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With this sort of surgery they used to give SQ epinephrine to

minimize bleeding as it makes small blood vessels constrict which if

enough gets into the systems will increase BP. They likely gave you

a lot of salt solution as well, esp if you lost a lot of blood.

Saline is called white blood by us old folks. Your BP is SS and this

prob contributed to it.. Did you gain any weight?

They probably gave you hydralazine post op which is OK but speeds

heart up and causes headaches but with your surgery you would not

have noticed that. They prob gave you some labetolol after as well.

Which in my experience is not very good in these circumstances. But

classically throbbing headaches (hydralazine) which we give BB to

counter act and slow heart rate down. I have written a chapter for

an Cards book on acute management of HTN before, during and after

heart and other surgery.

My thought is that as you come back into sodium balance your BP will

even out again. What did they give you for pain? Go back to DASHing

to the max for awhile if you are not already.

You will likely be very sensitive to nose sprays that contain

vasoconstrictors. What did they give you for this?

Might have been a good idea to talk to us before surgery to help

guide them. But then again they seemed to know it all.

Keep us posted.

May your pressure be low!



CE Grim BS, MS, MD

High Blood Pressure Consulting

Senior Consultant to Shared Care Research and Education Consulting

Inc.(sharedcareinc.com)

Clinical Professor of Internal Medicine Medical and Cardiology

Medical College of Wisconsin

Board certified in Internal Med, Geriatrics and Hypertension.

Interests:

1. Difficult to control high blood pressure.

2. The effect of recent evolutionary forces on high blood pressure

in human populations.

3. Improving blood pressure measurement in the office and out.

On Jan 9, 2009, at 10:45 PM, Farah Rahbar wrote:

> Dear Dr. Grim and all:

> Wishing you all a happy new year.

> I had sinus surgery(a concha ballosa, bilateral submucus resection,

> inferior

> turbinates, endoscopic sinus surgery, nasal septoplasty)

> All this because one of my eye lids is not draining and one attempt at

> putting a tube in, didn't work after 6 weeks. My Opht. wanted to do

> another

> surgery and in the meantime, I decided to consult with a ENT to see

> if there

> were any other thing wrong. Long story short, after a cat scan

> (which the

> Opht. never did), the ENT told me that I needed the above surgery

> or else

> any other procedure will only end up in a lot of bleeding and no

> success.

> So I did the surgery last Monday(4 days ago). This was done in an

> outpatient

> surgery center with general anestesia.

>

> I spoke the night before the sugery with the anesthesiologist and

> told him

> of my condition meaning PA - (which I feel he took me lightly) I

> had told

> him no matter what, not to give me labetalol, and norvasc as I have

> had

> disasterous outcomes. He told me that he was sure my bp will remain

> on the

> low side as is the case with all his surgeries.

> My bp morning of surgery was 115/60 before surgery. My K was also

> normal in

> the morning.

>

> After surgery, my recovery took about 5 hours(instead of 1 that I

> was told)

> because my bp went up . When I woke up he told me my bp had gone

> up . He had

> given me something for the bp(dont know what, I think he said

> something like

> hydrazine, it wasn't hctz) but it caused me to have palpitaitons

> and my bp

> went up even higher to 190/120, hr to 129 then he gave me (he said

> they

> worked like labetalol). then he injected me with metoprolol which

> helped a

> little to lower my hr.

>

> I was dischaged with a hr of 105-110 and bp of 120/90.

>

> Since then, my bp has been up to 180/120 and is up and down

> I am back on the spiro which I am now taking 100mg(I was on 50mgs

> before

> surgery) and all symptoms of shaking sweating and feeling sick is

> back.

> Well, that along with not being able to breath well because of the

> stitches

> in my nose is making me feel quite sick. I am to see the ENT on Mon

> afternoon to remove the stiches. Considering all of the team of

> doctors who

> work with me are all idiots who have no idea what aldosteronism is,

> I dont

> want to call any of them for advise and get myself sicker than I

> am, nor

> intend to end up in the ER with worst. Is there anything I can do

> to get

> myself back together?

> I did lose quite a lot of blood which I am sure could be the cause

> of low K

> and high bp so I am taking so much foods with K to accommodate.

> Is there anything I can do to get better?

>

> Thank you,

>

> Farah

>

> By the way, I also learned that they dont have liquid form

> aldactone unless

> its something that they have to order in advance. so if anyone else

> if going

> to have surgery, need to check on this to make sure you are

> injected with

> the right meds since you can't take pills during surgeries such as

> mine.

>

>

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Oh, that explains my splitting headaches. I've been having so much headache

and dizziness I can't even begin to tell you.

