Ok-You bought the blood pressure monitor and began recording your blood pressure twice a day as I asked you to-varying times and brought it with you to your visit. Good work!! Now as I suspected-it shows you have hypertension…high blood pressure..as most patients of The Kidney Group do. This record allows us to see times when your blood pressure IS NOT adequately controlled and it also may show when it dips too low.
Sometimes patients find the recordings are inconsistent-high one day-and not the next…or high at 7am two days and up three days at the same time. Of course you swear you take your medicine precisely(hmmm…). What to do? First tell me how you take your medications-how much and what time. I see you brought your typed list. Wonderful!! I can see you are doing everything just as we asked you to. Well, in many cases at this point we will place a 24 hour BP monitor on you…(for a simple explanation of this experience check out our March 2008 newsletter on THE KIDNEY GROUP website which explains it in greater detail.) This allows us to target your BP medicine type, dose and time with great precision. If we suspect your BP occasionally dips too low-we will want to also see what it does while you sleep as this can be a precarious time for hypotension(low BP). The 24 hour BP monitor and its analysis is covered by your insurance as well. Before you take copious amounts of drugs lets be sure you need them, shall we?
That’s not to say we often can’t tell what’s going on with your BP from your own record. In this case today I see you do well except late afternoon-just before your BP pill is due so a simple restructuring of times on your various medications should help. Again next visit bring this sheet-twice a day and we’ll see how you do. Of course once we have it where we want it you may take your blood pressure twice a week-varying times-and bring that with you every visit. (Yes..every visit)
That wasn’t so hard, was it? And-oh yes-go ahead-ask me..what do I think of the BP machines at the drugstore(public ones)or at Publix?(everyone asks)..they’re fine-I prefer you do it at home-but if that is not feasible for you then I think using the same store machine for a trend of your BP readings is an acceptable substitute. Now that we have your blood pressure under control(and that means you are taking all your medications at the time the doctor told you to, correct ??)next we will talk about what we are going to do with your weight.
