Staying the Course -- 01/20/2020

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Superbob

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Salutations and bravos to all of us staying our respective courses.

Well, two weeks of hype now leading up to a Super Bowl clash of powerhouses -- Chiefs versus Niners. I enjoy watching young Mahomes perform his magic at QB but I am awed by that defensive front of SF. Don't have a favorite team in this battle (mine is the Redskins -- go ahead and laugh at me) but DW and I will make a big batch of chili for the occasion in any event. Kids and grandkids, lots of munchies.

Hey, Steve, Johan, and Protimenow, thanks for the informative discussion of robotic technology. Wife and I will see a demonstration of it tomorrow at a local hospital. Supposed to be free hernia screenings too, but I see so much interest on Facebook and elsewhere, I wonder if there will be time for all. Might just take the surgeon's card and schedule a consult with him.

Anyway, I found online an interesting write-up on the pros and cons of robotic surgery. https://www.online-sciences.com/robotics/robotic-surgery-cons-pros-uses-and-how-does-robotic-surgery-work/

Many of these points are ones you guys made. If it works smoothly, there are benefits. If the damn machine breaks down, well they better have a quick-fix guy on hand. (At this point, I cringe thinking about it.) Okay, in my case, this may not be an option anyway, because the apparent hernia is in the incision/sternum area just four months out from OHS. Am thinking more healing may be needed before anything can be done. Lot to learn. Fortunately, it is not causing any kind of pain right now.

Okay, life goes on with dawgwalking and rehab. Maybe back in exercise class when rehab ends the first of February. We had an almost spring-like spell of weather that was great for walking, but now we've gone back in the freezer (though of course much less so than in northern climes).

What's happening along your courses?

Cheers,
Superbob
🦸‍♂️❤
 
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Superbob

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As Rich suggested, robotic surgery is like your surgeon is playing a video game. In that case, I want my teen-aged grandson to be my surgeon. lol
 

Protimenow

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The good thing about robotic surgery today - already in the hands of a skilled and experienced surgeon is that, if the robot stops working (unlikely, because they must have some backup system), the surgeon can take over and do the surgery laparoscopically, or with a scalpel.

Who knows what the future holds for robotic surgery? Will artificial intelligence do most or all of it? Will surgeons forget the basics in the same way that many young (and some older) people have forgotten the basics of simple math, taking out their phones to do simple calculations? (If you sell me something for 4.97 and I give you 5.22, do you need your phone to figure out how much change is due? Without some mechanical assistance, many people would be completely lost. Surgeons should learn, practice, and remember the basics, JUST IN CASE.
 

Suckyvalvegurl

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My surgeon (top CV surgeon) who did my minimally invasive AVR does not use the robot. I forget why, but basically he feels he can do a better job.
 

rich01

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My week sucks.

A couple of times my heart has beat really hard. My heart rate has also increased, but only to about 90. The 1st time it woke me up. My sinuses were congested so I was having trouble breathing through my nose. Did a breathing exercise to clear my nose and HR dropped back into 70's (usually about 60 in the middle of the night).

Then yesterday, I had the dreaded BP spike. My BP has been perfect until about a week ago and then suddenly systolic stayed about 25-30 points higher throughout the day. (This coincides with when the cold front hit). Yesterday afternoon BP went all the way up to 185/115. I used every trick I know to bring it down and after a couple of hours it was down to 145/91. Still too high, but not as scary.

The bp spike is something I thought I had fixed. It is driven by too much saturated fat in my diet and winter (less light) days. I think I might have let just a little too much saturated fat back into my diet and haven't been using my sun light in the morning. I don't mean high bp, but a spike that in 2 or 3 hours goes from a little on the high side to stroke level BP.

So first thing this morning I used my red light for about 20 minutes, 7 minutes on my chest for healing, and the rest on hips and knees for arthritis. Now I am sitting at my computer with the sun light on. I'm going to try limiting food to raw fruits and vegetables today and see if that will get my BP under control again.

I'm guessing this is a blood viscosity problem. Even with an aspirin and Plavix every day, if I cut myself it stops bleeding almost immediately. In the summer when I get a lot of sun and ground myself by getting my hands in the ground, I need only a small dose of BP med. As the days get shorter (light), my BP starts going up and usually peaks in January. In the past, the spikes usually start in late December and then by March the spike is much lower and for fewer hours. About 5 pm my BP starts going up until it peaks about midnight. About 1 am it starts coming back down. My best guess is this is some liver cycle that is trying to clear something out of my blood.

