seriously freaking out

  1. My body is such a drama queen. Where do I start?

    Okay, so I drag my carcass out of bed at 3pm for a doctor's appointment -- nothing unusual -- just to beg a refill from her (that's what she makes me do, don't get me started). While I'm sitting on the table, she decides to take my BP. 130/96 (!) on the left and 130/110 (!!!) on the right.

    Okay this is unusual. I have never had a BP that high in my life. It was a little on the high end of normal about a hear and a half ago, but balancing my thyroid levels put it back to normal. It's been great since.

    So we talk about my lifestyle. Okay I don't smoke but I am guilty as hell when it comes to the other biggies. Overweight, bizarre dietary habits, sedentary lifestyle big time, stressfull work environment (big time), inability to relax (can't remember when.....), big time family history.

    SHE WANTS TO PUT ME ON ANTIHYPERTENSIVES.

    OMG OMG OMG

    I'm only 26 years old. Is this jumping the gun a little?! After only 2 high readings? I'm having nightmares of myself walking down the street and having my BP fall into my boots. I couldn't talk her out of it? Sorry guys I was so freaked out that I don't remember the name of what she prescribed. Must either be new or unusual, B/c I've never given it and it's not in my old drug guides. Starts with an "A". Dropped off the prescription to be filled, so I don't have it here.

    She sent me to have a 10 lead EKG. She wants me to start on the meds and see her in 10 days. I am so not sure about this!
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  2. 17 Comments

  3. by   sunnygirl272
    i would advise you to start the meds and monitor bp yourself... i mean have coworkers and friends do random checks for you.
    26 is not too young for antihypertensives....unless you'd rather be a 27 yo stroke pt in a nursing home? seriously, the ages for strokes and MIs are dropping...it is scarey....
  4. by   OBNURSEHEATHER
    Slightly similar, I had a high readin at the OB/GYN once after about 15 cups of coffee and half a pack of cigarettes trying to stay awake for my early morning appointment (I was an evening clinical/class girl, not used to mornings)

    Anyhoo, she refused to refill my pills right there. I went home disappointed, but continued to take the ones I had at home. After getting the balls, I called back about a week later and demanded a recheck of my b/p. WNL.

    Now this could be one case scenario. The other could be that your pressure will still be high. If this is the case, are you willing to make the necessary lifestyle changes before attempting medications?

    I hope this is just a fluke for you Adrienne!

    Heather
  5. by   boggle
    Well Adrienurse, I can't second guess your doc, but think you could use some more information. Think of all the information we cover when obtaining signature on an informed consent: what are the risks of treatment vs non- treatment, what are the alternatives....that kind of stuff.

    Since you don't have the script yet anyway, can you live with the risk of waiting one day and call the doc with your questions?

    I got the "surprise" BP last year myself and had to do a lot of soul searching about what I was going to do about it. I didn't want to go on meds either. I reluctantly started to increase my activity a little, and cut back on calories a little. (I'm a slug when it comes to changing habits). But it's amazing what 10 lbs loss will do for your BP. It gave it a nudge downward enough to keep me off meds. I'm still working on it, little by little.

    Hey, why not call your doc and ask about another option to meds? I wish you well with whatever you end up doing.
  6. by   Stargazer
    It wouldn't have been my first choice to start you on meds without trying non-pharmaceutical lifestyle changes first, unless the BP was life-threateningly high. My personal cutoff tended to be higher than 110, but your doc may be more conservative.

    You can always wean off the meds later if you have some success with the lifestyle changes. In an occupational health setting, the factors I always tried to address with people were exercise, salt, caffeine and smoking. I had a pretty high success rate keeping people off meds by working with them on those issues first.

    In my early 20s, I had a pretty high BP at the doc's after slamming an entire pot of coffee that morning, as was my wont, and then rushing like crazy to get to my appt on time. My doc gave me a chance to work on it first before putting me on antihypertensives. I cut my caffeine intake by more than 1/2 and started working out regularly. In 3 mos. my BP was down by 20 pts systolic and 10 diastolic. In amother 3 months it was normal.
  7. by   LasVegasRN
    Hmmm. Agree with everyone else here, however, I was on BP meds at age 26 also. BIG family history of HTN and CAD. I figure taking the med was better than keeling over with a massive MI.

    Take care of yourself, you may not need to stay on them forever, especially with lifestyle changes.
  8. by   Ortho_RN
    I'm 26 and on BP meds also... I take Inderal and it actually works out well, cause I also have migraines which Inderal helps prevent
  9. by   VivaLasViejas
    I developed HTN at age 22 after being on BC pills for a year. For the next 10 years I refused to take meds because it would be WNL at times, then shoot into the stratosphere at the doctor's office. Then I ran around for a couple more years with BPs running in the 200/105 range before finally surrendering to the inevitable. THEN it took still another 10 years to refine my med regimen to where my BP now sits around 140/80 at the doctor's and 130/70 at home. I'll never forget the last time I worked at the hospital and couldn't hear a pt's BP because my own was thudding in my ears; when a co-worker took it, it was 260/130!! Now, was I smart enough to go downstairs to the ER and have myself checked out? NO! I waited till the next day and went to my own doc, because I knew the ER doc would've rushed me up to the ICU in short order, and I had patients to take care of. How stupid is THAT??!! But I was thinking, hey I'm only 40-something, I'm too young to have a stroke or MI.

