- Update from PCP appt. 7/29

[Guest guest]

Ment with my PCP yesterday and feel I should update everyone. I first saw the

assistant and was disappointed since I had only lost 5lbs. since the previous

Fri. (I had expectations of going under 300!) BP was 134/76 (Systolic has been

running 10-15 higher in the office but still below my target of 130/80 at home,

actually last week's average was 123/71!)

Dr. Webster, my PCP, took a moment to look at those numbers and turned her chair

to squarely face me, nothing between us, and said, " Okay, what's going on? Why

don't you start and also tell me what you,ve learned since I last saw you! "

I showed her my 1 & 6 month graphs for BP & BS from MyhealthEvet and she kept

switching between them and shaking her head! After a short pause for effect I

said, " Remember I told you I was going to start DASHing when my mouth healed? I

started Psydo-dashing a week ago! " (I explained that was my term because I

hadn't received 's book so it was my version.) Her only comment,

" Unbelieveable! "

I then suggested that if she thought that was unbelievable what was she going to

say when I told her my COPD was better also. She literally sat there in

disbelief as I showed her my Oximeter (slightly larger than 2 AAA batteries). I

told her I had verified it with the one her Tech. used and it was accurate. (I

paid $43 on line when the VA told me they didn't supply them because they were

too expensive!) Told her about walking to the mailbox and O2 had dropped to 90

and rebounded to 95 immediately when I got back and sat down.

I then explained Dr. G.'s theory that LVH started to correct in as little as 12

weeks (count back to Apr.23) and as the pump got stronger more blood would flow

to the lungs, hence picking up more O2 and since he is a HTN specialist I

thought he might be onto something!

I then explained that while getting PA and the excess Aldosterone under control

was the underlying cause/effect, I thought there were a couple other factors: I

am now able to get 8+hrs of uninterupted sleep, thereby getting into REM (Rapid

Eye Movement) sleep and that is where I understand a lot of the excess body fat

gets burned. The less weight around my middle allowed less stress on my

diaphragm and thereby making it easier to breath. (She really liked this

because it was her suggestion when COPD was DXed, make sure you give them credit

where credit is due!_

I then shared a couple of articles I had copied: " Fluid homeostasis in cronic

obstructive lung disease " by P.W. deLeeuw & A. Dees published in 2003 by ERS

Journals, Ltd. and a review article, " Common Secondary Causes of Hypertension and

Rational for Treatment " by Faselis, Doumas and Papademetriou published in Jan.

of this year in International Journal of Hypertension.(should be in our files if

it isn't but I don't know how to get it there

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057025/pdf/IJHT2011-236239.pdf

I particularly like this one because it speaks directly to three of the

complications I have/had ie. 5. Obstructive Sleep Apnea, 6. Primary

Aldosteronism and 7. Cronic Kidney Disease! I told her I was lucky to have 16

hrs/day to persue and an excellent online support group, too bad she had to work

for a living!

About the ony other thing we discussed was the proper way to take a BP reading.

I simply told her we would be using mine unless & untill the VA got the procedure

right according to AHA and DoD Standards! (Told her that BP & BS would be taken

every morning prior to am meds.

I no longer report the time since my Neproligist assumed I was " stacking the

deck " by taking it at 10:30 (AFTER am meda) when in reality being retired I can

get up anytime I want and usually it is between 10 and noon!)

Since my appt. time was just about up I asked her what she had on her agenda!

She asked if she could listen to my lungs and I agreed! She announced she

didn't see any reason for me to be on O2 ad long as I checked and to remained

>90. I told her I had a Pulmonary appt. in 2 weeks and thought I'd keep it,

" They need a Lesson also! " - that got a smile!

She then asked if she could setup a recall for 2mos (I think normally she would

have gone from 3mos to 6mos). It was cute the way she said it, something like,

" Can we meet again in 2 months, I want to keep an eye on your progress and

continue to be your biggest cheerleader! " She deserves a 20 min break!

SHE'S A KEEPER! (A term my Dad taught me 44 short years ago after I proposed to

my Wife!)

- 64 yo morb. ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank &

testicle pain. I have decided against an adrenalectomy at this time since

Meds. are working so well. Current BP(last week ave): 123/71

Other Issues/Opportunities: COPD w/ft Oxygen, OSA w Bi-Pap settings 13/19, DM2.

and PTSD

Meds: Duloxetine hcl 80 MG, Mirtazapine 15 MG, Metoprolol Tartrate 200 MG,

81mg asprin, Metformin 2000MG and Spironolactone 75 MG.