G'day G'day Folks,

Some of the hardest discussions we have are with ourselves occur when
life doesn't turn out the way we thought it was going to.

Last week I rang the local medical centre and asked if my diabetics
checkup wasn't perhaps due. A look through the computer records
confirmed I was due for a quarterly check up in August. I made an
appointment for the next day to have an A1c done. I received a note
in the mail saying that the results were normal and there was no need
for a doctor's appointment. <Surprises take adequate preparation>

Still I am a curious sort of person and wanted a copy of my A1c for my
files. So I went in to collect a copy. Now I confess to a certain
temptation to think the nurse was having a bad day and/or was giving
expression to a tendency to be bossy but I sort of got kidnapped into
having my feet checked. <Something to do with accepting positive
intentions.> My eyesight was checked. My exercise reviewed. All
that sort of stuff.

When it came to blood pressure we were both in for a surprise. While
I have been 120/80 since I took control of my life following
diagnosis, this time it was 138/88. Nothing to worry about I was
assured. [An alarm bell started jangling in the distance. Nagging
thoughts about acceptable levels for diabetics being lower.]
Routinely I was booked in for an appointment with the GP next day it
was all part of the routine diabetes check up.

Not likely.

There was nothing I needed to see a doctor about.

I canceled the appointment. The receptionists weren't used to such
self actualizing patients and one with more experience had to explain
the procedure. The new receptionist duly filled in "Patient declined"
as instructed and I was charged for a separate nurse's visit.

I took the dogs for a swim down the river between the two bridges ...
and reflected. By the time they had finished I hadn't quite decided.
For some people decisions are easy. Not only do they know the right
thing to do they go ahead and do it. They say a lawyer who defends
himself in court has a fool for a counsel and client. That is how it
is when one argues with oneself.

So perhaps arguing with oneself wasn't the best way to proceed. What
if I took myself on as client and didn't argue. I don't argue with
clients. I create healthy options. My guess is then I'd say
something like, "Logic will give you all the reasons imaginable for
staying stuck. Humour sets your free." I kinda laughed at that one.

Oh ... and I established some sort of rapport with myself. Looking at
oneself and accepting one's humanness with compassion makes getting it
right so much easier. The first response to being asked to make
changes is to search for danger. Our brains are wired that way.
There is a short circuits from the thalamus (a sorting station) to the
amygdala (a centre of emotion) that bypasses the parts of the brain
that see the wider perspective. That part has to play catch up and
sometimes falls for taking on the role of supporting the reflexive
protective pathway in weird and wonderful ways eg blaming others.

I went back and made another appointment with the GP. I wasn't that
sure I was going to till I heard the words come out of my own mouth.

He confirmed the blood pressure levels and put me promptly on ACE
inhibitors. Now I know many of your here have said that ACE
inhibitors are the best thing since slice bread. It is still hard to
accept that after never ever needing any blood pressure medication
that I need to now. That doesn't mean I don't take them. I am taking
them like a new religion and intend to do so. Hey, this is my life I
am talking about, the past is past, I must act now for my future good.

I did the things many of you would expect me to do. I went through
Pubmed rereading all the literature on the DASH diet, the dietary
approach to dealing with hypertension. At first I thought I would find
some glaring error in my diet. So far I found none. While I didn't
specifically design my diet to be antihypertensive I did recognise
elevated blood pressure was one possible component of syndrome X, now
called metabolic syndrome.

It has been a lonely time though. I have more acquaintances than
active friends. One doesn't realise it till it happens that many
friendships are situational, my friends from 22 years in tertiary
teaching are wedded to that environment.

What I would welcome is all the help I can get with understanding ACE
inhibitors. Don't be bashful or hold back because you think I might
already know something. I tend to be quite focussed in my attention so
freely admit that I haven't paid much attention to the threads on
meds.

If anyone is up for the hard yards of working through the possibility
of a Better-than-DASH diet you know who to call.

Some of you with better intuition than most will now be able to make
sense of the progression of my posts starting from "Two dogs, one
river." Getting to here hasn't been easy.


Thanks,
--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

Quentin Grady said this...
function issue, which I would ask the doctor about.

Ramipril (enalapril) is the ACE of choice, and a check should be made
early on that it is not causing any liver problems. That's what happened
with me.

Ratty
--
www.flyingrat.net

This post not CC'd by email
On Mon, 11 Aug 2003 00:05:18 +0100, Flying Rat <me9@privacy.net>
wrote:

G'day G'day Flying Rat,

I'm not due for an annual check up but I figure with an unscheduled
change in metabolism I could arrange for that to be done.