    Guess what.....somewhere along the line I DID have a silent MI; I have the abnormal EKG to prove it. Now I'm probably living on borrowed time, because I refused to believe my high blood pressure could hurt me when I was so young. But the damage is cumulative, happening over time, and you just never know when it'll bite you in the ass. So take the meds, monitor your BP, and do your best to reduce your risk factors while you're young enough to do so fairly easily and get the most benefits from it. And be thankful your doctor is willing to be aggressive in treating you!!!!!
  10. by   hapeewendy
    I dont know , I'm kinda wondering why she wanted to start the meds right away , I mean I know the information youve shared about your history n whatnot but still..... maybe I'm just ignorant in this area because I'm so darn hypotensive
    (I'm a hyper hypo haha) , either way , I would recommend a second opinion if youre concerned, but it sounds to me like she just wants to get things started immediately and it is nice that she is not minimizing the importance of the situation.
    good luck friend, keep us posted
  11. by   New CCU RN
    I also have blood pressure issues. I started having HTN at the age of 21. At that time I was running over 60 miles a week (ran division one cross country and track), granted I was quite stressed (nursing school, track which took up over 20 hrs a week, and working about 20 hrs a week, family issues...etc)
    I was also taking supplements that were supposed to help with endurance and wgt loss (at the time I thought I needed to loose weight) They contained ephedra and not only gave me high blood pressure but also a heart murmur. One day I was doing my usual stuff when all of a sudden I felt like I was gonna pass out. Major like weird hot flash, got all sweaty etc. (Id also been on BC pills for about 6 months...great combo there) Anyway, being the intelligent nursing student, I drove myself to the ER. BP 200/110. Rechecked a few times...didnt get much lower... did an EKG...normal... thank goodness.... gave some meds to bring it down and d/c'd me. Anyhow, starting going to a HTN doc, got put on Norvasc....did a whole workup to determine any secondary causes......do be sure your doc looks into this... it could be pheochromocytoma (tumors on your adrenals), a stenosis of the renal artery, and a few other secondary causes.
    The 12-Lead although scary is definitely a good idea. The doc also had me go for a chest xray and an echo.

    I just wanted to let you know that you aren't alone. Try making those adjustments as well and ya never know...it may come down!!!! But don't deny it! You will only make things worse and taking a pill once a day really isnt all that big of a deal!
  12. by   RNforLongTime
    Well, one year when I went to the Gyno, my Bp was 150/100! I chalk it up to the fact that I was nervous about something that I needed to tell him. So, OB/GYN is obviuosly concerned and rechecks bp after exam, it's still 145/100. He recommended that I check it at work and then let him know what the results are. They were fine 120's over 70-80's. I usually go to the doctor at least once a year for check-ups anyway. When I was in the ER after my car accident, my BP was actually low! Like 90 over 62 or something like that.

    I too am overweight, sedentary lifestyle, etc. Family hx of HTN, CAD and the like.

    I would take the BP pills for now but would seriously consider making some lifestyle changes. HTN isn't something to take lightly. Maybe if you dropped some pounds and exercised, she'd consider stopping the meds. I know, easier said than done. Good luck adrien!
  13. by   NICU_Nurse
    I agree with the 10-lead; this can't hurt. I am a little confused, despite the family history you listed, as to why she would be so eager to recommend medication. Has she approached you before with suggestions to change your lifestyle/diet/etc.? Is this her last ditch attempt, or is it the first time this was discussed (I know you said your BP was never that high...?)? You mentioned balancing your thyroid...are you on meds that could affect your BP to this degree? Any recent events or even built-up stress that could be eliminated or alleviated? Diet changes (ie, lower fat, higher fiber, lower salt, etc.) that could be made? Increase in aerobic activity (ie, walking or low-impact activities incorporated into your life)?

    I realize you have a family history, but at your age I can only see few circumstances that would warrant an immediate prescription (if you were severely obese and demonstrated arrythmias, etc.). I see a NUMBER of factors that could be manipulated, though, in an attempt to reduce that BP. I am also skeptical about taking one set of vitals (okay, so it was both arms, but they were what...two minutes apart?) and using that as basically your sole indicator for medication (you said that your BP has never been high like this before). I do not believe in medication for medication's sake- that's just me. I don't see the point in taking medication to control BP, in this case, instead of making the effort to change factors that could completely eliminate the high BP's, thus making medication needless. See what I'm saying? Sort of like the 'band-aid' method of practicing medicine. ;>)
  14. by   nursegoodguy
    You drink Coffee don't you... how much did you have before going to the doc? YOu were probably also stressed just being there... Have you rechecked it yourself since you left the doc's? When my Diastolic hits >110 I get a pounding headache and then when it starts to go down I get tired! Recheck your b/p and then decide what to do, oh and think about adjusting your thyroid med a bit too... as you know it can make a huge difference in how you feel!

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