Getting Diagnosed With High Blood Pressure
The Silent Killer
High Blood Pressure Can Be Cunning!
It is thought that there are many people out there living with high blood pressure and they have no idea that this is what is wrong with them. High blood pressure is sometimes referred to as "The Silent Killer" simply because it can mask its symptoms to mimic other conditions, which can potentially make it harder to detect if the patient happens to already have some other illnesses diagnosed.
Thinking back through my own history, high blood pressure was initially mentioned to me back in 2012, but I passed it off as a one off occurrence because it was perfectly plausible that my blood pressure might have been high because I might have been feeling stressed as a result of suffering an asthma attack and being admitted to hospital overnight as I was observed - besides, the person that mentioned it only did so in a manner that made me think that she was thinking aloud and she never mentioned that I might want to see my GP in the near future over it.
According to my GP, that must have been when high blood pressure started for me, since my readings have been high ever since then.
Of course, I wouldn't even be in a position of being aware of this if I hadn't requested a diabetes check because I'm probing another medical condition right now. It was because the results of that test happened to be at the top of my list and the fact that monitoring someone's blood pressure seems to be a good way of looking busy while you read through their notes that I got probed for the possibility.
There's A Battery Of Tests
So far in the process of chasing a diagnosis, I have had my blood pressure checked several times, my kidneys checked and an ECG. I have to go back to the doctor's surgery on Thursday, November 30th 2017 to have a blood pressure monitor fitted for 24 hours to monitor my blood pressure at home in order to rule out a type of high blood pressure that only affects the patient at the doctor's surgery.
I also have another blood test form that I need to get the blood drawn for in order to test something else to do with high blood pressure - so that will be 2 blood tests in as many weeks for me.
Getting an ECG
The first test that I had to have was an ECG to rule out Pulmonary Hypertension. This might or might not be the case for everyone, but it was something that was necessary in my case because I have a family history of Pulmonary Hypertension and I wouldn't have been able to rest without this test being done.
The test of itself isn't painful and it doesn't take long. In fact, the longest part of the test is setting it up.
It can be common to find that the person who carries out the test doesn't have full training to carry out a full analysis of the results that they obtain... however, they do know the "Red flags" and are able to refer you to a doctor right away if they see anything that gives them cause for concern.
For this test, you will be required to strip from the waist up for the test... and, no, ladies, you can't keep your bra on regardless of if it is wired or not since one of the pads that will be applied to you will be placed under your left breast.
You can expect the person who carries out the test to ask you a few questions for identification purposes and they may enter some of those into the machine that they will connect you to.
After this, you will have some sticky pads applied to your body. I had around 6 applied to my chest, one on my right wrist and one went on my right ankle. The one that will go on your ankle depends on which way your feet flay out as you relax - relaxing is key for this test. Ladies, you might not want to wear tights or stockings on the day of the test for this reason.
Once this is done, a bunch of wires will be rigged up to the pads that are now on your skin and you will be told to quietly relax before the machine is turned on. Around five minutes later, you will be informed that the test is over and the wires will be removed from the pads on your skin. After this is done, you can remove the pads and stick them to a piece of packaging that the operator will give to you for disposal. In my case, the operator also helped me with the removal process, too.
Once the pads are off, you will be told if there's anything that is cause for immediate concern or not. If not, you may be told to make an appointment with your referring doctor in the next few days to obtain your results.
I am currently at this stage in the process on this point.
Ambulatory Blood Pressure Monitoring
Ambulatory Blood Pressure Monitoring is a test that is carried out as you go about your daily activities as normal. It was carried out over a 24 hour time period in my case and began with a visit to my doctor's surgery.
My blood pressure monitor was fitted in a short appointment at my doctor's surgery on November 30th 2017 at 5pm, where I was instructed on which button I needed to press before I went to sleep that night and when I woke up the following morning and I was told how to turn the monitor off at 5pm on December 1st 2017.
The nurse took my initial reading as I sat in her room to ensure that the monitor was working as intended. The reading was 143/90... which, while not ideal, is a little on the low side in comparison to some of the results that I've been giving them in my appointments.
After having worn the monitor for 2 hours, I have learned that you might have to tighten the cuff every hour or two (just keep an eye on the clock so that you don't attempt to tighten it as it is taking your blood pressure) and, it doesn't show the readings it is taking on screen in real time... you have to wait until you see your doctor to get your results.
Initially, wearing the monitor might be a little scary as it tends to tighten with little warning. I know that I randomly screamed when it happened the first hour after I arrived home. In the second hour, I picked up on a subtle tip that my monitor seems to use to tell me that it's going to operate in the seconds immediately leading up to the cuff inflating. If I relax in the same way as I do when I am working, I can feel the cuff take in a slight puff of air before it pauses for a second. That is my cue to extend my arm because it's going to inflate.
I'm currently working on this stage in the process.
Author's personal experience edit:- It's 5am on December 1st 2017, and my monitor didn't activate this hour, I felt the initial puff of air going into the cuff that demonstrates that it's about to inflate, then it flashed an error code. I have no idea at this stage if it will activate at 6am or not at this stage in time. I'm also left wondering if I might have to wear the monitor for another 24 hours or not. There's nothing that I can do about it for the next three hours though, since my doctor's surgery doesn't open until 8am.
