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Suggest Treatment For High Blood Pressure

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Posted on Thu, 15 Dec 2016
Question: I was poisoned by quinolines a number of years ago with major neuromuscular and cellular damage. One of the problems is blood pressure that is highly variable and occasionally goes into stroke range, which is quite frightening. I have been tried on every category of blood pressure medication and have been unable to tolerate any. I currently control it to some degree with medical marijuana, but would prefer not to. I am a 74 year old male. I am in excellent physical condition, as is possible. I have mitochondrial damage, so I have limited ATP production, so when the tank runs out, I start to have severe muscle spasms. Any ideas to control the BP? I forgot to mention that I've also been dealing with Meniere's for the past 30 years.
doctor
Answered by Dr. Suresh Heijebu (5 hours later)
Brief Answer:
Please provide earlier BP medications detail s

Detailed Answer:
Hello Sir.

I can certainly understand your concern and I have worked through your query in detail.

Before guiding you further, I would like to know what medications have you earlier tried to control your blood pressure?

Please provide me with those drug details to guide you specifically.

Thank you.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Suresh Heijebu (13 hours later)
Before I give you that information, let me share a brief history. I was prescribed Cipro in 2003 for a jaw abcess because of a fractured tooth. I started having wild BP swings soon thereafter, along with increased fatigue, weakness and cramping. I had decided to train for an ironman competition and it wasn't happening. I continued on and in 2007 developed pneumonia and was prescribed Levaquin and Prednesone, and again in 2008 I developed pneumonia again and was again prescribed the same thing. After the 2007 dosing, my thyroid was damaged, as well as my kidneys, an my blood pressure was all over the place. In 2008, I went to Mayo Clinic in XXXXXXX for an evaluation, but they couldn't find anything, other than what we already knew had happened, but we still didn't know why. When my thyroid goes out of whack (I have Hashimoto's and recurrent thyroiditis), my BP does with it.

I started using medical marijuana around 2008 because of the intense tendon pain and the severe muscle spasms and cramping. It also helped with the BP.

My doctor(GI) now believes that I have developed "cannanbiniod hyperemesis syndrome", which put me in the hospital 6 months ago. I have to stop the marijuana, but I don't want to have a stroke. I was 205/106 in my GI's office last week because I had radically reduced. I immediately resumed, and got some lowering, but it's still high because I've cut down. I know that the intense tendon pain and muscle spasms will also recur. Because of my kidney damage, my nephrologist doesn't want me taking much. Now to the BP meds and my reaction:

Diuretics-I was given a two day renal insufficiency test using a diuretic and it put me into full body muscle spasms and the second day of the test was cancelled.

Beta Blockers- my resting heart rate is only 39 and at night with a monitor, I've gone down to 30. On the other hand, I can triple my heart rate easily and am quite fit for someone so screwed up.

ACE- Ok for 2 days, 3rd day started cramping and muscle spasms throughout.

Angiotensin II- same patter as ACE

Calcium Channel Blockers- started having chest pains(muscle) within an hour.

Vasodilator- Hydrazaline was tried, by the second day I was shaking uncontrollably, had back pain and was told to immediately stop.

I still believe that the solution somewhere lies in repairing the damage caused by the quinolines, which no one seems to have a clue about. One of my complaints is that I see a number of specialists, but no one pulls the pieces together. So here I am trying to find a partial solution.

By the way, I was forced to retire as a tenured full professor because of this and have a fully funded research XXXXXXX that I had to drop. This was last year. I have limped along for a long time with these issues. I have great genetics as I have a very large family and we keep track of each other's health issues. Longevity runs in the family (90-104) for virtually everyone.

Thank you for taking the time to read this. I'm not expecting a miracle, just a new and different look! XXXXXXX B. Palmer, Ph.D.
doctor
Answered by Dr. Suresh Heijebu (2 days later)
Brief Answer:
Cardioselective beta blockers will help.

Detailed Answer:
Hello Sir.

I have worked through your question in detail.

As per your reports, you possibly seem to have a good intrinsic heart rate.

Based on these parameters, it's important start extended release preparation of cardioselective beta blockers particularly Metoprolol.

I generally prescribe initially a low starting dose of 25 mg once daily at 9 am post breakfast.

Based on the therapeutic response, further dose modifications can be tried.

Pls check with your physician if he shares my view and if can prescribe these medications to you.

Post your further queries if any.
Thank you

Above answer was peer-reviewed by : Dr. REMY KOSHY
doctor
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Follow up: Dr. Suresh Heijebu (12 hours later)
Both my cardiologist and my nephrologist are afraid of beta blockers for me because of my low heart rate. My resting is 39, and on a 24 hour monitor I drop down to 30 at night. Yes, my heart is in good shape. My cardiologist and I are in some disagreement, as I believe the quinolines did some damage and slowed it more than it was before. When I was running daily it was only in the low 40's, and I'm not in that kind of condition now, although I'm as fit as possible. Truthfully, had I not experienced the quinolines, I would probably be the healthiest 74 year old around as I've never been out of shape in my life, even when rehabbing injuries. I will have the conversation again regarding the cardioselective beta blockers and see what they think. If you have any other ideas for me to discuss, I'd be appreciative. Thank you.
doctor
Answered by Dr. Suresh Heijebu (2 days later)
Brief Answer:
Indapamide can be considered

Detailed Answer:
Hello Sir.

Just speak to your Cardiologist with regards to Cardioselective beta blockers.They have minimal influence on resting heart rate.

Additionally you can check with low dose Indapamide.Even though it belongs to diuretic group, the typical side effects are minimal to absent.

Quninolone toxicity will take time to recover.

Post your further questions if any.
Thank you.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar
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Answered by
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Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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Suggest Treatment For High Blood Pressure

Brief Answer: Please provide earlier BP medications detail s Detailed Answer: Hello Sir. I can certainly understand your concern and I have worked through your query in detail. Before guiding you further, I would like to know what medications have you earlier tried to control your blood pressure? Please provide me with those drug details to guide you specifically. Thank you.