I moved to a new country, actually a new continent. I had a very thorough medical at my interview and then another medical 4 months later when I started the job. Both medicals found me fighting fit. Blood tests all came back negative, blood pressure fine and lungs the size of Nebraska. I have been a weightlifter for over thirty years.
After a few months I went to my new medical centre complaining of a headache which didnt go away after I took some paracetamol. The nurse took my blood pressure. This wasnt simple because I have huge muscular arms and he had to really pull on the cuff to get the velcro to overlap. He eventually managed this and got a blood pressure of 210/120. This is a really, really bad blood pressure. The nurse went into a panic and started shouting, literally, for a doctor. The doctor came running, again literally. I was sitting in a chair perfectly calm, reading a pamphlet about quitting smoking and feeling fine except for this light headache which would not go away.
Anyway, the doctor looked at me quite puzzled and asked me how I felt. A blood pressure of 210/120 is about the same as a truck tyre and blood should have been spouting out of my eye sockets. He hummed a bit and then decided to take my blood pressure again. This was after he told me that I was probably about to have a heart attack or at least a stroke. He actually could not get the blood pressure monitor cuff to fit around my arm. It was one of those all digital things. The cuff goes around your arm, the nurse hits a button and the display shows the blood pressure. Simple. In theory. The doctor asked me to go to a different part of the medical centre where there was another machine with a bigger cuff. The bigger cuff was still too small but it did just about fit round my arm. This time the reading was 170/85. Much more reasonable but still too high for a normal person. The doctor made me lie down on a bed for 15 minutes and took my blood pressure again with the machine with the bigger cuff. My reading was 200/100 and he was back to the "You are about to die ...." speech. I kept telling him I felt fine but he clearly wasnt listening to a word I was saying. He kept asking me if I felt dizzy had neck pain and a whole host of other questions which I answered no to. He took another couple of blood pressure readings, all in the "imminent death" quartile and decided to prescribe me some drugs which he assured me would make me feel better. I had to take the drugs and come back in one hour. So I did and I did feel better. My blood pressure reading was still in the red but the doctor seemed happy to send me home. I had to report twice a day to have my blood pressure taken. The medical centre was close to where I worked so this was not a problem.
My next day at work was interesting. The school nurse asked me to come to her to have my blood pressure taken. She had a fully equipped emergency room and a blood pressure machine which I later discovered costs over one hundred thousand dollars. It also had a micro cuff which would barely fit around the arm of a barbie doll. But she persevered, took my blood pressure and recorded my highest ever reading of 220/120. I actually watched the blood drain from her face and heard her call for an ambulance. I asked her if it was normal that the velcro of the bp meter cuff came apart but she was beyond listening and was obviously terrified to be the first school nurse to have a death by heart attack in her beautifully equipped room. I am a teacher, by the way.
The ambulance arrived, I heard the nurse, in hushed terrified tones, explain to the ambulance guys that my blood pressure was 220/120 and I could already be in cardiac arrest. So they walked into the treatment room serious-faced expecting to find an ashen-faced near-corpse. Instead they found me sitting calm, relaxed, pink with life and reading a pamphlet about post-natal incontinence. The two ambulance guys looked at each other, made a huff noise and then looked at the nurse and made the same huff noise. They asked me if I could get into the wheelchair they had brought for me. I said yes, I was able but wouldnt it be easier if I just walked down to the medical centre which was literally a 2 minute walk away. It would have taken longer to drive. They asked me lots of questions about how I felt, dizzy etc..... to which I replied I felt absolutely fine. They insisted I walk to the ambulance and then they drove me to the medical centre where I was seen in the emergency room by the attending doctor. He took my blood pressure again, 170/85, asked me the dizzy questions again, prescribed me more drugs and told me to come back in two hours. This I did. He took my blood pressure again, 170/75 and said it was still to high but the 75 was good. I forgot to tell him that I had spent over an hour in the gym lifting weights but he didnt seem to be interested in anything I said.
This went on for three months. I never had a blood pressure reading below 170/80 despite a variety of chemicals being applied. One doctor used the expression "aggressive" hypertension and used this to justify even more chemicals. These ones made me feel dizzy. I told the doctor this but he simply ignored me.
I had had enough. I then spent a few days looking up the whole blood pressure issue. My findings were that taking blood pressure is actually a bit of a lottery. Basing a diagnosis on a single reading is ludicrous. Taking blood pressure is also very prone to inaccuracy if the cuff is too small, too big or not placed correctly on the arm. Other factors which can affect accuracy include taking exercise before the reading, being very hot, having a full bladder and having muscular arms.
