We enjoyed a cool, slightly wet, getaway weekend and it was wonderful. I’m a fan of historical sites and Bear is more than willing to join me in seeing them, so we went to Tumacacori, the Presidio in Tubac, and The Pimeria Alta Museum in Nogales. I was taken with all of them, but saddened to hear of each of their financial plights. I know this is not the best economy, but this is history.
I was surprised to discover that The Tubac Presidio State Historic Park is manned (and womanned) by a staff of volunteers – except for their director, Shaw Kinsley, who is also the author of the well written Images of America: Tubac. The volunteers do an excellent job, as good as that done by the park rangers at Tumacacori.
That got me to thinking about the pressure they all must be under… which got me to thinking about pressure of all kinds and its effect on blood pressure. Being on a mini-vacation gave me loads of time to think, but this time I decided to write about just that: blood pressure.
Not only have I written about blood pressure in What Is It and How Did I Get It? Early Stage Chronic Kidney Disease, but you’ll notice several blogs about it if you use the topic search on the right side of the blog page.
So why write about the same topic again, you ask? This time, I took a look at how to take your blood pressure and some of the machines on the market.
Have I ever told you that when I am at my sleep apnea doctor’s office, my blood pressure always starts at about 150/89? That’s high and I tell them it’s not my usual reading. We’re way past the white coat syndrome (blood pressure rising simply because you’re in a doctor’s office) here, so they take it again on the other arm and it’s something about 110/72. I like that, but it’s not my usual reading, either. Back to the first arm: 130/79. Bingo!
I asked my primary care physician why this happens and she asked me to describe the monitor they used. As I did, she started nodding her head. Apparently, this type of automatic blood pressure monitor is notorious for being incorrect… yet doctors still use it for its ease.
Then she asked me how they held my arm while taking my blood pressure and slowly shook her head as I answered. It seems there is a right way and a wrong way to hold the arm and – to further complicate matters – they differ depending upon the type of monitor being used.
Allow me to return to my roots for a second: Oy gevalt! This is fairly complicated so let’s uncomplicate it.
I went to WebMD at http://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-home-monitoring for the following:
Before Checking Your Blood Pressure
- Find a quiet place to check your blood pressure. You will need to listen for your heartbeat.
- Make sure that you are comfortable and relaxed with a recently emptied bladder (a full bladder may affect your reading).
- Roll up the sleeve on your arm or remove any tight-sleeved clothing.
- Rest in a chair next to a table for 5 to 10 minutes. Your arm should rest comfortably at heart level. Sit up straight with your back against the chair, legs uncrossed. Rest your forearm on the table with the palm of your hand facing up.
Were you surprised as I was at the direction to empty your bladder? Think for a minute. Have any of your doctors requested you do that before they took your blood pressure reading? Yet, it makes sense. Not only will the full bladder itself affect the reading, so will the worry that you need to get to the restroom as soon as possible.
Okay, now we’re ready. What’s next?
This time, I went to the Mayo Clinic at http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20047889?pg=2
- Check your monitor’s accuracy.
- Measure your blood pressure twice daily. (Once in the morning before you take any medications, and once in the evening.)
- Don’t measure your blood pressure right after you wake up.
- Avoid food, caffeine, tobacco and alcohol for 30 minutes before taking a measurement
- Don’t talk while taking your blood pressure.
Whoa! This simple act of placing your arm, wrist, or finger in a monitor is not simple at all when you break it down into smaller elements. I admit it; I’m a talker and have been told a time or two to stop talking while my blood pressure is being measured.
I also like to get my chores out of the way as soon as I wake up, but I see I can’t. This makes for a long morning routine for me. First I take off the wrist braces I wear at night for the carpal tunnel. Then I clean the mandibular advancement appliance I’ve had in my mouth all night for the sleep apnea and brush it and my teeth. Usually I would drink that delicious first cup of coffee now, but if I do, I have to wait for 30 minutes before taking my blood pressure. Hmmm, I have to wait 15 minutes to use the bite rim to readjust my mandibular anyway. But where do I fit in the medications? Oh, I’ll work it out.
Well, what about the different kinds of blood pressure monitors? I use a wrist monitor which my PCP is simply not thrilled with. Her feeling is that I’m taking my pressure through two bones, the radius and the ulna, as opposed to only one bone, the humerus, with an arm device. There’s also the finger monitor, but that could be a problem if you have thin or cold fingers.
There are manual and battery operated versions of these monitors. If you use an arm monitor, be aware that larger cuffs are available if needed. The one thing most blood pressure sites agree upon is that it’s not a good idea to rely on drug store monitors for your readings.
Most doctors will agree that the old fashioned sphygmomanometer is the best. You’ll find this defined on page 135 of What Is It and How Did I Get It? Early Stage Chronic Kidney Disease:
The cuff, the measuring device and the wires that connect the two in a machine used
I find myself wanting to make some crack about writing this blog raising my blood pressure, but in all honesty, writing the blog is still one of my joys.
Until next week,
Keep living your life!