Blood Pressure/Medical (longish)

[Wizard of Draws[_3_]]

June 2007. I failed my 3rd class medical exam and was grounded. I am 50
years old, 5'9", 158 lbs. No family history of hypertension. But due to a
number of current stress factors in my life, mother in law and father in law
both passing away recently and suddenly, the work of disposing of the
estate, a promotion at work entailing additional duties and
responsibilities, a consistent lunch menu of Chinese food, and white coat
syndrome, my blood pressure was elevated over the FAA acceptable limits.

When a second visit to the AME the next day resulted in even higher
readings, he was forced to send the paperwork to Oklahoma City with his
findings. Note to self, don't drink coca-cola for lunch right before your BP
test.

I scheduled a visit with my personal doctor and he did the whole 9 yards,
EKG, blood and all. The only thing he found wrong was high blood pressure of
course, and that my cholesterol can be lowered a bit. But the BP was enough
to have him start me on 5 mg Lisinopril and 25 mg Hydrochlorothiazide daily.

I don't like taking drugs. I don't smoke, drink and never have. I push
through pain of headaches when I get them, which is pretty rare anyway,
thinking it's best to let my body rely on it's own coping mechanisms. Sorta
'what doesn't kill me, makes me stronger' mentality. This is not making me
happy, on top of not being able to fly. I grumble and fuss.

I begin to run. Long ago, before 30 years of monotony, er, monogamy and
kids, in the Land of Fruits and Nuts, I ran. 10 miles every other day at the
beach. I loved it. If I couldn't run for a few days for whatever reason, my
legs would get twitchy and the pent-up energy would explode the next time
out. If you've never had a runner's high, I can tell you it's amazing. You
feel as if you can run forever.

But now... now it's a bitch trying to get those 18 year old legs back. My
lungs are back after 2 months of slogging 3 miles every other day in the
heat and humidity of North Georgia, but the knees and ankles are still
protesting quite loudly. A good pair of running shoes help, but on some days
they help too much. I begin to feel comfortable with small glimpses of the
ol' high and end up pushing it too much, paying for it the next day with
very sore Achilles tendons.

Two more checkup visits to my personal doc, a new one this time, and he
feels the need to change the meds to 10 mg Lisinopril and 12.5 mg HCTZ.
Sigh. At least it's combined into a single pill now, so I don't have 2
prescriptions that run out alternately. But the doc says now he has enough
info to write the FAA a letter and let them know my medical status. So he
did. And I waited, not knowing how long the paperwork would take to work
it's way through the system. Surprisingly it isn't that long. Ten business
days after the letter was mailed, I received a medical certificate back from
the FAA.

I can fly again.
--
Jeff 'The Wizard of Draws' Bucchino

Cartoons with a Touch of Magic�
http://www.wizardofdraws.com

More Cartoons with a Touch of Magic�
http://www.cartoonclipart.com

[The Visitor[_2_]]

Nice post, thank you.

I am sure it will help many people facing similar events.

John



Wizard of Draws wrote:
> June 2007. I failed my 3rd class medical exam and was grounded. I am 50
> years old, 5'9", 158 lbs. No family history of hypertension. But due to a
> number of current stress factors in my life, mother in law and father in law
> both passing away recently and suddenly, the work of disposing of the
> estate, a promotion at work entailing additional duties and
> responsibilities, a consistent lunch menu of Chinese food, and white coat
> syndrome, my blood pressure was elevated over the FAA acceptable limits.
>
> When a second visit to the AME the next day resulted in even higher
> readings, he was forced to send the paperwork to Oklahoma City with his
> findings. Note to self, don't drink coca-cola for lunch right before your BP
> test.
>
> I scheduled a visit with my personal doctor and he did the whole 9 yards,
> EKG, blood and all. The only thing he found wrong was high blood pressure of
> course, and that my cholesterol can be lowered a bit. But the BP was enough
> to have him start me on 5 mg Lisinopril and 25 mg Hydrochlorothiazide daily.
>
> I don't like taking drugs. I don't smoke, drink and never have. I push
> through pain of headaches when I get them, which is pretty rare anyway,
> thinking it's best to let my body rely on it's own coping mechanisms. Sorta
> 'what doesn't kill me, makes me stronger' mentality. This is not making me
> happy, on top of not being able to fly. I grumble and fuss.
>
> I begin to run. Long ago, before 30 years of monotony, er, monogamy and
> kids, in the Land of Fruits and Nuts, I ran. 10 miles every other day at the
> beach. I loved it. If I couldn't run for a few days for whatever reason, my
> legs would get twitchy and the pent-up energy would explode the next time
> out. If you've never had a runner's high, I can tell you it's amazing. You
> feel as if you can run forever.
>
> But now... now it's a bitch trying to get those 18 year old legs back. My
> lungs are back after 2 months of slogging 3 miles every other day in the
> heat and humidity of North Georgia, but the knees and ankles are still
> protesting quite loudly. A good pair of running shoes help, but on some days
> they help too much. I begin to feel comfortable with small glimpses of the
> ol' high and end up pushing it too much, paying for it the next day with
> very sore Achilles tendons.
>
> Two more checkup visits to my personal doc, a new one this time, and he
> feels the need to change the meds to 10 mg Lisinopril and 12.5 mg HCTZ.
> Sigh. At least it's combined into a single pill now, so I don't have 2
> prescriptions that run out alternately. But the doc says now he has enough
> info to write the FAA a letter and let them know my medical status. So he
> did. And I waited, not knowing how long the paperwork would take to work
> it's way through the system. Surprisingly it isn't that long. Ten business
> days after the letter was mailed, I received a medical certificate back from
> the FAA.
>
> I can fly again.

[Morgans[_2_]]

"Wizard of Draws" > wrote

> Ten business
> days after the letter was mailed, I received a medical certificate back
> from
> the FAA.
>
> I can fly again.

Happy days!

I have no idea of what your weight situation is, but I'll pass along one
thing from my experiences.

I was having some BP problems, and went on medication.

A year or so later, I decided to lose some weight, but I resolved to do it
without a diet, but just eat smaller portions of everything.

It worked. 5 months later, I had gone from 195 to 175. No exercise
increase, no cutting out certain foods. Just less.

Guess what. No more BP medicine is necessary, now.
--
Jim in NC

[Wizard of Draws[_3_]]

On 9/25/07 8:06 PM, in article , "Morgans"
> wrote:

>
> "Wizard of Draws" > wrote
>
>> Ten business
>> days after the letter was mailed, I received a medical certificate back
>> from
>> the FAA.
>>
>> I can fly again.
>
> Happy days!
>
> I have no idea of what your weight situation is, but I'll pass along one
> thing from my experiences.
>
> I was having some BP problems, and went on medication.
>
> A year or so later, I decided to lose some weight, but I resolved to do it
> without a diet, but just eat smaller portions of everything.
>
> It worked. 5 months later, I had gone from 195 to 175. No exercise
> increase, no cutting out certain foods. Just less.
>
> Guess what. No more BP medicine is necessary, now.

I'm 5'9", 155 as of this morning. I asked the doc what BP he was looking for
in order to stop the meds: 100/60.

As of the last visit, I was 132/90. This may take quite a few miles, but I
will not be on meds for the rest of my life, no way.
--
Jeff 'The Wizard of Draws' Bucchino

Cartoons with a Touch of Magic�
http://www.wizardofdraws.com

More Cartoons with a Touch of Magic�
http://www.cartoonclipart.com

[James]

Wizard of Draws wrote:
> On 9/25/07 8:06 PM, in article , "Morgans"
> > wrote:
>
>
>>"Wizard of Draws" > wrote
>>
>>
>>>Ten business
>>>days after the letter was mailed, I received a medical certificate back
>>>from
>>>the FAA.
>>>
>>>I can fly again.
>>
>>Happy days!
>>
>>I have no idea of what your weight situation is, but I'll pass along one
>>thing from my experiences.
>>
>>I was having some BP problems, and went on medication.
>>
>>A year or so later, I decided to lose some weight, but I resolved to do it
>>without a diet, but just eat smaller portions of everything.
>>
>>It worked. 5 months later, I had gone from 195 to 175. No exercise
>>increase, no cutting out certain foods. Just less.
>>
>>Guess what. No more BP medicine is necessary, now.
>
>
> I'm 5'9", 155 as of this morning. I asked the doc what BP he was looking for
> in order to stop the meds: 100/60.
>
> As of the last visit, I was 132/90. This may take quite a few miles, but I
> will not be on meds for the rest of my life, no way.

