member.

> > Perhaps I will join just so I can see it.

> >

> Good group to join for you I think if you have not.

>  It is free of course.

> >

> > I have a history of glomerulonephritis diagnosed

> by

> > kidney bx and polyarteritis nodosa diagnosed by

> liver

> > bx secondary to Hep B.   Both conditions are

> thought to

> > be controlled since my recovery from Hep B.

> >

> I have reported a case of PAN that seemed to be due

> to renal artery stenosis.

>

> GN makes you Salt Sensitive. Have you done the DASH

> 14 day challenge?

> Did diuretics lower the BP at all?

> > Â

> >

> > This is only a partial list of medications I have

> > used. Â

> > I know I had more failed "experiments" with

> > frequently-used medications when I was first

> diagnosed

> > with high blood pressure.  They were given to me

> as

> > samples from the doctor's office, so I don't have

> good

> > records.  When my blood pressure was more

> controlled,

> > I was on Interferon, Nifedepine (calcium channel

> > blocker) and Beta blockers. . .these led to other

> > adverse effects that I was unable to tolerate.Â

> Diovan

> > helps to some extent,

> > but my blood pressure is typically over 150/90 in

> the

> > doctor's office, even when it is well-controlled

> > (120/80) at home, so doctors tend to keep

> increasing

> > medication and adding new medications even when

> I'm

> > doing well (for me).

> >

> Have you ever had a 24 hr BP reading done. This

> might convince them that your

> BP is OK out of the office.

> >

> > I have another list of some of the many

> combinations

> > I have been on, I think.  I will see if I can

> > find it for you.

> >

> > Nexium--stomach pain, ulcer.  Got a Vitamin B 12

> > deficency.

> >

> How was this documented (B12) rare in someone your

> age

> >

> > Pletal--pain when walking, ?? blood pressure.Â

> Stopped

> > taking it at some point.  I don't have pain when

> > walking any longer.  If it had helped with blood

> > pressure, the doctor would never have switched it

> to

> > something else. not for BP.Â

> >

> > Avapro--high blood pressure.  Did not help, I

> guess.

> > Doctor changed to a different medication.

> >

> > Promethazine--don't know why I would have been

> given

> > this.  I don't remember taking it, but it was in

> my

> > medicine chest.

> >

> > Nadolol--It brought my heart rate down to under 50

> > beats per minute within two hours of first taking

> it.

> >

> > The doctor kept me on 10 mg in combination with

> other

> > drugs for over a year, but my blood pressure was

> still

> >

> > not controlled.  I was also depressed during this

> time

> >

> > and I discovered that BBs cause me to be

> depressed.

> > I'm

> > not interested in any BBs at this point.

> >

> > Labetalol--made me suicidal within two hours of

> taking

> > it.  It brings down the blood pressure, but it's

> not

> > worth it.  It won't extend my life.

> >

> > Atenolol--This one made me sleep sixteen hours a

> day

> > and I soon became suicidally depressed from taking

> it.

> > I was started at 100 mg qd and had to taper off it

> > slowly.  I felt like I was in a coma until it was

> out

> > of my system.  I will never take it or other Beta

> > blockers again.

> >

> > Nifedepine--I took this for two years and my gums

> > became badly swollen and sore.  I could not care

> for

> > my teeth properly; my gums were so sore I could

> only

> > eat liquids and was unable to sleep through the

> night.

> > I lost a tooth due to an infection and told my

> doctor

> > to take me off it.  When I finally went off it,

> my

> > heart rate went back to normal after being in the

> > 120-150 range for a year.

> >

> Newer CCBs not as likely to have this problem.

> >

> > Verapamil--blood pressure.  Did not help.

> >

> > Verapamil SR--blood pressure.  Did not help.

> >

> > Hydrocortothyazide--edema.  Which turned out to

> be

> > caused mostly by Nifedpine.  Since going off

> > Nifedepine, I hardly ever have any edema.Â

> > HCT lost its effectiveness after a while.

> >

> HCTZ does not cause edema but Nif does.

>

> How much HCTZ were you on.   Some need more than

> others.

> >

> > Atacand--blood pressure.  I guess it didn't

> work.  The

> > doctor put me on something else.

> >

> >

> > Maxzide--edema.  Apparently the edema was caused

> by

> > Nifedepine, but anyway it's better now that I'm

> off

> > Nifedepine.

> > But the Maxzide lost its effectiveness after a

> while.

> >

> See above

> > Â

> > Diovan--Blood pressure.  It seems to help to some

> > extent.Â

> > My blood pressure is still high on Diovan,

> > particularly in the doctor's office.

> >

> > Hydralazine--aching joints and muscles, headache,

> > fever,

> > dark urine. I am told this is considered a true

> > allergic

> > reaction.

> >

>

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[Guest guest]

Again if the BP improved a lot on spiro it is virtually diagnostic of some PA like problem.

May your pressure be low!

Clarence E. Grim, BS (Chem/Math), MS (Biochem), MD, FACP, FACC, FAHS

Clinical Professor of Medicine and Epidemiology

Director, Hypertension Diagnosis and Treatment Center

Board Certified in Internal Medicine, Geriatrics and Hypertension

Published over 220 scientific papers, book chapters and 220 abstracts in the area of high blood pressure epidemiology, physiology, endocrinology measurement, treatment and how to detect curable causes.

Listed in Best Doctors in America

Specializing in Difficult to Control High Blood Pressure and the History and Physiology of High Blood pressure in the African Diaspora