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Thiazide diuretics.....

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Thiazide diuretics.....

Post by Jasmine2 on Fri Sep 19, 2014 7:49 pm

Well the idiot GP has come up trumps again! When I last saw Dr Miles Levy (my lovely endo) he spotted that I was still being prescribed bendrofluomethiazide for high blood pressure and said I should have been taken off this when I was first diagnosed with pHPT as thiazides are well known for raising calcium even higher; so he wrote to my (idiot) GP instructing him to stop prescribing it, which he duly did on the proviso that we would keep an eye on my blood pressure for a few weeks. I take Losartan as well for high BP and the combination of that and the bendro kept my BP well managed. So I went back to him today for a review and my BP was sky high - 189/100! He suggested another BP med was required and I agreed. He prescribed Amlopidine and said "I don't think this one messes with calcium". Er......you don't think so or you don't know so, in which case shouldn't you check, I thought? Although I wasn't over familiar with the drug's trade name somewhere in the back of my foggy brain something was saying "calcium channel blocker" so when I got home - and before filling the prescription - I googled Amlopidine - guess what, yep you've guessed it ..... generic name for Amlopidine is hydrochlorothiazide - yes, another bl**dy thiazide! On drugs.com it listed 18 conditions where Amlopidine is contraindicated, two of which are coronary heart disease and hyperparathyroidism - I have both! Needless to say I will NOT be filling this prescription! But I'm still left with worryingly high blood pressure and a weekend to get through with it unmanaged. The idiot GP retired today - yay, yay and thrice yay! No more patients to try and kill......! So on Monday I start the search for another GP who might be half decent, without a wish to kill me off or allow me to die from medical negligence!  Am I being a bit melodramatic? It's scary stuff when you put your life into the hands of idiots!

Rant over ......

Jasmine x
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Re: Thiazide diuretics.....

Post by Tigerlily on Fri Sep 19, 2014 8:39 pm

Geez, Jasmine, I'm incandescent with rage on your behalf. Back when I've cooled down.

Love from Tigerlily xxxx

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Re: Thiazide diuretics.....

Post by Brigitte0 on Fri Sep 19, 2014 9:00 pm

Oh Jasmine, another chapter in your very interesting book of 'Visits to my Idiot GP'. Why didn't he look it up in that drug book thingy every GP seems to have in his consulting room? I wish you luck trying to find a GP who isn't an idiot though since they appear to be a very rare breed  affraid

If you're at all worried about your high blood pressure over the weekend, go to A&E or at least visit a local walk in clinic or something similar. Do you have a blood pressure monitor at home? At least you could keep an eye on it if you do. Take it easy and rest as much as you can.

Love and many hugs and take care of yourself

Brigitte xxxx
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Re: Thiazide diuretics.....

Post by Tigerlily on Fri Sep 19, 2014 9:21 pm

Just repeating this email to you here, Lyn:


Hi Lyn – have just seen your post about the now retired idiot GP and the BP pills.

This is a case for seeing an out-of-hours GP tomorrow for an emergency prescription for something that won’t raise your Ca. That will also get this put on your medical records.

Give it a go, girl. I called NHS direct and explained my situation with the swollen face and they were sooooooo helpful. They listened, called me back and even arranged an appointment with the out of hours GP who was lovely.

If you’re worried, do it, Lyn. Call whatever the new number is (111?). Don’t risk your health on this, m’Dear.

Love Tigerlily xxxx

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Re: Thiazide diuretics.....

Post by Little Audrey on Sat Sep 20, 2014 1:03 am

Oh, my goodness, Jasmine, I feel your anger!    LOTS of idiot doctors out there in the world!!!    My doctors also had me on hydrochlorothiazide and Lasix while my tumors were still intact.   It was I who did the research and told them that both of these drugs affect calcium levels.   I took myself off of them so I could get some true levels when tested.    I was lucky.   My BP was not so high that I was in any real danger of doing so.    Was that BP of 189/100 at the doctor's office, or did you get that reading at home?     Before I started having trouble with the adrenal insufficiency, my BP was always around 185-190/90-100 at my appointments.  However, at home it was around 100-110/60-70!!!   Quite a difference.  I think that might earn me the title of White Coat Syndrome Queen or something!   Laughing   If you don't have a BP cuff at home, you really should get one.   Got to keep an eye on that BP!

It is a shame you are dealing with high blood pressure, and mine is practically nonexistent now.    My systolic pressure is now staying around 100, which is a LOT higher than it had been for months!  It sure beats 76!    But the diastolic pressure is still struggling.   I tested it 10 times in a row today like I always do.   It was in the very low 60s twice, the 50s three times, and the 40s five times.    Not good at all.  