They gave me Tylenol with Codeine and Z-pack for antibiotics to take at

home. I've been so out of it, basically very drowsy and in a lot of

headaches. and my mouth is blistered and hurst too probably from the

breating tube.

I decided to stop taking any pain meds regardless and drink lots of liquids

to get the meds out of my body. Today is the first day I am staying awake.

My weight went up about a pound or two. I am dashing like my life depends on

it, I can't eat anything anyway except for fruit shakes my husband makes

with bananas, orange juice and ice cubes.

Yes, definitely a lesson learned to inform you before any surgeries. By the

way I did give the anesth. your name to contact in case and my husband had

your contact info in case of emergency. Of course they didn't call him in

the waiting room for 6 hours after which he asked what happended to me, they

let him come see me and by then I was almost ready to go home when nurses

explained to him what had happened and deciding if they should send me to

the hospital for observation which thankfully didn't happend.

Most likely it would've been worse.

Thank you so much Dr. Grim. I'll just keep on taking the aldactone and dash.

Will keep you updated. Never again.

Farah

On Sat, Jan 10, 2009 at 1:26 AM, Clarence Grim <lowerbp2@...> wrote:

> With this sort of surgery they used to give SQ epinephrine to

> minimize bleeding as it makes small blood vessels constrict which if

> enough gets into the systems will increase BP. They likely gave you

> a lot of salt solution as well, esp if you lost a lot of blood.

> Saline is called white blood by us old folks. Your BP is SS and this

> prob contributed to it.. Did you gain any weight?

>

> They probably gave you hydralazine post op which is OK but speeds

> heart up and causes headaches but with your surgery you would not

> have noticed that. They prob gave you some labetolol after as well.

> Which in my experience is not very good in these circumstances. But

> classically throbbing headaches (hydralazine) which we give BB to

> counter act and slow heart rate down. I have written a chapter for

> an Cards book on acute management of HTN before, during and after

> heart and other surgery.

>

> My thought is that as you come back into sodium balance your BP will

> even out again. What did they give you for pain? Go back to DASHing

> to the max for awhile if you are not already.

>

> You will likely be very sensitive to nose sprays that contain

> vasoconstrictors. What did they give you for this?

>

> Might have been a good idea to talk to us before surgery to help

> guide them. But then again they seemed to know it all.

>

> Keep us posted.

>

> May your pressure be low!

>

> 

>

> CE Grim BS, MS, MD

>

> High Blood Pressure Consulting

>

> Senior Consultant to Shared Care Research and Education Consulting

> Inc.(sharedcareinc.com)

>

> Clinical Professor of Internal Medicine Medical and Cardiology

> Medical College of Wisconsin

>

> Board certified in Internal Med, Geriatrics and Hypertension.

>

> Interests:

> 1. Difficult to control high blood pressure.

> 2. The effect of recent evolutionary forces on high blood pressure

> in human populations.

> 3. Improving blood pressure measurement in the office and out.

>

>

> On Jan 9, 2009, at 10:45 PM, Farah Rahbar wrote:

>

> > Dear Dr. Grim and all:

> > Wishing you all a happy new year.

> > I had sinus surgery(a concha ballosa, bilateral submucus resection,

> > inferior

> > turbinates, endoscopic sinus surgery, nasal septoplasty)

> > All this because one of my eye lids is not draining and one attempt at

> > putting a tube in, didn't work after 6 weeks. My Opht. wanted to do

> > another

> > surgery and in the meantime, I decided to consult with a ENT to see

> > if there

> > were any other thing wrong. Long story short, after a cat scan

> > (which the

> > Opht. never did), the ENT told me that I needed the above surgery

> > or else

> > any other procedure will only end up in a lot of bleeding and no

> > success.

> > So I did the surgery last Monday(4 days ago). This was done in an

> > outpatient

> > surgery center with general anestesia.

> >

> > I spoke the night before the sugery with the anesthesiologist and

> > told him

> > of my condition meaning PA - (which I feel he took me lightly) I

> > had told

> > him no matter what, not to give me labetalol, and norvasc as I have

> > had

> > disasterous outcomes. He told me that he was sure my bp will remain

> > on the

> > low side as is the case with all his surgeries.

> > My bp morning of surgery was 115/60 before surgery. My K was also

> > normal in

> > the morning.

> >

> > After surgery, my recovery took about 5 hours(instead of 1 that I

> > was told)

> > because my bp went up . When I woke up he told me my bp had gone

> > up . He had

> > given me something for the bp(dont know what, I think he said

> > something like

> > hydrazine, it wasn't hctz) but it caused me to have palpitaitons

> > and my bp

> > went up even higher to 190/120, hr to 129 then he gave me (he said

> > they

> > worked like labetalol). then he injected me with metoprolol which

> > helped a

> > little to lower my hr.

