87yrs old and a BP of 214 even on meds??

Discussion in 'Health and medical' started by Bnd777, Dec 17, 2003.

  1. Bnd777

    Bnd777 Guest

    My mother who is slim but certainly eats the wrong foods has had high blood pressure for probably 20
    years ........been on meds but even then it was 180 ( she only knows the top numbers I cant get the
    lower ones )

    One doctor said she has white coat syndrome but i think thats a bit of a stretch with a BP of 214
    when on meds

    Recently despite them trying every different BP meds her BP is now 214

    Exercise is now out of the question as severe Osteoporosis has distorted her spine

    There are times when she seems to have laboured breathing and i suspect she has had several TIAs
    although she denies it

    Just how likely and how soon is a massive stroke or heart attack /kidney damage going to be
     
    Tags:


  2. bnd777 wrote:

    > My mother who is slim but certainly eats the wrong foods has had high blood pressure for probably
    > 20 years ........been on meds but even then it was 180 ( she only knows the top numbers I cant get
    > the lower ones )
    >
    > One doctor said she has white coat syndrome but i think thats a bit of a stretch with a BP of 214
    > when on meds
    >
    > Recently despite them trying every different BP meds her BP is now 214
    >
    > Exercise is now out of the question as severe Osteoporosis has distorted her spine
    >
    > There are times when she seems to have laboured breathing and i suspect she has had several TIAs
    > although she denies it
    >
    > Just how likely and how soon is a massive stroke or heart attack /kidney damage going to be

    It sounds like her cardiovascular risk is very high. I would guess about 20-25% per year.

    Humbly,

    Andrew
    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  3. Sounds like she has multiple problems. You may try to prevent her from breaking her hip - that's
    usually curtains within two years. A doc specializing in the elderly - gerontologist, might be a
    good idea. Her risk of stroke is very high - there may be a dietary measures that can help besides
    meds. You might try using some of the risk calculators on the web to assess her life expectancy.
    She's also at high risk of Alzemheimers - if she doesn't already have it. All cardio risk factors
    are also Alzemheimers risk factors.

    "bnd777" <[email protected]> wrote in message news:<[email protected]>...
    > My mother who is slim but certainly eats the wrong foods has had high blood pressure for probably
    > 20 years ........been on meds but even then it was 180 ( she only knows the top numbers I cant get
    > the lower ones )
    >
    > One doctor said she has white coat syndrome but i think thats a bit of a stretch with a BP of 214
    > when on meds
    >
    > Recently despite them trying every different BP meds her BP is now 214
    >
    > Exercise is now out of the question as severe Osteoporosis has distorted her spine
    >
    > There are times when she seems to have laboured breathing and i suspect she has had several TIAs
    > although she denies it
    >
    > Just how likely and how soon is a massive stroke or heart attack /kidney damage going to be
     
  4. On Fri, 12 Dec 2003 23:18:00 +0000 (UTC), bnd777 <[email protected]>
    wrote:

    > My mother who is slim but certainly eats the wrong foods has had high blood pressure for probably
    > 20 years ........been on meds but even then it was 180 ( she only knows the top numbers I cant get
    > the lower ones )
    >
    > One doctor said she has white coat syndrome but i think thats a bit of a stretch with a BP of 214
    > when on meds
    >
    > Recently despite them trying every different BP meds her BP is now 214
    >
    > Exercise is now out of the question as severe Osteoporosis has distorted her spine
    >
    > There are times when she seems to have laboured breathing and i suspect she has had several TIAs
    > although she denies it
    >
    > Just how likely and how soon is a massive stroke or heart attack /kidney damage going to be
    >
    >
    I might comment that you can never really understand her risk, statistically, accounting for over
    nearly 300 known risk (an unknown) factors for heart attack, stroke, or any of the other multiple
    problems for complications of atherosclerosis (including TIA) without understanding just how much
    atherosclerosis she currently has.

    Perhaps the doctor who says she has white coat hypertension is correct. Perhaps not. Perhaps her
    blood pressure is an accurate assesment of risk for her atherosclerosis. Perhaps not. How can you
    know? We can discuss statistically significant associations, but we are not discussing millions of
    people. We are discussing one person, your mother. There is no one on earth just like her, with the
    same past and the same future. Mathmatical calculations as to her risk are reduced to utter
    speculation, and nothing more. Considering the potential risks of different medications used to
    treat atherosclerosis it would be wise to consider basing her therapy on something other than a
    house of cards.

    What is right for your mother may not be right for you, or anyone else for that matter.

    Her atheroslcerosis management should be individualized specifically and precisely to her current
    level of disease. How is this done? How can someone take the out the guesswork? Take some time to
    learn how at our website. Registration is free to all.