The cuff of the digital blood pressure machine works by inflating to a point where a sensor detects that the blood has stopped flowing in the arm. This is the first number in the blood pressure reading. The cuff then deflates to a point where the blood starts to flow again and this gives you the second number. The digital blood pressure meters are not infallible. They can be wrong, especially if the cuff is too small. A cuff generally has to overlap about 50% otherwise the velcro cannot get a good grip and the reading is likely to be incorrectly high. In my case, the velcro hardly overlapped at all making an accurate blood pressure reading impossible.
The classic hand operated blood pressure meters are basically infallible. They cant go wrong. A trained person will use a stethoscope to listen to the arterial flow of blood and will use the hand pump to inflate the cuff until the pulse in the arm disappears. They will then slowly release the pressure in the cuff until the sound of blood rushing back into the arm is heard. This is the first bp number. The pressure is then released until the sound of blood flowing disappears, this is the second number. They had one of the old style blood pressure meters in my medical centre but the cuff physically would not go around my arm so I have had all of my blood pressure readings taken on the same digital machine using the same cuff.
Blood pressure is measured in the number of millimeters of mercury. So the perfect blood pressure of 100/80 means that 100 millimeters of mercury is the highest the blood pressure gets and the 80 is the lowest the blood pressure gets. There are two numbers because your heart sends blood around your body in one big squeeze. The pressure at the very beginning of the squeeze is highest and gradually goes down until the heart beats again. 100/80 means that the pressure at the very beginning of the heart contraction, or heartbeat, is 100mm of mercury and just before the next heartbeat it is 80mm of mercury.
I read many cases of misdiagnosed high blood pressure where medication has been prescribed unnecessarily and to the harm of the patient. I also read about "white coat" syndrome. This is where a patient presents high blood pressure only in the doctors surgery. Home readings can be as much as 20 or 30 mm of mercury lower.
I went back to my doctor and asked some questions. I made this case:
Firstly, I feel fine.
Second, I exercise regularly and perform feats of weightlifting which send my heart rate to over 160 beats per minute. I regularly spend 2 hours lifting weights in this manner and I have never died of a stroke so far. If I had high blood pressure surely I would now be dead.
Thirdly, my blood pressure was fine in my two medicals so why would it suddenly jump.
My doctor got really pissed off at my questions and refused to speak to me. Instead he sent me to have a barrage of blood tests. They all came back negative. I have low cholesterol, low sodium, perfect blood sugar, normal thyroid, liver and kidney function. Not bad for a 46 year old fat guy. I am overweight. OK I admit that. I have never been thin but I have always been fit. I spent a lot of my youth in gyms and when I was 27 I got over a broken heart by becoming a bodybuilder. I was huge. Even at my current advanced state of decrepitude I can still bench press a bar, not a cursed machine, weighing 60KG 25 times. I can still do cleans with a 50kg bar in sets of 5 and I can generally lift any woman I please above my head. Women dont like that and I havent done it since I was 30 and then it was my wife, sorry, ex-wife. I digress. My doctors' response to all of this anecdotal evidence was to prescribe different chemicals which made me even dizzier.
A clear pattern was emerging. Up till this point I had rarely ever been to see a doctor. My naive view of these omniscient, caring professionals was largely formed by watching tv hospital soaps. My reality was that they were arrogant pill-pushers whose main responsibility was to get you out of the consulting room with a bag of chemicals which they could justify and asking questions merely annoyed them.
One doctor sticks out in my mind. Imagine the stereotypical fat guy. The one you see in many silent black and white movies. This doctor was him. His every breath was like listening to someone suck molasses through a straw. His jowls drooped down to the middle of his chest and his fingers were so fat he could barely use a pen. My first consultation with doctor Fat would not be out of place in a tv comedy. He looked at my history on the computer, looked at me and then gave me the following advice, without asking me anything. He suggested that I stop eating junk food, cut down on the alcohol, start to take exercise, like walking for 10 minutes every evening and get my weight down as this was causing my high blood pressure which was now in danger of killing me. He actually used the words "killing me". I guess I had reached bullshit saturation point cos I could not take any more. I informed him, in a very sarcastic tone which my students are very familiar with, that he was totally wrong in all of the many assumptions he had made based on no actual evidence whatsoever. I am practically a vegetarian and I never eat any form of fast food. I am a foodie and a pretty good cook. I dont drink alcohol. I spend 2 hours at least three times a week in the gym and I swim. I weigh less now than when I had my medical three months ago and apparently my blood pressure was fine then so weight is not causing the alleged high blood pressure which I still doubt is actually real. His wee fat face went red and he started shouting at me. The bits I understood had words like "denial" and "sorry state". I was tempted to say something about the pot calling the kettle fat but I didnt. I got up and walked out. My view of doctors forever changed by doctor Fat.
When I started typing this I expected it to take 10 minutes. This is way too long but I feel a cathartic need to get all of this down. I will continue tomorrow.
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