> >

> > I was dischaged with a hr of 105-110 and bp of 120/90.

> >

> > Since then, my bp has been up to 180/120 and is up and down

> > I am back on the spiro which I am now taking 100mg(I was on 50mgs

> > before

> > surgery) and all symptoms of shaking sweating and feeling sick is

> > back.

> > Well, that along with not being able to breath well because of the

> > stitches

> > in my nose is making me feel quite sick. I am to see the ENT on Mon

> > afternoon to remove the stiches. Considering all of the team of

> > doctors who

> > work with me are all idiots who have no idea what aldosteronism is,

> > I dont

> > want to call any of them for advise and get myself sicker than I

> > am, nor

> > intend to end up in the ER with worst. Is there anything I can do

> > to get

> > myself back together?

> > I did lose quite a lot of blood which I am sure could be the cause

> > of low K

> > and high bp so I am taking so much foods with K to accommodate.

> > Is there anything I can do to get better?

> >

> > Thank you,

> >

> > Farah

> >

> > By the way, I also learned that they dont have liquid form

> > aldactone unless

> > its something that they have to order in advance. so if anyone else

> > if going

> > to have surgery, need to check on this to make sure you are

> > injected with

> > the right meds since you can't take pills during surgeries such as

> > mine.

> >

> >

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The Apresoline headaches usually go away within 6 hours. Just

remember that your BP will likely be a problem around other surgeries

and if it gets too high it is important to lower it. However pain

itself can increase BP itself and it is always a worry is it

necessary to lower BP due to pain.

I dont recall if some machines dont work on you but this is another

concern when in the hospital.

Would recommend they take it by hand after you are out of surgery and

recovery and if it is high by machine they document that the machine

is getting a good BP.

May your pressure be low!



CE Grim BS, MS, MD

High Blood Pressure Consulting

Senior Consultant to Shared Care Research and Education Consulting

Inc.(sharedcareinc.com)

Clinical Professor of Internal Medicine Medical and Cardiology

Medical College of Wisconsin

Board certified in Internal Med, Geriatrics and Hypertension.

Interests:

1. Difficult to control high blood pressure.

2. The effect of recent evolutionary forces on high blood pressure

in human populations.

3. Improving blood pressure measurement in the office and out.

On Jan 9, 2009, at 11:54 PM, Farah Rahbar wrote:

> Oh, that explains my splitting headaches. I've been having so much

> headache

> and dizziness I can't even begin to tell you.

> They gave me Tylenol with Codeine and Z-pack for antibiotics to

> take at

> home. I've been so out of it, basically very drowsy and in a lot of

> headaches. and my mouth is blistered and hurst too probably from the

> breating tube.

>

> I decided to stop taking any pain meds regardless and drink lots of

> liquids

> to get the meds out of my body. Today is the first day I am staying

> awake.

> My weight went up about a pound or two. I am dashing like my life

> depends on

> it, I can't eat anything anyway except for fruit shakes my husband

> makes

> with bananas, orange juice and ice cubes.

> Yes, definitely a lesson learned to inform you before any

> surgeries. By the

> way I did give the anesth. your name to contact in case and my

> husband had

> your contact info in case of emergency. Of course they didn't call

> him in

> the waiting room for 6 hours after which he asked what happended to

> me, they

> let him come see me and by then I was almost ready to go home when

> nurses

> explained to him what had happened and deciding if they should send

> me to

> the hospital for observation which thankfully didn't happend.

> Most likely it would've been worse.

>

> Thank you so much Dr. Grim. I'll just keep on taking the aldactone

> and dash.

> Will keep you updated. Never again.

>

> Farah

>

> On Sat, Jan 10, 2009 at 1:26 AM, Clarence Grim <lowerbp2@...>

> wrote:

>

> > With this sort of surgery they used to give SQ epinephrine to

> > minimize bleeding as it makes small blood vessels constrict which if

> > enough gets into the systems will increase BP. They likely gave you

> > a lot of salt solution as well, esp if you lost a lot of blood.

> > Saline is called white blood by us old folks. Your BP is SS and this

> > prob contributed to it.. Did you gain any weight?

> >

> > They probably gave you hydralazine post op which is OK but speeds

> > heart up and causes headaches but with your surgery you would not

> > have noticed that. They prob gave you some labetolol after as well.

> > Which in my experience is not very good in these circumstances. But

> > classically throbbing headaches (hydralazine) which we give BB to

> > counter act and slow heart rate down. I have written a chapter for

> > an Cards book on acute management of HTN before, during and after

> > heart and other surgery.

