Tuesday, September 30, 2014
Control with Monitors
A blood pressure monitor and blood sugar monitor do not cost much and can be bought at most pharmacies. They can help you keep control of your medication and your life. You do not need to worry about getting an over dose of hydrocortisone or fludrocort if you monitor your blood sugar and blood pressure.
Learn what is a normal pattern for you. Your blood pressure and blood sugar will
rise and fall during the day but they should near normal ranges. For me, my blood sugar and blood pressure are a bit low in the mornings until my morning dose of medicine reaches my blood stream. Sometimes my blood pressure is a bit high (130/80) in the mornings. That tells me that I am dehydrated. I drink a big glass of water, or two, and my blood pressure comes back down to around 120/80 in an hour. For a normal person it wouldn't be as low or high in the mornings, but I do not produce any cortisone on my own so my patterns range a little wider than most people. I have learned what is normal for me. It takes about an hour to bring up my blood pressure and blood sugar, so I have pretty slow starts in the mornings.
Your blood sugar and blood pressure should change during the day. Blood sugar should go up (around 20 to 40 points) for a couple of hours after eating. Blood pressure will rise after exercise or eating. Sometimes my blood sugar (60) and blood pressure (109/70) are a bit low in the mornings. I know then that I over did it the day before and did not take enough medicine. I record what I did in my health journal and next time I do the same thing, I try and take more medication. I've learned that taking more medicine now isn't going to help. All I can do is relax, rest, and eat a balanced meal every few hours. In a day or two my blood pressure and blood sugar will return to their normal levels and I will feel better.
You will need to work with your doctor to regulate your medication, but as my doctor has told me, I am responsible for my own health. Only I can know what is happening every minute and make the necessary dose changes. My doctor has given me ranges and I need to adjust my hydrocortisone as needed to meet different stresses. Hydrocortisone is easier to monitor because if you don't get it right, it only stays in your blood stream at a full level for a few hours. I you take too much, it can build up, but just cut the dose and it will come back down.
I never alter my fludrocort which manages water and mineral levels. That remains pretty constant for most people. Hydocortisone does need to be increased if you have additional stress such as excessive exercise, heat or cold, illness, surgery. (see articles on medication) I've found that blood pressure can drop if the hydrocortisone is low. You can have dramatic blood pressure changes if you change your fludrocort. I never change mine and I would never do it unless my doctor told me to do it..
Once I have my medication stable, I only take my blood pressure or blood sugar if I feel different. If I feel dizzy, nauseous, extra tired, have trouble thinking, am shaky, have blurry vision, very achy, or have bad headaches, then I know I need to check. Even if I feel fine, I will check my blood pressure and blood pressure every few weeks just to make sure that my dose is correct. It took me a while to learn how to use monitors to help me feel better, but now I really appreciate the control it helps me to feel over my life with Addison's disease.