What is it that appealed to you about ramipril.
I'm on inhibace 2.5 mg, one a day with a six day warm up of half a
tablet a day.

OK, I'll be mindful of that.

Thanks,
--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

Quentin,

ACE inhibitors caused my lower lip and tongue to swell. Not to the degree of
anaphylactic shock, but enough that my mouth felt really wierd. So that was
the end of ACE inhibitors for me.

The doctor switched me to Diovan, an ARB (second generation angiotensin
inhibitor) and I've been taking it since December. Zero side effects and I'm
the Side Effect kid. Blood sugar dropped a bit and my wieight gain picked up
too. There's some evidence that Diovan may counter insulin resistance. It is
in a clinical trial named NAVIGATOR to investigate this.

One thing I noticed when I started Diovan was that my anxiety levels went
down. I would be driving on a very icy New England country road in a sleet
storm and find myself downright relaxed. That is so out of character I knew
it had to be the drug. Unfortunately, this effect wore off after a couple
weeks.

It's worth mentioning that when I started the ARB my blood pressure had
gotten very high--over 180/110. Hydrochorlothiazide, a diuretic, only
reduced it to 160/95. It dropped very quickly with both the ACE inhibitor
and a low dose of Diovan. Now it tends to be, if anything, too low. I have
to go off it every week for a day because I get blood pressures in the 80/60
range. If I stop it for more than a few days my blood pressure goes back up
to 140/85. The literature says that these drugs do not cause a rebound blood
pressure rise, so I guess whatever is wrong with me is still wrong but the
drug counters it.

With both the ACE inhibitor and the Diovan, I had a very intense reaction to
the early doses where when my blood pressure dropped it dropped very fast
and my body cranked out some adreniline to push it back up. I'd wake up from
a sound sleep with my pulse racing and my blood pressure normal. The doctor
told me that my blood pressure had probably dropped a bit too low in my
sleep and the body had forced it back up. This only happens now if I don't
take a day off now and then from the meds.

My doctor told me not to take extra potassium when you're taking these
drugs. They are also toxic to fetuses so don't get pregnant. <g>

-- Jenny
168.5/138.5 30 lbs lost by 8/2/03!
Low Carb 9/1998 - 8/2001 and 11/10/02 - Now

http://www.geocities.com/jenny_the_bean
How to calculate your need for protein * How much people really lose each
month * Water Weight Gain & Loss * The "Two Gram Cure" for Hunger Cravings
* Characteristics of Successful Dieters * Indispensible Low Carb Treats *
Should You Count that Low Impact Carb? * Curing Ketobreath * Exercise
Starting from Zero * NEW! Do Starch Blockers Work?


"Quentin Grady" <quentin@paradise.net.nz> wrote in message
news:4nedjvsdssvaspkpup7feftahj93407tbt@4ax.com...

Quentin Grady wrote in message
<4nedjvsdssvaspkpup7feftahj93407tbt@4ax.com>...
Speaking as one of the ACE-pushers, the sentence in the HOPE trial
discussion which really got my attention was:

" . . .It is noteworthy that effects occurred independently of a blood
pressure-lowering effect. . ."

("Effects" in this sentence referred to decrease in heart attack, decrease
in stroke events, and decrease in death from cardiovascular event)

http://www.medscape.com/viewarticle/444960_5

.. . .The trial was stopped 6 months early (after 4.5 years) because
ramipril-treated patients showed consistent benefits when compared with
placebo-treated groups.[43,44] There was a 25% decrease in the composite
primary outcome in diabetic patients receiving ramipril (22% decrease in
myocardial infarction, 33% decrease in stroke, and 37% decrease in
cardiovascular mortality).[43] It is noteworthy that effects occurred
independently of a blood pressure-lowering effect. At randomization, the
mean blood pressure was 140/80 mm Hg, and, at entry, only 56% of the HOPE
trial participants with diabetes had hypertension. This study demonstrates
that the ACE inhibitor, ramipril, is beneficial for patients with diabetes
who are at high risk for cardiovascular events, even if they are
normotensive or have well-controlled hypertension.[44] Whether similar
results can be achieved with other ACE inhibitors is currently being
evaluated in other large clinical trials. . . .

and a quote from Doc Biggs which might appeal to the more frugal reader:

". . .We now have two generic ACE inhibitors, captopril & enalapril
(Vasotec). . . . "

When I was 15 years old, and watching my mother suffer her second heart
attack before age 46, I came to the conclusion that there was a heart
attack problem in my family. Thus, for 46 years now, I have been sensitive
to anything, anywhere which deals with reductions in CV mortality. . .and am
one of the chief anti-heart-attack-med pushers on the diabetes newsgroups.

