I swear, my doctor is such a pansy. First, it seems my commitment to have my annual physical once every five or six years is not sufficient for him. Then he insisted on “fixing” my blood pressure.
My blood pressure was showing signs of increasing numerous years ago, and when it reached the mid to high 130's over something or other, he put me on blood pressure medication. I don't recall what it was, except it was basically a diuretic that made me dizzy and flushed out my kidneys pretty well. My allergist, who is clearly a more manly man, thought that putting me on medication at that point was a bit of an overreaction, so I stopped taking it.
Oddly, standards or urgencies seem to have shifted on this front over the years, as my primary care doctor didn't seem concerned with my blood pressure the few times I saw him over the following years. In the last couple years, however, I experienced a fairly steady increase in my blood pressure that even caused concern for my manly man allergist. They seemed a tad put out when I rang the bell at 189 over 89 at my annual visit. It was something his nurse said that clued me in to their displeasure. It was something along the lines of “We should really send you to the hospital right now”.
This despite my assurances that when it got to 200, I planned to sell. In reality, I had been checking it at home, and knew I needed to address this. The highest reading I saw was 196 over 95 – so close to selling out. Or checking out. Whichever.
Thus, we departed down the path of finding the blood pressure solution that would work for me. I realize now why doctors call their business a “practice”. I was put on 10mg a day of Lisiniprol, an ACE inhibitor designed, from my experience, to lower blood pressure by making people cough. A lot.
One of the known potential side effects of Lisiniprol is a persistent cough. At 10mg I did notice that I would have a brief coughing spasm once or twice a day, but it was quick and not a real bother. Of course, it didn't lower my blood pressure to the level that satisfied anyone, so a few months ago my doctor increased my dosage to 20mg per day. That really did the trick.
Today I am coughing like a banshee. OK, banshee's usually howl, but you get the idea. Let's say I am coughing like a sick banshee. My coughing gradually started increasing, but the last few weeks it has become a real issue, now affecting my ability to sleep. Even more alarmingly, it is affecting my wife's ability to sleep, so it is in fact a potentially fatal condition. And that would mean we got my blood pressure under control for no reason at all.
I am not alone in this. I understand that about 20% of the people who are put on Lisiniprol have similar issues. Constant coughing is a real concern, especially when you are in client meetings or do any public speaking. It certainly does not draw a positive picture of rigorous health.
I had another appointment with my doctor yesterday. Because of this issue, I've seen far too much of him this year. He has changed my medicine suspecting, like I, that the cough is a direct result of my previous prescription. He has now put me on something called Losartan, which he tells me does not carry that side effect, and in fact “may do a better job with the blood pressure”.
Of course, that begs the question, “Then why didn't we try that in the first place?” We must remember, this is a “practice” after all.
This condition is by no means unusual. An estimated 75 million Americans, 1 in 3 adults, suffers from hypertension. Yet the medical world still must, to some degree, provide educated guesses as to which solution will be right for each patient. This puts into perspective some of the truly complex issues we see in workers' compensation.
We often expect or hope for quick fixes from our medical community. The complexity of the human body, combined with intricate genetic and psycho-social variations, means that for some of these cases that is just not possible. If the treatment of something as common and workaday as hypertension is still a “hit or miss” trial affair, then the challenges of treating serious workplace injuries and illnesses must be exponentially more difficult.
That doesn't mean we shouldn't demand the best from our medical providers. It just indicates that sometimes we won't know what the best is until we've tried a few options. Navigating the complexities of human health is nothing to sneeze at; which, by the way, is probably one of the side effects from my newest blood pressure medicine.
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Robert Wilson is President & CEO of WorkersCompensation.com, and "From Bob's Cluttered Desk" comes his (often incoherent) thoughts, ramblings, observations and rants - often on workers' comp or employment issues, but occasionally not.
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