Re: fluctuations in blood pressure

[Guest guest]

Beth,

I have a few observations based on what you wrote. First, you need

to know that some fluctuations in blood pressure are normal. For

instance most people (even without MSA) have a drop in blood pressure

after eating, as the more blood goes to the digestive system. MSA

patients have this more significantly, which is why the experts

recomend eating more frequent small meals, rather than fewer large

ones. Second, MSA patients generally see a significant change in

their blood pressure when going from lying down to sitting to

standing. Were all of your husband's' blood pressure readings taken

in the same position? If so, was he in that position for 5 to 10

minutes? If you are trying to get an accurate trend, you will have

to do that. Unfortunately, a " normal " blood pressure of, say, 120/80

can drop to 90/55-60 upon standing, so you need to be aware of that.

Even if he's " normal " sitting down, he may still feel faint standing

up.

Now, about medication. Florinef is a long acting medication, which

causes an increase in blood volume. In order for it to work

properly, he needs to get lots of salt (try bouillion or salt

tablets) and lots of water. The dose you mentioned of 5 0.1mg

tablets per day seems high to me, although I'm not an expert. My

husband takes 3 tablets, just as a calibration. There is another

medication you might want to mention to your doctor. It is called

proamatine or midodrine, and it is a short acting medication which

causes the blood vessels to constrict, thereby raising blood

pressure. The two are often used in concert when the blood pressure

is very low. You must be very careful with proamatine to not take it

too late in the day, as blood pressure lying down can get dangerously

high. Although it seems that MSA patients can tolerate somewhat

higher lying blood pressures, there is still a risk of stroke if it

goes too high.

Unfortunatley, the fluctuations can only be moderated by medication,

so some of what you describe will happen no matter what, since it is

the failure of the autonomic nervous system that is the underlying

cause.

Hope this helps a little!

Carol & Rob

> Hi,

>

> Lately my husband has been having fluctuations in his blood

pressure. He is 50 years old and was diagnosed with MSA several years

ago. When we were married, 9 months ago, he was taking 5 - 0.1 mg

tablets of florinef. (2 in the morning, 2 in the afternoon and 1 in

the evening) He would often have dizzy spells and have pain in his

head which would subside if he put his head lower than his feet for a

few minutes. This seemed to go away after he started eating better

and taking his medication on a regular schedule. For the past two or

three months the doctor has been reducing his florinef due to his

consistently high blood pressure. He is now only taking 2 - 0.1 mg

tablets of florinef. (1 in the morning and 1 in the afternoon) In the

past week his blood pressure has ranged from as low as 62/34 to as

high as 154/104 all in the same day! He has been having his blood

pressure checked mid afternoon about 2 hours after taking his second

dose of florinef. He will occasionally have it ta!

> ken mid morning also about 3 hours after taking his first dose of

florinef. I usually know when his blood pressure drops because he'll

put his head down because he's dizzy. I have not been able to

establish a pattern of highs and lows for his blood pressure. It

fluctuates daily. I try to get him to drink more water, he usually

only drinks about 16 ounces a day. I have also tried to get him to

drink Gatorade, he'll drink about 6 ounces, if I really nag him. ;-)

Does anyone have any other suggestions of ways to help him? Should I

not be so concerned about the fluctuations? So far I haven't been

able to get a response about this from his doctor and I'm not sure

how much his doctor knows about MSA.

>

> Thanks in advance for all your help!

>

> Beth Wetzel

>

>

>

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[Guest guest]

I take 9 mgs of florinef a day plus the other stuff (gatorade, tons of water, stockings, salt, ) and I am still very dizzy with hypotension. That is why I am so happy thatthe TENS unit and accupuncture are helping some. I am also on chronic prednisone and I am also trying antihistimines at night to see if any of it is immune related and use metrotonazol at bed for the dissiness of lying down. For nausea from dizziness I find Zofran most effective.

WHen my blood pressure gets to normal, say 110/80,

>>> cblanger@... 09/18/01 11:52AM >>> Beth, I have a few observations based on what you wrote. First, you need to know that some fluctuations in blood pressure are normal. For instance most people (even without MSA) have a drop in blood pressure after eating, as the more blood goes to the digestive system. MSA patients have this more significantly, which is why the experts recomend eating more frequent small meals, rather than fewer large ones. Second, MSA patients generally see a significant change in their blood pressure when going from lying down to sitting to standing. Were all of your husband's' blood pressure readings taken in the same position? If so, was he in that position for 5 to 10 minutes? If you are trying to get an accurate trend, you will have to do that. Unfortunately, a "normal" blood pressure of, say, 120/80 can drop to 90/55-60 upon standing, so you need to be aware of that. Even if he's "normal" sitting down, he may still feel faint standing up. Now, about medication. Florinef is a long acting medication, which causes an increase in blood volume. In order for it to work properly, he needs to get lots of salt (try bouillion or salt tablets) and lots of water. The dose you mentioned of 5 0.1mg tablets per day seems high to me, although I'm not an expert. My husband takes 3 tablets, just as a calibration. There is another medication you might want to mention to your doctor. It is called proamatine or midodrine, and it is a short acting medication which causes the blood vessels to constrict, thereby raising blood pressure. The two are often used in concert when the blood pressure is very low. You must be very careful with proamatine to not take it too late in the day, as blood pressure lying down can get dangerously high. Although it seems that MSA patients can tolerate somewhat higher lying blood pressures, there is still a risk of stroke if it goes too high. Unfortunatley, the fluctuations can only be moderated by medication, so some of what you describe will happen no matter what, since it is the failure of the autonomic nervous system that is the underlying cause. Hope this helps a little! Carol & Rob > Hi, > > Lately my husband has been having fluctuations in his blood pressure. He is 50 years old and was diagnosed with MSA several years ago. When we were married, 9 months ago, he was taking 5 - 0.1 mg tablets of florinef. (2 in the morning, 2 in the afternoon and 1 in the evening) He would often have dizzy spells and have pain in his head which would subside if he put his head lower than his feet for a few minutes. This seemed to go away after he started eating better and taking his medication on a regular schedule. For the past two or three months the doctor has been reducing his florinef due to his consistently high blood pressure. He is now only taking 2 - 0.1 mg tablets of florinef. (1 in the morning and 1 in the afternoon) In the past week his blood pressure has ranged from as low as 62/34 to as high as 154/104 all in the same day! He has been having his blood pressure checked mid afternoon about 2 hours after taking his second dose of florinef. He will occasionally have it ta! > ken mid morning also about 3 hours after taking his first dose of florinef. I usually know when his blood pressure drops because he'll put his head down because he's dizzy. I have not been able to establish a pattern of highs and lows for his blood pressure. It fluctuates daily. I try to get him to drink more water, he usually only drinks about 16 ounces a day. I have also tried to get him to drink Gatorade, he'll drink about 6 ounces, if I really nag him. ;-) Does anyone have any other suggestions of ways to help him? Should I not be so concerned about the fluctuations? So far I haven't been able to get a response about this from his doctor and I'm not sure how much his doctor knows about MSA. > > Thanks in advance for all your help! > > Beth Wetzel > > > > ________________________________________________________________ > GET INTERNET ACCESS FROM JUNO! > Juno offers FREE or PREMIUM Internet access for less! > Join Juno today! For your FREE software, visit: > http://dl.www.juno.com/get/tagj . If you do not wish to belong to shydrager, you may unsubscribe by sending a blank email to shydrager-unsubscribe