BP medication

L

LayOffTheDoritos

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Hi all, looking for some general input (read: reassurance) about a situation I’ve stumbled into. I've done plenty of homework so I'm fairly confident I'll be just fine, but I've always had a bit of anxiety about some surprise medical change having a detrimental impact on my upcoming 2nd class renewal, or even taking my wings away. Wouldn't mind a sounding board to ease the unease.

Had a doc visit recently after a long while without one due to the pandemic. I was in excellent shape in the summer of 2020, but unfortunately I got lazy and let my exercise routine slip away as my diet went to hell with it. I was aware I had let myself go a fair bit, but stepping on the scale at the doc's office was a VERY rude awakening(literally blurted out "that can't be right"). I also found out that my blood pressure had also gone up significantly, reading about 150/105ish iirc, when I've always known it to be right at 120/80. Not to mention, I'm now getting over a very new and unfamiliar brush with gout, which partly precipitated the visit in the first place. All amounting to a swift kick in the ass to get back in shape. I'm only 31 for christ sake, going from carefree 20s to suddenly being an old man sucks. Feels like all my dash lights just came on at once.

Anywho, on to the meat of my present concern. The doc wanted to put me on BP meds, but my lizard brain refused in favor of getting my diet and exercise back in shape first. I wanted time to research what kind of effect such a prescription would have on my flying. My readings lead me to believe it should not be a problem as long as it is well controlled on under 3 medications.

Asking for experienced opinions, did I choose wisely? Should I go ahead and accept the meds anyway, to get the BP down quicker while I shed the pounds? Or simply lean into getting fit, likely not even needing meds before long? I have another follow-up coming up soon to run some blood labs. I am very committed to taking better care of myself first and foremost, just don't want to needlessly risk the medical if I don't have to.


Thanks
 
Buy yourself a blood pressure cuff and a scale and use them regularly. The BP medications are no big deal. BP is wear and tear issue and the longer you let it go the more wear and tear on your parts.

Also white coat hypertension is a real thing. I take my BP at home almost every morning and I am in the one teens over seventies if I take it in the evening usually low one twenty's or high one teens. I go to the doctor it is always pushing 140 sometimes in the 150s and yes I have checked my cuff.

I get very frustrated how they check BP these days. They bring you in sit you down and the first thing they do is take your BP. They should probably take your BP later in the exam. They also rarely elevate your arm. Remember in the old days when the nurse would put your arm under her arm pit and check your BP? That is because the arm is supposed to be at the level of heart when the reading is taken. The other bad habit they have is asking you questions and talking to you while thy are taking your BP. It should be taken sitting up after a quiet period with your feet flat on the floor and arm elevated to heart level. I have told the nurse in the past to either wait or have the doctor take it a second time later in the exam after I have relaxed a bit. One last thing if you have large arms make sure they use a bigger cuff.
 
Blood pressure readings my most practitioners is atrocious. Doctors are by far the worst at it. In 40 years since I was trained to do it properly, I've seen probably twice a doctor do it right. Nurses do a bit better, but are usually pretty sloppy as well. Much like your right turning tendency most errors pile up on the overly high reading:

1. Not supporting the arm
2. Over inflation of the cuff (should be just enough to remove the palpated pulse).
3. Multiple inflations on the same arm in short order.
4. Improperly positioned cuff.
5. Wrong size cuff.
6. Cuff applied over clothing
7. Patient not sitting erect.
8. Patient not staying still/quiet.

Oh, and here's one that can run your pressure up 15 points: having to pee. Offer to get the urine sample out of the way first thing rather than dancing your way through the exam.
 
I've been on BP meds a long time. It's no big deal, there are many choices of meds, find one or two that work for you. You don't mention cholesterol but that is probably coming. I started those meds at your age, I'm almost twice your age now and still going strong. Anecdotally, I have a couple of friends who ignored these issues at my age, both had heart attacks in the past few years. One was hours away from the big one, but was saved with no damage. The other unfortunately lost a lot of heart function and is physically disabled now. I've been lucky and I hope it continues.

I think you are fine trying the exercise and weight loss thing, you need to refined carbs and limit portions. For me bike riding works best for exercise, followed by walking. I ride at least an hour 4 times a week. During the pandemic I lost control on my weight. I came back from Hawaii in March and weighed 212 pounds, I'm about 5"11". It was too heavy for me, especially with hypertension. So I joined Weight watchers, I do it online, and it has worked great. I did it about 10 years ago and got down to 185. Back then there was no app, just a little book. It's much better now. What I was shocked at this time around was just how much extra calories I was eating. I've turned that around now, haven't felt hungry since I started. I got on the scale this morning and was at 187. My goal is 175.

