Blood Pressure Question

[FastMover]

For the past year or so I have been going back and forth with my doctor about my blood pressure. Since I became aware that I (supposedly) had a problem I got a digital BP monitor and have kept thorough recordings of my pressure. I take it twice a day; in the mornings before I work out and at night around 8:00. I usually take it four or five times in one sitting. The first reading is almost always high (in the 140/85 range). The next three or four readings are usually in the 120-130/65-75 range.

My regular doc could never find a reason as to why my BP was elevated. I have worked out and ran 3-4 times per week since high school (I'm 23 now), don't have any family history of high BP, heart disease, etc.

His next move was to refer me to a nephrologist because he thought I may have some type of blockage in my kidneys. The nephrologist had me do an MRA and ultrasound of my kidneys, as well as a 24-hour urinalysis and blood workup. Everything came back better than normal with one exception. One of my kidneys is slightly smaller than the other (11cm and 9cm). The nephrologist said that this may be what the problem was and that the only way to address it was by medication. I explained to him that I wanted to stay off meds if at all possible because of the Navy's 140/90 unmedicated requirement for aviation. I'm supposed to go see another nephrologist to get a second opinion in a few weeks.

So, I guess my question is how lenient are the docs at MEPS/OCS/NAMI about this kind of thing? I did a search and read that if your BP is elevated that they have you come back three times over the course of a day to have it checked. Are they willing to take it a few times per sitting if your first reading is usually high like mine?

Thanks in advance for reading all of this. Any insight is very much appreciated.

 

[phrogpilot73]

Some tips from someone who has something similar (I always have 140-ish/over 90-ish at the beginning) and have been thorougly cleared. First, deep breaths (Count to 5 on inhale, and 10 on exhale), close your eyes and start to try to go to sleep, and tell them that the automated machine is always high and they'll do it manually. Every time I do that - 120/80.

 

[feddoc]

I don't know how lenient they are

Some other gouge....phrogpilot73 has some good info.....drink up before you head to the docs...water..., stay away from liquor and smoke for the day prior. Try to schedule your appointment for later in the day; avoid exercise for the 4-5 hours prior. Little things they are, but, they may help you avoid the pills.

I think they may be willing to take more than one reading at a sitting if you have 'white coat syndrome' ..... the anxiety that many have when visiting the docs.

Good luck to you

 

[phrogpilot73]

I would say that feddoc has got some good advice, since he knows a little bit more about medicine than me!

doc, I've got a theory about the automated machine and was curious if you think I'm off base... Every time, and I mean EVERY time they use the automated one on me, I'm over 140/90. Most Corpsman say "That can't be right" then whip out the old school cuff and stethoscope and find out that I'm 120ish/80ish. I don't have huge biceps, and when the automated one starts filling - it fills so much that I start to feel tingling in my hand and can feel the pulse in my fingertips. My theory is that because it fills it too much, it's actually increasing my blood pressure momentarily, is that right? Or do I just have the automated blood pressure machine syndrome?

 

[insanebikerboy]

Ask for a larger cuff to have the test with too. That'll help lower it some as well.

 

[FastMover]

Thanks for the pointers everyone. I've already been doing the deep breathing phrog suggested for a while and it does indeed work like a charm...except on that first try. I'm almost sure it's nerves. Even at home when I sit down to take it I can feel my heart start to pound at the beginning.

I've also started cutting back my tea intake and that seems to be helping a bit.

As far as automated vs. old school I would say that my readings are about the same on both of them. The nurse at the nephrologist's office only used the manual BP monitor and the results were still kind of high.

 

[BigRed389]

They can and will NPQ you for BP though.

I seem to do badly with both automatic machines and with white coat syndrome. And its always the systolic that's high, the diastolic was pretty much between 68-72 the entire time.