    --
    ~~~ Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
    http://www.familydoctor.org/blanchard ~~~ SonoScore Winning against heart attack and stroke
    http://www.sonoscore.com
     
  5. Bnd777

    Bnd777 Guest

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message
    news:[email protected]...
    > bnd777 wrote:
    >
    > > My mother who is slim but certainly eats the wrong foods has had high
    blood
    > > pressure for probably 20 years ........been on meds but even then it was
    180
    > > ( she only knows the top numbers I cant get the lower ones )
    > >
    > > One doctor said she has white coat syndrome but i think thats a bit of a stretch with a BP of
    > > 214 when on meds
    > >
    > > Recently despite them trying every different BP meds her BP is now 214
    > >
    > > Exercise is now out of the question as severe Osteoporosis has distorted
    her
    > > spine
    > >
    > > There are times when she seems to have laboured breathing and i suspect
    she
    > > has had several TIAs although she denies it
    > >
    > > Just how likely and how soon is a massive stroke or heart attack /kidney damage going to be
    >
    > It sounds like her cardiovascular risk is very high. I would guess about
    20-25%
    > per year.
    >
    > Humbly,
    >
    > Andrew
    > --
    > Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/
    >
    >
    Any other warning signs we would notice ? Whats scary is she is still driving !!!
     
  6. Mfg

    Mfg Guest

    > "bnd777" <[email protected]> wrote in message news:<[email protected]>...
    > > My mother who is slim but certainly eats the wrong foods has had high blood pressure for
    > > probably 20 years ........been on meds but even then it was 180 ( she only knows the top numbers
    > > I cant get the lower ones )

    > > Exercise is now out of the question as severe Osteoporosis has distorted her spine

    If your mother has had high blood pressure for 20 years and is still here, she's doing something
    right. Can her doctor get her into a pool program for elderly and disabled? The rehabilitation
    hospital where I live admits outpatients four times a week to use the supervised VERY warm pool. It
    is designed so that walkers and wheel chairs can go down the ramp into the water, which is not more
    than 4 feet deep. There are railings all around, and relatives are welcome to come and help.
    "Exercise" is a loose description of what happens, but it is soothing and takes weight off the
    affected joints and spine. MFG
     
  7. Patrick,

    Risk assessment is done all the time and is the basis for the insurance industry. It is not a "wild
    guess." If someone has cancer of a certain stage and cell type, an expected lifespan can be given.
    In regards to the 87 yr old woman with uncontrollable hypertension she will surely have a lower
    life expectancy than a normal 87 yr old. A normal 87 yr old can expect to live 6 yrs. I would guess
    3 years would be generous for a 87 yr old with uncontrollable hypertension. Would you like to
    insure her?

    "Patrick Blanchard, M.D." <[email protected]_nospam.com> wrote in message news:<[email protected]
    60.giganews.com>...
    > On Fri, 12 Dec 2003 23:18:00 +0000 (UTC), bnd777 <[email protected]> wrote:
    >
    > > My mother who is slim but certainly eats the wrong foods has had high blood pressure for
    > > probably 20 years ........been on meds but even then it was 180 ( she only knows the top numbers
    > > I cant get the lower ones )
    > >
    > > One doctor said she has white coat syndrome but i think thats a bit of a stretch with a BP of
    > > 214 when on meds
    > >
    > > Recently despite them trying every different BP meds her BP is now 214
    > >
    > > Exercise is now out of the question as severe Osteoporosis has distorted her spine
    > >
    > > There are times when she seems to have laboured breathing and i suspect she has had several TIAs
    > > although she denies it
    > >
    > > Just how likely and how soon is a massive stroke or heart attack /kidney damage going to be
    > >
    > >
    > I might comment that you can never really understand her risk, statistically, accounting for over
    > nearly 300 known risk (an unknown) factors for heart attack, stroke, or any of the other multiple
    > problems for complications of atherosclerosis (including TIA) without understanding just how much
    > atherosclerosis she currently has.
    >
    > Perhaps the doctor who says she has white coat hypertension is correct. Perhaps not. Perhaps her
    > blood pressure is an accurate assesment of risk for her atherosclerosis. Perhaps not. How can you
    > know? We can discuss statistically significant associations, but we are not discussing millions of
    > people. We are discussing one person, your mother. There is no one on earth just like her, with
    > the same past and the same future. Mathmatical calculations as to her risk are reduced to utter
    > speculation, and nothing more. Considering the potential risks of different medications used to
    > treat atherosclerosis it would be wise to consider basing her therapy on something other than a
    > house of cards.
    >
    > What is right for your mother may not be right for you, or anyone else for that matter.
    >
    > Her atheroslcerosis management should be individualized specifically and precisely to her current
    > level of disease. How is this done? How can someone take the out the guesswork? Take some time to
    > learn how at our website. Registration is free to all.
    >
    > --
    > ~~~ Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
    > http://www.familydoctor.org/blanchard ~~~ SonoScore Winning against heart attack and stroke
    > http://www.sonoscore.com
     
  8. bnd777 wrote:

    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message
    > news:[email protected]...
    > > bnd777 wrote:
    > >
    > > > My mother who is slim but certainly eats the wrong foods has had high
    > blood
    > > > pressure for probably 20 years ........been on meds but even then it was
    > 180
    > > > ( she only knows the top numbers I cant get the lower ones )
    > > >
    > > > One doctor said she has white coat syndrome but i think thats a bit of a stretch with a BP of
    > > > 214 when on meds
    > > >
    > > > Recently despite them trying every different BP meds her BP is now 214
    > > >
    > > > Exercise is now out of the question as severe Osteoporosis has distorted
    > her
    > > > spine
    > > >
    > > > There are times when she seems to have laboured breathing and i suspect
    > she
    > > > has had several TIAs although she denies it
    > > >
    > > > Just how likely and how soon is a massive stroke or heart attack /kidney damage going to be
    > >
    > > It sounds like her cardiovascular risk is very high. I would guess about
    > 20-25%
    > > per year.
    > >
    > > Humbly,
    > >
    > > Andrew
    > > --
    > > Dr. Andrew B. Chung, MD/PhD Board-Certified Cardiologist http://www.heartmdphd.com/
    > >
    > >
    > Any other warning signs we would notice ?