The key is to get this stuff under control. If exercise and diet works, great, if not, take the pills. You'll read horror stories about the meds if you look, my advice is don't. Remember that many people on these pills waited too long and have issues that they blame on the pills. If you have issues when you start, call your doc.

Oh, I have gout too. I treated that successfully with diet for a long time. No beer, distilled spirits, only red wine in moderation. Limited shell fish and certain seafood. Avoid high praline foods. I finally started a uric acid lowering med, I'm male, so I definitely waited too long to start. If you have more than one or two outbreaks a year, start the uric lowering meds. You'll be glad you did.

All these conditions can get a medical. If you don't take care of them, they will end your flying eventually.
 
Every day in which your diastolic is over 80, your are wearing tread off of your non replacable human tires. Get treated, get ti down and after you have lost he weight, get tit readjusted. Aeromedically, all we need is a note from your doc "I am satisfied with pilot Dorito's hypertension control" after each change.

Stop that silent treadwear. In its tracks.
 
LayOffTheDoritos said:
Hi all, looking for some general input (read: reassurance) about a situation I’ve stumbled into. I've done plenty of homework so I'm fairly confident I'll be just fine, but I've always had a bit of anxiety about some surprise medical change having a detrimental impact on my upcoming 2nd class renewal, or even taking my wings away. Wouldn't mind a sounding board to ease the unease.

Had a doc visit recently after a long while without one due to the pandemic. I was in excellent shape in the summer of 2020, but unfortunately I got lazy and let my exercise routine slip away as my diet went to hell with it. I was aware I had let myself go a fair bit, but stepping on the scale at the doc's office was a VERY rude awakening(literally blurted out "that can't be right"). I also found out that my blood pressure had also gone up significantly, reading about 150/105ish iirc, when I've always known it to be right at 120/80. Not to mention, I'm now getting over a very new and unfamiliar brush with gout, which partly precipitated the visit in the first place. All amounting to a swift kick in the ass to get back in shape. I'm only 31 for christ sake, going from carefree 20s to suddenly being an old man sucks. Feels like all my dash lights just came on at once.

Anywho, on to the meat of my present concern. The doc wanted to put me on BP meds, but my lizard brain refused in favor of getting my diet and exercise back in shape first. I wanted time to research what kind of effect such a prescription would have on my flying. My readings lead me to believe it should not be a problem as long as it is well controlled on under 3 medications.

Asking for experienced opinions, did I choose wisely? Should I go ahead and accept the meds anyway, to get the BP down quicker while I shed the pounds? Or simply lean into getting fit, likely not even needing meds before long? I have another follow-up coming up soon to run some blood labs. I am very committed to taking better care of myself first and foremost, just don't want to needlessly risk the medical if I don't have to.
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You don't say how much weight you've gained, but 150/105 is *really* high. Especially if you had always been normal before. Your doc didn't insist you go on meds or do further testing to determine if the new hypertension is secondary to some other issue?

As for your medical, if that BP can be lowered with meds, you won't have an issue as others have said. But you've got to get it down. Take the meds, then lose the weight, then see what happens.

Also, my understanding is that white-coat hypertension has been pretty much debunked.
 
flyingron said:
Blood pressure readings my most practitioners is atrocious. Doctors are by far the worst at it. In 40 years since I was trained to do it properly, I've seen probably twice a doctor do it right. Nurses do a bit better, but are usually pretty sloppy as well. Much like your right turning tendency most errors pile up on the overly high reading:

1. Not supporting the arm
2. Over inflation of the cuff (should be just enough to remove the palpated pulse).
3. Multiple inflations on the same arm in short order.
4. Improperly positioned cuff.
5. Wrong size cuff.
6. Cuff applied over clothing
7. Patient not sitting erect.
8. Patient not staying still/quiet.

Oh, and here's one that can run your pressure up 15 points: having to pee. Offer to get the urine sample out of the way first thing rather than dancing your way through the exam.
Click to expand...
I'd wager most docs know how to take it correctly, but quick and dirty is often Close Enough. It's all false precision anyway, since your BP can vary over a very short time.
 