If any of you are good at finding medical studies, there is a study I read which I have been unable to find again. The study found that for a subset of people with high blood pressure, they experienced a spike (220/130 area) after eating an evening meal high in saturated fat. They found moving saturated fat earlier in the day helped or taking vitamin C and vitamin E prior to the meal helped. I would love to get my hands on this study again if anyone can find it. I think I originally found it from an article I was reading referencing it. I have tried every combination of key words I can think of and can't find it.
 
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Protimenow

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Rich01 -- your observations are interesting.

You've falllen victim to the 'blood thinner' thing. There's a reason, probably 50 years old, why they call these things blood thinners - but it has ABSOLUTELY NOTHING to do with viscosity. Anticoagulants just make it take longer for clots to form.

If you're having small cuts - like those that you get when you incise your finger for a test, or small shaving cuts, they'll clot and close pretty quickly. (In other words, with an INR of 2.0, if your cut would normally clot in 30 seconds, it'll take about a minute to clot). For small cuts, the higher INR is really no big deal.

I'm interested in your comments about sunlight affecting your blood pressure. I'm aware of Seasonal Affective Disorder (SAD), which can affect your body and moods during days when you don't get enough sunlight (which explains your use of a light), but haven't looked closely enough to see whether it has any effect on BP.

If you don't have a meter for testing INR, I strongly suggest that you get one, and test weekly. And, at times when you are concerned that your INR may be too low - it'll be easier to verify, and could put your mind at ease.

I hope that your BP issue is rapidly resolved.
 

Superbob

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Rich -- I found this online, Things you may already know but maybe there is a useful nugget of additional info in here somewhere.


Also, stress can cause bp spikes. You've probably heard of the "white coat syndrome" -- bp rising upon a doc visit.

As I'm sure you know, bp does fluctuate a lot normally. Maybe some soothing music, naps, exercise, or other relaxation techniques would help. For whatever's it worth, the cardiac rehab nurses check our bp 3 times during a typical session. It is always lowest when I've just finished 45 minutes of exercise.

Hope all smoothes out for you.
 

rich01

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I was able to see nurse at cardiologist's office. Good news is I don't have afib. Bad news is they have no idea what is causing the sudden high bp and high heart rate. They added another med.

BP is still very high (170/95) and heart rate is still over 100. For this time of day, it normally is about 115/75 and 75.
 

rich01

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Rich01 -- your observations are interesting.

You've falllen victim to the 'blood thinner' thing. There's a reason, probably 50 years old, why they call these things blood thinners - but it has ABSOLUTELY NOTHING to do with viscosity. Anticoagulants just make it take longer for clots to form.

If you're having small cuts - like those that you get when you incise your finger for a test, or small shaving cuts, they'll clot and close pretty quickly. (In other words, with an INR of 2.0, if your cut would normally clot in 30 seconds, it'll take about a minute to clot). For small cuts, the higher INR is really no big deal.

I'm interested in your comments about sunlight affecting your blood pressure. I'm aware of Seasonal Affective Disorder (SAD), which can affect your body and moods during days when you don't get enough sunlight (which explains your use of a light), but haven't looked closely enough to see whether it has any effect on BP.

If you don't have a meter for testing INR, I strongly suggest that you get one, and test weekly. And, at times when you are concerned that your INR may be too low - it'll be easier to verify, and could put your mind at ease.

I hope that your BP issue is rapidly resolved.
You are right in that I confused the terms. The part about blood viscosity and blood pressure is accurate though..

What they found is that nitric oxide stored in the top layers of the skin reacts to sunlight and causes blood vessels to widen as the oxide moves into the bloodstream. That, in turn, lowers blood pressure.

In the summer, I take .2 mg of clonidine and bp stays below 120/80. In the fall and spring I have to take .4 mg of clonidine, and in the winter I have to go to .5 or .6 mg of clonidine. Some of it has to do with exercise, but mainly it seems to be sunlight. I spend several hours a day in warm weather in just shorts and shoes. I tan but never burn.
 

rich01

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Rich -- I found this online, Things you may already know but maybe there is a useful nugget of additional info in here somewhere.

Also, stress can cause bp spikes. You've probably heard of the "white coat syndrome" -- bp rising upon a doc visit.

As I'm sure you know, bp does fluctuate a lot normally. Maybe some soothing music, naps, exercise, or other relaxation techniques would help. For whatever's it worth, the cardiac rehab nurses check our bp 3 times during a typical session. It is always lowest when I've just finished 45 minutes of exercise.