I would have thought that 100/60 is pretty bloody low. Is the Doctor
getting kickbacks from the drug company? I get told my BP is pretty good
when it is 115/70. Genrerally I am 120/80 and the highest I know about
is 130/80. I did get a reall high reading after cutting myself badly,
152/95, but that does not really count!

James.

[Shirl]

James > wrote:
> I would have thought that 100/60 is pretty bloody low.

I just had mine renewed last week. My BP was 102/62. They just said it
was "good", nothing whatsoever about it being low.

[Matt Whiting]

James wrote:
>
>
> Wizard of Draws wrote:
>> On 9/25/07 8:06 PM, in article , "Morgans"
>> > wrote:
>>
>>
>>> "Wizard of Draws" > wrote
>>>
>>>
>>>> Ten business
>>>> days after the letter was mailed, I received a medical certificate back
>>>> from
>>>> the FAA.
>>>>
>>>> I can fly again.
>>>
>>> Happy days!
>>>
>>> I have no idea of what your weight situation is, but I'll pass along one
>>> thing from my experiences.
>>>
>>> I was having some BP problems, and went on medication.
>>>
>>> A year or so later, I decided to lose some weight, but I resolved to
>>> do it
>>> without a diet, but just eat smaller portions of everything.
>>>
>>> It worked. 5 months later, I had gone from 195 to 175. No exercise
>>> increase, no cutting out certain foods. Just less.
>>>
>>> Guess what. No more BP medicine is necessary, now.
>>
>>
>> I'm 5'9", 155 as of this morning. I asked the doc what BP he was
>> looking for
>> in order to stop the meds: 100/60.
>>
>> As of the last visit, I was 132/90. This may take quite a few miles,
>> but I
>> will not be on meds for the rest of my life, no way.
>
> I would have thought that 100/60 is pretty bloody low. Is the Doctor
> getting kickbacks from the drug company? I get told my BP is pretty good
> when it is 115/70. Genrerally I am 120/80 and the highest I know about
> is 130/80. I did get a reall high reading after cutting myself badly,
> 152/95, but that does not really count!

I'm guessing that is the BP the doc is looking for while taking the
meds. It needs to be unusually low with the meds if it is to stay low
enough without the meds.

Matt

[Mxsmanic]

Wizard of Draws writes:

> June 2007. I failed my 3rd class medical exam and was grounded. I am 50
> years old, 5'9", 158 lbs. No family history of hypertension. But due to a
> number of current stress factors in my life, mother in law and father in law
> both passing away recently and suddenly, the work of disposing of the
> estate, a promotion at work entailing additional duties and
> responsibilities, a consistent lunch menu of Chinese food, and white coat
> syndrome, my blood pressure was elevated over the FAA acceptable limits.

You can't be sure that any of these caused the hypertension, although it's
certainly plausible that some or all of these factors may have played a part.

> When a second visit to the AME the next day resulted in even higher
> readings, he was forced to send the paperwork to Oklahoma City with his
> findings. Note to self, don't drink coca-cola for lunch right before your BP
> test.

Coca-Cola wouldn't have much of an effect. However, white-coat syndrome can
be pretty extreme, and could produce higher readings simply because you worry
more on the second pass.

> I scheduled a visit with my personal doctor and he did the whole 9 yards,
> EKG, blood and all. The only thing he found wrong was high blood pressure of
> course, and that my cholesterol can be lowered a bit. But the BP was enough
> to have him start me on 5 mg Lisinopril and 25 mg Hydrochlorothiazide daily.
>
> I don't like taking drugs. I don't smoke, drink and never have. I push
> through pain of headaches when I get them, which is pretty rare anyway,
> thinking it's best to let my body rely on it's own coping mechanisms. Sorta
> 'what doesn't kill me, makes me stronger' mentality. This is not making me
> happy, on top of not being able to fly. I grumble and fuss.

I agree with you. Physicians treat hypertension with drugs because they don't
know how to treat it any other way. Diet and exercise helps some people, but
not others. The assumption is that hypertension is bad because it seems
clearly linked to so many other medical problems, and so it must be lowered by
force if it doesn't go down on its own. I think it would be better to find
out why bodies raise blood pressure in the first place, and correct the cause
rather than treat the symptom, but nobody knows how to do that, and there
doesn't seem to be a great deal of interest in finding out.

Did you ever have any ambulatory BP monitoring? BP that is elevated at the
doctor's office might not be anywhere else, if it is all due to white-coat
syndrome. If it is only moderately elevated this is a possibility. If it is
greatly elevated it is probably at least a little high even away from the
doctor's office. But you don't know if you don't measure it.

> But now... now it's a bitch trying to get those 18 year old legs back. My
> lungs are back after 2 months of slogging 3 miles every other day in the
> heat and humidity of North Georgia, but the knees and ankles are still
> protesting quite loudly. A good pair of running shoes help, but on some days
> they help too much. I begin to feel comfortable with small glimpses of the
> ol' high and end up pushing it too much, paying for it the next day with
> very sore Achilles tendons.

Are you overweight?

[Mxsmanic]

Wizard of Draws writes:

> I'm 5'9", 155 as of this morning. I asked the doc what BP he was looking for
> in order to stop the meds: 100/60.

In other words, he never plans to stop them. Unfortunately, there's no way of
knowing what your "natural" blood pressure is while you are taking medication,
and doctors don't like to risk taking you off medication if it will raise your
blood pressure above normal. But since your doctor wants you to have BP below
normal, the implication is that he doesn't ever plan to take you off the meds.

> As of the last visit, I was 132/90. This may take quite a few miles, but I
> will not be on meds for the rest of my life, no way.

Famous last words. Are you overweight?

[Mxsmanic]

James writes:

> I would have thought that 100/60 is pretty bloody low.

It is.

> Is the Doctor getting kickbacks from the drug company?

He is just being extremely conservative. I suspect he just doesn't want to
take him off medication.

> I get told my BP is pretty good when it is 115/70.

It is.

> Genrerally I am 120/80 and the highest I know about
> is 130/80. I did get a reall high reading after cutting myself badly,
> 152/95, but that does not really count!

Injury and disease can temporarily raise BP. So can dozens of other things.
Unfortunately, there aren't too many things that lower BP, besides medication,
so if you have a lot of things raising it, and you can't identify those things
and eliminate them, you end up on medication. Diet and exercise are very
important, although some people might prefer medication without diet and
exercise requirements rather than be required to diet and exercise in order to
avoid the meds.

[Mxsmanic]

Shirl writes:

> I just had mine renewed last week. My BP was 102/62. They just said it
> was "good", nothing whatsoever about it being low.

It's low, but low is generally good as long as it doesn't produce symptoms and
is not the result of any disease.

[Mxsmanic]

Matt Whiting writes:

> I'm guessing that is the BP the doc is looking for while taking the
> meds. It needs to be unusually low with the meds if it is to stay low
> enough without the meds.

Maybe. But if the meds counteract the body's own attempts to raise BP it may
never drop that low, simply because the body keeps raising it to more normal
levels. Thus, you never get off the meds. The only way to see if it's normal
without medication is to stop the medication, but most doctors won't risk
that. The bad effects of hypertension are well documented, and doctors don't
want to run the risk that the BP would run away if the meds were stopped.

[[email protected]]

Mxsmanic > wrote:
> Shirl writes:

> > I just had mine renewed last week. My BP was 102/62. They just said it
> > was "good", nothing whatsoever about it being low.

> It's low, but low is generally good as long as it doesn't produce symptoms and
> is not the result of any disease.

Say Dr. Mxsmanic, the source of all true knowledge.

You just don't get it, do you?

Pronouncements like this just show you to be an arrogant fool.


--
Jim Pennino

Remove .spam.sux to reply.

[Bertie the Bunyip[_19_]]

Mxsmanic > wrote in
:

> Matt Whiting writes:
>
>> I'm guessing that is the BP the doc is looking for while taking the
>> meds. It needs to be unusually low with the meds if it is to stay
>> low enough without the meds.
>
> Maybe. But if the meds counteract the body's own attempts to raise BP
> it may never drop that low, simply because the body keeps raising it
> to more normal levels. Thus, you never get off the meds. The only
> way to see if it's normal without medication is to stop the
> medication, but most doctors won't risk that. The bad effects of
> hypertension are well documented, and doctors don't want to run the
> risk that the BP would run away if the meds were stopped.
>

You are an idiot.

