An Unexpected Trip

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I take my blood pressure at 8:00 am, 3:30 pm, and 11:00 pm, or thereabouts. That’s when my alarms are set to go off, anyway. Sometimes I forget to take my pressure until later, as I take medications at those times as well. My blood pressure has been holding fairly steady at 160-165/100-105 – pretty high, but nothing to be immediately alarmed about.

My 3:30 alarm went off, and I took my meds first, then took my blood pressure. At 3:33, it read 191/117. So I waited a little longer and took it again.

At 3:39 it was 197/117. Wait a while longer, take again.

At 3:48 it was 195/118. Time to get dressed and head to the emergency room.

Just before climbing in the car, I took it again, at 3:55. It was 198/118.

The trip in the ER was a whirlwind. I got checked in at the front desk, and they told me someone would see me in a few minutes, so I sat down and started writing a Facebook post to explain the situation. I wasn’t even a sentence into it before they called my name, slapped ID and allergy wristbands on my arm, and took me to a seated triage area.

As soon as I sat down, the ER technician checked my temperature, my blood oxygen, and my blood pressure again (195/94 this time). As he was leaving, my nurse came to follow up, and explained what would likely happen was that I would get a pill called Clonidine to lower my blood pressure rapidly. I told her I’d been down this road before and that pill was why I was in the ER. She also asked if I had any other symptoms, and I told her I was starting to get a headache. She said they’d get me something like Tylenol, and then she was on her way.

Immediately following her visit – as in, was waiting outside to see me – was the representative from hospital registration. We went through the drill of getting me registered, but were interrupted by the doctor who came in to ask what was going on. We shared the record of blood pressure readings since 3:30, we explained that we’ve done this before, we told him we expected a Clonidine, which he confirmed they would be giving me. He also mentioned the headache, which I confirmed with him, and he asked if I preferred Tylenol or Advil. I told him I take an NSAID for my back, so it would need to be the Tylenol. He ducked out and registration came back in to finish up with me.

As registration was leaving, another nurse came by with the medications for me to take, and then a second came to assist with that process. One entered my data in the computer, the other scanned the meds and my bracelet, and then handed me the med cup and the water. I downed them, and she said it was up to me whether I wanted to stay, but the discharge papers had already been written. I said that I knew that the medication would work – it had done so before – and so I signed the paperwork and checked with the discharge representative on the way out for her to cut off my wristbands.

We got out into the lobby once again and I sat down to finish the Facebook post. I literally did not have time to look at my phone long enough to post while I was back in the ER. The entire visit was maybe 40 minutes long, if that. It is the most efficient trip through an ER I have ever taken, and I have, unfortunately, been to the ER a lot in my life.

I came home, and checked my blood pressure – it was 182/110, still high, but there hadn’t been time for the Clonidine to really start to work just yet.

And then about five minutes later, it kicked in.

I felt dizzy and lightheaded, and went to lie down for a short little nap, which I had just woken up from before writing this post. Before I started writing, I checked my blood pressure again.

163/102, back to what has been normal for me.

I have a follow up appointment with my doctor on Friday, so we can discuss this in greater detail, but in the meantime the ER doc recommended I double up on my hydrochlorothiazide, from 12.5 mg daily to 25 mg daily, and then consult with my doctor when I see her.

Hopefully we can start to work on getting this down, soon. I really can’t afford for my blood pressure to necessitate a trip to the ER every time it wants to spike a little bit.

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Venturing Into Unknown Territory

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Tonight I ate a tomato without salt.

There’s a lot of meaning in those seven words. For as long as I can remember, tomatoes have needed salt. One of my few fond early memories is of being at my grandmother’s house and taking a stool, a bucket of water, a rag, and a salt shaker down into her garden for lunch. I’d head about halfway down the row with the tomatoes and take a seat, looking for a good, ripe tomato. When I found one, I’d dip it into the water and wash the dirt off with the rag, then take a small bite to break the tomato’s skin. After that first bite, I’d alternate between salting and eating, just like an apple, til the whole thing was gone. It was meditative, the process of selecting a tomato, washing it, and eating it. Salt was an integral part of that process. I salted in moderation, but every bite that went into my mouth carried with it a sprinkling of salt to enhance the flavor.

As I grew older, I added steak and eggs to the “salt required” group of foods. I rarely oversalted anything, but in my early adulthood, a lot of foods were salted before I ever tasted them. I ate a lot of salty snacks, like potato chips, and I wasn’t a moderate eater of them. My waistline grew slowly over the years, and my need to salt food was aggravated by my pack-a-day habit that dulled my sense of smell and taste.

I quit smoking on September 4, 2000. I was driving to Austin from the Oklahoma City area when I got into an intense coughing fit behind the wheel, and I realized that I was going to either pass out or throw up, and regardless of which way I went I was going to wreck the car. I pulled over and switched with my wife (we were dating at the time and still lived three hours apart) so she could drive us to the next exit. We pulled into a restaurant and I got a glass of water while I continued to try and physically pull myself together. When we were ready to drive again, on the way out I tossed my half-finished pack of Marlboro Lights into the trash can.

I haven’t touched tobacco since.

In the aftermath of that momentous decision, I started packing on weight – some 40 pounds within a few months. The oral fixation I developed while smoking still had its grip on me, and my waistline suffered.