I pressed the day/night button on my monitor and my cuff inflated as I expected it to do at 6am... though I no longer know if the machine thinks that I am sleeping or not.
For the final 12 hours of my Ambulatory Blood Pressure Monitoring, I found that the monitor wasn't as accurate in it's time keeping as I was informed that it would be. Some hours, it wouldn't activate at all - while other hours, it activated several times in a row. Unfortunately, I'm not sure yet if this was normal and to be expected or a result of a malfunction. I will ask about this when I get my results and update at a later time.
My Thoughts On The Ambulatory Blood Pressure Monitoring
As far as medical tests go, I didn't mind it a whole lot - though it wasn't the most convenient of tests to go through.
I soon became a little time obsessed as I kept feeling the cuff slipping down my arm and knew that it would come off imminently if I didn't tighten it again.
The idea of this test is that you carry on life as you usually would during it, however, it is worth noting that if your monitor records high readings, you might be asked what you were doing at the time - so you might want to give intercourse and masturbation a miss if you aren't comfortable with sharing this information. Similarly, if you are likely to forget what you did on the day, you might want to take notes to remind yourself with.
During my time wearing the blood pressure monitor, I had to attend my local job center for a review of my commitments and I also did some shopping, too - so being active whilst wearing the blood pressure monitor isn't an issue... though you might find that you'll have to regularly re tighten the cuff on your arm - I found that to be annoying when I was busy, since I ended up adjusting myself in public on at least one occasion when there was nowhere more discrete for me to duck into and do it privately.
Personally speaking, I have decided that I wouldn't like to have to go through this test again because of the fact that what to expect wasn't explained clearly enough to me for my liking. I don't much care for surprises when it comes to my medical treatment.
I don't have much progress to report at the moment. My Sick note expires today, so I rang the surgery to renew that and I also made an appointment to pick up the results of my ambulatory blood test.
I had some minor issues with the Sick note, since the receptionist that I spoke to seemed to think that two weeks would be ample time to go through all the tests that the doctor seems to be keen on subjecting me to - and over Christmas, too! That would have been an amazing feat that I would love to see! I told her to make it out for another month since my appointment for the results isn't until the 19th December 2017 and two weeks wouldn't have factored in if she wants me to take any more tests or not.
I also still need to get the blood drawn to fill the blood test requests that she sent me with - though I should have heaps of time to get that done and have the results back in time for my appointment if I go one morning next week.
Getting The Results Of The Ambulatory Blood Pressure Test
This is the appointment where you might start to feel like some sort of progress is being made in your journey to diagnosis... though you most likely still won't be fully diagnosed just yet.
At this appointment, you will be informed as to if you have Hypertension (High blood pressure) or White Coat Hypertension (High blood pressure whilst in the doctor's surgery). In my case, I was told that I have hypertension. I also happen to be in a situation where I might have other conditions that hypertension is a symptom of.
I was referred to the cardiology department at my local hospital to see a specialist and I was also told to make an appointment to see my optician because high blood pressure can affect the back of your eyes. The doctor also prescribed me with some ACE inhibitors to begin the process of treating my high blood pressure. I was unusually confused and light headed as I went to the surgery, so the doctor also assessed me to see if I might be having a stroke - which I wasn't.
I was given yet another blood form to get filled in relation to the other condition that I'm not going to name just yet - so that makes 3 blood forms that I now have to get filled at my earliest convenience... all of which are for different items indicative of the potential syndrome that I might have.
After Two Days Of Ramipril
Having been on Ramipril for just two days so far, I did note some dizziness after the first dose and an increase in urine output. The dizziness was rough because it took me almost 12 hours to reach a point where I felt sort of human again. The good news is that both symptoms do settle down in time.
After the second dose, I went Christmas shopping around 4 supermarkets. I found that I was able to walk longer distances before I had issues with the numbness in my legs and feeling like I was going to fall, though I still had some minor issues with the dizziness. It is possible that I might get more improvement in my condition as my new medication works it's way into my system more.
After Two Weeks Of Ramipiril
At around the same time as I was prescribed Ramipiril, I found that my doctor was suddenly reluctant to continue to provide me with "Well Notes" as we continue to work down the path of getting me medicated.
I feel that whatever benefits I obtained from taking the Ramipiril were only short lived. I attended evening Mass on Christmas Eve... and, boy, was church packed! I eventually managed to find a seat right at the front.
Ultimately, I found out that I was still unable to fully participate in Mass without suffering symptoms related to my blood pressure, so I had to revert to worshipping in whichever way I could.
Referral to The Cardiology Department
If you have high blood pressure, you can expect to be referred to a cardiology department - and that experience was something in and of itself.
Be prepared to have your height, weight and blood pressure checked to start your first appointment off.
From there, you can expect a nurse to give you another ECG. Then you will go and see a consultant, who will ask you a lot of questions about the symptoms that you are experiencing. Just answer them as truthfully as you can. I struggled a little with that because a lot of the symptoms that he asked me about were very similar to what I experience with asthma, so I had to state that point quite a few times before he reached the end of questioning me.
In the end, I was referred for a heart scan and had my dosage of medication doubled from what I had been taking. You can also expect to be called back into the cardiology department a few months later so that they can monitor your condition.