Unmanageable hypertension

Hypertension is a PMB (prescribed minimum benefit)- meaning your medical aid has to pay in full for all tests / medicines (some conditions apply) etc related to it.
 
Polly101 said:
Hypertension is a PMB (prescribed minimum benefit)- meaning your medical aid has to pay in full for all tests / medicines (some conditions apply) etc related to it.
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Yep... with my Discovery plan ,they cover one ECG, plus basic blood works, 3 visits to your GP, 24hr Bp monitoring device, per annum... thats all ....and the meds they cover, very basic....I am forking out R 500 in co payments per month for my meds.....So far I had to have a sonargram of heart done, renal CT angiogram....either there was a co payment or, it came out of my pocket...
 
yebocan said:
I am a 33 year old male, who has always had high normal blood pressure....since my early 20s....must just add, I have a family history of hypertension and cardiac issues.... Two years ago, I had to start medication to control it. I live a very balanced and healthy lifestyle, I do heated yoga and run to keep fit....,and the bp was kept under control, no issues. In June of this year, I developed a continuous cough due to bp meds, and the current tablets were no longer doing an effective job, bp contentiously stayed in the 180+/90+ range. Meds were changed, but no real change in bp, another class of meds were added, no real effect again. So my doctor referred me to a cardiologist, to make sure that there is no underlying issue causing the hypertension.

I am now on 4 different classes of meds, and still my bp is still not under control.

Every test, that has been done so far has come back ok...No heart issues, no kidney issues, no thyroid issues, no hormone issue...my medical aid coverage for the year has been exhausted and now, I pay from my back pocket... and these test are not cheapest in the book.

Anyway...anyone out there, that has had issues with resistant hypertension, that can give some advice? At the moment I feel like I am stuck in mud and no movement in getting this sorted.
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ACE inhibitors will cause a cough that is a known side effect before I go any further I need to know what race you are before I can give you advice. Hypertension treatment is different for each race as reach race has a different form of ACE.

Though from what I can tell you need to drop the first line treatment and go hard at the issue. This is obviously something thats genetic and might not be primary hypertension at all. You might have to go into the alpha blockers in conjunction with beta blockers.

I would say you need to start HCT 12.5mg (do you have any pitting odema?)
+
Prazocin/doxazocin
+
Atenolol (or its more potent cousins)
+
amlodapine (or perhaps consider verapamil)
+
lorsartan (drop the ACE inhibitors and go straight to angiotensin receptor blockers)

I assume you have already initiated lifestyle modification

If your hypertension is this stubborn you going to be on 10 to 15 different tabs daily. I used to manage patients from the specialist hypertension clinic. Its such a pain to manage these patients they are very complex and require ALOT of medication. Do not waste your time with a GP you need to see a cardiologist and be managed by a specialist physician as they are the only ones that have the skills required to treat you properly.

unfortunately there is nothing you can do about the costs and the volume of tests, what you have (from what I get from your posts) is not a common nor basic pathology. This is not something you see in people that are your age often.

My advice if you really cant afford it is contact the professor of cardiology of your closest medical school. They are generally linked to the high end government facilities and will be able to procure specialised drugs for you under section 88 protocols. The professors of our medical schools across the country are still the best at what they do even on the world stage
 
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RiaX said:
ACE inhibitors will cause a cough that is a known side effect before I go any further I need to know what race you are before I can give you advice. Hypertension treatment is different for each race as reach race has a different form of ACE.

Though from what I can tell you need to drop the first line treatment and go hard at the issue. This is obviously something thats genetic and might not be primary hypertension at all. You might have to go into the alpha blockers in conjunction with beta blockers.

