Friday, September 22, 2006

Blood Pressure Update

This is a lot of technical info for Bruce and Bradley and Jane. You might want to skip this post - unless you are a health care professional - or unless you like details.

50 mg Toprol is equal in strength to 10 mg Lisinopril.

Doctor Johnson came onto Mom's case on Monday.

Three weeks previously, her blood pressure had (75% of the time) begun shooting very high(over 200 systolic) in the early morning hours(4 am ish). Over 200 systolic is stroke danger level. Her BP would go to normal levels when she got up and started moving around.

Her BP also (40% of the time) begun going very low(under 100 systolic) in the early evening hours( 8 pm ish).

Before her BP went wacky, Mom was taking:
5 mg Lisinopril @ 7a
25 mg Toprol @ 7a

This dosage slowly increased, and changed around in timing, from 9/8 through 9/18, eventually becoming this dosage:
10 mg Lisinopril @ 7a
50 mg Toprol @ 8p

Despite the changes in dosages and timing, Mom's wacky BP numbers never leveled off.

Dr. Johnson ordered this for Monday:

10 mg Lisinopril 7a(already taken when he saw Mom)
5 mg Lisinopril 8p
50 mg Toprol 8p

7a Tuesday: BP was 171/73. Yea!

Dr. Johnson ordered this for Tue and Wed:
5 mg Lisinopril 7a
25 mg Toprol 7a
5 mg Lisinopril 8p
25 mg Toprol 8p

Mom's BP went extremely high Wed 6a, and Wed 10p(she had been sleeping since 7:30p). Thursday 6a was better: 184/80.

Dosage for Thus:
5 mg Lisinopril 7a
25 mg Toprol 7a
10 mg Lisinopril 8p
25 mg Toprol 8p

Mom's BP for Fri morning was perfect. She will continue the current dosages through the weekend.

No one knows the origin of the problem. The problem is not a clogged shunt - Mom would be experiencing headaches if that were the case. The problem is unlikely to be cardiac: Mom had cardiac testing done at both Harris-Methodist, and at Baylor. Her cardiology is normal for a 70 year old woman.

Mom has been taking low doses of BP medication for some years. To me, it is disturbing that the problem suddenly arose - after her BP had been staying in the normal range for months. It is further disturbing that the BP would go both very low and very high. It is further disturbing that the BP goes high when she is sleeping/laying horizontally.

I don't know if the genesis of the problem will ever be diagnosed. It could be an undetectable abberation which is generated in her brain. I will, when next I speak w/Dr. Johnson, question him more rigorously about the genesis of the problem, and about whether he believes he will ever determine what the genesis is -- versus simply jiggering with the medication, until the BP readings are under control.