As my depression and anxiety grew worse over time, I began to comfort eat, and I was in need of comfort quite often. Gradually, over several years, I finally came to a point that I tipped the scales at three hundred pounds.

By that time, I had developed type 2 diabetes and stage 2 hypertension, and have been to the ER on multiple occasions to manage crises in both conditions. Fortunately, I’ve found a medication regimen that keeps my diabetes under control.

I cannot, however, say that about my hypertension.

Even with three medications, my systolic blood pressure is regularly over 160 and my diastolic is at least 100, and more often over 110.

It’s at this point that I acknowledge that this post has been all over the place as I spit out part of my life’s story in a stream of consciousness. But all the parts do fit together, and here’s how.

September 4, 2000 was not the first time I had tried to quit smoking. I had attempted, and failed, at least a dozen times before. But when I finally quit, it was like flipping a switch. I was done. And having made that decision, I’ve had the willpower to keep me tobacco-free all this time, without even one slip-up.

Likewise, I’ve tried several times to reduce my sodium intake and start eating healthier, only to fail every time. But figuratively speaking, I’m about to run the car off the road with regard to my high blood pressure, and it’s time to make a knee jerk decision and stick with it, just like I did with the cigarettes.

This time, it’s going to be harder, because while I can easily live without tobacco, I kind of have to eat. But I don’t have to continue to eat crappy processed foods that are going to spike my sodium intake, and I don’t have to salt everything in sight.

Tonight, I ate a tomato without salt. It was the first time in my life I ever recall doing such a thing. It’s so deeply ingrained in me that tomatoes have to have salt that my stomach was actually a little queasy for a time after eating. It felt unnatural, but I did it, even when my wife offered the salt to me with the suggestion that I could lightly salt the tomato. I stuck to my guns, and finished the tomato. And I survived.

And I’m going to survive steak and eggs and everything else without salt, too. Because that same willpower to keep me alive when I quit smoking is now focused once more on keeping me alive. And while my depression tells me often how much better it would be if I were to just end it all, I very, very much do NOT want to die.

So from here on out, nothing gets added salt. I’ll have to learn what foods actually taste like without it, and it’ll be a new experience. I’m sure steak and eggs are going to be just as weird without salt as the tomato was.

But dammit, I’m on a mission now. And I have the willpower to see it through this time, because I’ve made the decision.

And with that decision, I’ve given myself the power to live.

May 28, 2015: Three Good Things

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1. I found a seated cardio workout that’s 11 minutes long and fun to do. This is good for two reasons: first, I’m actually doing cardio; and second, it’s not 12 minutes long, cause I was DONE at the end of 11. Like, could barely lift my feet off the floor done. Given the weather in Austin lately, it’s a much more reliable workout than walking and I honestly feel it’s a better one, using much more of my body than walking at 21 minutes per mile. Arms went one way, legs went another, and there were times that I got so confused I had to stop and reset the motion because I’d gone past cardio into interpretive seizure, but I think my ability to keep it straight will improve with time – as well as my endurance.

2. Now for something that involves sitting on my butt for long periods of time. I’m something of a gamer, and I found the voice cast listing for the game that’s currently holding my attention. It’s amazing to see how versatile these voice actors are. There were many voices I recognize from the game that I would never have thought were performed by the same actor. I’ve always had an interest in voiceovers, so I was very happy to find this list.

3. Today was the first day with the changes to my checklist, and I made one more change mid-day, changing “walk” to “exercise” to reflect my newfound cardio program. (The program also features cooldown stretching, which took the place of yoga, so it’s killing two birds with one stone.) First impressions: today felt so much easier to manage, despite dealing with a headache for most of the day, and I got everything checked off.

Bonus! I have the medications that I need to manage my blood pressure, at least until my new primary care physician comes online June 30. My blood pressure is still very high, but it’s not quite to the point of being a hypertensive crisis, like it was last night. (I do not fancy regular visits to the ER to manage my blood pressure.) Hopefully over the next few days I can get that down even more.

Extra bonus! I started a food log that tracks what I eat and my exercise. It’s got me on track to lose a pound a week. Yesterday I was over my caloric allotment by 74 calories. Today I was under by 354!

Backed Into a Corner

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On May 11, my doctor asked me to start logging my blood pressure three times daily, which I’ve mostly done since then. Yesterday, my blood pressure escalated throughout the day to the point that the reading at around 10:15 pm was 205/119.

So off to the ER we went.

It’s back down now (relatively speaking) but still quite high, something like 162/109 at last reading about an hour and fifteen minutes ago.

But I’m in a quandary.

I know that exercise is going to be vital to getting my blood pressure lower, but with it being as high as it is, I’m scared to go walk just in case something happens while I’m out there alone.

At this point, I really don’t know what to do and I won’t have a doctor on board to advise me until the end of June. Walking in the evenings is going to be difficult due to the limited amount of time my wife and I have then to get everything done that we need to do at night, though that’s going to be rectified soon enough when her work schedule changes in a couple weeks. I’m just scared to wait until then; I feel that it’s a matter of extreme urgency that I start to lose weight and get my blood pressure down to manageable levels.

Anyone have any advice on what I should do?