Quick update on my health (especially blood pressure).
The image below shows my blood pressure from since I left the hospital up to yesterday evening (http://kruel.co/files/bp20131223-20140110.csv).
As you can see, it has been fine during the past few days and then went pretty high again yesterday evening. I took 10mg Diazepam, but that did not help. So I went to the hospital again. After an hour it went down to 140 SYS 80 DIA. The doctor said I could stay but that it would be fine if I go home. He also told me that I should stop thinking about it too much and do not panic (yeah right, easy!).
The first appointment with the internist is on Monday (who will also make and appointment with the radiologist to check the thyroid). So far I am taking 5 mg Amlodipin (http://en.wikipedia.org/wiki/Amlodipine) every morning.
I suspect that the cause of the rise yesterday could have been that I became increasingly worried after it had already been somewhat higher than in the past few days when I measured at midday. But how could I not be worried about it? Would it really be rational not to measure at all in order to avoid panic attacks? What if the cause isn't the worry and panic itself?
Anyway, I also visited the psychiatrist this week and the medications he suggested have a huge number of crazy side effects. So I am not sure if it is worth it to take them (how can I tell?). The suggested medications are Clomipramin 75 (http://en.wikipedia.org/wiki/Clomipramine) and Lyrica 100 mg (http://en.wikipedia.org/wiki/Pregabalin). He also told me that I should visit some sort of clinic (http://www.alexianer-muenster.de/alexianer_muenster/unsere_angebote/hilfen_bei_psychischen_erkrankungen/kliniken/maria_brunn_fachklinik_fuer_psychiatrie_und_psychotherapie/). All of which did not help at reducing the general stress this week.
Previous post: https://plus.google.com/u/0/+AlexanderKruel/posts/YuBvhhZq4co
The image below shows my blood pressure from since I left the hospital up to yesterday evening (http://kruel.co/files/bp20131223-20140110.csv).
As you can see, it has been fine during the past few days and then went pretty high again yesterday evening. I took 10mg Diazepam, but that did not help. So I went to the hospital again. After an hour it went down to 140 SYS 80 DIA. The doctor said I could stay but that it would be fine if I go home. He also told me that I should stop thinking about it too much and do not panic (yeah right, easy!).
The first appointment with the internist is on Monday (who will also make and appointment with the radiologist to check the thyroid). So far I am taking 5 mg Amlodipin (http://en.wikipedia.org/wiki/Amlodipine) every morning.
I suspect that the cause of the rise yesterday could have been that I became increasingly worried after it had already been somewhat higher than in the past few days when I measured at midday. But how could I not be worried about it? Would it really be rational not to measure at all in order to avoid panic attacks? What if the cause isn't the worry and panic itself?
Anyway, I also visited the psychiatrist this week and the medications he suggested have a huge number of crazy side effects. So I am not sure if it is worth it to take them (how can I tell?). The suggested medications are Clomipramin 75 (http://en.wikipedia.org/wiki/Clomipramine) and Lyrica 100 mg (http://en.wikipedia.org/wiki/Pregabalin). He also told me that I should visit some sort of clinic (http://www.alexianer-muenster.de/alexianer_muenster/unsere_angebote/hilfen_bei_psychischen_erkrankungen/kliniken/maria_brunn_fachklinik_fuer_psychiatrie_und_psychotherapie/). All of which did not help at reducing the general stress this week.