Not sure what works for others or what your doc might recommend but my doc put me on the treadmill (or brisk walk through the park) at least 30 minutes a day to get that heart rate in the zone. Had me lose a few pounds (a little extra weight goes a long way in raising BP especially if you're slacking), and making some dietary adjustments to include getting excess sodium out of my food as well as backing off the glucose stuff. I still eat some of these things but moderation really is the key and that takes discipline.

The amazing thing is that these changes also help cholesterol, give better stamina, and other great benefits. It's not a diet and exercise program ... it's a way of life.
 
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I was starting to get flack from my regular doctor(s) about my blood pressure. I spent about seven months exercising and losing 40 pounds. My BP numbers are well under 120/80 now and the lipid panel came back normal.

Of course, my wife's BP went down after she ditched her first husband. Her AME said that it was amazing what losing 170 excess pounds can do.
 
Thank you all so much for your input, I really appreciate it.

Tools said:
Now be truthful, have you been ignoring the check engine light? Just sayin...
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Yep, I have to admit, I’ve been feeling like relative crap for a while. While I obviously take full responsibility, it really crept up on me over time. Now I just feel totally sapped for energy most days. As I said, two summers ago I was doing great. Exercise and cardio almost every day, and kept my weight down to a comfortable and energetic 190 on a sensible diet. Then a few unfortunate life circumstances happened(relationship gone bad, covid affecting so much of my day-to-day, difficulties with poorly-run degree program, a crazy work schedule switching between days and nights, etc),I slipped off my fitness wagon and my diet slowly degraded from there. From salads and workouts everyday, to salty bottom-tier fast food frequently in a sedentary routine. I was already ashamed thinking I had ballooned back up to 230ish, but seeing 265 on the scale was a real embarrassing eye-opener.

I think I’ll go ahead and request the meds at my follow-up in a couple weeks now that I’m reasonably sure it won’t be a problem. May as well get that in check to “stop the wear” asap, then reassess as I lose weight and keep monitoring BP. I’m getting back on track already, down a few pounds and working hard to really get back into the workout groove. I agree with “health first, fly later and longer,” just didn’t want to throw a wrench in the gears while I worked on it. Flying is such a huge part of my life, I can’t imagine ever giving it up.

Clear skies and tailwinds,
-Dorito
 
LayOffTheDoritos said:
Thank you all so much for your input, I really appreciate it.

Yep, I have to admit, I’ve been feeling like relative crap for a while. While I obviously take full responsibility, it really crept up on me over time.
Click to expand...

In a similar situation... only my hiatus from working out was due to sever fractal of my elbow that required three surgeries... one to fix it, on to take care of an infection, and another to take come of the hardware out. Fun stuff..

Anyway the road back is a tough one.. I have a picture of me at age 30.. I know I'll never be like that, but I think I can do it weight wise. Chin up mate, you'll get there.
 
Ventucky Red said:
In a similar situation... only my hiatus from working out was due to sever fractal of my elbow that required three surgeries... one to fix it, on to take care of an infection, and another to take come of the hardware out. Fun stuff..

Anyway the road back is a tough one.. I have a picture of me at age 30.. I know I'll never be like that, but I think I can do it weight wise. Chin up mate, you'll get there.
Click to expand...
I broke both my arms in early 2020. I would have had surgery immediately if it hadn't been for covid. Instead i had it 8 months later. At the time of my accident, I was on the verge of obesity. I'm now in better shape that I was 25 years ago. Ironically, all the PT was the kick in the ass I needed.
 
bbchien said:
Every day in which your diastolic is over 80, your are wearing tread off of your non replacable human tires…
Stop that silent treadwear. In its tracks.
Click to expand...
Well, do everything you can to slow it down, but you can’t stop it. ;)
 
I got my BP down from 197/98 to 127/78 in 4 months of exercise 3-4 days a week lost about 15 lbs without any medication. Doctor didn't want to put me on meds because he said more then often he sees people use it as a crutch they don't exercise because the meds do the work. I'm in my mid 50's your in your 30's should be able to correct the BP with exercise even faster.
 
The other thing to do is to get really serious about calories, carbs, etc, and be brutally honest about it. I’m under 175, but had slowly gained nearly 20 during COVID and only recently got real serious about knocking that back off when it became apparent that the alternative was buying a new wardrobe of 34 inch waists…
So far, tracking everything with MyPlate on iOS and MapMyWalk I think I’ve got the trend reversed and hope to keep it going that direction. My motivation is the roughly 400# crew limit on my Luscombe and I don’t want to be turning 230# guys down for tailwheel because I’M the one that’s too heavy to accommodate.
 

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