Wellness

[Deree]

I take anything a doctor has to say to me with a grain of salt pun intended. Then I go home and research myself. I look up blood tests and other diagnostic tests to understand what they mean. I don't just take a doctor's say so that my test indicated this or that.

I recently went to a rheumatologist who very quickly diagnosed me with 2 autoimmune diseases. Knowing very little about these diseases I went home to research and decided there wasn't enough data for the diagnoses so I went to a second rheumatologist who said I had neither of these diseases.  Now that is extremely concerning that the first doctor had handed me a prescription for a toxic drug.

Moral of the story:  Don't take a doctor's advice as gospel. Do your own research. Be proactive. Be your own advocate.

[pitdakota]

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@novamc1 wrote:

Oh, for heaven's sake, @sidsmom

  The apparent cause of the low blood pressure (as far as the doctors know) is a low sodium level, which some apparently believe can be cured by increasing salt or sodium intake. (Thought that might be obvious, but I guess not.) 

And yes, all doctors routinely ask  all older people about their exercise regimen, and DH makes it clear that he is a heavy exerciser, which is exactly why they think he might need more sodium and has low blood pressure.

The post was supposed to be about how doctors may not agree and might dispense conflicting advice.  It wasn't supposed to be a disussion of anyone's personal medical history.

I should think it might prompt a better, more productive discussion about how research has raised doubts about whether sodium should so readily be blamed to cause high blood pressure---and might not help raise pressure.

Supposedly, not everyone reacts to salt/sodium in the same way, and it has been shown not to affect some people at all.

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If I may jump in here @novamc1, I would suspect this is just a difference of opinion between a couple of doctors as to whether to address the low blood pressure or how to address the low blood pressure.  

From what you have posted, it does not sound like they actually suspect a low sodium level as a cause of the low blood pressure.  Usually in cases of low sodium levels low blood pressure is not one of the presenting symptoms.  And if they did suspect hyponatremia (low sodium level) as a signficant causative factor, there are ways they treat that.  Hyponatremia can actually be caused by people drinking too much water/fluids.

I suspect they think the cause of the asymptomatic hypotension is either unknown (not uncommon) or from dehydration.  As we age, we tend not to store water as effectively as we did when we are younger & the receptors that regulate blood pressure don't work as well either.  In those cases many times docs will encourage drinking something like Gatorade which does have sodium, but also potassium & other electrolytes.  And if they know your husband does exercise and work out frequently which leads to loss of body fluids, they might be inclined to encourage something to replace those electrolytes.  They recommend the salt/electrolyte drinks because salt causes fluid retention and causes the body to retain more fluid.  More body fluid, means more blood volume, and more blood volume = higher blood pressure.  

You didn't say (nor do you need to state it here) what your husband's blood pressure was between the 2 different doctors.  Blood pressure changes routinely during certain times of the day, changes from day to day, etc.  We all know that.  It is quite possible your husband's blood pressure at his PCP was a tad bit higher than it was at the specialists office so that the PCP was inclined to discourage Gatorade if he/she just didn't think it was that low to worry about it.  Or it could be that since your husband is asymptomatic, the PCP is just not inclined to recommend any action, whereas the specialist routinely suggests Gatorade in these situations.  It doesn't necessarily mean they don't agree on the action of sodium or disagree about salt intake.  Chances are the specialist that recommended the Gatorade also recommends sodium restriction in a number of his/her patients as well.  

I hope this makes sense.  Believe me, many a nursing & medical student has agonized over fluid and electrolyte balance, not to mention the endocrine system that also plays a part in that whole set up.  But hopefully it makes a little sense.  At any rate, the good news is that the doctors are not overly concerned about his low blood pressure which means they have ruled out the much more serious problems that could be causative factors.  So that is a good thing! 

[qbetzforreal]

@pitdakota=

[hckynut]

@novamc1 

Are any of the doctors DH visited certified Sports Medicine Doctors? From what you say, your DH spends a lot of time exercising, and has a basket ball playing background. That is the reason of my question. 

Doctors certified, unlike many in their profession, are more deeply versed in exercise physiology, than those that have never been an athlete. They don't just listen, to their patient, they can personally relate to issues other specialists cannot.

You do not mention numbers, low blood pressure. Only the person living in the body knows, assuming they also know their Cardiovascular and Pulmonary/Respiratory condition, if their BP is too low. You mention "health", but not DH physical fitness, and they are 2 completely different animals. One can be "physically fit", but that does not denote "healthy, and viceversa.

Ones body's physical and healthy needs change as years and decades pass by. This I know from my own personal experiences with both health, and physical fitness. I also have many "elder" friends that are still very physically active and they concur on much of what has changed for me.

Getting "conflicting advice" from different doctors is not that unusual. There are different methods when it comes to reaching the same results. No doctor knows exactly what their patient is putting into their body to nourish it enough to match their chosen lifestyle. They know only what their patient tells them, and many are not totally honest in that regard.

I agree, there are "too many advice givers" even a few that practice medicine. A patient should be their own best advocate when it comes to both their health, and their physical fitness. The more they know for sure how and what makes their body function at its highest potential levels, the easier to make the decisions when it comes to what is right for their body, in health and total fitness.

hckynut

[Annabellethecat66]

I'll tell you guys a little story about why my husband dropped (really, he dropped) dead.

So, he took a very low dose of a diauretic for years.  His blood pressure was very slightly elevated and primary care Dr. thought it would be a good idea.

When he worked out he was like a crazy man.  We have a heavy duty treadmill.  The entire house shook when he ran like crazy on the thing.  Between that and the boom box so loud it was unbelievable.

