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Anxiety neurosis, Hypertension, Diabetes - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Good Posted in: General Health
Answered by

General & Family Physician
Practicing since : 2009
Answered : 638 Questions
Doctor :   hello
Doctor :  
how can i help u?
User :   Hello Doctor
User :   working as software engineer
Doctor :  
ok
Doctor :  
please proceed
User :   thank u,i have few helth problems which are bothering me for quite some time
User :   i have anxiety neurosis , compounded with hypertension
User :   for past 7 years
Doctor :  
ok
User :   in 2002 i had a sever pani attack and was diagnosed with panic disorder
User :   and i am on anxiety and depression medicines
User :   since then
Doctor :  
ok
User :   i take imipramine 25mg
User :   i take imipramine 25mg
User :   daily
User :   and escitalopram
User :   5 mg
User :   for anxiety
User :   and metoprolol 100mg
Doctor :  
ok
User :   and ramipril 5 mg
User :   for hypertension
Doctor :  
ok
User :   li was fine
User :   all these years
Doctor :  
ok
User :   but last month
User :   i had my anxiety problems
User :   reccurring once again
Doctor :  
ok
User :   the reason was i had mild fever and visited a doctor who ordered
User :   my blood test
Doctor :  
ok
User :   and found my fasting glucose levels were
User :   107
Doctor :  
ok
User :   and hb1ac was 6.3
Doctor :  
ok
User :   he told me that i am diabetic
Doctor :  
ok
User :   and i was terrified
Doctor :  
ok
User :   i know the ill effects of diabetes
User :   and started worrying a lot
Doctor :  
ok
User :   but then i was told to monitor my blood glucose levels
User :   everyday
User :   and to my surprise
User :   my fasting glucose initiall was btw 100-110
User :   and now
User :   it is 90-100
Doctor :  
ok
User :   and my post lunch glucose levels
User :   were btw 100-120
User :   after 2 hrs
User :   and were 100-110
User :   any time in the day
User :   and doctor did the random blood glucose test again
User :   and i was intimated that glucose levels were normal
User :   but then the fear constantly stayed in my mind
User :   and i am becoming axiuos day by day
Doctor :  
ok
User :   and my hypertension started elevated
User :   it is always around 140/95
Doctor :  
ok
User :   can you please let me know whether those glucose levels are fine
User :   am i diabetic
User :   and
Doctor :  
ok
User :   also if i take my Blood pressure values
User :   lying down on the bed
User :   it is always 130/88
Doctor :   below 100 fasting blood glucose is normal
User :   or 135/85
User :   after getting tested at doctors office
User :   initially
User :   for 5 days
User :   it was consistently
Doctor :  
and as ur levels are between 90 and 110 we can conider it as high normal
User :   oh ok
User :   i have reduced by 20 punds within 2 months
User :   after this episode
User :   and i am strictly on low carb low calorie diet
Doctor :  
ok
Doctor :  
whats ur height and weight?
User :   5'10"
User :   and i was 240 punds
User :   now ia m 220
User :   pounds
Doctor :  
ok
Doctor :  
just relax
Doctor :  
ur overweight is main reason for ur high glucose levels
Doctor :  
as it is the initial stage u can easily control diabetes by reducing weight
Doctor :  
and ur hypertension will also reduce by reducing weight
User :   how long do you think i can avoid becoming fully diabetic
User :   i dont want to take diabetic medicines
Doctor :  
if u take proper steps now u can totally avoid diabetes
User :   plzz let me what should i do , sir
User :   i am afraid to go to doctors office
Doctor :   yes defenetly
User :   after these things
User :   happened
Doctor :  
ok
Doctor :  
nothing to worry all u need is little dedication
Doctor :  
220 pounds is not good for ur health
Doctor :   u need to do three important things
User :   yes sir
Doctor :  
one is diet management...
Doctor :  
i know it is difficult to control food.....
Doctor :  
but u dont stop eating food suddenly thats not good for health
User :   ok
Doctor :  
u gradually reduce eating step by step..first try to reduce junk foods
Doctor :   they are not good for ur health
Doctor :  
and replace junk foods by fruits
User :   can i take any kind of fruit
Doctor :  
they are low in calories and good source of vitamins and minerals
User :   will that not make any difference in glucose levels
Doctor :  
yes but its better u avoid banana and mango as they are high in calories
User :   ok
Doctor :  
instead of taknig junk foods u first replace them...then u can reduce the quantity of fruits
Doctor :  
are u addicted to alchohol?
User :   no no
User :   never
User :   but i do smoke
Doctor :  
good
User :   couple of cigs
User :   a day
User :   just 2
Doctor :  
how many per day?
