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Having headache and back, neck pain. On Tegretol. Done with bone density test. Surgery needed?

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General & Family Physician
Practicing since : 2003
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Hi, My name is XXXXXX. I am on the following meds. Tegretol xr 200 mg (slow release) take one a day at 10:00 pm--I have Tri. N. since 1994, had surgery in 2003 for Atypical did not get relief until 2011. The pain quit in October of that year and I am still on the med (200) mg.. afraid that it may come back. Have not had a pain since Oct. 2011. I have A. Fib, started in XXXXXXX of 2008. Was hospitalized and was put on Atenolol 25 mg. one a day at 10:00 p.m. Also was put on Warfarin 15 mg. every night except Friday I take 10 mg. Take Vit D on Thursday night by prescription 50,000 units per week take @ night 1 tablet. My problem is: Whenever I eat -no matter what
time of day my blood P. dropps from 140 to 96 sometime lower and I can not navigate and have to go lay down. At this point I do not eat. Drink water, and Perrier. Also Soda Crackers. My BP drops immediately after I eat chicken, bread etc. no matter the menu. I suffer fatigue and cannot function, so I take salt with water, with in 45 to 60 min. I am able to function w/BP coming up to 127. My goal per heart Dr. is 140 over 80. Along with this problem I feel like someone is pushing on the top of my head, and then a headache. Sometimes the heaache in the back of my neck mostly on the right side with terrible pain. It also affects my sinus, I use Vicks to inhale and sometimes it helps, cold wet cloths and within two hours it disappears. I feel like a dish rag the balance of the day. I often feel pressure in my
sinus along with this discomfort. In Feb. of 2013 I went to my family Physician and she had me take a bone density test. The results were I may have hyperparathyroid (what is that I said) too much calcium in your blood stream and your bones are thin and brittle, and we must get you on a program of Fosomax (sp) after hearing all the horror stories about this drug I refused to take it. WOW that created a upset Physician. I asked don't you ave something natural I can take? I do not want to end up with a bone graft in my jaw!!! Anyway to make a long story short I have palpitations, cold feet and spike in blood pressure every day. I am a 77 year old female and on the down hill side of the pyramid, but my parents lived until 93 years of age (Norwegian decent)- I am 5ft. 9 XXXXXXX and weight 149 lb. The Ecologist visited yesterday will take three weeks before I have results from all the Lab. Tests, as she works Part-time. I do not have three weeks to go thru any more blood pressure spikes headaches or fatigue. In this day and age there must be something that can be done to help me. I know that Tegretol. Warfarin, are not the best as they are diluted by my other Meds. Also know they can cause irradiate heart rhythms. What do you suggest that I do? Please do not reply with" a female of your age has been known to rise quickly from a sitting position can suffer from spikes in blood pressure" Is this a seasonal disease ---summer-winter?? I would appreciate any help or advice you can give me. I know the answer to Parathyroid is surgery and the disease is over after the removal. It is uncuttable with meds..

Posted Sun, 21 Apr 2013 in Bones, Muscles and Joints
Answered by Dr. Vaishalee Punj 9 hours later

Thanks for your query.

You described your symptoms well.

While I was going through your history I felt like most of your symptoms of blood pressure (high and low) and headache are side-effects of the medicine tegretal. Check with your doctor if you can be taken off this medicine. A general rule about medicines is that medicines should be taken only if symptoms are present. Otherwise you may be unnecessarily subjecting yourself to the side-effects of it. At least ask for an alternative medicine.

Your second symptom is of post-prandial hypotension. It means drop of blood pressure after eating. In most people it stems from age-related changes that interfere with the body's ability to respond to sudden changes in blood pressure. It cannot be treated with medicines but some life-style changes can make a lot of difference.
The life-style changes can include:
1. drinking one glass of water 15 minutes before food
2. try 6-7 small meals in a day. Bigger meals can trigger hypotension
3. eat slowly digested food like whole grains, beans and proteins.
4. Less of juices, carbonated beverages and refined floor
5. Sit or lie down for an hour to cope with hypotension and to avoid falling down.

