Annual Labwork Dec 2022

 All levels of cholesterol are now out of the normal range:

Total Cholesterol: 207, was 185.  (<200)

HDL: 38, was 39 (>50)

LDL: 126, was 98 (<100)

Triglycerides: 299, was 358 (<150)  (mainly caused by too many calories.  Need to eat less and exercise more)

CHOL/HDLC ratio: 5.4, was 4.7 (<5.0)

NON HDL Cholesterol: 169, was 146 (<130)

Had a respiratory allergy test done also (Class range 1-5, 5 being worst).  Surprised with some of these:

Allergic to dust mites (2 & 3), cats (2), dogs (3!), cockroach (1), Alder and bermuda grass (3), Mtn Cedar (4), Olive tree, walnut tree, Elm, Timothy Grass, Johnson Grass (2), Oak (5), Cottonwood, Common Ragweed, Russian Thistle (1).

Immunoglobulin:  1001 (<114).  Guess I am in a highly allergic state.  Which is odd because I don't really have allergy symptoms right now.  Roshan suggested maybe it's Roscoe and I just got used to it.  Or right now there's medium levels of Alder.  If it's this high now, wonder what it will be when its allergy season. 

Diseases which cause the elevation of serum IgE levels include atopic diseases (asthma, allergic rhinitis, atopic dermatitis, urticaria), parasitic diseases, cutaneous diseases, neoplastic diseases, and immune deficiencies IgE levels can also be high when the body is fighting an infection from a parasite and from some immune system conditions.

Will need to maybe follow-up with an allergist or see if it goes down on the next test.  Maybe I should do every few months?  Or see if they can do a food allergy test or a specific serum IgE test.  Dunno if the allergies are causing my high BP.  Or could be causing my coughing.

Also new was my A1C is now 5.8 (<5.7) which now puts me into a 'pre-diabetes' category.  Diet and exercise important here as well.  

Labwork was done mid-Dec, I hadn't been eating well, it's cold so not much veggies/fruit, just eating more carb-y stuff.  Dr said she thinks I should go on statin.  I don't want to go on statins, so asked if we could re-test in 4-6 months, and see if changes to diet and exercise makes a difference.   So we'll see in a few months. 

At-home sleep study scheduled for Feb 16, 2023. 

Annual Exam 12.8.22

 New doctor at the Health Center.  We chatted and she asked how I felt and I said 'good', dunno if that's why but she didn't really give me an exam. Talked about my stroke history, she said to ask Dr. Bagheri at my next appt if they've ruled out PFO, Patent foramen ovale (PFO) is a hole between the left and right atria (upper chambers) of the heart.  Most chest xrays don't look for this unless it is suspected. But she also thinks Eisenhower would of checked for this when I had the stroke.  But this could cause a stroke.

Had her order me an allergy test and cancer antigen marker on the labwork.  And an order for a mammogram.  

Had her look to see if I have a deviated septum.  I don't but the right nostril is narrower, there's a bump on the inside, which is odd because she asked if I ever broke my nose because there is a bump on the left side on the outside.  Mentioned if this is causing my snoring and she said most likely.  As she looked surprised that I snore.  Said I should go for a sleep study.  

Looking at the last EKG and chest xray, she said my heart is not enlarged.  So I'm guessing it's not big anymore?  So I wonder why Dr. Woods said it was.  Wonder what led him to believe I could have heart failure...  Asked if I still should go see cardiologist, and she said yes. 

She asked why I went off Carvedilol (high HR) and calcium channel blocker (couldn't remember) but she likes those meds.  She thinks the carvedilol affected me because I was coming off the metoprolol and HR tends to go off as body gets rid of it.  She saids it takes at least a month for it to start working.  

Also got a flu shot.  Felt tired around 230p, took an hour nap.  Left arm little sore. 

BP at doctor's 150/100.  

Looking back on notes, Amlodipine is a calcium channel blocker.   At one point the dose was doubled (to be taken twice a day instead of once/day), which started causing burning tongue feeling.  Didn't go away even after returning to one dose.  At this time my meds switched to Metoprolol. 

Was on Amlodipine March 2014 to Feb 2017.  I think it was working at first then gradually started not working.  Same happened to Metoprolol.  Was working at first, then not, dose was doubled, side effects kicked in, meds changed.  On Metroprolol from Feb 2017 to early 2022 (I think).  Then switched to Carvedilol, then Bystolic. 