    It sounds like she is exhibiting enough already.

    >
    > Whats scary is she is still driving !!!

    Would suggest you take her to a hypertension specialist.

    Humbly,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  9. Bnd777

    Bnd777 Guest

    "mfg" <[email protected]> wrote in message
    news:[email protected]...
    > >
    > > "bnd777" <[email protected]> wrote in message
    news:<[email protected]>...
    > > > My mother who is slim but certainly eats the wrong foods has had high
    blood
    > > > pressure for probably 20 years ........been on meds but even then it
    was 180
    > > > ( she only knows the top numbers I cant get the lower ones )
    >
    >
    > > > Exercise is now out of the question as severe Osteoporosis has
    distorted her
    > > > spine
    >
    > If your mother has had high blood pressure for 20 years and is still here, she's doing something
    > right. Can her doctor get her into a pool program for elderly and disabled? The rehabilitation
    > hospital where I live admits outpatients four times a week to use the supervised VERY warm pool.
    > It is designed so that walkers and wheel chairs can go down the ramp into the water, which is not
    > more than 4 feet deep. There are railings all around, and relatives are welcome to come and help.
    > "Exercise" is a loose description of what happens, but it is soothing and takes weight off the
    > affected joints and spine. MFG

    Theres no facilities like that near her
     
  10. Brad, because risk assessment is frequently performed does not mean it is
    the best way to understand a condition or problem. Although I am by no
    means an expert on numbers or statistics, I have found the following book
    very helpful in trying to grasp complex situations: http://tinyurl.com/zdrr

    Incalculable risk is really quite common (although it is uncomfortable to admit it), and is
    manifest as a "suprise" that occurs outside of our comprehension. I agree with you that an expected
    lifespan can be given mathmatically, but the calculation is unlikely to account for all the known
    and the unknown factors that determine the true outcome. If lifespan does not meet expectations,
    then it is considered a "suprise" statistically speaking, which is really saying that the
    calculations were wrong.

    Would I insure a client who is 87 years old with uncontrollable hypertension?

    I don't know how to answer your question. However, if I were 87 years old, I would not want my
    therapy based on speculation, but on proper assesment.

    Regards, Patrick

    On 15 Dec 2003 13:15:38 -0800, Brad Sheppard <[email protected]> wrote:

    > Patrick,
    >
    > Risk assessment is done all the time and is the basis for the insurance industry. It is not a
    > "wild guess." If someone has cancer of a certain stage and cell type, an expected lifespan can be
    > given. In regards to the 87 yr old woman with uncontrollable hypertension she will surely have a
    > lower life expectancy than a normal 87 yr old. A normal 87 yr old can expect to live 6 yrs. I
    > would guess 3 years would be generous for a 87 yr old with uncontrollable hypertension. Would you
    > like to insure her?
    >
    >
    > "Patrick Blanchard, M.D." <[email protected]_nospam.com> wrote in message news:<[email protected]
    > 60.giganews.com>...
    >> On Fri, 12 Dec 2003 23:18:00 +0000 (UTC), bnd777 <[email protected]> wrote:
    >>
    >> > My mother who is slim but certainly eats the wrong foods has had high blood pressure for
    >> > probably 20 years ........been on meds but even then it
    >> was > 180
    >> > ( she only knows the top numbers I cant get the lower ones )
    >> >
    >> > One doctor said she has white coat syndrome but i think thats a bit of
    >> a
    >> > stretch with a BP of 214 when on meds
    >> >
    >> > Recently despite them trying every different BP meds her BP is now 214
    >> >
    >> > Exercise is now out of the question as severe Osteoporosis has
    >> distorted > her
    >> > spine
    >> >
    >> > There are times when she seems to have laboured breathing and i
    >> suspect > she
    >> > has had several TIAs although she denies it
    >> >
    >> > Just how likely and how soon is a massive stroke or heart attack
    >> /kidney
    >> > damage going to be
    >> >
    >> >
    >> I might comment that you can never really understand her risk, statistically, accounting for over
    >> nearly 300 known risk (an unknown) factors for heart attack, stroke, or any of the other multiple
    >> problems for complications of atherosclerosis (including TIA) without understanding just how much
    >> atherosclerosis she currently has.
    >>
    >> Perhaps the doctor who says she has white coat hypertension is correct. Perhaps not. Perhaps her
    >> blood pressure is an accurate assesment of risk for her atherosclerosis. Perhaps not. How can you
    >> know? We can discuss statistically significant associations, but we are not discussing millions
    >> of people. We are discussing one person, your mother. There is no one on earth just like her,
    >> with the same past and the same future. Mathmatical calculations as to her risk are reduced to
    >> utter speculation, and nothing more. Considering the potential risks of different medications
    >> used to treat atherosclerosis it would be wise to consider basing her therapy on something other
    >> than a house of cards.
    >>
    >> What is right for your mother may not be right for you, or anyone else for that matter.
    >>
    >> Her atheroslcerosis management should be individualized specifically and precisely to her current
    >> level of disease. How is this done? How can someone take the out the guesswork? Take some time to
    >> learn how at our website. Registration is free to all.
    >>
    >> -- ~~~ Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
    >> http://www.familydoctor.org/blanchard ~~~ SonoScore Winning against heart attack and stroke
    >> http://www.sonoscore.com
    >

