Social Distancing and High Blood Pressure

NEWARK

Social Distancing and High Blood Pressure


Do you like that title?  Pretty provocative, right?


Why did I write a title like that?  It is because I have seen an uptick in a bad and dangerous behavior in my office since I reopened the place that reminds me of the fools who are protesting about how they believe that wearing masks and keeping 6 feet between themselves and others is in violation of their liberty.


What is that behavior that I am seeing?  My patients are not taking their high blood pressure medications!!  I hear so many excuses from them but I think that many of them simply do not feel like their high blood pressure (HBP) is real because it doesn’t feel like anything is wrong!


There is a reason that high blood pressure is called ‘the silent killer’ – you just feel normal!  If anything, the medications make you feel sick!


It is easy for me to assume that everyone knows what I know but that is not true – my life has been spent in medicine and I forget that not everyone thinks about health and medicine every minute of every day like I do! Let me lay out the facts for all of you about high blood pressure:


1) The pressure of your blood on your arteries and organs causes slow damage to the proper functioning of your body.  Often HBP shows no symptoms until the first big one: a heart attack!  By that time the damage is done and if you are lucky enough to survive the heart attack you will be in poor health for the rest of your life.


2) So why worry about the rest of your organs when it is your blood pressure that is your concern?  When I am writing about organs affected by HBP the principal ones I am talking about are your kidneys and your liver; two organs vital to your existence and very hard to either replicate or replace.


Bad kidneys?  DIABETES!  Your future is dialysis which is 3 hours of being connected to a machine that cleans your blood probably 3 days a week.  This vital organ comes to you as a pair (you have 2 of them) but you only need one to live well.  Dialysis is necessary because you destroyed both of them.


Your kidneys are so embedded in your body so that if you do get a transplant (the best ones come from a family member who is a match but many come from people who are recently deceased and allowed their organs to be harvested) they are sewn on top of your non-functional kidneys because taking out a kidney, especially from someone who doesn’t have functioning kidneys, is too difficult and dangerous.  


READ THAT PARAGRAPH AGAIN!  Someone you know or are related to either had to have a very long operation to remove their kidney so you can have it or someone had to die!  


If you put yourself in the position of needing a kidney because you did not treat your high blood pressure you are a selfish person – no excuses!  You had working kidneys and now you need a replacement because you would not take your medicine or change your lifestyle to bring down your blood pressure.


3)  Many things people can change will lower their blood pressure: lose weight and stop eating salt.  Those two things will often lower your blood pressure enough to avoid or discontinue blood pressure medication.  


Nothing exotic, nothing unique, no unnecessary intervention: just two things that anyone can do – lose 10 to 15 pounds and stop eating so much salt and foods that have a lot of salt


I lost 8 pounds in 6 weeks while staying at home due to COVID-19.  I ate all my (large) meals at home (I am married to a Latina – they cook lots of food) and did not eat much delivery or takeout food.  Any human being can lose 1 pound a week!


Salt?  Do you even know what food is supposed to taste like without salt?  I grew up with a mom with HBP so salt was not an ingredient in our home.  A single container of salt lasted so long that the label would change 3 times between containers in our house. When we did need to buy it I couldn’t recognize the brand she preferred because sometimes not only did the label change but the brand would be gone! 


My daughters consider salt to be one of the 4 food groups (my wife cooks without salt and the girls add it to everything).  They are lucky because estrogen is a natural heart protector.  This is the reason that menopause is a bigger problem than you know: all the conditions men have been worrying about since their 40s like HBP become a new burden to women in their 50s as estrogen declines and they often have not been warned!


4) I can hear all the shouts from here: but I am a healthy guy, I eat right, I exercise so why do I have HBP?  I have a way to show you why you have HBP – go get a a calendar or look at your genitals.


Don’t worry, I wrote this essay long before you are reading it so I have time.


Go on – look at the calendar, or your genitals.  You could look in a mirror if you feel like getting off your butt.