Bertie

[Bertie the Bunyip[_19_]]

Mxsmanic > wrote in
:

> James writes:
>
>> I would have thought that 100/60 is pretty bloody low.
>
> It is.
>
>> Is the Doctor getting kickbacks from the drug company?
>
> He is just being extremely conservative. I suspect he just doesn't
> want to take him off medication.
>
>> I get told my BP is pretty good when it is 115/70.
>
> It is.
>
>> Genrerally I am 120/80 and the highest I know about
>> is 130/80. I did get a reall high reading after cutting myself badly,
>> 152/95, but that does not really count!
>
> Injury and disease can temporarily raise BP. So can dozens of other
> things. Unfortunately, there aren't too many things that lower BP,
> besides medication, so if you have a lot of things raising it, and you
> can't identify those things and eliminate them, you end up on
> medication. Diet and exercise are very important, although some
> people might prefer medication without diet and exercise requirements
> rather than be required to diet and exercise in order to avoid the
> meds.

Oh good god, he's dioing medicine now.


Bertie
>

[Bertie the Bunyip[_19_]]

Mxsmanic > wrote in
:

> Wizard of Draws writes:
>
>> June 2007. I failed my 3rd class medical exam and was grounded. I am
>> 50 years old, 5'9", 158 lbs. No family history of hypertension. But
>> due to a number of current stress factors in my life, mother in law
>> and father in law both passing away recently and suddenly, the work
>> of disposing of the estate, a promotion at work entailing additional
>> duties and responsibilities, a consistent lunch menu of Chinese food,
>> and white coat syndrome, my blood pressure was elevated over the FAA
>> acceptable limits.
>
> You can't be sure that any of these caused the hypertension, although
> it's certainly plausible that some or all of these factors may have
> played a part.
>
>> When a second visit to the AME the next day resulted in even higher
>> readings, he was forced to send the paperwork to Oklahoma City with
>> his findings. Note to self, don't drink coca-cola for lunch right
>> before your BP test.
>
> Coca-Cola wouldn't have much of an effect. However, white-coat
> syndrome can be pretty extreme, and could produce higher readings
> simply because you worry more on the second pass.
>
>> I scheduled a visit with my personal doctor and he did the whole 9
>> yards, EKG, blood and all. The only thing he found wrong was high
>> blood pressure of course, and that my cholesterol can be lowered a
>> bit. But the BP was enough to have him start me on 5 mg Lisinopril
>> and 25 mg Hydrochlorothiazide daily.
>>
>> I don't like taking drugs. I don't smoke, drink and never have. I
>> push through pain of headaches when I get them, which is pretty rare
>> anyway, thinking it's best to let my body rely on it's own coping
>> mechanisms. Sorta 'what doesn't kill me, makes me stronger'
>> mentality. This is not making me happy, on top of not being able to
>> fly. I grumble and fuss.
>
> I agree with you. Physicians treat hypertension with drugs because
> they don't know how to treat it any other way. Diet and exercise
> helps some people, but not others. The assumption is that
> hypertension is bad because it seems clearly linked to so many other
> medical problems, and so it must be lowered by force if it doesn't go
> down on its own. I think it would be better to find out why bodies
> raise blood pressure in the first place, and correct the cause rather
> than treat the symptom, but nobody knows how to do that, and there
> doesn't seem to be a great deal of interest in finding out.
>
> Did you ever have any ambulatory BP monitoring? BP that is elevated
> at the doctor's office might not be anywhere else, if it is all due to
> white-coat syndrome. If it is only moderately elevated this is a
> possibility. If it is greatly elevated it is probably at least a
> little high even away from the doctor's office. But you don't know if
> you don't measure it.
>
>> But now... now it's a bitch trying to get those 18 year old legs
>> back. My lungs are back after 2 months of slogging 3 miles every
>> other day in the heat and humidity of North Georgia, but the knees
>> and ankles are still protesting quite loudly. A good pair of running
>> shoes help, but on some days they help too much. I begin to feel
>> comfortable with small glimpses of the ol' high and end up pushing it
>> too much, paying for it the next day with very sore Achilles tendons.
>
> Are you overweight?
>

Are you?

Bertie

[Tina]

I seem to remember reading that in France one is likely to be treated
for hypotension at levels considered close to ideal in the states. Is
that still the case?

As far as being on meds for life, my husband's cardiologist wants
very much for him, by weight control and exercise, to wean himself off
the diuretic he's taking for mild hypertension. I guess he went to a
different med school than did mxs.

What fraction of Mxs's well written posts are wrong or misleading?
Certainly enough to get newbe pilots in trouble, of course, but those
who get their instruction here are likely to experience a new form of
Darwinean deselection.





On Sep 26, 7:36 am, "Viperdoc" > wrote:
> Be advised that Anthony Atkielski is not a physician or AME, and should not
> be making medical decisions, let alone offering medical advice. He is not a
> medical practitioner of any kind. Perhaps he stayed at a Holiday Inn
> Express.
>
> Just as in his flying related posts, he thinks he knows a lot more than he
> actually does, and taking his advice could be dangerous to those who weren't
> aware of his background.

[Scott[_5_]]

On Wed, 26 Sep 2007 06:38:34 -0500, in rec.aviation.piloting, "Viperdoc"
> wrote:

>Anthony, are you overweight?

http://www.monochrom.at/english/wow.jpg

[Bertie the Bunyip[_19_]]

Tina > wrote in
oups.com:

> I seem to remember reading that in France one is likely to be treated
> for hypotension at levels considered close to ideal in the states. Is
> that still the case?
>
> As far as being on meds for life, my husband's cardiologist wants
> very much for him, by weight control and exercise, to wean himself off
> the diuretic he's taking for mild hypertension. I guess he went to a
> different med school than did mxs.
>
> What fraction of Mxs's well written posts are wrong or misleading?


100%. Even when he's right it's usually only half right.

Bertie

[C J Campbell[_1_]]

On 2007-09-25 16:59:05 -0700, Wizard of Draws
> said:

>
> I can fly again.

Yea! Good to hear you are running again, too.
--
Waddling Eagle
World Famous Flight Instructor

[RST Engineering]

Jeff...

Welcome back to the land of aviators.

I do not say this as a physician, nor do I play one on TV. I only relate
what my own situation is. At 60 I started getting nudgingly close to that
magic blood pressure point myself. In some conversations on this ng I
learned that some people react to diet coke with elevated blood pressure
readings. Just to see whether or not that was the case, I went cold-turkey
on diet coke (not the sugary leaded stuff) for a week before my last two
physicals (normal ingestion here is about four cans a day). Blood pressure
was down on both visits to 120/75, the same as it was when I played college
sports at 18.

Just a comment. YMMV.

Jim

--
"If you think you can, or think you can't, you're right."
--Henry Ford

"Wizard of Draws" > wrote in message
news:C31F1909.C1E33%jeff.bucchinoSPAM@CATCHERgmail .com...
>
> When a second visit to the AME the next day resulted in even higher
> readings, he was forced to send the paperwork to Oklahoma City with his
> findings. Note to self, don't drink coca-cola for lunch right before your
> BP
> test.

[Mxsmanic]

Tina writes:

> I seem to remember reading that in France one is likely to be treated
> for hypotension at levels considered close to ideal in the states. Is
> that still the case?

France likes to medicate more than the U.S., as a general rule. I'm not aware
of specific differences with respect to treatment for hypertension, however.
It's hard to see why anyone would still be medicating for BP of 100/60, in any
case.

> As far as being on meds for life, my husband's cardiologist wants
> very much for him, by weight control and exercise, to wean himself off
> the diuretic he's taking for mild hypertension. I guess he went to a
> different med school than did mxs.

Or a different med school than many other doctors. Note that a diuretic isn't
really BP medication per se.

> What fraction of Mxs's well written posts are wrong or misleading?

That's where doing your own research can come in handy. Don't take anyone's
word for anything.

[JGalban via AviationKB.com]

Viperdoc wrote:
He's like the perpetual last kid chosen to play on the team-
>he needs attention and wants validation, but is unable to understand why he
>doesn't get it...

He gets an inordinate amount of attention right here. That's why he will
be with us indefinitely.

John Galban=====>N4BQ (PA28-180)

--
Message posted via AviationKB.com
http://www.aviationkb.com/Uwe/Forums.aspx/aviation/200709/1

[Jim Stewart]

Bertie the Bunyip wrote:
> Mxsmanic > wrote in

> Oh good god, he's dioing medicine now.

There's no limits to his knowledge and
opinions as long as he doesn't have to
strap into the front seats of a real
aircraft.