    --
    ~~~ Patrick Blanchard, M.D., A.B.F.P. Board Certified in Family Practice
    http://www.familydoctor.org/blanchard ~~~ SonoScore Winning against heart attack and stroke
    http://www.sonoscore.com
     
  11. Mfg

    Mfg Guest

    "bnd777" <[email protected]> wrote in message news:<[email protected]>...
    > "mfg" <[email protected]> wrote in message
    > news:[email protected]...
    > > >
    > > > "bnd777" <[email protected]> wrote in message
    > news:<[email protected]>...
    > > > > My mother who is slim but certainly eats the wrong foods has had high
    > blood
    > > > > pressure for probably 20 years ........been on meds but even then it
    > was 180
    > > > > ( she only knows the top numbers I cant get the lower ones )
    > >
    > >
    > > > > Exercise is now out of the question as severe Osteoporosis has
    > distorted her
    > > > > spine
    > >
    > > If your mother has had high blood pressure for 20 years and is still here, she's doing something
    > > right. Can her doctor get her into a pool program for elderly and disabled? The rehabilitation
    > > hospital where I live admits outpatients four times a week to use the supervised VERY warm pool.
    > > It is designed so that walkers and wheel chairs can go down the ramp into the water, which is
    > > not more than 4 feet deep. There are railings all around, and relatives are welcome to come and
    > > help. "Exercise" is a loose description of what happens, but it is soothing and takes weight off
    > > the affected joints and spine. MFG
    >
    >
    > Theres no facilities like that near her

    Make an appointment for your mother with a physical therapist. Go with her. They will assess her and
    develop a program of assisted movement appropriate for whatever condition she has. They will lead
    her through it, and show you how you can help her. They may also suggest she walk to whatever degree
    she can, even with a walker for example, in the halls of her building, or in a mall, with you or
    someone to help, a couple times a week. I can't stress enough how important it is for her to get to
    a physical therapist who will find appropriate and helpful movement for her. It will add greatly to
    her physical and emotional health. MFG
     
  12. Bnd777

    Bnd777 Guest

    "Patrick Blanchard, M.D." <[email protected]_nospam.com> wrote in message
    news:eek:[email protected]...
    > Brad, because risk assessment is frequently performed does not mean it is the best way to
    > understand a condition or problem. Although I am by no means an expert on numbers or statistics, I
    > have found the following book very helpful in trying to grasp complex situations:
    http://tinyurl.com/zdrr
    >
    > Incalculable risk is really quite common (although it is uncomfortable to admit it), and is
    > manifest as a "suprise" that occurs outside of our comprehension. I agree with you that an
    > expected lifespan can be given mathmatically, but the calculation is unlikely to account
    > for all the
    known
    > and the unknown factors that determine the true outcome. If lifespan does not meet expectations,
    > then it is considered a "suprise" statistically speaking, which is really saying that the
    > calculations were wrong.
    >
    > Would I insure a client who is 87 years old with uncontrollable hypertension?
    >
    > I don't know how to answer your question. However, if I were 87 years old, I would not want my
    > therapy based on speculation, but on proper assesment.
    >
    > Regards, Patrick
    >
    >
    >
    > On 15 Dec 2003 13:15:38 -0800, Brad Sheppard <[email protected]> wrote:
    >
    > > Patrick,
    > >
    > > Risk assessment is done all the time and is the basis for the insurance industry. It is not a
    > > "wild guess." If someone has cancer of a certain stage and cell type, an expected lifespan can
    > > be given. In regards to the 87 yr old woman with uncontrollable hypertension she will surely
    > > have a lower life expectancy than a normal 87 yr old. A normal 87 yr old can expect to live 6
    > > yrs. I would guess 3 years would be generous for a 87 yr old with uncontrollable hypertension.
    Would
    > > you like to insure her?
    > >
    > >
    > > "Patrick Blanchard, M.D." <[email protected]_nospam.com> wrote in message news:<[email protected]
    > > 60.giganews.com>...
    > >> On Fri, 12 Dec 2003 23:18:00 +0000 (UTC), bnd777
    <[email protected]>
    > >> wrote:
    > >>
    > >> > My mother who is slim but certainly eats the wrong foods has had high blood pressure for
    > >> > probably 20 years ........been on meds but even then it
    > >> was > 180
    > >> > ( she only knows the top numbers I cant get the lower ones )
    > >> >
    > >> > One doctor said she has white coat syndrome but i think thats a bit
    of
    > >> a
    > >> > stretch with a BP of 214 when on meds
    > >> >
    > >> > Recently despite them trying every different BP meds her BP is now
    214
    > >> >
    > >> > Exercise is now out of the question as severe Osteoporosis has
    > >> distorted > her
    > >> > spine
    > >> >
    > >> > There are times when she seems to have laboured breathing and i
    > >> suspect > she
    > >> > has had several TIAs although she denies it
    > >> >
    > >> > Just how likely and how soon is a massive stroke or heart attack
    > >> /kidney
    > >> > damage going to be
    > >> >
    > >> >
    > >> I might comment that you can never really understand her risk, statistically, accounting for
    > >> over nearly 300 known risk (an unknown) factors for heart attack, stroke, or any of the other
    > >> multiple problems for complications of atherosclerosis (including TIA) without understanding
    > >> just how much atherosclerosis she currently has.
    > >>
    > >> Perhaps the doctor who says she has white coat hypertension is correct. Perhaps not. Perhaps
    > >> her blood pressure is an accurate assesment of
    risk
    > >> for her atherosclerosis. Perhaps not. How can you know? We can discuss statistically
    > >> significant associations, but we are not discussing millions of people. We are discussing one
    > >> person, your mother. There is no one on earth just like her, with the same past and the same
    > >> future.
    > >>
    > >>
    > >> Her atheroslcerosis management should be individualized specifically
    and
    > >> precisely to her current level of disease.