If you are male and over 40 (hence the need for a calendar) you probably have built up cholesterol on the arteries going in and out of your heart and that makes it harder for the blood to go in and out of this vital organ.  Moreso, you have cholesterol in the arteries of your heart.


Yes, your heart itself has very important arteries that keep it alive.  Learn about this one before a cardiac surgeon has to introduce it to you: LAD, the lateral anterior descending.  Arteries of the heart often do not have cute names and this one is named by where it is located from the front of your body.


Oh yeah, it has a cute name: the widow-maker.  When this one gets clogged with cholesterol men are in their 40s and 50s and the men die, leaving their wives as widows hence the name.  PREVENTABLE!!


You ever hear of a bypass, double bypass, triple bypass or quadruple bypass?  This refers to the number of arteries that a heart surgeon has to go around to keep the patient alive.  It always include the LAD.  Arteries filled with the accumulation of cholesterol that started in their teens and finally killed them 25-35 years later because the men failed to maintain their health.


5) Often people are not paired to their medications correctly so side-effects are immediately apparent when they start their HBP regimen.  The answer?  GET ANOTHER MEDICATION!!  There are about 30 blood pressure medications so find a good match with the help of your prescribing doctor.  Therefore there is no reason that another medication can’t be found that works better for you.


Maybe more than one medication is necessary.  I have patients on 3 medications but that works well for them.


My story:  I do well on BYSTOLIC or it’s generic equivalent.  I was switched to atelenol and it did not agree with me (digestive upset and general discomfort) so my doctor switched me back.  Bystolic is not on the formulary for my insurance plan so I have to buy it from Canada from my own pocket (but 25% of the cost compared to if I bought it in the USA – thanks insurance companies!!).


So why did I start this article by comparing people who don’t take their blood pressure medication to people who fight social distancing and wearing masks during the COVID-19 pandemic as issues of liberty and self-expression?


Both of these groups (as well as people who continue to smoke cigarettes in 2020) have one thing in common:  when they become so sick that they need medical intervention, hospitals, or new kidneys or a heart they want modern medicine to work hard to keep them alive from conditions that were mostly preventable.


Don’t fill up my mailbox with examples of babies born with defective kidneys or deformed hearts or stories of guys with miner’s lung or diseases that attacked their heart or kidneys, stories of children born with diabetes just to muddy the waters of my essay.  This essay is only about the clowns who refuse to follow common sense rules of prevention or good self-care.


Today I saw 13 patients between 8:30 and 2.  3 of them refused to take their blood pressure medication and had been living with HBP for at least a year before they came to me: a year of damaging their organs.  


Maybe these guys will start to get healthy again and their organs will repair themselves.  Maybe they will care about themselves.


Oh, let’s be real here!  These guys will start their medications or go back to the ones prescribed by their doctors long enough to get me off their backs about their blood pressure and immediately stop taking the medications with no lifestyle changes.  They will come back to me in a year or two years of further damage and we will play the game again.


One last word on this subject:  do you love your kids?  How about your grandkids?


High blood pressure will take you from them years before you need to die.


Die?  If you are lucky you will die!  Most likely your organs will fail and you will get diabetes.  Now your kids and grandkids get to see you in bad health and a burden to them!  You don’t die – you just spend the rest of your shortened life being a problem as they have to change their plans to assist you, watch you in the hospital as you go in and out with your kidney and heart problems, do lots of nothing with you in the house because you are too sick to go outside to do fun things!  


Your grandkids like being inside when it involves computers and gaming but spending time with you will mean helping you to use the bathroom or rubbing creams and lotions on your diabetic skin or putting compression socks on you.  Any idea how much a typical 6-14 year old enjoys doing those things?  The statistics aren’t in front of me but I speculate that the answer is close to zero.


What about going outside to run with the dog or toss around a Frisbee or ball, hike around a forest or go to the beach with their grandparents?  Much higher chance of enjoyment.


High blood pressure and using mask and social distancing: your choice. Make the right decision and stop being an ass.


This is your choice but one that falls on the shoulders of the people you love, respect, and care about.

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