In this instance, he was the only one who seemed to understand the quality of life benefits I was getting from 5-HTP. He then developed the strategy that permitted me to continue using the supplement and to use nifedipine as needed to bring down unusually high blood pressure spikes.
I asked Dr. BP about the new suggestion being made that for those of us over age 80 who had no signs of heart disease, discontinuing blood pressure medication would be a viable option., He suggested I also consider going back on Avapro, the blood pressure medicine that didn't seem to have as many side effects as others I've tried.
We discussed the options for a time and then Dr. BP said: "It's your choice. But if you decide to drop the blood pressure meds I won't lose any sleep over it." So I decided to ditch the blood pressure meds..
That of course provoked more negative comment than my decision to continue taking 5-HTP. Again the opposition was based exclusively on the high BP readings taken in the doctors' offices.
But readings taken in a doctors office are notoriously unreliable. Here, for example, is a report on several papers presented to the American Society of Hypertension:
"Of all the procedures done in a doctor's office, measurement of blood pressure is usually the least well performed but has the most important implications for the care of the patient," said Norman M. Kaplan, MD, clinical professor of internal medicine at the University of Texas Southwestern Medical Center, who moderated one of the sessions.
Experts said the in-office assessment is unreliable because blood pressure can be raised or lowered by the presence of the medical professional taking it. The numbers also can be different from one arm to the other or from one minute to the next.
The American Heart Assn. guidelines -- which call for blood pressure to be measured at least five minutes after a patient arrives in the office while he or she is sitting in a chair with the arm supported -- often are not followed.Unfortunately this reliance on office blood pressure readings is just one example of the tendency in America to use "one-size-fits-all" medical care. Fortunately, there's a rapidly growing movement toward more personalized medical care, like what I've found with Dr. BP.
I want to talk later about the new Medicare guidelines for next year that will make it easier for doctors to adopt this approach.