Heather,
it is very normal for you to want to question your pcp's health plan for you since there actually seems to be no plan in place. It woud behoove you to request to see the doctor not the np when you go in for your next appt. Tell the office you have some concerns and really need the doctors advice for this personal issue. (even though it is not really personal, they cannot ask you once you say it is personal)

after being treated for ten years there should be an entire volume of your medical records that just involves your blood test and pressure workup information and what meds they are using to combat this problem. You should be having ultrasounds of your heart to verify that the size is right and many other tests. It is time to demand to see a specialist! You cannot depend on the primary care doctor to be a cardiologist just like the cardiologist cant be your pcp. Somtimes it is hard to convince a well intentioned pcp that they are not qualified to treat a special problem like you have.

Good luck and let us know how you do!

How do you demand to see a specialist without offending your pcp?
Can you go to one without your pcp advice? I actually doubt my pcp would refer me to one! I am 28 and have suffered from uncontrollable high bp since I was 23 along with numerous other problems that are never resolved, just keep being told everything is caused by anxiety, even though I rarely feel anxiety!
My bp ( on 3 meds) is in the 140/90 range, after a recent trip to the er with pvc's it was 174/108 or around that, and at recheck with my doc it was 150/102. The bottom number is way too high! My doc will not switch my meds, just plays with the dosages,and says we will watch and see.
I am afraid he is going to let me die while he waits. Or that he thinks I am a hypochondriac because I worry. But those numbers are not right for someone my age, especially when I have suffered from severe headaches, dizziness, chest pain , adrenaline rushesand numerous other things, along with the recent er trip with pvc and low potassium.
What do I do>

The best advice I can give would be to ask for a referal and if your primary care doc refuses to give you a referal, he/she is in the wrong. There is something wrong with a pompus doc that tells you he will not refer you.

You sould do the leg work of finding the doc you want to see and then ask him to give you the referal. He doesnt have to have an idc9 code to send you. You can just go to check if there is a real problem and if you need to have other service to get your heart under control.

It isnt just my high blood pressure that concerns me, I have had numerous issues in the past, and of all of them, my doc will do "tests" occassionally , if I am very annoying about constantly asking, then when/if they are negative, he is kind of "i told you so". But he makes no effort on his own to find a cause.

Honestly,

i understand your frustration and also your fear of the unknown. If you have had the same pcp for years and trust this doc. You should do what your heart tells you. If your heart is telling you that you need to see a professonial that specialises in the area you are concerned with. Get the referal. If your heart is telling you to trust him and not become demanding with him, you should follow your heart.

I am one to demand answers, and if I made a mistake "thank god" and pat the doc on the back and say, "you were right" but at least there is nop chance for either of you to be totally wrong and have you or a loved one lose their battle with life over a point of contention.

Your body is yours and if your physician will not help you to maintain it properly, you really need to find one that will. If when you get all of your results back, the other doc is right on the money. He can be proud of himself but heaven forbid he be wrong even one time.

This is an interesting topic.

I was diagnosed with hypertension in my late 20s (i'm now 34). I've tried every lifestyle change I could (quit drinking completely, quit smoking many years ago, cut down on salt, upped the exercise), but nothing worked. My cholesterol levels are excellent and i'm not overweight.

Finally, I started on medication and nearly every one would work really well for a while. The first time I tried a medication, my blood pressure went down that very day. Even my doctor remarked that it normally took a lot more experimentation than that. Then over time, for almost every one, the effects would wear off.

For the last year or so i've been on diovan and hctz/tm. They've been working really well and my blood pressure has been under excellent control (usually under or around 120/80). Now in the last few months it's been creeping back up. Two or three months ago it was getting close to borderline. Now my numbers are usually 160/100! I'm not doing anything different and still taking my medication every single day. I have an appointment in a few days.

I would definitely recommend seeing a different doctor if you're not satisified. When I was first diagnosed they did a fairly completely screening, I had an mri and blood work to rule out kidney problems, blood tests to rule out tumors, etc..

Under my insurance, I don't even need a referral. I decide who I want to see, my current doctor is in internal medicine with a special interest in hypertension, which is why I chose her. I've switched doctors three times over the course of six years or so. So check your insurance, you may not even need her permission to see someone else! Don't feel bad about offending anyone, this could be your life on the line and you're entitled to a second opinion.

I can't believe someone would complain about taking 3 pills a day. I take about 30 pills a day and still have trouble controlling my blood pressure. I have a cardiologist, a nephrologist, an endocrinologist and a PCP. I've had about every test, x-ray and scan you can think of. I am a Medical Lab Technician who has hounded my docs about tests to be done. No specific cause and not yet able to control it. Talk about frustrating.

I had a similar problem with uncontrolled high blood pressure. I was fortunate enough to have a cardiologist group following me. I ended up with a small benign tumor on my adrenal gland. This is somewhat uncommon but a cause for high blood pressure. I was taking 4 meds and had a heart attack that I never knew about. My potassium was low and that was a small clue, but a CT scan showed it.

I have similiar uncontrolled blood pressure. I've spent time with pcp's, cardiologists, and nephrologist. I also find that blood pressure meds will work for a time then fail to work while my blood pressure rises. In the 90's I was running 160's/99 with about five meds maxed out. My pressure would increase to 180's at times. I also notice if I quit taking the med's my pressure would decrease. I wouldn't suggest doing this without monitoring it closely.

I did find one thing that would reduce my blood pressure....and only one thing. Oh, by the way, I also tried all sorts of eastern style medicine without success but with enlightenment. This included acupuncture, acupressure, chiropractics, diets, reiki, massage, cranial sacro, chinese energetics, prayer.

The only thing that actually worked for me was doing the "Master Cleanse" diet. Look it up on the internet. I did this diet for 5 days and it would drop my BP to 120/80 without meds. That was in the nineties.

I had my bp down for a while without meds(140/80's), but then it started creeping up and I wasn't watching it(now in the 2000's).

It got high again and I went to the doctor and of course they put me back on meds and everytime I see the doc I get new meds and increased doses of my old stuff. I thought I'd let this doc give it a try since I also damaged my kidneys some since my bp was so high.

I'm current talking the following meds and my bp is anywhere from 180/99 to 240/120. Not good....

4mg Doxazosin, 200mg Metoprolol, 60mg Furosemide, 50mg Hydralazine, 10mg Enalapril, .3mg clonidine

Since the increase of meds hasn't seemed to help I started the "Master Cleanse" again. I'm on my 3rd day and I hope I will see my bp drop soon.

The biggest problem with the Master Cleanse is that I can't live on this. As soon as I start eating regular food my bp goes up. This time I'm going to start with just raw vegetables and fruit when by bp is back to 120/80 and I'm going to keep a good journal of what I can and can't eat.

Also, I'm 48 and look like I'm 30. I'm in good shape but I haven't been good about keeping my cardio up thought I work and physical job every day. I'm not overweight and people would never guess I have high bp.

Hope this helps someone and maybe give data back if you find something other than the Master cleanse.

CaptAndy

This post is being reviewed and is temporarily unavailable.