About your question about hyperparathyroidism, I will advise that you reconsider taking fosamax until you go for surgery. It will take care of the brittle bones and high blood calcium. It redistributes the calcium in such a way that calcium is deposited at places where it is needed most. Research has shown that it is very beneficial for cases like yours. Always weigh advantages against disadvantages.

Not much research has been done on natural medicines. The side-effects and uses are usually not well-documented. Thus I will advise not to try them.

It is normal to have a rise in blood pressure upon standing up. It may last for 30 min to 1 hour. I will worry if you were getting a low blood pressure upon standing.
Can you tell me how much rise of blood pressure have you noticed. The spike may be high in a background of a history of hypertension.

Hope I have answered your query. Please revert if you have any doubts.

Dr Vaishalee Punj
Above answer was peer-reviewed by
Follow-up: Having headache and back, neck pain. On Tegretol. Done with bone density test. Surgery needed? 15 hours later
Thank you for your advice. What do you suggest in meds. in exchange of Tegretol?
I read that Warfrarin is diluted by Tegretol also Atenolol has some nasty side effects. What do you think of me taking Bioflect (sp>) for AFib. as a replacement of Atenolol? I do not have a rapid heart beat (78/63) but during this I have feelings of my heart not doing another beat then it starts up again. It is fatiguing, also combing my hair when my arms are above my shoulders they feel as though they are very limp. Do you think that the Tegretol has damaged my bones? I will start the Fosomax tomorrow as you suggested. I guess @ 77 this med cannot do that much damage. I still am a bit dubious about age causing this illness when I eat. My para Dr. said I should eat more protein and fat. Can you suggest what some of these items would be. I am never hungry, do not drink soda's (once in a while)---do you feel I may have an autoimmune problem? It is deflating for me to have this problem as I have always been a very active female. Maybe my diet has not been the best. Last ? what are the symptoms of kidney problems? I have a great amount of pain in my lower back. Have to go to BR at least six times day and three times a night. Of course I drink a great amount of H2o. Also constipation which I blame the meds.
Thank you for your time and attention. Will wait for your reply. Thank you again. Bev King

Answered by Dr. Vaishalee Punj 9 hours later
Welcome back,

For trigeminal neuralgia, there are many options available like gabapentin, diazepam with prednisone, etc. Gabapentin has fewer side-effects than carbamazepine. Check with your doctor about which option is best for you. Since you have not had a pain episode in two years, you may discuss with your doctor about tapering the tegretol off.

Atenolol, tegretol, heart rhythm disturbances are all contributing to weakness in you.

I did not understand what bioflect is. If you can let me know in detail I will be better able to help you with that question.

Damage to bones in you seems to be age-related, although it can be a side-effect of medicines too.

Back pain may be related to bones. You need to get investigated for back pain with x-rays. If it is due to brittle bones then it can be taken care of with fosomax, pain-killers and skeletal support with elastic belts.

At 77 years, it is important to take nutritious and high calorie diet. Since you are already having loss of appetite, you may also include nutritional supplements in your diet. Protein and fat are found in appropriate ratio in milk. If you need extra energy you may add milk products like cheese, butter, ice-creams, etc. You need to take 3 proper meals and 3 small meals in a day.

You may also get checked for other causes of fatigue like iron-deficiency anemia, hypothyroidism, diabetes, etc.

None of your symptoms seem to be consistent with auto-immune diseases. Why do you suspect auto-immune disorders? Anyways it is always confirmed on a biopsy of the tissue undergoing autoimmune process.

It is good that you are drinking lots of fluids as it will take care of the extra-calcium in your blood.

Symptoms of kidney problems depend on the type of kidney problem. I think you need an explanation for passing urine at night. There can be many causes of polyuria and nocturia including drinking too much water, diabetes, infection of the urinary tract, medicine side-effects, etc. You may get a urinalysis done to rule out these conditions. You need to get a prescription from your doctor for investigations.

Take care.
Revert back for further clarification.

Dr Vaishalee Punj
Above answer was peer-reviewed by
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