[Bob Noel]

In article <78ce5a7befebf@uwe>, "JGalban via AviationKB.com" <u32749@uwe>
wrote:

> Viperdoc wrote:
> He's like the perpetual last kid chosen to play on the team-
> >he needs attention and wants validation, but is unable to understand why he
> >doesn't get it...
>
> He gets an inordinate amount of attention right here. That's why he will
> be with us indefinitely.

It's a troll. It would be less successful if people would just ignore it, like
they should every troll.

--
Bob Noel
(goodness, please trim replies!!!)

[B A R R Y]

On Wed, 26 Sep 2007 06:36:30 -0500, "Viperdoc"
> wrote:

>Perhaps he stayed at a Holiday Inn
>Express.

That would require leaving home.

[Tony]

As a shrink, I would not do diagnostics without having talked with
the subject. There are some with the skill to do so, those usually
work fot the government

We all recognize Mx's claim of skills as not uncommon among those
seeking attention. Consider his situation: probably intellegent but
isolated, poor, claiming an association with those who pilot
airplanes, a group with very different characteristics.

I deal with children who would like to be considered 'superior. The
good news is, some of these kids can actually make choices that will
lead them to leadership posiitons in society. Mx, I suspect, has
trouble holding professional level postions. My husband, who has is
own company, had mentioned, reading some of Mx posts, that he would
have to bring a huge amount to the table to avoid being terminated if
he was an employee of convenience. Mx's attitude and dogmatic defense
of his errors would be a serious handicap in industry. Most readers
would see that, and I'd offer great odds on bets that he has
experienced those kinds of things in his career (or job-holding, his
employment may not be a career).


On Sep 26, 8:57 am, "Viperdoc" > wrote:
>
> You're the psychologist- what do you think?

[Wizard of Draws[_3_]]

On 9/26/07 11:42 AM, in article
2007092608422516807-christophercampbell@hotmailcom, "C J Campbell"
> wrote:

> On 2007-09-25 16:59:05 -0700, Wizard of Draws
> > said:
>
>>
>> I can fly again.
>
> Yea! Good to hear you are running again, too.

Thanks. It felt too good again this evening. Tomorrow will see me limping a
bit I'm sure. But at least it seems to be getting just a bit less painful
each time.
--
Jeff 'The Wizard of Draws' Bucchino

Cartoons with a Touch of Magic�
http://www.wizardofdraws.com

More Cartoons with a Touch of Magic�
http://www.cartoonclipart.com

[Wizard of Draws[_3_]]

On 9/26/07 11:43 AM, in article , "RST
Engineering" > wrote:

> Jeff...
>
> Welcome back to the land of aviators.
>
> I do not say this as a physician, nor do I play one on TV. I only relate
> what my own situation is. At 60 I started getting nudgingly close to that
> magic blood pressure point myself. In some conversations on this ng I
> learned that some people react to diet coke with elevated blood pressure
> readings. Just to see whether or not that was the case, I went cold-turkey
> on diet coke (not the sugary leaded stuff) for a week before my last two
> physicals (normal ingestion here is about four cans a day). Blood pressure
> was down on both visits to 120/75, the same as it was when I played college
> sports at 18.
>
> Just a comment. YMMV.
>
> Jim

Thanks Jim. I'm trying to cut down on the cokes and substitute juice.
Certainly can't hurt.
--
Jeff 'The Wizard of Draws' Bucchino

Cartoons with a Touch of Magic�
http://www.wizardofdraws.com

More Cartoons with a Touch of Magic�
http://www.cartoonclipart.com

[Wizard of Draws[_3_]]

On 9/26/07 2:20 PM, in article ,
"Nomen Nescio" > wrote:

> -----BEGIN PGP SIGNED MESSAGE-----
>
> From: Wizard of Draws >
>
>> Two more checkup visits to my personal doc, a new one this time, and he
>> feels the need to change the meds to 10 mg Lisinopril and 12.5 mg HCTZ.
>> Sigh. At least it's combined into a single pill now, so I don't have 2
>> prescriptions that run out alternately. But the doc says now he has enough
>> info to write the FAA a letter and let them know my medical status. So he
>> did. And I waited, not knowing how long the paperwork would take to work
>> it's way through the system. Surprisingly it isn't that long. Ten business
>> days after the letter was mailed, I received a medical certificate back from
>> the FAA.
>>
>> I can fly again.
>
> At the risk of sounding like some whacko "new ager", have you considered
> Meditation? I was faced with a similar situation of rising blood pressure
> several
> years ago and, like you, hate the thought of treating it with drugs.
> My wife got me into trying to control the physical with the mental. Over the
> years,
> I've learned to control my blood pressure with my mind.
> I now can have fun every time they slap the BP cuff on me by asking the Dr. or
> nurse "What numbers do you want?". I'll give them nearly what they
> say.....from
> "You're about to explode" down to "I think you're legally dead". :)
> I still haven't perfected it to the level that my wife has. She has this weird
> ability
> to stop her heartbeat at will. She uses it to make some incredible shots with
> a
> rifle (bottle caps at 300 yards). I still have to time a shot between the
> beats.
> I've also found that diet and exercise has done wonders for my cholesterol
> level. Ten yrs ago it was 290 with triglycerides that ring the bell (690). Now
> my
> cholesterol level is down around 180 with triglycerides of 260 (still high,
> but a hell
> of a lot better). Now, if I could just get rid of this extra 20 lbs. But no
> way am I going
> to be running (unless I'm being chased). I do a lot of hiking, though.
> Anyway, congrats on getting the medical. But you may be surprised at how well
> the meditation could work at getting off the meds.
>
> This age thing is a bitch, ain't it?
>
>

Even though I'm a California native and it's logical to think I'd be all
over something like your suggestion, I'll stick with my old friend running
and change the diet for a while first. (Running probably works better for
weight loss too)
--
Jeff 'The Wizard of Draws' Bucchino

Cartoons with a Touch of Magic�
http://www.wizardofdraws.com

More Cartoons with a Touch of Magic�
http://www.cartoonclipart.com

[Jon]

On Sep 26, 2:20 pm, Nomen Nescio > wrote:
> -----BEGIN PGP SIGNED MESSAGE-----
>[...]
> Anyway, congrats on getting the medical. But you may be surprised at how well
> the meditation could work at getting off the meds.

Indeed. I discovered Benson's book, "The Relaxation Response," about
20 years ago and it works.

<http://relaxationresponse.org/>

> This age thing is a bitch, ain't it?
>
> -----BEGIN PGP SIGNATURE-----
> Version: N/A
>
> iQCVAwUBRvrJnJMoscYxZNI5AQGHHwP/SoMzmEy4Xvd40Hrg+kKJbjPgQG1CA4g/
> 3JTPfTw+4zQC86tif+zpIWE6GU25ItepzUKXPDn+P32rAt+2VT xJd/UmA8/88S69
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> OOCdPPv74LU=
> =8cUZ
> -----END PGP SIGNATURE-----

Regards,
Jon

[Morgans[_2_]]

"JGalban via AviationKB.com" <u32749@uwe> wrote

> He gets an inordinate amount of attention right here. That's why he
> will
> be with us indefinitely.

Right. That is why every post by him should be answered in a very simple
way, (like below) by everyone.

*****************
Shun mode = ON
*****************

Could we all please try to do this right, starting now?
--
Jim in NC

[Morgans[_2_]]

"Wizard of Draws" <> wrote

> Thanks Jim. I'm trying to cut down on the cokes and substitute juice.
> Certainly can't hurt.

It would appear as though weight is not much of a problem for you, after
re-reading your post that had your weight and height in it. (I missed it the
first time.) <(:-0)

Cokes are a big weakness for me too, and I refuse to consider diet Coke,
with all of the drawbacks and side-effects of aspartame, plus the nasty
after-taste. I managed to lose the weight and keep it off and the BP down
(for about 3 months now) even with my _many_ coke-a-day habit.
--
Jim in NC

[Bertie the Bunyip[_19_]]

"Viperdoc" > wrote in
:

> I agree: most people would have a difficult time working with or even
> socializing with Anthony,


Be fair, if you were drunk and armed with a taser he'd be the life of the
party!

bertie

[Bertie the Bunyip[_19_]]

Jim Stewart > wrote in
:

> Bertie the Bunyip wrote:
>> Mxsmanic > wrote in
>
>> Oh good god, he's dioing medicine now.
>
> There's no limits to his knowledge and
> opinions as long as he doesn't have to
> strap into the front seats of a real
> aircraft.
>
>
>
We should ask him what the cure is for cancer while hes here.

