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Timothy Upchurch
Timothy Upchurch, Board Certified MD
Category: Medical
Satisfied Customers: 962
Experience:  Board Certified Phyician with 12 years clinical experience
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Recently had a cva they said to the brain stem yet my speech

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Recently had a cva they said to the brain stem yet my speech and right side dexterity is almost normal...abit of vertigo...but newly prescribed norvasc 5mg 1xday...high blood pressure issues still....history of rrMS...why wont my bp come down?
JA: The Doctor can help. Just a couple quick questions before I transfer you. How long have they been using Norvasc? Has it helped at all?
Customer: Norvasc prescribed during hospital stay two weeks ago
JA: Have they seen a doctor about high blood pressure?
Customer: My pcp three days ago would not see me was referred to E.R. 35 miles away bc BP was 170/100...i was only there to get cardiac echo results
JA: Anything else in your medical history you think the Doctor should know?
Customer: Cholesterol a little high...L=170...given lipitor once a day

Hello, I'm Dr. Upchurch. Thank you for using JustAnswer! I'm reviewing your question and will post my reply shortly.

Customer: replied 4 days ago.
Thank you

I'm sorry to hear about your recent stroke and problems with high blood pressure. How long have you had high blood pressure, and have you used any other medication for this in the past? Do you have a blood pressure cuff at home, and are you checking your pressure frequently?

Please feel free to ignore any request for phone conversation unless you would like this; the request is automated. We can talk online if you would like.

Customer: replied 4 days ago.
Bp has been high before and took losartan...then it leveled out well off med...i do have bp cuff...i take pressure supine..sitting..then standing...averages out 150/86

Is Norvasc 5 mg the only medication you are taking for blood pressure at this time?

Customer: replied 4 days ago.
I take several meds...but that is the only one for BP

Thank you for that information! Hold on while I type a response.

Customer: replied 4 days ago.
I have been told i have white coat syndrome bc my bp is always a little high in clinical settings

Typical risk factors for stroke include high blood pressure, diabetes, and high cholesterol. Given that you had high blood pressure in the past (even though this may have come down with medication) suggets that this was likely a contributing factor to your stroke. However, after a stroke has occurred (which means that a blood vessel was blocked, depriving an area of the brain from oxygen) it is actually advisable to let blood pressure run high for a period of time (this is called "permissive hypertension") to allow the brain to have adequate perfusion (lood supply) so that the areas surrounding the injury are not damaged as well. The blood pressure is brought sown gradually in the weeks following stroke, and this is likely why you were not placed on a higher dose of Norvsc initially (5 mg is a low dose!). However, you will likely need to have your blood pressure medication adjusted over time to bring down your pressure and reduce your risk of a urther stroke. The best was to give your doctor information so that they can adjust your medication appropriately is to check your pressure at home (especially as your "white coat syndrome" can cause your pressure to go up in meical settings!) and recore blood pressure values 2-3 times per day to allow doctors to see how your pressure runs under "normal" conditions. I think that with further attention and medication adjustment, you will likely be aboe to get your presure into normal range. I think your doctors are actually being protective of your brain by allowing it to run slightly high at this time!

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Customer: replied 4 days ago.
Thank you for that info

You are very welcome! Thank you so much for using! My goal is to provide you with the highest quality (5-star rated) answer to your question. If I have fulfilled this goal, please rate me with our automated system. If not, feel free to ask more questions, and please request me in the future if you were happy with my service!

Customer: replied 4 days ago.
So no need to to the E.R. every time my bp gets a little high for a couple weeks...mar 23 i go back to my neuro to integrate post cva and rrMS intervention

I don't think you should go to the ER for minor elevations in blood pressure, but I think if your pressure goes above 180 on the top or 105 on the bottom, or if you have symptoms of headache or confusion with high blood pressure, you should think about going to the ER or to Urgent Care. However, please do monitor and record your blood pressure for your doctor; it is the best way for them to make sure your medication is adjusted correctly.

Customer: replied 4 days ago.
Ok...will do

Great! Best of luck to you!

Customer: replied 4 days ago.
One more thing...the lingering vertigo symptoms could be a side effect of the norvasc since other post cva symptoms are well resolved?

I think it is more likely that the vertigo symptoms represent a symptom of your stroke, as you said this affected the brainstem (and this controls structure for balance as well as for inner ear sensation) and also dizziness from Norvasc would be more like lightheadedness (a feeling of passing out) rather than vertgo (a spinning feeling, which is more likely brainstem related).

Customer: replied 4 days ago.

Thanks again!

Customer: replied 4 days ago.
Thank you so much...very informative and helpful

You are very welcome once again!

Customer: replied 21 hours ago.
In response to follow up PCP increased bp med to 10 mg...recheck at clinic tomorrow...thanks for the follow up

You are very welcome!