And now that I have learned HCTZ and Lasix both contain sulfa, I don't want to take either one!    I still haven't talked to my doctor about a different prescription.   I called today to talk to the other receptionist, but she was still out.   Not sure what to do over the weekend.

By the way, if you would have made those comments on that other support group page, you would have probably been in hot water!!!    No negative comments, you know!   Only if it's about Dr. Norman.  They it's ok to bash away!     Still not too happy about what is going on there.    I am SO happy it is different on this forum, and we can feel free to gripe when we need to, and instead of getting scolded, people understand!     Thank goodness for that freedom.

No, I don't think you should fill that darned prescription!!    What is wrong with these doctors?!    That's like my docs prescribing HCTZ  and Lasix when I could have a possible sulfa allergy!!     Not too smart!     Please keep us posted on this matter.   I would love to hear what your doc's next move is.    

Glad at least 1 of the idiot GPs of the world has retired!!!    cheers

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Re: Thiazide diuretics.....

Post by Kathi209 on Sat Sep 20, 2014 3:51 am

Jamine now in the USA the doc's all have little computers  they carry around so if there not sure of a med or even the diagnosis they can look it up. I am sure he has access to a computer all the crazyass had to do was look it up. Lazy darn doctors makes me so mad. Thank God he is retiring. Pray you get a good one this time. Audrey is right get a blood pressure meter for home and keep tract cause it might take a few days to get a new RX for your bp. Take care Kathi

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Re: Thiazide diuretics.....

Post by Jasmine2 on Sat Sep 20, 2014 9:27 am

Hi all, thanks for your help and support, and for allowing me some rant time. Audrey, couldn't find a way to get Dr Norman into that rant so couldn't give him a bashing haha! Bless him, he takes some flak doesn't he? Yes, I do have a BP machine at home and do keep a careful eye on my BP. Before I went to see the (idiot) GP it was regularly around 160-170/95 at home and did go up to a diastolic of 100 once, the evening before my GP visit, so athough it did go up a bit more in his room I don't think it's due to a huge degree of white coat syndrome. I'll be monitoring it very carefully over the weekend and will seek help from the out of hours GP if I get worried.

Jasmine x
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Re: Thiazide diuretics.....

Post by Jasmine2 on Sat Sep 20, 2014 9:37 am

Forgot to say Kathi, yes our GPs do everything on the computer as well and can look anything up online, and in fact I think that's what has contributed to their laziness in a way - they've lost or forgotten the art of diagnosis. It was just laziness on my GPs part, he clearly couldn't be bothered to look it up and relied on his feeling that he "didn't think it affected calcium"..... outrageous! But because I wasn't sure as I didn't recognise the trade name of the drug I couldn't challenge him. Just sheer laziness is all - I was virtually his last patient on the last day of his career and he just couldn't be bothered!

J x
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Re: Thiazide diuretics.....

Post by Brigitte0 on Sat Sep 20, 2014 11:03 am

Maybe he didn't know how his computer worked! He's in the past now, thank goodness. I think a vast majority of GPs diagnose from their chair and their brains full of out of date cr4p. You're well rid of him Jasmine. 

I'm glad you have a BP monitor so you can keep an eye on what your BP is up to. Take care and have a lovely weekend. 

Love and hugs 

Brigitte xxxx
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Re: Thiazide diuretics.....

Post by Admin on Sat Sep 20, 2014 11:16 am

Hmmmm.

My GP always dives into his printed copy of the BNF whenever he is looking to prescribe something new for me (as I have several medical conditions).
All docs are supposed to do this.  It's what the BNF is for.
http://www.bnf.org/bnf/index.htm

Edwin
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Re: Thiazide diuretics.....

Post by Lucycatnaps on Sat Sep 20, 2014 5:32 pm

Hi Jasmine,
Ohhh I know how frustrated you must be feeling.  It just seems to be more and more prevalent that we have to double check everything and   make sure it is correct.  You certainly do not need to give your calcium levels any extra help or your BP.  I hope when you have a new GP he will be much more switched on.  Before all this started I never queried anything, just assumed they were the experts and knew what they were doing.  
I am doing a little test today as I have been checking my last 24 hr urine results done in Feb and the one I recently did.  What has hit me is the actual amount recorded.  In February I had terrible thirst and was drinking water and passing a lot of urine and I was concerned I would need another container.  It was almost up to the neck and heavy.  The amount recorded was 2,884 mls
This time I was not so thirsty and I know I did not pass as much, same container size and approximately 2/3 full.  The amount recorded was 2966 mls.
I find that very strange but never thought to actually record the amount passed, so today I am just measuring everything to see roughly what I pass in a day.  How sad is that? It just makes me wonder did some lab tech spill half my first one and not say anything?  That is me showing how paranoid I am getting with this dratted disease.  I keep feeling nauseous every morning this week and today woke with a rotten headache again.  I am plodding on with the vitamin D but I think that is what is causing the calcium to elevate and started this nausea and burping.  I have just been out and bought some ranitidine to try and will try and get an appt with my GP and bring him up to speed with recent events.  I hope you find a new lovely GP who knows their stuff, at least I feel lucky in that respect with the one I see here.
Take care and hugs Sue
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Re: Thiazide diuretics.....