Bertie

[Morgans[_2_]]

"Bertie the Bunyip" > wrote
>
> Be fair, if you were drunk and armed with a taser he'd be the life of the
> party!

But I'm not, and I don't have a taser, and he's a punk.

I still say Shun. If you want to play, I can't stop you, but I'll bet you
are in the minority, at this point.
--
Jim in NC

[Jay Honeck]

> > Anyway, congrats on getting the medical. But you may be surprised at how well
> > the meditation could work at getting off the meds.
>
> Indeed. I discovered Benson's book, "The Relaxation Response," about
> 20 years ago and it works.

Care to expand on that, Jon? How's it work?
--
Jay Honeck
Iowa City, IA
Pathfinder N56993
www.AlexisParkInn.com
"Your Aviation Destination"

[Tina]

I do think arm's length posts to Mx's messages -- those that correct
errors -- are worthwhile but not engaging him in a message exchange is
important. It may not stop him, but newcomers should be warned of
misinformation. Viperdoc tends to do that and Bertie in his subtle way
does call attention to Mx's lack of credentials from time to time.

Bertie, it might be a good idea to not hold back as much as you do,
that restraint could have an affect on your health.

There is no charge for this professional advice, Bertie.

[Bertie the Bunyip[_19_]]

"Morgans" > wrote in
:

>
> "Bertie the Bunyip" > wrote
>>
>> Be fair, if you were drunk and armed with a taser he'd be the life of
>> the party!
>
> But I'm not, and I don't have a taser, and he's a punk.
>
> I still say Shun. If you want to play, I can't stop you, but I'll bet
> you are in the minority, at this point.

I,m almost always in th eminority.

Bertie

[Larry Dighera]

On Wed, 26 Sep 2007 21:02:05 -0400, Wizard of Draws
> wrote in
>:

>I'll stick with my old friend running and change the diet for a while first.

I find it interesting that throughout this entire message thread there
has been no mention of reducing sodium intake for lowering blood
pressure. I thought curtailing salt use was the number one remedy.

[Ross]

Larry Dighera wrote:
> On Wed, 26 Sep 2007 21:02:05 -0400, Wizard of Draws
> > wrote in
> >:
>
>
>>I'll stick with my old friend running and change the diet for a while first.
>
>
> I find it interesting that throughout this entire message thread there
> has been no mention of reducing sodium intake for lowering blood
> pressure. I thought curtailing salt use was the number one remedy.

I have to watch sodium for a different reason. I have never been one to
add salt to my food. I usually found it acceptable. But, since being on
a low sodium diet (<2000 mg/day) I find my self reading labels more. I
am astonished how much sodium processed food contains. I checked the
fast food, Arby's, and their regular roast beef sandwich combo is
2400mg. That is over a days requirement. Can vegetables, soups, frozen
dinners are very high in sodium. Even the breakfast cereals are high.
Shredded wheat is zero to very low. Also, people I noticed put way too
much salt on food. And, when I go out and get those wonderful french
fries, I ask for no salt.

--

Regards, Ross
C-172F 180HP
KSWI

[Montblack]

("Ross" wrote)
> I have to watch sodium for a different reason. I have never been one to
> add salt to my food. I usually found it acceptable. But, since being on a
> low sodium diet (<2000 mg/day) I find my self reading labels more. I am
> astonished how much sodium processed food contains. I checked the fast
> food, Arby's, and their regular roast beef sandwich combo is 2400mg. That
> is over a days requirement. Can vegetables, soups, frozen dinners are very
> high in sodium. Even the breakfast cereals are high. Shredded wheat is
> zero to very low.


In 2005 I had "gut" surgery - they took out a foot of colon, repaired my
bladder, etc, etc. I had a week long healthy eating) ramp-up to the surgery,
a 'brazillion' bags of fluids used during surgery (system flush?), and two
weeks of nothing but fruits and (no salt) blender'd veggies after surgery. I
FELT GREAT!

Then I ate some Triscuits, Wheat Thins and Ritz crackers, as the first (non)
all-natural food items in a month. WOW, ...too salty! Nothing tasted good,
as it all had too much salt for my newly cleansed pallet. (I was off of all
pop, too).

Two month later I was back to my old ways... :-(


Montblack

[RST Engineering]

It beats the hell out of the alternative.

Jim


>> This age thing is a bitch, ain't it?
>>

[Mxsmanic]

Larry Dighera writes:

> I find it interesting that throughout this entire message thread there
> has been no mention of reducing sodium intake for lowering blood
> pressure. I thought curtailing salt use was the number one remedy.

It doesn't necessarily work. In people who are sensitive to excess salt, it
may, but in other people it may not have any effect at all. People in normal
health tend to excrete excess salt without any lasting change in BP.

[Bertie the Bunyip[_19_]]

Mxsmanic > wrote in
:

> Larry Dighera writes:
>
>> I find it interesting that throughout this entire message thread
>> there has been no mention of reducing sodium intake for lowering
>> blood pressure. I thought curtailing salt use was the number one
>> remedy.
>
> It doesn't necessarily work. In people who are sensitive to excess
> salt, it may, but in other people it may not have any effect at all.
> People in normal health tend to excrete excess salt without any
> lasting change in BP.
>

Simply mindboggling


Bertie

[Wizard of Draws[_3_]]

On 9/27/07 10:53 AM, in article ,
"Larry Dighera" > wrote:

> On Wed, 26 Sep 2007 21:02:05 -0400, Wizard of Draws
> > wrote in
> >:
>
>> I'll stick with my old friend running and change the diet for a while first.
>
> I find it interesting that throughout this entire message thread there
> has been no mention of reducing sodium intake for lowering blood
> pressure. I thought curtailing salt use was the number one remedy.

A single pre-packaged Chinese entree has been my lunch for quite some time.
Lots o' sodium obviously. That has been replaced by PBJ sandwiches.
--
Jeff 'The Wizard of Draws' Bucchino

Cartoons with a Touch of Magic�
http://www.wizardofdraws.com

More Cartoons with a Touch of Magic�
http://www.cartoonclipart.com

[d.g.s.]

On 9/27/2007 11:47 AM Mxsmanic ignored two million years of human
evolution to write:

> It doesn't necessarily work. In people who are sensitive to excess salt

What does this have to do with aviation?
--
dgs

[Mxsmanic]

d.g.s. writes:

> What does this have to do with aviation?

Read the topic.

Hypertension is disqualifying for an aviation medical in the U.S.

[Bertie the Bunyip[_19_]]

Mxsmanic > wrote in
:

> d.g.s. writes:
>
>> What does this have to do with aviation?
>
> Read the topic.
>
> Hypertension is disqualifying for an aviation medical in the U.S.
>

So what?

You can stil fly, fjukkwit.

Oh wait, YOU can't

Bertie

[Tina]

Mx wrote


> Hypertension is disqualifying for an aviation medical in the U.S.

Readers of the group should know hypertension is commonly defined as
a blood pressure in excess of 140/90.

The FAA disqualifies those with blood pressures in excess of 155 over
something.

So the universe of those disqualified by the FAA is smaller than the
universe of those who have hypertension.

Mx's comment is a misleading statement of fact.

Again.

[Mxsmanic]

Tina writes:

> Readers of the group should know hypertension is commonly defined as
> a blood pressure in excess of 140/90.

Well, no. The threshold has been regularly lowered. Now some people are
saying that anything above "normal," which seems to be defined as 120/80, is
hypertension.

> The FAA disqualifies those with blood pressures in excess of 155 over
> something.

A threshold BP of 155/95 is the FAA's suggestion.

> So the universe of those disqualified by the FAA is smaller than the
> universe of those who have hypertension.

Not really. If the examiner determines that the applicant is hypertensive,
he's disqualified. The examiner has a certain latitude in this determination,
so one cannot say that a person with a BP of 140/95 (which makes him
hypertensive according to some) will not be disqualified.

[Jon]

Sorry about the delay, Jay. Just noticed your reply now.

On Sep 27, 8:40 am, Jay Honeck > wrote:
> > > Anyway, congrats on getting the medical. But you may be surprised at how well
> > > the meditation could work at getting off the meds.
>
> > Indeed. I discovered Benson's book, "The Relaxation Response," about
> > 20 years ago and it works.
>
> Care to expand on that, Jon? How's it work?

Ok, you asked for it :D


I'm not a doctor, so I can't give you the details but more of just a
subjective take on it based on my own experiences. Benson has decades
of research, so it's not like he's selling some the latest brand of
snake oil that's going to magically transform you. The site has some
good info, if you're looking for charts based on experiments.

