I had a hypertension specialist appointment yesterday. It turns out that there is a right way and a wrong way to take your blood pressure, and most of the nurses that have taken mine have done it the wrong way and have gotten erroneously high results. Taken properly, like the P.A. did at my appointment, my blood pressure isn't dramatically high. It's only a bit above where they want it to be.
So, all the panicking I've done about my blood pressure over the last four years not only wasn't necessary, but it also was bad for me because when I'm panicking... my blood pressure goes up.
My blood pressure still is higher than it should be so I'm still going ahead with the changes I've planned on, even though they will inconvenience other people.*
The doctor (who is the head of the Duke Hypertension clinic), said that I have plenty of time to work on natural methods of getting my bp down. Not only is it not as high as other doctors have measured (I'll get to that in a moment), they checked my blood vessels (including looking at the ones in the backs of my eyes), and I'm actually really healthy.
That was wonderful to find out, and I've been much more relaxed in the last 24 hours than I've been in the last four years - which can only help my bp.
At home, I've been taking my blood pressure the right way, but at the wrong times. Most doctors' offices haven't done either right. The P.A. yesterday told me not to even bother taking it the wrong way or at the wrong time because those readings are not relevant.
Here are the Mayo Clinic guidelines to taking blood pressure readings at home - with my comments in italics:
- Don't measure your blood pressure right after you wake up. You can prepare for the day, but don't eat breakfast or take medications before measuring your blood pressure. If you exercise after waking, take your blood pressure before exercising. So I shouldn't take my bp after Zumba or fast walking. The P.A. mentioned that, when people are rushing around doing errands and then stop at a pharmacy to measure their bp in the machines, those measurements are not representative.
- Avoid food, caffeine, tobacco and alcohol for 30 minutes before taking a measurement. Also, go to the toilet first. A full bladder can increase blood pressure slightly. They never mention any of this at doctor's offices.
- Sit quietly before measuring your blood pressure. When you're ready to take your blood pressure, sit quietly for three to five minutes beforehand. In a doctor's office?! I find the TVs in many doctors offices annoying. After I sit with the annoying TV in the waiting room, the nurse then taking my blood pressure while also taking my temperature and discussing my health with you. There hasn't been any sitting quietly since long before I left home. Sit in a comfortable position with your legs and ankles uncrossed and your back supported against a chair. Most doctors' offices take bp while I'm sitting on an examining table with my feet dangling (they're supposed to be flat on the floor) and no back support. Try to be calm and not think about stressful things. So, for instance, the blood pressure reading that they got at the allergists' office when my throat was closing up in reaction to the allergy shot was also not relevant.
- Make sure your arm is positioned properly when measuring. Rest your arm, raised to the level of your heart, on a table, desk or chair arm. You may need to place a pillow or cushion under your arm to elevate it high enough. They almost never do this at the doctor's office. Place the cuff on bare skin, not over clothing. Rolling up a sleeve until it tightens around your arm can result in an inaccurate reading, so you may need to slip your arm out of the sleeve. They don't do this either.
- Don't talk while taking your blood pressure. Take a repeat reading two to three minutes after the first one to check accuracy. You can wait as little as one minute in between your readings. If your monitor doesn't automatically log blood pressure readings or heart rates, write them down in your own log. Nurses and doctor's almost always ask questions while they're taking my blood pressure. Talking in an unfamiliar situation requires a lot of focus from me because it takes me a while to get my thoughts together so I feel like I'm talking on fast forward.**
As far as position (feet flat, back supported, etc.) goes, I've been taking my blood pressure the right way. But I've been taking it when I've been rushing around doing chores, when I've been angry or stressed, etc. I did read, a few months ago, about taking a repeat reading. In fact, one website recommended taking three readings, five minutes apart while relaxing, throwing out the first, and averaging the second and third. It's amazing how a little relaxation changes things. When I do that, my bp can go down by 20/10 between the first and third ones - even if I have a migraine and nausea (apparently that's also not a good time to measure it).
Rather than the up on the examining table/feet dangling/no arm or back support/taking way that most doctor's take bp, the P.A. took my bp while I was sitting in a comfortable chair, with back support, and my arm on the desk. Between the second and third measurements, she quietly looked at her computer for a few minutes, and I just did slow breathing and thought about LOLCats. My blood pressure that time was the same as it usually is when relaxing at home, and it was only a little bit above where they said they wanted it. I asked her about the differences between the way she did it and the way most doctors do it. She smiled gently and said that this was their specialty so they do it the right way.
I've lost over two months of time to blood pressure medication side effects only to end up with allergies and asthma/throat closings. I'm still making lots of other changes which are much easier to make if I'm not demotivated and stoned out on bp meds.
The most recent drug, in September, left me feeling hyper at night (I read an entire book and played a computer game between midnight and 4 am), and totally undisciplined during the day ("Hey look, there are dirty dishes in the kitchen!" Four hours later: "Hey look, there are dirty dishes in the kitchen!" Dear husband did the dishes). As far as side effects go, I actually had high hopes for it until my throat started closing up.
Since my appointment yesterday, I've been unusually relaxed, even when things haven't gone well (dizziness reaction to the flu shot). For the last four years, I've felt like I have a time bomb in my chest, and I don't feel that way anymore.
* For instance, one thing I'm changing, eating-wise, is that I'm no longer going to eat to be polite. I do a lot of polite eating because someone spent lots of time making the food, and they seem to really need me to eat it. I never push people to eat anything (besides my kids eating vegetables) so, when someone else pushes me to eat something, they seem really needy to me. I'm not going to give in to that anymore.
The other time I eat to be polite... well, sort of... is at restaurants. I always feel that I should eat everything on my plate, even though the portions are usually huge. I particularly have trouble with this if I'm traveling because I can't bring leftovers home so I feel like I'm wasting food. I end up eating much longer than I'm enjoying, which is ridiculous.
** Friends who let me have even just an extra second or two to get my thoughts together are wonderful.