Previous post: https://plus.google.com/u/0/+AlexanderKruel/posts/YuBvhhZq4co
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I suspect rationality is over rated (just as consciousness is over emphasised) - our neural networks usually make pretty good decisions without our symbolic logic skills or language skills being involved. I say this as a logical person and as a former maths whizz. I highly recommend Sue Blackmore's Zen and the Art of Consciousness - she is a very rational person but not a rationalist. See her website http://www.susanblackmore.co.ukJan 11, 2014
A lot of your blood pressure appears to be related to stress/anxiety.. You say you have elevated blood pressures at times, but a lot of your recounted events appear to be in the hospital. Home measurements are considered the "gold standard" because you are much more relaxed, and this is generally the blood pressure you are around [assuming you aren't hanging out in the hospital 24/7]. If you are measuring at home, usually you want to aim for a SBP <135/85. The <140/90 recommendation is for people at clinic/hospital. The time of day that you are checking will also affect your blood pressure, so it's good you are keeping a log, but the time is also important (Maybe you knew this already). Either way, keep a good log at home and continue taking the amlodipine. Once your stress decreases, perhaps you can be taken off of the amlodipine [also, if you don't want to be on as many drugs, exercise [good for hormonal balance as well] and decreasing your salt in your diet will help if you are not doing this already]
Drugs to control anxiety are a complicated thing. Of course, if you don't feel comfortable with the medication, then you shouldn't take it, but this should be a conversation with your psychiatrist, who is the one working with you and doing a full work up. If you can see a therapist and control your symptoms without needing medications, that may be best (and that could be why your psychiatrist mentioned this... also, some people do best when they have both therapy and medication).
I would try not to get too caught up with the side effects of medication. It is true that some people end up getting them, but you can work with your healthcare provider in that case to try another medication. Clomipramine is an older medication that we don't often use anymore in the US, though, because of its side effects. Not that it's bad.. but there are other agents that have shown benefit with less. Pregabalin (Lyrica) is a newer medication compared to some other antidepressants in the States, so it's usually used a little later (since it's more expensive)... We usually use SSRIs, or selective serotonin reuptake inhibitors.. it takes a while to set in, so if you were interested in using this medication, you might need to take some of your diazepam in the meantime (careful not to get addicted..)
In any case... your blood pressure, while it's elevated, isn't something we need to be super worried about... I had a patient yesterday come in with a blood pressure of 188/86.. of course it shot up to 196/92 after I told him his blood pressure was elevated... Overtreating is just as bad as undertreating, and it appeared to be due to him missing his medication at morning, so I told him to take his medications and recheck at home, then give us a call if it was still high... So keep those things in mind :) .. It's good you are being attentive about your medications, but you aren't going to die (unless your blood pressure is >190/100 or something.. I see some of your readings are nearing that point, but was this at home?)... Just keep monitoring as you have been. You are on amlodipine, so it will help, and you have space to go up to 10 mg if you needed to [of course, let your doctor know if you decide to this].. Amlodipine also takes a little longer to balance out in your system, so give it about a week to set in.
Perhaps the more pertinent issue at this time is your anxiety, which may just be worsening due to your concern over your blood pressure.. so stay strong and good luck :)Jan 11, 2014
+Emily Lin Thanks. Regarding the side effects, according to a German review site (http://www.sanego.de/Medikamente/Lyrica/), only 14% of 631 people report no side effects.
Some of the bad side effects are pretty high, e.g. vision disorders is at 9%, difficulties in concentrating 7%, speech disorder 5%. And if you are risk averse like me, and look at some of the reviews where people report worse side effects (there are 264 listed side effects: http://www.sanego.de/Medikamente/Lyrica/Nebenwirkungen/), then it seems like a drug I wouldn't take without 24h monitoring or the alternative of not taking it being much worse.
How in the beginning the anxiety can actually increase is also no small caveat here. That people report feeling drunk and not able to form coherent thoughts does not speak in favor of it either.
Like you my psychiatrist also said "not to get too caught up with the side effects of medication". Right...I am sorry, but this seems a very strange advice. If I'd get something like double vision due to Lyrica I'd probably freak out like never before. And I already have huge concentration problems.Jan 11, 2014- On page two of the package insert of Lyrica you can already read that Lyrica can cause a loss of vision. LOSS OF VISION????? When I read that I was like WTF, are you kidding me?!
Lyrica seems like a good way to test how you'd feel after you got a stroke.Jan 11, 2014 - Clomipramin is even better. At 7% without side effects and stuff like high blood pressure at 4%, never mind weight gain at 39%.Jan 11, 2014
Alexander, have you not considered non-drug therapies? Resperate, which works by slowing down breathing is FDA-approved (resperate.com). Meditation and Tai-chi are quite effective, too.Jan 12, 2014