    ...................

    Since she is in the UK not the USA the NHS attitude of care and assesment is very different along
    with any possible physical therapy

    Her Father died of a stroke age 86

    We believe she has already had several TIAs 3 yrs ago she drove into a brick wall 2 yrs ago she
    collapsed at Xmas Dinner Table .....paramedics said mini stroke .....hospital discharged her She is
    always saying she does not feel well but refuses to go to the doctor .... She is feisty as hell
    ..you cant tell her anything .....salts her food!!!.yet slow reactions /thought/and
    understanding.....heaven help other drivers Has been on Hypertension drugs for about 3 yrs maybe
    more BP is up and down like a yo yo but always way above160 and now as you say uncontrollable
    bouncing from 180 to 214

    Little we can do but await events
     
  13. Jim Chinnis

    Jim Chinnis Guest

    "Patrick Blanchard, M.D." <[email protected]_nospam.com> wrote in part:

    >Incalculable risk is really quite common (although it is uncomfortable to admit it), and is
    >manifest as a "suprise" that occurs outside of our comprehension. I agree with you that an expected
    >lifespan can be given mathmatically, but the calculation is unlikely to account for all the known
    >and the unknown factors that determine the true outcome. If lifespan does not meet expectations,
    >then it is considered a "suprise" statistically speaking, which is really saying that the
    >calculations were wrong.

    "Expectation" in mathematics is just another another word for "average." An expected lifespan is the
    average lfespan for a population with the individuals characteristics and other charactereristics
    typical of the full population. That is, it is an average value based on what is specifically called
    out as different about the individual. A surprise does not mean the calculations are wrong. There
    should be lifespans of all different values, but with an average of the expected lifespan.
    --
    Jim Chinnis Warrenton, Virginia, USA
     
  14. mfg wrote:

    > "bnd777" <[email protected]> wrote in message news:<[email protected]>...
    > > "mfg" <[email protected]> wrote in message
    > > news:[email protected]...
    > > > >
    > > > > "bnd777" <[email protected]> wrote in message
    > > news:<[email protected]>...
    > > > > > My mother who is slim but certainly eats the wrong foods has had high
    > > blood
    > > > > > pressure for probably 20 years ........been on meds but even then it
    > > was 180
    > > > > > ( she only knows the top numbers I cant get the lower ones )
    > > >
    > > >
    > > > > > Exercise is now out of the question as severe Osteoporosis has
    > > distorted her
    > > > > > spine
    > > >
    > > > If your mother has had high blood pressure for 20 years and is still here, she's doing
    > > > something right. Can her doctor get her into a pool program for elderly and disabled? The
    > > > rehabilitation hospital where I live admits outpatients four times a week to use the
    > > > supervised VERY warm pool. It is designed so that walkers and wheel chairs can go down the
    > > > ramp into the water, which is not more than 4 feet deep. There are railings all around, and
    > > > relatives are welcome to come and help. "Exercise" is a loose description of what happens, but
    > > > it is soothing and takes weight off the affected joints and spine. MFG
    > >
    > >
    > > Theres no facilities like that near her
    >
    > Make an appointment for your mother with a physical therapist. Go with her. They will assess her
    > and develop a program of assisted movement appropriate for whatever condition she has.

    Fyi, they'll likely want her blood pressure better though.

    Humbly,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  15. Sorry to hear that. Please do try to get her off the road. Have they placed her on blood thinners?
    I'd suggest seeing if she'll eat oily fish (salmon, herring) or take fish oil capsules (if she's not
    already on blood thinners - if she is, the dose would have to be adjusted).

