Doctors Make the Worst Patients (Part 2)

You can take the girl out of the mania, but you can't take the mania out of the girl.

That doesn't even make sense, I know, but most of December not long after I was diagnosed with hypertension was senseless. When I went for a follow up two weeks later the nurse asked if I forgot to take my medicine. "Are you on Adderall?" she asked. Heck no. This beta blocker is just about the only prescription drug I've taken in my life besides rare antibiotics. "Well take a deep breath. Maybe I can get some better numbers. You know you've gained three pounds." This, a pet peeve of mine. I hate when I tell them I don't want to know my weight due to my OCD tendencies with numbers and they make comments about it. I reminded her we are in the middle of the holiday, everyone gains weight. She smiled, shrugged, repeated the study. Still sky high. So my doctor started me on a second drug, told me to take my pressure once a day to make sure the numbers were going down, and come back in two weeks.

Sure enough the numbers came down, but I was in despair. Two prescription drugs? Hypertension doesn't even run in my family. I bumped into my cardiologist friend in the cafeteria on call New Year's Eve weekend, and shared my story. He told me to get on a low salt diet, specifically the DASH diet. I promised and walked over to get my normal lunch - a cup of soup, which to my alarm had almost as much sodium as a normal person needs in one day. I withdrew from the soup stand in fear and grabbed some fresh veggies from the salad bar.

Now I've been on a lot of diets in my life for various reasons - gluten free to calm down IBD, watching calories, etc., but I learned over the next few days avoiding salt is like avoiding the AIR WE BREATHE. It's in everything. Last year I was so proud of myself for buying unsalted butter but I needed to get a little more serious this time. Soup was out the window. Soy sauce, even the low salt OMG. Salad dressings. All preserved and canned foods. Most things pickled. The yummy salami and pringles and cheese that my impossibly and aggravatingly fit husband brings to the couch to watch TV after a full dinner every night; somehow he can do this whether he's riding his bike or sitting on the couch for two months and gains not an ounce of fat. My body is not so forgiving. It has to go.

I made a quick trip to the supermarket and bought every superfood to lower blood pressure I could find on Google on New Years Eve. Ordered ground flax seed off of Amazon.  Have you ever eaten naked beet chips? If you do, when you go to get that little bit out of your tooth don't worry, as I did, that your mouth is bleeding. And I guarantee one naked beet chip will be enough for the rest of your life. I drastically cut my food intake. I went back to the doctor for my yearly wellness visit a few days later, ugh. I've visited the doctor more in the past month than I have in years. The nurse, again with the weight thing. "You've lost 12 lbs since you were last here." I was startled. I certainly did feel less bloated. I guess I was so salt overloaded I was carrying at dozen lbs. of excess water weight that took only 10 days to shed. In retrospect I did spend much of the first two days in the bathroom. Current in office blood pressure: 100/70. Whew. The doctor was so impressed he advised cutting back the water pill in half.

Well, that didn't work. The numbers crept up. And thanks to the nurse telling me my weight, I was manically stepping on the scale every morning. The cardiologist informed me that some people have a low tipping point, and mine is obviously one of those - losing a few pounds could help a lot. When four days later my weight hadn't changed despite severe food restrictions and my blood pressure was so sky high it scared me into taking the second half of that pill I had an uncharacteristic ugly cry meltdown in the shower, laced with intermittent screams of rage at lack of control. The very same me that read The Untethered Soul two months back and decided my soul had transcended any Earthly need for control. I took a deep breath. I am the same person that looked at myself in the mirror admiringly a month ago without knowing the numbers. No more numbers. And what was that diet the cardiologist recommended again? I googled and found there was a book! On the DASH diet. Whew. I can do anything with a book. I ordered it on Amazon and learned it is ranked #1 Best Diet Overall by US News and World Report. It was developed as a heart healthy diet and turned into a sensation. And better yet there was a new one published advertising eternal youth as well! Well, younger you anyway.