He was in incredible shape.  He worked out evey single day even in middle July outdoors jumping rope.

He used to be a boxer in Junior golden gloves.  He even had a "six pack' Not one ounce of fat on the man but he was big (he'd been called 'muscle bound' like you see in gym rats.

OK, so he'd been running like crazy on the treadmill that morning.  He'd sweat terribly when he worked out.  Days after he'd run on the thing there'd be puddles of sweat.

He got off of the treadmill and went into the office downstairs (I heard the boombox shut off).

I left the house put ran back in because I forgot something.  (Split foyer.....he is in downstairs office).

I was ready to go out the door when I heard what sounded like a big box dropping.

Normally, I wouldn't have thought about it, but for some reason when I called out he didn't answer (again, he could have been on the phone...) but I went down there.

He was laying in the floor (with his leg bent on his stomach.  

I thought he'd had a heart attack.  I had one heck of a time getting him on his back, but I finally did.

I called 911 and started CPR.  I know I was doing it as good as I could because the air was going into his chest and it would come right back out.  He was muscular so pressing on his chest wasn't easy....but I did it right because I felt the rib give.

He never regained consciousness.  They shocked his heart 3 times.

Autopsy never identified what happened.  But about 1 month later I went to MY cardiologist.

I told him I thought his potassium was very, very low and that's what caused him to drop dead.

(Normally he would stand at our big water tank and drink at least (often 3 glasses of water, but at least 2 immediately before he worked out). 

That morning I was sitting next to the water tank and he never did drink any water because he was in hurry to work out and then go get a massage (which he did at least once a week).

So as quickly as you would blink, my life changed and he died.

It is nothing to mess around with.  He had gatorade sitting at his desk but it had been unopened.  He often drank gatorade, but didn't that morning.

Just letting you guys know how important a good potassium level is.

[cherry]

@Annabellethecat66  how awful for you..I am sending you a hug

[Q4u]

This is only my own story and not a recommendation.

I was a  very hard excerciser as I was a 2nd degree black belt.  When I worked out, I would sweat Moonsoon drops.... and then feel terrible afterwards.  One day after a workout I was still feeling awful and one of the advanced black belts saw me (I wasn't a black belt yet) and he said I looked like I felt terrible.....and recommended I drink 8 - 10 oz of Gatorade immediately and to drink a glass PRIOR to each workout.  I did so and immediately felt SO much better.  I had no idea.  I drank a glass of no-sugar Gatorade prior to every class (or demo or test) that I had after that until I stopped going to Karate and I never felt that bad again.  But I still fall back on a glass prior to really working out or working hard to this day.

I have talked to my doctor regarding this and was told that the extreme and sudden loss of the salts, potassium and electrolytes after a very hard workout can have a sudden and detrimental effect on the body and doing what I did through another student's recommendation was a good thing for me.

@Annabellethecat66, I'm so sorry this happened to you.

[hckynut]

@Q4u 

I can't imagine anyone in this day and age being a very hard exerciser, and not knowing the important minerals lost from sweating, especially excessive sweating. This information has been available for many decades and it boggles my mind when I read stories like this.

Seems that most adults have heard that exercise is good for ones body but somehow their knowledge ends there. I read all the time about healthy people that are dehydrated to the point of passing out and I just don't get it. Many of these stories are about those that exercise.

For someone to workout and "then feel terrible afterwards"? That should always be a clue that something is not right. I don't understand why anyone that is "a hard exerciser", on a regular basis, would continue if they "felt terrible afterwards".

While Gatorade and other similar drinks are good for replenishing a person after exercising, they are not so good to drink while trying to replenish while still doing some sort of high output exercising. Most have a sugar content so high, it slows the body's ability to absorb what is most needed. Most long distance runners never drink any full strength electrolyte replacement drink, while still running. They dilute it by 40-50 even 60%.

I am glad to hear that someone saw you and was knowledgeable enough to give you this important information. For me, because of working in a hot 100° + factory for 8 hours, and then running in the summer after work in hot and humid weather, drinking lots of water was a natural action for me.

I am sorry @Annabellethecat66  to read about how you found your husband, it's a sad thing to read here. 

Bed time!

hckynut

[lovesrecess]

Gatorade makes a low-sugar version which DH likes. I think it is called G2 or something similar.

[Bridgegal]

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@Nonametoday wrote:

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@novamc1 wrote:

Thought I'd share this story of conflicting advice given to DH by different doctors in the past year or less.

DH  just saw his heart doc who said he had low blood pressure and needs to eat more salt.

Another doctor earlier had  told him to drink Gatorade to replenish electrolytes he was losing in sweat at the gym (including sodium).  DH did indeed stock up on Gatorade and drank a bottle daily.

DH has always been a gym rat,  was a longtime basketball player until he was in his 50s, and will hardly go a day without sweating in a gym doing something in an exercise class plus miles on a stationary bike, even at his advanced age.

 Not long ago, he had asked his primary physician about drinking Gatorade and was told to avoid Gatorade because it contains too much sodium.

So the road to optimum health goes round-and-round.

We're beginning to laugh about all this  There are too many advice-givers in the world when it comes to health and nutrition.

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@novamc1   My BFF's husband has this issue and he eats more salty foods and drinks Gatorade at every meal to keep from going into the hospital.  People who have low sodium are at great and grave danger.  

This is so true.   My sister almost died 3 years ago when her sodium dropped to almost zero.    The Dr.s told her to cut back on the amount of water she drank and to substitute Gatorade for that water instead.