    "bnd777" <[email protected]> wrote in message news:<[email protected]>...
    > "Patrick Blanchard, M.D." <[email protected]_nospam.com> wrote in message news:eek:[email protected]
    > 60.giganews.com...
    > > Brad, because risk assessment is frequently performed does not mean it is the best way to
    > > understand a condition or problem. Although I am by no means an expert on numbers or statistics,
    > > I have found the following book very helpful in trying to grasp complex situations:
    > http://tinyurl.com/zdrr
    > >
    > > Incalculable risk is really quite common (although it is uncomfortable to admit it), and is
    > > manifest as a "suprise" that occurs outside of our comprehension. I agree with you that an
    > > expected lifespan can be given mathmatically, but the calculation is unlikely to account for
    > > all the
    > known
    > > and the unknown factors that determine the true outcome. If lifespan does not meet expectations,
    > > then it is considered a "suprise" statistically speaking, which is really saying that the
    > > calculations were wrong.
    > >
    > > Would I insure a client who is 87 years old with uncontrollable hypertension?
    > >
    > > I don't know how to answer your question. However, if I were 87 years old, I would not want my
    > > therapy based on speculation, but on proper assesment.
    > >
    > > Regards, Patrick
    > >
    > >
    > >
    > > On 15 Dec 2003 13:15:38 -0800, Brad Sheppard <[email protected]> wrote:
    > >
    > > > Patrick,
    > > >
    > > > Risk assessment is done all the time and is the basis for the insurance industry. It is not a
    > > > "wild guess." If someone has cancer of a certain stage and cell type, an expected lifespan can
    > > > be given. In regards to the 87 yr old woman with uncontrollable hypertension she will surely
    > > > have a lower life expectancy than a normal 87 yr old. A normal 87 yr old can expect to live 6
    > > > yrs. I would guess 3 years would be generous for a 87 yr old with uncontrollable hypertension.
    > Would
    > > > you like to insure her?
    > > >
    > > >
    > > > "Patrick Blanchard, M.D." <[email protected]_nospam.com> wrote in message news:<[email protected]
    > > > 60.giganews.com>...
    > > >> On Fri, 12 Dec 2003 23:18:00 +0000 (UTC), bnd777
    > <[email protected]>
    > > >> wrote:
    > > >>
    > > >> > My mother who is slim but certainly eats the wrong foods has had high blood pressure for
    > > >> > probably 20 years ........been on meds but even then it
    > was > 180
    > > >> > ( she only knows the top numbers I cant get the lower ones )
    > > >> >
    > > >> > One doctor said she has white coat syndrome but i think thats a bit
    > of a
    > > >> > stretch with a BP of 214 when on meds
    > > >> >
    > > >> > Recently despite them trying every different BP meds her BP is now
    > 214
    > > >> >
    > > >> > Exercise is now out of the question as severe Osteoporosis has
    > distorted > her
    > > >> > spine
    > > >> >
    > > >> > There are times when she seems to have laboured breathing and i
    > suspect > she
    > > >> > has had several TIAs although she denies it
    > > >> >
    > > >> > Just how likely and how soon is a massive stroke or heart attack
    > /kidney
    > > >> > damage going to be
    > > >> >
    > > >> >
    > > >> I might comment that you can never really understand her risk, statistically, accounting for
    > > >> over nearly 300 known risk (an unknown) factors for heart attack, stroke, or any of the other
    > > >> multiple problems for complications of atherosclerosis (including TIA) without understanding
    > > >> just how much atherosclerosis she currently has.
    > > >>
    > > >> Perhaps the doctor who says she has white coat hypertension is correct. Perhaps not. Perhaps
    > > >> her blood pressure is an accurate assesment of
    > risk
    > > >> for her atherosclerosis. Perhaps not. How can you know? We can discuss statistically
    > > >> significant associations, but we are not discussing millions of people. We are discussing one
    > > >> person, your mother. There is no one on earth just like her, with the same past and the same
    > > >> future.
    > > >>
    > > >>
    > > >> Her atheroslcerosis management should be individualized specifically
    > and
    > > >> precisely to her current level of disease.
    >
    >
    > ...................
    >
    > Since she is in the UK not the USA the NHS attitude of care and assesment is very different along
    > with any possible physical therapy
    >
    > Her Father died of a stroke age 86
    >
    > We believe she has already had several TIAs 3 yrs ago she drove into a brick wall 2 yrs ago she
    > collapsed at Xmas Dinner Table .....paramedics said mini stroke .....hospital discharged her She
    > is always saying she does not feel well but refuses to go to the doctor .... She is feisty as hell
    > ..you cant tell her anything .....salts her food!!!.yet slow reactions /thought/and
    > understanding.....heaven help other drivers Has been on Hypertension drugs for about 3 yrs maybe
    > more BP is up and down like a yo yo but always way above160 and now as you say uncontrollable
    > bouncing from 180 to 214
    >
    > Little we can do but await events
     
  16. Mfg

    Mfg Guest

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
    > mfg wrote:
    >
    > > "bnd777" <[email protected]> wrote in message news:<[email protected]>...
    > > > "mfg" <[email protected]> wrote in message
    > > > news:[email protected]...
    > > > > >
    > > > > > "bnd777" <[email protected]> wrote in message
    > news:<[email protected]>...
    > > > > > > My mother who is slim but certainly eats the wrong foods has had high
    > blood
    > > > > > > pressure for probably 20 years ........been on meds but even then it
    > was 180
    > > > > > > ( she only knows the top numbers I cant get the lower ones )
    > > > >
    > > > >
    > > > > > > Exercise is now out of the question as severe Osteoporosis has
    > distorted her
    > > > > > > spine
    > > > >
    >> > >
    > > > Theres no facilities like that near her
    > >
    > > Make an appointment for your mother with a physical therapist. Go with her. They will assess her
    > > and develop a program of assisted movement appropriate for whatever condition she has.
    >
    > Fyi, they'll likely want her blood pressure better though.
    >
    > Humbly,
    >
    > Andrew

    "It will add greatly to her physical and emotional health."

