Maybe my uttering the words fear of stroke was enough to warrant the ct.

When I go in for my next physical ..I will diplomatically question the clonidine with my pcp.

Still concerned about hair though. I really like having hair and it’s down on my shoulders and below and if I bald on top ..then this SeaSpray will look like one of those weird balding with tufts of long hair Dr Seuss critters ..and I’m just not ready for that.

I truly appreciate being better informed through what I have learned through your post and comments.

Thank you ERP.

I thought I’ve heard the ED nurses, concerned about a patient’s high bp say they were concerned about the patient stroking out ..but maybe they were reacting to something else that I am unaware of.

***Is there a correlation to excessively high bp and strokes? If so what are the parameters of elevated bp that if a patient goes over ..you would want them to come in?

Out of the blue ..my numbers went wackadoodle and were climbing. As I said ..never did it again.

***What is the DANGER ZONE of BP readings?

***Also ..regarding the head ct ..it’s easy to Monday morning quarterback ..normal ct ..thus I didn’t need the head ct.

Everyone talks about lawsuits and cya medicine.

***What is the criteria used to determine if indeed the patient should get the head ct?

I didn’t think the elevated BP caused my headache ..but because I was hurting so much I checked the bp. Still no need to go to ED and hoped it would pass.

Again ..please bear with me because I have no idea whether or not bp would go up with an impending stroke.

But what eventually freaked me out ..yes ..I admit it did ..but not until going through denial first ..I then became scared I could stroke out because the bp was climbing. NEVER did that before… or since. (aug 2004) The headache was minimal at that point. I was resting and yet bp was 227/115 (ballpark -was at least that high). I didn’t know if it would keep climbing or what that would mean. My concern was stoke.

Not having any medical expertise … I thought I *should* be evaluated by an emergency physician.

Now after reading the comments here tonight..I wonder if I even needed the head CT or was that just done for CYA purposes?

Because as a patient..I was not seeking specific tests or treatment because I did not know what they would or should be. I thought if the ED doc orders it ..then he must’ve thought I needed it.

Was I *WRONG* to seek the medical expertise of the ED physician around midnight on a Friday night?

Should I have called my pcp who I have never gotten on a weekend because he always has a doc from another county covering? And should I have waited for the return call? And then ..I am going to guess that the doc who does not know me from Adam..would have TOLD me to go to the ED.

Regarding my bp going back up after the clonidine wore off ..I followed up with my pcp the following Monday (3 days later) afternoon and it went to where it usually was with the spironolactone .. 140s or 150 over 90 something. Don’t recall now.

**** Is there any reason a patient with escalating bp as mine was in the 200s should go to an emergency room if their private docs aren’t available? *****

***Or was I wrong to seek treatment in the ED when my bp was so high and seemed to be at a steady climb while at rest?

I worked with an ED for 20 years (reception) and would *never* go and waste their time for something I knew was not important.

Most patients (not talking about the frequent fliers who use the ED as a clinic), go to the ED because they are concerned they have an *emergency* and their doc is NOT available. I have seen the other side of that and do know how frustrating stupid things are to the medical staff, especially when it is bogging down the ED, etc. How many times do patients call into the ED seeking advice for something simple, which of course staff can’t risk advising for(for fear of error and lawsuit)and so they tell the patient they can’t give advice over the phone but if they would like to come in the staff will be happy to see them?

Most patients coming into the ED ..think *their* emergency *is* an emergency. Even the 3 week arm pain that comes in at 2 am.

I really would have thought that a bp climbing like that was a *potential* emergency. if it wasn’t ..I would’ve preferred sleeping in my bed… seriously.

A patient attending an A&E(ED) in UK with a BP of 200+ systolic would NOT be admitted for that, there has to have been another reason. He should have had a discharge letter from the hospital stating why he was admitted, what his diagnosis was and what medication he was discharged on. One reason I can think of is that he went to a private hospital which would do anything if it was being paid, NHS is a bit more selective.

A personal observation, had a lady appear at triage one Sunday morning who stated that the reason she was there was because her BP was high and she wanted it “checked”. She was informed by me that under no circumstances would I check her BP unless it was clinically indicated – it wasn’t. She had no symptoms of any kind but she thought it was high. She was advised that she should see her own doctor and that an A&E department was not the place to deal with this. Very unhappy lady whose BP probably got even higher after she had moaned at me and I had refused to do anything for her.

My understanding is that is that I take a low dose of clonidine and so maybe that is better regarding the concerns. ?

The 50mg spironolactone wasn’t initially for htn, but a water pill because we thought the diazide was causing a rash. I do remember pcp saying it would be potassium sparing… but I never had an issue with potassium loss.

Anyway.. this spring..when I saw the other doc (1 time) he said spironolactone wasn’t as effective as a diuretic then some diazide he put me on. Then I go back to pcp and he started to say “but the spironolactone is better because” ..and then he stopped himself. I adore my doc, but I hate when docs do that! They don’t want to step on their colleague’s toes.

I think it would be better for the *patient* if they said what *they* think and then let the patient decide. If they have a strong opinion about something they should just say it because the colleague is not their patient ..their patient is and if they believe something is better for their patient then a colleagues does … then they should speak up regardless… even though the colleague weighed in with a different opinion. Then present all the facts to the patient..wade through it with them and let the patient decide what’s best… assuming they have the capability to do so.

I have a great rapport with my pcp and I could’ve pushed for an explanation.

That being said ..I did not push for his opinion because the diazide worked more effectively. Then because I swim and am in the sun a lot ..I switched back to the spironolactone in the summer then back to the diazide one in the fall.

What I need to do (admittedly a struggle), is LOSE weight and this would all be a moot point!

Guess I should suck it up about the hair and have a talk with my pcp again. I also know another cardiologist from work ..maybe I could just run it by him and get a 4th opinion in the mix.

ERP ..I appreciate being able to have read your informative post Thank you for sharing your thoughts about the med! Hopefully some ED docs will rethink their use of the drug too.