Sounds trite, but there's just more stuff to deal with now then there
was growing up in the 60's. For me, it's basically about, big
surprise, relaxing ;) It's tough, what with having to run around to
get things done, attempting to set records for sleep deprivation to
recover lost schedule on <n> projects at work ;), dealing with the
mircosecond pace of life, traveling around the world, trying to avoid
the high cholesterol diet that existing in Coach tends to bring ;) Of
course, no one on here has ever BTDT, right? ;)

Again, not scientific, but when the body isn't feeling 'right', it
affects the mind. It can manifest itself but one getting irritable
over little things. being confrontational, defensive, etc. And then
sometimes this whole feedback loop thing starts executing and just
exacerbates everything. Snap decisions without thinking things
through. I'm sure we all know how that goes.

I had an uncle, whose motto for dealing with things, was "F*ck It" ;)
Yeah, it was kinda cute and I could see where he was coming from to
some extent. And if he felt it worked for him, far be it from me to
try and prove him wrong by obsessing on Google, textbooks, etc. ;)

Then again, he went about 10 years ago at only 52. A fair amount of
abuse, diabetes, kidney failure, coma. I found him on the bed one
morning, completely unresponsive with eyes wide open yet starting off
into space. His body temp was ice. Rushed him off to the hospital and
they were able to get him back. but the body just had nothing left and
it was only about a year after that.

Sad, but I'll tell ya, there's no textbook or research that drives
home the point like experiencing it first hand. It really caused a re-
awakening inside that "hey, there are no guarantees in life, but I
ain't going down like this if I don't have to!' And I decided it was
time to get back into repairing the whole.

I had already cut way down on the drinking years ago. Still a social
drinker but no where near the crazy college days of unlimited
quantities. More recently, I've cut out a lot of the daily junk/fast
food diet habits, virtually eliminated adding salt to food (other than
when cooking calls for it), manage to walk a bit each day to catch the
bus/train. And just generally to slow the whole thing down.... "don't
sweat the small stuff; it's all small stuff" yadda yadda....

You can't eliminate, or at least I can't, all of the stressors that
life seems to take this sick pleasure at ensuring will come at you.
You wouldn't be human if you didn't feel anything or tried to pretend
that emotions aren't part of who you are. But I found the technique
provides a way of minimizing the impact over the long haul and it's
maybe, what ~15 minutes out of the day? My opinion is, if you can't
find 15 minutes somewhere, you're waaaay to freakin' busy and it's
time for a reassessment ;)

They claim that 15 minutes of it is equivalent to hours of sleep. I
can't say for sure, but I do find that I feel better afterwards and am
able to approach the working set of problems for the day, with a
better overall attitude that helps me to just get stuff done.

Can't prove that it's going to get me past 52, but I'll let you know
in 6 years ;)

That's about all I got :)

> --
> Jay Honeck
> Iowa City, IA
> Pathfinder N56993www.AlexisParkInn.com
> "Your Aviation Destination"

Regards,
Jon

[Larry Dighera]

On Tue, 25 Sep 2007 19:59:05 -0400, Wizard of Draws
> wrote in
>:

>But the BP was enough to have him start me on 5 mg Lisinopril
>and 25 mg Hydrochlorothiazide daily.

Another point I find lacking in this discussion of the treatment of
high blood pressure with diuretic drugs is the failure to mention the
necessity to supplement dietary potassium to compensate for that
flushed out through increased urination.

Has you doctor mentioned potassium? Are you aware that you may
require supplementing it while on your course of diuretic medication
(Hydrochlorothiazide)?

I took the liberty of doing some fundamental research:


http://en.wikipedia.org/wiki/Lisinopril
Lisinopril (lye-SIN-o-pril) is a drug of the angiotensin
converting enzyme (ACE) inhibitor class that is primarily used in
treatment of hypertension or high blood pressure, congestive heart
failure, heart attacks and also in preventing renal and retinal
complications of diabetes.

Historically, lisinopril was the third ACE inhibitor, after
captopril and enalapril, and was introduced into therapy in the
early 1990s.[1] Lisinopril has a number of properties that
distinguish it from other ACE inhibitors: it is hydrophilic, has
long half life and tissue penetration and is not metabolized by
the liver.

Pharmacology
Lisinopril is the lysine-analog of enalapril. Unlike other ACE
inhibitors, lisinopril is not a prodrug and is excreted unchanged
in the urine. In cases of overdosage, it can be removed from
circulation by dialysis.

Clinical use
Its indications, contraindications and side effects are as those
for all ACE inhibitors. Its long half-life allows for once a day
dosing which aids patient compliance. The usual daily dose in all
indications ranges from 2.5mg in sensitive patients to 40mg. Some
patients have been treated with 80mg daily and have tolerated this
high dose well. Lower dosages must be used in patients with higher
grade renal impairment (glomerular filtration rate (GFR) lower
than 30ml/min). Lisinopril has an iGuard risk rating of Blue[2]
(general risk).
----------------------------------------------


http://en.wikipedia.org/wiki/Hydrochlorothiazide
Hydrochlorothiazide, sometimes abbreviated HCT, HCTZ, or HZT is a
popular diuretic drug that acts by inhibiting the kidney's ability
to retain water. This reduces the volume of the blood, decreasing
blood return to the heart and thus cardiac output and, by other
mechanisms, is believed to lower peripheral vascular resistance.
Hydrochlorothiazide is sold both as a generic drug and under a
large number of brand names, including: Apo-Hydro, Aquazide H,
Dichlotride, Hydrodiuril, HydroSaluric, Microzide, Oretic.

Activity
Hydrochlorothiazide belongs to the thiazide class of diuretics,
acting on the kidney to reduce sodium (Na) reabsorption in the
distal convoluted tubule. This reduces the osmotic pressure in the
kidney, causing less water to be reabsorbed by the collecting
ducts. This leads to increased urinary output.

Indications
HCT is often used in the treatment of hypertension, congestive
heart failure, symptomatic edema and the prevention of kidney
stones. It is effective for nephrogenic diabetes insipidus
(paradoxical effect, which decreases urine formation) and is also
sometimes used for hypercalciuria.

Hypokalemia, an occasional side-effect, can be usually prevented
by potassium supplements or combining hydrochlorothiazide with a
potassium-sparing diuretic.

Side effects:
Hypokalemia
Hypomagnesemia
Hyperuricemia and gout
High blood sugar
High cholesterol
Headache
Impotence
Nausea/Vomiting
--------------------------------------


http://en.wikipedia.org/wiki/Hypokalemia
Hypokalemia is a potentially fatal condition in which the body
fails to retain sufficient potassium to maintain health. The
condition is also known as potassium deficiency. The prefix hypo-
means low (contrast with hyper-, meaning high). The middle kal
refers to kalium, which is Neo-Latin for potassium. The end
portion of the word, -emia, means "in the blood" (note, however,
that hypokalemia is usually indicative of a systemic potassium
deficit).

Signs and symptoms
There may be no symptoms at all, but severe hypokalemia may cause:

Muscle weakness and myalgia
Increased risk of hyponatremia with resultant confusion and
seizures
Disturbed heart rhythm (ranging from ectopy to arrhythmias)
Serious arrhythmias
EKG changes associated with hypokalemia

Flattened (notched) T waves
U waves
ST depression
Prolonged QT interval

Causes
Hypokalemia can result from one or more of the following medical
conditions:

Perhaps the most obvious cause is insufficient consumption of
potassium (that is, a low-potassium diet). However, without
excessive potassium loss from the body, this is a rare cause of
hypokalemia.

A more common cause is excessive loss of potassium, often
associated with excess water loss, which "flushes" potassium out
of the body. Typically, this is a consequence of vomiting,
diarrhea, or excessive perspiration.

Certain medications can accelerate the removal of potassium from
the body; including thiazide diuretics, such as
hydrochlorothiazide; loop diuretics, such as furosemide; as well
as various laxatives. The antifungal amphotericin B has also been
associated with hypokalemia.

A special case of potassium loss occurs with diabetic
ketoacidosis. In addition to urinary losses from polyuria and
volume contraction, there is also obligate loss of potassium from
kidney tubules as a cationic partner to the negatively charged
ketone, ß-hydroxybutyrate.

Hypomagnesemia can cause hypokalemia. Magnesium is required for
adequate processing of potassium. This may become evident when
hypokalemia persists despite potassium supplementation. Other
electrolyte abnormalities may also be present.

