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The next day I saw the doctor, my GP, and right from the start there was some kind of undercurrent of antagonism there. He immediately told me that one glass of wine with a meal was all I could have and I could completely forget beer, and on top of that I was to get my blood pressure down to 120/80. Oh yes I said, why don’t you take 30 years off me and I’ll attain that blood pressure no problem. I also told him that I didn’t like Ace inhibitors and that I’d rather have some other medication if any more was needed. He completely ignored me on that one and prescribed Ramipril, I was already on Amlodipene and Aspirin and the day after, after being in hospital for neurological tests I was further prescribed Persantin.
Now I’m a chemist myself and in my job I work with some sophisticated instruments and one thing I know from that experience is that when you change things on any kind of sophisticated instrument you should change one thing at a time, that way you know what does what. So this sudden onslaught of pharmaceuticals should have concerned me, considering myself at the very minimum to be a sophisticated instrument of some excellence, but I was not as aware as my normal self and I was extremely vulnerable and easily led, I mean Santa Claus would have been welcome in my world at that point. So, off home I go armed to the teeth with pharmaceuticals to ingest at various times of the day, warnings aplenty to keep me nervous, and a single beer and a mug of hot chocolate to calm me down and then to bed. I awoke to the sound of my doorbell being rung in an unbelievably insistent and rapidly repeated way as if some utterly imperative message just had to reach me before the previous ring had faded. I threw on some clothes and descended the stairs feeling sorry for the bell.
I get to the door; it’s the guy through the kitchen wall, 3rd floor flat next to mine, and I don’t like this twat at all. You think you could ring that a bit more insistently next time I say as I open the door and he finally extricates his index finger from the doorbell cavity and the bell finally stops ringing, I have an image of it gasping away on the wall. He goes on about a car being clamped, not mine, someone else’s, yes right, so what’s this got to do with me, or you for that matter, when did you become the caretaker around here I think. I don’t know whose car it is and I leave him, post mini stroke victim that I am, angry at this intrusion but generally glad to get away and leave this unemployed self important jobsworth trying to work out who else he can show his self importance to, sheesh, I need some coffee.
I was signed off for three weeks while I tried to get my life back together, which for a while I thought I was doing quite well under the circumstances. Though I did have some strange feelings some nights, not sure at the time what they were but it certainly felt very weird, but I just put it down to the post brain flash situation, or communication blockage as I thought of it, as it’s apparently caused by a temporary blood clot, that stays long enough to cause damage but liquidises itself quickly enough to keep damage at a reasonably low level. Anyway I coped with whatever it was and crawled my way, time wise, through the following three weeks and went back to work.
Two weeks at work then two weeks off and everything looking ok, and then I was driving into work and I tried to go in the wrong gate. Now I’ve been driving in here for over 10 years so this was a bit of a surprise, which became even stranger, when after correcting my error I went on to compound it by missing the turn for the proper entrance and had to turn round again at the end of the road. Finally though I did actually get through the gate but when I did, the streets and turns seemed terribly unfamiliar. I did manage to get my car parked and get into the laboratory and everything in there was alright so I decided that it was best to stay with the alright and put the strangeness thing down to some blip, temporary blockage, geo-spatial aberration. Though entrance to the site was achieved with previously customary ease, this unfamiliarity on site lingered for a few more days, which was a concern yet it did feel as if the unfamiliarity faded a bit each day until, like the Cheshire cat perhaps, left only a fading, though possible baleful, grin.
The doctor in the meantime had raised the level of the Ramipril, from 2.5mg, to 5.0mg, and then to 7.5mg, saying that he had to do this because my blood pressure was too high. It was then that I started to get serious weird sensations that turned out to be hypo and hyper tension attacks. As I didn’t like ace inhibitors, I don’t know why really, maybe just the name, it suggests stopping the sharpest card in the pack, which suggests a kind of cheating to me, I didn’t focus on that drug at the start but told the doctor of these problems and we agreed to stop the Persantin for a week and see if that sorted it. It didn’t of course and these attacks, which at that time were completely sporadic but with increasing frequency, so that some of these occasions began to coincide with my time at work.
