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For many months my 83-year-old mother has been having bp readings all over the place. From pass-out lows (80's/40's-she notices she urinates her self when coming to) to highs around 220/130.
The only other notable thing is she has trouble with low sodium.
When the highs, lows, or quick drops or rises, she feels terrible. She's had to start taking her bp frequently because she can't take meds until it starts rising from the lows. They have her adding hydralazine as an emergency med when the top number goes above 180. No consistent dosing because of the extreme difference in readings. She's on a combo of olmesartan, carvedilol, and amlodipine. He told her not to take morning medicine until top number reaches 150 because of the dramatic drops.
This has greatly diminished her quality of life and caused her to quit going out with friends/Silver Sneakers etc because she's afraid she'll pass out or have it spike and feel bad. Taking her bp is taking over her life.
She's had bloodwork, kidney ultrasound (nephrolithiasis and 11x 8 mm parapelvic cyst), abdominal CT which showed no answers, echo which showed no answers.
Her doctor is waiting for a response from her cardiologist (he appears to be out of next steps) but the cardiologist has not been helpful up to this point so I don't expect her to be now.
My main question is what should she do next? Endrocrinologist to check hormones/renin/cortisol etc? A new cardiologist? I've pretty much given up on her present doctors being able to help.
If there are no answers, then we will have to accept that but I feel as though we haven't found the right test or doctor yet to give up. I'd think at least an endocrinologist visit is in order?
Any thoughts? TIA

No answers or advice to give but wanted to say that my dad had high blood pressure and took Lisinopril for at least 5 years from age 70 on, then in the last 1-2 years of his life, it was going from normal to so low that he would get dizzy, see flashing lights, and fall, then it would go back to normal. First they thought it was his eyes then his brain. They took him off the Lisinopril which helped a little. But by then he had a terrible diet and lot of other issues including dementia and everything was snowballing.

good luck!
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Reply to Suzy23
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slkcma Dec 23, 2024
Thank you Suzy!
It's hard figuring this stuff out as it sounds like you already know.
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I'm surprised her Primary Doctor hasn't had her admitted to the hospital, or referred her to various specialists. Time to get a second opinion, at least from a cardiologist or internist.

I had my hypertension diagnosed at 215 when I turned 65. I had no idea! I now keep it at 115-120 with 20 mg Lysinopril once a day. I have never heard of all those drugs you mentioned at all.

Time for Doctor shopping, start getting second opinions....NOW.
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Reply to Dawn88
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slkcma Dec 23, 2024
Thanks Dawn!
Fingers crossed we find the right doctor that has answers.
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Definitely, yes, a serious problem given that the sodium is fluctuating so badly and you seem to have no answer as to why. I think that it is reasonable to see an endocrinologist. You are going to need an answer to why all this is happening regularly if possible, and if not, then you need solid, clear followup with frequent blood pressure checks. At some point she is not going to be safe without managed care if you cannot come up with some answer to this. A medical problem this serious is definitely a MEDICAL problem and you need their expertise.
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slkcma Dec 23, 2024
Thank you AlvaDeer,

I messaged about checking hormones to her doctor and he never addressed that part of the message so was wondering if that was a sensible next step. It's the only other thing I could think of to check.

Her doctor has her using Cadence which sends him her readings a couple times a day and he knows it's a problem. It's apparently over his knowledge level at this point so I figure it's going to take specialists.

I told her if we can't get answers in the next few months, she's going to have to sell her house and go to assisted living. Living alone isn't safe with all this. Hoping we can figure it out instead, we'll see.
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