Going over my medical record:
Had three bps on the auto machine that never went below 140/90 during the initial workup.
At this point they went only with manual readings.
Few weeks later at followup I had two measurements both in the high 130s.
At the gym bp machine I got a couple I did on my own that were 115/68.
2 days prior to commissioning, I averaged about 137 on the systolic for 5 different measurements.
Day prior to commissioning, I average 120/68 for 3 consecutive when I'm just shooting the shit with HN "Timmy," w/resting HR of 65.
Then the flight doc takes two measurements and she got two readings of 150.
I got NPQd on that basis.

They recommended that I get secondary workups done too, I'm hoping they actually do find something wrong so they can go and fix it so I can try a lat xfer down the line.

 

[feddoc]

I would say that feddoc has got some good advice, since he knows a little bit more about medicine than me!

doc, I've got a theory about the automated machine and was curious if you think I'm off base... Every time, and I mean EVERY time they use the automated one on me, I'm over 140/90. Most Corpsman say "That can't be right" then whip out the old school cuff and stethoscope and find out that I'm 120ish/80ish. I don't have huge biceps, and when the automated one starts filling - it fills so much that I start to feel tingling in my hand and can feel the pulse in my fingertips. My theory is that because it fills it too much, it's actually increasing my blood pressure momentarily, is that right? Or do I just have the automated blood pressure machine syndrome?

Therein lies your problem.....A double of scotch with that macanudo will help. I have the same problem with the automated machine even with bigger cuffs. Do you have one of those handheld devices, the kind that fit around your wrist? The one we have has been surprisingly accurate when compared to the stethoscope and the machine.

Oh, your theory may be partially correct since the heart will be pushing a bit harder to get past a too tight cuff. I usually get a bit pisssssed when the cuff gets so darn tight and I'm sure that pushes the numbers up a bit.

However, I think it will have little effect on the lower number (heart relaxes and accepts blood) as opposed to the higher number (when the heart contracts and pushes blood). Hmmm, gonna have to ponder this one a bit.

 

[BACONATOR]

as long as you get get it below like 140/80 after an attempt or two. I had to redo my BP at MEPS, and the second reading was within limits and off I went to the next station. It's not like they take 1 test, out of limits and consult the Flight surgeon for possible NPQ. Didn't have the problem at NAMI, but I imagine it's probably the same deal and they'll give you a few chances...they know some people get nervous.

 

[Raptor2216]

The only experience I have had with the high BP problem is a buddy from TBS who lost his air contract because the docs at OCS told him to take some medication not approved for aviation. I don't know much else on the subject but I would definitely stay away from the meds if I were you.

 

[FastMover]

as long as you get get it below like 140/80 after an attempt or two. I had to redo my BP at MEPS, and the second reading was within limits and off I went to the next station. It's not like they take 1 test, out of limits and consult the Flight surgeon for possible NPQ. Didn't have the problem at NAMI, but I imagine it's probably the same deal and they'll give you a few chances...they know some people get nervous.

Thanks for the insight...that's what I was hoping to hear.

 

[llnick2001]

I like to pretend I just took a big grumpy. I'm not sure if it helps but it's very relaxing.

 

[WheelsUpHeelsUp]

Eat NO salt the day before, mine goes up with sodium.

 

[Recidivist]

I like to pretend I just took a big grumpy. I'm not sure if it helps but it's very relaxing.

This will help. It's called the Vagal Manuever, and it stimulates the vagus nerve (which does some physiological shit, stimulating vasodilation I think). You can actually pass out like this. I'm not a Doctor and you will want to try this yourself before the test to see if it works for you.

Take your thumb and place it on your pursed lips and blow like you are blowing a whistle. Your BP should drop.

 

[skim]

When I went to Meps, they decided to run my blood pressure right after a processor and chief fought about whether or not to send me home on some issue regarding my packet and me needing the asvab (the processor wasn't familiar with Officer programs) for about 3 hours while I sat in the lobby hearing it and also fighting being sent home. I got hit with high BP from the machine. The corpsman seemed pretty concerned. They ran me through the rest of the stuff and when I did the interview the doc asked if I had a history of high BP. I told him what happened, he did a manual test and passed me.