(Off Subject) Incorrect Taking of BP at Local VA!

[Guest guest]

Thought I would share the e-mail I just sent to the other doctor on my

healthcare team (My PCP was not available). I had explained that my PCP used

only my home BP readings because nobody at the VA could do it right! She asked

me to watch and let her know how she did! Here is the message:

" BTW Dr. Cochran, you failed the " Proper BP Taking Critique " ! I call your

attention to the " VA/DoD Clinical Practice Guideline For The Management of

Hypertension in Primary Care " manual, page 10. Source:

http://www.healthquality.va.gov/hypertension/htn04_pdf1.pdf

(This is the same procedure that is described in the Hypertension Primer fourth

edition chapter C103. As a point of interest, this chapter was written by Dr.

Clarence Grim and his wife Carelene who is the doctor who has the PA online

support group that I subscribe to. He actually understudied with Dr. Conn back

in the `60s)

Major points: I have never had my BP taken in the supine position so I don't

know how that affects the results. I was not sitting quietly for 5 mins. W/feet

flat on floor. You didn't ask if I had smoked or ingested caffeine w/i the

last 30 mins (you know I don`t exersize!) And you did not take 2 readings and

average them. (This is how I take my bp every morning before I take any meds or

eat or drink.) I then record it in Myhealthevet and share it along with BS

taken at the same time w/Dr. Webster at each appt. I apologize for not bringing

it today but I had been in the woods for over a week with no way to update it

and thought we were just checking my breast bump. (I should have known you were

too thorough to let me get away with that!)

For a good poster on proper technique go down your hallway past the nurses

office and look on the wall in the 4th or 5th office on the right. It would be

great if everybody could see and follow it! "

BTW, I was laying on the exam table, naked from the waist up preparing for my

first exam of my " new " breasts after finding a " pea sized " growth in my right

breast. Who would have thunk my BP might have been slightly elevated! Damn,

they are just over a year old and already damaged!

- 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank

pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60

Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin

2000MG and Spironolactone 50 MG.

[Guest guest]

Frist response to my msg. Georgina (GeGi) is the only person who has checked my

BP correctly and Dr. Grim and I awarded her some dark chocolate.

Mr. ,

Thank you for bring our attention to this I will pass the message on to Dr.

Cochran.

Georgina merrill, LPN

Team 4 Nurse

>

> Thought I would share the e-mail I just sent to the other doctor on my

healthcare team (My PCP was not available). I had explained that my PCP used

only my home BP readings because nobody at the VA could do it right! She asked

me to watch and let her know how she did! Here is the message:

>

> " BTW Dr. Cochran, you failed the " Proper BP Taking Critique " ! I call your

attention to the " VA/DoD Clinical Practice Guideline For The Management of

Hypertension in Primary Care " manual, page 10. Source:

>

> http://www.healthquality.va.gov/hypertension/htn04_pdf1.pdf

>

> (This is the same procedure that is described in the Hypertension Primer

fourth edition chapter C103. As a point of interest, this chapter was written

by Dr. Clarence Grim and his wife Carelene who is the doctor who has the PA

online support group that I subscribe to. He actually understudied with Dr.

Conn back in the `60s)

>

> Major points: I have never had my BP taken in the supine position so I don't

know how that affects the results. I was not sitting quietly for 5 mins. W/feet

flat on floor. You didn't ask if I had smoked or ingested caffeine w/i the

last 30 mins (you know I don`t exersize!) And you did not take 2 readings and

average them. (This is how I take my bp every morning before I take any meds or

eat or drink.) I then record it in Myhealthevet and share it along with BS

taken at the same time w/Dr. Webster at each appt. I apologize for not bringing

it today but I had been in the woods for over a week with no way to update it

and thought we were just checking my breast bump. (I should have known you were

too thorough to let me get away with that!)

>

> For a good poster on proper technique go down your hallway past the nurses

office and look on the wall in the 4th or 5th office on the right. It would be

great if everybody could see and follow it! "

>

> BTW, I was laying on the exam table, naked from the waist up preparing for my

first exam of my " new " breasts after finding a " pea sized " growth in my right

breast. Who would have thunk my BP might have been slightly elevated! Damn,

they are just over a year old and already damaged!

>

> - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt.

flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76

HR 60

> Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD.

> Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin,

Metformin 2000MG and Spironolactone 50 MG.

>

[Guest guest]

Will try to get you the handout we use.CE Grim Md Frist response to my msg. Georgina (GeGi) is the only person who has checked my BP correctly and Dr. Grim and I awarded her some dark chocolate. Mr. , Thank you for bring our attention to this I will pass the message on to Dr. Cochran. Georgina merrill, LPN Team 4 Nurse > > Thought I would share the e-mail I just sent to the other doctor on my healthcare team (My PCP was not available). I had explained that my PCP used only my home BP readings because nobody at the VA could do it right! She asked me to watch and let her know how she did! Here is the message: > > "BTW Dr. Cochran, you failed the "Proper BP Taking Critique"! I call your attention to the "VA/DoD Clinical Practice Guideline For The Management of Hypertension in Primary Care" manual, page 10. Source: > > http://www.healthquality.va.gov/hypertension/htn04_pdf1.pdf > > (This is the same procedure that is described in the Hypertension Primer fourth edition chapter C103. As a point of interest, this chapter was written by Dr. Clarence Grim and his wife Carelene who is the doctor who has the PA online support group that I subscribe to. He actually understudied with Dr. Conn back in the `60s) > > Major points: I have never had my BP taken in the supine position so I don't know how that affects the results. I was not sitting quietly for 5 mins. W/feet flat on floor. You didn't ask if I had smoked or ingested caffeine w/i the last 30 mins (you know I don`t exersize!) And you did not take 2 readings and average them. (This is how I take my bp every morning before I take any meds or eat or drink.) I then record it in Myhealthevet and share it along with BS taken at the same time w/Dr. Webster at each appt. I apologize for not bringing it today but I had been in the woods for over a week with no way to update it and thought we were just checking my breast bump. (I should have known you were too thorough to let me get away with that!) > > For a good poster on proper technique go down your hallway past the nurses office and look on the wall in the 4th or 5th office on the right. It would be great if everybody could see and follow it!" > > BTW, I was laying on the exam table, naked from the waist up preparing for my first exam of my "new" breasts after finding a "pea sized" growth in my right breast. Who would have thunk my BP might have been slightly elevated! Damn, they are just over a year old and already damaged! > > - 65 yo super ob. male - 12mm X 13mm rt. a.adnoma with previous rt. flank pain. Treating with Meds. And DASH. . Current BP(last week ave): 131/76 HR 60 > Other Issues/Opportunities: OSA w Bi-Pap settings 13/19, DM2, and PTSD. > Meds: Duloxetine hcl 80 MG, Metoprolol Tartrate 200 MG, 81mg asprin, Metformin 2000MG and Spironolactone 50 MG. >