Will go do labwork and mammogram next week.  Call if I can do sleep study at home.

Just read over notes from when I saw Dr. Woods.  One cause of high BP is dehydration.  I haven't been drinking much water since it's been cold.  Maybe about 4-5 cups of warm water.  That could be it.  

Menopause??? & update

 Last period was mid-September, almost three months ago.  It's a bit weird it just kinda stopped, leading up to it it was pretty regular, even coming early some months but never getting farther and farther away.   Looking back, when I had hot flashes, that was probably the beginning of perimenopause about 5-6 years.  Some other symptoms that may been related to this:  restless leg syndrome, tinnitus (ear ringing), joint pain (right hand mainly), increased forgetfulness, heart palpitations, insomnia, burning mouth (tho I think was medication), bloating/gas, bladder incontinence, vaginal itching, anxiety/depression, breast/nipple tenderness first month of missed period, and high blood pressure (mainly now, even with medication.)  

Average age is 52-53.  I', 50 now.  Since it's menopause when I've officially had no period for 12 months, I'll be 51-52 most likely. 

Been having somewhat more of an urge to go pee lately, can kinda feel bladder getting full and then feel like I gotta go.  Memory def getting worse.  More gray hairs coming in.  Hip pain still about the same, if anything a little better.  Knees seem to be better as well.  LIb got me a standing desk.  I think that's been helping. 

Left underarm/left boob dull ache/sensitivity.  Also along left should blade when pressed.  Not sure if it's related to heart? BP has also been somewhat high so seeing the cardiologist (Dr. Bagheri) in Jan.  

In two days I have annual checkup.  Asking for mammogram along with some other questions.  Will update after appointment. 

Update 9.14.22

BP has been creeping back up to 140-155/90-110.  Pulse in the upper 70s-80s for most part.   BP was doing good couple months ago so started to only take meds every 3 days or so.  Which then turned into I forget to take for at least a week.  BP then started coming back up on some days.  Still have been trying to eat better, less meat and more brown rice.  No dairy, switched to oat milk for my lattes.  Exercise level is still just my daily Roscoe walk.  Been working a lot, lib ladies taking vacation and Chantel got sick and she'll be out till maybe Dec. so been working Anza on Sundays as well.  And seeing Baba when I have a couple days off.  Feeling busy and always on the move.  Miss my four days off.   But car needed radiator and brakes which was about $2300 so I feel like I need to work to pay for that.  Vacation coming up mid-Oct.  

Hip pain was starting to get worse, wake up during night with pain, and pain in the morning.  Usually got better as I got up and walked around but felt I need to do more.  Starting looking in fascia stretches, and other forms of stretching that engage the muscles during the stretch.  Had a breakthrough in my stretching and things are starting to progress.  Forward bend, was stuck at only reaching my first knuckles.  Then was able to get the fist down.  Now I can palm it, tho it is pushing it.  Getting close to doing a pancake stretch and now also working on the front and side splits.  Its nice to actually see progress!  Dunno if eating less meat is making me more flexible?  I knew I have tight calves (only on left), the side with the hip pain and heel pain.  Been working on massaging the calves at night and I think it was been helping.  Today had left pain in hip in the morning.  Also started to wonder why its just the left leg that has problems for the most part.  Maybe related to the stroke? Which was on the right so it affects the left side.  Read it can cause muscle weakness, nerve issues, among other things.  I dunno but that might be one reason why the left is so tight.  

Feeling like I get tired quicker lately.  Feeling more tired after work, going grocery shopping.  Maybe my muscles are getting weaker from just sitting all day at work. Haven't hiked nor rode my bike in months, it's been too hot and now I don't have the time.  Maybe I should put the bike on the trainer again.  That might be good for my hips as well.   

Need to clean the bedroom.  All that stuff around me is slowly getting to me.  Abby moved out so will move her queen down in a couple weeks.  Maybe things will seem roomier.  Finally cleaned the top of my desk, tho basically just moved everything to the floor...  I need to start doing creative things again.  Maybe i'm just depressed from not doing anything for myself in a while.  I'm hoping this being busy won't last too much longer.  Thinking about changing my Baba visits to every three weeks instead of two after our Oct vacation.  It's starting to wear on me a little.   Emi is coming in two months already. Need to get upstairs ready. Then winter. Still need to paint the house and deck.  And fix deck and get new chandelier...   Lots to do. Always.  