Regards
Old Al (Who avoids buying sliced bread unless there is just no
alternative)

Quentin, my husband who has always watched everything he eats, but
everything enough to make me want to vomit, has high blood pressure, his
mother has it, his father had it. My pressure before diabetes was
110/70 or moswt 120/80 which was considered the norm at the time,. I
never had a problem, overwieght and bad eating habits, So it is safe to
assume that it isnt anything you have done, I dont know ifyou have
edema or eat a lot of salt,

I was on an ace inhibitor but developed a cough, I dont remember the
name I am on diovan now for kidney protection but the side effect has
been bp of 95/65.

I dont know if you won the battle of your self exploration or lost, but
whatever you absolutely did the right thing by remaking the doctors
appointment, We are the leaders of our own team, but we are supposed to
be part of a team and therefore should not make unilateral decisions
without the input of the medical community.

I know that each new diagnosis we get is hard to accept,. How did this
happen, why me, why not me, what can I do about it, As you do
everything else., I know you will do this and accept, Is it all part of
the aging process,. I think so.

But I have no doubt as each thing develops, you will handle it, You are
a strong person and you know I think you are brilliant.

Follow the yellow brick road and you will be fine Quentin,.

Look you know my email address so if there is ever a time you need to
talk, just type me in,

Loretta

--
In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled with strife and
terrorism.

This post not CC'd by email
On Mon, 11 Aug 2003 07:48:39 -0400, "Jenny"
<jenny_the_bean@yahoo.com> wrote:

G'day G'day Jenny,

I'm glad I haven't experienced those side effects.

It is good to know there are further options. Dropping blood sugars a
bit and countering insulin resistance all seems to be to the good.
I'm struggling a bit with "and my weight gain picked up too."
Did you mean weight loss? The sentence structure suggests you are
listing another positive point.

Darn.

But you can remember what that was like. It is amazing when people
have strong representations for what it like to feel relaxed how it is
possible to experience some of that just by remembering. Often an odd
colour or a particular direction you were looking is enough bring back
the feeling.

I'm having a little moment of feeling grateful ... and that is
confusing the hell out of the subliminal sense of panic at needing to
be on ACE inhibitors.

All this presupposes you measure blood pressure regularly ... perhaps
at home.

What do people think of home monitoring of blood pressure?
Is it analogous to home measuring of blood pressure?
What have you guys figured out?

Well there are certainly some thrills in store.

That seems to be crucial.

I've had plenty of practice ... a life times experience ... perhaps
I've mastered that by now.

--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

This post not CC'd by email
On Mon, 11 Aug 2003 11:10:04 -0400, "oldal4865" <oldal4865@yahoo.com>
wrote:

G'day G'day Al,

Darn. I am on one of the OTHER ACE inhibitors.


LOL. Thanks Al.

--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

"Quentin Grady" <quentin@paradise.net.nz> wrote in message
news:g1tdjvg2kq6fos0lo4ghius90rgjnijsft@4ax.com...

I *think* K has to do with regulating heartbeat, but I'm not really sure of
details. I didn't perceive any symptoms, the very slight elevation came out
in a blood test (interestingly, it was done after my thyroid cancer
treatment and was mainly to check about thyroid/meds levels; my pcp called
to ask if the endo had discussed the elevated K -- he hadn't -- and to
discuss what to do about it).

Until recently I have only had thyroid and bp meds to contend with. Last
week I started Fosamax. It's beaucoup fun when you have two incompatible
meds that have to be taken on an empty stomach, not together, and wait to
eat. At least the Fosa is only once/week.

The only diabetes meds I have are the shoes I buy at the running-shoe-store.

bj

Quentin Grady wrote in message ...

Cost. A 3-month supply of minimum-dose Diovan costs 7 times as much
as a 3-month supply of minimum-dose generic Enalapril in the U.S..

AFAIK, there are no generic ARB's yet. There are only two generic ACE and
only one, Captopril seems to be available via Canadian mail order.

Regards
Old Al

Jenny wrote:

I take Accupril (an ACE inhibitor) and it does cause retention of
potassium. Also avoidance of caffeine is recommended. For a while I took
the combination of quinapril and the diuretic you mentioned and it
dropped my bp too much.
I have backed off on Accupril on occasion because my bp was getting too
low and I would get light headed. After a couple of weeks it creeps back
up again.

There are suppose to be some secondary benefits to ACE inhibitors. Old
Al is sold on them.

