Overzealous doctor

Posted , 6 users are following.

Having problems with a doctor who desperately wants to prove I have high BP and medicate me!

Never had issues until 2 months ago when a routine checkup gave a reading of 165/94. I have bad anxiety with a real issue around medical stuff. Nurse recommended I get my own monitor which I did, tested for a month then brought the readings in to the doctor. Home results were mostly on the high end of normal. She took it again at her office, refusing to use the necessary large cuff, and giving a reading around 155/85. She told me I would need to go on medication for white coat hypertension...!

Since then I've had tests all coming up normal (kidneys, cholesterol, ecg). They insisted on doing the ECG directly before a blood test - knowing I am extremely scared of needles. My heart rate was around 103 and the nurse & doctor told me I had "severe tachycardia" (what?!) even though it started to come down after a bit. They repeated the ECG 3 more times and eventually got it down to 87. I tried to tell them that my normal resting is ~65 and they basically laughed in my face. They started talking about medication for my heart rate as well as bp.

I had a 24hr BP monitor 2 weeks ago which was awful. As soon as the nurse put it on, it inflated and was so painful I was nearly sick. She told me it's because my arm is big that it has to inflate more, which I understand. For the next 12 hours it was mostly just uncomfy and a bit painful. Every single reading when I was resting was around 125/75, with a few of 130s/80s while walking, cleaning etc. In the night, it woke me up every hour and adrenaline went through my body spiking my heart rate up to 80 or 90, giving "night time" readings of 130-140/80s! By this time every inflation was sickening,crushing agony so I gave up at 3am and took it off!

I'm seeing my doctor tomorrow to discuss but I just found out she went behind my back and referred me to a cardiologist without telling me... I'm already in trouble with work for taking time off for hospital appointments etc and I honestly don't think I have an issue. Why won't she trust me, and why is she continuing to try and test me for things after my normal 24hr results?!

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  • Posted

    Well, you don't actually have to take the stuff your doctor prescribes, you know. Nearly 20 years ago, when my BP reached 150/90, my doctor prescribed a calcium channel blocker. I said nothing, but didn't get the prescription filled and put myself on magnesium instead. Six months later, when my BP was down to 120/80 I told her what I'd done. She was furious, said magnesium was very dangerous (which it isn't, but CCBs can be) but gave in gracefully. For the past couple of years I've been having a different problem. My systolic BP has risen very slightly, but the diastolic has fallen drastically, which is a sign of hardening of the arteries. But I'm still in no hurry to go on medication.

    I realise that if you live in the UK you might not have the luxury of simply telling your doctor you don't want to take medication, as she could bump you off her list and you might have a problem finding another doctor. But why not pretend to accept it for the time being, then have a go at reducing your BP by lifestyle changes? Could you do with losing a bit of weight? Losing around 7lb probably helped get my BP down, as well as the magnesium. Could you cut down your salt intake? That can make a massive difference, especially if you're eating a lot of salt. Do you need to exercise more? This would also bring your pulse rate down a bit. Do you smoke? And magnesium works for a lot of people, though it can cause diarrhoea for some.

    Sorry to ask what probably sounds like a stupid (or rude) question, but why do you feel you have to follow your doctor's orders if you're convinced she's mistaken? Doctors aren't gods. They often make mistakes. Also, some are more inclined to jump straight to medication than others. If you're happy that your BP and pulse are normally within acceptable limits, why bother about what your doctor says? By all means go and see the cardiologist if it will keep the peace - and if you are in the UK it won't cost you anything - but don't get too worried about the results. In any case, the cardiologist might disagree with your doctor and say there's nothing wrong!

    Once again, sorry if this all seems a bit simplistic, but I'm a former nurse and my experience with doctors has taught me to plough my own furrow to some extent.

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  • Posted

    You should have taken the cuff of and asked for it to be redone with a bigger sized one. I omce had one that was so tight that it left me with a 'Chinese Burn' tht took days to fade.

    A medication for white coat hypertension was it a tranquiliser?

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  • Posted

    Have you asked why you have been referred to a cardiologist?
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  • Posted

    I had similar problems with my GP.

    My medication came with a warning that it could cause Congestive Heart Failure (CHF).

    I saw a medical paper published by a doctor in the USA showing that high-resolution pulse oximetry could predict the early stages of CHF onset.

    I bought a recording pulse oximeter capable of recording pulse and blood O2 saturation overnight. Following data transfer to computer, a printout after a particulary bad night showed a sudden tachycardic pulse rate together with an alarm state on blood sats. The printout mirrored the waveforms in the medical paper.

    I showed it to my GP the next day. I've never seen a doctor in such a panic.

    I knew I had to terminate medication but he had to disagree - withdrawal sysmptoms can be worse than taking a drug in the first place.

     

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    • Posted

      Hi Bob,

      I'm just getting to grips with my situation of a hospital stay of two months, two years ago, of which I'm still an outpatient. I was kind of hoping that at some stage someone would sit me down and go into the details, but it never really happened.

      A couple of the medications I take seem to be related to people with CHF. Could you tell me what paper it was you read, what medications can cause heart failure and any other details of the pulse oximeter.

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    • Posted

      The paper I read was Patient Saf Surg. 2011; 5: 3.

      Patterns of unexpected in-hospital deaths: a root cause analysis by Lawrence A Lynn and J Paul Curry.

      I emailed Dr Paul Curry in 2014 and explained how had I had used a Crucial Medical Systems Pulse Oximeter CMS50E to produce nocturnal high resolution recordings during treatment for blood pressure.

      The printouts, showing blood oxygen saturation (SpO2) and pulse rates together with statistics as my drug regime changed, persuaded me that what I was experiencing was not just in my imagination - it was real and measurable with an accuracy of +-2% yet was completely non-invasive with measurements being made whilst I was asleep.

      Dr Curry replied that this was an exciting finding after I undertook to publish a case history at some stage.

      However whilst my career involved work as a professional in computer modelling of stress responses in volunteers undertaking complex tasks I am not a medical professional.

      I  sought to test my experiences anonymously through the disqus discussion forum where the use of pulse oximeters were perceived as more of a fashion statement than a serious tool suitable for making critical decisions about medication.

      I'll dig out some charts derived from my pulse oximeter reports showing how a SpO2 Desaturation Chart illustrates the dangers of drugs inducing arousal failure - a precursor to Congestive Heart Failure as set out in Dr Curry's paper.

      Regards

      Bob

       

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