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Waiting for Amlodipine

You keep on pushing my love over the borderline
Little T's BP is on the borderline between meds and no meds.

Damn I discovered the great reading we had was invalid, because the pulse was too low. The nephrology doctor said to call if his systolic was over 120 and we've had several over 120. I called Nephrology and the nurse said his pulse should be 90-100. I asked "Should I give him the medication?" The nurse said "The doctor's not in today. Go get his monitor checked at his pediatrician's office. Get the prescription filled and have it ready just in case." I said "okay." What I wanted to say was Yes ma'am. Will do that, but Consumer Reports says most of these monitors are accurate and that doesn't answer my question. Argh.

I fumed for a bit. I hate being confused. I like to understand what's going on. I can handle a lot if I understand what's going on. I prolly should have asked better questions on Wednesday, but I was reeling from the hospital/not hospital fire drill.

I called his hemo doctor. Because she explained it to me. I knew she would. She said "We're sorry [about the fire drill]. That's why we referred him to Nephrology." She explained how to interpret the numbers better and what numbers I really should worry about. The upshot is that he's on the borderline. He's not going to be on steroids much longer. So it's not clear whether he should go on meds or not. Left unsaid was whether or not to just wean him off steroids and put him on Vincristine. We'll need to see his platelet numbers on Tuesday.

Just in case the monitor was wonky like the Nephrology nurse implied, I got his blood pressure monitor checked at his pediatrician's office. Esmerelda, the nurse is a sweetheart. She checked his blood pressure manually while he was sitting up 110/60 and 112/68. Then while he was lying down 90/58. These were close to the monitor readings of 96/49 and 91/47. His best BP numbers ever. He was calm and quiet. Though if you agree that the manual diastolic numbers are the most accurate, he still has high blood pressure. Sigh.

BTW I like the word Nephrology. Especially if you say or type it 3 times Nephrology Nephrology Nephrology. Maybe if I say it often enough, Little T's blood pressure will stay low.

Little T's BP stats

96/49 2:34pm
91/47 2:30pm
119/66 95 8:27
126/65 104 8:19
85/67 53 8:17 (beautiful number, but invalid because pulse too low)
113/70 100 8:01
122/65 99 7:57
83/65 96 7:58
154/97 61 7:55 (fortunately invalid, because pulse too low)
125/92 81 7:53

98/61 81 8:35am (pulse too low)

117/65 96 5:53pm


( 5 notes — Leave a note )
Jan. 21st, 2006 05:37 am (UTC)
blood pressure meds
My experience taking BP meds daily has been very good. The first one I took gave me a dry cough at night, but my doctor warned me about that, so we switched quickly to Cozaar. I've had no side-effects with it at all, which is unusual for me. As drugs go, I suspect BP medications have fewer drastic side effects and are much milder. They're designed for long-term use, unlike steroids or chemo. But, I have no idea about pediatric BP meds.

There's no telling how T would respond to BP meds, and the worst (and non-trivial) part about taking them would be staying in the hospital for monitoring. So, I hope he manages to avoid them!
Jan. 21st, 2006 07:17 pm (UTC)
Re: blood pressure meds
Thanks for the info!
Jan. 21st, 2006 05:45 am (UTC)
I just took a look at the numbers when you were checking the monitor:
110/60 vs. 96/49
112/68 vs. 91/47

Your monitor readings look low by more than 10%, closer to 15%. That seems like a big difference to me, especially since a lot of his readings are close to 120. Maybe I didn't understand it.
Jan. 21st, 2006 07:15 pm (UTC)
Re: readings
Sorry it's a little confusing.
You need to compare 96/49 91/47 (digital lying down) v.s. 90/58 (manual lying down)
110/60 112/68 are both manual sitting. We couldn't get good monitor readings while he was sitting up.
(Deleted comment)
Jan. 21st, 2006 09:57 pm (UTC)
Re: readings
Good! Those are much better comparisons. I hope the BP gets resolved soon. "Brain bleed" sounds like another way of saying stroke, which you *really* don't want.

BP is so tricky, because you can't really feel it going up or down, unless it gets so low you get dizzy, or so high that you have a headache. But, mine was fairly high (140something/118) at one point, and I had no idea. But, I was more conderned with the lower number and its long-term consequences than stroke.

It also changes a LOT during the day, and is affected by almost everything (eating, moving, position, emotions, pooping, etc.).

I've got my fingers crossed for him!
( 5 notes — Leave a note )