I would say you need to start HCT 12.5mg (do you have any pitting odema?)
+
Prazocin/doxazocin
+
Atenolol (or its more potent cousins)
+
amlodapine (or perhaps consider verapamil)
+
lorsartan (drop the ACE inhibitors and go straight to angiotensin receptor blockers)

I assume you have already initiated lifestyle modification

If your hypertension is this stubborn you going to be on 10 to 15 different tabs daily. I used to manage patients from the specialist hypertension clinic. Its such a pain to manage these patients they are very complex and require ALOT of medication. Do not waste your time with a GP you need to see a cardiologist and be managed by a specialist physician as they are the only ones that have the skills required to treat you properly.

unfortunately there is nothing you can do about the costs and the volume of tests, what you have (from what I get from your posts) is not a common nor basic pathology. This is not something you see in people that are your age often.

My advice if you really cant afford it is contact the professor of cardiology of your closest medical school. They are generally linked to the high end government facilities and will be able to procure specialised drugs for you under section 88 protocols. The professors of our medical schools across the country are still the best at what they do even on the world stage
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Thanks for the insight, will be taking this up with my cardiologist when next I see her....thanks again.
 
My friend also had some weird BP issues, weight gain etc. Turned out he had a sleep disorder. He now sleeps with one of those machines and his troubles are a problem from the past.
 
yebocan said:
I mostly drink green tea...normal tea/ coffee on the odd occasion...I have cut red meat out of my diet...some chicken, pork if I want something special...Salt intake is minimal...I have become one of those label readers in stores...My diet is mostly a veg based one...
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I cried inside when I read this ... sorry to hear!
Seriously said:
Like with me the case was I think you are dealing with the wrong doctor. Go see a real specialist for your hypertension, the advise here could be dangerous for your well being and your current specialist doesn't seem to know what cutting!
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What Seriously said. Go for another opinion at a specialist
 
The_Librarian said:
OP stated that his medical aid was exhausted....
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Yes but....










Medical scheme beneficiaries







Is my medical scheme obliged by law to provide cover for certain medical conditions?







Yes, these are known as Prescribed Minimum Benefits (PMBs). They were introduced into the Medical Schemes Act to ensure that beneficiaries of medical schemes would not run out of benefits for certain conditions and find themselves forced to go to State hospitals for treatment. These PMBs cover a wide range of ±270 conditions, such as meningitis, various cancers, menopausal management, cardiac treatment and many others, including medical emergencies. However, take note that certain limitations could apply, such as the use of a Designated Service Provider and specified treatment standards.

quoted from the council for medical schemes website
 
OK, so you haven't gone to a specialist yet?

Where do you live? If in the northern suburbs I'd recommend my haematologist, Dr. Kevin Gartrell at Louis Leipoldt

I'm a year younger than you and had similar issues in the past, until I started seeing him.
 
Discovery never pays for your PMB's , if you don't know about it and you don't fight them until you want to cry. I have kidney stones (repeatedly) and every bloody time I have to write on hellopeter to get to someone higher to take off any co-payments and bills.
 
YingYang said:
OK, so you haven't gone to a specialist yet?

Where do you live? If in the northern suburbs I'd recommend my haematologist, Dr. Kevin Gartrell at Louis Leipoldt

I'm a year younger than you and had similar issues in the past, until I started seeing him.
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My GP referred me to a cardiologist...that is where I am at now....test after test...and with each round nothing new, only a new tab to pop...thanks for the info...
 
Do you donate blood? If not, consider it every 60 days. A friend had a similar story and now looks forward to his blood-letting window.
 
Just a bit of an update: So after about three visits to the cardiologist and a litany of tests, still no answer to my unmanageable hypertension. All I was getting, was being booked for more tests and more tablets being prescribed. No one tells you of the crap side effects the meds have on you...anyways, got to the point, when I said enough....I am not going for another test, or adding another set of medication...this route is clearly not working....my bp might be becoming down, but i feel crap! Started looking at more natural approaches,...beetroot and celery juice,...well what the hell did I have to lose? Bought a juicer, and have merrily been juicing each morning...beetroot,celery,carrot and apple...with a dash of ginger....kid you not, after day one, I could already feel a difference....that low mood feeling and low grade headache that I had to endure, was gone...my bp has stabilised around 130/78...meds alone was only able to get it around 138/85,....will see my Doc in the new year and take it from there.....hopefully, by then, there is a real improvement and I can start getting off some of these crappy medicine;-)
 