User :   jsut
User :   2
User :   i am very much in cotrol
User :   of that
Doctor :  
ok
Doctor :  
thats good
Doctor :  
if possible reduce it to one
User :   ok sir
Doctor :   how many times u take food per day?
User :   sir in th morning these days i am taking sprouts or carrots or cereal bars
User :   in the after noon
User :   lunch
User :   with rice
User :   or some times three chappathi's
User :   night
User :   tiffins
User :   like
Doctor :  
ok
Doctor :  
ok
User :   idly, dosa , or chappathi
User :   or occasioanlly rice
User :   i stopped taking coffe
User :   that i used to take in the evening
User :   or morning
Doctor :  
ok
Doctor :  
ok
Doctor :  
thats good dont change ur menu..
Doctor :  
and are u married?
User :   yes sir
Doctor :  
ok good
Doctor :  
ask ur wife to have add lss oil while cooking
User :   ok,
Doctor :  
food wise fine
Doctor :  
next step is exerscise
Doctor :  
do u go to any gym?
User :   no but these days after dinner i am walking for 30 minutes
Doctor :  
very good
User :   or any time when i get some time
User :   but making sure
User :   atleast 30 minutes
User :   walk isthere
Doctor :   yes thats really good
User :   i use to play tennis a lot
Doctor :  
regular ga walk cheyyandi
User :   in summer
Doctor :  
ok
User :   but as it is winter now here
User :   it is freezing cold
User :   cannot go out
Doctor :   ok
Doctor :  
avoid using car as much as possible to near by destinations
User :   ok sure
Doctor :  
u enjoy ur workout dont take it as a burden
User :   but i am bit afraid with my BP
User :   some times it is touching 150/100
User :   and i feel little bit light headed at that time
Doctor :   ur bp will be automaticlly reduced once ur weight comes down
Doctor :  
fcontinue walking and slowly increase 5 minutes and after 1 or months u should walk for an hour
User :   i am bit afraid that if in office or outside it will raise and i will fall down
User :   do you think my medicines are working
User :   because after taking metoprolol
User :   in the morning
Doctor :  
are u restruicting salt intake?
User :   trying to avoid it in the butter milk
User :   and extra salt
User :   on some items
User :   avoiding all packaged snaks
Doctor :  
not extra salt...u should completely stop salt as much as possible
Doctor :  
i know its very difficult but still no other go
User :   just assure me that there wont be any problem
User :   wwith my BP readings
Doctor :  
problem with hypertension and diabetes is lifestyle change is more importanat than medicines
User :   150./100
User :   at this moment
Doctor :  
ok
Doctor :  
150/90 is a bit high
Doctor :   what are the tablets u are taking now?
User :   metorpolol 50mg in the morning , 50 mg in the night
Doctor :  
ramipril?
User :   rampril 2.5 mg in the morning and 2.5mg in the evening
Doctor :  
ramipril is a good drug
Doctor :  
but any bp drug is only through prescription
User :   ok, but is my dosage at correct levels
Doctor :  
from how many days are u using this medications?
User :   almost for 3 years from now
Doctor :   ok
Doctor :  
from how many days ur bp is 150/90
User :   occassionally
User :   one day it shows
User :   133/88
User :   but occasionally 150/90
User :   i have omron BP monitoring
User :   instrument with me
User :   i check with it freqeuntly
User :   it varies
User :   in a day to
User :   if i am relaxed and take my reading lying down
Doctor :  
ok
User :   then it is always normal or doesnt cross high normal
User :   ie., 140/90
Doctor :  
ok
User :   but if i take the reading sitting it is always 140/94
Doctor :  
this high is because u are stressed
User :   if take my BP same time while lying down and situp after 5minutes and take the reading again it is showing difference
User :   i am really confused with the that
Doctor :   yes

Doctor :  
there will be differnece between postures
User :   so which one will be the correct reading
User :   or average it
Doctor :  
lying down is correct
Doctor :  
ramipril is availabele from 2.35 to 2o mg
Doctor :  
but any change in the dosahge requires close moniterin as some times it may lead to hypotension
Doctor :   ur bp is continously 140/90 ?
User :   while lying dow it is less than that, only when i take it in sitting postion it is always 140/90
Doctor :  
ok
Doctor :  
what about lying down?
User :   yeah its 120-130/90-76
Doctor :  
ok
Doctor :  
then i dont think so u require any dose change
User :   so i should be worried only if the readings are high even in the lying down postion
Doctor :  
yes
Doctor :  
u are right
User :   i think i have asked enough questions, i think you have given lot of confidence
User :   thank you very much for your advice,
Doctor :  
welcome
Doctor :  
pls fill the feedback form
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