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Walk with a Doc Newsletter
September 10th, 2010 |
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Greetings!
Good morning! Hope this letter finds you well. What a great time of year this is. Weather is just about perfect everyday. Tons of great college football tomorrow (Buckeyes v. Miami, Michigan v. Notre Dame, PSU v. Bama, OK v. FSU,...thanks Herbstreit - if I wanted this weekend's rundown I'd be on espn.com), and a great weekend for apple picking (one a day keeps me far away).
Okay, I'm not supposed to talk about patients but this is okay (I hope). This happens almost every time a patient comes in for a stress test. The patient says, "I'm not sure if I can do this - it's been a while". After 10-15 minutes of walking, they've given a great effort and they're sweaty, not stinky, sweaty...and they're smiling.
"Wow, that was kind of fun. I feel great! I should do that more often." I feel great! I should do that more often. They say that 95% of the time.
What's happening is their body is full of serotonin, endorphins, and adrenaline. Happy stuff. Happy stuff saying, "Nice work Carol. You just erased or dramatically reduced the odds of getting 40+ diseases. So I'm going to reward you by making you feel like a million bucks - for the next 3-12 hours." Doesn't it make you feel like we were genetically designed to feel this good after exercise? Okay, Dr. Happy Pants - get on with it!
We get so many great questions about blood pressure. Thought we could address a few in front of the group. Let me please say that these are my opinion only. They do not necessarily represent the viewpoints of the hundreds of other physicians we are proud to team with for Walk with a Doc.
*My beautiful (attorney) wife after reviewing this newsletter says: As always, you should talk to your doctor if you have concerns
Q: Is blood pressure really important?
A: Yes. Very.
Q: What does caffeine do to my blood pressure?
A: It raises it. But only temporarily. I would check your blood pressure about 30 minutes after caffeine use. If you are one of our sensitive walkers where it raises it 5-10 points you may consider reducing your intake to a couple cups a day or cutting it altogether.
Q: What blood pressure is too high?
A: Systolic (top #) of 140. If you are diabetic, have CAD (coronary
artery disease), cerebrovascular disease, or PAD (peripheral arterial
disease) your top number should be below 130. In almost all our patients, our
goal is an average of 110's to 120's. You will live longer, have fewer
heart attacks, strokes, and heart failure at these #s.
Q: What blood pressure numbers are too low?
A: As long as you can walk, talk, and pee - it's fine.
Q: How often should I check my blood pressure?
A: We have patients that check it once a year in the doctor's office (not enough)
We have patients that check it 4x day (too much)
We have patients that like green eggs in a boat
We have patients that like green eggs in a coat
*We recommend our patients check it 6 or 7x week until we see where their average is. Once we know the average, we recommend maybe once or twice a week - max.
Q: What time of day should I check it?
A: Some docs like the same time everyday. I like to get reads from various points in the day because some of us tend to run higher at times different than others and we can adjust the medications and dosing schedules accordingly. * There is a diurnal pattern to our body's release of cortisol (cortisol raises blood pressure and is usually peaking around 8 a.m.), but due to a multitude of other factors, we can still run high at later hours of the day
Q: My blood pressure is "all over the place". Is something wrong with me?
A: Probably not. You need to check with your own physician, but blood pressures can range by 20 mm Hg on a regular basis.
Q: Why are you only mentioning the one number? There's two. Didn't you go to med school you moron.
A: Yes, I went to med school. A favorite professor of mine always said, "Don't kill it with science". Knowing your top number and keeping it down is 99-100% of the battle. There are of course rare exceptions (outside the scope of this newsletter).
Q: White-coat hypertension?
A: White coat hypertension is high blood pressure only while in doctor's offices. We used to blow this off, but not anymore. Studies have proven that patients with White-coat hypertension are more likely to develop hypertension down the road. If you have White-coat hypertension, you should check your blood pressure on a more regular basis than the next person.
Q: Are the blood pressure cuffs at CVS, Meijer, etc. reliable?
A: Yes - for the most part. Most health care personnel trust them because they are regularly calibrated. There is a small catch. To get these accurate results, you need to rest for 5 minutes before taking your BP. A Target employee told us they appropriately pulled theirs. Their cuff machines were very intriguing toys to the children and played with to a point that they began producing unreliable numbers.
We hope this may answer a question or two you may have regarding hypertension. If not, I apologize for boring you. If you have other questions, please ask me or any of the other Walk with a Doc physicians/nurses this week. That's why we are here.
Have a fantastic weekend and thank you for letting us be a part of your day.
See you Saturday,
David
Walk with a Doc
"When I'm no longer rapping, I want to open up an ice cream parlor and call myself Scoop Dogg."
Snoop Dogg
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