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Re: BP tweaks

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In a message dated 2/14/06 7:19:03 PM, bayabas76@... writes:

I am on Spiro and Lasix. I lowered the Lasix dose and my bp readings

became better and reading more stable into the 120s/80s region. Into

three weeks straight now.

However for the recent two days, I noticed slight dizziness spells, so

quick it could have lasted no more than a couple of seconds or

thereabouts, accompanied by sweating. Could this possibly indicated I

may have to also lower my Spiro dose. I am currently taking 50mg

b.i.d. making it 100mg total and just 40mg Lasix.

Is this an indication that my potassium is increasing beyond normal? I

am remotely away from a lab at this moment. The thing is I  have to

drive myself and a dizzy driver on the road is too risky.

My idea is that the body may heal itself as the bp gets better, and

therefore medications will have to be tapered accordingly.

Most likely one of the first chapters on the book readers will read

first - guide to bp tweaks! Thanks.

If you BP is lower or if it falls when you stand up then I would consider backing down on the Lasix first but talk with your team.

As you are away now are you in a hot environment? May lower BP. Eating better? May be affecting BP as well.

May your pressure be low!

CE Grim, BS(Chem/Math), MS(Biochem), MD.

Board Certified in Internal Medicine, Geriatrics and Hypertension

Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC

Specializing in Difficult to Manage High Blood Pressure

Clinical Professor of Medicine, Medical College of Wisconsin

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>

> As you are away now are you in a hot environment? May lower BP.

Eating

> better? May be affecting BP as well.

>

The ambient temperature here is about 30 degrees C and 78% humidity.

Though appetite has been good, I think I am not eating well due to

food restrictions regarding my recent gout attacks. I am taking mostly

veges, fresh semi-ripe tomatoes eaten raw from the garden and rice

diet. However, I have read contradicting issues on tomatoes, where

some say it is good while another site says it is not good for gout.

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Suspect you are loisng more salt through sweat and perhaps a lower

sodium diet. This may be lowering your BP.

May your pressure be low!

CE Grim MD

Clinical Professor of Internal Medicine

Professor of Epidemiology

Board Certified in Internal Medicine, Geriatrics and Hypertension

Re: BP tweaks

>

> As you are away now are you in a hot environment? May lower BP.

Eating

> better? May be affecting BP as well.

>

The ambient temperature here is about 30 degrees C and 78% humidity.

Though appetite has been good, I think I am not eating well due to

food restrictions regarding my recent gout attacks. I am taking mostly

veges, fresh semi-ripe tomatoes eaten raw from the garden and rice

diet. However, I have read contradicting issues on tomatoes, where

some say it is good while another site says it is not good for gout.

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In a message dated 2/17/06 4:43:51 AM, bayabas76@... writes:

Would you advise allopurinol (zyloprim) to reduce uric acid?

I would: stop Lasix to see effect on BP and UA.

Is my

Furosemides partly responsible for my elevated blood sugar levels?

Only way to tell is to stop it and see what happens.

Is

it advisable to take metformin then? No, only if weight loss to bmi less than 25 and stopping Lasix doesnt get HbA1c to goal. Ask what it its. You cannot make a Dx of DM without it in my book as this is what you treat to goal.

Your high creatinine suggests BP may be too low for your kidneys. Please sent them as far back as you can and also the drugs you were on at the same time. Also BUN if you have it. Need both to think about what is the problem.

May your pressure be low!

CE Grim, BS(Chem/Math), MS(Biochem), MD.

Board Certified in Internal Medicine, Geriatrics and Hypertension

Former Epidemiologic Intelligence Services Officer (Lt. Comdr.), CDC

Specializing in Difficult to Manage High Blood Pressure

Clinical Professor of Medicine, Medical College of Wisconsin

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>

> Suspect you are loisng more salt through sweat and perhaps a lower

> sodium diet. This may be lowering your BP.

>

Yes sir I am on a low sodium diet for six months now. My basal

metabolic panel today showed Sodium at 135 meq/L and Potassium at 4.1

meq/L. However, to confirm my recent gout attack, my Uric Acid is

10.77 mg/dl, Creatinine is 1.8 mg/dl and BUN at 21 mg/dl. Blood sugar

is 122 mg/dl.

Would you advise allopurinol (zyloprim) to reduce uric acid? Is my

Furosemides partly responsible for my elevated blood sugar levels? Is

it advisable to take metformin then?

Thanks.

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