    And that may very well lower her blood pressure somewhat, at least enough to satisfy all the white
    coats and leave an old woman in what peace she can find. Were it me, I would say: leave well enough
    alone. Don't medicate her any more. Have the physical therapist, whom she will likely grow to trust,
    check her blood pressure from time to time. PTs operate very differently from physicians or
    cardiologists. They nurture their clients. At least, it is taught that they should in their training
    and education. Also, I think it is part of the personality of one who would choose that as a
    profession. IMHO. MFG
     
  17. mfg wrote:

    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message
    > news:<[email protected]>...
    > > mfg wrote:
    > >
    > > > "bnd777" <[email protected]> wrote in message news:<[email protected]>...
    > > > > "mfg" <[email protected]> wrote in message
    > > > > news:[email protected]...
    > > > > > >
    > > > > > > "bnd777" <[email protected]> wrote in message
    > > news:<[email protected]>...
    > > > > > > > My mother who is slim but certainly eats the wrong foods has had high
    > > blood
    > > > > > > > pressure for probably 20 years ........been on meds but even then it
    > > was 180
    > > > > > > > ( she only knows the top numbers I cant get the lower ones )
    > > > > >
    > > > > >
    > > > > > > > Exercise is now out of the question as severe Osteoporosis has
    > > distorted her
    > > > > > > > spine
    > > > > >
    > >> > >
    > > > > Theres no facilities like that near her
    > > >
    > > > Make an appointment for your mother with a physical therapist. Go with her. They will assess
    > > > her and develop a program of assisted movement appropriate for whatever condition she has.
    > >
    > > Fyi, they'll likely want her blood pressure better though.
    > >
    > > Humbly,
    > >
    > > Andrew
    >
    > "It will add greatly to her physical and emotional health."

    Maybe so. However, if she suffers a hemorrhagic stroke because of her poorly controlled blood
    pressure worsening during the exercise/therapy, it could adversely the financial picture (and
    emotional health) of the physical therapist.

    Humbly,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  18. Mfg

    Mfg Guest

    "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message news:<[email protected]>...
    > mfg wrote:
    >
    > > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message
    > > news:<[email protected]>...
    > > > mfg wrote:
    > > >
    > > > > "bnd777" <[email protected]> wrote in message
    > > > > news:<[email protected]>...
    > > > > > "mfg" <[email protected]> wrote in message
    > > > > > news:[email protected]...
    > > > > > > >
    > > > > > > > "bnd777" <[email protected]> wrote in message
    > news:<[email protected]>...
    > > > > > > > > My mother who is slim but certainly eats the wrong foods has had high
    > blood
    > > > > > > > > pressure for probably 20 years ........been on meds but even then it
    > was 180
    > > > > > > > > ( she only knows the top numbers I cant get the lower ones )
    > > > > > >
    > > > > > >
    > > > > > > > > Exercise is now out of the question as severe Osteoporosis has
    > distorted her
    > > > > > > > > spine
    > > > > > >
    > > >> > >
    > > > > > Theres no facilities like that near her
    > > > >
    > > > > Make an appointment for your mother with a physical therapist. Go with her. They will assess
    > > > > her and develop a program of assisted movement appropriate for whatever condition she has.
    > > >
    > > > Fyi, they'll likely want her blood pressure better though.
    > > >
    > > > Humbly,
    > > >
    > > > Andrew
    > >
    > > "It will add greatly to her physical and emotional health."
    >
    > Maybe so. However, if she suffers a hemorrhagic stroke because of her poorly controlled blood
    > pressure worsening during the exercise/therapy, it could adversely the financial picture (and
    > emotional health) of the physical therapist.
    >
    > Humbly,
    >
    > Andrew

    What kind of 'exercise therapy' do you imagine a physical therapist is going to give a woman with
    high blood pressure? She is probably going to take her blood pressure, and if it's down (white-coat
    response was what her doctor said, after all) walk around the perimeter of the PT room with her, 14
    ft x 20 ft. if it's like the one I attend. And the lady will probably use a walker AND one hand on
    the therapist. I would imagine, if the therapist found her blood pressure up, she would do nothing
    and report to the doctor. PTs are trained in medical schools, as you of course must know. Here in my
    city, none I know have less than MSc, unless they just haven't finished yet. There are many unknowns
    here with this lady, but IF it is white-coat hypertension, and IF there is access to a hospital
    based PT clinic, then her son might investigate it. Of course, in the UK as in most Canadian
    provinces, the doctor MUST write a prescription before one can see a PT. Enough safeguards for you?
    But if it was me, I would refuse more medication, which seems to be what this lady is doing too.