Frank

"Quentin Grady" <quentin@paradise.net.nz> wrote in message
news:relfjvc71p6k42jv410p3dsempcorc7ct8@4ax.com...
I bought one, and it works pretty well. I found mine to be very
"sound" sensitive, and have to make sure there is no extraneous
noise while doing the test. Without it, I wouldn't have picked up
the Prinzmetal's (variable) angina - where the BP goes high late at
night when one is not doing anything (ie is "resting"). During the
day I had "normal" to 'slighly elevated" blood pressure.

So why did I buy the meter? LOL. I read in an article that just
monitoring one's BP at least 4 times a day could reduce BP levels
all by itself! I talked to a woman who had experienced this effect
during a stay in hospital, (for an unrelated condition), where her
blood pressure was being monitored day and night because of various
other concerns. No meds were involved. Her BP dropped to healthy
levels by the time she was discharged, nothing to do with the other
condition. She DID ask and noted down her readings each time. I
wondered if some kind of feed-back, self control effect was
operating. Remember those experiments with biofeedback and brain
waves? They showed that people COULD self-control their blood
pressure as well, given good feed back in controlled conditions.

So I bought a meter. Didn't work for me, as I had hoped, but I
found something very significant out, anyway. It's usually only
detected during a hospital stay, otherwise.

It wasn't very costly, and anyway it has proved it's worth.

Annette



---
Outgoing mail is certified Virus Free.
Checked by AVG anti-virus system (http://www.grisoft.com).
Version: 6.0.507 / Virus Database: 304 - Release Date: 5/08/03

I would bet that it Was the Special Hospital Diet even if it was A
Hospital " Regular " Diet .

tim

"Annette" <acianthus@bigpond.com> wrote in message news:<bhasgd$10dc2j$1@ID-194908.news.uni-berlin.de>...

This post not CC'd by email
On Mon, 11 Aug 2003 18:17:22 -0400, Frank Roy <froy@erols.com> wrote:

G'day G'day Frank,

Feel like it is getting to low? Are there recognizable symptoms?

My previous belief was that high blood pressure was hard to detect
unless one did the cuff measurement.

Oh goodie.

Nothing like some extra incentive to clarify the mind so wonderfully.

You point makes sense though I'm more focussed on live at the moment.

Hmmm. Apart from one devastating frost we have had a mild Winter.
Being at home more during the day with the dogs they nag me more often
to take them for walks. My intuition on the matter is that I have been
getting more exercise this Winter than in previous Winters.

--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

G'day G'day Frank,


Thanks for the URLs. I am still coming to grips with it all.


This post not CC'd by email
On Mon, 11 Aug 2003 19:07:29 -0400, Frank Roy <froy@erols.com> wrote:

--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

This post not CC'd by email
On Mon, 11 Aug 2003 16:07:31 -0400, "oldal4865" <oldal4865@yahoo.com>
wrote:

G'day G'day Al,

Apart from current cost is there any downside to ARBs. Thinking
ahead a bit ... there will be a time when there is a generic ARB.

Is that something to look forward to?

Thanks for the succinct answer.
--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

This post not CC'd by email
On Mon, 11 Aug 2003 19:37:36 GMT, "bj" <bjones44@bellatlantic.net>
wrote:

G'day G'day bj

I keep being reminded how lucky I am. It is not that anyone tries to
make the point. I just appreciate the openness with which people
discuss the things that don't go right in life AND the fact that they
have lived through it.

Nice one. Perhaps I need to do more running.

--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

BJ thanks for the tip - finally tracked down that guy - he said he gave you
the wrong pill so you need to get the antidote - also said to tell you
"don't quit your day job" :-)

Ralph scribbled these tid bits

No and neither is the FTC or FBI both of whom investigate Internet fraud.
Since your post points to where the book can be purchased I am taking it
that you are promoting and selling this product?

---- Ad Snipped ------


--
"If the Lord can see his way clear to bless
the Republican Party the way it's been carrying
on, then the rest of us ought to get it without
even asking." - Will Rogers
-----------------------------------------------
http://www.livejournal.com/users/ronnie_in_dc

"Ralph" <ralphyde@hotmail.com> wrote in message
news:3f46c01c.0308122131.7b9d554f@posting.google.c om...
What a bunch of nonsense! A 10 day fast of purified water is not advisable
for anyone! And for a person with type 2 diabetes, it is likely to send
their BG soaring as their liver dumps glucose! Diabetes is not curable. BP
fluctuates. I would not say it is "curable" either since it can go up or
down frrequently.
If you don't have diabetes, then why are you posting here?

<snip>

--
Type 2
http://users.bestweb.net/~jbove/