Health Update 6.23.22

 BP ranging from 112-150/74-104.  Pulse 66-84 (mostly in the 70s).  Since Baba's cancer diagnosis (June 8), been trying to eat more veggies and not drink everyday.  Donated blood three days ago, cholesterol was 197.  It's in the normal range (125-200) so that's good.  Been foam rolling a little over a month (maybe 2-3 times a week).  At chiropractor two days ago, he didn't have to crack the middle of my upper back.  So I'm guessing the foam rolling is helping.  Hips had been hurting tho, looks like torqued pelvis.  Prolly from sitting all day.  Will need to work on stretching more and sitting up straight.  Joint pain in hand went away after stopping Valsartan.  Still drinking a glass of water upon waking and trying to drink during the day.  Still not at the target 8 cups tho. Maybe 6-7 cups.  Getting better. 

One month on Valsartan/HCTZ

Had been having hip pain for about a month now, just thought something was tight or off.   Went on drugs.com last night and read some user reviews on Valsartan.  Just passed one month on Valsartan/HCTZ combo.  Common side effects seemed to be tiredness, knee pain, joint pain.  This morning when I woke up, had bad knee pain, muscle pain in thigh, the usual hip pain, and my foot hurt.  All on left side.  Started to wonder if it was related to Valsartan.  Most people said their symptoms improved after going off it for two days.  So going to try that.  Had also been feeling low energy, not drowsy but tired and no motivation.  Not to ride a bike nor hike.  Didn't want to do anything that required energy.  I did go on a four mile hike with Debra last week.  Felt good.  Tho pelvic pain after...  Just feeling blah lately.  Could be the Valsartan.   But also read user reviews on the Bystolic/Nevibolol and same sort of side effects.  I have been on that one for about two months now.  Right middle finger joint (herberden's nodes) been acting up last few weeks.  It's red and bigger and hurts.  Middle finger also been locking up.  We'll see if going off Valsartan for couple days will help. 

Natural alternative to Valsartan is vitamin B6.  Food sources:  milk, garbanzo beans, carrots, ricotta, tuna, eggs, chicken, spinach, sweet potato, green peas, bananas, fortified cereal, avocado.  Will pick up either b-complex of B6 supplements (no more 100mg).  

Food sources of B vitamins: salmon, beef, leafy greens, eggs, milk, oysters/clams/mussels, legumes, chicken/turkey, yogurt, nutritional yeast, pork, fortified cereal, sunflower seeds. 

Valsartan was also making my tummy funky.  Like I pooped several times a day, in small amounts.  but soft and pasty.  Dunno if my body was starting to adjust but it has started to become less frequent.  

Don't think I've been drinking my 8 cups of water a day.  Should be monitor that more closely and drink more water.  I think I maybe drink 6 cups on a good day. 

UPDATE 6/23/22:  Stopped Valsartan end of April.  No real change in BP.  Tummy is improving.  About 4 out of 7 days out of the week, need to poop in morning within 30 min of waking up.  Just on Bystolic and HCTZ now.  

Pelvic ache after hiking. Possible weak pelvic floor muscle.

 Went hiking with Debra to Jack's Shack.  About 4 miles, 2 hrs.  After the hike I start noticing an ache on the front of my pelvis on the right side.  Is it from the hike or just a coincidence?  

Could be Pelvic Muscle Pain:

Pelvic muscle pain can feel like you have an ongoing cramp in your pelvic area most of the time. "The pain can also be sharp or stabbing and shoot up the vagina or rectum," she says. "You might have pain with sex or using tampons, which can last for hours afterwards.

"Pelvic muscle pain often gets worse with exercise, especially core-strengthening exercises such as pilates, sit-ups or crunches. Women can often find some relief by lying in the foetal position, using a heat pack, doing pelvic muscle stretches and seeing a pelvic floor physiotherapist."

Stretches of help relax the pelvis:

https://www.pelvicpain.org.au/easy-stretches-to-relax-the-pelvis-women/

How do you know if your pelvic floor is weak?