Post by Little Audrey on Sat Sep 20, 2014 6:22 pm

Sue, I had the same problem with my 24-hour urine tests!     I don't know if those lab techs think none of us pay attention or what, but I knew EXACTLY how much urine was in those just when I turned them in to the hospital, and when I received the results of the second test, there was not quite as much recorded!    I thought the same thing.   Are they spilling it?    Do they not realize how important it is that it is ALL recorded?     I guess it must happen pretty often!

Sorry to hear about your nausea and headache.   I still suffer from both, so I can totally sympathize.   Life simply stinks when your in pain and feeling sick!   It is amazing how we continue on, feeling as awful as we do.    I hope you get some relief very soon!    

Yes, Dr. Norman says if your calcium is high, you should not be taking vitamin D.   Although, it didn't seem to make a difference with my calcium levels.   Did your doctor prescribe it, or are you taking it on your own?   Not that it matters, I was just curious.     When my PTH was first round to be high almost 4 years ago, and my vitamin D was low, my doctors prescribed massive doses of vitamin D.   They prescribed 50,000 IU twice weekly.   Like I said, it didn't seem to make any difference with my calcium.   Actually, it wasn't until I stopped taking it that my calcium rose to 10.7, the highest it ever was.   So I don't know what to think about this.   Can't really give you any advice.  I'm sorry.  Crying or Very sad

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Re: Thiazide diuretics.....

Post by Admin on Sat Sep 20, 2014 6:56 pm

My god ladies how do you all wee that much Shocked. When I did mine it was barely a 1/3rd up the container and that was pushing it.

Nelly
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Re: Thiazide diuretics.....

Post by Little Audrey on Sat Sep 20, 2014 7:26 pm

Nelly, I needed 2 containers when I did each of mine before surgery!!    My first one was 3900 mLs.   The second one was a little less; I can't remember exactly what it was.  I could look it up.

Since surgery, I had 2 more 24-hour urine tests.    I only needed 1 jug for each of those.    I still drink a lot of water, but not quite as much as before parathyroid surgery.   I'm not quite as thirsty now.

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Re: Thiazide diuretics.....

Post by Lucycatnaps on Sat Sep 20, 2014 7:34 pm

Hi Audrey,
Because my first 24 hr urine showed a low urine calcium/creatinine ratio the dreaded FHH was mentioned.  A low vitamin D can also cause a low urine calcium and sure enough when they tested my D in June it was 42, it should ideally be over 75.  So the plan was, take low dose D for 3 months, 800iu, check blood calcium for levels and then repeat the 24 hr urine and I will see you in November.  Silly system sends me an appt for Sept instead so have to redo tests early, this time my urine calcium has gone up but the doctor I saw( no idea who he was ) says my urine calcium is normal and so cannot be PHPT and is FHH.  I have since worked out my CCCR ratio which is just higher than the cut off point for FHH.  I just wonder if they lost some of my first test and thus triggering all this FHH malarkey.  I have read that many of Dr N's patients do indeed have lower urine calciums.
Since taking Vitamin D my calcium has gone to its highest of  2.79, and 2.74 adjusted and my PTH has gone back up to 53.72.  I thought taking D would lower it.  I think the D has helped, am still not replete but getting there, no idea if I have to continue on it but if it is the calcium causing this nausea and gerd then I may stop.
Hugs from Sue x
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Re: Thiazide diuretics.....

Post by Little Audrey on Sat Sep 20, 2014 7:55 pm

Sue, tell your idiot doctors that your urine calcium does NOT have to be abnormally high to have hyperparathyroidism!!     Mine never was, which was another reason I could not get diagnosed.   Since we don't use adjusted calcium here in the US, I am not used to using that to diagnose.   Would you mind posting your serum calcium levels?    Although, from looking at the levels you just posted, I would say you DO have hyperparathyroidism, and you need surgery!

My vitamin D was 23 the first time it was tested with PTH and calcium.   That is why my doctors prescribed so much vitamin D.    My level went up to 99 while taking the 50,000 IU bi-weekly.    Then they told me everything was ok!   They just don't get it!!

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