These were neither pleasant nor confidence building situations; quite frankly they were bloody horrible. I was taken to hospital again from work, driven home twice, called from home for an ambulance three times; I didn’t know what the hell was going on. As for work, well this would look good on my record wouldn’t it? More time off work. Now I realised that it had to be the ace inhibitor and I told the doctor but he wouldn’t have it, but as my blood pressure was down a bit he reduced the dose to 5 mgs. A partial victory, which, unlike partially bad things that become wholly bad, don’t become victories at all and in this particular case it made a Pyrrhic victory look like a glorious success.
The attacks lessened which undoubtedly was a good thing, and they became regular, therefore predictable, which initially one would think to be a good thing too. This unfortunately was not to be the case. There were two attacks overall I discovered, one whilst I was asleep, which didn’t really count and one around tea time each day. Now, you would think that knowing when this attack was due, more or less, would be a chance to prepare for it, make sure you were in a safe place and so on, and yes, it did enable that, but plain sailing it was not to be.
First of all I didn’t have a clue what these attacks really were, and, neither, so it seems did my doctor. I had though, proven the ace inhibitor to be the culprit, but still he would not reduce the dose. This proof was how I discovered the second attack, the middle of the night one. I did this by altering the time I took the pill, delaying the ingestion by some six hours and waiting to see when the attack, or as it turned out attacks, which was I freely admit, a bit of a shock when it occurred, occurred. So this shifting of the attacks, the tea time one to late night and the middle of the night one to the afternoon, left no doubt as to what was causing these attacks. Yet still he would not reduce the dose, saying that my blood pressure was too high, I even argued that even on the couple of occasions I was in hospital they had said the dose needed to be reduced. Whatever, nothing could sway him, I argued that it was all very well setting a target and devising a means to get there but when the means is creating a worse problem than not reaching the target then either you forget the target at least temporarily, or you change the means, and you are not prepared to do either, but it is me who is suffering here.
So there was serious antagonism between me and my doctor, there were serious concerns regarding my work situation, at the time I couldn’t go in because I wasn’t sure some attack wouldn’t waylay me in the lab. The biggest problem though, was the regular time. As it approached, you must remember that these attacks were bloody scary, lasted anything up to an hour, and left me utterly exhausted afterwards, I found an anticipatory dread building up each time. These circumstances lasted some four months, so these anticipatory horrors had some time to build their gothic landscape in my imagination. The attacks over this period neither got worse nor improved; they were in fact, the only horrendous constant in my life at that time.
The simple fact is this. I was fast losing any trust of my doctor, what he was saying as regards the need to keep this dose up was beginning to sound like excuses, I began to look at changing surgeries, there being one nearer me, so I looked at their website. On there, they had a link for recommendations for safe levels of blood pressure and it turned out, according to this information, that not only was my blood pressure considered safe at this time, but it would have been considered safe when my current doctor had raised the level of the ace inhibitor. Not only that but according to this information his target was nonsense, nice to reach of course, but unnecessary.
So, over this period, I find that I can’t trust my doctor, I’m having these attacks, I’m losing time at work, and my social life is shot to hell, and my anticipatory horrors are building up.
So I go to this new surgery and sign up on the Wednesday and that evening, during the usual attack this develops into a full-fledged panic attack, looks like the anxiety department of my brain finally thought it was time to react.
The last time I saw that doctor was that Friday. I told him about the panic attack. The next thing I know he’s telling me he wants to stop the ace inhibitor! What? After all this, you have got to be kidding me. He also suggests I go on Prozac for a week. No thanks mate. Has that been your target all the time? I tell him I will reduce the ace inhibitor back to 2.5mg and then see after that. Weird, I’d become the more responsible of the two of us. Now I think of it, there was another weird occasion with him: He’d started to give a very strange kind of apology for what I’d been going through, with some strange inference that something had been done to me, but saying that he hoped I understood that everything he’d done was all for my good. It was kind of creepy, very disturbing, and at that point didn’t really mean anything to me to tell the truth. Anyway I walked out of there, got back to work and joined the new surgery and as the dose of the ace inhibitor decreased the attacks ceased and the panic attacks began to lessen. Things were looking up.
Tagged in jim barrass