Disease states that lead to abnormally high aldosterone levels can
cause hypertension and excessive urinary losses of potassium.
These include renal artery stenosis and tumors (generally
non-malignant) of the adrenal glands. Hypertension and hypokalemia
can also be seen with a deficiency of the 11ß-hydroxylase enzyme
which allows cortisols to stimulate aldosterone receptors. This
deficiency can either be congenital or caused by consumption of
glycyrrhizin, which is contained in extract of licorice, sometimes
found in Herbal supplements, candies and chewing tobacco.

Rare hereditary defects of renal salt transporters, such as
Bartter syndrome or Gitelman syndrome can cause hypokalemia, in a
manner similar to that of diuretics.

Rare hereditary defects of muscular ion channels and transporters
that cause hypokalemic periodic paralysis can precipitate
occasional attacks of severe hypokalemia and muscle weakness.
These defects cause a heightened sensitivity to catechols and/or
insulin and/or thyroid hormone that lead to sudden influx of
potassium from the extracellular fluid into the muscle cells.

Pathophysiology
Potassium is essential for many body functions, including muscle
and nerve activity. Potassium is the principal intracellular
cation, with a concentration of about 145 mEq/L, as compared with
a normal value of 3.5 - 5.0 mEq/L in extracellular fluid,
including blood. More than 98% of the body's potassium is
intracellular; measuring it from a blood sample is relatively
insensitive, with small fluctuations in the blood corresponding to
very large changes in the total bodily reservoir of potassium.

The electrochemical gradient of potassium between intracellular
and extracellular space is essential for nerve function; in
particular, potassium is needed to repolarize the cell membrane to
a resting state after an action potential has passed. Decreased
potassium levels in the extracellular space will cause
hyperpolarization of the resting membrane potential. This
hyperpolarization is caused by the effect of the altered potassium
gradient on resting membrane potential as defined by the Goldman
equation. As a result, a greater than normal stimulus is required
for depolarization of the membrane in order to initiate an action
potential.

Pathophysiology of Hypokalemic Heart Arrythmias
Potassium is essential to the normal muscular function, in both
voluntary (i.e skeletal muscle, e.g. the arms and hands) and
involuntary muscle (i.e. smooth muscle in the intestines or
cardiac muscle in the heart). Severe abnormalities in potassium
levels can seriously disrupt cardiac function, even to the point
of causing cardiac arrest and death. As explained above,
hypokalemia makes the resting potential of potassium [E(K)] more
negative. In certain conditions, this will make cells less
excitable. However, in the heart, it causes myocytes to become
hyperexcitable. This is due to two independent effects that may
lead to aberrant cardiac conduction and subsequent arrhythmia: 1)
there are more inactivated sodium (Na) channels available to fire,
and 2) the overall potassium permeability of the ventricle is
reduced (perhaps by the loss of a direct effect of extracellular
potassium on some of the potassium channels), which can delay
ventricular repolarization.

Treatment
The most important step in severe hypokalemia is removing the
cause, such as treating diarrhea or stopping offending medication.

Mild hypokalemia (>3.0 mEq/L) may be treated with oral potassium
chloride supplements (Sando-K®, Slow-K®). As this is often part of
a poor nutritional intake, potassium-containing foods may be
recommended, such as tomatoes, oranges or bananas. Both dietary
and pharmaceutical supplements are used for people taking diuretic
medications (see Causes, above).

Severe hypokalemia (<3.0 mEq/L) may require intravenous
supplementation. Typically, saline is used, with 20-40 mEq KCl per
liter over 3-4 hours. Giving intravenous potassium at faster rates
may predispose to ventricular tachycardias and requires intensive
monitoring.

Difficult or resistant cases of hypokalemia may be amenable to
amiloride, a potassium-sparing diuretic, or spironolactone.

When replacing potassium intravenously, infusion via central line
is encouraged to avoid the frequent occurrence of a burning
sensation at the site of a peripheral iv, or the rare occurrence
of damage to the vein. When peripheral infusions are necessary,
the burning can be reduced by diluting the potassium in larger
amounts of IV fluid, or mixing 3 ml of 1% lidocaine to each 10 meq
of kcl per 50 ml of IV fluid. The practice of adding lidocaine,
however, raises the likelihood of serious medical errors [1].
-----------------------------------------

[Shirl]

Jon > wrote:
[snip long-but-important story about relaxing]
Thanks for posting that Jon. It's something we all know but need to be
reminded of every so often with stories like yours. Relaxing has become
more, rather than less, difficult with age. I thought it's supposed to
be the other way around! Society so programs us that EVERYTHING has to
move fast-fast-fast in order to be worth anything. God forbid anyone
should have to WAIT for a cup of coffee or stand in line more than 30
seconds to pay for something -- immediately people get impatient and
stressed out. WAY too much emphasis on going *faster* ... no one takes
time to see, experience or savor things like we did in "the old days"
(you know, about 20 years ago!). Grrr.

[Bertie the Bunyip[_19_]]

Mxsmanic > wrote in
:

> Tina writes:
>
>> Readers of the group should know hypertension is commonly defined as
>> a blood pressure in excess of 140/90.
>
> Well, no. The threshold has been regularly lowered. Now some people
> are saying that anything above "normal," which seems to be defined as
> 120/80, is hypertension.


Awww wassamatta, widda fat boi can't get a medical?
Believe me, even if you looked like Johnny Weismuller you wouldn't get a
medical.




Bertie

[Mxsmanic]

Bertie the Bunyip writes:

> Believe me, even if you looked like Johnny Weismuller you wouldn't get a
> medical.

I don't recall saying anything about me. I only pilot simulated aircraft, so
I don't need a medical.

[Mxsmanic]

Larry Dighera writes:

> Another point I find lacking in this discussion of the treatment of
> high blood pressure with diuretic drugs is the failure to mention the
> necessity to supplement dietary potassium to compensate for that
> flushed out through increased urination.

While that may be relevant with the diuretics under discussion here, it should
be noted that diuresis is not synonymous with potassium loss. The opposite is
possible as well.

[Bertie the Bunyip[_19_]]

Mxsmanic > wrote in
:

> Bertie the Bunyip writes:
>
>> Believe me, even if you looked like Johnny Weismuller you wouldn't
>> get a medical.
>
> I don't recall saying anything about me. I only pilot simulated
> aircraft, so I don't need a medical.

You don't pilot anything and you would never get a medical.


Bertie

[Bertie the Bunyip[_19_]]

Mxsmanic > wrote in
:

> Larry Dighera writes:
>
>> Another point I find lacking in this discussion of the treatment of
>> high blood pressure with diuretic drugs is the failure to mention the
>> necessity to supplement dietary potassium to compensate for that
>> flushed out through increased urination.
>
> While that may be relevant with the diuretics under discussion here,
> it should be noted that diuresis is not synonymous with potassium
> loss. The opposite is possible as well.
>

Boggle.

Bertie

[[email protected]]

On Sep 25, 6:59 pm, Wizard of Draws
> wrote:
> June 2007. I failed my 3rd class medical exam and was grounded. I am 50
> years old, 5'9", 158 lbs. No family history of hypertension. But due to a
> number of current stress factors in my life, mother in law and father in law
> both passing away recently and suddenly, the work of disposing of the
> estate, a promotion at work entailing additional duties and
> responsibilities,

Email me if you want to see where I posted my high BP experiences and
bi-annual med review and it's been a doozy.

Fortunately, I had and AME that referred me to a cardio guy that
treated my high BP AGGRESSIVELY (220/170)

Yes you read correctly.

I have posted my experiences elsewhere in another aviation related
forum and got some very good sound advice and opinions.

I much rather not feed the troll(s) new waters to pollute so if I
dont' recognize your name, I will not respond..

Allen
Cloud dancing to be found at http://www.youtube.com/profile?user=BeechSundowner

[Wizard of Draws[_3_]]

On 9/29/07 12:23 PM, in article ,
"Larry Dighera" > wrote:

> On Tue, 25 Sep 2007 19:59:05 -0400, Wizard of Draws
> > wrote in
> >:
>
>> But the BP was enough to have him start me on 5 mg Lisinopril
>> and 25 mg Hydrochlorothiazide daily.
>
> Another point I find lacking in this discussion of the treatment of
> high blood pressure with diuretic drugs is the failure to mention the
> necessity to supplement dietary potassium to compensate for that
> flushed out through increased urination.
>
> Has you doctor mentioned potassium? Are you aware that you may
> require supplementing it while on your course of diuretic medication
> (Hydrochlorothiazide)?
>

He has. They gave me long-winded printouts of what it does and what to do,
side effects, etc. I take a multi-vitamin every day anyhow and have started
drinking OJ in the mornings, and after every run.