It arrived Sunday and I skimmed it over an hour. Got the gist. To my relief I can actually add food to my  current restricted diet, a lot of it, if I just eat the right things. And it's really easy, except the suggested recipe part that almost gave me a nervous breakdown. And the part where it gives examples that seem to require I quit my job and tie myself to the kitchen to create such a varied diet. Luckily I can largely achieve the basic formula with food at my grocery store and in the hospital cafeteria. Maybe try a recipe every few months if I get a day off. And it encourages daily red wine! Perhaps not as much as I'd like but definitely a plus. I'm just waiting on my food scale from Amazon to learn what four ounces of fruits and veggies are, guestimating in the meantime. Reminding myself that this doesn't have to happen overnight. Hopefully if I keep it up a few months I can get off of the meds. I'm 44 years young, I've got a lot of days left in this meat suit. I've got to keep it going - there's much more to do.

Doctors Make the Worst Patients

     I have always been blessed with great health. When I got my life insurance a few years ago, I got the best rates because my blood work was so good. I have always taken pride in that, kind of like getting straight A's or being number one on a test in medical school (ok, that only happened once, and in pathology, my future profession, but it happened! Out of a class of 150!). So you can imagine my despair last Fall in the midst of wedding preparation when my OB incidentally discovered I had hypertension. I'm not talking minor hypertension: my systolic would swing up in the 2 teens and diastolic would go over 100 easily. I know, because I bought a sphygmomanometer (I love that word) for home and work, and became obsessive.

     My OB recommended a family doctor and he prescribed me with metoprolol. I have been long acquainted with beta blockers - learning from a friend in med school that they are good for anxiety inducing situations such as giving talks in front of large groups of people. I applied this knowledge to many situations - that time I was interviewed about the swine flu on TV, going out on excruciating first dates on match after I was divorced. They are great for calming your physiologic response to stress without messing with your thought process. But the same bottle lasted me almost ten years and learning I had to take it daily really upset me. I have always run low, why the sudden change? I learned that I accidentally gained 26 pounds after I got engaged, and was determined to lose half before the wedding.

     That was two months of mania. It didn't seem to me that the beta blockers were doing much - I checked five or six times a day and my blood pressure was all over the map. I was religiously weighing myself every morning - something I normally stay away from doing. I managed to carve my weight gain in half before I got married. I was texting my cardiologist friend and hospitalist friend weekly with my numbers and quizzing them on how to get them down. "My systolic is way over 200! My diastolic is over 100! Should I take another beta blocker? Go to the ED? AHHH."

   About a week before the October wedding when I finally fit in my dress I had bought in June I was like ENOUGH. I made myself stop getting on the scale. I stopped checking my pressures. I was determined to enjoy my wedding and honeymoon. On a follow up appointment with my family doc in January, my pressure was fine. Not low, but systolic was 130, diastolic mid 80's. "I wouldn't treat those numbers," he said, and I breathed a sigh of relief. It was the weight gain, the wedding, the holidays, I told myself. This is over now. I'm back to perfect health.

     So you can imagine my surprise three weeks ago at my yearly OB check-up when the nurse asked to take my pressure again, "These numbers cannot be right. Are you symptomatic? Do you have a headache or anything?" No, never. My OB recommended another appointment with family doc. His nurse measured it twice too. 164/100. "Stop talking take a deep breath let me do it again." 152/90. I looked at her expectantly, "That's not very good, is it?" The doctor in me knowing it wasn't but the perfectionist in me wanting reassurance. No such luck. "No, it's not. Are you stressed?" I told her no, I was on vacation, I spent the entire weekend watching Homeland on the couch.

     Family doc decided to re-start the metoprolol daily. I told him I cannot go back to the manic numbers oriented person I was last Fall. I made him laugh describing crazy texts to mutual colleagues. I said, "This is your territory, not mine. Can we keep it that way, is that ok?" He laughed and told me to come back in six weeks for a physical and we would check it then. I asked him to review my blood work from last fall. He said it all looked great. Cholesterol was fine. Then he said something with utter surprise that filled my bruised ego with pride. "I think that is the best LDL I've ever seen. Yup, I've never seen one lower than that."

     I could think of worse things than having to take a daily beta blocker. It sure made me chill in the face of a large cooking project yesterday - not my area of expertise. I had to call my pulmonologist friend in Philly in a panic when my Instapot wasn't working, but I managed to figure it out without blowing up the kitchen or burning myself. I guess I keep going on as usual - working out a few times a week, eating as normal (my low salt diet attempt last Fall was dismal but I'll keep it in mind) and healthy as possible. Aging is tough, but I guess we all have to do it.