Friday, November 13, 2020

YOU CAN’T PISS ON MY HEAD AND CONVINCE ME IT’S RAINING.

 


 





I have a new blood pressure cuff at the house.  The readings with my new cuff corresponded with my old cuff, which is 13 years old.   I was concerned that my blood pressure was reading higher than normal so I made an appointment with my primary care physician for a check.   

 

I took in my new cuff for comparison.  The reading in the office was lower than my new cuff.   The doctor told me that over-the-counter blood pressure cuffs historically read higher than actual pressure as measured in the doctor’s office, and not to put too much reliance on the accuracy of readings taken from an over-the-counter purchased cuff.  

 

I could buy that if the reading in the doctor’s office was taken with an electronic monitor that is regularly calibrated, but the office reading was taken by a nurse with a stereoscope.  

 

Everybody by age forty has some significant degree of hearing loss.   We are raised listening to television with the volume turned up, we listen to music top high with headphones and ear buds, we ride motorcycles, fly in airplanes, gun fire, lawn mowers, loud cars, church bells, sporting events, concerts – the ambient noise we experience daily is eventually deafening

 

The nurse, with some level of hearing loss, was listening to my pulse through two layers of clothing and making a judgement as to when she begins to hear the pulse at the top of the compression and when she loses the pulse at the bottom of the compression.   

 

An electronic monitor would seem to be more sensitive and accurate than a blood pressure taken involving a variable human factor.    The accuracy, of course, depends on the accuracy of the calibration of the home cuff; but if over-the-counter cuffs are so unreliable why do doctors suggest we take readings at home?

 

If your blood pressure readings differ between the nurse at the doctor’s office and the cuff you have at home; which should you believe?


It is never good to be confrontational with your primary care physician, so I just said thank-you and left without really having an answer.   And maybe a concise answer is not possible.   Blood pressure readings are just a shot in the moment.  They can, and do, change within seconds according to your activity and your emotions. 


Fuck it.  At my age, as long as I have a blood pressure, I am not going to complain.  

                     

the Ol’Buzzard


9 comments:

  1. I would believe that the two cuffs that read essentially the same would be my choice.

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  2. Mine changes too. Usually it's good but I was concerned when it was high with my home blood pressure machine and the one at my doctors. A few weeks later it was within healthy measures again.

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  3. The nurse doesn't need to hear. When you've been checking blood pressures manually for years a person gets really good at noticing when the needle on the gauge bounces. Who would I trust? An electronic gizmo assembled in a sweat shop in China or the judgement of someone who's been taking blood pressures the old fashioned way for hundreds of patients? No contest, the nurse wins. There's also the time of day factor -- blood pressure is lowest in the afternoon -- and the white coat factor. Just being in the examining room can make some people's bp rise (nervous about bad news) or fall (relaxed because you trust your primary care physician). Mine really spikes when they use one of those annoying automated robots that always wants to amputate my arm by cranking the pressure in the cuff up to what feels like the highest possible amount before dropping down. There is a minor debate in the medical community about changing the way blood pressure is measured: instead of cutting off the circulation and then dropping down to where the pulse is detectable again there are practitioners who think they should start on the low end, get the diastolic first and work up until they hit the systolic. Less stress on the patient, more accurate readings.

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  4. Do you sit and rest for a few moments before taking your BP at home? Apparently that's important to do for an accurate reading.

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  5. Personally the old fashioned way is better than the battery powered way. Batteries lose their juice after a while and that leads to inaccuracies. Watching the needle bouncing the old fashioned way is better. Don't waste your money on things from China. Just exercise and eat right, no problem.

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  6. If it's accuracy you're after, I'd trust the nurse who's been taking BP for years. However, I *think* the purpose of home meters is more to track changes. If it's fairly close to the same for weeks, and suddenly starts going up, or down and not going back to normal readings - it's time to get it check with the doctor. Sort of like the scales - they probably will say you weigh differently, but your home scale is great to track changes so you know when to lay off the 2nd helping or add an extra mile to the walks.

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  7. If it's accuracy you're after, I'd trust the nurse who's been taking BP for years. However, I *think* the purpose of home meters is more to track changes. If it's fairly close to the same for weeks, and suddenly starts going up, or down and not going back to normal readings - it's time to get it check with the doctor. Sort of like the scales - they probably will say you weigh differently, but your home scale is great to track changes so you know when to lay off the 2nd helping or add an extra mile to the walks.

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  8. We have a store bought unit. How precise is not very relevant. When my wife's or my BP spikes to 170 (not often but happens) it is time to take corrective action. We are both on BP meds and both have reasonably regular BP. Why the spikes, no one knows but we can sure feel it.

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  9. I have white coat syndrome..my drs nurse takes my blood pressure twice.once when i come in and right before I leave..wow, the difference.

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COMMENT: Ben Franklin said, "I imagine a man must have a good deal of vanity who believes, and a good deal of boldness who affirms, that all doctrines he holds are true, and all he rejects are false."