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Your ‘Hypertension’ Diagnosis – Get a Second Opinion
Feeling lightheaded or dizzy? Have you been newly diagnosed with hypertension and taking medications for it? Retake your blood pressure! Better yet, have a professional nurse take it with a stethoscope and a sphygmomanometer, note your blood pressure. A normal blood pressure should read 120/80. A blood pressure that reads higher than that for a depicted period may lead your physician to diagnose you with an ICD-10 (I10) billing code of HYPERTENSION. My concern is a two-fold question; did the person taking the blood pressure use an automatic machine and did he/she use proper technique? It is not a mystery or unknown that some technicians will perform their jobs better than others. This concerns me.
Technique is used when taking a blood pressure. The apparatus used is paramount. The reason I say this is because the automatic machines will give you a false reading versus a stethoscope and a sphygmomanometer. With a stethoscope and sphygmomanometer, the technician can auscultate or hear the first ‘thump’ which is the systolic number where the vessel is beginning to open and pressure against the vessel walls are measured when the heart beats. The last ‘thump’ is the diagnostic number; the vessel is open and blood pressure is determined here while the heart rests between beats. This renders a reading of systolic over diastolic. This reading can determine a person’s blood pressure. A diagnosis of hypertension or hypo tension or normal will be more accurate when heard through a stethoscope. I believe this method is more dependable and should be used to diagnostically rather than using an automatic machine.
Automatic blood pressure machines: Automatic machines can be reliable if the baseline (by using a stethoscope and sphygmomanometer) of an individual’s pressure has already been determined; otherwise, there is ambiguity in the reading. Automatic machines offer a ‘quick, fast, and in a hurry’ reading which can be correct but more often incorrect. Some automatic machines may render more accurate readings than others; most will not even read the same on the same person using the same arm at the same time. I haven’t studied the machines, but I’ve fallen victim to an automatic machine used in my doctor’s office. To sum up the use of automatic blood pressure machines… the readings can be false and should never be used for diagnosis, especially those used on the wrist.
Oh, I know someone is saying, “well the machines are used in the hospital all the time, so they have to be somewhat reliable”. Right! The machines used in hospitals and other acute care facilities are not the same caliber of machines used in doctors’ offices and clinics. Listen, I’m not saying not to trust the machines; I’m saying educate yourself about your own blood pressure and how it was measured in all capacities.
Technique: Healthcare professional’s technique should be noted and reprimanded rather it be an automatic machine or the conventional way. For instance, blood pressures should never be taken with bulky sleeves due to clothing. The cuff should start snug and not tight nor loose. The rubber air tubing should be placed at the antecubital space and not in the back or elsewhere. By way of the auscultation, the bell of the stethoscope should be placed right under the air tube as well. For auscultation accuracy while using a stethoscope, the area should be quiet.
My experience: In 2013, my doctor diagnosed me with hypertension. I questioned it. I had my blood pressure taken repeatedly after which for a period of six months and sure enough, a high reading was never revealed. So, I stop taking the medication. At that time, I was taking a small dose of Lisinopril, which made me cough to almost death anyway. By the way, the coughing ceased after about two weeks of discontinuing the Lisinopril. That was the worst experience, ever! Sorry, but folk need to know that too.
I returned to the doctor’s office for a diabetes visit and noticed the technique of the office aide that took my pressure and it read something high. Well, the technique was way off, and I didn’t believe the reading. The doctor asked if I had taken my BP medications and I answered, ‘no, because I do not have high blood pressure’. He then began to look to see what it read on that day and assured me I had high blood pressure and requested that I take the medications to get it down or make it normal. I said, ”OK” but had no intentions on taking the medication. I monitored my own BP once again with a nurse (my staff nurse) that used a stethoscope and sphygmomanometer. My pressure read 122/84 (ishes) without taking any medication. My baseline is textbook (120/80). I knew this.
So, on the next visit I noticed the technician used the automatic machine and cuff wrong again and my pressure read high again and at the same time of that visit the doctor thought he would send me to a specialist for diabetic teaching and stabilization. On that first visit, the office aide took my pressure with a stethoscope and sphygmomanometer and it read pretty normal. The doctor came in and said ‘well, I don’t think you have high blood pressure, but continue to monitor it and let us know if it is higher than 140. I said sure.
Time passed, a year or so with normal pressures recorded every three months until one visit it read high even with the conventional equipment, but I can’t recall the technique.
It read high and the doctor prescribed for me Losartan 50mg once daily. I had to take my first dose on a short vacation, so I couldn’t monitor my pressure before I had taken it. I was driving home from Arkansas and realized I couldn’t feel the pavement as I drove; I was lightheaded and dizzy and had to pull over into a rest stop to rest until the dizziness and lightheadedness subsided, nearly an hour. I was convinced that I did not have high blood pressure, I was nonfunctional and weak because I’d taken an antihypertensive drug unnecessarily and decided not to take anymore Losartan until I saw the doctor again.
The next visit my husband joined me for a yearly physical at the doctor’s office where the nurse aide uses an automatic machine. His blood pressure is always normal. After visiting the same doctor with the same office help, he was told that his blood pressure needed to be monitored because it read HIGH. Why? Because the office help, medical assistant, nurse aide or even a nurse took his blood pressure wrong? I know she did because the same person took mine and it read high as well. I was appalled thinking this can’t be really happening. I was thinking, “is this what’s going on in the world? maybe just this country for monetary or pharmaceutical greed?” I was thinking, “do I need to warn the public about this cavalier attitude of taking blood pressures?” I was thinking, “do I blow the whistle to all the insurance companies who are paying for these cockamamie diagnoses of hypertension and medications?”. The warm part of my heart which the largest part of my heart lead me to write about my experience because it may be happening more often than it should and people need to know.
This is not a petty belief. It is more real than the footprints of Sasquatch that I’ve never seen but seemingly others have. But the folk that have had similar experiences will think over their experiences and hopefully add light to this cause of public awareness.
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