> >

> > My thought is that as you come back into sodium balance your BP will

> > even out again. What did they give you for pain? Go back to DASHing

> > to the max for awhile if you are not already.

> >

> > You will likely be very sensitive to nose sprays that contain

> > vasoconstrictors. What did they give you for this?

> >

> > Might have been a good idea to talk to us before surgery to help

> > guide them. But then again they seemed to know it all.

> >

> > Keep us posted.

> >

> > May your pressure be low!

> >

> > 

> >

> > CE Grim BS, MS, MD

> >

> > High Blood Pressure Consulting

> >

> > Senior Consultant to Shared Care Research and Education Consulting

> > Inc.(sharedcareinc.com)

> >

> > Clinical Professor of Internal Medicine Medical and Cardiology

> > Medical College of Wisconsin

> >

> > Board certified in Internal Med, Geriatrics and Hypertension.

> >

> > Interests:

> > 1. Difficult to control high blood pressure.

> > 2. The effect of recent evolutionary forces on high blood pressure

> > in human populations.

> > 3. Improving blood pressure measurement in the office and out.

> >

> >

> > On Jan 9, 2009, at 10:45 PM, Farah Rahbar wrote:

> >

> > > Dear Dr. Grim and all:

> > > Wishing you all a happy new year.

> > > I had sinus surgery(a concha ballosa, bilateral submucus

> resection,

> > > inferior

> > > turbinates, endoscopic sinus surgery, nasal septoplasty)

> > > All this because one of my eye lids is not draining and one

> attempt at

> > > putting a tube in, didn't work after 6 weeks. My Opht. wanted

> to do

> > > another

> > > surgery and in the meantime, I decided to consult with a ENT to

> see

> > > if there

> > > were any other thing wrong. Long story short, after a cat scan

> > > (which the

> > > Opht. never did), the ENT told me that I needed the above surgery

> > > or else

> > > any other procedure will only end up in a lot of bleeding and no

> > > success.

> > > So I did the surgery last Monday(4 days ago). This was done in an

> > > outpatient

> > > surgery center with general anestesia.

> > >

> > > I spoke the night before the sugery with the anesthesiologist and

> > > told him

> > > of my condition meaning PA - (which I feel he took me lightly) I

> > > had told

> > > him no matter what, not to give me labetalol, and norvasc as I

> have

> > > had

> > > disasterous outcomes. He told me that he was sure my bp will

> remain

> > > on the

> > > low side as is the case with all his surgeries.

> > > My bp morning of surgery was 115/60 before surgery. My K was also

> > > normal in

> > > the morning.

> > >

> > > After surgery, my recovery took about 5 hours(instead of 1 that I

> > > was told)

> > > because my bp went up . When I woke up he told me my bp had gone

> > > up . He had

> > > given me something for the bp(dont know what, I think he said

> > > something like

> > > hydrazine, it wasn't hctz) but it caused me to have palpitaitons

> > > and my bp

> > > went up even higher to 190/120, hr to 129 then he gave me (he said

> > > they

> > > worked like labetalol). then he injected me with metoprolol which

> > > helped a

> > > little to lower my hr.

> > >

> > > I was dischaged with a hr of 105-110 and bp of 120/90.

> > >

> > > Since then, my bp has been up to 180/120 and is up and down

> > > I am back on the spiro which I am now taking 100mg(I was on 50mgs

> > > before

> > > surgery) and all symptoms of shaking sweating and feeling sick is

> > > back.

> > > Well, that along with not being able to breath well because of the

> > > stitches

> > > in my nose is making me feel quite sick. I am to see the ENT on

> Mon

> > > afternoon to remove the stiches. Considering all of the team of

> > > doctors who

> > > work with me are all idiots who have no idea what aldosteronism

> is,

> > > I dont

> > > want to call any of them for advise and get myself sicker than I

> > > am, nor

> > > intend to end up in the ER with worst. Is there anything I can do

> > > to get

> > > myself back together?

> > > I did lose quite a lot of blood which I am sure could be the cause

> > > of low K

> > > and high bp so I am taking so much foods with K to accommodate.

> > > Is there anything I can do to get better?

> > >

> > > Thank you,

> > >

> > > Farah

> > >

> > > By the way, I also learned that they dont have liquid form

> > > aldactone unless

> > > its something that they have to order in advance. so if anyone

> else

> > > if going

> > > to have surgery, need to check on this to make sure you are

> > > injected with

> > > the right meds since you can't take pills during surgeries such as

> > > mine.

> > >

> > >

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