Hope all smoothes out for you.
What I have experienced in the past is a sudden spike in BP where it increases from 130/85 to 220/120 in 2 or 3 hours. My best guess is it is a liver problem, but I haven't found any liver specialists around. I have genetics that indicate a problem digestion and metabolizing saturated fat. I think if the amount of saturated fat I eat goes over some minimal amount, the liver has trouble clearing it out of the blood. Based on a couple things I found, I think the liver does a major clean cycle about 1 am, which is when my bp spike starts to come down, only to repeat the next day.

In the past, as the days got longer, the spikes got shorter, finally stopping around March/April. The question is am I having the same problem I had a few years ago or is this some new problem? I know my heart never pounded like it does now. Right now my HR is about 110, but not pounding. It gets scary when it is 110 and pounding.
 

Protimenow

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Blood viscosity has NOTHING to do with coagulation. Warfarin is NOT a blood thinner. Equating viscosity with INR is incorrect -- blood isn't like motor oil.

Years ago, before researchers knew how warfarin worked, they assumed that blood must be THICKER if it clots faster than THINNER blood that takes longer to clot. This is why warfarin is referred to as a blood thinner. It doesn't change the viscosity of blood -- it just slows the actions that are responsible for clotting. You can still clot. It just takes longer. (If your INR is WAY HIGH, the blood may not clot, but you'll see all kinds of problems and will probably NEVER have an INR that high -- especially if you manage it yourself, take your meds regularly, test weekly, and have your own meter to test with).
 

rich01

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Blood viscosity has NOTHING to do with coagulation. Warfarin is NOT a blood thinner. Equating viscosity with INR is incorrect -- blood isn't like motor oil.

Years ago, before researchers knew how warfarin worked, they assumed that blood must be THICKER if it clots faster than THINNER blood that takes longer to clot. This is why warfarin is referred to as a blood thinner. It doesn't change the viscosity of blood -- it just slows the actions that are responsible for clotting. You can still clot. It just takes longer. (If your INR is WAY HIGH, the blood may not clot, but you'll see all kinds of problems and will probably NEVER have an INR that high -- especially if you manage it yourself, take your meds regularly, test weekly, and have your own meter to test with).
I admitted to my mistake. In the post you are responding to, I was talking about blood viscosity, not coagulation.
 

rich01

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I had 1 trick left to try. A few years ago, I accidentally discovered that a baked potato lowered my BP. Plain is best. A little after 5 pm I ate 2 baked potatoes. About 6:30 pm I checked bp and it is now under 120/80 after being about 180/110 (on average) all day. My heart rate is also slowly coming down. The last time I tested was about 4 pm and it was 110. Now it is high 80's.

It may or not be attributable to the potatoes, but it is something that has appeared to work several times for me before. I know there is a study that shows blue/purple potatoes brings down bp. The study shows only a small decrease, but what I do is to eat mainly baked potatoes when I'm trying to fight a spike. Today I had a banana, some raw carrots, and 2 potatoes.

The result: The systolic blood pressure in an average of 3.5 percent, the diastolic to 4.3 per cent has been reduced by the potato Spa.
 

Superbob

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I had 1 trick left to try. A few years ago, I accidentally discovered that a baked potato lowered my BP. Plain is best. A little after 5 pm I ate 2 baked potatoes. About 6:30 pm I checked bp and it is now under 120/80 after being about 180/110 (on average) all day. My heart rate is also slowly coming down. The last time I tested was about 4 pm and it was 110. Now it is high 80's.

It may or not be attributable to the potatoes, but it is something that has appeared to work several times for me before. I know there is a study that shows blue/purple potatoes brings down bp. The study shows only a small decrease, but what I do is to eat mainly baked potatoes when I'm trying to fight a spike. Today I had a banana, some raw carrots, and 2 potatoes.

Wow -- all new to me! Fascinating. I must say, though, when i googled this, I found articles on both sides -- some saying potatoes help lower bp, some saying they raise it. But whatever works for you. I don't know how much science supports this article I am linking, but thought you would be interested. Other foods also lauded.

 

Protimenow

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rich01 -- I've heard something about blood viscosity. It has something to do with the outside temperatures - or something. It's the reason that someone who visits Los Angeles, coming from Massachusetts, sees 40 degree (F) days as t-shirt days, while Los Angeles natives bundle up. It's why this Angeleno (slang for someone from Los Angeles) can go to New Jersey in August, handling the 100 degree (again F) weather much less uncomfortably than the New Jersey natives.

If it's blood viscosity that makes the difference (is it?), then let me apologize when I responded to your comments about viscosity with my rant about 'blood thinners.' (Part of my reason for my lecture was an ad that I saw on eBay a few years ago. It was an ad for a meter that was used to test 'blood viscosity' - with the seller assuming that this had something to do with viscosity because it tests for blood thinning).
 
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