Symptoms of pelvic floor muscle dysfunction

1. leaking urine when coughing, sneezing, laughing or running.
2. failing to reach the toilet in time.
3. passing wind from either the anus or vagina when bending over or lifting.
4. reduced sensation in the vagina.
5. tampons that dislodge or fall out.
6. a distinct bulge at the vaginal opening.

So maybe my pelvic floor is just weak from sitting all day and not exercising.  Something to be aware of post-exercise.   

BP Follow-up and Lab Results 3.22.22 + Update 4.21.22 (deviated septum?)

 Stopped taking HCTZ 2 weeks ago but BP went back up so went on it for a couple days to test if it was the cause and looks like it was.  So back on it plus Quincy added Valsartan since my bottom number is still high.  New med is a Valsartan/HCTZ combo.  Said we'll start with low dose.  May have GI tract issues at the beginning but should stay with it for a month unless I start developing swelling of tongue and lips, in which case stop immediately. 

Valsartan is an angiotensin II receptor blocker (ARB). It works by blocking a substance in the body that causes blood vessels to tighten. Valsartan relaxes the blood vessels and lowers blood pressure. A lower blood pressure will increase the supply of blood and oxygen to the heart.  Avoid getting up too fast from a sitting or lying position, or you may feel dizzy.

Valsartan (Diovan) side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• a light-headed feeling, like you might pass out;

• little or no urination; or

• high potassium level--nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

• ARBs also cause your body’s potassium levels to increase, which can lead to aching bones and muscles that keep you awake. 

• When taking valsartan, your healthcare provider will order blood tests to determine how well the kidneys are working. The most important tests are blood urea nitrogen (BUN) and creatinine. High BUN or creatinine levels often indicate the kidneys are failing. Potassium levels will also need monitoring.
  

Lab results:

Everything "Normal", no problems with my adrenal glands (hormones).   Calcium, Sodium, Potassium, Magnesium all normal.   

Asking to prescribe at-home sleep study kit to test for sleep apnea.  One of last reasons left for medicine unresponsive high blood pressure.

Go see a cardiologist.  Last EKG showed enlarged heart.  Cardiologist may request different tests or change med.   Would like to see if I can do sleep study first.

Quincy leaving in 2 weeks.  He may end up at the Do Doctors in Hemet.   https://www.thedodoctors.com  Considering switching over if they take Aetna and if I still don't have a solution after seeing cardiologist. 

UPDATE 4.21.22:

BP doing better.  Average of last 20 readings are 116/84.   Not sure if its the meds or me drinking more water.  Or a combo of both.  When the medication switch first happened, was having to go poop first thing in morning and it was soft and felt like I couldn't fully empty.  Wasn't sure if it was the meds or drinking more water.  Dr. Woods had said the magnesium might of had a part, part drinking more water.  Stopped taking magnesium to see the poop situation would get better and it has a little.  Still need to poop in the morning but not always first thing anymore.  Sometimes it would be after Roscoe's walk or about an hour after waking up.  For the most part it still is soft and most days feel like I need to sit on the toilet again within the next hour or two.    I guess I should still go see the cardiologist, tho things seem to be doing better.   Will wait on the sleep study till maybe the end of the year when my deductible will be met.  One thing that I want to get checked out is if I have a deviated septum.  Lately it seems like snoring is thru my nose with may suggest one side is "clogged" which is something I've noticed.  That my right side seems stuffy and hard to breathe thru.  Deviated septum can leave to nose snoring and dryness in the other side (the side I get the nose bleeds.)  So rather than sleep apnea, I may have deviated septum?  I find that I can breathe better thru my nose when I wear the nose strip, and also when I sleep on the wedge, I wake up less tired than usual and often times wake up before the alarm.  It's like I'm sleeping better.  Sleeping with the nose strip gives me an itch I can't scratch, and also the last couple times I somehow pull it off during sleep.  I am going to start doing the sinus rinse when I remember.  Hoping that will help.  The thing with the deviated septum is that every now and then I can breathe clearly out of my right nose.  So if I did have a problem, would I always have a hard time breathing out of the right nostril?  Hmmm...   Still much to try to figure out...