yebocan said:
Just a bit of an update: So after about three visits to the cardiologist and a litany of tests, still no answer to my unmanageable hypertension. All I was getting, was being booked for more tests and more tablets being prescribed. No one tells you of the crap side effects the meds have on you...anyways, got to the point, when I said enough....I am not going for another test, or adding another set of medication...this route is clearly not working....my bp might be becoming down, but i feel crap! Started looking at more natural approaches,...beetroot and celery juice,...well what the hell did I have to lose? Bought a juicer, and have merrily been juicing each morning...beetroot,celery,carrot and apple...with a dash of ginger....kid you not, after day one, I could already feel a difference....that low mood feeling and low grade headache that I had to endure, was gone...my bp has stabilised around 130/78...meds alone was only able to get it around 138/85,....will see my Doc in the new year and take it from there.....hopefully, by then, there is a real improvement and I can start getting off some of these crappy medicine;-)
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That "low mood feeling" is from the meds. I got that when I took 8mg instead of 4mg tablets. If you stop the meds, or take the correct dose (in my case), that goes away.
 
yebocan said:
Just a bit of an update: So after about three visits to the cardiologist and a litany of tests, still no answer to my unmanageable hypertension. All I was getting, was being booked for more tests and more tablets being prescribed. No one tells you of the crap side effects the meds have on you...anyways, got to the point, when I said enough....I am not going for another test, or adding another set of medication...this route is clearly not working....my bp might be becoming down, but i feel crap! Started looking at more natural approaches,...beetroot and celery juice,...well what the hell did I have to lose? Bought a juicer, and have merrily been juicing each morning...beetroot,celery,carrot and apple...with a dash of ginger....kid you not, after day one, I could already feel a difference....that low mood feeling and low grade headache that I had to endure, was gone...my bp has stabilised around 130/78...meds alone was only able to get it around 138/85,....will see my Doc in the new year and take it from there.....hopefully, by then, there is a real improvement and I can start getting off some of these crappy medicine;-)
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Maybe Dr Beetroot was correct after all... :p A juicer and some fresh carrots, apple, beet etc is lovely to have :D Let your imagination run wild! :D

And it's healthier than the so-called fresh fruit drinks you get in shops.

Anyways, I found that avocado also bring my BP down. I can only eat a quarter - any more than a quarter avo, and I start feeling woozy - BP goes below 100/60! :eek:
 
Slootvreter said:
That "low mood feeling" is from the meds. I got that when I took 8mg instead of 4mg tablets. If you stop the meds, or take the correct dose (in my case), that goes away.
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My goal is manage my hypertension naturally,for now I will endure their side effects....but hopefully will be able to say good bye to them, very soon.
 
yebocan said:
My goal is manage my hypertension naturally,for now I will endure their side effects....but hopefully will be able to say good bye to them, very soon.
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It is better to try and manage it, and keep it below 140/90 as long as possible.

I also had hypertension, but now my BP remains below 130/85. Still monitoring it on and off with a portable BP machine.

No wonder why they call it the silent killer (high BP)...
 
The_Librarian said:
Maybe Dr Beetroot was correct after all... :p A juicer and some fresh carrots, apple, beet etc is lovely to have :D Let your imagination run wild! :D

And it's healthier than the so-called fresh fruit drinks you get in shops.

Anyways, I found that avocado also bring my BP down. I can only eat a quarter - any more than a quarter avo, and I start feeling woozy - BP goes below 100/60! :eek:
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LOL...maybe...!! lol
 
*sigh* mine was also high last time it got measured.

Thats despite it being below avg for the last 25+ years.

grrr stupid stress.
 
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