One of the first days I was on the meds, I was given a very good
demonstration of what they can do. I had been outside cutting grass on a
riding mower in the heat for a good 3 hours and at the end of that time, I
was whipped. I could hardly stand. But once I had some juice in me and got
rehydrated, I was fine. I paid attention after that.
--
Jeff 'The Wizard of Draws' Bucchino

Cartoons with a Touch of Magic�
http://www.wizardofdraws.com

More Cartoons with a Touch of Magic�
http://www.cartoonclipart.com

[Roger[_4_]]

On Tue, 25 Sep 2007 20:22:19 -0400, Wizard of Draws
> wrote:


>
>I'm 5'9", 155 as of this morning. I asked the doc what BP he was looking for
>in order to stop the meds: 100/60.

That doesn't sound right, or even realistic unless you are an athlete
in top shape for competition.

>
>As of the last visit, I was 132/90. This may take quite a few miles, but I

The 90 is on the high side, but the 132 ain't all that bad.

BTW you didn't say what it was to fail the 3rd. According the AOPA
there is no set figure, but anything under 150 over 90 should pass the
third. (Both numbers need to be under)

Roger (K8RI)

>will not be on meds for the rest of my life, no way.
Roger Halstead (K8RI & ARRL life member)
(N833R, S# CD-2 Worlds oldest Debonair)
www.rogerhalstead.com

[Tina]

Readers of the thread could contribute to start what would be the
longest thread in the site -- The Mx msistatement of fact thread.

In spite of the Mx pontifications, in the United States the medically
accepted threshold for hypertenison is 140/90. Those interested can
verify this with their own research.

In the United States the trigger point for FAA concern for medical
disqualification is 155 over something. Those interested can verify
this with their own reseach as well.

Statements typed by MX are at best mestleading.

There are exceptions, but those are the facts.


On Sep 29, 5:26 am, Mxsmanic > wrote:
> Tina writes:
> > Readers of the group should know hypertension is commonly defined as
> > a blood pressure in excess of 140/90.
>
> Well, no. The threshold has been regularly lowered. Now some people are
> saying that anything above "normal," which seems to be defined as 120/80, is
> hypertension.
>
> > The FAA disqualifies those with blood pressures in excess of 155 over
> > something.
>
> A threshold BP of 155/95 is the FAA's suggestion.
>
> > So the universe of those disqualified by the FAA is smaller than the
> > universe of those who have hypertension.
>
> Not really. If the examiner determines that the applicant is hypertensive,
> he's disqualified. The examiner has a certain latitude in this determination,
> so one cannot say that a person with a BP of 140/95 (which makes him
> hypertensive according to some) will not be disqualified.

[Marty Shapiro]

Tina > wrote in
ps.com:

> Readers of the thread could contribute to start what would be the
> longest thread in the site -- The Mx msistatement of fact thread.
>
> In spite of the Mx pontifications, in the United States the medically
> accepted threshold for hypertenison is 140/90. Those interested can
> verify this with their own research.
>
> In the United States the trigger point for FAA concern for medical
> disqualification is 155 over something. Those interested can verify
> this with their own reseach as well.
>
> Statements typed by MX are at best mestleading.
>
> There are exceptions, but those are the facts.
>
>
> On Sep 29, 5:26 am, Mxsmanic > wrote:
>> Tina writes:
>> > Readers of the group should know hypertension is commonly defined
>> > as a blood pressure in excess of 140/90.
>>
>> Well, no. The threshold has been regularly lowered. Now some people
>> are saying that anything above "normal," which seems to be defined as
>> 120/80, is hypertension.
>>
>> > The FAA disqualifies those with blood pressures in excess of 155
>> > over something.
>>
>> A threshold BP of 155/95 is the FAA's suggestion.
>>
>> > So the universe of those disqualified by the FAA is smaller than
>> > the universe of those who have hypertension.
>>
>> Not really. If the examiner determines that the applicant is
>> hypertensive, he's disqualified. The examiner has a certain latitude
>> in this determination, so one cannot say that a person with a BP of
>> 140/95 (which makes him hypertensive according to some) will not be
>> disqualified.
>
>

Everything MX says is "FACT" - Fully Assinine & Completely Trash.

--
Marty Shapiro
Silicon Rallye Inc.

(remove SPAMNOT to email me)

[Mxsmanic]

Tina writes:

> In spite of the Mx pontifications, in the United States the medically
> accepted threshold for hypertenison is 140/90. Those interested can
> verify this with their own research.

I've done so. The threshold varies depending on whom you ask.

> In the United States the trigger point for FAA concern for medical
> disqualification is 155 over something. Those interested can verify
> this with their own reseach as well.

155/95

It's not a "trigger point," though, just a figure suggested in the
documentation. The AME makes the final determination.

[Bertie the Bunyip[_19_]]

Mxsmanic > wrote in
:

> Tina writes:
>
>> In spite of the Mx pontifications, in the United States the medically
>> accepted threshold for hypertenison is 140/90. Those interested can
>> verify this with their own research.
>
> I've done so. The threshold varies depending on whom you ask.
>
>> In the United States the trigger point for FAA concern for medical
>> disqualification is 155 over something. Those interested can verify
>> this with their own reseach as well.
>
> 155/95
>
> It's not a "trigger point," though, just a figure suggested in the
> documentation. The AME makes the final determination.
>



Not that any of that matters in your case since you couldn't get a medical
anyway.


Bertie

[Wizard of Draws[_3_]]

On 9/30/07 1:55 AM, in article ,
"Roger" > wrote:

> On Tue, 25 Sep 2007 20:22:19 -0400, Wizard of Draws
> > wrote:
>
>
>>
>> I'm 5'9", 155 as of this morning. I asked the doc what BP he was looking for
>> in order to stop the meds: 100/60.
>
> That doesn't sound right, or even realistic unless you are an athlete
> in top shape for competition.
>

Well, I'm running 3 miles every other day, so I guess it's theoretically
possible. I'm actually in fairly good shape, just missing a some competitive
edge, that's all. Yeah, that's the ticket.

>>
>> As of the last visit, I was 132/90. This may take quite a few miles, but I
>
> The 90 is on the high side, but the 132 ain't all that bad.
>
> BTW you didn't say what it was to fail the 3rd. According the AOPA
> there is no set figure, but anything under 150 over 90 should pass the
> third. (Both numbers need to be under)
>

There were a lot of numbers being thrown around, so I can't remember
exactly, but I think I started out at 140+/105. It went up every single
time from then on, with the final numbers the next day at 165/115.

Personally, that tells me the primary cause was probably White Coat
Syndrome.
--
Jeff 'The Wizard of Draws' Bucchino

Cartoons with a Touch of Magic�
http://www.wizardofdraws.com

More Cartoons with a Touch of Magic�
http://www.cartoonclipart.com

[Roger[_4_]]

On Thu, 27 Sep 2007 12:50:15 -0000, Tina >
wrote:

>I do think arm's length posts to Mx's messages -- those that correct
>errors -- are worthwhile but not engaging him in a message exchange is
>important. It may not stop him, but newcomers should be warned of
>misinformation. Viperdoc tends to do that and Bertie in his subtle way

He gets enough right, that like many of us knows just enough to be
dangerous at least to the uninformed.

>does call attention to Mx's lack of credentials from time to time.
>
Tina, you owe me a new keyboard. Seeing Bertie and subtle in the same
sentence .... I just don't know how to put it into words<:-))

>Bertie, it might be a good idea to not hold back as much as you do,
>that restraint could have an affect on your health.

Yes, it do build stress and could even lead to Migraines, or worse
yet, hypertension. Keep in mind I have less learning than MX,, my
degree is in computer science, I didn't stay at the Holiday Inn
Express last night, and my memory is shot, but I am honest...most of
the time, more or less. Oh! and I am suffering withdrawal symptoms as
I've not been 6 months since I last flew.

>
>There is no charge for this professional advice, Bertie.

Roger (K8RI)

>
>
>
>
Roger Halstead (K8RI & ARRL life member)
(N833R, S# CD-2 Worlds oldest Debonair)
www.rogerhalstead.com

[Tina]

Readers concerned about this may wish to read the FAA's documentation
on the matter of hypertension.

http://www.faa.gov/licenses_certificates/medical_certification/specialissuance/hypertension/index.cfm