BP Follow-up on New Med (Bystolic)

• Been on new med for 1.5 weeks
• Drastically cut down tea intake.  Only drink in morning every 2-3 days
• Upped my water intake, at least 7 cups/day.  Drink 1.5 cups upon waking.  Dunno if related but been having BM almost first thing in morning

• BP at Dr. office was 110/70, probably the lowest its been.  Overall BP improved since med change, averaging 130/90.  

• Dr Woods still thinks bottom number high.  Wanted to start me on Valsartan.  But will wait for Lab results (adrenal test) and diet/exercise change.
• Last EKG was a little abnormal.  I think electrolyte imbalance.  Will do again at next visit since I'll be "hydrated" more
• Possible referral to cardiologist after next visit if no improvements

• For now... continue to do what I've been doing.  Stop taking HCTZ.   Eat better, exercise more.  Take my supplements.  Next visit in 2 weeks.
• Get a Sleep Apnea app and track sleeping

BP follow-up with Dr. Quincy Woods

 Bridgette is on maternity leave so saw her sub doctor today.  He has experience in cardiology. He said several things:

• I'm on the wrong medication cuz its not working.  New med:  Nebivolol (Bystolic), also a beta blocker.  Follow up in 1.5 weeks.  Seems similar to Metoprolol. Once a day pill.  Happy about that. 
• I need to drink more water and less tea.  Even if it's low caffeine tea.  OK to drink one cup in the morning, rest of day should be water.  He thinks that's making me dehydrated, thus BP high.  Aim for 8 cups.  
• Exercise more. Do cardio.  Walking Roscoe doesn't count
• Stay on HCTZ for now, even tho that's dehydrating me, it is also doing something beneficial
• Get labwork.  One of which is something to do with adrenal gland.  Adrenal gland disorder can cause high BP.  If not fixed it will lead to Adrenal Fatigue which can't be reversed. 
• Get chest xray.  Want to see heart is enlarged.  Told him yes, it is.  But that was 8yrs ago.  Want current image. 
• Do I snore?  Yes.  Maybe I have sleep apnea. Sleep Apnea causes high BP that medication won't fix.  Didn't order a test tho. 
• Chest pains?  No.  But palpitations, yes.  Noticeable after coffee.  Which means caffeine affects my heart.  So did an EKG
• Would going to cardiologist offer different insight/meds?  Probably no.  But may consider diff tests.
• Why are you on Hydralazine?  I'm not, its just "as needed".   Don't take it, it'll raise your heart rate. 
• If I don't end up with Adrenal Fatigue, i'll get heart failure.  Need to figure out my problem before that.
• Cut down on salt.  Soy sauce has more sodium than you think.
• One alcohol a day, preferably red wine.  Two max. 
• No more grapefruit.  Affects BP med
• Magnesium, important to take.  Also consider garlic supplements

Bottom line, he thinks I'm dehydrated.   Maybe have sleep apnea or adrenal issues?

Commonly, overproduction of aldosterone can occur, which causes a condition known as hyperaldosteronism, primary hyperaldosteronism. This causes high blood pressure, which is resistant to conventional blood pressure control tablets, and salt disturbances. High blood pressure may cause headaches and visual problems. Some studies have suggested that hyperaldosteronism may account for up to 5% of all people with high blood pressure and an even higher proportion of those who have treatment-resistant hypertension.

More info: https://www.healthline.com/health/hyperaldosteronism#outlook

BP still high, brain function decreasing?

 There's been more instances where I forget to turn off the stove lately.  The other day, I came home and stood in front of our locked front door and pushed the Unlock button on my car keys thinking that would unlock the house door.  After the car beeped, I realized, duh, wrong key!  I know my brain was thinking "unlock" but still, this was the first time I did this.  Kinda had a "whoa" moment, my brain is showing signs of failing...   Often can't remember what we discussed the day before.  Dunno if its related to the high BP these past several months.  BP followup tomorrow, will ask Bridgette.  

BP... Switched to Carvedilol 10-28-21.  Stopped after 4 doses, BP was getting high.  Went back to metoprolol 75mg.  At next followup a month later, end of Nov, Bridgette bumped metoprolol up to 100mg. A month later, BP still high.  Switched myself back to 50mg about a week ago.  No change yet.  BP still averaging 160/115.  Considering looking into acupuncture.   And back to drinking chia water.  Exercised more than usual this past week, but no real change in BP.  Don't get it.