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Dr. Phil, MD
Dr. Phil, MD, Medical Doctor
Category: Cardiology
Satisfied Customers: 55777
Experience:  Cardiology Expert
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This is a follow on question about my previous questions

Customer Question

Hi this is a follow on question about my previous questions about the fluctuations in my mothers BP. M y mothers BP increases to 210/140 and after medication can drop to 90/50. What are the implications of these fluctuations in BP on heart. Which way does
the causation lie?
Submitted: 2 years ago.
Category: Cardiology
Expert:  Dr. Phil, MD replied 2 years ago.

What meds is she on?

Customer: replied 2 years ago.
Tel cad 40, Sustamet, Isordil.
Expert:  Dr. Phil, MD replied 2 years ago.

how old is she?

Expert:  Dr. Phil, MD replied 2 years ago.

any other meds?

Customer: replied 2 years ago.
No just these.
Customer: replied 2 years ago.
She is 80
Expert:  Dr. Phil, MD replied 2 years ago.

her medicine is too aggressive then

what solution have been suggested?

Customer: replied 2 years ago.
The doctor reduced the dose. We monitor her BP in the morning and evening. This seems to work but sometimes the BP drops too much. Her hemoglobin in 10.5 and the doctor says that she needs to be more careful with her diet to make sure BP does not drop that much.
Expert:  Dr. Phil, MD replied 2 years ago.

why is her hemoglobin so low?

Customer: replied 2 years ago.
She follows a poor diet.
Expert:  Dr. Phil, MD replied 2 years ago.

That is not a valid reason. This is a VERY low hemoglobin. A diet lone cannot do this. This needs investigated.

Also, her salt intake may be affecting her BP

Customer: replied 2 years ago.
How do we investigate the low hemoglobin issue. What do you suggest?
Expert:  Dr. Phil, MD replied 2 years ago.

She could be bleeding. First tests would be iron, B12, folate, reticulocyte count, and thyroid. These are the most common causes.

sometimes cancers first sign is anemia. So we need those first then go from there.

Customer: replied 2 years ago.
What do you mean that she could be bleeding?
Expert:  Dr. Phil, MD replied 2 years ago.

slow blood loss from the GI tract is probably the most common cause of anemia.

you won't even see it

Customer: replied 2 years ago.
how can this be investigated?
Expert:  Dr. Phil, MD replied 2 years ago.

Like, I said before. The blood tests first. And a stool test for blood. Then go from there