    What ARE you gonna do with us old broads, eh Andrew? MFG
     
  19. [email protected] (mfg) wrote in message news:<[email protected]>...
    > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message
    > news:<[email protected]>...
    > > mfg wrote:
    > >
    > > > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message
    > > > news:<[email protected]>...
    > > > > mfg wrote:
    > > > >
    > > > > > "bnd777" <[email protected]> wrote in message
    > > > > > news:<[email protected]>...
    > > > > > > "mfg" <[email protected]> wrote in message
    > > > > > > news:[email protected]...
    > > > > > > > >
    > > > > > > > > "bnd777" <[email protected]> wrote in message
    > news:<[email protected]>...
    > > > > > > > > > My mother who is slim but certainly eats the wrong foods has had high
    > blood
    > > > > > > > > > pressure for probably 20 years ........been on meds but even then it
    > was 180
    > > > > > > > > > ( she only knows the top numbers I cant get the lower ones )
    > > > > > > >
    > > > > > > >
    > > > > > > > > > Exercise is now out of the question as severe Osteoporosis has
    > distorted her
    > > > > > > > > > spine
    > > > > > > >
    > > > >> > >
    > > > > > > Theres no facilities like that near her
    > > > > >
    > > > > > Make an appointment for your mother with a physical therapist. Go with her. They will
    > > > > > assess her and develop a program of assisted movement appropriate for whatever condition
    > > > > > she has.
    > > > >
    > > > > Fyi, they'll likely want her blood pressure better though.
    > > > >
    > > > > Humbly,
    > > > >
    > > > > Andrew
    > > >
    > > > "It will add greatly to her physical and emotional health."
    > >
    > > Maybe so. However, if she suffers a hemorrhagic stroke because of her poorly controlled blood
    > > pressure worsening during the exercise/therapy, it could adversely the financial picture (and
    > > emotional health) of the physical therapist.
    > >
    > > Humbly,
    > >
    > > Andrew
    >
    > What kind of 'exercise therapy' do you imagine a physical therapist is going to give a woman with
    > high blood pressure?

    If her blood pressure is poorly controlled, I would imagine "none."

    Humbly,

    Andrew

    --
    Dr. Andrew B. Chung, MD/PhD
    Board-Certified Cardiologist
    http://www.heartmdphd.com/
     
  20. Mfg

    Mfg Guest

    [email protected] (Dr. Andrew B. Chung, MD/PhD) wrote in message news:<[email protected]>...
    > [email protected] (mfg) wrote in message
    > news:<[email protected]>...
    > > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message
    > > news:<[email protected]>...
    > > > mfg wrote:
    > > >
    > > > > "Dr. Andrew B. Chung, MD/PhD" <[email protected]> wrote in message
    > > > > news:<[email protected]>...
    > > > > > mfg wrote:
    > > > > >
    > > > > > > "bnd777" <[email protected]> wrote in message
    > > > > > > news:<[email protected]>...
    > > > > > > > "mfg" <[email protected]> wrote in message
    > > > > > > > news:[email protected]...
    > > > > > > > > >
    > > > > > > > > > "bnd777" <[email protected]> wrote in message
    > news:<[email protected]>...
    > > > > > > > > > > My mother who is slim but certainly eats the wrong foods has had high
    > blood
    > > > > > > > > > > pressure for probably 20 years ........been on meds but even then it
    > was 180
    > > > > > > > > > > ( she only knows the top numbers I cant get the lower ones )
    > > > > > > > >
    > > > > > > > >
    > > > > > > > > > > Exercise is now out of the question as severe Osteoporosis has
    > distorted her
    > > > > > > > > > > spine
    > > > > > > > >
    > > > > >> > >
    > > > > > > > Theres no facilities like that near her
    > > > > > >
    > > > > > > Make an appointment for your mother with a physical therapist. Go with her. They will
    > > > > > > assess her and develop a program of assisted movement appropriate for whatever condition
    > > > > > > she has.
    > > > > >
    > > > > > Fyi, they'll likely want her blood pressure better though.
    > > > > >
    > > > > > Humbly,
    > > > > >
    > > > > > Andrew
    > > > >
    > > > > "It will add greatly to her physical and emotional health."
    > > >
    > > > Maybe so. However, if she suffers a hemorrhagic stroke because of her poorly controlled blood
    > > > pressure worsening during the exercise/therapy, it could adversely the financial picture (and
    > > > emotional health) of the physical therapist.
    > > >
    > > > Humbly,
    > > >
    > > > Andrew
    > >
    > > What kind of 'exercise therapy' do you imagine a physical therapist is going to give a woman
    > > with high blood pressure?
    >
    > If her blood pressure is poorly controlled, I would imagine "none."
    >
    > Humbly,
    >
    > Andrew

    Me too, because I know most PTs are well-educated and careful. But I also think physicians rely too
    much on a pharmacology approach. It sounds to me like this woman has other ideas, and there is just
    a possibility that insistence on telling her what she must do could negatively affect her blood
    pressure. Isn't 'get some exercise' (even if only walking the length of your living room with a
    walker) something we are told to do by cardiologists?

    Or would you be putting her on one of the new antihypertensives, which have been shown (not by
    pharma, or cardiology 'consultants', but by epidemiologists) to perform no better than a diuretic,
    but with far greater side effects and cost? I think the new heart guidelines would suggest we start
    her on statins, too Andrew.

    And then when she gets acid reflux, pancreatitis and gall bladder symptoms (any statin side effect
    list, the physician's desk ref, perhaps?) let's give her pimozide; and when she gets a helicobactor
    pylori ulcer (vida supra)let's get her on an antibiotic, and then when the statin causes depression
    (vida supra the PDR) an SSRI. Of course, that will keep her awake (vida supra ad nauseum)-- bring on
    the Ativan to conk her out. Ooops she fell in her half numbed state on the way to the bathroom and
    broke her hip... .

    MFG
     
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